00 MHP Organizer Cover - North Carolina Health Insurance ......health insurance. Our family of Blue...

Health Organizer

HEALTH ORGANIZER

Asthma

DiabetesManagement Tools

Fibromyalgia

Medical History

Fibromyalgia

Health Records

Control

HealthMember Health PartnershipsSM1

Asthma CareManagement Tools

Asthma CareManagement Tools

FibromyalgiaAsthma CareFibromyalgia

Tobacco FreeMedical HistoryTobacco FreeMedical History

ControlTobacco FreeControlTreatmentTreatmentTreatmentTreatmentDiabetesTreatmentDiabetes

Health Organizer

Health Organizer

Property of:

Name:

Address:

Telephone:

Health Organizer

Introduction

General Health Information

Nutrition and healthy eating

Steps to better nutrition

Visualizing serving sizes

Physical activity

Stress management

Tobacco cessation

High blood pressure

High cholesterol

Preventive health reminders

Medication adherence

Providers and Resources Medical History

Office Visits

Health Maintenance Records

Health Diary

Notes

Health Organizer

1-4

5-22

6

7

8

9-10

11-12

13-14

15-16

17-18

19-20

21-22

23-26

27-46

47-56

57-64

65-74

1 - Health Organizer

Health Organizer

How to use your Member Health Partnerships Health Organizer

The Member Health PartnershipsSM1 Health Organizer is a one-stop reference for your personal health information. In addition to providing valuable health-related information, the organizer has health management tools you can use to track your medical history, medications, routine health and other health services. It also contains tips on how to communicate with your health care provider and how to take prescription medications as well as preventive health plans and health maintenance records. Keeping a record of your personal health information will help you work more effectively with your health care providers. We encourage you to take your organizer with you to all of your visits with your health care provider to review the information.

NOTE: The information contained in this Organizer was consolidated for your convenience from various health resources. The information should not be viewed as medical advice from BCBSNC. If you have any questions concerning your medical condition or any drugs, treatment plan, or new symptoms, consult your health care provider.

The relationship you have with your health care provider is the key to obtaining the best health care that you can. Ask your health care provider how to be an active partner in making decisions about your health. Use the Member Health Partnerships Health Organizer to help build that partnership. Good communication, shared goals and informed decision-making will help you and your health care provider achieve the healthy outcomes you both desire.

Communication is not always easy. During a visit to your health care provider, everyone’s time is limited. You may forget to tell your provider important facts, and he or she may not address the issues you think are important. At times, you may not know the provider well, and he or she may not have your complete medical history. There may be times you feel embarrassed and are not straightforward and honest about your symptoms, lifestyle or habits.

Taking charge of your health means asking questions when explanations or instructions given by your health care provider are unclear, bringing up problems or questions even if he or she does not ask, and letting him or her know when a treatment does not seem to be working.

Keeping a personal health organizer is one step to building a good relationship with your health care provider. Whether you are dealing with a health crisis, managing your condition or documenting routine health care, the Member Health Partnerships Health Organizer will help you record and plan for a healthy future.

Health Organizer - 2

What you say to your health care provider plays a big role in how he or she diagnoses and treats your medical problems.

Health Organizer

Making the most of your visit to your health care provider

Health Organizer

Here are some ways you can get the most out of visits with your health care provider:

• Before your appointment, make a list of health concerns and questions

Bring the list of questions with you to your appointment.

• Bring a list of all of your medications Your list should include prescriptions, over-

the-counter medications, vitamins, herbal products or other supplements; also include the dosage you take and how often you take the medication. Be sure to tell your health care provider if you have any allergies.

• Do not be afraid to ask questions about your diagnosis and treatment plan

Ask about your treatment options and how each option will benefit your health. Let your health care provider know if you are seeing or being treated by any other health care professionals. It is OK to say, “I do not understand.”

• Be honest about your personal health habits

Talk with your health care provider about your diet, physical activity level, sexual history, smoking or alcohol use. Ask what diet or lifestyle changes you can make to help improve your health.

• Be sure your questions are answered before you leave

It is easy to forget what your health care provider tells you. Take notes, or bring a family member or friend with you. Sometimes, an extra set of eyes and ears can help you remember the questions you have and the answers you are given.

3 - Health Organizer

Getting the most out of visits with your health care provider

Refer to the Office Visits section of your Health Organizer to help you record this useful information.

Health Organizer

What are Blue ExtrasSM ?Your Blue Cross and Blue Shield of North Carolina (BCBSNC) membership gets you more than just health insurance. Our family of Blue Extras discount programs are available to members at no additional cost and complement your health insurance plan.1 With these programs you get information on health-related topics and discounts on everything from vitamins and supplements to massage therapy and laser vision correction. Learn more about these programs so you can save money and take charge of your health.

Alt Med BlueSM Up to 25% off of alternative medicine servicesSave on therapies intended to increase wellness and prevent illness such as acupuncture, biofeedback, massage therapy, personal trainers and more.

Audio BlueSM Save up to 25% or $250 per hearing aidPresent your BCBSNC ID Card at a participating provider location for a hearing consultation and receive a discount on hearing aids, custom fittings, follow-up visits, warranties, supplies and much more.

Blue PointsSM Earn free prizes for being physically activeJust 30 minutes of activity each day earns you points for prizes like clothing, electronics, sports, camping equipment and more.2

Cosmetic Dentistry BlueSM Save at least 10% on cosmetic dentistryYou can save at least 10 percent on a variety of cosmetic dental procedures not typically covered by dental plans. Visit Cosmetic Dentistry Blue

network providers statewide to receive discounts on procedures such as teeth whitening, bonding, implants and more.

Cosmetic Surgery BlueSM Cosmetic surgery discounts and informationReceive a 15 percent flat-rate discount on a participating physicians’ regular surgical fees for procedures that are not typically covered by insurance. Visit Cosmetic Surgery Blue network physicians statewide to receive discounts on procedures such as rhinoplasty, facelifts and liposuction.

Get Fit BlueSM Nutrition and fitness discounts and informationSave on nutrition and fitness products, programs and services and receive information on the latest fitness and nutrition news.

Health Line BlueSM 24-hour health information resourceTalk with a specially trained nurse, or search our online health information library 24 hours a day, seven days a week. Call 1-877-477-2424.

Optic BlueSM Discounts on laser eye surgeryChoose from a large statewide network of trusted eye doctors to receive discounts on corrective laser eye surgery and the LASIK procedure.

Vita BlueSM Save 40% on vitamins and supplementsChoose from over 100 different vitamins and supplements at about 40 percent off of the average drug store, retail and mail-order prices.3

To learn more about these and other Blue Extras programs, visit our Web site at bcbsnc.com .

1 BCBSNC reserves the right to discontinue or change these programs at any time. Blue Extras are not a covered benefit under your health plan. BCBSNC does not accept claims or reimbursement for these services and members are responsible for paying all bills. BCSBNC provides these programs for your convenience and is not liable in any way for the goods or services received. Decisions regarding your care should be made with the advice of your doctor. Due to specific contracts, certain groups will not be participating in Blue Extras at this time. Check with your benefits administrator or BCBSNC Customer Service to determine your eligibility. 2 Prizes subject to change. 3 BCBSNC Market Research, April 2000.

Health Organizer - 4

Take charge of your health with Blue Extras SM

Gen

eral

hea

lth

info

rmat

ion

TAB page -Do not print in document

Health Organizer – General health information - 5

General health information

Maintaining a healthy lifestyle involves making good choices for yourself such as staying physically active; eating a balanced, healthy diet; getting enough sleep; and managing your level of stress. You also will gain many health benefits by achieving and maintaining a healthy weight.

Leading a healthy, active lifestyle can help you feel good and look your best. It can also help decrease your chances of developing conditions such as high blood pressure, high cholesterol and heart disease. If you already have these conditions, modifying your lifestyle can help lower your risk of developing complications. As always, talk to your health care provider about any concerns you might have about your risk factors. He or she can help answer your specific questions.

This section of your Member Health Partnerships Health Organizer provides information about:

• Nutrition and healthy eating• Physical activity• Stress management• High blood pressure• High cholesterol• Preventive health reminders

This information can help you understand more about making healthy decisions to help you better manage your health. The Health Maintenance Records section of your Health Organizer can be used to record your health screenings and results.


6 - Health Organizer – General health information

Nutrition and healthy eating

Healthy nutrition does not mean going on a diet — it is a way of life. Healthy nutrition means choosing healthful foods every day. Learn about the foods that you like to eat and make it a habit to make nutritious choices. Eating well will help you maintain or lose weight, reduce your risk for heart disease and other chronic conditions, give you more energy and can make you feel good about yourself.

