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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Hives (urticaria) and swelling (angioedema) are common conditions that affect about 20 percent of people at least once in their lives. There are two types of hives and swelling: acute and chronic. Acute hives can disappear rather quickly, whereas chronic hives last for more than 6 weeks.
Hives form when immune cells in the skin, called mast cells, are activated. When triggered, these cells release natural chemicals, including histamine. Histamine causes itching, redness, and swelling of the skin, and hives result.
Some people are more susceptible to hives than others. Hives are not contagious and cannot be spread to other people.
Symptoms
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Hives are red, raised, itchy patches of skin called wheals or welts. They usually have red borders and pale centers. Hives range in size from 1 inch to 3 inches across or more. Hives may seem to move from place to place. They do not stay in the same area of your skin for more than 48 hours. Several hives may join to form a large area of raised, red skin.
Hives can occur with swelling under the skin, though swelling may also occur without hives. The swelling may hurt a bit, but it does not usually itch like hives. In rare instances, the swelling can affect your throat, which can be a dangerous warning sign.
Types
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There are 2 types of hives and swelling:
- Acute hives and swelling last less than 6 weeks. It is normal for acute hives to last just a few days or up to a few weeks.
- Chronic hives and swelling can last for more than 6 weeks despite treatment. Chronic hives and swelling can be frustrating, but they are usually not serious. About half of hives cases will get better within a year. Others can last longer, in some cases up to five years, but this is rare.
Causes
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Acute hives are commonly caused by viruses, medicines, reactions to insect bites, and food allergies. When food allergies are the cause of your symptoms, they occur within 1 hour of eating the trigger food. Fish, shellfish, nuts, eggs, and strawberries are the most common trigger foods.
The cause of chronic hives and swelling is often not known. Some possible causes include:
An autoimmune disorder. More than one-half of people with chronic hives may have a mild autoimmune disease. This is caused by an abnormality in the way your body's immune system works.
Medicines and supplements. Over-the-counter or prescription medicines, as well as vitamins and herbal products, can cause a reaction. This may even happen with products you've taken for years. Sometimes changing a dose can cause a reaction. Some common trigger medications include:
- Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen.
- High blood pressure medicines known as ACE-inhibitors may cause swelling.
- Pain killers containing codeine or codeine-like drugs.
- Antibiotics such as penicillin and sulfa drugs.
- Sedatives and tranquilizers.
- Diet supplements and vitamins.
Physical factors. Scratching, exposure to cold or heat, exercise, sunlight, or pressure on the skin may trigger hives.
Infections. Hives may occur with infections including hepatitis, mononucleosis, and the common cold.
Family history. There may be a hereditary disease that is causing chronic swelling. Usually there would be other members in your family who had this condition as well.
Systemic disease. Hives are sometimes a symptom of an underlying disease, such as thyroid disease.
Food allergies are a much less common cause of chronic hives.
Stress can also be a source of hives.
Diagnosis
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Hives are mainly diagnosed by their appearance and by the questions we ask you about your health history. Lab tests are not usually needed, especially in acute cases where your hives and swelling go away rather quickly.
If you have chronic hives and swelling, a few lab tests may be done to rule out other more serious conditions that could be causing your problem. The results of these tests are usually normal since serious underlying conditions are rare.
Treatments
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If you know what is causing your hives and swelling (like a food or medicine), then try to avoid it if you can. If you do not know the cause, you can try the following treatment:
- Take an antihistamine such as loratadine (Claritin) to control the hives and swelling. Diphenhydramine (Benadryl) or chlorpheniramine (Chlor-Trimeton) may be used, but these drugs can make you feel sleepy and less alert. Do not drive while using them.
- If you are taking an oral corticosteroid (such as prednisone) or another medication, make sure to take it exactly as directed.
- If you have a severe allergy, such as to bee stings or a specific food, you should carry an allergy kit (EpiPen® or Twinject). The kit has a shot of epinephrine to use in case you have a serious allergic reaction.
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. 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.