Thursday, 16 October 2014 13:03

MHC - Learn Problem Solving Steps


 My Health Counts! Learn Problem Solving Steps

Like most things, self-management is rarely a smooth process. Chances are you will run into a few roadblocks along the way. When it seems like you're getting a little worse or hit a plateau, keep in mind that ups and downs are unavoidable. If your plan doesn't work, don't give up! As we saw in “Ann's Story” there are specific steps that can help you tackle the barriers that get in your way.

Kate Lorig at Stanford University has developed a very successful program called the Chronic Disease Self Management Program . The following steps are adapted from this program:

Identify the problem. This is the first and most important step, but it is usually also the most difficult step, it may take some work to identify the root of the problem.

List ideas to solve the problem. Once you have your list it may be helpful to consult with your “self-management support team”—friends, family, your doctor or community resources.

Select one method to try. New activities can be difficult, so make sure you give your selection a fair chance before deciding that it doesn't work.

Assess the results. If you've solved the problem great! If not it's time to substitute another idea from the list.

Reach out for additional resources. If you still don't have the solution it's time to reach out once again to your “self-management support team” for more ideas.

Accept that the problem may not be solvable at this moment. Just because that problem isn't immediately solvable, doesn't mean it won't be solvable later. Don't give up.

Don't dwell on what you can't do. Start working on another goal you'd like to accomplish.




Wednesday, 15 October 2014 18:38

MHC - Goals & Action Planning


 My Health Counts! Goals & Action Planning

Getting peace of mind about health care begins largely with finding the right doctor—one who values relationships based on openness and trust and provides high-quality care. Regardless of what kind of relationship they have with their doctor, there is a lot people can do to manage their own health, like watching what they eat, getting exercise, and limiting stress.

Once you've decided to take an active role in your health, one of the first steps is to set a goal for yourself. This is something you and your doctor or other members of your healthcare team should do together. It's part of your treatment plan—allowing you to extend your care beyond the exam room walls and into your everyday life.

Pick a problem. Talk to your doctor and take an honest look at the unhealthy aspects of your lifestyle. It's your turn to zero in on a particular behavior that you'd like to change to help prevent future illnesses, to have better control of conditions you already have and to prevent complications. For example, you might decide that you want to make healthier food choices, increase your physical activity or take your medications as your doctor has prescribed. Write down your goal and date it. Share it with your doctor and other people you trust and ask for their help.

Look for ways to accomplish your goal. There are many ways to reach any specific goal. If your goal is to lose weight you could start an exercise program, decide not to eat between meals or decide to cut out cola of other sweetened beverages from your diet. Sometimes what keeps us from reaching our goal is the failure to see alternatives, so you'll want to list all the options. Share your goal with family, friends and your healthcare team and ask them to help you add to your list.

Turning your Goals into Action Plans. When you think about reaching that goal it can be overwhelming. Generally, goals are too big to work on all at once. If your thinking about losing a significant amount of weight, say 50 pounds, it's not something you can achieve in one week, or even one month. You'll need to break down those goals into smaller achievable steps—this is action planning.

To be successful action plans need to:

  • Come from YOU. The action plans should be something you want to do or accomplish. Don't choose something to please your doctor or your loved ones.
  • Be Reasonable. It should be something that you can accomplish within a week. Remember, it's the combination of successful actions plans that will help you achieve your goal.
  • Be Specific. The more specific your goal is, the more likely you are to succeed. For example, instead of saying, “I'm going to exercise more,” decide what kind of exercise you'll do. Be specific about what days of the week you'll exercise and what times you'll exercise on those days. Your new goal might be: “After dinner on Mondays, Wednesdays and Fridays, I'm going to walk 1 mile in through the neighborhood, with my dog.” Try to answer the questions what, how much, when and how often.
  • Be Realistic. Go or the real, not the ideal. The ideal might be walking 10,000 steps a day, but if you're currently walking only 500 to 1,000 steps a day, going for 10,000 may be too much. A more realistic goal may be 1,200 to 2,000 steps. When you do that, add a few more.
  • Be Behavior Specific. Think behavior, not results. For example instead of saying, “I'm going to eat healthier,” decide to add one serving of vegetables to your dinner at least five days this week and switch from drinking Coke to water at lunchtime.

Plan ahead. Try to think of things that could go wrong and plan how you'll deal with them. For example, if it rains and you can't walk in the park as planned, where will you go to walk? Is there an indoor track nearby, or could you go to the mall? If you plan how to handle problems in advance, they won't prevent you from following through with your action plan.

Check your confidence level. Ask yourself, “How confident am I that I'll be able to meet this goal?” Calculate your confidence level on a scale o 1-10 with 1 being not sure at all and 10 being totally sure. If the answer is below 7, you may need look at your action plan and either plan or foreseeable problems or change your plan so you are more confident of success.

Keep track of results. Once you are confident of your action plan write it down and post it where you will see it every day. It's a good idea to keep track of how you are doing each day. Check off accomplishments and list any problems you encounter. Ask family and friends to check in with you to see how you are doing—they can be good motivators. At the end of the week, see if you've accomplished your action plan and if you're made progress toward your goal. If you are struggling with your plan it's time to problem solve.