What is a healthy diet?The U.S.D.A.’s dietary guidelines describe a healthy diet as one that:• Emphasizes fruits, vegetables, whole grains,

and fat-free or low-fat milk and milk products• Includes lean meats, poultry, fish, beans, eggs

and nuts• Is low in saturated fats, trans-fats, cholesterol,

salt (sodium) and added sugars

How should I eat each day?There is no simple answer that is right for everyone. Every person’s body is different, so learning what is the right amount of food for you is important. Talk with your health care provider about how many calories you should eat each day.

You can get a personalized nutrition guide called the My Pyramid Plan, which is based on your age, gender and activity level. Visit mypyramid.gov , or call 1-800-687-2258, Monday through Friday from 10:00 a.m. to 4:00 p.m. EST, to request your copy of the guide. The My Pyramid Plan can help you choose the foods and amounts that are right for you.

At least half of the grains that you eat should be whole wheat Try whole-wheat pastas and brown rice. Buy cereals that have at least five grams of fiber. When buying foods, look for the words “whole wheat” on the package and on the ingredient list. When eating out, ask for wheat bread on sandwiches and brown rice at restaurants.

Eat five to nine servings of fruits and vegetables each day Fresh, frozen, and canned foods all count. Add dark, green vegetables to soups and stews. When eating out, order dishes that include vegetables or a salad. Use fruit as toppings on cereals, pancakes and other foods. Choose whole fruit instead of just juice as it is more filling and contains more fiber.

Choose low-fat or lean meats, fish and poultryBuy meats and poultry that are at least 90 percent lean. Trim any fat that you can see and take off the skin from chicken and turkey. Choose fish that are high in omega-3 fatty acids, like salmon or trout. One serving of meat or poultry is about the size of a deck of cards.

Get three cups of milk or three servings of milk, yogurt or cheese each dayOne serving of yogurt is one cup. One serving of cheese is about the size of your thumb. Choose nonfat or low-fat milk, cheese and yogurt. If you are lactose intolerant, lactose-free and lactose-reduced products are available at most supermarkets. These include hard cheeses and yogurt. Also, enzyme preparations can be added to milk, which makes it more digestible for people who are lactose intolerant.

Avoid foods that are high in sugar or salt Choose water, fat-free milk or unsweetened tea instead of soft drinks with sugar. Enjoy desserts or sweets occasionally, but not every day.

Pack healthy snacks like fruit, low-fat yogurt or a granola bar

Eat out less When you do eat out, choose meals with lots of vegetables. Watch out for big portions — save half of your meal for later. Cut down on fried foods like fried meats or French fries. Ask for substitutes like a fruit cup or tomato slices instead.

Set small goals that you can achieveMaking too many changes to your diet at once can be overwhelming. Start with little steps and set specific goals. For example, a goal might be to eat one serving of vegetables every day at lunch. Write down your goal and how you achieved it each day. At the end of the week give yourself a small reward (not food!) if you reached your goal. Once the goal becomes a habit, set another small goal. Slowly make your goals healthy habits that you can keep for life.


Be sure to check with your health care provider to see if you have any special dietary restrictions or needs.


Steps to better nutrition

Source: MyPyramid.gov



Visualizing serving sizes

Healthy eating includes making healthy food choices and understanding serving sizes. It can be difficult to visualize a half-cup or three ounces, let alone one serving. Here are some everyday comparisons to help you better understand serving sizes:

Here’s what the My Pyramid plan suggests based on a 2,000-calorie daily diet:

Food group Daily requirements and measurements VisualGrainsIn general, 1 serving equals1 ounce

This group should provide 6 one-ounce-equivalents (one-ounce-equivalent means 1 serving), half of which should be whole grains.

A large handful is the size of one serving of whole grains or an ounce of snack food.

1 slice of bread or 1/2 of a bagel the size of a hockey puck.

VegetablesIn general, 1 serving equals1/2 cup

This group should provide 5 servings, which is 2.5 cups.

One-half cup of chopped, cooked or raw vegetables is the size of a light bulb.

FruitIn general, 1 serving equals1/2 cup or a mediumsized fruit

This group should provide 4 daily servings, which is 2 cups.

A medium apple or peach is about the size of a baseball.

OilIn general, 1 serving equals 1 teaspoon

This group should provide 24g or 6 teaspoons.

A teaspoon of margarine is the size of the tip of your thumb to the first joint.

MilkIn general, 1 serving equals 1 cup

This group should provide 3 cups/servings.

One serving of yogurt is one cup or 8 ounces. One ounce of cheese is equal to about four dice.

MeatIn general, 1 serving equals 2-3 ounces

This group should provide 5.5 ounce-equivalents or servings.

Three ounces of meat is the size of a deck of cards or a checkbook.

Based on a 2,000 calorie dietSource: MyPyramid.gov, American Dietician Association, National Dairy Council

Physical activity can be both fun and energizing. The good news is that it is never too late to start an active lifestyle. Living an active lifestyle can help improve your overall health. Incorporating physical activity into your life does not have to be exhausting or boring. There are many ways you can get moving by doing activities you enjoy. Reap the health benefits of exercising while you are working toward and maintaining an active way of life.

Becoming more physically activeIncreasing your physical activity helps you feel your best and decreases your risk for stroke, diabetes, high cholesterol and high blood pressure. If you are not very active or have health problems, be sure to consult your health care provider first and start out slowly. Find an activity that you enjoy and feel that you can stick with, and then vary it with other activities so that you do not get bored. In order to prevent injury, keep safety in mind and learn about the risks of any new activity.

Examples of physical activity

• Walking or hiking• Jogging• Bicycling• Gardening or yard work• Swimming or water aerobics• Walking on a treadmill• Stair climbing• Dancing

Take the following steps to make physical activity a regular part of your day:

• Make exercise a routine Make an appointment with yourself to

exercise and pick a time each day when you are most likely to keep it.

• Get support from others By having the support of friends and family,

you are more likely to stick with your physical activity plan and maintain a healthy lifestyle. Schedule time to exercise with a friend.

• Set fitness goals By developing and following a specific

program, you are more likely to succeed. You can start by setting a one-month goal that you can reach.

• Monitor your progress Keep a record of what you do. Recording

your physical activity makes you more aware of your progress.

• Reward yourself When you meet your goal, celebrate your

accomplishment. If it is helpful, you can build on your successes week by week.



Physical activity

If you have a chronic condition such as diabetes, asthma, heart disease or any other condition, be sure to talk with your health care provider about what activities are safe for you.



Physical activity

A physical activity routine does not need to be strenuous or costly to be beneficial. Regular, moderate-intensity physical activity, such as 30 minutes of brisk walking five or more times a week, can be helpful to people of all ages. Try to spread it out through the week. If you do not have time to take a 30-minute walk, break it up into three 10-minute walks. Every other day might work best for you.

Benefits of physical activity• Helps to control your weight, blood

pressure and cholesterol

• Strengthens your heart, lungs, muscles and bones

• Helps to increase your energy and strength

• Helps you look and feel better

• Helps you to sleep better and manage stress

• Helps to reduce your risk of heart attack

For the best health results, work up to 30 to 60 minutes of physical activity most days of the week. Before beginning any kind of physical activity plan, be sure to talk with your health care provider about what activities are safe for you.

Here is another incentive to get moving! Earn free prizes for being physically active with Blue PointsSM! For details, go to bcbsnc.com and click on “I’m a Member” then “Blue ExtrasSM”

What is stress?Stress is a part of life. Our reaction to stress is the way that our body responds to change or tense situations. Often, the stress we feel comes as much from how we react to things as from the things themselves. Our reaction is related to our mind’s perception of our ability to cope with an event or situation. Some stress can be positive; it can motivate us and help us to focus. While some stress is normal, too much stress can negatively affect your health. Also, if you do not cope with stress very well, it can lead to harmful symptoms.

What causes stress?Events that provoke stress are called stressors. Becoming more aware of your stressors and what you can change can help you better respond to stressful events. There are many causes of stress, whether it is a difficult situation or an ongoing problem that lingers over a period of time. Things that may cause stress include:

• Minor problems like being late for work

• Major life-changing events such as getting married, having a baby, moving or experiencing a change in employment

• Ongoing concerns like health problems, finances, family or relationship problems or job-related stress

Understanding what types of situations trigger stress is important in thinking about how to manage stress.

