Newly Diagnosed PI.pdf

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1 www.hcvadvocate.org1 www.hcvadvocate.org

Newly Diagnosed Hepatitis C Support Project


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Newly Diagnosed Hepatitis C Support Project

Alan Franciscus

Executive Director

Editor-in-Chief, HCSP

Publications

Author

Lucinda K. Porter, RNManaging Editor, Webmaster

C.D. Mazoff, PhD

Publication Design

Leslie Hoex, Blue Kangaroo Design

www.bluekangaroodesign.com

Reviewed by

Rose Christensen

Contact Information

Hepatitis C Support ProjectPO Box 427037

San Francisco, CA 94142-7037

[email protected]

This publication is supported by an

unrestricted educational grant from

Merck and Co.

The information in this guide is designed

to help you understand and manage

hepatitis C virus infection (HCV) and

is not intended as medical advice.All persons with HCV should consult

a licensed medical practitioner for

diagnosis and treatment of hepatitis C.

Version 3.0, 2011 2011 Hepatitis C Support Project

As I take my frst steps

with hepatitis C,

I am not alone because

o all those who will

help me along my journey

with their wisdom,

encouragement and hope.


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Hepatitis C Support Project Nwy Dignd

Table of CoNTeNTs1. Introduction Letter . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

2. FAQs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

3. Getting Organized . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

4. Choosing a Medical Provider . . . . . . . . . . . . . . . . . . . . . 7

5. Medical Provider Inormation . . . . . . . . . . . . . . . . . . . . . 9

6. Maximizing Your Medical Appointments. . . . . . . . . . . . . . . . 10

7. New Appointment Checklist . . . . . . . . . . . . . . . . . . . . . . 11

8. Your Medical History . . . . . . . . . . . . . . . . . . . . . . . . . . 16

9. Medication and Supplement History. . . . . . . . . . . . . . . . . . 17

10. Medication Guidelines . . . . . . . . . . . . . . . . . . . . . . . . . 18

11. Tips or Lowering Prescription Drug Costs . . . . . . . . . . . . . . 20

12. Follow-up Appointment Checklist . . . . . . . . . . . . . . . . . . . 21

13. Medical Appointment Short Form . . . . . . . . . . . . . . . . . . 26

14. Calling Your Medical Provider . . . . . . . . . . . . . . . . . . . . . 27

15. More Tips about Medical Appointments . . . . . . . . . . . . . . . . 28

16. The Medical Alphabet . . . . . . . . . . . . . . . . . . . . . . . . . 29

17. HCV Laboratory and Diagnostic Tests. . . . . . . . . . . . . . . . . 31

18. HCV Lab Tracker. . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

19. Dos and Donts . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

20. Tips or Living Well . . . . . . . . . . . . . . . . . . . . . . . . . . . 34

21. Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

22. Notes Pages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36


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Nwy Dignd Hepatitis C Support ProjectNwy Dignd Hepatitis C Support Project

a letter t The Newy Digned with Heptiti C

Hello,

You recently ound out that you have hepatitis C. Beingdiagnosed with this brings up a lot o eelings and

questions about hepatitis C.

Some requently asked questions are:

WhatishepatitisCvirusinfection(HCV)?

Isitserious?WillIdie?

WillIneedalivertransplant?

IstheretreatmentforhepatitisC?

Cannaturalmedicinehelpme?

Isitcontagious?CanIgiveittomy familyandfriends?

HowdidIgetit?HowlonghaveIhadit?

DoesthismeanIamdisabled?

WheredoIgethelp,informationandsupport?

WhatdoIdonext?

Enclosed is inormation to help you nd answers to your

questions. This inormation is basic and assumes that you

have very little knowledge about hepatitis C. Hopeully it

reassures you. How can inormation about a disease be

reassuring?Webelievethatonceyougetthefacts,the

uture will look a little brighter.

In the beginning, you might be scared or angry. You might

eel hopeless or depressed. You might try to ignore the

situation, telling yoursel that this is not a big deal. These

reactions are normal. These eelings will not go away

overnight. This is part o the process o living with a disease.You are not alone. There are millions o people in the United

States and the world living with hepatitis C. What you dont

know yet is what some o us have learned over timethat

hepatitis C can teach you how to live better. Sure, all o us

would rather live without it. Treatment or hepatitis C is

eective or about one-hal o those who try it so someday

you may have the experience o living without it. However,

until that time comes, it is important to learn how to live

with hepatitis C.

You are embarking on a process that will teach you how

to make the best o a bad situation. Some people take

better care o themselves ater having this wake-up call.

They become healthier because they know that their lives

depend on it.

For now, lean on the rest o us who have aced this or along time. We probably have experienced some o what

you are going through and are more than willing to help.

You do not have to go through this alone. Enclosed is

inormation that will get you started.

lucindaK.Porter,R

N


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www.hcvadvocate.org 2www.hcvadvocate.org 2

Hepatitis C Support Project Nwy DigndHepatitis C Support Project Nwy Dignd

Here are some brie answers to some common questions.For more complete inormation, visit the Hepatitis C Support Projects website at

www.hcvadvocate.org

Wht is htitis C?Hepatitis C is a disease caused by the hepatitis C virus(HCV).Itprimarilyaffectstheliverandovertimecan

damage the liver and health o an individual. Usually ittakes a long time to do any damage, especially i the

person who has it doesnt drink alcohol and maintains ahealthy liestyle. Sometimes the damage is so minimal

that people will go through their entire lives withoutknowing they have HCV.

Is HCV rr?No. Approximately 3 to 4 million people in the United

States have HCV. Worldwide, more than 170 millionpeople have HCV.

How is htitis C digosd?

It is diagnosed with a blood test. The rst test most

people have is an HCV antibody test. I this is negative,it means you do not have hepatitis C, assuming you

have not been exposed in the past 6 months. I theresults are positive, then you need another blood test

called a viral load test. It is important that you have thissecond test because some people have a positive HCVantibody test but do not have HCV. Until you have this

test, you will not know or sure i you have HCV.

Is it srious?

Maybe. It should be regarded as a potentially seriousproblem. The good news is that or most people, HCV

will not create major health problems. Your medicalprovider will be able to determine the seriousness o

your particular situation.

Wi I di fro HCV?Most people will die with HCV and not o HCV. Out o

100 people who have hepatitis C, 3 or ewer will die anHCV-related death.

T WO

frequenty aked Quetin

Wht r th stos of htitis C?

Some people have little or no symptoms. This could

be because they hardly have any liver damage.Unortunately, it also could be because the liver is a

non-complaining organ. This means that there couldbe a lot o liver damage and hardly any symptoms.The most common symptom o HCV is atigue. Body

aches, fu-like symptoms, depression, and abdominaldiscomort are also symptoms o HCV. Since these are

symptoms o many medical conditions, it is important toseek medical help.

How do I kow if ivr is dgd?

The most accurate and reliable way to nd out is by

having a liver biopsy. Researchers are trying to developother ways to measure liver damage, but currently, liver

biopsy is the most reliable.

Dos hvig HCV I disbd?

No, it does not automatically mean you are disabled.The majority o those with HCV are able to work and

unction well. However, HCV aects everyone dierentlyand may interere with work and quality o lie.

Wi I d ivr trst?

This is very unlikely. The majority o people living with

HCV will not need a liver transplant.

Is thr trtt for htitis C?Yes, the medications to treat hepatitis C inection cancure it in about 50% o people who take them. Thesedrugs do have side eects. Talk to your medical

provider about whether treatment is right or you.

Continued


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Nwy Dignd Hepatitis C Support Project

If I dcid to udrgo trtt, wh shoud I strt?This depends on a number o actors. It is important tobe inormed about the treatment, what is involved, the

side eects and costs. Also, you need to evaluate thecurrent actors in your lie. Talk to your medical provider

about this. Treatment decisions do not need to be madeinstantly. I you need to delay treatment, ask your medical

providerifyoucandososafelyandforhowlong?