One of the most important things to remember is that you can change your behavior. Even though chronic conditions can make you feel helpless at times, if you work with your doctor to set goals and you take responsibility for following through with them, you can make changes that will lead to better health and decrease the advancement of disease.

Ready to start . . . Make a Plan for Your Health!


Make a plan resources:

My Health Counts! Action Plan

My Health Counts! Living Well with Diabetes Guide

CDC Healthy Living - Healthy Living




Wednesday, 15 October 2014 13:11

MHC - Wellness & Self-Management


 My Health Counts! Wellness and Self-Management

What are the top five things you can do to stay healthy? Eat healthy, get active, get screened, quit smoking and watch your weight.

These health behaviors, like the ones you learned in your sixth grade health class, are the kinds of things that prevent a lot of chronic conditions from occurring. And when they do occur, it's these same health behaviors that can help minimize the level of severity and allow you to be as healthy as possible living with that chronic condition.

The good news is when it comes to wellness and prevention; we have a lot of control! The bad news is unhealthy behaviors become habits; and changing those habits can be hard.

For some people the concept of wellness is the total absence of disease and that you don't have to take medications. But one of the ways that one might think about wellness is that you are the healthiest that you can be given the health conditions that you're living with.

Often the words “health” and “medicine” are used interchangeably. But the distinction is important. “Health” is the state of physical, mental and emotional wellbeing while “medicine” is the process that can help take us from being sick to being well.

You have an important role to play when it comes to both health and medicine. Your daily choices and behaviors allow you to maintain your health. But when you do get sick, it's your partnership with your doctor and your healthcare team that helps ensure your medical care is successful.

Quality health care happens when people take an active role in their own care, becoming partners with their doctor to create a more effective, trusting relationship that helps them stay healthy or determine the right care when they need it.

Regardless of what type of relationship you have with your doctor, there is a lot you can do on your own to manage your health like watching what you eat, getting exercise and limiting stress.

Learn more in the Quick Guide to Healthy Living from the U.S. Department of Health & Human Services.


Tools & more on self-management on the web:

My Health Counts! Daily Food Diary

My Health Counts! Exercise Log

My Health Counts! Action Plan

Adult BMI Calculatorfrom the Centers or Disease control & Prevention

Child & Teen BMI Calculator - from the Centers or Disease control & Prevention

My Fats Translator - Fat Calculatorfrom the American Heart Association

Build Your Question List - from the Agency for Healthcare Research and Quality

What Vaccines Do You Need? - from the Centers for Disease Control and Prevention

Mental Health Screening Center - from the Depression and Bipolar Support Alliance 

myhealthfinder - Tools to get personalized health recommendations

Stay Connected - Apps and online communities for healthy living from

Español - en español le ofrece la información más actualizada para que usted y sus seres queridos se mantengan saludables.



Tuesday, 14 October 2014 16:33

MHC - More Questions to Ask the Doctor


 My Health Counts! More Questions to Ask the Doctor

Most doctors are pressed for time these days and patients feel like they don't have time to really talk and ask their doctors questions. Rushed doctor visits can leave people with lingering concerns about their treatments or medications, or not having fully explained their symptoms.

You can improve your care by learning more about your conditions—asking questions, sharing your medical history and making sure you understand your doctor's recommendations, and taking the necessary steps to feel better sooner.

Make Sure You Get What You Need

  • Think about what you want to talk about before your doctor's appointment.
  • Bring up the most important questions at the beginning of your appointment. Don't wait until the end of the appointment—the doctor may not have time to get to the issues that are important to you.
  • Bring a trusted family member or friend with you to listen, ask questions and remind you of things you wanted to talk about.
  • If your doctor's office uses a computer to record medical information and notes from the visit (electronic medical record), ask if you can have a copy of the summary.
  • If your doctor is using too many medical words that you don't understand, ask, “Could you put that in plain language, please?”
  • If you are not sure whether you will follow through with your doctor's directions, tell your doctor about your concerns and ask for time to think it over.


Questions about the agenda & goals for your appointment:

  • I'd like to tell you about what I would like to accomplish today.
  • What do you think we need to cover today?

Questions about treatment:

  • Are there any alternatives or options?
  • What are the side effects? What are the benefits?
  • How confident are you that this will help?
  • How will I know if the treatment is working?
  • When can I expect to see a change?
  • What will I notice?

Questions about the condition:

  • What ideas do you have about what is contributing to my problem?
  • What concerns you the most?
  • What kinds of problems or difficulties should I watch out for?

Questions about self-management:

  • What can I do to manage my condition?
  • What might get in the way of my success?
  • What resources/materials might help?
  • What programs or services in my community might be helpful?
  • How can my family/friends help?

