Coronavirus

Updated on 1/1/2021

Check in  Protocol

 

We were one of the fist clinics in Denver to offer COVID tests for molecular, serology and rapid antigen tests. We did them before any of the big hospitals were able to do it because we are focused on providing most affordable, most accessible and highest quality primary care. 

We have learnt a lot in the last nine months and built the processes to avert another crisis in the future. We have stocked up PPEs, stored life saving medicines and created fault tolerant processes.

Our appointments now can be flipped from office visit to virtual visit or vice versa at a moment's notice. You just need to chat securely with our office at Caregram 

All our results are delivered over Caregram 

If you need to come in to the clinic for any reason you must check in online at Carrie our patent  pending AI based front office.

If you need to book an appointment you have the option of booking an  in office appointment as well as a video appointment. After the visit is over please access your visit link once again from the phone to download any visit documents. 

Most of the labs can be done in the clinic, but you need to book  a slot to come in. If you are in the clinic, your labs are done at the time of visit. If you did a virtual visit, you are provided lab orders or imaging orders. You can take the lab order to nearest LabCorp and imaging order to nearest HealthImages. 

Please note it is absolutely necessary to wear masks to come in to the clinic. It is also essential to check in for your appointment at least 24 hours before your appointment.  You are provided a link to check in as a text message. You must finish all the COVID screening and all the paper work from that text message. You can take even upload your documents from the link.

Approximately 8 hours before your appointment our system starts planning for your visit.

At this time you may be asked to fill additional forms and get additional screening. So please check your phone for any messages from us in the morning and fill all the forms. 

If you have checked in you will be able to see a screen that says you are checked in. Only those appointments which are checked in remain on our calendar. If you have not checked in, you may lose your spot to someone else if they check in first. We absolutely limit patients to ensure at least half an hour is spent with every patient. So if you do not check in, you are very likely to be turned away because our system does not allow your rooming unless you have a QR code that shows you are checked in. 

All this ensures that you do not come in contact with other sick patients as much as possible. Also check in is important, if your symptoms pose threat to the community, we ask you to do video visit. If required, you may come to our parking lot for further treatment but you must finish your video visit. 

 

Cellulitis and Erysipelas

What is Cellulitis?

Cellulitis and erysipelas are infections of the skin.

Symptoms are redness, pain, swelling, chills, fever.

Erysipeles affects the superficial layer of the skin, cellulitis affects the deeper layers.

Normally our skin has germs superficially. Skin cuts or breaks allows the germs to enter under the skin and cause infections.

Other conditions also increase the chances of skin infections like chronic skin conditions (ex: eczema), overweight, certain medications. 

Common location of erysipelas and cellulitis are legs or arms. It can affects skin on the belly, the face, in the mouth, or around the anus.

 How is it diagnosed and treated?

You should see a health care provider immediately. Untreated skin infections can be dangerous, it can spread to the rest of the body causing complications.

Your health care provider will diagnose you and order tests if indicated.

Treatment is with oral antibiotic pills.

Please finish all the prescribed antibiotic pills even when you feel better with only a few pills. The bacteria does not die completely if you do not finish all the antibiotics prescribed to you.

 How to care for yourself?

You should do the following at home

Finish medications as prescribed. If any problems with medications, contact your health care provider immediately

Raise the arm or leg for 30 minutes 3-4 times per day to reduce swelling

Keep the infected area clean and dry

Wash your personal clothes with disinfectant detergent

Personal hygeine, wash hands frequently with soap and water.

See your health care provider immediately if you have, worsening redness, swelling, fever, pain or any worsening of health.

Your health care provider can determine if you need antibiotics changed or if you need to go to the hospital.

 Prevention

Avoid skin cuts, shower daily, maintain normal body weight, obtain instructions for skin care if you have chronic skin conditions like eczema, hand hygeine wash frequently with soap and water, shower after using public swimming pools, hot tubs.

 

HPV Positive

Our methods are effective in preventing health complications. 

We do Pap Smear and HPV test during our well women exam.

Pap Smear is used to determine malignancy. HPV is used to determine the presence of HPV virus that is linked to future incidence of cervical cancer that can lead to malignancy.  This post is for explaining HPV test.

The human papilloma virus (HPV) test detects the presence of the human papillomavirus, a virus that can lead to the development of genital warts, abnormal cervical cells or cervical cancer. 

The HPV test is a screening test for cervical cancer, but the test doesn't tell you whether you have cancer. Instead, the test detects the presence of HPV, the virus that causes cervical cancer, in your system. Certain types of HPV — including types 16 and 18 — increase your cervical cancer risk. Knowing whether you have a type of HPV that puts you at high risk of cervical cancer means that you and your doctor can better decide on the next steps in your health care. Those steps might include follow-up monitoring, further testing, or treatment of abnormal or precancerous cells.