Is HCV trtt xsiv?Yes. However, many insurance plans cover most o thecost. See i you qualiy or a pharmaceutical patient

assistance program. For more inormation contactPartnership or Prescription Assistance www.pparx.org, or

Needy Meds www.needymeds.com, or the pharmaceuticalmanuacturer o the drug your doctor prescribes.

C tur dici h ?No herbs, supplements or alternative treatments havebeen proven to eectively treat HCV. Some herbs

may be harmul and even lethal. Some people haveexperienced health improvement rom acupressure,acupuncture, meditation, Tai Chi, Yoga and other

complementary health practices.

Is thr thig I c do to h ivr?Yes, there is a lot you can do. First, talk to your medical

provider. Avoid alcohol. Do not eat raw or undercookedshellsh. Get regular medical care. I you have never

had hepatitis A or B, be sure to get vaccines to protectyou rom these. Avoid or be cautious with potentially

liver toxic drugs, supplements, and chemicals. Tryto quit smoking and other tobacco use. Aim or thehealthiest liestyle you can manage, one that includes

regular exercise.

How did I gt it?HCV may be transmitted during activities that involveblood. In order to acquire HCV, a persons blood needs

to be in contact with HCV-inected blood. This canhappen in various ways. Some common ways are rom

blood transusions beore 1992 and sharing needlesor other injection drug utensils or works. There is an

occupational risk or those who have had a needle-stickinjury or mucosal exposure to HCV-positive blood. Thereis low risk o acquiring HCV sexually or or a mother

transmitting it it to her etus during pregnancy or delivery.There are other ways to acquire HCV and it is important

to obtain more inormation about this. It is normal towonder how you got hepatitis C. However, it can be

unhealthy to obsess about this. Try to ocus on what youcan do or yoursel now, rather than on the past.

How og hv I hd it?Your medical provider can help you determine this.Sometimes it is easy to answer this, but oten aneducated guess is made based on risk actors, medical

history and your current health inormation.

Is it contagious? Can I give it to my family and friends?Yes, it is contagious, but mostly only through blood. It isusually transmitted when people come in contact with

someones blood, such as by sharing contaminatedneedles, piercing and tattooing instruments and other

blood-related practices. I you do not share these withyour amily and riends, it is unlikely they will get HCV

rom you. We do recommend that you do not sharerazors, toothbrushes and other instruments that may haveyour blood on it. We do not know or sure that sharing

personal items is a risk, but it is better to be sae. Alwayscover any bleeding wounds or sores. It is not transmitted

by hugging, kissing, sneezing, coughing, sharing eatingutensils or glasses, or by casual contact. Although the

risks are low, it is recommended that amily members betested, especially children o women who may have had

HCV at the same time they were pregnant. You shouldnot donate blood or semen. Body organ and tissuedonation is made on a case-by-case basis. There is a

major shortage o donated organs, so sometimes an

HCV-positive organ is used or an HCV-positive recipient

Wht bout sx?The research is conusing about this sensitive,complicated and important subject. The Centers orDiseaseControl(CDC)doesnotrecommendany

changes in sexual practices between monogamous,long-term partners. Sexual transmission rates increase

with multiple sexual partners and risky sexual practiceswhere blood may be present. It is important to get

accurate inormation about sexual transmission o HCV.

Frequently Asked QuestionsContinued

a prm i chnc

r yu t d yur t. Duk eingtn


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Shoud I t sx rtr(s)?Yes. Although sex is a basic part o lie, many o us are

uncomortable talking about it. Honesty and openness areimportant. I your partner is uncomortable with the current

sexual practices in your relationship, it is his or her right to

express and change this. I you want to practice saer sex,it is your right to express and change this.

Wht shoud I t rtr, fi,or d co-workrs?Legally, you are not required to tell anyone. There areadvantages and disadvantages to telling others. For

more inormation about this, see: HCSPs Easy C Facts: Whom

Should I Tell? and Hep C Basics: Disclosure.

How do I tk to chidr bout this?It depends on their age and your assessment o your

childrens ability to handle this inormation. Sincechildren can sense when we have something onour minds, its a good idea to talk to them so theirimaginations dont make things worse than they might

already be. Try to nd something genuinely reassuringto tell them. Be brie but truthul. Ask them i they have

any questions. The CDC recommends that amilymembers be tested. Talk to your childrens doctor

about this. I your children are adults or old enough togive their assent, talk to them about testing. The mostimportant issue to discuss is prevention. Make sure

they know never to use your toothbrush, razor or cuticleclippers. Explain to them that they shouldnt share

anyones personal items.

Is thr vcci tht rotcts gist HCV?No, not at this time.

Wht do I do xt?Get accurate inormation and support. Avoid alcohol.Attend a support group. Try to make healthy choices.Find a medical provider who has a lot o experience

working with HCV patients and is someone you trust. Iyou have any reservations about your medical provider,

get a second opinion.

Whr do I gt h, ifortio d suort?

For more inormation about HCV rom HCSP, see:

Easy C: A Guide to Understanding Hepatitis C

Understanding HCV: A Patient Pocket Guide

HCSPsFactSheetSeries

The Hepatitis C Support Project lists support groups,

HCV specialists and has inormation about hepatitis C inmultiple languages. The website is www.hcvadvocate.org.


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This chapter will help you get your healthcare records in order by maintaining an allergy list,medication log, a health and medical history and emergency contact list.

Organizing your inormation helps you take charge o your own health.

T HR ee

Getting orgnized r the Heth It

Orgizig our hthcr rcords hs dvtgs. Ths r:

Allowsyoutouseyourtimemoreefciently

Willhelpyougetthemostoutofyourmedicalappointments

ReduceswheredidIputitfrustration

Maximizesyourabilitytonavigatethemedicalsystemeffectively

Ensuresthatatleastsomeonehasalltheinformation

Emphasizesthefactthatyouareinchargeofyourownhealth

How to OrganizeStart by asking or copies o your medical records.Although you have a right to copies, it is a common

legitimate practice to charge a ee or this. From now on,make it part o your routine to ask or copies o every

important piece o your medical records, especially testresults. The most recent copies are usually sucient.Important medical documents to have are:

HepatitisCviralload(HCVRNA)Genotype

Resultsfromliverfunctiontests,especiallyALTand AST values

Mostrecentcompletebloodcount(CBC)

Liverbiopsypathologyreport

Ultrasoundandimagingreports

HepatitisAandBimmunizationrecordsorlabresultsordates or those who have a history o either o these

Allrecentlabresultsthatscreenforotherdiseases or conditions

Here is a list o medical inormation that everyone should

maintain, young, old, healthy or living with a chronic disease:

AllergylistIncludemedications,foods,insects,latex, chemicals, etc.

Yourmedicalhistoryfromyourperspective (see Your Medical History)

Medicationlog (seeMedication and Supplement History sheet)

Alistofmajordiseasesinyourfamily

Noteswithdatesandpurposesofmajor

surgeries or other procedures

Ongoingjournalofmajormedicaleventsrom this day orward

Alistofcurrenthealthconcernsandquestions

Immunizationrecords

Contactinformationofallyourmedicalproviders (see Medical Provider Inormation sheet)

Emergencycontactinformation

HealthscreeningremindersandresultsHealthinsuranceinformation

Medicalcardormedicalidenticationnumber

AdvanceDirectives(Legaldocumentsstatingyourwishesforend-of-lifecareandyourdesignation o someone to advocate or these wishes. Althoughonly a small percentage o people with HCV will die rom it, AdvanceDirectives arerecommendedforeveryone.)


