EXPERT
Dr. Douglas Raymond Hilbert, MD
Internist
Dr. Hilbert practices traditional internal medicine with evidence-based medicine and judicious use of medications when appropriate. Dr. Hilbert is a board-certified internal medicine physician as well as a Fellow of the American College of Physicians (FACP). This distinction is reserved for those recognized by their peers to have accomplishments and achievements over and above the practice of medicine. Dr. Hilbert was named in the most recent publication of Top Doctors of San Antonio 2021. This is another colleague-recognized honor.
Dr. Hilbert is very adept at managing complex acute and chronic medical problems, as anyone who knows him, he is passionate about prevention. This is best through healthy eating choices and regular exercise. Dr. Hilbert has had tremendous success in helping his patients become healthy through significant lifestyle changes. We put our patients first. I am looking for a long relationship that is cooperative and collaborative. I truly love what I do I am passionate about the health and well-being of my patients. I always do my best.
"The aim of medicine is to prevent disease and prolong life, the ideal of medicine is to eliminate the need of a physician."
- William J. Mayo
"The doctor of the future will give no medicine but will instruct his patient in the care of the human frame, in diet, and the cause and prevention of disease."
- Thomas A. Edison
"Success is not the key to happiness. Happiness is the key to success. If you love what you are doing, you will be successful."
- Albert Schweitzer
Dr. Hilbert is very adept at managing complex acute and chronic medical problems, as anyone who knows him, he is passionate about prevention. This is best through healthy eating choices and regular exercise. Dr. Hilbert has had tremendous success in helping his patients become healthy through significant lifestyle changes. We put our patients first. I am looking for a long relationship that is cooperative and collaborative. I truly love what I do I am passionate about the health and well-being of my patients. I always do my best.
"The aim of medicine is to prevent disease and prolong life, the ideal of medicine is to eliminate the need of a physician."
- William J. Mayo
"The doctor of the future will give no medicine but will instruct his patient in the care of the human frame, in diet, and the cause and prevention of disease."
- Thomas A. Edison
"Success is not the key to happiness. Happiness is the key to success. If you love what you are doing, you will be successful."
- Albert Schweitzer
22 years
Experience
Dr. Douglas Raymond Hilbert, MD
- San Antonio, TX
- Cleveland Clinic Foundation
- Accepting new patients
Psoriasis: What is it and can it be Cured?
Psoriasis can be defined as a skin condition that affects most, if not all, part of your skin. Symptoms can be skin redness, flaky skin, or even pus-filled sacs. To date, medical...
Take Control of Your Diabetes Now!
Know your “ABCs” of Diabetes If you have diabetes (diabetes mellitus), get control of your "ABCs": "A" stands for "A1C" – A1C is a blood test that shows your average blood sugar...
“The Silent Killer”
Hypertension, what’s that? Hypertension is high blood pressure When you hear that from your physician, it consists of two numbers The top number is the “systolic” which is the...
Depressed? Seems Worse Since Covid, is it just me?
Depression is consistently one of the leading reasons people seek a primary care physician. My clinical experience, and that of many of my colleagues, is that we have seen much...
What is Human Papillomavirus?
What is HPV? HPV is a small, double-stranded DNA virus There are more than 200 types of HPV HPV can infect either cutaneous or mucosal tissues Natural History Most HPV infections...
COVID-19 Omicron Approved Treatments
Treatments for COVID-19 Omicron VariantFDA or EUA approved(Current as of 2/13/2022) Paxlovid(EUA 12/21/21) Paxlovid received Emergency Use Authorization (EUA) in late December...
GoRedForWomen
Heart disease is unfortunately becoming more and more common in the world. Heart disease is now the leading cause of death in both men and women. Risk factors play a major part...
“The worst thing in the world is to try to sleep and not to.” F. Scott Fitzgerald
The negative effects of chronic sleep deprivation are underappreciated. Lack of sleep has negative physiological effects by raising insulin and cortisol levels. The raised levels...
