Do I need a Primary Care Physician?

Many people think that now they are adults, they don’t need a primary care physician; when, in actuality, the important role that this doctor plays can’t be overstated. 

Besides doing your yearly physical, your primary care physician is often your first stop in identifying autoimmune disorders such as chronic fatigue syndrome, psoriasis, lupus, thyroid disease, rheumatoid arthritis and more.

Think again if you feel that only children need regular check-ups. Adults need them, too. They need regular visits to their primary care physician or to Los Gatos Doc’s primary care physicians. These visits result in better health care management because during them, you get to know your doctor and vice versa. They also result in better health care management because of the chronicity of autoimmune diseases. Your primary care physician can give you ideas which will result in a better quality of life!

A relationship with your primary care physician often gives both patient and doctor a chance to get to know each other. The relationship becomes special and built on a foundation of trust. Nurture the relationship now because it might be much easier to discuss possibly uncomfortable health issues later if you have developed a bond with your primary care physician. 

Research has shown that people who visit their primary care physicians regularly experience the benefits of better overall health, lower health care costs and have more satisfaction with their health care and lives. It is especially important to discuss how lifestyle changes can have a major effect on autoimmune disorders.

A major benefit of your relationship with a primary care physician is that it’s so much like having your own ‘health care hub’. Other physicians in the practice can access, provide vital information and coordinate all of your care in one place.

Some of the services provided by your primary care physicians can include:

  • Autoimmune disease management
  • Preventative care; disease prevention and screening
  • Checking for hypertension (high blood pressure)
  • Checking for hypoglycemia (low blood sugar/diabetes)
  • High cholesterol
  • Checking for cancer
  • Depression
  • STD’s
  • Help manage your chronic conditions
  • Give recommendations
  • Discuss sensitive and private concerns
  • Make referrals to specialists
  • Inoculations
  • Physicals

Your primary care physician is quite knowledgable in all of these areas and many more. Discussing preventative measures and developing strategies for dealing with health issues is one of the biggest reasons for making regular visits to Los Gatos Doc’s family clinic  or to your primary care physician. When we know who you are what your baseline is, we can easier detect changes or patterns which make diagnosing more accurate.

A major advantage of having a primary care physician is in having a team organizer, the hub of a health care wheel. The primary care physician has the ability to identify a patient’s need for a specialist. If you need an allergist and/or a pulmonologist, your primary care physician will point you in the right direction and assist you in understanding what your part might be as you  work together to achieve your health goals. Your primary care physician might also point you towards a rheumatologist who he/she has worked with before, if you need this specialty.

When you go to Los Gatos Doc’s primary care physicians, we treat you as a person and not a disease. If you want to live longer and have better health we are here to advocate for you, to treat you with compassion and to help guide you through your individual health care journey.

About the Author: Arun Villivalam, MD is a concerned and caring family physician and primary care doctor serving the community of Los Gatos, CA. Dr. Villivalam attended Thomas Jefferson University, where he received his medical degree, and completed his residency in family medicine at Cook County Hospital. Dr. Villivalam provides a variety of services to ensure the health and wellbeing of his patients, including physicals for all ages, chronic care management, stress management, urgent care, medicare wellness visits, school physicals and more.


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LUPUS, in a nutshell

Every disease, everything that ails us, usually has a descriptor, a very easy way of describing it. and here is a lupus descriptor that is a very basic. Future articles will expound on this video:

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Lupus and Sjogren’s Syndrome and IVig

My doctor called, “We’ve found out why you have such problems with your balance, walking and weird sensations in your legs. ”

She proposed treating me with either high-dose IV steroids or immunoglobulins because the inflammation and viral activity in my blood was so great. She chose IVig instead of steroids, because steroids would suppress my immune system enough, so that fighting infection would be a problem.

The immunoglobulins would be given to me through an intravenous line. Having learned about immunoglobulins years ago in nursing school, there was no time like the present for a brusher upper! Briefly put, immunoglobulins are proteins found in the blood that are used to fight viruses and bacteria.

Because immunoglobulins are heavy, they require much volume for infusion. Because my doctor needed to know if I could tolerate the volume for the infusion, a right heart catheterization was to be done. In this procedure, a catheter would be placed in my neck, threaded through the heart and lungs and measurements taken in various places of the heart and lungs to help determine if I would be able to tolerate the volume of the immunoglobulins.

So, should steroids be used to treat the lupus and its massive inflammation or immunoglobulins to treat the antibody deficiency? I opted for, and the doctors felt the latter stood a better chance of being effective against the known culprit of Sjogren’s Syndrome. Stay tuned to this channel for the effectiveness of IVig.











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What is Pulmonary Hypertension?

We’ve talked about some ways in which lupus can affect the heart: its inflammation can cause pericarditis; a painful inflammation of the lining around the heart, lupus patients are at an increased risk for development of Coronary Artery Disease, dyslipidema and many other heart-related problems.

