------------------ MY HEALTHEVET PERSONAL HEALTH INFORMATION ------------
                     *************CONFIDENTIAL*************
                           Produced by the Blue Button (v11.3.1)
                              11 Jul 2011 @ 0550

This summary is a copy of information from your My HealtheVet Personal
Health Record. Your summary contains information that you entered and
may also include a copy of some of the information in your VA medical
record as it becomes available in My HealtheVet. Please let your health
care team know if you have questions about your health information.

Name: MHVTESTVETERAN, ONE                       Date of Birth: 01 Mar 1948

------------------------ DOWNLOAD REQUEST SUMMARY -----------------------

System Request Date/Time: 11 Jul 2011 @ 0550
User Request Type:        Download all of my available data from My HealtheVet
File Name:                mhv_MHVTESTVETERAN_20110711.txt

Data Types Selected:
  My HealtheVet Account Summary
  Demographics
  Health Care Providers
  Treatment Facilities
  Health Insurance
  VA Wellness Reminders
  VA Appointments (Future)
  VA Appointments (Limited to past 2 years)
  VA Medication History
  Medications and Supplements
  VA Allergies
  Allergies/Adverse Reactions
  Medical Events
  Immunizations
  VA Laboratory Results
  Labs and Tests
  Vitals and Readings
  Family Health History
  Military Health History

--------------------- MY HEALTHEVET ACCOUNT SUMMARY ---------------------

Source: VA

Authentication Status: Authenticated
Authentication Date: 18 May 2011
Authentication Facility ID: 648
Authentication Facility Name: PORTLAND, OREGON VA MEDICAL CENTER

   VA Treating Facility                     Type
   ----------------------------            -----------  
   AUSTIN MHV                              OTHER
   AUSTIN PSIM                             OTHER
   PORTLAND, OREGON VA MEDICAL CENTER      VAMC

----------------------------- DEMOGRAPHICS ----------------------------

Source: Self-Entered

First Name: ONE
Middle Initial: 
Last Name: MHVTESTVETERAN
Suffix: 
Alias: MHVVET
Relationship to VA: Patient, Veteran

Gender: Male   Blood Type: AB+         Organ Donor: Yes

Date of Birth: 01 Mar 1948
Marital Status: Married
Current Occupation: Truck Driver

Mailing Address: 123 Anywhere Road
Mailing Address2: Apt. 123
Mailing City: Anywhere
Mailing State: DC
Mailing Country: United States
Mailing Province: 
Mailing Zip/Postal Code: 00001

Alternate Address: 
Alternate Address2: 
Alternate City: 
Alternate State: 
Alternate Country: 
Alternate Province: 
Alternate Zip/Postal Code: 

Home Phone Number: 000-020-0202
Work Phone Number: 000-040-0404
Pager Number: 
Cell Phone Number: 000-030-0303
FAX Number: 000-050-0505
Email Address: mhvveteran@emailaddress.com
Preferred Method of Contact: Email

EMERGENCY CONTACTS

Contact First Name: Two
Contact Last Name: MHVVeteran
Relationship: 
Home Phone Number: 000-010-0001
Work Phone Number:               Extension: 
Cell Phone Number: 
Address Line 1: 123 Anywhere Road
Address Line 2: 
City: Anywhere
State: DC
Country: United States
Province: 
Zip/Post Code: 000001
Email Address: 

Contact First Name: Three
Contact Last Name: MHVVeteran
Relationship: 
Home Phone Number: 000-010-0101
Work Phone Number: 000-080-0808  Extension: 
Cell Phone Number: 000-090-0909
Address Line 1: 123 Anywhere Road
Address Line 2: 
City: 
State: DC
Country: United States
Province: 
Zip/Post Code: 00001
Email Address: 

------------------------- HEALTH CARE PROVIDERS -------------------------

Source: Self-Entered

Provider Name: John Doe
Type of Provider: Primary
Other Clinician Information:  
Phone Number: 000-000-0000    Ext: 1234
Email: provider@institution.org
Comments: Dr. Doe can be reached on the weekend if needed by leaving a message 
with the clinic. 

Provider Name: Jane Smith
Type of Provider: Specialist
Other Clinician Information:  
Phone Number: 000-000-0001    Ext: 1234
Email: specialist@institution.org
Comments: Dr. Smith should be notified of any changes in my medical condition. 
Requires a referral from my health insurance company. 

