Clinic Services

Clinic Services at Attune Health

At Attune Health, we are dedicated to providing comprehensive and personalized medical care to our patients. Our facility offers a range of services, including consultations, follow-up visits, and advanced in-house laboratory testing. Our commitment to innovation and excellence is evident in every aspect of our patient care.


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In-House Labs

Attune Health is equipped with a state-of-the-art, CLIA-certified laboratory, allowing us to provide real-time results to our patients. Our web portal makes it easy for patients to access and review their lab results, providing them with convenient and secure access to their health information. Sign up for the CS link portal by clicking here.

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Infusion Therapy

Our Infusion Clinic offers a comfortable and safe environment for infusion therapy, where patients can receive intravenous and injectable medications for various conditions, including RA, lupus, osteoporosis, and more. Our highly trained registered nurses our medical providers ensure the highest level of care and comfort for our patients during their infusion therapy. If you’re interested in receiving your infusion care to Attune Health, please have your physician complete this infusion referral form or please send an inquiry to our office.

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Therapeutic Injections and Ultrasound-Guided Procedures

With state-of-the-art technology and equipment, our highly trained and skilled healthcare professionals perform ultrasound scans to accurately diagnose and monitor the progression of various rheumatologic conditions. Our diagnostic ultrasound services provide a non-invasive method of assessing joint inflammation and soft tissue damage, enabling us to provide an accurate diagnosis and individualized treatment plan for our patients.


In addition to diagnostic ultrasound, we also offer therapeutic injections to alleviate joint and soft tissue pain and improve function. The new technique of ultrasound guided synovial biopsies allows for a safe and effective way to evaluate cellular inflammation in patients with inflammation and improves our precision diagnostic capabilities. Our expert providers, led by Dr. Ami-Ben Artzi, have extensive experience in the latest injection techniques and are dedicated to ensuring that our patients receive the highest level of care.


Whether it's for joint injections or ultrasound-guided procedures, our patients can expect a comfortable, safe and personalized experience at Attune Health. Our team works closely with each patient to develop a tailored treatment plan that aligns with their unique needs and goals. Contact us today to learn more about how we can help improve your quality of life.

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EMG/NCS and Other Neurodiagnostic Services

At Attune Health, our team led by Dr. Mahajan, offers the latest in neuro-electrodiagnostic testing. We utilize state-of-the-art equipment to perform diagnostic nerve conduction studies (NCS) and electromyography (EMG) to assess a wide range of neurological disorders, including nerve compressions, radiculopathies, diabetic neuropathies, myopathies, ALS, and muscular dystrophies.


Dr. Mahajan is not only highly skilled in performing muscle biopsies, but is also Board Certified in interpreting nerve and muscle histopathology. This allows her to integrate pathology with the clinical management of neuromuscular diseases and provide a comprehensive approach to the evaluation and treatment of patients.


In addition to muscle biopsies, Dr. Mahajan also performs skin punch biopsies, a highly sensitive and specific test used to evaluate small-fiber neuropathy. This procedure, performed with a local anesthetic, is used to diagnose conditions such as diabetes and rheumatological diseases like Sjogren's syndrome and lupus.


As one of the few neuromuscular physicians with both electrodiagnostic and histopathological qualifications, Dr. Mahajan is able to offer a unique and comprehensive approach to the evaluation and treatment of autoimmune neuromuscular diseases, including those related to rheumatological conditions.

  • NCS and EMG: Procedure Information

    Nerve Conduction Studies (NCS) and Needle Electromyography (EMG) are procedures performed to assess and diagnose the structural and functional integrity of the peripheral nervous system, including the peripheral nerves and muscles. These procedures are needed to assess a variety of neurological disorders including nerve compressions, radiculopathies, diabetic neuropathies, myopathies, ALS, and muscular dystrophies.



    PATIENT INSTRUCTIONS FOR THE PROCEDURE


    1.) No fasting or sedation is required prior to the procedure.

    2.) Dress in loose fitting clothes that permit access to the area to be tested or that are easily removed. Wear comfortable shoes that are easily removable.

    3.) Please do not apply any moisturizers or lotion on your body on the days leading up to the test.

    4.) Based on your medical condition, your physician may request other specific preparations.

    5.) Notify your physician of all medications (prescribed and over-the-counter) and herbal supplements that you are taking.



