Blog Archives - Perlman Clinic

Medical Emergencies Facing Baby Boomers

9/19/2017 - written by Perlman Clinic

Emergency rooms and medical clinics are facing new challenges as the baby boomer population is aging. By 2030, studies have shown that 6 out of 10 people in this age group will develop various medical issues. Here are some of the leading medical conditions that senior citizens are dealing with.


Falls are one of the most common accidents that senior citizens encounter leading to other problems. If you or someone in your family falls, chances are there will be other issues from broken bones to a head injury. It’s really important you get to a urgent care in San Diego as soon as possible to get a thorough examination. Falls are actually preventable unlike certain health issues so make sure your home or apartment is fitted with devices to prevent falls such as hand rails in the shower or tub. Senior citizens can lose their balance due to a weakened back or unsteady legs or suddenly become dizzy, with some safety measures installed, falls can be preventable.

Chest Pain:

Chest pains can be caused by a number of reasons but are quite alarming when it happens to older people. Pains can be caused by anything as minor as acid reflux to a high-alert heart attack. If you or a loved one is experiencing chest pains it’s extremely important to get to your doctor or hospital in a timely manner. There are many other issues that can cause chest pain so it’s important a doctor diagnoses what has happened and hopefully give you some peace of mind or understand you have a serious situation that must be treated immediately.


Pneumonia or other upper respiratory infections are common and can be very serious in older adults. Some symptoms are coughing, shortness of breath and even confusion. In most cases, it’s advisable you get yourself or family member to the emergency room as soon as possible.

Abdominal Pain:

In older people, abdominal pain can be caused by a number of issues such as an infection, dehydration, digestive problems, or more serious conditions. It’s always wise to visit your doctor for an examination to determine what’s going on.


If a senior family member has a stroke, there is no time to waste. You must act very quickly and call for an ambulance. Strokes can prevent the flow of oxygen to the brain and further damage to the body. Symptoms to watch out for include slurring of speech, loss of motor skills, a loss of vision, weakness, and paralysis.

It is very important that if you or a family member suffers from any of these symptoms you should get to a walk in clinic or an emergency room before contacting your family doctor. Once there has been an examination and diagnosis, the doctor will be able to recommend the next step or what treatments will be applied.

As baby boomers continue to age, they are facing more physical challenges and must be aware if their body is trying to tell them something. No one enjoys aging, but it’s a fact of life and in order to live a long and happy one, medical treatments are going to pop up from time to time. You should know your medical options when your doctor is not available, such as local urgent care clinics vs emergency rooms.

Nerve Blocks: What Are They and Should I Get One?

4/20/2017 - written by Perlman Clinic

If you have chronic pain, you’ve probably asked around for pain treatment options that might be more effective. In your research, you might have heard of something called a “nerve block.”

There are different types of nerve blocks, varying by the location and intensity of pain. Remember that chronic pain is defined as pain lasting longer than three months. If this describes your pain, and doctors haven’t been able to offer much in the way of a pain solution, a pain management clinic—where nerve blocks are often an option for treatment—might be what you’ve been looking for.

What are nerve blocks?

The goal of a nerve block is pretty clear from the name of this treatment: to block pain signals from nerves. For many, chronic pain is derived from an autoimmune disease, arthritis, an old injury, or another source (usually nerve related). In these cases, there is no specific cure, and a patient’s only option may be to simply manage the pain.

Good thing there are pain management specialists! Many medical companies exist solely to develop pain treatment options, which are in turn provided to the general public through doctors and pain management clinics.

A nerve block, then, becomes an appealing option. This treatment option functions as a local anesthetic or anti-inflammatory treatment, depending on the cause of pain. Nerve blocks are usually administered via injections with the aim of “turning off” the pain signal. Your physician will use image guidance to pinpoint the exact location of the nerve for better results. This type of pain relief is temporary and often administered to the spine, neck, legs, or buttocks. 


Diagnostic Nerve Blocks

Diagnostic nerve blocks are used to discover the nerve sending the pain signals. In a diagnostic nerve block session, a doctor injects anesthesia in one section of skin where they think the pain might be originating. After the injection is complete, they allow time to determine how much the pain has decreased. If the pain is still present, they will inject another site, repeating the process until the pain has significantly decreased.

Diagnostic nerve blocks may take a little time in office, but once a patient shows significant improvement in pain levels after injection to one place, the patient can then plan to receive additional nerve blocks or a radiofrequency ablation to this area in the future without having to repeat a diagnostic session.

Sympathetic Plexus Blocks

It might sound funny to call something inside the body “sympathetic”—it’s like we’re personifying tissue and organs. But that’s not the case at all. The sympathetic nerves are bundles of nerves that run the length of the spine from the neck to the tailbone. These nerves run pretty much all of the body’s organs. Keep in mind that a plexus is defined as “a network of…interlacing blood vessels or nerves,” which is how the sympathetic nerves can be described.

When it is determined that pain signals have been transmitting through these sympathetic nerves, a sympathetic plexus block can be helpful. A sympathetic plexus block is a type of nerve block that seeks to stop the pain signals in these nerves. The plexus block is usually administered with local anesthesia, a needle, and x-rays to determine the exact location of the pain-causing nerve.

