Are you having back pain with any of the following?
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.
Nosebleeds (also known as epistaxis) are common and are generally temporary. Most nosebleeds can be controlled within 10 to 30 minutes and can be cared for at home.
Bleeding can occur on one, or both, sides of the nose. Your blood might flow out of your nose and/or down the back of your throat. Bleeding can last for a few seconds or a few minutes or longer and range from a few drops to a rapid flow.
Nosebleeds usually stop when a blood clot forms. The blood clot is loosely attached to the mucous membranes. An increase in blood pressure can loosen the clot and your nose will start bleeding again.
Contact us immediately or go to the Emergency Department if you have a severe nosebleed. If your nosebleed lasts longer than 30 minutes, or if you see blood rushing or pulsing out of one or both nostrils, you are dealing with something more serious than a common nosebleed. We will want to examine you as soon as possible to determine causes and to intervene, as necessary. Sometimes a severe nosebleed signifies an underlying condition, such as bleeding disorders, high blood pressure, or hardening of the arteries.
Your nosebleed might be associated with:
Your nosebleed might be caused by dry air:
Dry air causes the nasal mucous membranes to become dry and irritated. The cilia (hair cells lining the membrane of the nose) may dry so that nasal secretions are not swept to the back of the nose for swallowing, but stay in the nose and become crusted and scabbed.
As the nasal mucous membrane dries, it becomes thin and develops cracks, which expose underlying nasal blood vessels, particularly the front of the septum (the wall that divides the nose into two sides). An increase in blood pressure from coughing, sneezing, blowing, straining, or just turning over in bed, can cause a blood vessel wall to rupture and a nosebleed results.
Certain medications may cause or increase your nosebleeds:
Most nosebleeds can be treated at home. If you have an active nosebleed, sit down, relax, and breathe through your mouth. Pinch your nostrils closed firmly with your thumb and finger. Do this for at least 5 to 10 minutes. If this doesn't stop the bleeding, lightly blow the blood out of your nose and continue to apply constant pressure for another 10 minutes. If the bleeding continues for 30 minutes, call us right away. If you get dizzy, faint, vomit blood, or if blood is spurting or gushing from your nose, please go directly to the Emergency Department.
If you have had surgery or have a history of nosebleeds, you can reduce nosebleeds by moistening the air you breathe and changing or reducing some of the medication you take. This can help reduce nasal dryness, crusting and scabbing in your nose and can eventually eliminate nasal bleeding. Here are the steps we recommend to moisten the air:
During your visit, your doctor may look into your nose. Occasionally, your doctor may use a scope with a camera to look into the back of your nose. This is not a painful procedure, and is not done with every visit.
If your doctor finds prominent blood vessels on your septum, s/he may cauterize these vessels for you in clinic to help prevent further nosebleeds. This is not a painful procedure. It involves touching the vessels or bleeding area in your nose with silver nitrate. Silver nitrate is a chemical that burns away the small spot. A scab will form there, so it is very important to moisturize the nose (described above) well for at least 2 weeks to prevent re-bleeding.
Occasionally, you may need to come back to cauterize the other side of the nose if prominent vessels are found on both sides of the nose.
If you cannot control severe bleeding by applying pressure to your nose, call 911 or go to the nearest Emergency Department.
Most nosebleeds can be managed at home by following the steps described in Home Remedies. 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. I will discuss your history of nosebleeds with you and give you pointers on how to apply pressure to your nose to stop them. I may perform an exam, using a flexible scope with a lens to look into the back of your nose. This is not a painful procedure and is not done with every visit. 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.
If you have prominent blood vessels on your septum (the tissue that divides the two nostrils), I may cauterize these vessels for you to help prevent further nosebleeds. If you have active bleeding, I may need to insert packing into the nose to stop the bleeding.
Sometimes blood tests will also be ordered if you have unusual bleeding episodes.
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.
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.
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:
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 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.
I will recommend you review educational information and tools to help you prepare for your procedure or surgery. The information will often help you decide whether surgery is right for you. If you decide to have a surgery or procedure, the information will provide details about how to prepare and what to expect.
If we proceed with surgery, I will have my Surgery Scheduler contact you to determine a surgery date and provide you with additional instructions regarding your procedure. Once your surgery is scheduled, a medical colleague of mine will contact you to conduct a preoperative medical evaluation that will assure that you are properly prepared for your surgery.
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:
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.