Thanksgiving Is National Family History Day

 

Note: This post is essentially an updated version of last year’s National Family History Day blog entry.

 

# 8006

 

 

Every year since 2004 the Surgeon General of the United States has declared Thanksgiving – a day when families traditionally gather together - as National Family History Day.

 

As a former paramedic, I am keenly aware of how important it is for everyone to know their personal and family medical history.  Every day emergency room doctors are faced with patients unable to remember or relay their health history during a medical crisis. And that can delay both diagnosis and treatment.

 

Which is why I keep a medical history form – filled out and frequently updated – in my wallet, and have urged (and have helped) my family members to do the same.

 

The CDC and the HHS have a couple of web pages devoted to collecting your family history, including a web-based tool to help you collect, display, and print out your family’s health history.

 

Family History: Collect Information for Your Child's Health

Surgeon General's Family Health History Initiative

 

Using this online tool, in a matter of only a few minutes, you can create a basic family medical history.  But before you can do this, you’ll need to discuss each family member’s medial history. The HHS has some advice on how to prepare for that talk:

 

Before You Start Your Family Health History

Americans know that family history is important to health. A recent survey found that 96 percent of Americans believe that knowing their family history is important. Yet, the same survey found that only one-third of Americans have ever tried to gather and write down their family's health history.

Here are some tips to help you being to gather information:

• Before You Start (English) (PDF - 557 KB)
• Before You Start (Spanish) (PDF - 214 KB)

I’ve highlighted several other methods of creating histories in the past, some of which you may prefer.  A few excerpts (and links) from these essays.First, I’ll show you how I create and maintain histories for my Dad (who passed away last year) and myself.  This was featured in an essay called A History Lesson.

 

Today I’m going to impart a little secret that will ingratiate yourself with your doctor and not only improve the care you receive, but also reduce the amount of time you spend in the exam room. When you go to your doctor, have a brief written history printed out for him or her.

I’ve created a sample based on the one I used for my Dad (the details have been changed).   It gets updated, and goes with him, for every doctor’s visit.

And his doctors love it.

While every history will be different, there are a few `rules’.

• First, keep it to 1 page.     Even if the patient has an `extensive history’.   If your doctor can’t scan this history, and glean the highlights, in 60 seconds or less . . . it isn’t of much use.
• Second, paint with broad strokes.   Don’t get bogged down in details.  Lab tests and such should already be in your chart.
• Third, always fill in a reason for your visit.   Keep it short, your doctor will probably have 10 to 15 minutes to spend with you.   Have your questions and concerns down in writing before you get there.
• Fourth, list all Meds  (Rx and otherwise) and indicate which ones you need a refill on.   If you have a question about a med, put a `?’ next to it.   And if you have any drug allergies, Highlight them.
• Fifth,  Make two copies!   One for your doctor to keep, and one for you.  As you talk to your doctor, make notes on the bottom (bring a pen) of your copy.  

Once you create the basic template (using any word processor), it becomes a 5 minute job to update and print two copies out for a doctor’s visit.

The history above is great for scheduled doctor’s visits, but you also should have a readily available (preferably carried in your wallet or purse), EMERGENCY Medical History Card.

 

I addressed that issue in a blog called Those Who Forget Their History . . . .   A few excerpts (but follow the link to read the whole thing):

 

Since you can’t always know, in advance, when you might need medical care it is important to carry with you some kind of medical history at all times.  It can tell doctors important information about your history, medications, and allergies when you can’t.

Many hospitals and pharmacies provide – either free, or for a very nominal sum – folding wallet medical history forms with a plastic sleeve to protect them. Alternatively, there are templates available online.

I’ve scanned the one offered by one of our local hospitals below. It is rudimentary, but covers the basics.

And a couple of other items, while not exactly a medical history, may merit discussion in your family as it has recently in mine.

 

• First, all adults should consider having a Living Will that specifies what types of medical treatment you desire should you become incapacitated.
• You may also wish to consider assigning someone as your Health Care Proxy, who can make decisions regarding your treatment should you be unable to do so for yourself.
• Elderly family members with chronic health problems, or those with terminal illnesses, may even desire a home DNR (Do Not Resuscitate) Order.

 

Verbal instructions by family members – even if the patient is in the last stages of an incurable illness – are likely to be ignored by emergency personnel.

 

In Florida, the form must be printed on yellow paper. Different states have different requirements.  You should check with your doctor, or the local department of health to determine what the law is in your location.

 

My father, who’s health declined greatly in his 86th year, requested a DNR in early 2011. That – along with securing home hospice care (see His Bags Are Packed, He’s Ready To Go) – allowed him to die peacefully at home in his own bed. 

