Hospital Discharges

There will be situations when you are admitted to hospital. Because of aggressive cost cutting by the third parties and other reasons, you are now instructed at the hospital to follow up with your physician. This follow up saves lot of harm to the patient.  Everyday we see patients who have been put on wrong medications with improper discharge planning. Hospitals are not only discharging patients quicker but also are using unsafe practice of using non physicians to discharge patients.

 

So getting a physician to properly go thorough your discharge papers and ensure that medications are proper and conditions are properly diagnosed is always a good idea. If hospital asks you to see your physician, book your office visit within 7 days of hospital discharge and bring your hospital discharge papers. Please do not mix your regular office visits with hospital discharge follow ups.  We provide same day or next day appointments when you need. 

HIV and AIDS

Most people infected with HIV experience a short, flu-like illness that occurs 2-6 weeks after infection. After this, HIV may not cause any symptoms for several years.

It's estimated up to 80% of people who are infected with HIV experience this flu-like illness.

The most common symptoms are:

  • raised temperature (fever)
  • sore throat
  • body rash

Other symptoms can include:

  • tiredness
  • joint pain
  • muscle pain
  • swollen glands

The symptoms usually last 1-2 weeks, but can be longer. They're a sign that your immune system is putting up a fight against the virus. 

But having these symptoms doesn't necessarily mean you have the HIV virus. Remember: they're commonly caused by conditions other than HIV.

If you have several of these symptoms and think you've been at risk of HIV infection within the past few weeks, you should get an HIV test our clinic.

 

We have seen patients who were never checked this even with multiple hospital admissions and hence we are now proactively testing patients for this whenever your doctor feels it is necessary.  

Chronic Kidney Disease

When patients get their annual wellness visit done at New Horizons Primary Care, we order labs to calculate your eGFR.  One of our patients wanted to know what is the significance of this and wanted to know how to get better number on this test. Hence this post.

 

What is eGFR?

eGFR is short for estimated glomerular filtration rate. Your eGFR is a number based on your blood test for creatinine, a waste product in your blood. It tells how well your kidneys are working. At the end of the test you get a number (two or three digit number), higher the number better is your kidney health.

 

A normal eGFR is 60 or more. If your eGFR is less than 60 for three months or more, your kidneys may not be working well. If you eGFR is below 15, you may need to start dialysis or have a kidney transplant. Use this scale to see what your eGFR may mean.

Stage 1 Stage 2 Stage 3 Stage 4 Stage 5

eGFR in normal range (greater than 90) with other signs of kidney damage, like protein in urine or physical damage to the kidneys

eGFR in normal range (60-89) with other signs of kidney damage, like protein in urine or physical damage to the kidneys

eGFR 30-59, moderate kidney damage

eGFR 15-29, severe kidney damage

eGFR less than 15, the kidneys are close to failure or have already failed

 

My  eGFR came back lower than normal. How can I get that improved?

Good thing about wellness visit is that they catch the problems very young. If you learn your lesson and make life style modifications, you can avert progression of any disease. So here are some things you can do to  help your kidneys to help you!

 

    • Eat a lot of fresh or frozen vegetables

 

    • Drink water (add a few lemon slices and mint sprigs to a large pitcher of water and store in your fridge for a cold and refreshing beverage)

 

    • Cook at home

 

    • Cook with very little oil and salt

 

    • Choose no-salt-added canned and jarred products

 

    • Add herbs and spices instead of salt to your dishes for BIG flavor

 

    • Choose whole grains (like brown rice) instead of refined grains (like white rice)

 

    • Choose lean proteins like: chicken, fish, turkey, quinoa, beans, soy products - tofu, edamame, tempeh, soy milk, and on occasion: lean beef or lean pork

       

        • Aim for 0.8 gm of protein per kg of body weight or:

           

            • 8 ounces (~56 grams) of lean protein per day for the average man*

           

            • 6 to 7 ounces (~46 grams) of lean protein per day for the average woman*

           

 

I have made life style modifications. What next?

Get the test repeated again in approximately 3 months to confirm that life style modifications are working. If your eGFR does not change and continues to decrease, you may have to be seen again to run a few additional diagnosis tests and figure out cause of Kidney injury.

 

Unintentional Weight Loss

Your body weight can regularly fluctuate, but the persistent, unintentional loss of more than 5% of your weight over 6 to 12 months is usually a cause for concern. Losing this much weight can be a sign of malnutrition, where a person's diet doesn't contain the right amount of nutrients.

You should pay particular attention if you experience other symptoms, such as:

  • tiredness
  • loss of appetite
  • a change in your toilet habits
  • an increase in illnesses or infections

If you believe you have unintentional weight loss, please get checked at the clinic to ascertain no serious issues exist. 

Epididymitis

Epididymitis

Epididymitis is where a tube (the epididymis) at the back of the testicles becomes swollen and painful. It's often caused by an infection and is usually treated with antibiotics.

If the testicles are also affected, it may be called epididymo-orchitis.

Check if it's epididymitis

Symptoms of epididymitis may include:

  • sudden or gradual pain in 1 or both of your testicles (balls)
  • the bag of skin containing your testicles (scrotum) feeling tender, warm and swollen
  • a build-up of fluid around your testicle (a hydrocele) that feels like a lump or swelling

You may have other symptoms depending on the cause, such as difficulty peeing, or a white, yellow or green discharge from the tip of the penis.

Causes of epididymitis

Epididymitis is usually caused by a sexually transmitted infection (STI), such as chlamydia or gonorrhoea. This is more likely in younger men under 35 years old.

It can also be caused by a urinary tract infection (UTI), but UTIs are less common in men.

A UTI is more likely if you have:

  • an enlarged prostate gland
  • a urinary catheter
  • recently had surgery to the groin, prostate gland or bladder

Sometimes a cause cannot be found.

What happens at your appointment

You'll usually need some tests first to find out the cause.

These may include:

  • a groin examination
  • a swab of the tube that carries pee out of the body (urethra) – to test for infection
  • urine and blood tests
  • a rectal examination – to check for problems with your prostate

Treatments for epididymitis

If you have an infection, you'll usually be given antibiotics. You should start to feel better within a few days, but it may take up to 2 weeks to fully recover.

It's important to finish the whole course of antibiotics, even if you start to feel better.

There are some things you can do while you recover to help ease pain and swelling and prevent any further problems.

Do

  • take painkillers, such as ibuprofen, to help with the pain
  • hold a cold pack (or a bag of frozen peas wrapped in a tea towel) on your groin
  • wear underwear that supports your scrotum

Don't

  • do not have sex if you have gonorrhoea or chlamydia until you have finished the full course of treatment

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.