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.
Allergies
Overview
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Allergic reactions to food occur when your immune system mistakes a food ingredient, usually a protein, for something harmful and creates a defensive reaction to fight it. Only 2 percent of adults and 6 percent of children have a true food allergy. Most of the time, the reaction is not a true allergy but intolerance to the food or an inability to digest it properly.
The most common types of foods that trigger true allergic reactions are peanuts; tree nuts like walnut, pecans, cashews, and almonds; fish; shellfish; milk; eggs; soy products; wheat; and sesame seeds.
With good self-care, you can learn to avoid foods that trigger your symptoms or treat a reaction if you have one.
Symptoms
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Symptoms of a food allergy usually occur quickly (30 to 60 minutes after eating or being exposed to the food). It may take only a small amount of the food to trigger a reaction. Your reaction can range from mild to severe.
Common symptoms of an allergic reaction are:
- Itchy mouth and lips
- Rash or hives
- Itchy skin
- Shortness of breath or wheezing
- Chest pain
- GI symptoms (nausea, vomiting, and diarrhea)
- Throat swelling
- Anaphylaxis – a severe reaction, usually with swelling of the face and throat, rapid heartbeat, and drop in blood pressure that may lead to collapse
Diagnosis
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It is important to determine if you have a food allergy or intolerance. The first step is to ask you questions about your medical history and to do a physical exam. This will help determine what additional allergy tests to perform and how to interpret the test results.
To better understand what may be triggering symptoms, we may ask that you:
- Keep a food diary. We may ask that you keep a careful record of what you eat, in order to help determine which foods are causing your symptoms.
- Try an elimination diet. By taking certain foods out of your diet one at a time, and seeing if this improves your symptoms, you can help us to diagnose food allergies. In severe food allergies, elimination diets are generally supervised by your doctor directly.
If additional allergy tests are needed, they may include:
- Prick/puncture skin testing. During this test, the skin of your arms or upper back will be pricked with small amounts of the suspected food source placed onto your skin. If the antibodies to the food are located under your skin, an allergic reaction will occur, causing a raised, red itchy area. This test takes about 20 minutes.
- Blood tests. RAST (Radioallergosorbent tests) are allergy tests that are done using a sample of your blood to identify possible antibodies to foods. These tests are not as sensitive as the prick/puncture skin tests, but they are easier to perform and safer for patients with severe symptoms.
Treatments
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Avoiding the food that triggers symptoms is the most effective way to treat your food allergy, but that may be challenging to accomplish.
Here are some tips to consider:
- Learn to read food labels. You can look for the ingredients that may cause your allergy. Avoid foods that are made in a facility that processes the foods you are allergic to.
- Prepare safe meals at home. If you read food labels carefully, and focus on fresh ingredients such as fruits and vegetables, you will be more likely to avoid problem foods.
- Exercise care when eating in restaurants. When you dine out, ask your server if the food ingredients you are allergic to (like peanuts or shellfish/fish) are used in the kitchen. There could be cross-contamination with the food served to you.
- Check ingredients in items other than food. Be aware that the food ingredients that cause your allergies may be present in other items, such as toys or cosmetics. Avoid them as much as possible.
- Don't share utensils or kiss anyone who has eaten a problem food. Saliva may contain the food ingredient that causes your reactions, so you will need to be careful kissing or sharing food utensils.
- Carry antihistamines with you at all times. Liquid Benadryl or Zyrtec (cetirizine) are good antihistamines to treat mild allergic reactions. They can be readily absorbed, and you can adjust the dose easily.
- Carry and use an EpiPen® for severe reactions. Since it is impossible to completely avoid a food ingredient that you are allergic to, you may be prescribed an EpiPen® containing epinephrine. Keep your EpiPen® with you at all times so that you can self-inject if you are exposed to a trigger food.
Additional References:
- PDF Link to How to Read the Food Label
- External Link to Giving Yourself an Epinephrine Shot - Health Encyclopedia
Your Care with Me
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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. It is extremely rare for an adult to develop true food allergies. It is more often a food intolerance or adverse reaction to a food. It is unlikely that you will need to have allergy testing. Once we determine which foods are triggering your food allergies, we can work with you to develop strategies for avoiding or treating a reaction.
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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.