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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Infectious disease (ID) is a specialty that focuses on the diagnosis and treatment of infections. ID specialists often evaluate patients who have health problems with unclear causes and are called medical detectives because often they are using various aspects of a patient’s history, physical exam, and testing to find a diagnosis. Doctors often consult ID specialists if a patient has a fever or other symptoms suggestive of an infection but has not improved after routine testing or treatment. Many times the cause can be due to infections, although not necessarily contagious.
Examples of some types of problems seen by an ID physician include infections that occur after surgery; infections that are obscure but serious, such as endocarditis, which involves the heart valves; human immunodeficiency virus (HIV) disease; and tuberculosis. Contagious diseases occur infrequently, and you will not be exposed to these types of diseases by visiting us or being in our waiting room. ID specialists treat contagious disease and help make sure these diseases don’t spread to other people.
ID specialists may also be involved with improving the quality of care in the hospital and clinics to prevent the spread of infections. They will assist other doctors in the selection of antibiotic treatments for both outpatient and in hospital conditions.
An infectious disease specialist has undergone about 10 years of medical training, including 4 years of medical school and 3 years of internal medicine training. This is followed by 2 to 3 years of specialty training in infectious disease, gaining experience with difficult and unusual infections and those that occur in people with weak immune systems (such as patients with cancer, organ transplants, or HIV). These specialists also frequently do clinical or laboratory research during their training.
The world we live in surrounds us with germs (bacteria, viruses, fungi, and even parasites). Our bodies are not sterile. Bacteria and other germs are always living on our skin, in our mouths, in our intestines.
We all get infections on occasion. We hope these are minor and often random events we experience in life. The less common, and sometimes more severe, infections may be caused by those same germs around us. These more severe infections may result in emergency visits, hospitalizations, and even surgery. Even the most healthy of us may still be at risk of a serious infection. However, there are circumstances that increase our risk. These include:
If an infectious disease is suspected, the initial evaluation often starts with your primary care physician, another specialist, or the physician managing your care in the hospital. Your physician may also consult with an ID specialist by phone when they are attending to you as their patient. If it appears necessary or would be beneficial to your care, they would refer you to us.
Some examples of the types of infectious diseases that we see and treat in our office include bone infections (osteomyelitis), HIV, tuberculosis, and valley fever (coccidioidomycosis). We spend about half our time seeing patients in the clinic and the other half in the hospital.
There are times, fortunately not that often, when an infection may be picked up from direct or very close contact with something or someone where we live. Some examples may include influenza (from exposure to other people), salmonella diarrhea (from contaminated foods), hepatitis or HIV (from blood or certain other deep body fluids from another infected person), and malaria (transmitted by mosquitoes in certain parts of the world).
When there is a contagious illness, we work to advise patients and family on how to prevent any possible spread. We also work with other medical and public health staff to assure that all efforts are made to prevent spread to the general public or occasional visitors.
A proper diagnosis is seldom made on the basis of only one symptom or test result. For many illnesses, the symptoms and exam findings need to be matched up with:
For your appointment with us, please come prepared to share:
After reviewing the above information, we will do the appropriate physical exam, which usually includes examining any chronic wound (if that exists). Additional blood or other imaging tests may be done. If a specific treatment appears needed, we would discuss this and, in many cases, arrange to start treatment.
Our specialty takes great care to prevent spreading infections between patients or to the public or to ourselves. Our staff members, as well as our own family members, have become quite comfortable knowing that we are safe spending our careers in this world of infections.
Contagious diseases occur infrequently, and you will not be exposed to these types of diseases by visiting us or being in our waiting room. You will often see staff washing their hands. In certain settings, you may also see gloves, masks, etc., being used, until we can determine that there is no risk.
If you have concerns about your personal risks, please feel free to ask us or one of our staff members.
Your primary care physician may call us to ask a question at any time, especially while you are at a clinic visit with them. Another possibility is that we may have already seen you in the hospital during a recent admission. The Kaiser Permanente electronic medical record system allows us to easily review your medical history, as well as communicate with your primary care physician or other specialist, even if they are located at a different Northern California Kaiser Permanente center.
From the beginning, we need to collect enough history and diagnostic information to know when you have an infection and help us determine treatment. We may need to enlist the help of other specialists, such as surgeons, to diagnose or manage your treatment.
We match the treatment to the illness you may have. Treatment may be antibiotics available in pill, liquid, or intravenous form. Additional X-rays or lab tests may be needed to verify that the infection is responding or that the treatments are not harmful. Excessive or unnecessary antibiotics may occasionally cause serious harm. Some infections, such as many common viruses, do not have any antibiotic treatment.