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Store everything in one place. Use whatever system

you preera notebook, le cabinet, computer or a box.The important goal is to make it a habit to keep all your

records in one place. I you store inormation on yourcomputer, make sure you keep a back up copy.

Keep all your appointment inormation in one calendar or

date book. You can also use this to record when you startor stop medications and other medical-related events.

Make it a habit to update your home medical records atereach medical visit or event. Do an annual review. Pick a

memorable date or this review, such as your birthday, NewYears Day, or the day ater you le your income taxes.

Home Health LibrarySome communities and hospitals have excellent reerencelibraries. Kaiser Permanente has many resources orits members. You can also start your own home health

library. You can save money by purchasing books atlibrary book sales, used bookstores, and garage sales,but check the copyright date to make sure the inormation

is current. See Resources or a more complete list. Here area ew suggestions:

Generalmedicalreferencebooks.Manyarewritten

or people without a medical background. The AmericanMedical Association, the Merck Manual, and major medicalcenters oer excellent reerence books or people

without a medical background.

Booksfocusingonhealthimprovement.The Owners Manual:

An Insiders Guide to the Body that Will Make you Healthier and Younger

by Roizen and Oz is a good one.

BooksabouthepatitisC.Therearemanygoodones.Livingwith Hepatitis C: A Survivors Guide, by Gregory Everson, andDr. Melissa Palmers Guide to Hepatitis and Liver Disease are

comprehensive and easy to understand.

T knw whr yu cn nd thing i th chi prt rning.

surc Unkwn


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Finding a new doctor or other medical proessional can take a

little eort. Doing some homework up ront can make your frst

appointment go more smoothly. Start by asking or a reerral.

I you are currently satisfed with one or more o your medical

providers, ask that source or a reerral. You can also ask

amily, riends and co-workers or suggestions. I you attend

a support group, that is another excellent resource. Next you

can check the providers background. Ater you have some

names, you can use the Internet to confrm that the provider

has a current license. The American Medical Association

(AMA),yourstatesmedicalboardandthecountymedical

association have inormation about physicians.

foU R

Ching Medic Prvider

This chapter will help you nd a new doctor or medical provider. You will learn how to check theirbackgrounds, ask the right questions and nd out what hospitals or medical clinics use physicians

in training. Doing some homework up ront can make your rst appointment go more smoothly.

www.ama-assn.org/aps/amahg.htmCan veriy a physicians credentials.

Also has tips on how to choose a doctor.

www.docboard.orgKeeps records o malpractice judgments or

some states and has links to other states.

www.docino.orgSearches or malpractice judgments or a ee per physician.

www.hcvadvocate.org

The Hepatitis C Support Projects physician database.

Note: Click on nd a physician button.

Clinics and hospitals that are aliated with medicalschools may use interns, residents and ellows as part

o their team. Interns are in their last year o medicalschool and have a good deal o medical training up to

that point. Residents are physicians who are training in aspecialty, such as internal medicine or gastroenterology.

Fellows are advancing their training in a specialized area

beyond residency, such as hepatology or oncology. Theadvantage to you is oten more time and attention during

your medical appointment. Many medical students andnew physicians have made a signicant impact on their

patients lives. There is also the satisaction o knowingyou are an important part o the medical education

process when you see someone during his or her training

Tip:Teaching hospitals and clinics rotate new

interns, residents, and ellows during the

monthsofJuly(andsometimesJanuary).Alwaysask

who will actually be perorming any procedures. I you

have the option to wait and it is medically sae to do so,

you may want to avoid complicated elective procedures

during July or January.


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Questions to Ask

Here are some questions to help you choose a medical provider. You

can ask these over the phone when talking to the oce sta, thus

saving precious ace-to-ace time.

Askiftheproviderisacceptingnewpatients.

Findouthowsoonyoucanbeseen.Whatisthe

typicalwaittimeforanappointment?

Isyourinsuranceaccepted?Ifso,becertainyou

understand any co-pays, deductibles, or otherout-o-pocket costs or which you may be responsible.

Doestheofcebillyourinsuranceorwillyouneedto pay the ee directly and manage the insurance

reimbursementyourself?

Ifyouareseeinganursepractitionerorphysician

assistant, then who is the physician overseeing his/herpractice?

Willyoubeseeinganintern,residentorfellow?

Whatarethefees?Doestheproviderchargefortimespenttalkingtoyouonthephone?

Willyoubeseeingtheprovideryouhavebeenassignedorwillyouseeotherpeopleinthatmedicalgroup?

Whichhospitalisthephysicianafliatedwith?

Doesthemedicalgrouphaveanadvicenursewhois

availableforphonecalls?

Ater you have met with the medical provider, take a moment to refect

on the appointment. Consider the ollowing:

Didtheproviderseemknowledgeable

andexperienced?

Doesthisprovidercommunicatewell?

Doyoufeeltheprovidergaveyouhisor herfullattention?

Isthisapersonyouwouldwantonyourmedicalteam?


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fI V e

Medic Prvider Inrmtin

Providers Name Phone Number Address

Primar CareProvider

Nurse(s)

Specialists

GI/Hepatolog

Nurse(s)

Other

Other

Pharmacist

Dentist

Other

NOTES

NOTES

NOTES

NOTES

NOTES

NOTES

NOTES

NOTES

NOTES

NOTES


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The time we spend talking to our doctors or other medical providers seems to be getting shorter.Here are some tips on how to maximize the time spent with your care provider.

1. Be prepared. Beore your appointment write down allo your medications, any pertinent allergies, a brie

medical history, and your chie health complaints.Include the names, addresses, and phone numberso your primary care provider and any specialists who

may be involved with your current medical issue.

2. You can prepare or your medical appointment byprioritizing and writing down your questions.

3. Maintain your own health records. It can expeditematters i you bring copies o your most recentpertinent medical reports.

4. Make eye contact beore speaking to your medical

provider. Once you begin speaking, your provider maytake notes. This does not mean s/he is not listening.

5. Beore you start with your list, ask how much time the

provider has or questions. Respect these limits andyou will benet in the long run.

6. Prioritize your health issues. Be brie but clear. Startwith the most important details and i there is time, you

can add the less important inormation at the end. Iyou have any ears or eelings, discuss them. It can be

reassuring to learn that your symptoms have nothing todo with some disease you have been dreading.

7. When describing your symptoms, begin with the

general picture and end with the specics. Example:My stomach hurts. I eel nauseous in the morning.

8. Ask or clarication. I your doctor uses words orexplanations you do not understand, ask her to clariy

or simpliy her words.

9. Take notes. I the doctor makes suggestions, write

them down. Ask him to spell any words you mightwant to reer to later, such as a diagnosis, medicationor procedure. I during the appointment you dont

have time to write everything down, write your notesimmediately ater while sitting in the lobby or your car.

10. Take a riend, especially or the complicated

appointments. Ask your companion to take notes oryou. I its all right with your provider, you can also recordthe appointment. Smartphones, iPhones, iPod touches

and similar devices have recording capabilities.

sIX

Mximizing Yur Medic appintment

This chapter discusses how to get the most out o your medical appointments. You pay or time

spent with your medical provider, so learning how to get the most out o it benets you.

11. I medication is prescribed, ask what the common sideeects are and how to take the medication.

12. Express your reservations. I your doctor suggests a

treatment plan that you have some concerns about,let her know. Sometimes these concerns can beeasily addressed.

13. Ask i there are any alternatives. I your doctor makesa treatment suggestion and it is not one that you are

prepared to ollow, ask about other options.

14. Keep an open mind. This can be your strongest

ally. It is amazing how many people will avoid amedication because o their ear o side eects, only

to nd out later that the reality was not anywherenear what they imagined.

15.Askthedoctor(orprovider)ifthereareresourcesor

support groups she would recommend.

16. Discuss the ollow-up plan. I diagnostic tests areordered, ask the provider when you can expect theresults and how these results will be conveyed to you.

