How you can help your health care provider to help yo1

At a VA Healthcare facility, you will have a limited amount of time to meet with your doctor, nurse practitioner, clinician, or healthcare provider. A complete health assessment/physical would take over an hour to complete. A comprehensive health assessment would address: • Allergies, if any. Allergies can be to foods, medications, insects, animals, smoke (second-hand smoke for non-smokers) or products in the environment, and can be life-long or more recently acquired. • Past surgeries/ hospitalizations, or illnesses • Review of your major body systems (circulatory/vascular, respiratory, neurological (nerves and brain), urinary, digestive, genital, skin, musculoskeletal (muscles and bones), psychiatric) • Changes in lifestyle such as divorce, job loss, retirement, or death in the family • Current use of medications, herbals, supplements, alcohol, tobacco, and • Allergies to medications, food, other items.
As a veteran, at your VA healthcare facility, you will most likely not receive a complete
physical/health assessment during your appointment. You will be coming to the doctor
with specific issues, concerns, signs, and symptoms. Your appointment may last 10
minutes, not the hour plus that is necessary to explore health issues. Being organized,
with clearly defined reasons for the appointment are essential for you to get the assistance
you need.
Information that you prepare is specific for your personal health and for your particular
doctor’s visit.
If you have trouble hearing, announce this at the beginning of the visit. If you do not
understand a word or term that the healthcare provider uses, IMMEDIATELY ASK

Notes will help to keep the appointment moving in the right direction, which is helpful for

• Write down how you are feeling or what your concerns are regarding your health and what has brought you to this appointment. • Include any questions you have. To make a list of what you want to know will help you to get your answers during the brief visit. You will be able to remain focused on your reason for being at the appointment and will have a greater chance of getting the help you seek. • Take a moment to write down information that the healthcare provider may give
Bring a list of your medications and dosages with you to your appointment

• Include any side effects you may be having from the medications. • List any herbs, vitamins, supplements you are taking. Some herbs have the same effects as medications. You may be getting an overdose or the herbs and medications may be acting against each other. If your military service was during a conflict or war, announce this at the beginning of the exam. 1. If you were in the Gulf War, please inform your health care provider and arrange
for a full review of possible illness related to Gulf War Illness.
2. If you were in Vietnam, were you exposed to Agent Orange, or have the
potential to have been exposed? There are several diseases that are likely caused by Agent Orange exposure:
One is chronic lymphocytic leukemia (CLL) and is a type of cancer of the bone marrow
and blood. This leukemia most commonly affects older adults.

• Enlarged but painless lymph nodes (lumps under the arms, under the chin, on the neck, in the groin, behind knees, in any area of the body). SERVING AMERICA'S VETERANS

Risk factors:

• Family history of blood and bone marrow cancers • Exposure to chemicals such as certain herbicides and insecticides, which includes Agent Orange used during the Vietnam War Other symptoms that can be related to exposure to dioxin in Agent Orange are: • Joint pains and deterioration of joint function • Loss of hair on legs, even up to mid-thigh • Hard time fighting off infections including the flu (influenza)
Another illness seen in those exposed to the dioxin in agricultural and chemical agents
such as Agent Orange, is multiple myelomas (skin cancer which has the potential to
spread to other parts of the body, Please read the article, on this web site, located
under health that relates to myelomas
Another illness closely linked to any combat exposure is Post Traumatic Stress Disorder
(PTSD) associated with illnesses.
Symptoms are:
• Feeling numb to what is going on around you • Difficulty falling and staying asleep • Nightmares/reliving past unpleasant experiences • Difficulty in maintaining relationships • Difficulty in dealing with co-workers SERVING AMERICA'S VETERANS