What are the symptoms of stress?We each respond differently to stressful situations. You may experience tension in your neck or muscle strain as your first signal of stress. Below are some common symptoms that we often feel when we experience stress:

• Headache• Pain in neck, shoulders and back• Anger or irritability• Unable to concentrate • Fatigue • Upset stomach, nausea diarrhea• Overeating • Rapid breathing/heart rate• Sweating and sweaty palms

Lifestyle tips to relieve stressStress is a normal response that everyone feels from time to time. However, there are a few things that you can do to decrease or prevent stressful incidents:

• Prioritize and manage your time – plan ahead• Engage in moderate exercise most days

of the week• Balance personal, work and family needs• Eat a healthy diet• Get a good night’s sleep• Build healthy coping strategies• Limit your alcohol consumption • Do not smoke• Build a social support system • Avoid or limit caffeine



Stress management

Stress is often defined as any type of change that causes physical, emotional or psychological strain.

Source: This information is collected from various pages available at: https://dc.healthdialog.com/kbase/default.htm andhttp://www.apahelpcenter.org



Stress management

What can I do to better manage stress?Stress often occurs when the demands in your life exceed your ability to cope with them. Here are some important measures to take in order to help your body effectively handle stress:

• Change your thinking Your outlook, attitude and thoughts greatly

influence the way you see things. A healthy dose of optimism can help you make the best of stressful circumstances. Try to think of challenges as opportunities and stressors as temporary problems—not disasters.

• Practice healthy coping strategies By picking up an enjoyable or relaxing

leisure activity, you can lower your stress level. To be sure you stay relaxed, build time into your schedule to enjoy these activities that are pleasurable and calming.

Healthy coping strategies

• Listen to music• Take a bath or shower• Exercise – go for a walk or bike ride• Write in a journal • Read a book or a magazine

• Learn to relax Practice techniques such as deep-breathing,

imagery and other methods of relaxation to help alleviate stress and tension from your body. Getting a good night’s sleep also helps your body feel more refreshed, so you can have a clear mind to tackle the challenges of the day.

• Be realistic Balance your obligations. Placing too many

demands on yourself can potentially add to your stress level. No one is perfect—ask for help when you need it. Plan ahead and allow yourself adequate time to get things done. Prioritize the important things and manage your time wisely.

• Treat your body well Engage in regular physical activity and eat

a well-balanced diet. Exercise is one of the most effective ways to handle your stress.

• Solve the small problems You can maintain a sense of control by

solving everyday problems. Develop your skills at approaching problems in a calm manner, figuring out possible solutions and taking action. Improving this skill can also help you build your confidence to move on to life’s bigger challenges.

• Get the support you need Support systems can be your family, friends

or even coworkers. Getting their help during stressful times can help you better handle stressful situations. Express your feelings in a positive manner – emotions are normal responses to stress.

Source: This information is collected from various pages available at: https://dc.healthdialog.com/kbase/default.htm andhttp://www.apahelpcenter.org


If you are having a hard time stopping smoking or chewing tobacco, there are programs and treatments that can help you. Talk to your doctor or health care provider about treatment options that can help you quit.

People quit using tobacco every day, and you can, too! Here are some tips to help you quit:

• Be clear on why you want to quit Some common reasons include not wanting

to be a slave to addiction, the way cigarettes make your hair and clothes smell, and the prospect of saving money. Some people recognize the health benefits of being tobacco-free. In addition to increasing your risk of heart disease, stroke and lung cancer, smoking can harm nearly every organ in your body, reducing your health in general. Quitting tobacco has immediate and long-term health benefits.

• Keep track of when and why you use tobacco

Discovering your triggers can help you to prepare for them and/or avoid them. Common triggers are driving in your car, finishing a meal, feeling stressed or being with others who use tobacco. Be prepared for your triggers so you can stay away from situations that may tempt you.

• Pick an official Quit Day Get out a calendar and pick a day in the next

few weeks to be your official Quit Day. Do not pick a day when you know you will be highly stressed, and do not pick a holiday.

• Come up with a plan Decide how you want to quit. Do you want to

go cold turkey, or do you want to use nicotine replacement therapy? Are you interested in joining a support group in your community, or would you prefer to participate in an online quit program?

• Get motivated Tell people you are going to quit and ask

them for their help and support. Give yourself something to look forward to and set up a series of rewards for your milestones, such as your first day tobacco-free, your first week, and your first month free of tobacco.

• Plan ahead Get yourself ready for situations that may

trigger you to use tobacco and make a plan. Stay away from those situations and be ready for the effects of nicotine withdrawal. Get through your cravings by doing other things, like taking a walk, going places that are smoke-free, talking to a supportive friend or using stress management techniques.

• Do not quit quitting If you do slip and use tobacco again, do not

give up. Pick up where you left off. You quit once, you can do it again.

If you need help, call 1-800-QUIT NOW (1-800-784-8669) anytime between 8 a.m. and midnight, seven days a week, to talk to a tobacco-cessation specialist. You can also visit their Web site at quitl inenc.com .

How to become tobacco free


Source: http://www.ahrq.gov/path/tobacco.htm

14 - Heatlh Organizer – General health information

How to stay tobacco free

You quit using tobacco—congratulations! The following tips will provide you with additional tools and resources to help you maintain your tobacco-free lifestyle.

• Plan ahead for times that may lead you to smoke again

Remember your triggers and be prepared for them. If you used tobacco after a meal, brush your teeth directly after your meal or do the dishes. If you used to use tobacco when you were hungry, make sure not to skip meals and have healthy snacks on hand. If you used tobacco when you were stressed, use stress reduction techniques such as meditation, yoga, physical activity or talking to a friend.

• Stay positive Challenge negative thoughts such as, “Just

one cigarette will not hurt.” Remember all that you have gained through quitting: more energy, easier breathing, more money in your pocket and better health. Do not let negativity ruin all of your hard work. Stay strong and review your reasons for quitting.

• Continue to reward yourself Rewarding yourself reinforces your decision

to stay tobacco-free. Give yourself a reward for every milestone you reach, such as your birthday or the anniversary of your quit date. Rewards do not have to be big or cost much; they can be anything you enjoy doing, such as going to a movie, spending extra time on a hobby, or getting tickets to a concert or sporting event.

• Keep your guard up The key to staying tobacco-free over

the long-term is to keep your guard up. It is common for tobacco users to feel overconfident after making it through a few days or weeks. Some people even purposely put themselves in potential trigger situations to test their resolve. Do not tempt yourself. Until you no longer have any withdrawal symptoms and notice that your urges to use tobacco have become less frequent, it is a good idea to be cautious.

• Seek support when you need it There may be times when you feel tempted

to use tobacco again. If this does happen, call someone. Tell them you are thinking about using tobacco and ask them to help you through it. Talk to friends who have successfully quit and ask for their support. North Carolina has a free Quit Line that is available 8 a.m. – midnight, seven days a week: 1-800-QUIT NOW (1-800-784-8669).

Take pride in your tobacco-free life. Since you have stopped using tobacco, you have added healthy, full days to each year of your life. If you used cigarettes, you have cut back on dangerous second-hand smoke for your loved ones. Finally, by quitting, you have set a good example to others by showing that life without tobacco is a longer, healthier and happier life.


Source: http://www.ahrq.gov/path/tobacco.htm

What is high blood pressure?High blood pressure, or hypertension, is a condition in which the force of blood against artery walls is too strong. If left untreated, high blood pressure can damage the arteries, heart and kidneys and can lead to heart disease and stroke.

A blood pressure reading consists of an upper number and a lower number and is measured in millimeters of mercury (mm Hg). The upper number is referred to as systolic blood pressure, which is the pressure in the artery when the heart beats and fills with blood. The lower number is diastolic blood pressure, which is the pressure in the arteries when the heart rests between beats.

What is considered a normal blood pressure reading?

Are you at risk for high blood pressure?Little is known about what causes most cases of high blood pressure, although there are several risk factors related to its development. Some risk factors are beyond your control, such as race, family history of high blood pressure and your age. However, several factors that are in your control may contribute to high blood pressure and raise your risk for heart attack and stroke. These risk factors include:

• Being overweight or obese • High sodium (salt) intake in some people• Drinking three or more alcoholic

beverages a day• Lack of physical activity



High blood pressure

High blood pressure usually does not have any warning signs—that is why it can be so dangerous. Make sure you get your blood pressure checked regularly and treat it the way your health care provider advises.

Blood pressure category Systolic (mm Hg) Diastolic (mm Hg)

Normal Below 120 and Below 80

Prehypertension (border-line)

120-139 or 80-89

High

Stage 1 140-159 or 90-99

Stage 2 160 and above or 100 and above

Source: This information is collected from various pages available at: http://www.nhlbi.nih.gov and http://www.americanheart.org



High blood pressure

While high blood pressure usually cannot be cured, it can be prevented and controlled in most cases. Talk with your health care provider about lifestyle changes that you can make to help lower your risk of developing high blood pressure.