Whendoesyourproviderwanttoseeyounext?Askifthere are any signs or symptoms that could be urgent

and need immediate reporting. I the results are goingto be disclosed at your next appointment, and i there

is going to be a long interval between appointments,ask how you can obtain earlier results. Additionally, askthe physician what the best way is to contact his oce

should a need arise that may not require an oce visit.

17. I this is a ollow-up appointment, ask or copies odiagnostic test results and surgical reports. This sets

a standard that you are the manager o your healthcare. It also makes it easier to give copies to other

health practitioners.

18. I you run out o time and still have more questionson your list, ask how you might be able to get the

answers to your questions without disrupting thephysicians schedule. Ask i you can leave a copy othe questions along with the request that they call you

back within a specied time rame.


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Complete part A o this orm and bring it with you when you see a medical provider or the rst time. I you can, bringcopies rather than your own copy o your records. Complete part B during or ater your medical appointment.

Bring the ollowing i you have them:

qYour advocate

qLaboratory test results

qLiverbiopsypathologyreport(s)

qHepatitis A & B immunization records or lab results(if available)forthosewhohaveahistoryofeitherofthese

q Allergy list Include medications, oods, insects,latex, chemicals, etc.

qYour medical history rom your perspective. Start with your _ currentmedicalproblems.(seeYour Medical History)

q Medication and Supplement Log (seeMedication and Supplement History)

q Liverultrasoundorimagingreport(s)

qA list o major diseases in your amily

qNotes with dates and purposes o hospitalizations,major surgeries or other procedures

qEmergency contact inormation

qContact inormation o all your medical providersqHealth insurance inormation

qMedical card or medical identication number

qAppointment book or calendar

qFor women date o last menstrual period

Whatisyourmainhealthconcern?

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

Whatquestionsorconcernsdoyouwanttocoverduringthisappointment?

List in order o importance, starting with the most important:_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

Ifyouhavesymptoms,whatarethey?

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

Dothesesymptomsinterferewithanything,suchassleep,exercise,eating,orqualityoflife?

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

Ifyouareexperiencingpain,howmuchpainareyouhaving?Ratethisonapainscaleof1to10,with 1 being the least and 10 being the most pain.

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

Howlonghaveyouhadthesesymptoms?Whatmakesthemworse?Whatmakesthembetter?

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

s e V e N

New appintment Checkit r HCV Ptient

It is highly recommended that you bring an advocate with you to your rst ew or any complicatedmedical appointments. This can be a riend, amily member or someone rom your support group.

PART A

NEW APPOINTMENT FORM SECTION


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MEDICAL PROVIDERS COMMENTS

Summary o visit: You or your advocate can complete this during or immediately ater your appointment.

Note: This is a very thorough orm. I your medical provider does not have time to answer all your questions, ask or the best way to get theseanswers.There may be someone else in the ofce that can help you. Some providers will call or email you later when they have more time.

Writedowninformationfromassessments,suchasbloodpressure_________________andweight_________________

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

Whatisthenameforyourmedicalproblem(diagnosis)?_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

Whatisthelikelycourse(prognosis)ofyourmedicalproblem?_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

Arethereanysymptomsyoushouldwatchoutfororneedtocalltheproviderfor?_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

Whatdoesyourmedicalproviderwanttodonext?

(If medication, treatment, surgery, or medical tests are ordered, see the next few pages.)_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

I you have any concerns or reasons why you might not be able to ollow the treatment recommendations, state them during the appointment.

Isthereanythingyoucandotohelpyourproblemorimproveyourhealth?_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

Ifyourmedicalproviderwantsyoutoseeanotherspecialist,nurse,dietician,etc,whatisthenameandreason?

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

Wherecanyougetmoreinformationorsupportaboutthisproblem?

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

Doesyourmedicalproviderwantyoutoreturnforanappointment? q Yes q No Ifyes,when?

__________________________________________________________________________________________________________________________________________________________________________________________________________________

Othercommentsornotes:

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

PART B



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LABORATORY AND OTHER MEDICAL TESTS(Make multiple copies o this page in case your medical provider orders multiple lab tests)

If you have any concerns or reasons why you might not be able to have these recommended tests, state them during the appointment.

Doyouneedlaboratoryorotherdiagnostictests? qYes qNo

Ifyes,whenshouldyoucallorreturnfortestresults? ____________________________________________________________

I yes, complete the ollowing:

Nameoftest:_____________________________________________________________________________________________

Reasonforthetest: _______________________________________________________________________________________

_________________________________________________________________________________________________________

Whatisinvolved? _________________________________________________________________________________________

_________________________________________________________________________________________________________

Doyouneedtodoanythingprepareforit? qYes qNo _______________________________________________________

_________________________________________________________________________________________________________

Doesanythingaffecttheresults,suchasdrugs,alcohol,food,etc? qYes qNo _________________________________

_________________________________________________________________________________________________________

Arethereanyrisksordiscomfortinvolvedwiththistest? qYes qNo ___________________________________________

Whowilldoit?____________________________________________________________________________________________

_________________________________________________________________________________________________________

Wherewillitbedone? _____________________________________________________________________________________

_________________________________________________________________________________________________________

Howsoondoesitneedtobedone? ________________________________________________________________________

_________________________________________________________________________________________________________

Whenandhowdoyougettheresults? ______________________________________________________________________

_________________________________________________________________________________________________________

Wherecanyougetmoreinformationaboutthistest? __________________________________________________________

_________________________________________________________________________________________________________

Othercomments:_________________________________________________________________________________________

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________



17/40



MEDICATIONS AND TREATMENTS(Make multiple copies o this page in case your medical provider orders multiple medications or treatments)

If you have any concerns or reasons why you might not be able to follow the treatment recommendations, state them during the appointment.

Note: When you pick up your medications, read the label and make sure it states the same information your medical provider told you.

Doyouneedanymedicationortreatment?qYes qNo

I yes, complete the ollowing:

Name o medication or treatment: _____________________________________________________________________________

Isagenericformavailable?qYes qNo_______________________________________________________________________

Doestheproviderhaveanysamplesintheofceforyoutotrythemrst?qYes qNo

Reason or the medication or treatment: _______________________________________________________________________

Howmuchshouldyoutake? _________________________________________________________________________________

Howoftenshouldyoutakeit?________________________________________________________________________________

Whenshouldyoutakeit?____________________________________________________________________________________

Howlongwillyouneedtotakethismedicationfor? _____________________________________________________________

Willitinteractwithanyothermedicationsorsupplementsyouaretaking? qYes qNo ______________________________

___________________________________________________________________________________________________________

Shouldyoutakeitwithorwithoutfood? _______________________________________________________________________

Whatshouldyouavoidwhiletakingit,suchasalcohol,grapefruitjuice,drugs,certainfoods,oractivities?

___________________________________________________________________________________________________________

Whatarethepotentialbenets? ______________________________________________________________________________

Whatarethechancesitwillwork?____________________________________________________________________________

Arethereanymajorrisksandsideeffects? qYes qNo _________________________________________________________

Howcommonaretheserisksorsideeffects?___________________________________________________________________

Howsoonshouldyouexpecttoseeresults?___________________________________________________________________

Iftherearesideeffects,aretherewaystomanagethese? _______________________________________________________

Arethereanysideeffectsyoushouldreportorthatmaybepotentiallyurgent? qYes qNo _________________________

___________________________________________________________________________________________________________

Whatmighthappenifyouavoidedordelayedtakingthismedicationortreatment? _________________________________

Arethereotheroptions?qYes qNo _________________________________________________________________________

Wherecanyougetmoreinformationaboutthistreatment? ______________________________________________________

Other questions or comments:

___________________________________________________________________________________________________________

___________________________________________________________________________________________________________

___________________________________________________________________________________________________________



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SURGICAL OR MEDICAL PROCEDURES


Remember: It is your right to ask or a second opinion. It is oten a good idea to get a second opinioni the surgery is complicated, or i you have reservations about the procedure or surgeon.

