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.
Welcome to My Doctor Online, a web site that my colleagues and I developed to make it easier for you to take care of your healthcare needs. On this site you will find answers to many of your questions about my clinical practice. Also included are several online features that will allow you to e-mail me, check your laboratory results and refill prescriptions. I hope you find its content informative and useful.
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Infection of the sinuses is called sinusitis. Sinuses are the air-filled cavities found in your cheekbones, forehead, and the skull bones between and behind your eyes. The sinus cavities are lined with mucous membranes. Sinus fluids usually drain easily through the nose unless the sinuses become inflamed or infected.
Sinus infections may occur because of inflammation following colds, hay fever, or asthma, or from air pollution. This happens because:
Although adults tend to get sinus infections more often than children, infants and small children can be affected.
Acute sinusitis typically lasts a short time and usually responds to decongestants. Sometimes antibiotics are needed. Sinusitis lasting 12 consecutive weeks or more is considered chronic sinusitis and may require antibiotics or surgical treatment.
The symptoms of sinusitis may include:
More than 37 million Americans suffer from at least one episode of sinusitis a year. The occurrence of sinusitis has increased over the last decade, possibly due to increases in air pollution and antibiotic resistance. The most common causes of sinusitis are:
Additional causes are rare and can include a dental root infection that spreads into the sinus cavity, getting water into the nasal cavity through swimming, intranasal cocaine use, nasal polyps (growths), foreign bodies, fungi, or tumors.
Diagnosis depends on the type of symptoms you have. We will ask you about your symptoms and evaluate the cause of your illness. There are 2 basic types of sinusitis:
If you do not respond to several courses of antibiotics, we might order a CT scan of the sinuses. If you have a chronic condition such as diabetes or hypertension, it is important to check with us before using any over-the-counter medications.
It’s important to get treatment for sinusitis. Left untreated, sinus infections can cause unnecessary pain and discomfort. The type of treatment we recommend will depend on the type of sinus infection you have.
In about 10 percent of cases, medical treatment with multiple courses of antibiotics may not be effective. If that occurs in your case, we may recommend surgery.
We will give you a thorough ear, nose and throat examination. We will also explore your facial features to determine where swelling and redness exist, as well as feel and press your sinuses for tenderness. Additionally, we may tap your teeth to help identify an inflamed sinus. We may insert a small scope to examine the inside of your nose.
We may prescribe medications such as antibiotics, decongestants or nasal steroid inhalers. If you have not responded to medications, we may recommend the option of surgery to enlarge the openings to drain your sinuses. This is necessary for only a few patients.
Sinus surgery has been revolutionized by the nasal endoscope, a special instrument to help evaluate and treat chronic sinusitis. Endoscopic surgery will open the natural pathways in the sinuses to improve drainage. If this is successful, the affected sinus membranes often return to normal.
During surgery, we may insert a very small scope into your nose while you are under local or general anesthesia. The surgeon can see into your sinuses with the endoscope. With state-of-the-art microsurgical instruments, the abnormal tissues that are obstructing your sinuses can be removed. In the majority of cases, the surgical procedure is performed entirely through the nostrils, leaving no external scars. There is little swelling and only mild discomfort.
After the procedure, you may have nasal packing, a type of dressing to absorb drainage. A few days after the procedure, nasal irrigation with a mild saline solution will be recommended to decrease crusting as the surgery site heals.
Some steps you can take to care for yourself at home include:
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. I may recommend other diagnostic studies as needed, such as a sinus CT scan, if you have not had one prior to your visit. We will discuss treatment options, such as endoscopic sinus surgery, and together we will create a treatment plan that is right for you.
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.