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.
As your Nurse Practitioner, I value my relationship with you. And I know that maintaining a good relationship means being able to communicate with each other. My colleagues and I have developed My Doctor Online so that we can stay in touch more easily. Because the better connected we are, the healthier you are.
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Acne is the most common skin problem in the United States, affecting millions of adolescents and adults. About 85 percent of teens have acne, and it may continue into adulthood.
Acne is a complex condition in which hormones and other factors can cause the hair follicles in your skin to become clogged. This can create pimples or pus bumps that become visible on your face, neck, back, chest, and shoulders. Acne can be distressing, but there are effective combinations of treatments available that can help you.
The symptoms of acne can be mild to severe, and they include:
Severe acne can also lead to other problems. It may affect your emotional well-being, causing depression, embarrassment, or lowered self-esteem. These negative feelings can discourage you from interacting socially, on the job, or at school.
We can usually diagnose acne by looking at your skin. In most cases, no additional testing is needed.
In rare cases, there are problems with hormone levels that may be linked to a condition called polycystic ovary syndrome, or PCOS. If you are a woman with moderate to severe acne, irregular menstrual periods, and excess hair on the face or body, you may have PCOS or another hormonal imbalance.
There are several different types of acne lesions. Most of the time, if you have acne, you will have a combination of these lesions in varying severity:
The following factors cause acne:
As you go through puberty, some hormones cause your skin to produce more oil. This oil combines with a buildup of debris and shedding skin, causing hair follicles on your face and other acne-prone areas to plug up. This causes the acne lesions.
More sebum results in an increase in the number of bacteria (P. acnes) on the skin surface. As bacteria break down surface oil and interact with your immune system, your skin becomes irritated and inflamed. This causes acne pimples to form.
Because the highest concentration of the sebaceous or oil glands is present on the face, chest, and back, these are the areas where acne usually develops.
Hormones are one of the most important causes of acne. Several kinds of hormonal changes can affect this condition, including:
The role of diet in acne remains controversial. It is best to avoid foods that make your acne worse. Some studies suggest that milk and other dairy products may increase the risk or severity of acne because of the animal hormones they contain.
Foods rich in carbohydrates, such as simple sugars found in candy, cookies, and other baked goods, may make acne worse. There is no good evidence that chocolate or fried foods cause or worsen acne.
Stress and tension have been shown to worsen acne. When we are stressed, our body releases cortisol – a natural steroid hormone that further increases your skin's production of oil.
Certain medications are known to worsen acne. These include medications that contain steroids such as prednisone, methyl prednisolone, topical steroids, and some psychiatric medications such as lithium.
You may be able to control your acne by caring for your skin at home. However, if you are concerned about your skin or if you don't see an improvement with home treatment, please contact the Appointment and Advice line. Our advice nurses can give you immediate advice and our telephone staff can send me a message or schedule an appointment for you.
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.
If your concerns are urgent, please contact 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 schedule an appointment for you.
If you are experiencing an emergency, call 911 or go to the nearest Emergency Room.
Teens 13 and older can get help from any medical professional without parental permission for these confidential services.
Make an appointment to talk with me privately if you:
You can make your own appointments for confidential services by calling our Appointment and Advice Line, 24 hours a day, seven days a week.
What we talk about is private. In most cases, I cannot tell your parents or guardians anything about your visit for any of the confidential services listed.
One important exception: I do need to tell them if you are in danger or if you are thinking about hurting yourself or someone else.
We will protect your privacy. We also encourage you to talk with your parents or another trusted adult, if possible, for advice and support.
Important notes about e-mail
In partnership with you as a parent, we want to teach our young adolescent patients to begin to take charge of their personal health care as they transition from childhood to adulthood.
We sometimes request confidential time with teens to ask about sensitive issues. Time alone allows us to address important health and safety issues. It also gives your teen a chance to confidentially ask questions or voice concerns about topics that may be embarrassing. Many teens (and adults) find it difficult to talk about sensitive issues and prefer to see their doctor privately.
As your teen’s doctor, I also want to talk with you about your questions or concerns. At your teen’s appointment, please let the medical assistant or nurse know if you have any specific concerns that you wish to discuss. I will make sure to set aside time during the appointment to talk with you about any concerns or questions you may have.
For nonurgent concerns or questions, you can e-mail me using this site, once you have set up access to manage your teen’s health. Use the Manage Your Family’s Health links to get started.
If your concerns or questions 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 schedule an appointment for your teen.
Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology, and health education, makes getting care easier.
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.
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.
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.
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, such as X-rays, we will schedule an appointment with the Radiology Department.
When the results are ready, we will contact you with the results by phone. We may ask you for a phone number where you can receive your results confidentially. If you do not have a cell phone, we may ask you to call us for the results instead, to ensure that we protect your privacy.
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.
My goal is 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 to help you manage your care at any time that is most convenient for you. From my home page you can sign up for kp.org and:
*Secure means e-mail communication between you, me, and other members of your health care team is behind our firewall and password protected. Anyone who can act on your behalf (for example, your parents) will have access to this e-mail box. If you want to talk confidentially, l encourage you to call me or make an appointment to see me in person, instead of sending a secure message online.
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.