 

Admittedly, not the cheeriest topic of conversation in the world, but for a lot of people, this is an important issue to address.

 

A few minutes spent this holiday weekend putting together medical histories could spare you and your family a great deal of anguish down the road.

NPM13: Those Who Forget Their History . . .

 

 

Note: This is day 5 of National Preparedness Month.  Follow this year’s campaign on Twitter by searching for the #NPM or #NPM13 hash tag.

This month, as part of NPM13, I’ll be rerunning some updated preparedness essays (like this one) , along with some new ones.

 

# 7632

. . . .  are condemned to wait longer in triage.

 

Not where you thought I was going, is it?  But this is an important aspect of personal preparedness.

 

Knowing, and having immediately available, a  medical history on every member of your family should be part of everyone’s emergency plan.

As a former paramedic - one who has struggled to take thousands of medical histories in the back of a moving vehicle, or at the scene of a medical emergency -  I know how difficult getting an accurate and complete medical history can be.

 

As you might imagine, when someone is unconscious, or unable to respond to questions, getting a medical history becomes more problematic.

 

You have to rely on relatives, friends, neighbors . . .and sometimes even snooping in their medicine cabinet.

 

Often, people don’t even know what medicines they are taking, or why.

 

If I had a nickel for every time a patient denied taking meds, but under the pressure of additional questioning, admitted to taking `a red one, a blue one and two white ones in the morning . .  and 3 white ones at night’ -  well, I’d have a lot of nickels.

 

Since I act as a medical advocate for several relatives, I maintain a pretty elaborate medical history on each of them.   When one of them falls ill, a copy goes with them to the doctor or the emergency room.

 

I never see my doctor without bringing him an updated history.  Sure, he knows me.  But he sees hundreds of patients, and me only every few months.  There is no way he can remember the details of my medical history.

So I provide him with a short, 1 page synopsis that he can scan in about 30 seconds, to make his life, and mine, easier (see A History Lesson to learn how).

 

Since you can’t always know, in advance, when you might need medical care it is important to carry with you some kind of medical history at all times.  It can tell doctors important information about your history, medications, and allergies when you can’t.

 

Many hospitals and pharmacies provide – either free, or for a very nominal sum – folding wallet medical history forms with a plastic sleeve to protect them.

 

I’ve scanned the one offered by one of our local hospitals below. It is rudimentary, but covers the basics.

 

In a medical emergency, minutes can make the difference between life and death.  And even in less urgent cases, having all of this information can go a long ways towards speeding your treatment.

 

You should make it a point, this week, to get medical history forms for every member of your family – regardless of their age – and fill them out.

 

Except for small children, everyone should find a way to carry it with them at all times.

 

This is not a one-time, make it and forget, prep.  You need to update it every time you add or change your medications, or your medical history changes.    It only takes a few minutes now.

 

But it could save a lot of time later.

 

 

 

Note: I’m still away from my desk, and so my blogging schedule will be light until I return on Sunday.  I would invite you to visit Crofsblog, Virology Down Under, and FluTrackers for the latest infection disease news.

NPM12: Those Who Forget Their History . . .

 

Note: This is day 24 of National Preparedness Month.  Follow this year’s campaign on Twitter by searching for the #NPM or #NPM12 hash tag.

 

This month, as part of NPM12, I’ll be rerunning some updated  preparedness essays (like this one) , along with some new ones.

 

 

# 6577

 

 

. . . .  are condemned to wait longer in triage.

 

Not where you thought I was going, is it?  But this is an important aspect of personal preparedness.

 

Knowing, and having immediately available, a  medical history on every member of your family should be part of everyone’s emergency plan.

As a former paramedic - one who has struggled to take thousands of medical histories in the back of a moving vehicle, or at the scene of a medical emergency -  I know how difficult getting an accurate and complete medical history can be.

 

As you might imagine, when someone is unconscious, or unable to respond to questions, getting a medical history becomes more problematic.

 

You have to rely on relatives, friends, neighbors . . .and sometimes even snooping in their medicine cabinet.

 

Often, people don’t even know what medicines they are taking, or why.

 

If I had a nickel for every time a patient denied taking meds, but under the pressure of additional questioning, admitted to taking `a red one, a blue one and two white ones in the morning . .  and 3 white ones at night’ -  well, I’d have a lot of nickels.

 

Since I act as a medical advocate for several relatives, I maintain a pretty elaborate medical history on each of them.   When one of them falls ill, a copy goes with them to the doctor or the emergency room.

 

I never see my doctor without bringing him an updated history.  Sure, he knows me.  But he sees hundreds of patients, and me only every few months.  There is no way he can remember the details of my medical history.

