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.

Provider photo for Jeremy Swartzberg

Jeremy Swartzberg, MD

Hospital Medicine

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.

My Offices

Oakland Medical Center
Appt/Advice: 510-752-1190

See all office information »

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Overview

Asthma affects the small breathing tubes (bronchial tubes) in your lungs. Some people with asthma are sensitive to certain "triggers" that can affect the airways and make it hard to breathe. When you are exposed to one or more of your triggers, 3 reactions occur:

  • The insides of your breathing tubes swell up (inflammation).
  • Your body makes lots of thick, sticky fluid (mucus) inside your breathing tubes.
  • The muscles surrounding your breathing tubes get tight and make the air passages smaller (bronchospasm).

This makes it hard to breathe. This is called an asthma flare-up or exacerbation

Asthma medications work to control the inflammation. When your asthma is well controlled, you should not have breathing problems and you will be able to do whatever activities you want to do.

Types

Allergic asthma is the most common form of asthma. It is triggered by substances called allergens that you breathe into your lungs. The most common allergens are:

  • Dust mites
  • Pet dander (most common triggers are from cats and dogs)
  • Pollen (grasses, trees or weeds)
  • Molds

Asthma can also be triggered by:

  • Cold or flu viruses
  • Smoke (tobacco)
  • Pollution
  • Exercise 
  • Cold dry air 
  • Anxiety 
  • Stress

Causes

Asthma is probably caused by many factors, including your:

  • Genes
  • Immune system
  • Lung development and growth in early childhood
  • Exposure to infections and allergens in the environment

Asthma Triggers

Triggers can cause your asthma symptoms to get worse

If you avoid your triggers and limit your exposure to those you cannot avoid, you may need less medicine to keep your asthma in control.

The most common types of asthma triggers are:

  • Allergies (caused by allergens)
  • Infections (including viral infections)
  • Air pollutants, smoke, and other irritants
  • Physical activity

Less common asthma triggers include:

  • Stress
  • Changes in weather
  • Humidity or changes in elevation
  • Aspirin or other aspirin-like drugs, such as ibuprofen
  • Preservatives (sulfites)

Symptoms

Asthma symptoms may be different for each person. Your symptoms may not even be the same each time you have a flare-up. Common symptoms include:

  • Coughing
  • A tight feeling in the chest
  • Wheezing (breathing with a whistling sound)
  • Shortness of breath
  • Difficulty breathing

Diagnosis

We diagnose asthma based on your symptoms, medical history, and physical exam. We may also perform a lung function test called spirometry.

Keep track of any patterns related to your symptoms, and tell us about them. You may want to keep an asthma diary to track your symptoms. For example:

  • Are your symptoms worse in the spring or in the fall (allergy seasons)?
  • Does exercise, a respiratory infection, or exposure to cold air trigger an attack?
  • Do you have a family history of asthma or allergic disorders, such as eczema, hives, or hay fever?
  • Have you had any occupational or long-term exposure to chemicals?
  • Do you have fewer symptoms on weekends or vacations?

Lung Function Testing

A lung function test (spirometry) measures the air breathed into and out of your lungs. It is more accurate than using a peak flow meter and may be used to confirm your asthma diagnosis. This helps rule out other health conditions that have symptoms similar to asthma.

The results may tell us if medication will be helpful in treating your condition. We conduct the test in the clinic. It usually takes about 30 to 60 minutes.

Living with Your Condition

When your asthma is under control, you can live a healthy, symptom-free life. You should be able to:

  • Work or attend school without any limitation.
  • Play sports and be active.
  • Sleep without being awakened by asthma symptoms.
  • Use your quick-relief medication no more than 2 days a week (other than for physical activity).
  • Avoid Emergency Department visits.

Asthma symptoms can change throughout the year. Sometimes your symptoms will be in better control than at other times. By keeping track of your symptoms, you can predict when a flare-up is coming and do something about it before it gets worse.

Managing your asthma every day

Here are some tips for helping you to manage your asthma during your busy day:

  • Take your medicines as prescribed.
  • Make sure your medicines are always available to you, including when you travel.
  • Keep a copy of your asthma self-management plan with you.
  • Talk with your supervisor about anything you need at work to control your asthma, such as keeping your work area free of triggers.

Treatment

Medications are one of the keys to treating your asthma. Most people need more than one type of medicine to manage asthma.