Controlling your blood pressureBy making certain lifestyle or behavioral changes, you can help control your high blood pressure and reduce your risk of developing complications. Here are some tips to help you:

• Know what your blood pressure should be and work with your health care provider to keep it at that level.

• Lose weight if you are overweight or maintain a healthy weight.

• Be more physically active.

• Eat a healthy diet that is low in saturated fats and cholesterol.

• Avoid using too much salt (sodium). Healthy adults need no more than 2,300 mg of sodium a day (Roughly 1 teaspoon of salt).Your health care provider may say you need less.

• Take your medication as prescribed by your health care provider.

• Limit alcohol use. That means no more than one drink per day for women and two drinks per day for men.

• Reduce stress.

• Stop smoking.

Thirty minutes of physical activity most days of the week can help you improve your health. Before beginning any kind of physical activity plan, be sure to talk with your health care provider about what activities are safe for you.

Source: This information is collected from various pages available at http://www.nhlbi.nih.gov and http://www.americanheart.org

Cholesterol is a type of fat (lipid) that is found in all cells of the body. Your body makes cholesterol and uses it to perform important functions like producing new cells. It also comes from eating foods high in fat, such as meat, eggs and milk products. These foods can increase the amount of cholesterol in your body.

High cholesterolToo much cholesterol in the blood, or high cholesterol, can be serious. If excess cholesterol is in your blood, it can build up in the wall of your arteries and can cause them to narrow. Over time, this buildup of cholesterol, called plaque, can decrease the blood flow to your heart and other parts of your body. This condition is referred to as atherosclerosis, or hardening of the arteries. People with high cholesterol have a greater chance of heart disease and stroke.

Total cholesterolA total cholesterol test measures if your cholesterol is high or low. A total cholesterol test can be performed at anytime, regardless of when you last had anything to eat or drink.

Bad cholesterolLDL (low-density lipoproteins) is considered “bad” cholesterol. This kind of cholesterol leads to a buildup of cholesterol in arteries. High LDL can raise your risk of getting heart disease.

Good cholesterolHDL (high-density lipoprotein) is sometimes called “good” cholesterol because it helps prevent cholesterol from building up in the arteries. High levels of HDL appear to help protect against heart disease.

TriglyceridesTriglycerides are the most common type of fat found in the blood and are a major source of energy. However, having high triglyceride levels may increase your risk of developing coronary artery disease (CAD).



High cholesterol

High cholesterol itself does not cause symptoms, so many people are unaware that their cholesterol level is too high. Make sure you discuss this test with your health care provider so he or she can advise you about what is right for you.




High cholesterol

How is high cholesterol diagnosed?You will need to have your blood tested to see if you have high cholesterol. The lipoprotein profile (or lipid panel) measures your total cholesterol, LDL, HDL and triglycerides levels. This is the preferred test for measuring cholesterol levels. This test requires that you avoid eating or drinking anything for 9 to 12 hours before your blood is drawn for the test.

Are you at risk for high cholesterol?High cholesterol may run in your family, and if people in your family have it, your risk is higher. As we age, our body’s cholesterol levels tend to increase. Some risk factors such as age, gender and family history are outside of our control. However, the factors below can also lead to high cholesterol levels and are ones we can control:

• Being overweight or obese• Lack of physical activity• Eating foods high in fat

Lowering your cholesterolThere are some ways you can help to reduce your cholesterol:

• Lose weight if you are overweight• Be more physically active• Quit smoking• Drink alcohol in moderation• Eat a healthy diet that is low in saturated

fats and cholesterol

Sometimes, lifestyle changes may not be enough to get your cholesterol levels under control. If a more healthy diet and an increase in exercise do not lower your cholesterol, then your health care provider may prescribe drug therapy. If that is the case, it is important to take your medication as prescribed by your health care provider.

Working with your health care provider can help you design a treatment plan for reducing your cholesterol and keeping your heart healthy.

Total cholesterol

Less than 200 mb/dl Normal

200 - 239 mg/dl Borderline high

Above 240 mg/dl High

LDL - Cholesterol (“Bad” cholesterol)

Less than 100 Optimal

100-129 Near optimal

130-159 Borderline high

160-189 High

190 and above Very high

HDL - Cholesterol (“Good” cholesterol)

Less than 40 Low

60 or above High

Triglycerides

Below 150 Optimal

150-199 mg/dl Borderline high

200 or more High

Source: National Cholesterol Education Program 2006.http://www.nhlbi.nih.gov/guidelines/cholesterol/atp3xsum.pdf

Adults over the age of 20 should have their cholesterol checked at least every five years. You and your health care provider can discuss how often you should be tested.


Regular checkups, screenings and immunizations are important to promote good health and to prevent and identify health issues early, before they become more serious. Use the information and recommendations below to work with your health care provider to help you stay healthy and active at every age.

Recommendations for staying healthyThese recommendations are designed to help you better manage your health. They were written based on guidelines from national organizations, including the U.S. Preventive Services Task Force, the American Academy of Pediatrics and the American Academy of Family Physicians. In addition, each guideline is reviewed and approved annually by the Physicians Advisory Group of Blue Cross and Blue Shield of North Carolina.

These are general health recommendations. Be sure to consult with your health care provider for more specific advice. To minimize your out-of-pocket costs, visit an in-network provider for your preventive care. For additional information, go to our Web site at bcbsnc.com and select Preventive Health from the “I’m a Member” home page.

Adults (19-64 years)Adults ages 19 to 64 should visit their health care provider for a routine checkup every one to three years.

Recommended routine screening and testing includes:• Height and weight (body mass index –

screening for healthy weight)• Blood pressure• Vision• Chlamydia every year for women

(up to age 26) • Cholesterol every five years, if normal• Colon cancer1 starting at age 50• Mammogram each year starting at

40 for women• Pap test every year for women (testing

less often may be recommended by your physician)

Recommended immunizations:• Tetanus-Diphtheria vaccine (every 10 years)• Influenza (flu) vaccine (adults 50+ years,

annually)• Hepatitis B vaccine (adults at risk)• Measles-Mumps-Rubella (MMR) vaccine

(adults who have never received the vaccine) • Meningococcal vaccine (college students in

dormitories)• Varicella (chicken pox) vaccine (adults who

have never had chicken pox and never received the vaccine)

For more detailed information, you can view or download the Adult Vaccine Schedule in the Preventive Health section of our Web site at bcbsnc.com .




Source: This information is collected from various pages available at: http://www.cdc.gov




Adults (65+ years)Adults ages 65 and over should visit their health care provider each year for routine health checkups.

Recommended routine screening and testing includes:• Height and weight (body mass index—

screening for healthy weight)• Blood pressure• Vision• Hearing• Cholesterol• Colon cancer1

• Mammogram every year for women• Osteoporosis (bone density test)2, as

recommended by physician for women

Recommended immunizations:• Tetanus-Diphtheria vaccine (every 10 years)• Influenza (flu) vaccine (every year)• Pneumococcal vaccine (one dose)• Hepatitis B vaccine (adults at risk)• Measles-Mumps-Rubella (MMR) vaccine

(susceptible adults)• Varicella (chicken pox) vaccine

(susceptible adults)

For more detailed information, you can view or download the Adult Vaccine Schedule in the Preventive Health section of our Web site at bcbsnc.com .

Use the Health Maintenance Record section of your Member Health Partnerships Health Organizer to record your health screenings.

Notes:

1 One of the following screening tests is recommended: Annual fecal occult blood test (FOBT) or stool sample Flexible sigmoidoscopy, every five years Annual FOBT and flexible sigmoidoscopy, every five years Total colon examination by double-contrast barium enema

(DCBE), every 5 to 10 years Total colon examination by colonoscopy, every 10 years

2 Refer to the BCBSNC Medical Policy on Bone Mineral Density Studies

Source: This information is collected from various pages available at: http://www.cdc.gov

Do you need to take prescription medicine every day?If so, then be sure that you know what you are taking. If you are taking many different medications, the first thing you should do is keep an up-to-date list of all the medications you take: prescription medications, nonprescription medications, vitamins, herbals and dietary supplements. You can use the log on the following page to track your medications. You can download additional logs from in the Member Health Partnerships section of our Web site at bcbsnc.com , or you can photocopy the enclosed logs.

Take this list with you when you visit your health care provider. Better yet, place all of your medications (in their original containers) in a bag and take them with you to your provider appointments. Make sure that your provider knows exactly what you are taking so he or she can be sure that your medications are appropriate for your medical condition(s) and he or she can check for possible drug interactions.

Also, it is important to let your pharmacist know about all the medications you take as well. They may not know about medications you may be taking that do not require a prescription or that were filled at another pharmacy.