 

So I provide him with a short, 1 page synopsis that he can scan in about 30 seconds, to make his life, and mine, easier (see A History Lesson to learn how).

 

Since you can’t always know, in advance, when you might need medical care it is important to carry with you some kind of medical history at all times.  It can tell doctors important information about your history, medications, and allergies when you can’t.

 

Many hospitals and pharmacies provide – either free, or for a very nominal sum – folding wallet medical history forms with a plastic sleeve to protect them.

 

I’ve scanned the one offered by one of our local hospitals below. It is rudimentary, but covers the basics.

 

 

In a medical emergency, minutes can make the difference between life and death.  And even in less urgent cases, having all of this information can go a long ways towards speeding your treatment.

 

You should make it a point, this week, to get medical history forms for every member of your family – regardless of their age – and fill them out.

 

Except for small children, everyone should find a way to carry it with them at all times.

 

This is not a one-time, make it and forget, prep.  You need to update it every time you add or change your medications, or your medical history changes.    It only takes a few minutes now.

 

But it could save a lot of time later.

Getting Your Family’s Affairs In Order

 

# 6017

 

 

Last January I wrote of my elderly father’s brush with pneumonia last Christmas, and the steps we had taken in advance to make sure his wishes were respected regarding his treatment.

 

I’m happy to say, he survived that bout, and is still with us, having recently celebrated his 87th birthday.

 

This week, another family member living in another state – also in her mid-80s – underwent major lung surgery, and her recovery is apparently not going well.

 

While her children believe she would not want heroic measures taken at this point (i.e. life support), she is  - at least for now - unable to make her wishes known, and they are without legal guidance.

 

Her children are now scrambling to see if they can find a living will, or if she had assigned a health proxy (things she should have done pre-surgery), all the while being faced with making increasingly difficult medical decisions.

 

I don’t know how this medical drama is going to turn out, but I do know that this angst ridden family vignette is replayed in hundreds of hospital waiting rooms every day in this country.

 

Frankly, this is a conversation – and a legal matter – that everyone needs to deal with before they end up in a hospital, or on an operating table.

 

While perhaps not the happiest of yuletide conversations - this is the time of year when many families get together - and that makes it a perfect time to get your family’s affairs in order. 

 

That means updated family and medical histories on everyone (see A Family Affair), and putting together the legal documents to ensure your wishes are respected should you be unable to direct the course of your own care.

 

With that in mind, below you’ll find a reprint of a blog from last January, on living wills, health care proxies, and DNR orders.

 

 

On Having `The Conversation’

(First printed 01/03/11)

 

I don’t generally put personal anecdotes in my blog because . . . well,   I’m really not all that interesting.   But today, an exception.

 

My father, who turned 86 last November and now lives with my sister in another town, contracted a serious respiratory infection over the Christmas holidays. By late last week he was in pretty rough shape with wheezing, shortness of breath, weakness, and violent coughing.

 

My sister took him to his doctor, who fearing Dad had pneumonia, wanted to hospitalize him.

 

Dad refused.  Adamantly.

 

All Dad really wanted was to go back to his own bed. If something `bad’ happened, he said, so be it.  Better at home than in some strange hospital.

 

His doctor, after several futile attempts to talk him into going to the hospital, gave up.  She wrote him an Rx for Zithromax, and let him go home with the promise that if he got worse over the weekend, he’d go to the emergency room.

 

Dad muttered a diplomatic, but completely non-binding,  “We’ll see.”

 

I am pleased to tell you that the worst did not happen, and Dad is doing much better after 5 days at home on an antibiotic.

 

But, as Dad is quick to remind people, when you are 86 years of age – and have the kinds of health problems he has - you really shouldn’t be buying any green bananas.

 

Dad has serious (and inoperable) coronary and carotid artery issues, has had several serious bouts with cancer, lives with chronic back & hip pain, and his quality of life is continually declining.

 

Dad believes he is approaching the end of a long road, and feels no need to take extraordinary steps to prolong that journey beyond whatever nature intends.  He’s made that abundantly clear to his kids, his doctors, and to anyone else who will listen.

 

Which is why Dad, my sister and I have had `the conversation’.

 

We’ve discussed, in detail, exactly what Dad would want us to do if he were unable to make medical decisions for himself.

 

In fact, a few months ago Dad asked if I would get for him a legally binding Do Not Resuscitate (DNR) order, so that if something happened to him, and an ambulance were called, no heroics would be performed.

 

Verbal instructions by family members – even if the patient is in the last stages of an incurable illness – are likely to be ignored by emergency personnel.

 

Dad now proudly has the bright yellow DNR order posted over his bed, and carries another credit-card sized one in his wallet.

