OK y’all Do you have a pet?
When was your pet’s last rabies shot?
If you answered this in 10 seconds or less–then try this one—When was your cholesterol last checked? How about, when was your last pap smear? Have you ever had your thyroid tested? What is your blood type?
If you don’t know–or said, “Well my DOCTOR knows”—-aaarrrggghhh!! TIME TO GET IN CONTROL!! Your doctor’s office is closed at 3 am—and so is your pharmacy–since they know your meds! You come to the ER with a problem, and we just don’t have that Harry Potter crystal ball!
So—I think as physicians, we are very much to blame for this medical apathy—the old “We’ll call you if there is a problem”, instead of, “You need to call us to get results”.
So—let’s change that! You will find that if you know results, and know what screening tests are needed when, you will get more out of your visit with your doctor.
So, I typically recommend you get a marble composition book. You can also do it on-line–or on your smart phone on the notes app-just print it out! Take pictures of lab requisitons, scans, meds, EKGs, and e-mail to yourself then move them to a folder marked HEALTH RECORD.
Get your book and on the first page (Page being front and back of the sheet), write:
address (in pencil–in case you move)
NEXT OF KIN – name, address, phone number
MAJOR HEALTH PROBLEMS–ie diabetes, cancer, lung disease
ALLERGIES–write “NONE” if you have no allergies. Write down what happens–rash, tongue swelling etc.
MEDICATIONS (see back of book)
Family doctor: name, address, phone number
INDEX-–number your pages- and allow room–you don’t have to get it all into the first 6 pages!
HEAD AND NECK-two pages–thyroid can go under here
CHEST– two pages, five pages if you smoke
BREASTS – two pages
HEART--ten pages for blood pressures–in many columns
two pages for cholesterol readings—here are your “normal” levels. Put in columns too:
Good cholesterol is HDL. Bad is LDL
DATE TOTAL CHOLESTEROL GOOD BAD Triglycerides Comments
Diabetics need even LOWER levels for cholesterol!
three pages for other heart issues
STOMACH AND BOWELS—three pages
KIDNEY AND BLADDER —three pages
REPRODUCTIVE (woman stuff)—three pages (one page for pap smears, one page for contraception(birth control), one page for other conditions)
SKIN 1 page
MUSCLES 1 page
JOINTS 1 page
BONES 1 page
IMMUNIZATION RECORD—date, vaccine, lot number
BLOOD WORK (take a picture of your requisitions).
So many come in and say “My doctor didn’t even test my thyroid!” I look on the computer and see that it WAS tested–so, they are running down the doctor because they just don’t know. OR, a patient will say “I had a bunch of blood work”—I’ve googled “Bunch of blood work”—no definition!
MEDS (start at back of book and move towards the front)
PUT IN COLUMNS:
name of drug, dosage, how many times a day, for what reason, color of pill
If a pill is discontinued, put a line through the drug–so you can still see what it was, and write discontinuation date.
Bring a piece of paper with you when you go to the doctor. Write down your concerns and questions, write down what the doctor says. IF YOU DO NOT UNDERSTAND WHAT YOU ARE BEING TOLD—SPEAK UP!!! ASK YOUR DOCTOR TO EXPLAIN AGAIN!! If nothing else, ask your doctor to print something off from the internet that you can read.
Take a picture of your prescription bottle labels!
If you get an EKG done–ask for a copy, or take a picture of it with your phone if you have one, and put it in your file—that is your baseline EKG–so if you have chest pain, the doctor can compare your EKGs
If you have a biopsy , ask for a copy of the path report.
GET RESULTS!!!!! GET RESULTS!!
NO NEWS IS NO NEWS!!!!!
IF SOME TIME GOES BY, AND YOU HAVE NOT HEARD—CALL THE OFFICE!!!
We try many times to reach a patient, leaving messages etc. Voice mail boxes can be full or “not set up yet”, or answering machines erased with power outage!
So—off you go—!! You’ll get the hang of it pretty quickly!
The other cool thing out there are MEDIC ALERT THUMB DRIVES–you don’t have to install a program, and you can put a lot of information on the drive. All ambulances have computers–they can put the drive in and BAM!!—there is your medical history. It is cheaper than an engraved MedicAlert–and you can even scan your EKG and load that onto drive!
NOW–WHAT TESTS ARE RECOMMENDED AT WHAT AGE?