Name o procedure _________________________________________________________________________________________Reason or the procedure ____________________________________________________________________________________

Whatisinvolvedwiththeprocedure? __________________________________________________________________________

Will you need any anesthesia qYes qNoifyes,whatkind?_________________________________________________

Whatarethepossiblebenetsoftheprocedure? _______________________________________________________________

Whatarethepossiblerisksorcomplications? __________________________________________________________________

Howcommonarethese?____________________________________________________________________________________


Howsoonshouldtheproceduretakeplace?___________________________________________________________________

Arethereothereffectivebutlessinvasiveoptions? _____________________________________________________________Whatmighthappenifyouavoidordelaytheprocedure? ________________________________________________________

Whatdoyouneedtodotopreparefortheprocedure? __________________________________________________________

Name o person perorming the procedure: ____________________________________________________________________

Howmuchexperiencedoesthesurgeon/doctorhavewiththisprocedure? ________________________________________

Willaresidentbeworkingwiththesurgeonordoctor? qYes qNo ______________________________________________

Whowillactuallybeperformingtheprocedure? _________________________________________________________________

Wherewilltheprocedurebeperformed? _______________________________________________________________________

Howlongwilltheproceduretake? ____________________________________________________________________________

Howlongwillyouhavetostayaftertheprocedure? _____________________________________________________________Willyouneedsomeonetodriveyouandcareforyouaftertheprocedure? qYes qNo

Howlongistherecoveryperiod?_____________________________________________________________________________

Arethereanyrestrictionsaftertheprocedure? qYes qNo ______________________________________________________

Willyouhaveanydiscomfortaftertheprocedure? qYes qNo __________________________________________________

Howarepainandotherpost-procedureproblemstreated? ______________________________________________________

Ifabiopsyisinvolved,howandwhendoyougettheresults? ____________________________________________________

Wherecanyougetmoreinformationaboutthisprocedure? ______________________________________________________

Other questions or comments: _______________________________________________________________________________

______________________________________________________________________________________________________________________________________________________________________________________________________________________

Tip:It is common practice to stop taking any medications that

reduce blood-clotting or a period o time prior to most

procedures, such as liver biopsies. These include aspirin, ibuproen,

naprosyn, and other common medications. Dietary supplements may

also reduce blood-clotting, such as vitamin E, licorice, dandelion, etc.

Report all supplement use to your medical provider.



19/40



e I G HT

Yur Medic Hitry

You can maximize your time by preparing or the appointment. Keeping a written record o your medicalhistory will help you use the time more eciently. Bring a copy o this with you to the appointment. You

can give your healthcare provider a copy or you can reer to it during the appointment.

Yourname,dateofbirth,andethnicorracialbackground.

Anyallergiestomedications,food,orothersubstances.

Alldietarysupplementsanddrugsthatyouaretaking

or have taken recently. Include prescription, over-the-counter, etc.

Ifyouarepregnantorbreastfeeding.

Childhoodillnessesandimmunizationsyouhave

had and when.

Anymajorillnessesyouhavebeendiagnosedwith,especially those that are still active or have been

diagnosed recently.

Anysurgeriesyouhavehad.

When you see a new healthcare proessional the appointment starts with communicating details

about your present and past medical history. The time to talk will probably be short, so use it well.

Lifestyle-Areyoumarried?Anychildren?Whatare

their ages?Whatisyouroccupation?Whatisyourbirthplace?

Describeyourdrinking,smoking,eatingandexercise habits.

Placesyoutraveledtorecentlywhereyoumayhave

been exposed to health risks.

Familyillnessesandcauseofdeathofcloserelatives.

Anyrecentlifechanges,suchasdivorce,jobchange,

death or illness o amily member or close riend.

Thenames,address,andphonenumbersofall.

healthcare providers and pertinent past providers.

Anyrecentdiagnosticresultsorothermedicalreports.

When listing your illnesses and surgeries, start with themost recent and work backwards. Your wisdom teethremoval when you were 15 years old is ar less important

than last years gall bladder surgery. A recent diagnosiso thyroid disease is more important to mention than the

bladder inection you had two years ago. The exception tothis is i you are being seen or a current bladder inection

and you get them requently.

Try to be honest. It takes time to build trust. However,medical proessionals who dont have all the inormation

cant make inormed recommendations. I a concerninfuences your ability to be truthul, state that. For

example, I dont want to tell you that I smoke tobaccobecause I dont want to be lectured about it. The truth is Ismoke, I know it is bad or me, and I am not ready to quit

at this time. I I need your help with this in the uture, I willbring it up. This is a clear message. It tells the healthcare

provider that you are a smoker, aware o the risks andrelieves you o the ear o a lecture.

Stay current. Review your medical history annually and

every time you have a change in your health. Pick anannual date or this review, such as around your birthdayor ater you le your income taxes. Keeping your medical

history up-to-date beore you have an urgent medicalneed will help you when you will need it the most.

What to include in a medical history


I ik gd try w td.Tht i th rn I m m-tim rcd t t thm my-

. Mrk Twin


20/40



N I N e

Medictin nd suppement Hitry


Name

How MuchHow Often

How Long Reason

Prescribing

(Dose) Providers Name

Prescription

Medication

Non-prescription

Medication

Dietary

Supplements

RegulaR

OCCaSIOnal/aS neeDeD

ReCenTly STOppeD (paST mOnTH)

OTHeR

Medications Taken

in the Past Year

Recreational

Drugs

Prescription

Medication

Non-prescription

Medication

Dietary

Supplements

Prescription

Medication

Non-prescription

Medication

Dietary

Supplements


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T eN

Medictin Guideine

Know the ollowing about your medications

Genericandbrandnamesofmedication

Reasonyouaretakingthemedication

Thedoseofthemedication

Thefrequencyyoushouldtakethemedication

Thetimeofdayyoushouldbetakingyourmedication

Ifitwillinteractwithanyothermedicationsorsupplements you are taking

Ifyoushouldtakeitwithorwithoutfood

Ifyoushouldavoidanythingwhiletakingit,suchasalcohol, graperuit juice, drugs, certain oods or activities

Thelengthoftimeyouwillneedtotakethismedication

Ifyouneedtonishtheentireprescription

Thedrugsexpirationdate

This chapter discusses ways to manage your medications. Since this can be tricky,

particularly medications used or HCV treatment, spending a little time reading and askingquestions about your medications will help you take them saely and correctly.

Thestorageinstructionsforthemedication

Themajorrisksandsideeffects

Iftheserisksorsideeffectsarecommon

Iftherearesideeffects,waystomanagethese

Ifanysideeffectsshouldbereportedorthatmaybepotentially urgent

Howsoonyoushouldexpecttoseeresults

Whattodoifyouarelateormissadose

Howtorellthemedication

Howmanydaysbeforeyourunoutshouldyou

request a rell

Whatthismedicationwillcostyou

Wheretogetmoreinformationaboutthismedication

Guidelines or Managing Medications Saely

1. Ask your medical provider i there are ways you

can care or yoursel that may help you avoid orreduce the need or medications, surgery, or anyinvasive procedures.

2. Understand the correct instructions or taking your

medication. Make sure these exactly match theprescription label. I the two instructions are not

identical, clariy this beore taking the medication.

3. Know the medications side eects beore youstart taking it.

4. Beore taking a new medication, ask i there are anymedications or oods that should not be mixed with it.

5. Take the minimum eective prescribed dose unlessadvised otherwise.

6. Take medication with a ull glass o water unlessotherwise directed.

7. Ask i you are supposed to take all o your

prescription. For instance, always take the entireprescription o antibiotics even i you eel better.