    MEDICATIONS TO AVOID PRIOR TO PROCEDURE


    It is recommended to stop taking blood thinners prior to the EMG. Please always consult with your physician before stopping any medications* and notify our office if your physician advises you not to stop taking any blood thinning medications. Please refer to the list below to see when you should stop taking them prior to your electrodiagnostic test.


    LIST OF BLOOD THINNERS (ANTICOAGULANTS)


    1 Day (24 Hours) Prior:

    1. Fragmin (Dalteparin)

    2. Heparin

    3. Lovenox (Enoxaparin)


    3-4 Days Prior:

    1. Eliquis (Apixaban)

    2. Aspirin (81 mg “Baby Aspirin”)

    3. Aleve/Advil


    5 Days Prior:

    1. Aspirin & Aspirin containing products

    2. Coumadin (Warfarin)

    3. Arixtra (Fondaparinux)

    4. Plavix (Clopidogrel)

    5. Ticlid (Ticlopidine HCl)

    6. Effient (Prasugrel)

    7. Xalreto (Rivaroxaban)


    14 Days Prior:

    1. Aggrenox (Aspirin/Dipyridmaole)

    2. Refludan (Lepirudin)

    3. Angiomax (Bivalirudin)


    *For IV Medications, consult with referring doctor.



    DESCRIPTION OF THE PROCEDURE


    1.) You will be given a gown to wear and asked to remove any clothing, jewelry, hairpins, eyeglasses, hearing aids, or other metal objects that may interfere with the procedure.

    2.) You will be asked to sit down or lie down for the test.


    NERVE CONDUCTION STUDY (NCS)


    1.) A recording electrode will be attached to the skin over the nerve with a special paste and a stimulating electrode will be placed at a known distance away from the stimulating electrode.

    2.) The nerve will be stimulated by a mild and brief electrical shock given through the stimulating electrode.

    3.) You may experience minor discomfort for a few seconds.

    4.) The response of the nerve will be displayed and recorded on a monitor.A recording electrode will be attached to the skin over the nerve with a special paste and a stimulating electrode will be placed at a known distance away from the recording electrode.


    ELECTROMYOGRAM (EMG)


    1.) A needle electrode that is attached by wires to a recording machine is inserted into a muscle.

    2.) When the electrodes are in place, the electrical activity in that muscle is recorded while the muscle is at rest.

    3.) Then the physician will ask you tighten (contract) the muscle slowly and steadily. The electrical activity is recorded.

    4.) The electrode can be moved a number of timers to record the activity in different areas of the muscle or in different muscles.



    AFTER THE PROCEDURE


    The skin electrodes will be removed from your skin. The areas of the skin where a needle was inserted will be cleaned. After the test, you may return to your previous activities, unless your physician advises you differently. Your physician may give you additional or alternate instructions after the procedure, depending on your particular medical situation.



    RISKS OF THE PROCEDURE


    The voltage of the electrical pulses used during NCS is considered very low. There may be risks depending on your specific medical condition. Be sure to discuss any concerns with your physician prior to the procedure. Tell your physician if you have a cardiac defibrillator or pacemaker, as precautions may need to be taken.

  • Muscle Biopsy: Procedure Information

    Information coming soon.

  • Skin Punch Biopsy: Procedure Information

    A skin punch biopsy procedure is performed to evaluate diseases such as small fiber neuropathy. This is a simple procedure in which a small circular piece of skin (about 2-3 mm in diameter) is taken from the surface of the skin. The punch biopsies are usually taken from three sites, typically in the lower limb. Your physician will determine the three sites. The entire procedure is performed in the office and takes only a few minutes. 


    PROCEDURE


    The biopsy areas are first cleaned, usually with alcohol and betadine, and then a local anesthetic such as lidocaine is injected with a very fine needle to numb the area. The patient will feel a slight pinch of the needle and then a brief burning sensation as the anesthetic is injected. Once the skin is anesthetized, with the help of a circular punch needle, a small punch biopsy is made into the skin, about 2-3mm in diameter and about 3mm deep. Three of these biopsies are obtained and sent to specialized dermatopathology labs for processing. No sutures are needed. The biopsy sites heal by scabbing over.