Questions you might ask about a specific illness or symptom:

  • What's wrong with me? What else could it be?
  • Can you draw a picture or show me what is wrong?
  • What causes this kind of problem?
  • Can I give this illness to someone else, and if so, how and for what period of time can I pass this on?
  • Are there any activities or foods which I should avoid?
  • When can I return to work or school? What is the long-term prognosis of my condition?
  • How can I prevent this from happening again?
  • How will this problem affect me in the future?
  • What will happen if I don't treat my condition right away?
  • What treatment should I follow, including dietary, medical treatment, and lifestyle changes?
  • What are the risks and benefits of the treatment options and the consequences of not treating?
  • When do I need to see the doctor again? Where can I get more information about my condition?
  • Should I return for a follow-up? Until then, what symptoms should I watch for and what should I do if they occur?


Questions you might ask about medications your doctor prescribes (Talk to your doctor, healthcare team member or pharmacist):

  • What is the name of the medication?
  • Why do I need this particular medication?
  • What is the medication supposed to do? How does it work?
  • When will it take effect?
  • What are the possible side effects of the drug?
  • How and when do I take this medication, and how much should I take?
  • How long will I need to take the medication?
  • Are there any tests necessary to monitor the use of this medicine?
  • Is this medication safe to take with other medications, over the counter medications, and supplements I may be taking?
  • Are there any foods, drinks, other medications or activities I should avoid while I take this medication?
  • How often will I need to get the medication refilled?
  • How will I know if the medication is working?
  • What are the risks of not taking the medication?
  • Is there a generic drug or less expensive medications available for my condition?
  • Are there lifestyle changes I could make that would lessen my dependency on the medication?
  • What if I miss a dose?
  • What if I accidentally take an extra dose?
  • How should I store this medication?
  • Do you have any written materials about this drug?

Questions you might ask about surgery or a procedure:

  • Why do I need an operation?
  • What are the benefits and risks of the operation?
  • How long will it take to recover?
  • When do I check in to the hospital and where?
  • What can I expect to happen before the surgery or procedure?
  • Can you draw a picture or show me what will happen during the procedure?
  • How long will the procedure take?
  • Can my family go with me?
  • What effects will the procedure have on me in the short and long term?
  • What is the doctor's experience in performing the procedure?
  • What medications will be given to me?
  • Are there any treatments I could have instead of an operation?
  • What will happen if I don't have the procedure?

Questions you might ask about a lab test, an x-ray, or another test:

  • Why is the test necessary?
  • How will the test be done?
  • How accurate will the test be?
  • What will happen if I do not have the test?
  • What are the benefits and risks of the test?
  • Will it hurt? If so is there anything I can do to lessen the pain?
  • Can the doctor perform the test in the office or will I have to go to the hospital or the laboratory?
  • Is there any preparation for the test?
  • What are the side effects of the test?
  • What changes or effects should I report to the doctor?
  • When and how will I receive the results?
  • What should I do if I don't receive the results?
  • Can I get a copy of the test results? 


More questions to ask your doctor on the web:

Be Prepared for Medical Appointments

Improving health care quality is a team effort. You can improve your care and the care of your loved ones by taking an active role in your health care. Ask questions. Understand your condition. Evaluate your options. Build your question list. (from the Agency for Healthcare Research and Quality)



My Health Counts! How to Get Copies of Your Tests & Records

Keeping copies of your health records and tests can improve communications and coordination between hospitals, doctors, nurses and patients. It allows you to be a better partner with your doctors and helps you manage your own health.

You should request a copy of your health records from all your healthcare providers, including your general practitioner, plus your eye doctor, dentist, and any other specialist you have seen and include them in your Personal Health Record. Ask if your records are in an electronic format that you can access or if you need to request copies. Also, ask your doctor or a member of the office staff to help you determine which parts of your record you need.

All hospitals, and most doctors' offices, have a release form to authorize the release of information. In most cases you can request the medical information directly from the doctor's office or medical records department at a hospital. Most facilities charge for copies. The fee can only include the cost of copying (including supplies and labor), as well as postage if you request the copy to be mailed. It can take up to 60 days to receive your medical records, so ask when you can expect to receive the information you requested. Keep in mind that offices may only keep records for a certain amount of time as required by state law. You should call the office to be sure your records still exist. In many cases you can simply send a letter that includes the relevant information rather than using a specific form. This letter will need to include:

  • Your birth date.
  • Your full name (including any information about name changes).
  • Time frame when you were seen (for example July 1998 to September 2000).
  • The specific types of information you want sent (such as reports from a brain scan, your cholesterol levels, etc.).

You can have your records sent to yourself to share with a healthcare professional, or directly to a health professional. If you do have the records sent to a health professional, let them know to expect the files.

It is best to get in the routine of asking for copies of tests as they are done. Some testing facilities will send copies of the results directly to the patient if it is noted on the doctor's test orders.

Did you know?

If your physician has moved, retired, or died, his or her estate has an obligation to retain your record for a period defined by federal and state law. You may be able to locate your records by contacting:

  • Your physician's partners
  • The health information manager at a nearby hospital where the physician practiced
  • The local medical society
  • The state medical association
  • The state department of health


More on getting copies of your records & tests on the web:

Do I Have the Right to See My Medical Records?

Information about obtaining medical records in New York State. (from the New York State Department of Health)

Records Are Yours for the Taking

Learn how to get a hold of your medical records. (from Trisha Torrey)