There are 3 types of asthma medicines:

  • Control medicines (also called "preventers" or "controllers"). You should take these medicines every day to control your asthma and prevent asthma symptoms and flare-ups. Examples include Singular, Qvar, and Dulera.
  • "Quick-relief" or “rescue” medicines ("relievers"). Use these medicines to relieve asthma symptoms quickly, and to prevent flare-ups. This is important before physical activity or if you know you may come into contact with any of your triggers. Rescue medications do not reduce inflammation (swelling or mucus). Albuterol is an example of a reliever.
  • Flare-up reversing medicines ("burst" medicines). Use these medicines for a severe flare-up of your symptoms. Prednisone is an example.

Flu Shots and Pneumococcal Vaccine

The flu, pneumonia, and meningitis are caused by viruses and bacteria that often lead to asthma flare-ups or exacerbations. Annual flu shots and the pneumococcal vaccine protect against these viruses and bacteria.

Your Care with Me

As your hospital medicine physician, my first contact with you will be either in the Emergency Department or in your hospital room.  Together we will go over your medical history and medications you are currently taking, perform a physical examination, and come up with a treatment plan.

While you are in the hospital

I will work closely with your bedside nurse and patient care coordinator each day of your stay to improve your health and to plan for a safe return home. We will also inform your family members of your care plan. If you are having symptoms that concern you when you are in the hospital, please inform me or one of the hospital staff immediately.

If specialty care is needed during your hospital stay, I may contact one of my specialty colleagues and discuss your care with them.

If I prescribe medications

During your hospital stay, we will work together to monitor and assess how your medications are working and make adjustments over time. Before you leave, we will go over each new medication, how to take it, and when/if to stop the medication. At the time of discharge, all medications can be picked up at the discharge pharmacy. 

After you are discharged from the hospital, you will have a follow up visit with your primary care clinician. You may also receive a follow up phone call from one of the hospital staff to see how you are doing once you are at home.

If you are having symptoms that concern you and you are not currently in the hospital:

  • You may contact your personal physician, who will evaluate your health and symptoms.
  • If you have urgent concerns or issues 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 and make an appointment with your doctor if needed.  
  • If you are experiencing an emergency, call 911 or go to the nearest Emergency Room.

Coordinating Your Care

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 that 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.

This applies especially to your primary care physician, who will be notified electronically when you are hospitalized, and may review the care you are receiving while in the hospital. Upon discharge, your doctor will receive a summary of your care in the hospital, including some tests or imaging results that may still be pending.

Care After Hospital Discharge

If you require further testing and medications, or are having symptoms after leaving the hospital, we recommend that you contact your primary care physician.
You can also call the Appointment and Advice line. Our call centers are open every day of the year around the clock. If you need advice, we will transfer you to one of our skilled advice nurses (RNs). They can help you determine when you need to be seen and in what location. The advice nurse can often start your treatment by telephone depending on the situation and has access to your electronic medical record.

If refills are needed in the future after you leave the hospital, you can:

  • Contact your primary care physician.
  • Order them online or by phone.
  • Order future refills from my home page or your primary care physician’s home page.
  • Order by phone using the pharmacy refill number on your prescription label.
  • Have them delivered to you by mail at no extra cost.
  • Or pick up your medications at the pharmacy. If no refills remain when you place your order, the pharmacy will contact your primary care physician regarding your prescription.
If further lab testing or imaging is needed 

For lab tests that are needed after discharge, 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. Your primary care physician will follow up on these results unless your condition needs immediate attention. In addition, you can view most of your laboratory results online, along with any comments that your primary care physician may 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, I will make an electronic referral to the appropriate department and they will contact you for an appointment.

If Surgery or a Procedure is a Treatment Option

Occasionally, a procedure and/or surgery can be postponed until you are healthier and have recovered from your hospitalization. Then I will refer you to the appropriate service and they will follow up with you once you are discharged from the hospital.

If you are considering a procedure or surgery, please take a moment to go to the “Tools & Classes” tab above and select the “Prepare for Your Procedure - Emmi” link. There you can watch videos about different procedures.

Convenient Resources for You

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 to your primary care physician and specialist.
  • 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.
  • Manage your family’s health by setting up access to act on their behalf. Learn how to coordinate care for the ones you love.
Learn more about your condition
  • Read about causes, symptoms, treatments, and procedures of common conditions we take care of in the hospital.
  • 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.

Related Health Tools:

Interactive Programs

See more Health Tools »

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.

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