There is an increase in incidents of prostate cancer among those exposed to Agent
. Symptoms may include:
• Inability to fully empty the bladder. • Need to urinate frequently, but only small amounts of urine. • Difficulty in getting the stream of urination started. • Getting up to the use the bathroom during the night.
If you were involved in the Gulf War do you have symptoms such as:
• A combination of memory and concentration problems
These symptoms could be caused by exposure to the many insecticides and bug repellants
used during this war. Did you take pyridostigmine bromide pills to neutralize the effects
of nerve gas attacks or were you exposed to neurotoxic insecticides?
For your appointment, be sure that there are no pre-appointment restrictions such as diet
Write down key personal information, which includes any major stresses and life
changes. Mention past medical and/or surgical history. Family medical history is
important, as many illnesses and diseases can be hereditary. Even if you are not
specifically asked for this information, offer it to the healthcare provider.
List of all medications, vitamins, supplements, herbals you are taking. Include dosages
and how long you have been taking the medication, whether it helps, does not help, and
any side effects that you might be experiencing.
Take along a family member or friend so that you have emotional backup as well as
someone who can remember something you forgot or missed.
If you have had tests or treatments are suggested your questions should then be:
• What are the side effects I may have during treatment? • Is one treatment better than others for my specific condition? • How will this treatment affect my daily life? • Is there printed material that I can take with me. YOU HAVE MADE THIS APPOINTMENT TO GET HELP. THE APPOINTMENT IS ABOUT YOU AND MAKING YOU FEEL BETTER, NOT ABOUT THE TIME OF THE HEALTHCARE PROVIDER. MAKE ANOTHER APPOINTMENT IF YOU HAVE NOT REACHED A COMPLETE UNDERSTANDING OF WHAT IS GOING ON WITH YOUR HEALTH. YOU ARE ALLOWED TO ASK QUESTIONS AND ARE ENTITLED TO COMPLETE ANSWERS. Attached is a form that you may print and fill out before your appointment. SERVING AMERICA'S VETERANS
Signs and Symptoms Health Form
Take this form with you to your next healthcare appointment
This form is designed to be of help at your medical appointment, but in no way
contains all the symptoms you may have. You may add your symptoms to the list.
Please contact your regular healthcare provider.
Compiled by Carol Ware Duff MSN, BA, RN MILITARY/VETERANS HEALTH EDITOR VETERANS TODAY Alert the healthcare provider to any allergies you may have. ALLERGIC REACTIONS
Allergies can develop to medications, foods bee stings, insect, chemicals, plants, and
basically anything in the environment. You can develop allergies, as you get older. The
sooner swelling appears after exposure the more severe the reaction.

Circle the symptoms you are having.


• Seeing flashing lights with loss of vision SERVING AMERICA'S VETERANS
Signs and Symptoms Health Form
• Inability to fall asleep or stay asleep • Missing time/ can be minutes, hours, day or days

• Shortness of breath/ while resting/ while performing usual daily activities/ while • Pain or discomfort when taking breath • Chest pain/ when did it start?/ What were you doing when it started?/ Does it come and go or stay? Sharp, crushing, dull, aching, moving out from chest, stays in one place? • Does it feel like you have a lump in your throat? • Is feeling worse when lying down or reclining? • Tingling and or numbness in arms, hands, legs, feet • Cold feeling in arms, hands, legs, feet • Coughing- occasional/frequent, seemingly constant/ only during night/only during • Cough produces mucous/color and consistency of mucous • Feelings of anxiousness or that something is not right • Gray or bluish color to skin, especially around mouth • Fingers and toes have gray, pale, or bluish color • Breathing very fast/ Hyperventilation • Recently choked when eating, drinking, or swallowing medications SERVING AMERICA'S VETERANS
Signs and Symptoms Health Form
Pain in Abdomen or anywhere in body. Define as:

• Define level of pain. On a scale from 1 to 10 with a minimal pain being a 1 and 10 • Is there a specific area of pain? Have you had it before? • Did the pain start in the abdomen and then move to your back? When was your last bowel movement? Nausea and/or vomiting Increase in size of abdomen Do foods or antacids relieve pain? Are there triggers for the pain? Does body position affect the pain? Symptoms of gas, diarrhea, constipation Vomiting comes before or after the pain Color of vomit Color and consistency of stool/bowel movement Involuntary weight loss or gain Rectal pain, bleeding, itching
Frequency of urination
• How much urine each time?
• Is there an extra urgency to urinate? • Stream of urine is not strong/ stops and restarts • Getting up more than once during the night to urinate SERVING AMERICA'S VETERANS
Signs and Symptoms Health Form
• Pain in the back, above the waistline

• Location of pain and type of pain (see above) • Possibility of being bit by a tick (Lyme Disease). Often an area of redness in the
form of a circle will develop where bitten. • A change in mole (see article on myelomas in health section of this web site) Where did rash begin? Changed?/Spread? Does it itch or burn? Triggers for rash Have you been traveling? Has your living situation changed? Do you have pets? • Have you recently had a change in medication? Some can cause rashes or

Signs and Symptoms Health Form
• Sleeping too much, or unable to sleep • Worried that you are not the same person • Difficult to perform the tasks of daily living • Prior mental illness/family history of mental illness • Has there been a life-altering change in your personal/family/social status? • Alternating periods of being extremely energetic and then very lethargic
Provide a full list of your medications and what your dosage is.

• How long have you been taking each specific medication? • Are you having what may be side effects to the medications? • Do you think the medications are helping? List all herbals, vitamins, and supplements you are taking.
Be honest about the amount of tobacco and alcohol you consume.

Signs and Symptoms Health Form


LEAVING CERTIFICATE BIOLOGY HIGHER LEVEL EXAM PAPER SOLUTIONS Sample Paper 4 Section A Question 1 a) D: Zone of Differentiation/C: Zone of Elongation/A: Root Cap/B: Meristem 4(1)New Tissues: Zone of Differentiation/Mitosis: Meristem/Growth Regulators: Zone ofElongation/Absorbtion of water: Zone of Differentiation 4(1)(i) A: Vascular bundle/B: Air Spaces/C: Guard Cells/D: Stoma 4(1).

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