Do any of the following statements apply to you?

I often forget to take my medication• Keep your medicine out in the open where

you will see it every day. However, be sure to store it in a dry place and away from small children.

• Make it a habit to take your medicine every day at the same time that you do something

else that is routine, such as brushing your teeth, doing the dishes or putting on your pajamas.

• Give yourself reminders to take your medication: set an alarm or leave yourself a note on the bathroom mirror or kitchen counter.

• If you are taking a medicine that needs to be taken several times a day, ask your health care provider if there is a once-a-day medicine or dose that will work just as well for you.

I do not refill my medications right away when I run out• Figure out how long the medicine in your

container will last or ask your pharmacist. Make plans to get your refill five days before the medicine runs out. Put the refill date on your calendar or on your list of errands.

I am having side effects from a medication, or I am afraid that I will have side effects• Share your concerns about side effects with

your health care provider or pharmacist right away. He or she will be able to tell you how likely it is that any side effects you may be experiencing are coming from your medicine, as well as what you might be able to do to decrease the side effects, or if certain side effects might mean it is time to consider a different treatment.

• Your provider or pharmacist can give you information that may help you weigh the benefits and risks of taking a particular medication.

• In some cases, it is more dangerous to stop a medication suddenly because you are afraid of possible side effects than the side effects themselves.







I have trouble opening the childproof cap on the medicine container• If you are in a household with no risk of

small children accidentally getting into your medicines, ask your pharmacist for a non-childproof cap.

• Do not transfer your medication into another container.

I have trouble paying for my medications• Let your health care provider know that you

have a problem with the high cost of your medicines.

• Ask your provider if lower-cost generic versions, generic alternatives or other lower-cost therapy options are available in place of your most expensive medicines, and if they might be right for you.

I do not think my medication is working• Ask your health care provider or pharmacist

how to know if your medicine is or is not working. Many times, medicines improve your medical condition even though you may not feel any different.

• It is important to take your medicines exactly as your health care provider has ordered. Do not stop taking your medicine until you have talked about your thoughts or concerns.

I do not think my medical condition is serious enough that I need medications• Again, have an honest discussion with your

health care provider about his or her opinion about the seriousness of your condition. Find out what the risks might be if you do not take the medication.

• To control most chronic medical conditions, you must take your medication regularly in order for it to help. This means taking medication on days you feel bad and on days you feel good.

• Ask for printed material about your medical condition if you want to learn more about it.

I am unsure how to take my medication correctly, and I have questions about it• Ask your health care provider or pharmacist

any questions you might have about your medicine. You should never feel embarrassed to ask questions.

• Read any printed material that comes with your prescription.

Talk to your doctor and pharmacistTell your health care provider or pharmacist if you are having any problems with your medications. Health care professionals want you to get as much benefit from your medications as possible and want you to be as healthy as you can be. Be sure to take advantage of their expert advice.

For more information about medications on Blue Cross and Blue Shield of North Carolina’s formulary (list of covered drugs), visit bcbsnc.com/services/formulary . You will find information about lower-cost alternatives such as generic drugs, over-the-counter medications and much more. In addition, visit PharmaAdvisorTM under Decision Support Tools on the “I’m a Member” page. For more information about medications and questions you can ask your health care provider.

TM Trademark of Subimo, LLC

Pro

vid

ers/

Res

our

ces


Heatlh Organizer – Providers/Resources - 23

Providers/Resources

Information resource tools

This section of the Member Health Partnerships Health Organizer will help you keep track of all of the general information you need for managing your health care.

Provider contact listComplete the contact list for all of the various health care providers you may have. This includes your primary care physician, specialists, dentists and complementary care providers.

Health information resourcesThis section lists address information, phone numbers and Internet Web addresses for many nationally known organizations that provide educational resources and support groups for several different health conditions and general health information.

Providers/Resources

24 - Health Organizer – Providers/Resources

Provider contact list

Name:

Address:

Phone:

Name:

Address:

Phone:

Primary Care Physician

Name:

Address:

Phone:

Specialist (cardiologist, endocrinologist, pulmonologist, neurologist, etc.)

Specialty:

Fax:

Name:

Address:

Phone:

Specialty:

Fax:

Name:

Address:

Phone:

Specialty:

Fax:

Pharmacy

Name:

Address:

Phone:

Specialty:

Fax:

Dentist

Name:

Address:

Phone:

Specialty:

Fax:

Hospital

Name:

Address:

Phone:

Specialty:

Fax:

Other (complementary care providers, therapists, etc.)

Name:

Address:

Phone:

Specialty:

Fax:

Name:

Address:

Phone:

Specialty:

Fax:

Health Line BlueSM. . . . ........ . . . . 1-877-477-2424Blue Cross and Blue Shield of North Carolina’s 24-hour health information resource staffed by specially trained nurses.

Member Health PartnershipsSM1

Program information. . . . . . . . .1-800-218-5295

BCBSNC Web site . . . . . . . . . . . . . bcbsnc.com

Online Healthy Living ProgramsBlue Cross and Blue Shield of North Carolina (BCBSNC) is proud to offer you Online Healthy Living Programs at no additional cost. Whether you want to eat better, lose weight, quit smoking, shape up, prevent disease or reduce stress, there is an Online Healthy Living Program that is right for you. Go to bcbsnc.com and log in to My Member Services. Click on Online Healthy Living Programs located under the Health and Wellness section. These programs are available 24 hours a day.

Stay informedIt is important that you have access to current information so that you can make informed choices. The next section provides address information, phone numbers and Internet Web addresses of many nationally known organizations that provide educational resources and support groups for several different health conditions. BCBSNC does not maintain, control or endorse the Web sites found on the following page, and we are not responsible for their content. Always consult your health care provider prior to making any medical decision.

Heatlh Organizer – Providers/Resources - 25

For additional information, visit bcbsnc.com.

Providers/Resources

Health information resources

26 - Health Organizer – Providers/Resources

Providers/Resources

Health information resources

AsthmaAsthma and Allergy Foundation of

America1233 20th Street, NWSuite 402Washington, DC 20036(800) 727-8462www.aafa.org

American Lung Association61 Broadway, 6th FloorNY, NY 10006(800) 586-4872www.lungusa.org

DiabetesAmerican Diabetes Association1701 North Beauregard StreetAlexandria, VA 22311(800) 342-2383www.diabetes.org

Juvenile Diabetes ResearchFoundation International120 Wall StreetNew York, NY 10005-4001(800) 533-2873www.jdf.org

FibromyalgiaNational Fibromyalgia Association2200 Glassell Street, Suite AOrange, CA 92865(714) 921-6920www.fmaware.org

Heart HealthAmerican Heart AssociationNational Center7272 Greenville AvenueDallas, TX 75231(800) 242-8721www.americanheart.orgHeart Failure Society of America,

Inc.Court International, Suite 240 S2550 University Avenue WestSaint Paul, MN 55114(651) 642-1633www.hfsa.org

MigraineNational Headache Foundation428 West St. James Place2nd FloorChicago, IL 60614(888) 643-5552www.headaches.org

Tobacco CessationNorth Carolina Quit Line(800) QUIT NOW (800-784-8669)www.quitlinenc.com

NutritionAmerican Dietetic Association120 South Riverside Plaza, Suite

2000Chicago, Illinois 60606-6995Phone: 800/877-1600www.eatright.org

General Health InformationCenters for Disease Control and

Prevention(800) 311-3435www.cdc.gov

N.C. Division of Public Health1931 Mail Service CenterRaleigh, NC 27699-1931(919) 707-5000www.ncpublichealth.com

National Institutes of Health9000 Rockville PikeBethesda, MD 20892(301) 496-4000www.nih.gov

Mayo Clinic

www.mayoclinic.com

For additional information, visit bcbsnc.com.

Med

ical

his

tory


Health Organizer – Medical history - 27

Medical history

Your personal medical history, as well as the medical history of your family members, is perhaps the most important information you can give to your health care provider. This information will help your provider avoid potential adverse interactions with the medications you may be taking and can help build on treatments you know have worked for you in the past. Your family history can also be used to plan preventive health measures for the future. Keeping a written health history can improve the health care that you receive and help you stay well.

Medical history

Diagnosis historyTo the best of your ability, write down your personal health history. Begin with the earliest diagnosis you can remember. Do not be concerned if you cannot remember the exact date or name of the health care provider who treated you. It is important to record childhood illnesses such as chicken pox, scarlet fever, measles or mumps and any surgeries you may have had, such as having your tonsils removed. Record your current health status, as well as any treatments you may be receiving to treat your current condition(s). Continue this process as your health status changes in order to stay up-to-date with your personal health history.