Patients will come in and ask for genetic testing to see if the are at risk for breast cancer etc. There are crietria for testing in NovaScotia–so check out this form from IWK.
If you do not meet criteria but you are so worried about this and want to be tested then the USA is your best bet. It costs THOUSANDS of dollars to be tested in Canada–but for less than a thousand–sometimes less than 200 bucks you can get tested in USA–you can now send saliva across the border.
There are many centres –but LABCORP is the lab I used for over 20 years in the USA. The testing is now so commonplace you can get it done in MANY places. DO MAKE SURE THE LAB IS LEGIT WITH CERTIFICATION.
CLICK here for a very good review of BRCA testing.
IWK-HALIFAX GENETIC SCREENING FORM
Guidelines for Genetic Consultation: Hereditary Cancer Syndromes
The Maritime Hereditary Cancer Service (MHCS), based at the IWK Health Centre, is a multidisciplinary clinic offering assessment, education, counselling, genetic testing, interpretation of test results and screening recommendations for individuals and families with suspected hereditary cancer syndromes.
The following guidelines have been designed to ensure the referral of individuals who will most likely benefit from consultation with the MHCS. These criteria will be reviewed regularly as new data becomes available and may be revised in the future. Genetic counselling and the option of genetic testing will not be offered to all patients referred to the clinic. Only those with a significant likelihood of having a detectable mutation will be offered genetic testing.
Guidelines for referrals for breast / ovarian cancer and colorectal cancer are specified on the reverse side.
Referrals to the MHCS are also appropriate for:
1. Persons from families with a strong history of cancers known to be associated with specific gene mutations for which genetic testing or screening is available (e.g. retinoblastoma, multiple endocrine neoplasia).
2. Individuals with rare types of cancer that have been linked to a particular hereditary syndrome (e.g. medullary thyroid carcinoma, pheochromocytoma).
3. Individuals personally affected with a malignancy presenting with clinical features suggestive of a possible hereditary etiology (e.g. synchronous, or multifocal tumours, tumours at multiple sites, earlier onset of cancer than expected in the general population).
Guidelines for Genetic Consultation: Hereditary Cancer Syndromes
REFERRAL OF AN INDIVIDUAL IS APPROPRIATE IF:
BREAST / OVARIAN Cancer
1. Diagnosed with breast cancer < age 40.
2. Diagnosed with triple negative breast cancer < age 50.
3. Diagnosed with ovarian cancer < age 60.
4. Diagnosed with both breast cancer and ovarian cancer at any age.
5. Diagnosed with bilateral breast cancer with 1st diagnosis < age 50
6. Male breast cancer at any age.
7. Diagnosed with breast cancer < age 50 and a relative on same side of the family with ovarian cancer.
8. Ashkenazi Jewish ancestry with a personal or family history of breast and/or ovarian cancer.
9. French Canadian or Icelandic ancestry with breast cancer diagnosed < age 50.
10. Blood relative of an individual with a confirmed mutation of a cancer-related gene (BRCA1 or BRCA2).
11. Two or more 1st and/or 2nd degree* relatives diagnosed with breast cancer < age 50.
12. Two or more 1st and/or 2nd degree* relatives diagnosed with ovarian cancer at any age.
13. Personal and/or family history of pancreatic cancer.
1. An individual diagnosed with colorectal cancer < age 50.
2. An individual diagnosed with colonic polyp(s) < age 40.
3. An individual with a family history or multiple cases of the following primary cancers (in a single individual or in first or second degree relatives*):
Small Bowel Adenocarcinoma
4. Individuals with colonoscopic evidence of Familial Adenomatous Polyposis (FAP)
5. Individuals with ten or more adenomatous polyps.
6. A blood relative of an individual with a confirmed mutation in a gene associated with Lynch syndrome (Hereditary Non-Polyposis Colon Cancer, HNPCC) or Familial Adenomatous Polyposis (FAP).
1. Individuals diagnosed with an earlier onset of cancer than expected in the general population.
2. Individuals diagnosed with rare types of cancer that have been linked to a particular hereditary syndrome (e.g. thyroid cancer, pheochromocytoma, retinoblastoma).
*1st degree relatives: parents, siblings, and children;
2nd degree relatives: half-siblings, grandparents, grandchildren, uncles, aunts, nephews and nieces.
OK, GIRLS!!! we can multitask–this will be easy!
Any questions–please post in comments, and I can add to this post.