ARTHRITIS INJECTION SERVICES:
Dr Shibuya and Dr Elias are both board certified general internist and rheumatologist, specializing in the care of persons with arthritis, osteoporosis and
auto-immune diseases.  This certification means that they have qualified, after extensive training and testing, to specialize in the care of patients with arthritis
and auto-immune conditions.  Dr Shibuya and Dr Elias works with your primary care physician to understand your other medical problems and provide the best
rheumatologic care for you.

There are many arthritis pills that are useful to help you decrease your pain and improve your physical functioning.  As with all medications, there are certain
risks and benefits to each type of arthritis medication and the doctors will help you find the right medicine for your specific arthritis.  You will find more
information on these types of medications on our
useful links page.

In addition to oral medications, sometimes Dr Shibuya recommends
injection therapy for your arthritis.  There are two types of injections: cortisone
and
visco-supplementation.  Cortisone injections tend to work more quickly, but may not last as long as the visco-supplementation injections.  Although
there are risks with performing a joint injection, Dr Shibuya has extensive training and experience performing these procedures and uses sterile equipment and
local anesthesia each time to greatly reduce any complications and or pain you may experience.
 
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Peripheral DEXA service (no longer available since 2013):
Dr Shibuya is a clinical densitometrist (osteoporosis specialist) who is ISCD (International Society of Clinical Densitometry) certified.  His office is equipped
with a
peripheral DEXA (bone density) machine to screen for osteoporosis which generally has no symptoms until a fracture occurs.  It is a quick and painless
procedure that tells you the strength of your bones and subsequent risk for fracture.  Your bone density test is also performed in conjunction with an
osteoporosis risk factor assessment and patient education on calcium and vitamin D supplementation.  Dr Shibuya will also help you to determine if you need
any additional medications to further lower your risk for fractures.








Nerve Conduction Testing (no longer available since 2013):
Arthritis can sometimes compromise the normal functioning of your nerves, leading to symptoms of numbness, tingling, heaviness and or weakness.  If you
have degenerative arthritis of your neck or low back, the nerves of your arms and or legs may be affected.  If you have rheumatoid arthritis, the swelling of the
wrists can compromise the median nerve at the wrist, resulting in symptoms of carpal tunnel syndrome.  A simple and painless "nerve test" allows Dr Shibuya
to know about the functioning of your nerves.
Fremont Rheumatology is dedicated to state-of-the-art treatment of the >100 types of arthritis, osteoporosis, and auto-immune
diseases. Here are some of the extra services that we provide.
Fremont Rheumatology Infusion Suite also serves as an infusion facility for local dermatologists and
gastroenterologists, who are diseases that can sometimes be associated with arthritis.

The FDA-approved biologics infused at Dr Shibuya’s infusion center include Remicade, Orencia, Rituxan, Actemra,
Simponi ARIA. Dr Shibuya’s infusion center was established in 2006, and has successfully treated hundreds of patients
with
Rheumatoid Arthritis (RA), Psoriatic Psoriatic (PsA), Ankylosing Spondylitis (AS), Inflammatory Bowel Disease:
Crohns's Disease (
Tysabri, Entyvio) and Ulcerative Colitis related arthritis, and more recently, also for Lupus (Benlysta) and
Gout (Krystexxa).

The intravenous infusion of the biologics is given in a comfortable and friendly atmosphere. Our infusion nurses are highly
skilled in IV catheter placement and management of the entire infusion process. Depending upon the biologic prescribed,
infusions are given monthly, every 2 months, or every 6 months. Our office staff will assist with insurance benefit verification
and prior authorization for treatment, if required by the insurance company, to make sure that the infusion medication and
associated services will be covered, or at least affordable to you.  
Dr Shibuya’s infusion center also provides Boniva quarterly (every three months) injections, Prolia (every 6 months),and
yearly
Reclast infusions for the treatment of osteoporosis.  Dr Shibuya’s office serves as an infusion facility for
local primary care physicians, who are commonly faced with osteoporosis patients who are unable to tolerate oral forms of
similar medications used to treat osteoporosis like Fosamax (alendronate), Actonel (residronate) or oral Boniva
(ibandronate), because of stomach upset, severe GERD (Gastro-Esophageal Reflux Disease) or hiatal hernias.  
Self-Injectable Biologics:
IOVERA (Focused
Cold Therapy)
In the USA, the iovera°
treatment is FDA
cleared to block pain
at peripheral nerve
sites. e.g
Knee Pain!
How it works?
IOVERA (Focused Cold
Therapy)  
In the USA, the iovera°
treatment is FDA cleared to block
pain at peripheral nerve sites. e.g
Knee Pain!  How it works?
INJECTION SERVICES
Previously, there were only two types
of injections:
cortisone and
visco-supplementation. Cortisone
injections tend to work more quickly, but may
not last as long as the
visco-supplementation injections.  

Although there are risks with performing a
joint injection, Dr Shibuya & Dr Elias has
extensive training and experience performing
these procedures and uses sterile
equipment and local anesthesia each time
to greatly reduce any complications and or
pain you may experience.
 

More recently, we added IOVERA
cold focus therapy
(2014) and
Traumeel-Zeel injection
(2015)
services
.
INFUSION SERVICES
Shared Medical Appointment (SMA)  New Starting 2016
Oral "Biologics":
Fremont Rheumatology
Arthritis, Osteoporosis, and Auto-Immune Diseases
Barry Shibuya M.D.  and  Christine Elias M.D.
Theralogix® supplies safe, effective, evidence
based nutritional supplements, recommended for use
under the supervision of a treating healthcare provider
Call (800)449-4447 to order
with Provider Referral Code (PRC): 094538