Medication historyConsider calling your pharmacy or pharmacies for a list of all the medications you have had filled to help you complete this section. Your medication history can start with the medications you are currently taking. This would include any conditions for which you either take medication on a daily basis or medication you take only occasionally. Be sure to include any over-the-counter medications you may be taking such as pain relievers, antacids or allergy medications. Continue to add and update this list as your medications change or as you begin new medications.

Diagnosis orcondition

Datediagnosed

Date resolved

Treatingprovider

Treatment

Chicken pox Age 8

Appendicitis Age 15 Age 15 Dr. Miles Appendectomy

Asthma Age 7 Ongoing Dr. Taylor Medication

Medication Dose Frequency Condition Date started

Date stopped

Prescribingprovider

Prilosec 25 mg As needed Heartburn 8/24/2006 Ongoing Dr. Jones

Aspirin 30 mg Once a day Heart attack 9/2/2005 Ongoing Dr. Smith

28 - Health Organizer – Medical history

For example:

For example:

Vitamins, supplements and herbal productsRecord any vitamins, supplements or herbal products you are currently taking. Many over-the-counter supplements can interact with prescription medications and cause unwanted side effects. That is why it is very important to let your health care provider know about any supplements you may be taking. If a provider suggests you take an over-the-counter vitamin, supplement or herbal product, be sure to record the name of that provider.

Adverse allergic reactionsRecord any allergies you now have or had in the past and the type of reaction you had or have had to the allergen. If you can recall the first time you reacted to the allergen, record that date and any treatment you had to deal with the reaction. You may also include in this section any drug allergies you have.

Medical history

Medication Dose Frequency Condition Date Started

Date stopped

Prescribingprovider

Echinacea 25 mg Occasionally Prevents colds

Multivitamin 1 tablet Once a day Vitamins and mineral needs

3/7/2006 Ongoing

Allergy Type of reaction Date of first reaction

Treatingprovider

Treatment

Bees Swelling andanaphylactic shock

Unsure Epipen-Emergency room

Pollen Hives Age 5

Penicillin Rash

Health Organizer – Medical history - 29

For example:

For example:

30 - Health Organizer – Medical history

Medical history

Family historyYour family medical history may be the most important information you have for your health care provider to review regarding possible hereditary illnesses. Record in this list as much information as you can about the medical conditions of both your mother’s and father’s sides of the family. Include sisters, brothers, grandparents, aunts and uncles. If the family member is deceased, record his or her age at the time of death. You can make additional notes about your family history on the back of the family history form.

Relationship Medical conditions/Cause of death

Age at death

Grandfather Diabetes, heart disease 62

Father Heart attack 67

Sister Diabetes NA

Dia

gnos

is h

isto

ry

31 -

Hea

lth O

rgan

izer

– D

iag

nosi

s hi

stor

y

Med

ical

hist

ory

Diag

nosi

s/Co

ndit

ion

Date

dia

gnos

edDa

te r

esol

ved

Trea

ting

phy

sici

anTr

eatm

ent

Dia

gnos

is h

isto

ry

32 -

Hea

lth O

rgan

izer

– D

iag

nosi

s hi

stor

y

Med

ical

hist

ory

Diag

nosi

s/Co

ndit

ion

Date

dia

gnos

edDa

te r

esol

ved

Trea

ting

phy

sici

anTr

eatm

ent

Med

icat

ion

hist

ory

33 -

Hea

lth O

rgan

izer

– M

edic

atio

n hi

stor

y

Med

ical

hist

ory

Med

icat

ion

Dose

Freq

uenc

yCo

ndit

ion

used

m

edic

atio

n fo

rDa

te s

tart

edDa

te s

topp

edPr

escr

ibin

g ph

ysic

ian

Med

icat

ion

hist

ory

34 -

Hea

lth O

rgan

izer

– M

edic

atio

n hi

stor

y

Med

ical

hist

ory

Med

icat

ion

Dose

Freq

uenc

yCo

ndit

ion

used

m

edic

atio

n fo

rDa

te s

tart

edDa

te s

topp

edPr

escr

ibin

g ph

ysic

ian

Med

icat

ion

hist

ory

35 -

Hea

lth O

rgan

izer

– M

edic

atio

n hi

stor

y

Med

ical

hist

ory

Med

icat

ion

Dose

Freq

uenc

yCo

ndit

ion

used

m

edic

atio

n fo

rDa

te s

tart

edDa

te s

topp

edPr

escr

ibin

g ph

ysic

ian

Med

icat

ion

hist

ory

36 -

Hea

lth O

rgan

izer

– M

edic

atio

n hi

stor

y

Med

ical

hist

ory

Med

icat

ion

Dose

Freq

uenc

yCo

ndit

ion

used

m

edic

atio

n fo

rDa

te s

tart

edDa

te s

topp

edPr

escr

ibin

g ph

ysic

ian

Vita

min

s, s

uppl

emen

ts

and

herb

s hi

stor

y

37 -

Hea

lth O

rgan

izer

– V

itam

ins,

sup

ple

men

ts a

nd h

erb

s hi

stor

y

Med

ical

hist

ory

Med

icat

ion

Dose

Freq

uenc

yCo

ndit

ion

used

m

edic

atio

n fo

rDa

te s

tart

edDa

te s

topp

edPr

escr

ibin

g ph

ysic

ian

Vita

min

s, s

uppl

emen

ts

and

herb

s hi

stor

y

38 -

Hea

lth O

rgan

izer

– V

itam

ins,

sup

ple

men

ts a

nd h

erb

s hi

stor

y

Med

ical

hist

ory

Med

icat

ion

Dose

Freq

uenc

yCo

ndit

ion

used

m

edic

atio

n fo

rDa

te s

tart

edDa

te s

topp

edPr

escr

ibin

g ph

ysic

ian

All

ergi

c re

acti

ons

39 -

Hea

lth O

rgan

izer

– A

llerg

ic re

actio

ns

Med

ical

hist

ory

Alle

rgy

Type

of

reac

tion

Date

of

first

rea

ctio

nTr

eati

ng p

hysi

cian

Trea

tmen

t

All

ergi

c re

acti

ons

40 -

Hea

lth O

rgan

izer

– A

llerg

ic re

actio

ns

Med

ical

hist

ory

Alle

rgy

Type

of

reac

tion

Date

of

first

rea

ctio

nTr

eati

ng p

hysi

cian

Trea

tmen

t

Medical history

Health Organizer – Surgery record - 41

Surgery record

Type of surgery:

Surgeon:

Date admitted:

Date discharged:

Reason for the surgery:

Type of surgery:

Surgeon:

Date admitted:

Date discharged:


Type of surgery:

Surgeon:

Date admitted:

Date discharged:


Type of surgery:

Surgeon:

Date admitted:

Date discharged:


42 - Health Organizer – Surgery record

Medical history

Surgery record

Type of surgery:

Surgeon:

Date admitted:

Date discharged:


Type of surgery:

Surgeon:

Date admitted:

Date discharged:


Type of surgery:

Surgeon:

Date admitted:

Date discharged:


Type of surgery:

Surgeon:

Date admitted:

Date discharged:


Medical history

Health Organizer – Tests and procedures - 43

Tests and procedures

Date:

Test/Procedure:

Reason:

Results:

Follow-up recommendations:

Ordering physician:

Date:

Test/Procedure:

Reason:

Results:


Ordering physician:

Date:

Test/Procedure:

Reason:

Results:


Ordering physician:

44 - Health Organizer – Tests and procedures

Medical history

Tests and procedures

Date:

Test/Procedure:

Reason:

Results:


Ordering physician:

Date:

Test/Procedure:

Reason:

Results:


Ordering physician:

Date:

Test/Procedure:

Reason:

Results:


Ordering physician:

Medical history

Health Organizer – Family history - 45

Family history

Relationship Medical conditions/Cause of death Age at death

MOTHER’S side of the family

Grandmother

Grandfather

Mother

Aunt/Uncle

Aunt/Uncle

Aunt/Uncle

Aunt/Uncle

Aunt/Uncle

Aunt/Uncle

FATHER’S side of the family

Grandmother

Grandfather

Mother

Aunt/Uncle

Aunt/Uncle

Aunt/Uncle

Aunt/Uncle

Aunt/Uncle

Aunt/Uncle

BROTHERS and SISTERS

46 - Health Organizer – Family history

Medical history

Family history

Additional notes on family history

Offi

ce v

isit

s


Health Organizer – Office visit checklist - 47

Office visit checklist

Checklist

Date: Doctor’s name:

What do you think the main problem is?

What are the symptoms?