 

In Florida, the form must be printed on yellow paper. Different states have different requirements.  You should check with your doctor, or the local department of health to determine what the law is in your location. 

My twin brother and I, both former paramedics (hey, it was a hereditary defect), and my sister fully support Dad’s decision to have a DNR.

 

We’ve also had (for many years) a living will and a Health Care Proxy drawn up for Dad, so either my sister or I can make decisions regarding Dad’s health care should he no longer be able to.

 

As an aside, I’ve had a living will and an assigned Health Care Proxy in place for decades, to ensure that my wishes would be respected if I were suddenly unable direct my medical care.

 

Frankly, I consider them absolutely essential for all adults to have.

 

These are difficult subjects for many people to discuss, and so far too often, they get put aside until it is too late.  But better to talk about it now, and to have the proper papers in place, than to face a family medical crisis unprepared.

 

As a former medic, I’ve seen the anguish that relatives have suffered trying to make a life or death decision without input from the patient.

 

And I’ve also seen what happens when family members argue over what should be done about a loved one on life support. These are deeply emotional issues, and can create life-long rifts in the fabric of families.

 

While nothing can eliminate the emotional trauma that comes with a medical crisis, making rational decisions now – and making them known and binding – can greatly reduce the strain later.

 

Take my advice.  Whether you want heroic measures taken, or not.

 

Make your wishes known.

 

Have the conversation.

A Family Affair

 

 

 

Note: the following essay is a slightly edited repost of a blog I posted a year ago called Thanksgiving Is Family History Day.

During a medical emergency, having an accurate and current medical history available can be lifesaving. And making your wishes known about the types of medical treatment you would desire if you should become unable to direct your own care can save you, and your loved ones much anguish later.

 

 

# 5972

 

 

As a former paramedic, I am keenly aware of how important it is for everyone to know their personal and family medical history.

 

And as a son whose father turns 87 tomorrow, I’ve been charged with creating and maintaining my Dad’s medical history for a number of years.

 

And of course,  I also maintain one on myself.

 

Every Thanksgiving since 2004 the Surgeon General has declared Thanksgiving as National Family History Day. Over the holiday weekend - while you are visiting with family - is an ideal time to ask about and share family medical histories.

 

The CDC and the HHS have a couple of web pages devoted to collecting your family history, including a web-based tool to help you collect, display, and print out your family’s health history.

 

Family History: Collect Information for Your Child's Health

Surgeon General's Family Health History Initiative

 

Using this online tool, in a matter of only a few minutes, you can create a basic family medical history.

 

I’ve highlighted several other methods of creating histories in the past, which you  may prefer.  A few excerpts (and links) from these essays.

 

First, I’ll show you how I create and maintain histories for my Dad and I.   This was featured in an essay called A History Lesson.

 

Today, though, I’m going to impart a little secret that will ingratiate yourself with your doctor and not only improve the care you receive, but also reduce the amount of time you spend in the exam room.

 

When you go to your doctor, have a brief written history printed out for him or her.

I’ve created a sample based on the one I use for my Dad (the details have been changed).   It gets updated, and goes with him, for every doctor’s visit.

 

And his doctors love it.

While every history will be different, there are a few `rules’.

 

• First, keep it to 1 page.     Even if the patient has an `extensive history’.   If your doctor can’t scan this history, and glean the highlights, in 60 seconds or less . . . it isn’t of much use.
• Second, paint with broad strokes.   Don’t get bogged down in details.  Lab tests and such should already be in your chart.
• Third, always fill in a reason for your visit.   Keep it short, your doctor will probably have 10 to 15 minutes to spend with you.   Have your questions and concerns down in writing before you get there.
• Fourth, list all Meds  (Rx and otherwise) and indicate which ones you need a refill on.   If you have a question about a med, put a `?’ next to it.   And if you have any drug allergies, Highlight them.
• Fifth,  Make two copies!   One for your doctor to keep, and one for you.  As you talk to your doctor, make notes on the bottom (bring a pen) of your copy.  

Once you create the basic template (using any word processor), it becomes a 5 minute job to update and print two copies out for a doctor’s visit.

 

I get raves from every doctor I present this to.  They have all said they wished more people would take the time to prepare for their visits.

 

The history above is great for scheduled doctor’s visits, but you also should have a readily available (preferably carried in your wallet or purse), EMERGENCY medical history.

 

I addressed that issue in a blog called Those Who Forget Their History . . . .   A few excerpts (but follow the link to read the whole thing):

 

Since you can’t always know, in advance, when you might need medical care it is important to carry with you some kind of medical history at all times.  It can tell doctors important information about your history, medications, and allergies when you can’t.

 

Many hospitals and pharmacies provide – either free, or for a very nominal sum – folding wallet medical history forms with a plastic sleeve to protect them.

