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.
Asthma
Asthma is a lung disease that affects your breathing. The airways that carry air in and out of your lungs become inflamed and constricted. Wheezing, cough, chest tightness and difficulty breathing are common symptoms.
Asthma Medications [Read/Print full article]
Overview
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We will work with you to develop an asthma action plan that helps you know which medications to use and when to take them. There are 3 main types of asthma medications:
1. Long-term control medications (also called "preventers" or "controllers"). Use these medications to control your asthma. Usually, they are used daily to prevent asthma symptoms and avoid flare-ups. They help to prevent and control swelling and mucus in the breathing tubes.
2. "Quick-relief" medications ("relievers"). Use these medications to relieve your asthma symptoms quickly. You may also need to use relievers to prevent flare-ups before physical activity or exposure to any of your triggers. Remember, these medications do not reduce swelling or mucus.
3. Flare-up reversing medications ("burst" medications). Use these medications for a severe flare-up of your symptoms.
Additional References:
- PDF Link to Adult Asthma Self-Management Plan
Long-term Control Medications
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There are several types of long-term control medications to help you manage your asthma.
Inhaled corticosteroids
You can manage your asthma by using your controller medications.
Medications called "inhaled corticosteroids" are the most important long-term control medications for asthma. They help to prevent and control swelling in your airways. These medications are safe when you use them according to your asthma plan. Using inhaled corticosteroids is one of the best ways to keep your asthma in good control.
Controller medications do not provide quick relief. They can take a week or more to start working and a month or more to become fully effective. You will get the most help from these medications when you use them as prescribed even when your asthma is in good control. We can work together to find the smallest amount of medicine to manage your asthma.
Inhaled corticosteroids for asthma are not the same as the steroids (anabolic) misused by some athletes.
Side effects are uncommon, but they can include:
- Throat irritation and cough right after taking the medicine
- Hoarse voice
- Mild yeast infection in the mouth (thrush)
You can reduce side effects by:
- Using your metered dose inhaler with a spacer
- Rinsing your mouth afterwards with water
- Taking your medications just before you brush your teeth
Other Long-term Control Medications
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We might prescribe additional medications to control your asthma. These medications are different from inhaled steroids, and usually they are used in addition to them. These medications include long-acting beta agonists, leukotriene modifiers, theophylline, combination medications, and others.
Inhaled long-acting beta agonists
These medications are always used in combination with inhaled corticosteroids because they do not reduce inflammation. They work by relaxing the muscles of your airways over a longer period of time.
Leukotriene modifiers
Our bodies produce chemicals called leukotrienes, which can cause the airways to swell. This type of medicine reduces these chemicals or blocks their action to lessen airway swelling.
Theophylines
This medicine is used very infrequently because of side effects. It relaxes the muscles and can improve breathing. Common side effects include:
- Nausea
- Vomiting
- Abdominal pain
- Jitteriness
- Insomnia
- Rapid heart beat
Combination medications
These medications combine a controller (corticosteroid) with a long-acting inhaled beta agonist.
Additional References:
Quick-Relief or Rescue Medications
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When you have an asthma flare-up, these medications relax the muscles around your breathing tubes and quickly help make breathing easier. Always carry your quick-relief medicine with you.
Quick-relief medications generally come in a metered dose inhaler (MDI) and can be used prior to exercise or other potential triggers. Once administered, they start working within about 5 to15 minutes. Their effects can last for 4 to 6 hours.
If you need to use your quick-relief medications more than 2 days per week (other than for physical activity), your asthma is not in good control. We may need to adjust your medications to improve your asthma self-management.
Possible side effects of quick-relief medications include:
- Fast heart rate
- A shaky or jittery feeling
- Nervousness
- Headache
Flare-up Reversing or Burst Medications
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Flare-up reversing medications are also called "burst" medications. They are corticosteroids taken orally in pill or liquid form. In the Emergency Department, they may be given as IM (intramuscular) or IV (intravenous) injections. It takes several hours for burst medications to start working and can take days for them to become fully effective. They reduce the swelling inside your breathing tubes and help stop a severe asthma flare-up.
When taking burst medications, you should also continue to use your long-term control and quick-relief medications as prescribed.
It is important to take burst medications exactly as prescribed.
You can avoid having to take burst medications by keeping your asthma under control with your long-term control medications.
Side Effects
Short-term side effects go away after the medicine is stopped. They include:
- Mood changes.
- Increased appetite.
- Weight gain (mainly because the body will retain water when you are taking this medicine).
Osteoporosis (bone thinning) might be a longer-term side effect of taking flare-up reversing (burst) medications.
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. We may have you wait a few days to come in so allergy testing can be done at your first appointment.
Before your first office visit, we need for you to complete an Allergy new patient questionnaire. This will be provided by your personal physician when she or he schedules our visit. It is also available online, or you may arrive 15 minutes early and complete the form before your appointment.
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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Related Health Tools:
Interactive Programs
- Quit smoking with Breathe™ Quit smoking with Breathe™
Videos
- Asma (Spanish) Asma (Spanish)
- Adult Asthma Adult Asthma
- Understanding Your Child's Asthma Understanding Your Child's Asthma
- El asma y el cuidado de su niño (Spanish) El asma y el cuidado de su niño (Spanish)
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.