    POST-OPERATIVE CARE


    After your skin biopsy, keep the biopsy site covered with a Band-Aid. You can apply an over the counter antibiotic ointment, such as Neosporin. This will help healing and minimize scarring. A small rim of redness will likely occur at the edge of the biopsy but if you see excessive redness, fever, chills, pus, or significant pain, it may signify infection, in which case, please contact your physician. Most biopsy sites heal within 1-2 weeks.

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Nutrition and Wellness

At Attune Health, we believe that optimal health and wellness starts with the right nutrition. That's why our team of highly trained physicians and nutritionists work together to create individualized nutrition programs for our patients. By using the latest functional testing methods, we can get to the root cause of any health conditions and identify any nutritional deficiencies that may be contributing to chronic conditions.


Our functional medicine approach involves collecting a detailed medical history and utilizing specialized tests such as genetic testing, comprehensive stool analysis, adrenal stress profile testing, metabolic, amino acid, and oxidative stress analysis. These tests help us assess various aspects of a patient's health, including malabsorption and gut dysbiosis, cellular energy and mitochondrial metabolism, neurotransmitter metabolism, vitamin deficiencies, and toxin exposure and detoxification status.


Based on the results of these tests, our nutritionists make targeted recommendations for our patients. They work closely with each patient to create a personalized nutrition program that meets their unique needs and helps them achieve their health and wellness goals.


At Attune Health, we believe in the power of nutrition to heal and transform lives. That's why we are always striving to improve our knowledge and understanding of how best to incorporate nutrition into our care paradigm for patients. By monitoring our patients' progress and conducting research studies, we are constantly learning and refining our approach to help our patients achieve optimal health and wellness.

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Research-Based Clinical Programs

Research is a central part of our mission. We are grateful to our patients who participate in our research programs. With our extensive clinical experience in autoimmune diseases, our main research focus is to understand the causes and clinical manifestations of autoimmune diseases and to develop therapeutic approaches. Our physicians and research staff work with leading faculty locally and globally to further our knowledge and understanding of autoimmune diseases and arthritis. Our research is focused on advancing therapeutic options for patients with arthritis and autoimmune disease. Having access to research programs differentiates Attune Health’s clinical offerings and allows us to offer our patients advanced diagnostic and therapeutic options. Some of our programs include the following:

  • Undiagnosed Arthritis Program

    A significant portion of patients who have inflammatory arthritis do not have a definitive diagnosis for the cause of their arthritis. Several possibilities such as crystal-induced arthritis, rheumatoid arthritis, other autoimmune inflammatory arthritis, viral and other infectious arthritis and low-grade cancers need to be considered in such cases. Our research program offers detailed histories, cutting edge laboratory testing, synovial biopsy with advanced synovial tissue analyses. Our expert physicians and researchers are committed to advancing knowledge in this field. Click here for more information on the Undiagnosed Arthritis Synovial Biopsy Project.

  • Inflammatory Muscle Disease (Myositis) Program

    Myositis is an autoimmune disease that causes severe muscle weakness. An accurate diagnosis of the type of myositis can help direct the management of myositis. Our clinical and research programs in myositis include detailed histories and advanced neurodiagnostic testing, including muscle biopsies and research level immune and cytokine testing.

  • Sjogren’s Program

    Sjogren’s syndrome is an autoimmune condition which primarily causes dysfunction of glandular secretions. Other organ systems can also be targeted. Along with our collaborators, we collect and analyze tissue and serum samples in patients with Sjogren’s syndrome. As future biologics become available for Sjogren’s syndrome, we plan to offer clinical trials in Sjogren’s syndrome to our patients.

  • SLE Research Program

    Our practice has one of the largest cohort of patients with SLE in the United States. We are involved in cutting-edge research in the field of SLE, including biobanking, long-term outcomes research and multiple clinical trials of biologic therapies. We are the recipient of numerous grants to study SLE, including NIH and DOD.

  • Rheumatoid Arthritis Program

    We are involved in multiple clinical trials of biologics for rheumatoid arthritis. Additionally, we offer patients consultations in our undiagnosed arthritis program.

  • Osteoporosis Program

    The clinic is primarily run by our physician’s assistant, Bryant Uy, who conducts the initial evaluation with support from our expert rheumatologist, Dr. Swamy Venuturupalli, MD.  We are currently accepting patients for comprehensive evaluations and infusion services.

  • Therapeutic Injection Program

    Patients with arthritis can get relief from various injection therapies such as corticosteroid injections, hyaluronic acid injections and newer therapies such as PRP.

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