 

I’ve scanned the one offered by one of our local hospitals below. It is rudimentary, but covers the basics.

 

 

In a medical emergency, minutes can make the difference between life and death.  And even in less urgent cases, having all of this information can go a long ways towards speeding your treatment.

 

You should make it a point, this week, to get medical history forms for every member of your family – regardless of their age – and fill them out.

 

And a couple of other items, while not exactly a medical history, may merit discussion this weekend in your family as it has recently in mine.

 

First, adults should consider having a Living Will, that specifies what types of medical treatment you desire should you become incapacitated.

 

You may also wish to consider assigning someone as your Health Care Proxy, who can make decisions regarding your treatment should you be unable to do so for yourself.

 

Elderly family members with chronic health problems, or those with terminal illnesses, may even desire a home DNR (Do Not Resuscitate) Order.

 

Verbal instructions by family members – even if the patient is in the last stages of an incurable illness – are likely to be ignored by emergency personnel.

 

In Florida, the form must be printed on yellow paper. Different states have different requirements.  You should check with your doctor, or the local department of health to determine what the law is in your location.

 

 

My father, who has extensive health problems, requested a DNR earlier this year and now carries a yellow card in his wallet and keeps a yellow DNR form on the wall next to his bed.

 

Admittedly, not the cheeriest topic of conversation in the world, but for a lot of people, this is an important issue to address.

 

A few minutes spent this holiday weekend putting together medical histories could spare you and your family a great deal of anguish down the road.

On Having `The Conversation’

 

 

 

# 5202

 

 

I don’t generally put personal anecdotes in my blog because . . . well,   I’m really not all that interesting.   But today, an exception.

 

My father, who turned 86 last November and now lives with my sister in another town, contracted a serious respiratory infection over the Christmas holidays. By late last week he was in pretty rough shape with wheezing, shortness of breath, weakness, and violent coughing.

 

My sister took him to his doctor, who fearing Dad had pneumonia, wanted to hospitalize him.  

Dad refused.  Adamantly.

 

All Dad really wanted was to go back to his own bed. If something `bad’ happened, he said, so be it.  Better at home than in some strange hospital.

 

His doctor, after several futile attempts to talk him into going to the hospital, gave up.  She wrote him an Rx for Zithromax, and let him go home with the promise that if he got worse over the weekend, he’d go to the emergency room.

 

Dad muttered a diplomatic, but completely non-binding,  “We’ll see.”

 

I am pleased to tell you that the worst did not happen, and Dad is doing much better after 5 days at home on an antibiotic. 

 

But, as Dad is quick to remind people, when you are 86 years of age – and have the kinds of health problems he has - you really shouldn’t be buying any green bananas. 

 

Dad has serious (and inoperable) coronary and carotid artery issues, has had several serious bouts with cancer, lives with chronic back & hip pain, and his quality of life is continually declining.

 

Dad believes he is approaching the end of a long road, and feels no need to take extraordinary steps to prolong that journey beyond whatever nature intends.  He’s made that abundantly clear to his kids, his doctors, and to anyone else who will listen.

 

Which is why Dad, my sister and I have had `the conversation’.   

 

We’ve discussed, in detail, exactly what Dad would want us to do if he were unable to make medical decisions for himself.  

 

In fact, a few months ago Dad asked if I would get for him a legally binding Do Not Resuscitate (DNR) order, so that if something happened to him, and an ambulance were called, no heroics would be performed.

 

Verbal instructions by family members – even if the patient is in the last stages of an incurable illness – are likely to be ignored by emergency personnel.  

 

Dad now proudly has the bright yellow DNR order posted over his bed, and carries another credit-card sized one in his wallet.

 

In Florida, the form must be printed on yellow paper. Different states have different requirements.  You should check with your doctor, or the local department of health to determine what the law is in your location. 

 

 

My twin brother and I, both former paramedics (hey, it was a hereditary defect), and my sister fully support Dad’s decision to have a DNR.

 

We’ve also had (for many years) a living will and a Health Care Proxy drawn up for Dad, so either my sister or I can make decisions regarding Dad’s health care should he no longer be able to.

 

As an aside, I’ve had a living will and an assigned Health Care Proxy in place for decades, to ensure that my wishes would be respected if I were suddenly unable direct my medical care. 

 

Frankly, I consider them absolutely essential for all adults to have.

 

These are difficult subjects for many people to discuss, and so far too often, they get put aside until it is too late.  But better to talk about it now, and to have the proper papers in place, than to face a family medical crisis unprepared.

 

As a former medic, I’ve seen the anguish that relatives have suffered trying to make a life or death decision without input from the patient.