Can I get COVID vaccine if I am pregnant?
yes absolutely! Your baby's health is most tightly linked to your health. If you become seriously ill while pregnant this puts your child at great risk. It is safe and effective READ MORE
yes absolutely! Your baby's health is most tightly linked to your health. If you become seriously ill while pregnant this puts your child at great risk. It is safe and effective protects you both from serious complications that are completely unavoidable.
Do I need to take folic acid before getting pregnant?
Yes, this helps prevents neural tube defects which can be devastating to the developing child.
What vitamins can help you get pregnant?
First, always consult your ob/GYN physician. Most recommend a pre-natal vitamin nothing more. This ensures when pregnancy occurs your baby has the proper nutrients to be healthy. READ MORE
First, always consult your ob/GYN physician. Most recommend a pre-natal vitamin nothing more. This ensures when pregnancy occurs your baby has the proper nutrients to be healthy. Also helps protect mothers from nutrient deficiencies. I would not take any other herbal supplement or vitamin unless told specifically by your physician. An example is the common over-the-counter medication claritin and other similar anti-histamine allergy medicines thin the cervical mucus and makes pregnancy more difficult.
How accurate is a CT scan for fatty liver?
It has its role. Most physicians start with ultrasound less invasive no radiation exposure. Then if needed a more detailed examination with MRI or fibroscan.
Trouble urinating - med side effects or not?
Medication side effects are always possible. I would want to rule out other urologic-related conditions. PSA or prostrate at your age is unlikely to be an issue. Recommend you READ MORE
Medication side effects are always possible. I would want to rule out other urologic-related conditions. PSA or prostrate at your age is unlikely to be an issue. Recommend you see a urologist to rule out a urethral stricture or another congenital type of obstructing the process. If you have had symptoms for 10 years unlikely to be anything serious. Good luck!
Do we have to do endoscopy?
Yes, 100%. The presumption given his cirrhosis is that he has esophageal varices. Abnormal veins in the lower part of the tube running from the throat to the stomach. Esophageal READ MORE
Yes, 100%. The presumption given his cirrhosis is that he has esophageal varices. Abnormal veins in the lower part of the tube running from the throat to the stomach. Esophageal varices usually develop when blood flow to the liver is blocked. They often occur in people with advanced liver disease. When you identify them depending on the size you “band” then and or use specific medications to help decrease the pressure in the system. Also, you want to identify other sources of blood loss such as gastric or duodenal uclers...
AST and ALT Test?
First some context. The lab ranges are determined by your local lab that samples the community to determine what is "normal". However, where I live in San Antonio the population READ MORE
First some context. The lab ranges are determined by your local lab that samples the community to determine what is "normal". However, where I live in San Antonio the population is disproportionally obese and diabetic, which creates a normal range that does not actually represent what is considered healthy. For most men both AST and ALT should be <30. For most women these values should be less than 20. Assuming no symptoms, the most prudent thing would be to repeat testing and see if is transient or persistent. If repeat testing continues to show elevation, then further testing could be considered. When AST/ALT ratio is >/= 2 that is very consistent with alcohol use regardless of magnitude. i.e., 20/10 vs 400/200. If you drink at all need to take a hard look at that and really be clear with your physician how much you are drinking. Best to be very exacting.
How to make sure I don't catch a bacterial infection along with covid?
Taking antibiotics prior to having bacterial infection will not decrease the risk of future bacterial infection in any meaningful way and is not recommended. Luckily, bacterial READ MORE
Taking antibiotics prior to having bacterial infection will not decrease the risk of future bacterial infection in any meaningful way and is not recommended. Luckily, bacterial superinfection is uncommon with prior forms of Covid and especially Omicron. By taking antibiotics you have little chance of benefit and are risking the side effects of the antibiotics which can be significant, in addition to risk causing a future resistant infection if you do actually develop a secondary bacterial infection. If you develop chest pain, shortness of breath, it's best to go to the ER, urgent care. Otherwise, wait it out and supportive care ie Tylenol, Motrin, and fluids.