The problem first began:

Frequency of the problem:

If the problem involves pain, what does the pain feel like?

If the problem involves pain, does the pain spread out or move?

If yes, where does it move?

What concerns you about the problem?

Have you had the problem before?

If yes, what worked for you in the past?

Any changes in your life (stress, medications, food, exercise, etc)?

If yes, explain:

Have you seen another doctor about this problem?

If yes, name the doctor:

What was done for you at that time?

List current health conditions:

Sharp or Pricking Stinging Aching Burning Dull Throbbing

Yes No

Yes No

Yes No

Medications/Supplements Dose/Frequency Prescribing physician Reason for taking


48 - Health Organizer – Office visit checklist

Checklist

Today’sweight:

BloodPressure: over

(systolic) (diastolic)

Pulse:

What did the doctor say was wrong?

What should I expect in the coming weeks?

Are there warning signs I should look for?

Are there things I can do at home to help feel more comfortable while I recover?

Where can I get more information to explain my condition?

Do I need to return for a follow-up visit? No Yes, when?

Condition:

What is the name of the medication? Dose:

How do I take this medication? (oral, topical, injection, etc.)

At what time of day? With food On an empty stomach

Why do I need this medication/what will it do for me?

What happens if I don’t take the medication?

What side effects or adverse effects should I look for?

How might this medication affect other medications I take?

Is there a generic alternative? If yes, list:

If medications are prescribed, ask:

What is the test or procedure?

What are the risks? Are there alternatives?

How do I prepare?

How and when will I get the results?

What if I do nothing?

If X-rays, lab tests, or other exams are needed, ask:



Checklist













If yes, explain:






Yes No

Yes No

Yes No




Checklist

Today’sweight:

BloodPressure: over


Pulse:







Condition:












How do I prepare?






Checklist













If yes, explain:






Yes No

Yes No

Yes No




Checklist

Today’sweight:

BloodPressure: over


Pulse:







Condition:












How do I prepare?






Checklist













If yes, explain:






Yes No

Yes No

Yes No




Checklist

Today’sweight:

BloodPressure: over


Pulse:







Condition:












How do I prepare?






Checklist













If yes, explain:






Yes No

Yes No

Yes No




Checklist

Today’sweight:

BloodPressure: over


Pulse:







Condition:












How do I prepare?




Hea

lth

mai

nten

ance

rec

ord

s


Health Organizer – Health maintenance records - 57

Health maintenance records

Maintaining healthy practices and getting preventive health screenings is key to detecting illnesses early. Simple things like keeping track of your height, weight, blood pressure and cholesterol will enable you to note small changes early, so you can take preventive action before you potentially develop a chronic illness. You should discuss with your health care provider the advantages of lifestyle changes that can both improve and protect your health.

Health Maintenance RecordThe Health Maintenance Record lists a number of general tests, exams or vaccinations your health care provider may recommend. Record the date you had the test or exam and the result. Additional space is available to include other tests that your provider may order.

For example:

Health maintenance and preventive screening

Date 2/2004 3/2005 10/2006

Blood pressure 120/82 116/72

Total cholesterol 220 152

HDL 55 60

LDL 120 100

58 -

Hea

lth O

rgan

izer

– H

ealth

mai

nten

ance

reco

rds

Heal

th m

aint

enan

ce re

cord

s

Dat

e (m

ont

h/ye

ar)

Hei

ght

Wei

ght

Bod

y M

ass

Ind

ex (B

MI)

Blo

od p

ress

ure

Cho

lest

erol

(tot

al)

H

DL

LD

L

Trig

lyce

rides

Com

ple

te b

lood

cou

nt (C

BC

)

Urin

alys

is

Che

st X

-ray

Flu

vacc

ine

Eye

exam

Pneu

mon

ia v

acci

ne

Oth

er

Oth

er

Oth

er

59 -

Hea

lth O

rgan

izer

– H

ealth

mai

nten

ance

reco

rds

Heal

th m

aint

enan

ce re

cord

s

Dat

e (m

ont

h/ye

ar)

Hei

ght

Wei

ght

Bod

y M

ass

Ind

ex (B

MI)

Blo

od p

ress

ure

Cho

lest

erol

(tot

al)

H

DL

LD

L

Trig

lyce

rides

Com

ple

te b

lood

cou

nt (C

BC

)

Urin

alys

is

Che

st X

-ray

Flu

vacc

ine

Eye

exam

Pneu

mon

ia v

acci

ne

Oth

er

Oth

er

Oth

er

60 -

Hea

lth O

rgan

izer

– H

ealth

mai

nten

ance

reco

rds

Heal

th m

aint

enan

ce re

cord

s

Dat

e (m

ont

h/ye

ar)

Hei

ght

Wei

ght

Bod

y M

ass

Ind

ex (B

MI)

Blo

od p

ress

ure

Cho

lest

erol

(tot

al)

H

DL

LD

L

Trig

lyce

rides

Com

ple

te b

lood

cou

nt (C

BC

)

Urin

alys

is

Che

st X

-ray

Flu

vacc

ine

Eye

exam

Pneu

mon

ia v

acci

ne

Oth

er

Oth

er

Oth

er

61 -

Hea

lth O

rgan

izer

– H

ealth

mai

nten

ance

reco

rds

Heal

th m

aint

enan

ce re

cord

s

Dat

e (m

ont

h/ye

ar)

Hei

ght

Wei

ght

Bod

y M

ass

Ind

ex (B

MI)

Blo

od p

ress

ure

Cho

lest

erol

(tot

al)

H

DL

LD

L

Trig

lyce

rides

Com

ple

te b

lood

cou

nt (C

BC

)

Urin

alys

is

Che

st X

-ray

Flu

vacc

ine

Eye

exam

Pneu

mon

ia v

acci

ne

Oth

er

Oth

er

Oth

er

62 -

Hea

lth O

rgan

izer

– H

ealth

mai

nten

ance

reco

rds

Heal

th m

aint

enan

ce re

cord

s

Dat

e (m

ont

h/ye

ar)

Hei

ght

Wei

ght

Bod

y M

ass

Ind

ex (B

MI)

Blo

od p

ress

ure

Cho

lest

erol

(tot

al)

H

DL

LD

L

Trig

lyce

rides

Com

ple

te b

lood

cou

nt (C

BC

)

Urin

alys

is

Che

st X

-ray

Flu

vacc

ine

Eye

exam

Pneu

mon

ia v

acci

ne

Oth

er

Oth

er

Oth

er

63 -

Hea

lth O

rgan

izer

– H

ealth

mai

nten

ance

reco

rds

Heal

th m

aint

enan

ce re

cord

s

Dat

e (m

ont

h/ye

ar)

Hei

ght

Wei

ght

Bod

y M

ass

Ind

ex (B

MI)

Blo

od p

ress

ure

Cho

lest

erol

(tot

al)

H

DL

LD

L

Trig

lyce

rides

Com

ple

te b

lood

cou

nt (C

BC

)

Urin

alys

is

Che

st X

-ray

Flu

vacc

ine

Eye

exam

Pneu

mon

ia v

acci

ne

Oth

er

Oth

er

Oth

er

64 -

Hea

lth O

rgan

izer

– H

ealth

mai

nten

ance

reco

rds

Heal

th m

aint

enan

ce re

cord

s

Dat

e (m

ont

h/ye

ar)

Hei

ght

Wei

ght

Bod

y M

ass

Ind

ex (B

MI)

Blo

od p

ress

ure

Cho

lest

erol

(tot

al)

H

DL

LD

L

Trig

lyce

rides

Com

ple

te b

lood

cou

nt (C

BC

)

Urin

alys

is

Che

st X

-ray

Flu

vacc

ine

Eye

exam

Pneu

mon

ia v

acci

ne

Oth

er

Oth

er

Oth

er

Per

sona

l hea

lth

dia

ry


Health Organizer – Personal heatlh diary - 65

Personal health diary

Keeping a health diary can be helpful in many ways. By using the health diary, you can track your health and wellness, any symptoms you may have, learn what works best for you, as well as understand what makes your condition worse. You will be able to provide your health care provider with much more accurate and complete information. It may also help you spot habits that need improvement such as diet and physical activity. Keep each sheet and review them with your health care provider for patterns.

Additional copies are available on the Member Health Partnerships Web site at bcbsnc.com .

Filling out your personal health diary:

• Note when the first symptoms of condition begin, changes in intensity, and when pain/symptoms end.

• List all medications taken and food eaten each day.

• List any stressors that you experience, such as rushing to work, relationship issues, money problems, etc.

• Note when you were sleeping, including all naps.

• The Other Comments column is for any other factor that you feel has affected your health on a particular day. If you are required to take your blood pressure or sugar level each day, you may use this section to record that information. You may also record your weight here as well.

