What is gout?

Gout is a medical condition where the uric acid levels in the joints increase and cause sudden, severe joint pain.

What are the symptoms of gout.

Sudden severe pain in any joint. Common joints affected are big toes, fingers, wrists, elbows or knees.

Redness, heat, swelling over the affected joint.

Triggers for gout?

Trauma to the joint, genetic, stress, serious illness, alcohol use, women after menopause, overweight, Food habits, some medications

What should I do if I have symptoms of gout ?

You should consult your healthcare provider.

How can my healthcare provider help me?

Your healthcare provider will ask you questions about your symptoms, your lifestyle.

You might be sent for a blood test, ultrasound, or x-ray.

Sometimes a needle is inserted into the joint to extract fluid and sent for testing.

What is the treatment for gout?

Your healthcare provider will prescribed medicines to relieve pain.

If symptoms do not get better in the next couple of days, medicines like steroids are prescribed.

Over long-term, medicines are prescribed to lower uric acid levels.


Self-help are for mild symptoms. If you symptoms persist, please consult your doctor immediately.

Take medicines as prescribed by your healthcare provider.

Rest and raise the limb.

Keep an ice pack for about 20 minutes at a time every 2-3 hours.

Stay hydrated, unless you are on fluid restriction.

Avoid bedclothes off the affected joint at night. Do not put pressure on the joint.

Long-term recommendations for gout:

Start a healthy diet.

Plenty of vegetables, low-fat dairy

At least 2 alcohol free days a week.

Exercise regularly, but avoid intense exercise or trauma to the joints.

Stay hydrated.

Avoid smoking.

Don't eat a lot of red meat, kidneys, liver or seafood.

Don't eat a lot of sugary Beverages, snacks.

Don't eat a lot of fatty food.

Do not drink more than 112 grams of pure alcohol a week. [A standard drink contains about 14 grams of alcohol. This corresponds to a 12-US-fluid-ounce (350 ml) glass of beer, a 5-US-fluid-ounce (150 ml) glass of 12% ABV (alcohol by volume) wine, or a 1.5-US-fluid-ounce (44 ml) so-called "shot" of spirit.]

Do not drink the recommended amount of alcohol for a week all at once in 1-2 days.

Chronic gout:

When gout is not addressed for a long period of time, it leads to chronic gout.

Chronic gout can also cause tiny white lumps (tophi) to appear under your skin, especially on your ears, fingers or elbows. They can be painful.

You can get kidney stones if your uric acid levels are very high.


Gout on left foot

Image result for gout

Cast care

 What is a cast?

Casts made up of bandage and a hard covering made of Fiberglass or plaster of Paris.

Why are casts placed?

They are placed to immobilize the injured area. Immobilization helps with healing.

How should I care for my cast?

Plaster casts are made up of a bandage and a hard covering. They allow broken bones in the arm or leg to heal by holding them in place, and usually need to stay on for between 4 and 12 weeks.

Taking good care of your cast will help ensure a better recovery.

Cast care advice

Keep your arm or leg raised on a soft surface, such as a pillow, for as long as possible in the first few days. This will help any swelling to go down.

Don't get your plaster cast wet.

Fiberglass cast does not fall apart, but the soft padding underneath will get wet. It will make the skin itch, smell.

It's possible to buy special covers for casts to keep them dry when washing or bathing. Ask your local pharmacist for more information. Don't try to use plastic bags, bin liners, cling film or similar to keep the cast dry, as these are not reliable methods. 

Always remove any covering as soon as you can to avoid causing sweating.

Even if the plaster cast makes your skin feel very itchy, don't poke anything underneath it. This could cause a nasty sore and lead to infection.

Do not walk on a cast unless you have been told it is safe to do so and have been given a plaster shoe.

The itchiness should settle down after a few days.

More plaster cast tips:

Exercise other joints which are not covered by the cast. It will improve your circulation.

Avoid getting smaller objects underneath your cast, it will irritate your skin.

Don't alter, cut, trim or change the position of your cast.

Please talk to your healthcare provider about the activities that you can perform.

Use crutches, sling as advised by your healthcare provider.

Use medicines as prescribed for pain relief.

See your healthcare provider right away if:

Your cast feels too tight even after keeping it elevated for 24 hours.

You experience persistent itching, burning underneath the cast.

Your fingers or toes on the affected limb become swollen, tingly, painful or numb.

