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

Your chance of developing heart disease depends on many risk factors. 

Some factors are outside of your control, such as your:

  • Family history of heart disease
  • Age
  • Gender (sex)

Luckily, you can improve other risk factors. We’ll help you make key lifestyle and health changes, including:

  • Eating for heart health.
  • Increasing physical activity and exercise.
  • Managing high blood pressure, high cholesterol, and other conditions.

Lifestyle Recommendations

Use these guidelines to help lower your blood pressure, improve blood cholesterol and blood sugar levels, and boost your overall heart health.

  • Exercise for 30 to 60 minutes most days of the week.
  • Manage stress. Find a stress-reducing activity you enjoy, such as walking, dancing, tai chi, yoga, or meditation.
  • Maintain a healthy weight, or lose weight if needed. Losing 5 to 10 percent of your body weight can help reduce high blood pressure.
  • Make heart-healthy food choices. Eat whole grains, vegetables, fruits, low-fat dairy, lean meat, and beans.
  • Limit salt to less than 2,000 mg per day. Read food labels to check for sodium content.
  • Quit smoking (tobacco and marijuana). This is the most important change you can make to improve your health.
  • Limit alcohol to no more than 1 drink per day (for women) or 2 drinks per day (for men). One drink equals 4 ounces of wine, 12 ounces of beer, or 1½ ounces of liquor.

Drinking too much alcohol affects your heart health in several ways. It increases your risk for: 

  • Weight gain (from extra calories)
  • Diabetes
  • High blood triglycerides level
  • High blood pressure
  • Stroke (especially with excessive or binge drinking)
  • Alcoholism
  • Accidents
  • Several cancers, including breast cancer
  • Suicide
Additional References:

Stay Active

Exercising 30 minutes a day reduces your risk for heart disease. It benefits your heart’s health by:

  • Strengthening your heart muscle
  • Improving your circulation
  • Helping maintain a healthy weight
  • Improving blood cholesterol and blood sugar levels
  • Reducing stress

Use these tips to start and stick to an exercise program:

  • Choose activities you enjoy. You may want to dance, swim, cycle, or take an exercise class.  
  • Choose a specific goal, such as walking 3 times a week for 30 minutes or swimming for 15 minutes without stopping.
  • Schedule time to exercise. Schedule time to go to the gym, a yoga class, or on a walk.
  • Chart your progress in a notebook or fitness app. Keep track of when and how long you exercise, and how you feel before and afterward.
  • Find an exercise partner. You’ll help keep each other motivated and provide mutual support.

Lose a Little Weight

Losing as little as 10 pounds can reduce your risk for heart disease by:

  • Lowering your blood pressure. When you’re overweight, your heart must work harder.
  • Improving your blood cholesterol.
  • Improving your blood sugar levels, if you have diabetes.

Your body mass index (BMI) is based on your height and weight. Your risk for heart attack or stroke increases if your BMI is 25 or higher. Asian Americans’ health risks start to rise at a lower BMI. Ask your doctor about your BMI and risks. 

Eating healthier and being more active are important steps toward losing weight. Taking a nutrition or exercise class can help you get started. Ask us about classes and other resources.

Take Deep Breaths

For you, being stressed may feel like anger, depression, or anxiety. Stress can affect your heart by:

  • Raising your blood pressure.
  • Reducing your commitment to exercise and healthy eating. 

Try these strategies to reduce your stress level:

  • Take deep breaths and relax. Take a few minutes to breathe slowly and deeply. Count to 4 as you breathe in, feeling your breath go down into your belly. Then breathe out more slowly through your nose, for 6 to 8 seconds. Notice how you feel. 
  • Get moving. Exercise reduces stress.
  • Reduce caffeine. Caffeine can make anxiety worse. It also affects sleep.
  • Don’t use alcohol, drugs, or tobacco to cope with stress. Even in small amounts, they can make you feel worse.

Call us if you continue to have stress that interferes with your daily activities or causes discomfort.

Additional References:

Don't Use Tobacco

Quitting tobacco is one of the best things you can do for your health. Your heart disease risk will be cut in half in the first year after you quit.

Using tobacco increases your risk of heart disease by:

  • Reducing oxygen to your heart.
  • Raising your blood pressure and pulse rate.
  • Causing blood to clot more easily.
  • Damaging cells that line your heart’s arteries.

We have resources to help you quit successfully. Here are a few tips:

  • Write down your reasons for quitting. Read them daily.
  • Set a quit date and start getting ready. Plan healthy things to do at times you would have had a cigarette.
  • Get support by going to a class or from a friend or family member. Ask former smokers for advice.
  • Consider medications to reduce cravings after you quit.
Additional References:

Blood Pressure

Blood pressure (hypertension) is the force that your blood places on your blood vessels as it flows through the body. If the blood pressure is too strong, your heart must work too hard to pump blood out to the body.

Over time, high blood pressure can damage your blood vessels. Lowering your blood pressure with lifestyle changes and medications (if needed) protects your heart and blood vessels.

Blood pressure is measured in ranges:

If you are:

Your blood pressure target is:

An adult 18–59 years old139/89 or below
A person with diabetes139/89 or below
A person with certain types of kidney problems139/89 or below
An adult 60 years of age or older without diabetes and without certain types of kidney problems149/89 or below

The first number in this measurement is systolic pressure. This is the force of blood moving through your arteries as your heart sends blood to your body.

The second number is diastolic pressure. This is the force of blood against your arteries while your heart rests between beats.

To have healthy blood pressure, both numbers need to be in the normal range.

Additional References:

Cholesterol

Cholesterol is a fatlike substance. It is made by the body and found naturally in animal-based foods. The body needs cholesterol to make hormones and vitamins and support brain function.

Cholesterol levels in your blood depend on genetic traits you’ve inherited and on your lifestyle choices.

The 2 main types of cholesterol are:

  • Low-density lipoprotein (LDL), or "bad" cholesterol
  • High-density lipoprotein (HDL), or "good" cholesterol

When "bad" LDL levels are too high or "good" HDL levels are too low, fats can build up inside the blood vessels. This can reduce blood flow to the heart, brain, and other organs.

Triglycerides are another group of fats found in the blood. High triglyceride levels can also lead to heart and blood vessel problems.

We measure cholesterol and triglyceride levels with a blood test.

For most people, healthy levels are:

  • Total cholesterol: Lower than 200
  • LDL cholesterol: Lower than 100
  • HDL cholesterol: Higher than 60
  • Triglycerides: Lower than 100

Some people need medications to control their cholesterol. We may prescribe a statin medication if you have a history of:

  • Stroke or heart attack
  • Diabetes
  • Bypass surgery
  • Peripheral arterial disease
Additional References:

Diabetes

If you have diabetes, it’s important to reduce your risks for complications, such as a heart attack, stroke, or kidney problems.

We use the blood tests hemoglobin A1C and estimated average glucose (eAG) to measure your average blood sugar over the previous 2 to 3 months. We learn how well you’re managing your blood sugar.

We recommend having a hemoglobin A1C test at least once year, or more often if we need to adjust your treatment plan.

Talk with us about your personal target for A1C and eAG. Here are the usual ranges:

A1C target (%)             eAG target (mg/dL)
Most peopleBelow 7Below 150
People older than 65 or with additional health conditionsBelow 8Below 180
Additional References:

Related Health Tools:

Classes and Coaching
Interactive Programs
Podcasts
Videos

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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