• Keep a diary for a minimum of one week.

66 -

Hea

lth O

rgan

izer

– P

erso

nal h

ealth

dia

ry

Pers

onal

hea

lth d

iary

Dat

e:D

ay o

f the

wee

k:M

onth

:D

ay:

Year

:

How

did

you

sle

ep la

st n

ight

(how

man

y ho

urs,

how

oft

en d

id y

ou w

ake

up, e

tc.)?

Tim

eM

edic

atio

nFo

od

Sig

ns a

ndsy

mp

tom

sSt

ress

ors

Phy

sica

lac

tivi

tySl

eep

Fati

gue

leve

lO

ther

com

men

ts

Mor

ning

Mid

day

Aft

erno

on

Even

ing

Goo

d

Fair

Poor

Extr

eme

Goo

d

Fair

Poor

Extr

eme

Goo

d

Fair

Poor

Extr

eme

Goo

d

Fair

Poor

Extr

eme

67 -

Hea

lth O

rgan

izer

– P

erso

nal h

ealth

dia

ry

Pers

onal

hea

lth d

iary

Dat

e:D

ay o

f the

wee

k:M

onth

:D

ay:

Year

:

How

did

you

sle

ep la

st n

ight

(how

man

y ho

urs,

how

oft

en d

id y

ou w

ake

up, e

tc.)?

Tim

eM

edic

atio

nFo

od

Sig

ns a

ndsy

mp

tom

sSt

ress

ors

Phy

sica

lac

tivi

tySl

eep

Fati

gue

leve

lO

ther

com

men

ts

Mor

ning

Mid

day

Aft

erno

on

Even

ing

Goo

d

Fair

Poor

Extr

eme

Goo

d

Fair

Poor

Extr

eme

Goo

d

Fair

Poor

Extr

eme

Goo

d

Fair

Poor

Extr

eme

68 -

Hea

lth O

rgan

izer

– P

erso

nal h

ealth

dia

ry

Pers

onal

hea

lth d

iary

Dat

e:D

ay o

f the

wee

k:M

onth

:D

ay:

Year

:

How

did

you

sle

ep la

st n

ight

(how

man

y ho

urs,

how

oft

en d

id y

ou w

ake

up, e

tc.)?

Tim

eM

edic

atio

nFo

od

Sig

ns a

ndsy

mp

tom

sSt

ress

ors

Phy

sica

lac

tivi

tySl

eep

Fati

gue

leve

lO

ther

com

men

ts

Mor

ning

Mid

day

Aft

erno

on

Even

ing

Goo

d

Fair

Poor

Extr

eme

Goo

d

Fair

Poor

Extr

eme

Goo

d

Fair

Poor

Extr

eme

Goo

d

Fair

Poor

Extr

eme

69 -

Hea

lth O

rgan

izer

– P

erso

nal h

ealth

dia

ry

Pers

onal

hea

lth d

iary

Dat

e:D

ay o

f the

wee

k:M

onth

:D

ay:

Year

:

How

did

you

sle

ep la

st n

ight

(how

man

y ho

urs,

how

oft

en d

id y

ou w

ake

up, e

tc.)?

Tim

eM

edic

atio

nFo

od

Sig

ns a

ndsy

mp

tom

sSt

ress

ors

Phy

sica

lac

tivi

tySl

eep

Fati

gue

leve

lO

ther

com

men

ts

Mor

ning

Mid

day

Aft

erno

on

Even

ing

Goo

d

Fair

Poor

Extr

eme

Goo

d

Fair

Poor

Extr

eme

Goo

d

Fair

Poor

Extr

eme

Goo

d

Fair

Poor

Extr

eme

70 -

Hea

lth O

rgan

izer

– P

erso

nal h

ealth

dia

ry

Pers

onal

hea

lth d

iary

Dat

e:D

ay o

f the

wee

k:M

onth

:D

ay:

Year

:

How

did

you

sle

ep la

st n

ight

(how

man

y ho

urs,

how

oft

en d

id y

ou w

ake

up, e

tc.)?

Tim

eM

edic

atio

nFo

od

Sig

ns a

ndsy

mp

tom

sSt

ress

ors

Phy

sica

lac

tivi

tySl

eep

Fati

gue

leve

lO

ther

com

men

ts

Mor

ning

Mid

day

Aft

erno

on

Even

ing

Goo

d

Fair

Poor

Extr

eme

Goo

d

Fair

Poor

Extr

eme

Goo

d

Fair

Poor

Extr

eme

Goo

d

Fair

Poor

Extr

eme

71 -

Hea

lth O

rgan

izer

– P

erso

nal h

ealth

dia

ry

Pers

onal

hea

lth d

iary

Dat

e:D

ay o

f the

wee

k:M

onth

:D

ay:

Year

:

How

did

you

sle

ep la

st n

ight

(how

man

y ho

urs,

how

oft

en d

id y

ou w

ake

up, e

tc.)?

Tim

eM

edic

atio

nFo

od

Sig

ns a

ndsy

mp

tom

sSt

ress

ors

Phy

sica

lac

tivi

tySl

eep

Fati

gue

leve

lO

ther

com

men

ts

Mor

ning

Mid

day

Aft

erno

on

Even

ing

Goo

d

Fair

Poor

Extr

eme

Goo

d

Fair

Poor

Extr

eme

Goo

d

Fair

Poor

Extr

eme

Goo

d

Fair

Poor

Extr

eme

72 -

Hea

lth O

rgan

izer

– P

erso

nal h

ealth

dia

ry

Pers

onal

hea

lth d

iary

Dat

e:D

ay o

f the

wee

k:M

onth

:D

ay:

Year

:

How

did

you

sle

ep la

st n

ight

(how

man

y ho

urs,

how

oft

en d

id y

ou w

ake

up, e

tc.)?

Tim

eM

edic

atio

nFo

od

Sig

ns a

ndsy

mp

tom

sSt

ress

ors

Phy

sica

lac

tivi

tySl

eep

Fati

gue

leve

lO

ther

com

men

ts

Mor

ning

Mid

day

Aft

erno

on

Even

ing

Goo

d

Fair

Poor

Extr

eme

Goo

d

Fair

Poor

Extr

eme

Goo

d

Fair

Poor

Extr

eme

Goo

d

Fair

Poor

Extr

eme

73 -

Hea

lth O

rgan

izer

– P

erso

nal h

ealth

dia

ry

Pers

onal

hea

lth d

iary

Dat

e:D

ay o

f the

wee

k:M

onth

:D

ay:

Year

:

How

did

you

sle

ep la

st n

ight

(how

man

y ho

urs,

how

oft

en d

id y

ou w

ake

up, e

tc.)?

Tim

eM

edic

atio

nFo

od

Sig

ns a

ndsy

mp

tom

sSt

ress

ors

Phy

sica

lac

tivi

tySl

eep

Fati

gue

leve

lO

ther

com

men

ts

Mor

ning

Mid

day

Aft

erno

on

Even

ing

Goo

d

Fair

Poor

Extr

eme

Goo

d

Fair

Poor

Extr

eme

Goo

d

Fair

Poor

Extr

eme

Goo

d

Fair

Poor

Extr

eme

74 -

Hea

lth O

rgan

izer

– P

erso

nal h

ealth

dia

ry

Pers

onal

hea

lth d

iary

Dat

e:D

ay o

f the

wee

k:M

onth

:D

ay:

Year

:

How

did

you

sle

ep la

st n

ight

(how

man

y ho

urs,

how

oft

en d

id y

ou w

ake

up, e

tc.)?

Tim

eM

edic

atio

nFo

od

Sig

ns a

ndsy

mp

tom

sSt

ress

ors

Phy

sica

lac

tivi

tySl

eep

Fati

gue

leve

lO

ther

com

men

ts

Mor

ning

Mid

day

Aft

erno

on

Even

ing

Goo

d

Fair

Poor

Extr

eme

Goo

d

Fair

Poor

Extr

eme

Goo

d

Fair

Poor

Extr

eme

Goo

d

Fair

Poor

Extr

eme

No

tes


Health Organizer

Notes

Notes

Health Organizer

Health Organizer

Notes

Health Organizer

Notes

An independent licensee of the Blue Cross and Blue Shield Association. ®, SM Marks of the Blue Cross and Blue Shield Association. SM1 Mark of Blue Cross and Blue Shield of North Carolina. U3936, 7/06

Date post:	15-Jul-2020
Category:	Documents
Upload:	others
View:	1 times
Download:	0 times

00 MHP Organizer Cover - North Carolina Health Insurance ......health insurance. Our family of Blue...

Documents