Medical Hx Form?

[ericaj]

I was wondering if anyone could help me out a bit, I am seeing a Pulmonary
Doc tomorrow about some abnormal results that came back from my Exercise Stress Test a couple weeks back - to do with breathing - and i'd like to type up a medical history to take along that kind of lists everything i've had in the past.. tests, surgeries, current meds, a couple of questions I have for her, etc. Does anyone have a format they like to use or a copy of one I could use to type up my own?

I also have a CT Scan in the early morning and pulm. function test at noon, before appt. at 1:00.

Thanks,

Erica

 

[Nancy]

I have two sheets that I use for Joe, one for his meds (and it's completely up to date), showing the doses and when it is taken, and at the bottom I listed all his drug allergies and any drugs that gave him an adverse reaction. In the case of his Coumadin, I have listed his target range which nobody ever knows, and I printed it up in red so they cannot miss it, but of course they always do. The second is a list of his medical problems, conditions, surgeries, unusual happenings, hospitalizations. This includes the doctor who treated him and the hospital he was treated in, how long he was hospitalized and any unusual outcomes. I started with his younger years and continued on down the list to the present time at the bottom. I kept this all on one sheet. I had to use a small font to get it all on one page. But it's easier for the doctors to read if it is on one page. Then at the very bottom, I listed all of his known medical problems, CHF, pulmonary hypertension, double valve replacement, etc, etc.

I always have copies of these in my wallet in case there is an emergency.

I can't tell you how handy these sheets are.

 

[Harpoon]

Somewhere along the way here there was a discussion regarding Medic Alert and I posted a breakdown of the sheet I have in my wallet (much like what Nancy and Joe have)

IMPORTANT MEDICAL INFORMATION
(my full name)
TAKING ANTI-COAGULANTS (in nice bold print)

Then it lists my congenital heart defects and when they were repaired
Then my tricuspid valve replacement with a reference to the ID card I got from St Jude Medical.
My DOB and Blood type, B Negative
A listing of all the meds I'm on.
No known allergies or sensitivities beyond what my meds react with.

Phone numbers
"CALL FIRST FOR HEART RELATED EMERGENCIES"
My "primary" cardiologist, the one who's been following me for years.
My heart surgeon, Dr Mee ("everyone" knows him so it's OK if I use his name....
Another cardiologist at Cleveland Clinic plus everyone's phone numbers
My primary physician's name and number
My wife's phone numbers
My father's phone numbers
And the date it was last updated (mainly for my own reference)


Medic Alert (and the like) is probably the best thing because most paramedics and such are trained to look for such things. The list is there for times when I may be in distress, but can still pull it out of my wallet and put it into someone else's hands and at least point emphatically if not be able to say what's going on and why....

It's never been used.


Oh, and I've got a cell phone that I carry with me almost ALL the time. The only time it's not on me physically is when I'm asleep, in the shower, or at kung-fu class. I figure if I ever did find myself in "'trouble" I'd probably use the cell phone before anything else.