My Doctor Online The Permanente Medical Group

Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

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.

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Allergies

Overview

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If you or someone you're with has a severe allergic reaction, call 911 and seek emergency medical help immediately.

Anaphylaxis is a severe allergic reaction, which can involve many different parts of the body. If not treated immediately, it can be life-threatening.

The symptoms of anaphylaxis can occur within minutes or within a few hours after exposure to something you are allergic to, called an "allergen." An anaphylactic reaction can happen by getting stung by an insect, eating foods to which you are allergic, or taking a medication that causes a reaction. Even if you have had only mild allergic reactions in the past, you still may be at risk of anaphylaxis.

Children are more likely than adults to have allergic reactions to food. Anaphylaxis can be potentially fatal, so you should seek emergency care immediately.

Causes

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When you are having an allergic reaction, the allergen activates your immune system. It floods your bloodstream with certain chemicals, including histamine. These substances cause the symptoms of anaphylaxis, sometimes called anaphylactic shock.

It is not always easy to identify the trigger for an allergic reaction. Allergens may be in something you ate, inhaled, or injected into your body, including certain medications (such as penicillin). Other allergens include latex, insect stings, blood transfusions, or contrast dyes you may be asked to drink during certain x-ray tests.

Symptoms

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The symptoms of anaphylaxis can occur within minutes or within a few hours after exposure to something you are allergic to, called an "allergen." Symptoms can include:

  • Hives, itching, redness, or rashes all over the body
  • Swelling of the face, lips, tongue, and throat, leading to wheezing or difficulty breathing
  • Sneezing, runny nose, and nasal stuffiness
  • Increased asthma symptoms
  • Rapid, often irregular heartbeat
  • Stomach cramps, nausea, vomiting, or diarrhea

As symptoms progress, you may feel dizzy, experience a drop in blood pressure, or even collapse.

Treatments

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If you or someone you're with has a severe allergic reaction, call 911 and seek emergency medical help immediately.

If you carry an epinephrine injector, or EpiPen®, you should:

  • Have someone help you give yourself a shot right away.
  • Even if symptoms improve after your injection, go to an emergency department.
  • If symptoms are not improving, call 911. You need to have medical help to be sure that your symptoms don't reoccur.
  • After an epinephrine injection, take Benadryl quick dissolve oral strips; these work faster than tablets.
  • If an insect sting is the suspected cause, tying a tourniquet above the sting will help to slow down the absorption of the venom. Do not squeeze the insect bite or try to push out the stinger. 

Prevention

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If you have had a severe allergic reaction in the past, you should plan for possible future reactions.

If your allergen is not known, you need to be evaluated and tested by an allergist. Skin tests or blood tests may be done to identify the allergen. Make sure you carry an epinephrine or adrenaline kit at all times. They are easy to use. There are some other things you can do to help prevent future severe reactions:

  • Always carry two epinephrine injectors (EpiPen®) with you.
  • Avoid known allergens as much as possible.
  • Eliminate foods that may cause reactions.
  • Read food labels carefully.
  • Wear protective clothing when outdoors.
  • Avoid using scented sprays or lotions.
  • Immunotherapy or allergy shots may be helpful for insect allergies.
  • If you need an x-ray that requires contrast medication, have a discussion with your allergist. You may need to take antihistamines or steroids before the procedure.

Your Care with Me

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If you or someone you're with has a severe allergic reaction, call 911 and seek emergency medical help immediately.

Anaphylaxis is a severe allergic reaction, which can involve many different parts of the body. If not treated immediately, it can be life-threatening.

If your allergen is unknown, you will be referred to me or one of my colleagues for evaluation and allergy testing.

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, the Emergency Room physician or 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.

Your first contact with me may be a phone consult regarding your acute attack of anaphylaxis. Once this has subsided and the allergic reaction is under control, you will have a follow-up appointment with me to determine what caused your reaction.

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.

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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.

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Coordinating Your Care

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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.

If you come to an office visit
  • At the beginning of your visit, you will receive information about when you are due for your next test, screening, or immunization. We can discuss and schedule any preventive tests that you need. 
  • At the end of your visit, you may receive a document called the “After Visit Summary” that will summarize the issues we discussed during your visit. You can refer to it if you forget what we discussed or if you just want to recheck your vital signs and weight. You can also view it online under Past Visits.
  • To help you prepare for your visit, please see additional details under Office Visit. 
If I prescribe medications

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:
  • Order them online or by phone. Order future refills from my home page or by phone using the pharmacy refill number on your prescription label.
  • Have them delivered to you by mail at no extra cost. Or you can pick up your medications at the pharmacy. If no refills remain when you place your order, the pharmacy will contact me regarding your prescription.
If lab testing or imaging is needed

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 I refer you to another specialty colleague

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.

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Convenient Resources for You

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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:

Manage your care securely
  • 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.
Learn more about your condition
  • 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.
Stay healthy
  • 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.

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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.

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