 

And I’ve also seen what happens when family members argue over what should be done about a loved one on life support. These are deeply emotional issues, and can create life-long rifts in the fabric of families.

 

While nothing can eliminate the emotional trauma that comes with a medical crisis, making rational decisions now – and making them known and binding – can greatly reduce the strain later.

 

Take my advice.  Whether you want heroic measures taken, or not. 

 

Make your wishes known.

Have the conversation.

Thanksgiving Is Family History Day

 

 

# 5082

 

 

 

As a former paramedic, I am keenly aware of how important it is for everyone to know their personal, and family, medical history.  

 

As a son whose father turns 86 today, I’ve been charged with creating and maintaining my Dad’s medical history for a number of years.

 

And of course,  I also maintain one on myself.

 

Every Thanksgiving since 2004 the Surgeon General has declared Thanksgiving as National Family History Day. Over the holiday weekend - while you are visiting with family - is an ideal time to ask about and share family medical histories.

 

The CDC and the HHS have a couple of web pages devoted to collecting your family history, including a web-based tool to help you collect, display, and print out your family’s health history.

 

Family History: Collect Information for Your Child's Health

Surgeon General's Family Health History Initiative

 

Using this online tool, in a matter of only a few minutes, you can create a basic family medical history. 

 

I’ve highlighted several other methods of creating histories in the past, which you  may prefer.  A few excerpts (and links) from these essays.

 

First, I’ll show you how I create and maintain histories for my Dad and I.   This was featured in an essay called A History Lesson.

 

Today, though, I’m going to impart a little secret that will ingratiate yourself with your doctor and not only improve the care you receive, but also reduce the amount of time you spend in the exam room.

 

When you go to your doctor, have a brief written history printed out for him or her.

 

I’ve created a sample based on the one I use for my Dad (the details have been changed).   It gets updated, and goes with him, for every doctor’s visit.

 

And his doctors love it.

 

While every history will be different, there are a few `rules’.

• First, keep it to 1 page.     Even if the patient has an `extensive history’.   If your doctor can’t scan this history, and glean the highlights, in 60 seconds or less . . . it isn’t of much use.
• Second, paint with broad strokes.   Don’t get bogged down in details.  Lab tests and such should already be in your chart.
• Third, always fill in a reason for your visit.   Keep it short, your doctor will probably have 10 to 15 minutes to spend with you.   Have your questions and concerns down in writing before you get there.
• Fourth, list all Meds  (Rx and otherwise) and indicate which ones you need a refill on.   If you have a question about a med, put a `?’ next to it.   And if you have any drug allergies, Highlight them.
• Fifth,  Make two copies!   One for your doctor to keep, and one for you.  As you talk to your doctor, make notes on the bottom (bring a pen) of your copy.  

Once you create the basic template (using any word processor), it becomes a 5 minute job to update and print two copies out for a doctor’s visit.

 

I get raves from every doctor I present this to.  They have all said they wished more people would take the time to prepare for their visits.

 

The history above is great for scheduled doctor’s visits, but you also should have a readily available (preferably carried in your wallet or purse), EMERGENCY medical history.

I addressed that issue in a blog called Those Who Forget Their History . . . .   A few excerpts (but follow the link to read the whole thing):

 

Since you can’t always know, in advance, when you might need medical care it is important to carry with you some kind of medical history at all times.  It can tell doctors important information about your history, medications, and allergies when you can’t.

 

Many hospitals and pharmacies provide – either free, or for a very nominal sum – folding wallet medical history forms with a plastic sleeve to protect them.

 

I’ve scanned the one offered by one of our local hospitals below. It is rudimentary, but covers the basics.

 

In a medical emergency, minutes can make the difference between life and death.  And even in less urgent cases, having all of this information can go a long ways towards speeding your treatment.

 

You should make it a point, this week, to get medical history forms for every member of your family – regardless of their age – and fill them out.

 

And a couple of other items, while not exactly a medical history, may merit discussion this weekend in your family as it has recently in mine.   

 

First, adults should consider having a Living Will, that specifies what types of medical treatment you desire should you become incapacitated.

 

You may also wish to consider assigning someone as your Health Care Proxy, who can make decisions regarding your treatment should you be unable to do so for yourself.

 

Elderly family members with chronic health problems, or those with terminal illnesses, may even desire a home DNR (Do Not Resuscitate) Order.

 

Verbal instructions by family members – even if the patient is in the last stages of an incurable illness – are likely to be ignored by emergency personnel.   

 

In Florida, the form must be printed on yellow paper. Different states have different requirements.  You should check with your doctor, or the local department of health to determine what the law is in your location. 