8. Never break, crush, or dissolve a pill, tablet, or

capsule without making sure this is all right to do.Some medications need to be intact so stomach acidsdo not destroy them. I swallowing pills is dicult or

you, tell your medical provider.

9. Do not take medication in the dark or without yourglasses i you need them to read the label.

10. For liquid medications, use standard measuringspoons rather than eating utensils.

11. Try to take your medications on time. Find out what

you are supposed to do i you are late or miss a dose.

Never double up on a dose unless you are clearlyinstructed to do so.

12. I you have trouble remembering to take medication,

ask a pharmacist, nurse or other health provider ortips. Calendars, alarms, computer reminders, notes

and daily pill cases can provide reminders.

Continued


22/40



13. Do not take a medication that has expired, smellsor looks odd to you. This is especially important orliquid medications.

14. I you pick up a prescription and the medication looks

dierent rom the last time you took it, talk to yourpharmacist to make sure there has not been an error.

15. I you did not take the medication as prescribed, tell

your medical provider.

16. Do not use someone elses medication or give yourmedication to anyone else.

17. Keep medications in their original container with a

secure cap.

18. I the cap is dicult to remove, ask your pharmacistor a dierent type.

19. Store medications as directed.

20. I you are traveling by air, carry medications with youin the cabin. Keep them in their original containers

with the prescription label.

Gs fr Maagg Mcas Safy Continued

21. Do not leave medications in a hot car.

22. Keep medications away rom childrens reach.23. I you are or may be pregnant, tell your provider this

beore you take any medication. Also, mention i you

are breasteeding.

24. I you are hospitalized or in a position where someone

else gives you your medication, look at what you aretaking beore you take it. I something does not lookright, ask or clarication or assurance.

25. I you think you are having an allergic reaction to a

medication, seek immediate medical help.

26. Formulate an emergency plan in case o accidentaloverdose or medical emergencies. In the United

States, 911 is the standard emergency phone number.I you use a cell phone, calls go to a central dispatch

location. This can cause delays. Near your phone,post the numbers o your local poison control center,police, re, physician, and hospital emergency room.

Poison Control Center: 1 (800) 222-1222

Th crt hth r thmind nd dy i nt t murnr th pt, wrry ut th u-

tur, r nticipt tru ut t

iv in th prnt mmnt wi-

y nd rnty. buddh


23/40



e l e V e N

Tip r lwering Precriptin Drug Ct

Prescription drug costs are going up. Dont be embarrassed i you cant aord a medication. Nearly everyone hasbeen hit by rising healthcare prices. The ollowing are some cost-saving tips to consider:

This chapter suggests ways to lower your prescription drug costs with cost-saving tips, suchas purchasing wholesale or through reliable Internet-based pharmacies.

Askyourdoctorifthereisacheaperversionofyourmedication,suchasagenericform.

Inquireaboutfreesamples.

Shopforthebestdrugprice,suchasthroughCostco,wholesale,orreliableInternet-basedpharmacies.

Askifthereareanyclinicaltrialsinyourareausingthedrugtreatmentthatyouneed.

Lookfordiscounteddrugprices,suchasthroughyourinsuranceplan,orAARP.Insurancepharmacy

mail order plans can really cut costs.

Ifitsadrugyouarecondentyouwillbetakingforsometimeandatasteadydose,seeifa90-daysupply costs less than a 30-day supply.

Seeifyouqualifyforapharmaceuticalpatientassistanceprogram.Formoreinformationcontact

Partnership or Prescription Assistance www.pparx.org or Needy Meds www.needymeds.com


24/40



Complete part A o this orm and bring it with you when you see a medical provider or the rst time. I you can, bring

copies rather than your own copy o your records. Complete part B during or ater your medical appointment.

Brg h fwg f y hav hm:

qYour advocate

qAny new test results that were ordered by anothermedical provider

qMedicationlog(seeMedication andSupplement History)

q Any new inormation or allergies to add to yourmedical records

q Medical card or medical identication number

qAppointment book or calendar

qFor women date o last menstrual period

Whatisyourmainhealthconcern? _________________________________________________________________________

_________________________________________________________________________________________________________

Whatquestionsorconcernsdoyouwanttocoverduringthisappointment? List in order o importance, starting with the

most important: ____________________________________________________________________________________________

Ifyouhaveanynewmedicalproblemsorsymptoms,whatarethey? ____________________________________________

_________________________________________________________________________________________________________

Dothesesymptomsinterferewithanything,suchassleep,exercise,eating? ______________________________________

_________________________________________________________________________________________________________

Ifyouareexperiencingpain,howmuchpainareyouhaving?Ratethisonapainscaleof1to10,with 1 being the least

and 10 being the most pain: _______________________________________________________________________________

_________________________________________________________________________________________________________

Howlonghaveyouhadthesesymptoms? ___________________________________________________________________

_________________________________________________________________________________________________________

Whatmakesthemworse?Whatmakesthembetter? __________________________________________________________

_________________________________________________________________________________________________________

Haveyouhadanychangesinyourlifethatmayhaveaffectedyourhealth,suchasdeathofalovedone,divorce,

insomniaorsubstanceuse?________________________________________________________________________________

_________________________________________________________________________________________________________

It is highly recommended that you bring an advocate with you to your rst ew or any complicated medical appointments.This can be a riend, amily member or someone rom your support group.

T WelV e

fw-Up appintment Checkit r HCV Ptient

This section suggests guidelines or how to maximize your ollow-up appointments with your

medical provider. Providing up-to-date inormation will help make your appointment go smoothly.

PART A

FOLLOW UP APPOINTMENT FORM SECTION


25/40



MEDICAL PROVIDERS COMMENTSSummary of visit: You or your advocate can complete this during or immediately after your appointment.

Note: This is a very thorough orm. I your medical provider does not have time to answer all your questions, ask or the best way to get theseanswers.There may be someone else in the ofce who can help you. Some providers will call or email you later when they have more time.

Writedowninformationfromassessments,suchasbloodpressure_________________andweight_________________

_________________________________________________________________________________________________________

Ifyouhaveanewmedicalproblem,whatisthenameofyourmedicalproblem(diagnosis)? ________________________

_________________________________________________________________________________________________________

Whatisthelikelycourse(prognosis)ofyourmedicalproblem?__________________________________________________

_________________________________________________________________________________________________________

Arethereanysymptomsyoushouldwatchoutfororneedtocalltheproviderfor?_________________________________

_________________________________________________________________________________________________________

Istherenewinformationortreatmentaboutyourmedicalproblem? _____________________________________________

_________________________________________________________________________________________________________

Whatdoesyourmedicalproviderwanttodonext?

(If medication, treatment, surgery, or medical tests are ordered, see the next few pages.)

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________


Isthereanythingyoucandotohelpyourproblemorimproveyourhealth? ________________________________________________________________________________________________________________________________________________

Ifyourmedicalproviderwantsyoutoseeanotherspecialist,nurse,dietician,etc,whatisthenameandreason?

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

Wherecanyougetmoreinformationorsupportaboutthisproblem? ___________________________________________

_________________________________________________________________________________________________________

Doesyourmedicalproviderwantyoutoreturnforanappointment?q Yes q No

Ifyes,when? _____________________________________________________________________________________________

Othercommentsornotes:

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

PART B



26/40



LABORATORY AND OTHER MEDICAL TESTS(Make multiple copies o this page in case your medical provider orders multiple lab tests)

If you have any concerns or reasons why you might not be able to have these recommended tests, state them during the appointment.