Pulmonary Hypertension is not to be confused with high blood pressure, the systemic type in which your doctor measures your blood pressure with a cuff around your arm. For the purposes of this discussion, we speak of PULMONARY hypertension, or HIGH BLOOD PRESSURE IN THE LUNGS and treatment for it involves sophisticated treatment by subspecialists- after a through diagnostic workup. The World Health Organization has chosen to classify 5 types of Pulmonary Hypertension into Groups:

Group 1. Pulmonary Arterial Hypertension-the Pulmonary Artery becomes narrowed, so the pressure inside this artery becomes high.

Group 2. Pulmonary Hypertension due to left heart disease. This is often seen when stiff LEFT-SIDED HEART vessels don’t completely relax. A good example might be one which is caused by left ventricular diastolic dysfunction.

Group 3. Pulmonary Hypertension due to lung disease- the diseases here include COPD, mainly empyhsema and chronic bronchitis, as well as any disease that leads to scarring of the lungs, like pulmonary fibrosis and sleep-disordered breathing. In this instance (sleep-disordered breathing) CPAP for Obstructive Sleep Apnea is necessary.

Group 4. Pulmonary Hypertension due to blood clots in the lungs: this is sometimes called Chronic Thromboembolic Pulmonary Hypertension and in it, (blood clots) form within the lungs causing pulmonary hypertension by blocking the flow of blood through the pulmonary arteries., not only raising the blood pressure in the pulmonary artery, but since blood flow is blocked, more clots form.

Group 5. blood and other rare disorders that result in Pulmonary Hypertension-or Chronic Thromboembolic Pulmonary Hypertension. For an unknown reason, blood clots form in the lungs and in addidtion to the formation of clots which create more clots, these clots increase the pressure inside the pulmonary arteries.

The diagnosis of Pulmonary Hyptertension is often one made during a work-up of shortness of breath. Shortness of breath can have multiple causes and unless diagnosed and treated by subspecialists early, the shortness of breath of Pulmonary Hypertension  can have a poor outcome.

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The unknown

Surgery to replace my hip was called off. Was it because I was chicken? No. I was advised against surgery at the time because of a risk to my lungs and heart. Does that mean that I am forever at high risk for any surgery?

High risk. I don’t like the sound. You mean, one of these times, I might not ‘wake up?’ Now, there’s a humbling thought and a reason to examine my own mortality. I have Shrinking Lung Syndrome (sometimes known as Vanishing Lung Syndrome) from lupus or from Sjogren’s Syndrome (it is a rare pulmonary effect of either) and I experience severe shortness of breath with next to no exertion. However, upon measuring my oxygen saturation at the time, the result is usually normal, @ 98%-99%.

That’s why supplemental oxygen didn’t help. However, that was the past and I just wonder about the present.  A recent sleep study monitored oxygen all night long. We’ve tried inhalers: So far, none have worked.  So the next step/treatment.

The shortness of breath is now much more involved as it takes on a life of it’s own. Walking is limited to 10-20 yards before it becomes so severe that I need to rest. The shortness and breath, along with weakness, makes it next to impossible to walk without use of a cane.  My balance, issues are getting worse everyday. Hardly the way I wanted to spend the ‘golden years!’

Having not much more than time on my hands, I write here or at my other blog, annies analysis, frequently. My rheumatologist has prescribed several medications, and a diary of my journey with these can be found in TREATMENT CHRONICLES. Come, join me on my journey!

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Lupus and Asbestos

Landon Biehl

Have you been exposed to asbestos? Complications that result from exposure to hazardous materials in the environment are often times hard to identify and track down. We come into contact with a large number of potential health threats everyday, making our ability to identify exactly what causes our complications or health issues not easily identifiable.

Lupus has quite an effect on the lungs and can mimic other lung diseases, such as mesothelioma, making the differences in the health threat closely related in nature. A large percentage of lupus patients develop pulmonary issues, and different lung complications and diaphragm issues. Similarly, asbestos exposed victims can develop some of the same complications.

A very common trigger for lung complications is asbestos. Since the risk of exposure to asbestos is common, and tracking down its initial place of contact is nearly impossible, many times individuals believe they have been exposed when they really have not come into contact with asbestos.  However, if there has been exposure, medical treatment should be sought out immediately.

Often times, when experiencing lung complications, many people seek treatment for asbestos. However, after no positive recovery from the symptoms, an alternative diagnosis should be considered.  In many cases, the patient suffers from pulmonary complications of lupus and there was never a problem with asbestos in the first place. Identifying and letting your doctor know of some of the symptoms you are experiencing is critical for correctly diagnosing your complications. In addition, its a good idea to do some background research on any health complications you might be experiencing, anytime an issue arises. Educating yourself on the differences between asbestos exposure and lupus will only increase your chances for a correct diagnosis.

In addition, educating yourself on some of the hazardous threats and materials that we come into contact with on a daily basis can help to ensure our safety and will ensure we are alert at all times. Identifying areas of potential asbestos exposure in your city would be a great start. In addition, educating yourself on the differences between asbestos exposure and lupus will help you to obtain a speedier recovery.

Landon Biehl is a advocate for healthy living and fitness tips. Residing in North Carolina, he enjoys spending time writing and helping to inform others with wellness information that can benefit families. In his spare time, Landon enjoys spending time at the beach, and being outdoors- running, swimming and kayaking among his favorite activities.

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