 

 

My father, who has extensive health problems, requested a DNR earlier this year and now carries a yellow card in his wallet and keeps a yellow DNR form on the wall next to his bed. 

 

Admittedly, not the happiest topic of conversation in the world, but for a lot of people, this is an important issue to address.

 

A few minutes spent this holiday weekend putting together medical histories could spare you and your family a great deal of anguish down the road.

NPM10: Create & Maintain A Medical Hx

 

 

Note: Today is Day 5 of National Preparedness Month, and since I’m enjoying a lazy long Labor Day weekend I figured it would be a good day to re-run this essay (slightly updated) from June of 2009.

 

 

# 4872

 

 

 

Those Who Forget Their History . . .

 

. . . .  are condemned to wait longer in triage.

 

Not where you thought I was going, is it?

 

But this is an important aspect of personal preparedness.

 

Knowing, and having immediately available, a  medical history on every member of your family.

 

As a former paramedic - one who has struggled to take thousands of medical histories in the back of a moving vehicle, or at the scene of a medical emergency -  I know how difficult getting an accurate and complete medical history can be.

 

As you might imagine, when someone is unconscious, or unable to respond to questions, getting a medical history becomes more problematic.

 

You have to rely on relatives, friends, neighbors . . .and sometimes even snooping in their medicine cabinet.

 

Often, people don’t even know what medicines they are taking, or why.

 

If I had a nickel for every time a patient denied taking meds, but under the pressure of additional questioning, admitted to taking `a red one, a blue one and two white ones in the morning . .  and 3 white ones at night’ -  well, I’d have a lot of nickels.

 

Since I act as a medical advocate for several relatives, I maintain a pretty elaborate medical history on each of them.   When one of them falls ill, a copy goes with them to the doctor or the emergency room.

 

I never see my doctor without bringing him an update history.  Sure, he knows me.  But he sees hundreds of patients, and me only every few months.  There is no way he can remember the details of my medical history.

 

So I provide him with a short, 1 page synopsis that he can scan in about 30 seconds, to make his life, and mine, easier (see A History Lesson to learn how).

 

 

Since you can’t always know, in advance, when you might need medical care it is important to carry with you some kind of medical history at all times.  It can tell doctors important information about your history, medications, and allergies when you can’t.

 

Many hospitals and pharmacies provide – either free, or for a very nominal sum – folding wallet medical history forms with a plastic sleeve to protect them.

 

I’ve scanned the one offered by one of our local hospitals below. It is rudimentary, but covers the basics.

 

 

 

In a medical emergency, minutes can make the difference between life and death.  And even in less urgent cases, having all of this information can go a long ways towards speeding your treatment.

 

You should make it a point, this week, to get medical history forms for every member of your family – regardless of their age – and fill them out.

 

Except for small children, everyone should find a way to carry it with them at all times.

 

This is not a one-time, make it and forget, prep.  You need to update it every time you add or change your medications, or your medical history changes.    It only takes a few minutes now.

 

But it could save a lot of time later.

Your Medical Hx On A USB Card?

 

 

# 4512

 

 

As a paramedic long ago, roughly around the time dinosaurs walked the earth, I know how difficult it can be to get a good medical history from someone in the midst of a medical emergency.   

 

Sometimes they are unconscious, other times they may be confused, intoxicated, forgetful or simply overwhelmed by events.  All too often, people are simply unaware of the details of their medical history. 

 

You ask if they are taking any meds, and they respond . . .

 

`Yes,  I take two white pills in the morning, a white and a blue one at noon, and two white, 1 blue and a red at bedtime . . . “

 

You ask if the patient has any cardiac problems, and they respond . . .

 

“No . . . but my doctor says I have a `weak heart’.”

 

No . . I’m not kidding.

 

Taking a history usually involves a tortuous session of 20 (or more) questions – and the results are often less than optimal.  

 

Recently my Sister and Dad were in a serious auto accident.  She was airlifted to a Tampa trauma center, while he was transported by ambulance to a local hospital.

 

Although my Dad had a list of his meds and a brief medical history in his wallet, my sister did not, and for a couple of hours the trauma center was operating at a great disadvantage.  My sister had a concussion, and was no help in providing information.

 

I finally got a list faxed from her doctor’s office to the ER, and provided as much detail on her medical history as I could over the phone.

 

I carry a simple medical ID card in my wallet (see Those Who Forget Their History . . .), which lists my meds, brief medical history, along with emergency contact and doctors names.

 

 

In a medical emergency, minutes can make the difference between life and death.  And even in less urgent cases, having all of this information can go a long ways towards speeding your treatment.

 

You should make it a point, this week, to get medical history forms for every member of your family – regardless of their age – and fill them out.

