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.
Sexually Transmitted Diseases (STDs)
It's important to understand that when you become sexually active, you can be at risk of getting a sexually transmitted disease (STD). Some STDs are easily treated with no long-term effects, while others can be carried for life or cause serious or life-threatening diseases.
Hepatitis Prevention [Read/Print full article]
Overview
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Hepatitis is an inflammation of the liver caused by a virus. The kinds of hepatitis we hear about most often are caused by viruses, but other types of hepatitis can be caused by certain foods or drinks, herbs, or bacteria. Most often, when we say hepatitis we are thinking of one of the infectious hepatitis viruses that attack the liver. The three main viruses in the United States are hepatitis A, hepatitis B, and hepatitis C. A person can be infected by one of these viruses, two of them, or all three.
Types of hepatitis
- Hepatitis A is an infection caused by a virus. It causes acute hepatitis; that is, the infection does not last longer than 6 months and does not cause long-term damage to the liver.
- Hepatitis B and hepatitis C can become chronic, meaning that they last for years. They are the two most common causes of infectious liver disease in the world. Some people with hepatitis B and C do not develop long-term medical problems, but others go on to have permanent liver scarring, damage, and even liver cancer or liver failure.
Symptoms, Screening, and Diagnosis
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If you become infected with hepatitis, you might not have any symptoms at all. However, you might also be sick for several weeks with:
- Fatigue
- Weight loss
- Nausea and vomiting
- Jaundice (yellow skin, dark tea-colored urine, and light-colored stool)
- Abdominal pain
If you are experiencing these symptoms, or if you are at higher risk for contracting infectious hepatitis, we recommend that you be tested. You are at higher risk for hepatitis if:
- You have shared needles or other equipment to inject intravenous drugs.
- You have had unprotected sex with someone who has hepatitis or with someone with an unknown sexual history.
A blood test can diagnose hepatitis and can tell us which type of hepatitis you have.
If you are sexually active and younger than 25, we recommend you come in once a year to be screened for STDs.
Causes and Prevention
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Causes
Each kind of hepatitis is spread differently.
Hepatitis A is spread when very small pieces of human feces (stool) are swallowed. People who do not wash their hands can accidentally get feces into water or food other people drink and eat. Feces can be spread from one person's hands to another person's hands and then into the mouth. Sexual contact that involves the anus can also spread the virus.
Hepatitis B is spread by blood or other body fluids. Body fluids include men's sexual fluid (semen and "pre-cum") and women's vaginal fluid. Improperly sterilized needles used for drugs or tattoos can spread the virus. Only a very small amount of blood is needed to spread the virus. Deep kissing (or "French kissing") can spread the virus if someone has a mouth sore or if his and her gums are bleeding a little.
Hepatitis C is found in the blood and is spread by exposure to infected blood. You are most likely to catch it by coming in contact with infected blood, whether by contaminated medical needles or syringes or by intravenous drug use. Tattoos and drug snorting have also been suspected as causes of infection, although it has been hard to prove this for certain. While hepatitis C can be spread sexually, transmitting it this way is rare.
Prevention
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Get vaccinated
There is a vaccine available for hepatitis A and B that can protect you from getting infected. The vaccines are recommended for specific groups that may have increased risk of getting the infection or becoming very ill if they become infected. These groups include:
- All children and young adults (younger than 25 years)
- Health care employees
- Day care workers
- Travelers who visit locales with high prevalence of hepatitis
- IV drug users
- Those with high-risk sexual partners or partners who have hepatitis
- Homosexual men
| Vaccine for | How it is performed |
| Hepatitis A | The vaccine takes two shots at 6 to 12 month intervals. |
| Hepatitis B | The vaccine takes three shots: an initial shot, followed by the second shot 1 month later, and then a third and final shot 6 months after the first shot. If you need the vaccine, be sure to get all the shots. If you do not get all the shots, you may not be fully protected. |
| Hepatitis C | There is no vaccine. |
Practice safer sex
It is important to understand that when you become sexually active, you can be at risk of getting a sexually transmitted disease (STD). This is true for all forms of sexual activity such as oral, vaginal, or anal intercourse.
Except for not having sex (abstinence), there is no sure way to avoid contracting an STD. You can reduce your risk of catching viral hepatitis by:
- Limiting the number of your sex partners.
- Practicing safer sex.
- Using condoms correctly and consistently.
Before you start a sexual relationship, talk with your partner about STDs. Find out whether he or she is at risk for them. Remember that a person can be infected without knowing it.
Talk openly and honestly with your partner about your risk for STDs and practicing safer sex. Be clear about what you will and will not do sexually, and respect what your partner will and will not do. Decide together what is right for both of you.
Avoid contaminated blood
If you use needles to inject intravenous drugs, it is important not to share them with others. Clean needles and syringes are available through local needle exchange programs. We recommend you seek treatment if you use illicit drugs, and we have resources that can help you.
Find Help if Your Partner Has Ever Hurt or Threatened You
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Unfortunately, abusive relationships are common. Abuse can include pressuring or forcing you to have sex, or refusing to use a condom to protect against pregnancy or STDs. If you think you are being abused, you can get help by talking to us or you can:
- Contact the National Domestic Violence Hotline, 1-800-799-7233 or 1-800-787-3224 for hearing/speech impaired.
- Visit the National Sexual Assault Hotline or call 1-800-656-4673.
Additional References:
- PDF Link to You Deserve a Safety Zone
- PDF Link to Everyone Deserves a Safe Relationship
Your Care with Me
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If you are at higher risk for contracting hepatitis, we recommend that you be screened. You are at higher risk for contracting hepatitis if:
- You have shared needles or other equipment to inject intravenous drugs.
- You have had unprotected sex with someone who has hepatitis or with someone whose sexual history is unknown to you.
To arrange to be tested, e-mail me or call the Appointment and Advice line and request screening.
It is important to be tested for sexually transmitted diseases (STDs), even if you do not think you are at risk.
- If you are under 25 years old, I recommend that you be tested for STDs every year.
- Everyone should be tested for HIV at least once in a lifetime. Even if you think you are not at risk, it is important to be sure.
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Contacting Me
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You can connect with me in a variety of ways, depending on the situation and what is most convenient for you at the time. I am available online, by telephone, or in person.
- For nonurgent questions or concerns, you can e-mail me using this site. You can also book an appointment online to see me in person.
- If your concerns are immediate, or you simply prefer to use the telephone, please call our Appointment and Advice line, which is available 24 hours a day, 7 days a week. Our advice nurses can give you immediate advice, and our telephone staff can send me a message or book an appointment for you.
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How We Coordinate 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 current on your health status and to 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 as needed. 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 a specialist
My specialty colleagues are readily available to assist me if I need additional advice about your condition. In some cases, I may contact them during your visit, so we can discuss your care together. If we decide you need a specialty appointment after that discussion, we can often schedule it the same day or soon thereafter.
If you are due for preventive screenings or tests
As part of our commitment to prevention, additional members of our health care team may contact you to come in for a visit or test. We will contact you if you are overdue for cancer screenings or conditions which may require monitoring.
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Convenient Resources for You
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As your personal physician, 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 24/7 so that you can access and manage your care where and when it is most convenient. From my home page you can:
Manage your care securely
- View and compose secure e-mail messages.
- Manage your prescriptions and schedule appointments.
- 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 our 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.