 

Results

Results from your HPV test will come back as either positive or negative.

  • Positive HPV test. A positive test result means that you have a type of high-risk HPV that's linked to cervical cancer. It doesn't mean that you have cervical cancer now, but it's a warning sign that cervical cancer could develop in the future. Your doctor will probably recommend a follow-up test in a year to see if the infection has cleared or to check for signs of cervical cancer.
  • Negative HPV test. A negative test result means that you don't have any of the types of HPV that cause cervical cancer.

Depending on your test results, your doctor may recommend one of the following as a next step:

  • Normal monitoring. If you're over age 30, your HPV test is negative and your Pap test is normal, you'll follow the generally recommended schedule for repeating both tests in five years.
  • Colposcopy. In this follow-up procedure, your doctor uses a special magnifying lens (colposcope) to more closely examine your cervix.
  • Biopsy. In this procedure, sometimes done in conjunction with colposcopy, your doctor takes a sample of cervical cells (biopsy) to be examined more closely under a microscope.
  • Removal of abnormal cervical cells. To prevent abnormal cells from developing into cancerous cells, your doctor may suggest a procedure to remove the areas of tissue that contain the abnormal cells.
  • Seeing a specialist. If your Pap test or HPV test results are abnormal, your health care provider will probably refer you to a gynecologist for a colposcopic exam. If test results show that you might have cancer, you may be referred to a doctor who specializes in treating cancers of the female genital tract (gynecologic oncologist) for treatment.

If pap or HPV test is positive, we typically have patient come back to office and choose appropriate care plan. 

Birth control

 What are the different forms of birth control?

There are various forms of birth control available in the United States.

Contraceptive methods based on effectiveness?

 More than 99% effective.

Implants like Nexplanon

IUD like Mirena, Copper devices.

Tubal ligation which is permanent.

Vasectomy which is permanent.

Contraceptives that are more than 99% effective if always used correctly, but generally less than 95% effective with typical use:

Birth control injections like Depo shot

Birth control pills [combination of estrogen and Progesterone]

Progesterone only pills.

Birth control patches.

Vaginal rings.

Contraceptives that are 98% effective if used correctly:

Male condoms

Contraceptives that are 95% effective if used correctly:

Female condoms

Contraceptives that are 92 to 96% effective if used correctly

Diaphragm or with spermicide gel

 

Contraceptive methods depending on duration 

Intrauterine device [IUD]- 5-10 years.

Birth control implant-3 years.

Birth control injection-Every 8-12 weeks.

Vaginal ring: worn vaginally 3 out of 4 weeks

Birth control patch: 3 weeks on, 1 week off

Oral birth control pills: to be taken daily.

Male or female condoms: to be used consistently during every act of sex.

 

Please talk to your healthcare provider which method of contraception is appropriate and safe for you.

Your healthcare provider will determine the appropriate birth control after taking your medical history, performing a physical exam and your preferred method.

 

Bacterial vaginosis, BV

 What is Bacterial vaginosis?

It is a change in the balance of bacteria in your vagina.

What are the symptoms of Bacterial vaginosis?

Unusual vaginal discharge with strong fishy smell, particularly after sex.

Change in the color, consistency of the vaginal discharge

How is Bacterial vaginosis diagnosed and treated?

Consult your healthcare provider.

Your healthcare provider will talk to you about your symptoms, and perform a vaginal exam.

Your healthcare provider will order a urine test or a vaginal swab. 

Bacterial vaginosis is treated with oral antibiotics or vaginal gel.

If your symptoms persist, please contact healthcare provider.

How can I decrease the risk of Bacterial vaginosis?

Do's:

Use water and plain soap to wash your genital area.

Take a shower instead of bath

Use condoms during all acts of sex

Use sanitary pads instead of tampons

Daily consumption of probiotic products.

Don'ts:

Do not use perfumes, soaps, bubblebath, shampoo, shower gel in the bath.

Do not use vaginal deodorants, washes or douches.

Do not put disinfectant liquids in the bath

Do not use strong detergents to wash your underwear

Do not smoke.

 

 

 

Information

At the time of office visit, please present your insurance card.  We bill your visit to the insurance card you present. 

In the event of an error in your insurance, please let our front office staff know.

We are in network with most insurances. However individual plans may vary and not known till a claim is adjudicated.

We are a smoke free facility.

We need every patient to finish all the forms online and check in online if possible. 

Most visits start on time, so please plan to be at the office, fifteen minutes before your appointment.

Habitual no show patients are terminated from the patient panel.

We charge a no show fee.

If you are not able make the commute, or take time off for commute , explore tele medicine available now.