Doyouneedlaboratoryorotherdiagnostictests? qYes qNo

Ifyes,whenshouldyoucallorreturnfortestresults? ____________________________________________________________

if ys, cm h fwg:

Nameoftest:_____________________________________________________________________________________________

Reasonforthetest: _______________________________________________________________________________________

_________________________________________________________________________________________________________

Whatisinvolved? _________________________________________________________________________________________

_________________________________________________________________________________________________________

Doyouneedtodoanythingprepareforit? qYes qNo ______________________________________________________

_________________________________________________________________________________________________________

Doesanythingaffecttheresults,suchasdrugs,alcohol,food,etc? qYes qNo _________________________________

_________________________________________________________________________________________________________

Arethereanyrisksordiscomfortinvolvedwiththistest? qYes qNo ___________________________________________

_________________________________________________________________________________________________________

Whowilldoit?____________________________________________________________________________________________

_________________________________________________________________________________________________________

Wherewillitbedone?_____________________________________________________________________________________

_________________________________________________________________________________________________________

Howsoondoesitneedtobedone? ________________________________________________________________________

_________________________________________________________________________________________________________

Whenandhowdoyougettheresults? ______________________________________________________________________

_________________________________________________________________________________________________________

Wherecanyougetmoreinformationaboutthistest? __________________________________________________________

_________________________________________________________________________________________________________

Othercomments:_________________________________________________________________________________________

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________



27/40



MEDICATIONS AND TREATMENTS(Make multiple copies o this page in case your medical provider orders multiple medications or treatments)

If you have any concerns or reasons why you might not be able to follow the treatment recommendations, state them during the appointment.

Note: When you pick up your medications, read the label and make sure it states the same information your medical provider told you.

Doyouneedanymedicationortreatment?qYes qNo

if ys, cm h fwg:

Name o medication or treatment: _____________________________________________________________________________

Isagenericformavailable?qYes qNo_______________________________________________________________________

Doestheproviderhaveanysamplesintheofcesoyoucantrythemrst?qYes qNo

Reason or the medication or treatment: _______________________________________________________________________

Howmuchshouldyoutake? _________________________________________________________________________________

Howoftenshouldyoutakeit?________________________________________________________________________________

Whenshouldyoutakeit?____________________________________________________________________________________

Howlongwillyouneedtotakethismedicationfor? _____________________________________________________________

Willitinteractwithanyothermedicationsorsupplementsyouaretaking? qYes qNo ______________________________

Shouldyoutakeitwithorwithoutfood? _______________________________________________________________________

Whatshouldyouavoidwhiletakingit,suchasalcohol,grapefruitjuice,drugs,certainfoods,oractivities?

___________________________________________________________________________________________________________

Whatarethepotentialbenets? ______________________________________________________________________________


Whatarethemajorrisksandsideeffects? _____________________________________________________________________

Howcommonaretheserisksorsideeffects?___________________________________________________________________

Howsoonshouldyouexpecttoseeresults?___________________________________________________________________

Iftherearesideeffects,aretherewaystomanagethese? qYes qNo

Arethereanysideeffectsyoushouldreportorthatmaybepotentiallyurgent? qYes qNo _________________________

Whatmighthappenifyouavoidedordelayedtakingthismedicationortreatment? _________________________________

___________________________________________________________________________________________________________

Arethereotheroptions?qYes qNo _________________________________________________________________________Wherecanyougetmoreinformationaboutthistreatment? _______________________________________________________


___________________________________________________________________________________________________________

___________________________________________________________________________________________________________

___________________________________________________________________________________________________________



28/40



SURGICAL OR MEDICAL PROCEDURES


Name o procedure: ________________________________________________________________________________________

Reason or the procedure: ___________________________________________________________________________________Whatisinvolvedwiththeprocedure? __________________________________________________________________________

Will you need any anesthesia qYes qNoifyes,whatkind?_________________________________________________

Whatarethepossiblebenetsoftheprocedure? _______________________________________________________________

Whatarethepossiblerisksorcomplications? __________________________________________________________________

Howcommonarethese?____________________________________________________________________________________


Howsoonshouldtheproceduretakeplace?___________________________________________________________________

Arethereothereffectivebutlessinvasiveoptions? _____________________________________________________________

Whatmighthappenifyouavoidordelaytheprocedure? ________________________________________________________

Whatdoyouneedtodotopreparefortheprocedure? __________________________________________________________

Name o person perorming the procedure: ____________________________________________________________________

Howmuchexperiencedoesthesurgeon/doctorhavewiththisprocedure? ________________________________________

Willaresidentbeworkingwiththesurgeonordoctor? qYes qNo ______________________________________________

Whowillactuallybeperformingtheprocedure? _________________________________________________________________

Wherewilltheprocedurebeperformed? _______________________________________________________________________

Howlongwilltheproceduretake? ____________________________________________________________________________

Howlongwillyouhavetostayaftertheprocedure? _____________________________________________________________

Willyouneedsomeonetodriveyouandcareforyouaftertheprocedure? qYes qNo

Howlongistherecoveryperiod?_____________________________________________________________________________

Arethereanyrestrictionsaftertheprocedure? qYes qNo ______________________________________________________

Willyouhaveanydiscomfortaftertheprocedure? qYes qNo __________________________________________________

Howarepainandotherpost-procedureproblemstreated? ______________________________________________________

Ifabiopsyisinvolved,howandwhendoyougettheresults? ____________________________________________________

Wherecanyougetmoreinformationaboutthisprocedure? ______________________________________________________


___________________________________________________________________________________________________________

___________________________________________________________________________________________________________

Tip:It is your right to ask or a second opinion. It is oten a good

idea to get another opinion i the situation is complicated, or

i you have reservations about the procedure or surgeon.



29/40



Beore your appointment

Prepare or the appointment by bringing the ollowing:

Briefsummaryofyourmainhealthconcern.

Questionsorconcernstocoverduringtheappointment.

Prioritize, starting with the most important.

Resultsofalllaborotherproceduresorderedbyanother medical provider. I you can, bring copies rather

than your own copy o your records.

Listofallmedicationsandsupplementsyoutake.

(see Medication and Supplement Historylog)

Anynewinformationorallergiestoaddtoyour medical records.

Medicalcardormedicalidenticationnumber.

Appointmentbookorcalendar.

Itishighlyrecommendedthatyoubringanadvocate

with you to your rst ew or any complicated medicalappointments. This can be a riend, amily member or

someone rom your support group.

During your appointment

Start with your main problem. Be brie and clear. Describe

your symptoms and how these aect you. I this is arecurring problem, explain how it aected you and whatwas done.

I you have more questions or concerns, tell your medicalprovider. Ask your provider i you should state all your

concerns now or ater you have discussed the mainproblem rst.

I medications, tests, surgery or other procedures are ordered,

write down:

Nameofthemedications,tests,surgeryorprocedures.

Thereasonforthemedications,tests,surgery

or procedure.

Therisksinvolved.

Thepotentialbenets.

Whathappensifyoudelayoravoidthemedication,test, surgery or procedure.

Howtotakethemedicationorprepareforthetest

or procedure.

Ifyouarereferredtoanotherspecialist,nurse,dietician,etc., what is the name and reason.

Howwillyoundoutyourtestresults.

At the end o the appointment

Arethereanysymptomsordangersignstobeawareof.Isthereanythingelseyouneedtoknow.

Doesyourproviderwantyoutocallorreturnforanother appointment.

Ater your appointment

During or immediately ater the appointment, you or your advocate

should write down the ollowing:

Thenameofyourmedicalproblem(diagnosis).

Whatthemedicalproviderwantsyoutodonext.

Whatchangesyoucanmakethatmayhelpyourproblem

Everythingyoucanrememberthatyourprovidertoldyou.

T HI R T eeN

Medic appintment Checkit: The shrt frm

This orm is or those who preer a shorter version o the medical checklist.

a I it, vry dyyu d n tw thing: uid

hth r prduc

di in yur. ad Dvi


30/40



Here are a ew tips when calling your medical provider:

Inoneortwosentences,writedownthereasonforyour call.