What are precautions to be taken by relatives tending to ICU patients ?
This is a difficult time obviously. I would follow the guidance of ICU nurses firstly. Some precautions are specific to the condition, requires masks, gloves, gown. Wash hands READ MORE
This is a difficult time obviously. I would follow the guidance of ICU nurses firstly. Some precautions are specific to the condition, requires masks, gloves, gown. Wash hands with soap thoroughly whenever using the restroom. If you are ill make sure you have a negative Covid test prior to returning and have been afebrile regardless to ensure you do not pass on any illness to your mother. Most importantly is that you are there providing love and support. Also, important that you are sleeping and eating right. I often tell patients this is a marathon, not a sprint. If you wear yourself out it diminishes your ability to take care of your mom, let alone is negative for your health.
My wife has abdominal pain and vomiting?
You should be seen by a physician ASAP, she needs to be examined if symptoms are still ongoing.
Blood work results?
I see the t4 value, which is low, but not the actual TSH. Given fsh lh both low, if tYSH is also low, then looks like panhypopituitary. Most important thing not checked is your READ MORE
I see the t4 value, which is low, but not the actual TSH. Given fsh lh both low, if tYSH is also low, then looks like panhypopituitary. Most important thing not checked is your adrenal function. You need to see an endocrinologist. The fsh lh should be telling your ovaries to make estrogen. TSH tells thyroid gland to make thyroid hormone. The pituitary is the control center for most of your hormones.
Should I visit urgent care if I have COVID infection?
If you meet criteria for treatment with Monoclonal antibody infusion or Paxlovid. Otherwise, your symptoms should guide you, such as chest pain, shortness of breath, dehydration. READ MORE
If you meet criteria for treatment with Monoclonal antibody infusion or Paxlovid. Otherwise, your symptoms should guide you, such as chest pain, shortness of breath, dehydration. Best to call your pcp to help keep ER and urgent care from being overwhelmed. For milder symptoms, they can also determine eligibility for specific treatments as mentioned above.
At what heart rate should you go to the hospital?
At rest doing nothing? If yes absolutely!
My aunt sleeps all day?
You need to get her to her PCP. Most likely severe depression. “When your parent dies, you lose your mortality. When your child dies, you lose your immortality.” That loss is READ MORE
You need to get her to her PCP. Most likely severe depression. “When your parent dies, you lose your mortality. When your child dies, you lose your immortality.” That loss is profound. Also need to have PCP rule out possibility of underlying medical condition contributing to her current state.
My friend has scurvy with .1 vitamin C blood levels?
Wow, not seen commonly. I have seen one time in my career. In general, not specific to this case recommend take both vitamin C and iron supplement. If he is deficient in vitamin READ MORE
Wow, not seen commonly. I have seen one time in my career. In general, not specific to this case recommend take both vitamin C and iron supplement. If he is deficient in vitamin C, very likely has deficiency in other vitamins. Would also take a multivitamin and separate thiamine supplement. I would see a gastroenterologist because he could have a malabsorption problem. Very important to have a well-balanced diet of fruits, vegetables, whole grains, legumes. If this is part of anyone’s diet, these types of deficiencies are virtually unheard of. Vitamin C should be checked in fasting state, most accurate way to test is RBC level of vitamin C, which is very hard to arrange primarily in research centers.
Good luck!
Good luck!
Annual flu shot?
Absolutely get both vaccines booster and high dose flu shot. Both vaccines are very effective at reducing risk of hospitalization and death!!
I am having headaches?
If you have never had this type of headache before then you should see your primary care physician for further evaluation.
COVID question?
You should continue to get better. If you have been vaccinated and are improving 7 days out, I would spend no time worrying about it.
Ativan and alcohol?
No! Ativan is a controlled substance partially for this reason. Directly contraindicated to use with alcohol. This combination can be very dangerous
Covid vaccine question?
Key is get something. I would stick with Moderna however if that is a deal breaker get J&J. Both greatly reduce risk from death and hospitalization
