Are you having back pain with any of the following?
We understand that you are experiencing one or more of the health issues that might be impacting your back pain.
We recommend that you discuss these health issues with your doctor before proceeding with this program.
Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.
Hepatitis means inflammation of the liver. It can be caused by many things, including certain food or drinks (for example, alcohol), certain herbs, medicines (too much acetaminophen, for example), bacteria, or viruses. Most often, when we say hepatitis we are referring to viruses that attack the liver; these are called hepatitis viruses.
The 3 main causes of viral hepatitis in the United States are hepatitis A, hepatitis B, and hepatitis C. All 3 viruses are very different, and a person can be infected by 1 of these viruses, 2 of them, or all 3.
Hepatitis C is an infection that is caused by the hepatitis C virus. It can be passed from person to person through:
When a person becomes infected with hepatitis C, the virus attacks the liver. In 20 to 40 percent of people, the immune system will be able to rid the body of the virus. In the remaining 60 to 80 percent of people, the body's immune system is unable to eliminate the virus. The hepatitis C virus will then become a chronic infection.
The amount of damage caused by the virus to the liver depends on the immune system's response to the virus. Some people develop severe liver scarring, while others may have the same amount of virus in their bodies and have minimal damage. Long-term consequences of hepatitis C include the following:
There is increased risk for progression to cirrhosis for patients who:
There is no safe amount of alcohol for patients with the hepatitis C virus. It causes liver damage by itself and can increase the damage caused by the hepatitis C virus.
Hepatitis C has been called the "silent epidemic" because a person can have the virus for many years and look and feel healthy. A person can have the virus without knowing it and spread the infection to others. In most cases, there are no symptoms until serious liver damage appears.
HCV can be diagnosed by a blood test. These tests include:
Other tests can be done to be sure there are no other causes for liver disease. Blood tests have limited value in people with HCV in determining the amount of damage to the liver or the degree of fibrosis. We will perform other kinds of tests for liver damage. These liver tests fall into 2 categories:
In some cases, cirrhosis can be diagnosed with a physical examination, combinations of the blood work mentioned above, or with X-rays. In other cases, the only way to tell the severity of liver damage is by doing a liver biopsy.
In a liver biopsy, a very fine needle is used to take a tiny piece of the liver, which can then be examined under a microscope. We can determine the amount of inflammation, which helps to determine the extent and severity of liver damage and guide treatment decisions.
There is no cure for hepatitis C and no vaccine. Because of this, the only way to prevent infection is to avoid exposure to the virus.
Avoid exposure to hepatitis C by doing the following:
Get tested if you are at risk. We recommend that you get tested for hepatitis C if you answer yes to any of these questions:
Treatment is available for HCV. The recommended therapy and its effectiveness will depend on the type of hepatitis C you have. Hepatitis C has several different variations, known as genotypes.
For genotypes 2 and 3, therapy is a combination of 2 medications, pegylated interferon and ribavirin. The interferon is injected underneath the skin once weekly. Ribavirin is an antiviral drug that works together with the interferon to increase the response rate to treatment. It is effective in 75 percent of patients with HCV genotype 2 or 3 after 24 weeks of treatment.
There are now 2 approved protease inhibitors for use with pegylated interferon and ribavirin for the treatment of genotype 1 HCV: telaprevir and boceprevir. This triple therapy is effective in curing 60 to 70 percent of patients with genotype 1 disease.
Side effects occur in almost all patients undergoing treatment. The most common side effects include:
Those who respond to treatment with antiviral medication and are free of the virus 24 weeks after the last treatment almost always remain negative over many years and can be cured of the disease. Even after treatment, you can be reinfected with the virus if you are reexposed.
Ongoing research to develop more effective medications to eliminate the virus is under way. Current research with direct antiviral agents such as protease inhibitors and polymerase inhibitors shows promise for the future. Currently, these medications are being used with interferon and ribavirin. Clinical trials look promising for newer, more effective, and shorter-duration treatment regimens with and without interferon and ribavirin.
We recommend a healthy lifestyle for patients who are diagnosed with hepatitis C. Regular medical checkups and ongoing care are important to maintain good health. A healthy diet and a regular exercise routine can strengthen your immune system.
A healthy lifestyle includes the following:
If you have hepatitis C, there are precautions you can take to protect others from catching the virus.
If you are having symptoms that concern you, your first contact will typically be with your personal physician, who will evaluate your health and symptoms.
If specialty care is needed, your personal physician will facilitate the process of scheduling an appointment in my department. If appropriate, she or he might call me or one of my colleagues while you are in the office so we can all discuss your care together. If we decide you need an appointment with me after that discussion, we can often schedule it the same day or soon thereafter.
During your office visit, we will discuss your medical and family history and I will perform a physical exam. I will explain the findings of your exam and answer any questions or concerns you may have. We will discuss treatment options, and together we will create a treatment plan that is right for you.
If you need to talk with me after your visit or procedure, please call my office. You can also e-mail me with nonurgent issues from this website whenever it is convenient for you.
If you have urgent concerns or issues while my office is closed, or need general medical advice, you can call the Appointment and Advice line, available 24 hours a day, 7 days a week. You will be connected with a nurse who can give you immediate advice.
If you are experiencing a serious problem or an emergency, call 911 or go to the nearest Emergency Room when the clinic is not open.
Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology, and health education, makes getting your care easier for you.
Another major benefit is our comprehensive electronic medical record system, which allows all of the doctors and clinicians involved in your care to stay connected on your health status and collaborate with each other as appropriate.
When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.
We will work together to monitor and assess how your medications are working and make adjustments over time. Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you, and I will send the prescription electronically in advance of your arrival at the pharmacy.
If refills are needed in the future, you can:
For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures, we will schedule an appointment with the Radiology department. When the results are ready, I will contact you with your results by letter, secure e-mail message, or phone. In addition, you can view most of your laboratory results online, along with any comments that I have attached to explain them.
If we decide together that your condition would also benefit from the care of other types of specialists, our staff will help arrange the appointment(s) with one or more of my specialty colleagues.
I will recommend that you review educational information and tools to help you prepare for your procedure or surgery. The information will often help you decide whether surgery is right for you. If you decide to have a surgery or procedure, the information will provide details about how to prepare and what to expect.
If we proceed with surgery, I will have my Surgery Scheduler contact you to determine a surgery date and provide you with additional instructions regarding your procedure. Once your surgery is scheduled, a medical colleague of mine will contact you to conduct a preoperative medical evaluation that will assure that you are properly prepared for your surgery.
As your specialist, I have a goal to provide high-quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.
My Doctor Online is available at any time that is most convenient for you. From my home page you can:
• View and compose secure e-mail messages.
• Manage your prescriptions.
• View your past visits and test results.
• View your Preventive Services to see whether you are due for a routine screening or updated immunization.
• Read about causes, symptoms, treatments, and procedures.
• Find interactive health tools, videos, and podcasts to help you manage your condition.
• View programs to help you decide on or prepare for a surgery or procedure.
• Locate health education classes and support groups offered at every medical center.
• Explore interactive programs, videos, and podcasts that focus on helping you stay healthy.
• View your Preventive Services to see whether you are due for a routine screening or updated immunization.
If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.
This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.