Listyoursymptomsandhowlongyouhavehadthem.

Havecalendar,pen,andpaperavailablebeforeyoumake the call.

Ifthecallisforaprescriptionrell,leavethenameofthe

medication, the dose, amount, prescription number and

the name and phone number o your pharmacy.Makeyourcallrstthinginthemorning.

Writedownthenameofwhoyouspokewith.Thismaybe a nurse, receptionist or answering service.

Askwhenyoumightexpectareturncall.

Leavethephonenumberthathasthebestchanceof

getting through to you over the course o a day. Formany people this is a cell phone number. Few o us arein one place all day.

Keepthephonelineclearasmuchaspossible.Ifthereasonforyourcallcanberesolvedwitha

return message, state clearly i it is okay to leavea recorded message or to give the message tosomeone else who answers your phone. Because o

privacy regulations, medical providers will not leavemessages unless specically authorized to do so.

foU R T e e N

Cing yur Mdic Prvidr

You may need to call your medical provider or inormation, to renew aprescription, or to see i it is necessary to be seen in the oce.

This section oers ways to improve phone communication with your provider.


31/40



Time spent seeing your medical provider is short. Here are some tips on how to set up a good appointment:

MondaysandFridaysareoftenbusierthantherestoftheweek. The best times to call or appointments are usuallybetween 10 a.m. to noon and rom 2 p.m. to 4 p.m.

Haveyourmedicalnumber,insuranceinformationandcalendar on hand.

Ifseeingyourmedicalproviderontimeisimportant,ask

or the rst appointment o the morning or aternoon.

Ifyourconditioniscomplicatedorifhavingextratime

is important to you, explain this at the time you makethe appointment. It can be rustrating to nd out that

you were scheduled or a 10-minute time slot when youactually needed 45 minutes.

Youmayalsotryaskingforthelastappointmentoftheday. However, keep in mind that you may have to wait

longer because i others arrived late, that will accumulateby the days end. Also, remember that on busy days, your

medical provider may not have had a minute to eat or sitdown. Even i you are sick, try to be considerate.

Whenmakingtheappointment,stateiftheappointment

is routine or urgent. I you think it is urgent, be preparedto explain why you think so. For instance, I have been

vomiting or the last 48 hours is urgent. For the last twoyears I get a mild stomach ache every time I eat mayeel urgent but it probably is not.

fI fT e e N

Mre Tip but Medic appintment

Iftheappointmentyouaregivenseemstoofaroff,ask i you can be put on a cancellation waiting list.Cancellations are more common than you may think.

Conrmyourappointmentafewdaysbeforeandthen

keep the appointment. It is amazing how oten peopledo not show up or appointments.

Beontime.Beingearlyisevenbetter.Planningtoarrive15 minutes early is a good rule o thumb.

Ifyouknowyouaregoingtobelate,calltheofce.

Sometimes you can still be seen.

Bepreparedtowait.Bringsomethingtooccupy

yoursel. There are many reasons why medical providerscan run behind in their schedules.

Ifyourproviderseemshabituallylate,callinadvance

and see i he or she is running behind. I appointmentsare running an hour behind, ask i you can arrive 45minutes later than your scheduled time.

Donottakefrustrationoutonthestaff.Ifyouhavebeen

waiting excessively long you can request an explanationGood manners go arther than irritability does.

Ifyouknowinadvancethatyourtimeisshort,tellthe

sta when you arrive or even call in advance. I youhave an appointment and need to be across town in

two hours, say so. Explain, Something has come upand I need to leave here by such and such time. Have Iallowedenoughtimetoseethedoctor?

Ifyourproviderwantsyoutoreturnforafollow-up,make

the appointment beore you leave the oce. Ask thesta to write the date and time down on a card with the

oce phone number so it is handy should you need tochange the appointment.

Ifyouneedtochangeorcancelanappointment,tryto do so at least 24 hours in advance. You may be

charged i you do not cancel within a certain time rame.Remember that other patients may need that time slot.

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R.N. Registered Nurse

RNs work in hospitals, clinics, homes and other communitysettings. They perorm many tasks such as making

patient assessments, educating patients, administeringmedications and other treatments. There are many types onurses such as advice nurses, public health nurses, clinic

nurses, surgical nurses, home health nurses and psychiatricnurses. RNs receive their training in a number o ways

and may have a bachelors degree, associates degree,or nursing school diploma. The addition o a C ollowed

by other letters signies that the nurse is certied in a

specialty. RNs are licensed and usually report to physiciansor other advanced level practitioners.

s I XT e e N

The Medic aphbet

Our health is in the hands o numerous people with a variety o letters trailing their names. For instance, nursescan have over 50 dierent abbreviations ater their names. What do these letters mean and what do these people

do?Hereareafewdenitionsofsomecommonabbreviationsformedicaloccupationsyoumayencounter:

M.A. Medical Assistant

MAs perorm routine clinical and clerical tasks. The MA

may be the person who escorts you to the examiningroom, takes vital signs, and asks you some general

questions. MAs are usually trained through a ormalprogram, but are not licensed. MAs are supervised byphysiciansornurses.(Note:Outsideofmedicine,MA

generallymeansMasterofArts.)

N.A. Nursing Assistant

NAs work in hospitals at the same level as MAs. NAs

may give patient baths, take vital signs, and help withpatients basic needs. NAs are supervised by nurses andare not licensed.


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L.V.N. or L.P.N. Licensed Vocational Nurse or Licensed Practical Nurse

These nurses unction in much the same way as RNs. They

are licensed, but have less education. The roles o LVNsand LPNs are slightly restricted rom those o RNs, but thereis a great deal o overlap. They are usually supervised by

RNs, physicians, or other advanced level practitioners.

N.P. Nurse Practitioner

NPs are highly trained advanced practice RNs, who

usually have at least a masters degree. Sometimes NPsmay have RNP, FNP or other letters ollowing their names.

These simply signiy a ocus in their education. The lawsdescribing the scope o responsibility dier betweenstates. NPs can work independently, but they usually work

under a physicians supervision. Usually the physiciandoes not need to be immediately present in order or an

NP to unction. They can prescribe medications, orderlab tests, and in certain cases, perorm some surgical

procedures and administer anesthesia.

P.A. Physician Assistant

PAs are highly trained mid-level practitioners who practiceunder the license and supervision o physicians. They

usually have at least a bachelors degree. In general, PAscan practice in all medical and surgical specialties provided

they are properly trained and supervised. Usually thephysician does not need to be present in order or a PA tounction. They can write prescriptions, order lab tests and

do other medical tasks oten perormed by physicians.

M.D. Medical Doctor

MDs have attended medical school and passed rigorous

licensing exams. They can be physicians or surgeons.There are a host o other letter combinations that can ollowMD. These are earned when the doctor has obtained some

advanced training, education or certication.

A note ABout HCV MediCAl SpeCiAltieS:

Gastroenterologists

These physicians specialize in diseases o the

digestive system. The liver is part o that system.

Hepatologists

These are gastroenterologists who specialize in liver

diseases. Hepatologists usually practice in medicalcenters that have liver transplant programs.

Therearemanyothercombinationsoflettersthatdesignateprofessionaldistinction.Pharmacist(PharmD),

dentist(DDS),doctorofosteopathy(DO),doctorofchiropractics(DC)physicaltherapist(PT),respiratorytherapist(RT)andsoon.ProfessionssuchasChinesemedicine,naturopathy,etc.alsohavetheirown

letter designations. I you see unamiliar abbreviations ollowing a name, ask about them. Proessionalshave earned those abbreviations and are usually happy to explain the meanings.

Each member o your healthcare team has a role. Although some have more training than others, theirtraining makes them more suited or specic tasks. Learn how each is involved i

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