The skin on your fingers or toes turned blue or white.

The cast feels too loose.

Your cast is broken or cracked.

Skin underneath are around the cast feels sore, or the cast feels sore.

There is unpleasant smell, discharge coming from your cast.


Fiberglass cast

Image result for cast



Mycoplasma genitalium, Nongonococcal urethritis

 What is Mycoplasma genitalium?

It is a bacteria which is transmitted through sex.

What are the symptoms of Mycoplasma genitalium?

Burning on urination.

Pain during urination.

Discharge from the penis, vagina

Itching of the genitals

Infection of the cervix, pelvic organs

Abdominal pain, pelvic pain, vaginal bleeding after sex

In men who are sexually active with men, or rectal sex, rectal pain, discharge, bleeding, constipation, difficulty having a bowel movement.

How is it diagnosed and treated?

Please consult your healthcare provider.

Your healthcare provider will talk to you about your symptoms, perform an exam.

Your healthcare provider will obtain urine specimen or a swab from the genitals.

Oral antibiotic medicines are prescribed.

You should repeat the test to make sure the infection has cleared after three weeks of finishing antibiotics.
Your sexual partner has to be tested and treated.
How can I decrease the risk of catching Mycoplasma genitalium?
Stay monogamous if possible.
Use condoms during every oral, anal and regular sex.


 What is a fracture?

A fracture occurs when there is a crack or break in the bone.

What causes Fracture?

They're usually caused by a fall or an injury to the bone, but may occasionally be caused by a health condition, such as cancer that weakens the bone.

What are the symptoms of fracture?

Pain at the site of the fracture

Not being able to lift, move, rotate your limb or site of fracture

Not being able to stand or put weight on your leg.

Bruising and swelling.

Injured area leg/arm appears shorter than the other one.

Injured area looks deformed

Unable to use the arm or leg

What should I do if I have symptoms of Fracture?

Consult your healthcare provider immediately.

Your healthcare provider will ask you questions related to your symptoms, performing physical exam.

Based on your condition, they may order Imaging.

Depending on the condition, splint, cast is recommended.

Sometimes you will need surgery at a hospital.

How can I prevent fractures?

Reduce the risk of falling by:

Assessing your home for hazards such as loose carpeting, cables, clutter around the house. Address the hazards.

Doing exercises to improve your balance.

Using walking aids such as walking stick, cane, walker.

Adequate lighting around the house.

Grab bars, non-slip shower mat in the bathroom

Addressing osteoporosis

Taking precautions to avoid slipping and falling on ice and snow, uneven ground, stairs, steps, parking areas, unfamiliar areas. 


Plantar fasciitis

 What is Plantar fasciitis?

Plantar fasciitis occurs due to sprain of the tissue which connects the heel to the toes.

You'll notice pain on the bottom of your foot, around your heel and arch. 

What causes plantar fasciitis?

Recently started exercising on hard surfaces.

Exercise with a tight calf or heel.

Overstretch the sole of your foot

Recently started a lot of walking, running or standing for long periods of time.

Shoes with poor support.


Diabetes, liver disease, Thyroid issues, alcoholism, advanced age, smoking,Bone spurs, Genetic

What are the symptoms of Plantar fasciitis?

Discomfort in the bottom of the foot when you start walking after sleeping or resting.

Pain feels better during exercise, but returns after resting

It is difficult to raise that toes off the floor.

What should I do if I have symptoms of plantar fasciitis?

Consult your healthcare provider.

Your healthcare provider will ask you questions related to your symptoms, performing physical exam.

Based on your condition, they may order Imaging.

Medicines, exercises are advised.

If symptoms do not get better, see your healthcare provider for further instructions.


Self-help is for my symptoms only. If you symptoms persist, please consult your healthcare provider.

Rest and elevate your foot.

Put an ice pack in a towel on the painful area for 20 minutes every 2-3 hours.

Wear comfortable shoes with low heel and soft sole/Heel pads with good support.

Regular gentle stretching exercises like swimming

As needed medicines for pain relief as prescribed by your doctor.

Avoid the following

Do not walk or stand for long periods of time.

Do not wear high heels, tight pointy shoes, flip-flops or backless slippers.

Do not try to walk barefoot on hard surfaces. 


Plantar fascia and Achilles tendon

Image result for Plantar fasciitis





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.