Medial Facet Joint Blocks

Facet joint blocks involve injection of anesthetic in order to numb a nerve, just like any nerve block. The important thing about this type of nerve block is its location. The name of this type of block is derived from both the medial branch nerves and the facet joint, where the medial branch nerves send pain signals from injured facet joints—located in the neck or back—to the brain.

Usually a medial facet joint block is injected into one of the small joints which can be found on either side of the vertebrae in the spine. A lumbar facet joint block, for example, is injected into a facet joint on both sides of the lower spine. If more than one joint is involved, you may receive more than one injection. This type of block is common for patients with arthritis in their lower backs.

Do I need a nerve block?

The only way to determine if a nerve block is for you is to talk to your doctor and pain management specialist. If you have chronic pain that might be related to nerves near the spine, a nerve block might very well be within the realm of possibility for your treatment.


Do you suffer from chronic pain?

How To Treat a Sports Injury

3/3/2017 - written by Perlman Clinic

Sports injuries can happen at any time to anyone, not just dedicated athletes. That’s why it’s important to know what to do if you find yourself knocked down on the field or court.

Whether you’re practicing for a big game or just playing after work with some colleagues, a sports injury can happen to any of us. You need to know how to evaluate the injury and determine where you need to seek assistance—whether at home, at an urgent care, or at the ER. Some of the most common sports injuries include:

athlete with sports injury in San Diego, CA

What types of sports injuries are most common?
Sports injuries run the gamut, from collisions to tendonitis. Some are obvious results of collisions, while others cause constant pain over the long term. So what kinds of injuries should you be looking for on the field or court?

There are several main categories of sports injuries, such as sprains, strains, pulls, and tears. Sports injuries can be either “acute” or “chronic”. For example, “acute” injuries occur as a result of an obvious collision or accident during play. “Chronic” injuries arise from repeated injuries to the same joint, ligament, or muscle that isn’t obvious at first, but eventually lead to constant pain. They are often called overuse injuries.

Acute injuries can include ankle sprains, ACL tears, pulling the groin, a concussion, or pulling a hamstring. Chronic injuries include tendonitis, tennis elbow, or shin splints. While chronic or overuse injuries aren’t as easy to spot because they don’t suddenly occur during a sporting event, they are just as painful—perhaps more so because they occur everyday. So what should you do if you’ve encountered an acute or chronic sports injury?

Evaluating the Injury
Before you decide what treatment you need for your sports injury, it’s important to gather some basic knowledge about the source of the pain. Make sure that the injured person has stopped using their injured body part, whether after an accident during play or if an overuse injury has been identified.

Next, ask the patient (or yourself) about their pain level. Try the following line of questions:

  • Can they put weight on it?
  • Is the pain severe/unbearable?
  • Is there swelling?
  • Is there numbness?
  • Is the pain on the site of an old injury? If so, is there swelling, joint abnormality, or instability here?

The answer to these questions will tell you where you need to go next.

How to Know You Can Treat It at Home
If you have an accident while playing sports, you can quickly tell if you will able to treat the injury at home or not. The bottom line is that if you don’t have any of the symptoms mentioned above, then you’re probably all set to treat the injury at home, at least at first.

For example, if you have minimal swelling and can put weight on your injury, there is not much more an urgent care facility or ER can do for you besides what you can do at home. Use the RICE method to treat less painful injuries at home: Rest, Ice, Compression, and Elevation. Remember that if your pain worsens or does not get better after a few days, it may be time to seek medical attention.

When to Go to an Urgent Care Facility
At the site of a sports injury, you can quickly evaluate whether or not you need to go to an urgent care facility. The bottom line here is whether or not you need a doctor. Once it is established that you do need to see a doctor, the next step is to evaluate whether this need requires an urgent care visit or an ER visit.

Think of an urgent care facility as the less expensive brother to the ER. An urgent care is often equipped with x-ray machines, triage care, and other things you’ll get at the ER for a fraction of the cost. This doesn’t replace your primary care doctor—an urgent care won’t refill your prescriptions, for instance—but if you are bleeding (unless it’s a sensitive area), you’re having unexplained joint pain, or even suspect a concussion, an urgent care is the place to go.

It’s also often more convenient to go to an urgent care facility than a doctor for sports injuries. Sports are often played after hours and on weekends, when primary care doctors are closed.

Should you go to the ER?
Save an ER visit for actual emergencies, when you can tell that the injury is life-threatening. That’s really what an ER is for. Go to an ER for a sports injury when:

  • You think you may be having a heart attack
  • You’re having a hard time breathing
  • Your severe pain is located in the abdomen or halfway down the back
  • You faint
  • You have a sudden and severe headache
  • You have a broken or dislodged bone
  • The injury is to your eye
  • You suddenly get a high fever
  • You vomit uncontrollably
  • You have a seizure without a history of them

As you can see, there are different levels of injuries involved with sports. If you’re ever injured while playing sports, or have a flare-up of a chronic condition that is worse than usual, you need to take a moment and evaluate the situation. Do you need to go home, to an urgent care facility, or to the ER?

1 2