 

Except for small children, everyone should find a way to carry it with them at all times.This is not a one-time, make it and forget, prep.  You need to update it every time you add or change your medications, or your medical history changes.

 

It only takes a few minutes now. But it could save a lot of time later.

 

 

Recently however, I had an opportunity to look at a new high-tech solution called an ICE Medical ID Card.

 

 

Sold in a variety of incarnations (and prices) online, or via pharmacies (CVS seems to be a big provider), these credit-card sized USB flash drives have a built-in data-entry program that allows you to store the same sort of information as the low-tech handwritten version I carry  PLUS room to store a photo ID, scanned medical tests, a living will, DNR, or other important documents.

 

This is a nifty idea, and I may buy one for myself (CVS sells them for under $20), although I have a few reservations.

 

First, you have to have access to a Windows Computer in order to read the contents of this card – a barrier not encountered with a written medical history card. Equipment available in most hospital emergency rooms or a doctor’s offices . . . but not always in the field.  

 

Second, and more concerning, it is plays fast and loose with computer security rules to be plugging possibly malware or virus infected USB flash drives into a hospital, ambulance, or Doctor’s office computer or network.  

 

I have to wonder how willing most providers are going to be to access these cards.  USB devices are easy enough to hack that I would have concerns about plugging one from an unknown source into my computer system.

 

 

Third, you have the ability (and incentive) to put a lot of sensitive personal and medical information on one of these cards – legal documents, lab tests, insurance information – that if you lost your wallet, and it got into the wrong hands, could invite identity theft.

 

And finally it requires a certain comfort level with (and access to) a Windows computer in order to input the information in the first place.

 

High-tech phobia, particularly among the elderly (my 85 year-old father for instance), could prove a substantial barrier to using these cards – particularly since they need to be updated when one’s medical history changes.

 

Despite these concerns, I am tempted to get one of these cards and to keep it - along with my low-tech handwritten medical history card – in my wallet.  

 

The ability to store scans of radiologist’s reports, recent lab tests, and a copy of my living will are powerful incentives for me, even if they might not be immediately accessible in every instance.

 

Almost every technological advance comes with downsides to consider.  Unintended consequences. And a period of time where acceptance and utilization may be low.

 

As much as I like this concept, until the security and acceptance concerns I mentioned above can be addressed, I’m reluctant to rely solely on one of these USB Cards, and will keep my handwritten card updated as well.

 

Which I suppose makes me only half a Luddite. 

 

I would be interested in responses from those in the health care field as to how you view these cards, and how likely your facility would be to access them. 

 

You can either comment here, or email if you prefer anonymity.

 

I’ll be talking to several doctors over the coming weeks about this, and If I get enough reader’s responses, I’ll follow up with another post on this in the future.

A History Lesson

 

 

# 4449

 

 

As a former paramedic one of the skills I honed was taking a good history, a feat not always easy to do in the midst of an often chaotic and confusing scene of an emergency. 

 

Life would have been a lot simpler for me back then if people had taken it upon themselves to make, and keep updated, a simple history of their medical problems.   This is a step I’ve urged in the past, in blogs such as Thanksgiving Is National Family History Day  and Those Who Forget Their History . . .

 

Today, though, I’m going to impart a little secret that will ingratiate yourself with your doctor and not only improve the care you receive, but also reduce the amount of time you spend in the exam room.

 

When you go to your doctor, have a brief written history printed out for him or her.

 

I’ve created a sample based on the one I use for my Dad (the details have been changed).   It gets updated, and goes with him, for every doctor’s visit. 

 

And his doctors love it.  

 

 

 

While every history will be different, there are a few `rules’.

 

• First, keep it to 1 page.     Even if the patient has an `extensive history’.   If your doctor can’t scan this history, and glean the highlights, in 60 seconds or less . . . it isn’t of much use.
• Second, paint with broad strokes.   Don’t get bogged down in details.  Lab tests and such should already be in your chart.
• Third, always fill in a reason for your visit.   Keep it short, your doctor will probably have 10 to 15 minutes to spend with you.   Have your questions and concerns down in writing before you get there.
• Fourth, list all Meds  (Rx and otherwise) and indicate which ones you need a refill on.   If you have a question about a med, put a `?’ next to it.   And if you have any drug allergies, Highlight them.
• Fifth,  Make two copies!   One for your doctor to keep, and one for you.  As you talk to your doctor, make notes on the bottom (bring a pen) of your copy.  

 

Once you create the basic template (using any word processor), it becomes a 5 minute job to update and print two copies out for a doctor’s visit.

 

I get raves from every doctor I present this to.  They have all said they wished more people would take the time to prepare for their visits.

 

Try it, you’ll be amazed how much more productive your next encounter with your doctor will be.