------------------------- TREATMENT FACILITIES --------------------------

Source: Self-Entered

Facility Name: Anywhere VA Medical Center
Facility Type: VA            VA Home Facility: Yes
Phone Number: 000-000-0001   Ext: 1234
Mailing Address: 123 VA Drive
Mailing Address2: Suite 4
Mailing City: Anywhere
Mailing State: DC
Mailing Country: United States
Mailing Province:  
Mailing Zip/Postal Code: 00001
Comments: Contact clinic when calling to make my appointments. 

Facility Name: Health Care Inc.
Facility Type: Non-VA        VA Home Facility: No
Phone Number: 000-000-0002   Ext: 5678
Mailing Address: 123 Anywhere Road
Mailing Address2: B-Wing
Mailing City: Anywhere
Mailing State: DC
Mailing Country: United States
Mailing Province:  
Mailing Zip/Postal Code: 00001
Comments: Reminder to bring My HealtheVet printouts for all visits 

--------------------------- HEALTH INSURANCE ----------------------------

Source: Self-Entered

Health Insurance Company: My Health Insurance Company
Primary Insurance Provider: Yes
ID Number: 0001234                      Group Number: 0000000
Insured: One MHVveteran
Start Date: 01 Jan 2009                 Stop Date: 
Pre-Approval Phone Number:              000-000-0003
Health Insurance Company Phone Number:  000-000-0004
Comments: Need to get pre-authorization for special services. 

Health Insurance Company: My Other Health Insurance Company
Primary Insurance Provider: No
ID Number: 000567891010                 Group Number: ABC123456789
Insured: One MHVveteran
Start Date: 01 Jan 2009                 Stop Date: 
Pre-Approval Phone Number:              000-000-0005
Health Insurance Company Phone Number:  000-000-0005
Comments: Coverage only for vision and dental. 

---------------------------- VA WELLNESS REMINDERS -------------------------

Source: VA
Last Updated: 11 Jul 2011 @ 0523

Wellness Reminder                  Due Date    Last Completed   Location
----------------------------------------------------------------------------
Control of Your Cholesterol        DUE NOW     UNKNOWN          PORTLAND, OR
Influenza Vaccine                  DUE NOW     UNKNOWN          PORTLAND, OR
Pneumonia Vaccine                              06 Mar 2011      PORTLAND, OR
Body Mass Index more than 25       DUE NOW     UNKNOWN          PORTLAND, OR
Colon Cancer Screening             DUE NOW     UNKNOWN          PORTLAND, OR

Learn more about these Wellness Reminders by visiting My HealtheVet.
Please contact your health care team with any questions about your VA
Wellness Reminders.


--------------------------- VA APPOINTMENTS -----------------------------

Source: VA
Last Updated: 11 Jul 2011 @ 0523

VA Past Appointments are limited to two years from the date of your
download request.

FUTURE APPOINTMENTS:
--------------------
Date/Time:      30 May 2012 @ 1600
Location:       PORTLAND
Status:         NOT APPLICABLE
Clinic:         111A TEST NOTE LOCATION
Phone Number:   000-000-0001

Date/Time:      07 May 2012 @ 1100
Location:       PORTLAND
Status:         NOT APPLICABLE
Clinic:         111A TEST NOTE LOCATION
Phone Number:   000-000-0001

Date/Time:      27 Jan 2012 @ 1400
Location:       PORTLAND
Status:         NOT APPLICABLE
Clinic:         111A TEST NOTE LOCATION
Phone Number:   000-000-0001
Note:           This appointment has pre-appointment activity scheduled:
                Lab:    27 Jan 2012 @ 1000

Date/Time:      15 Dec 2011 @ 1300
Location:       PORTLAND
Status:         NOT APPLICABLE
Clinic:         111A TEST NOTE LOCATION
Phone Number:   000-000-0001
Note:           This appointment has pre-appointment activity scheduled:
                Lab:    15 Dec 2011 @ 0800
                EKG:    15 Dec 2011 @ 1030
                X-Ray:  15 Dec 2011 @ 0900

Date/Time:      03 Nov 2011 @ 1100
Location:       PORTLAND
Status:         NOT APPLICABLE
Clinic:         111A TEST NOTE LOCATION
Phone Number:   000-000-0001
Note:           This appointment has pre-appointment activity scheduled:
                X-Ray:  03 Nov 2011 @ 0800


PAST APPOINTMENTS:
--------------------
Date/Time:      15 Mar 2011 @ 1000
Location:       PORTLAND
Status:         NOT APPLICABLE
Clinic:         111A TEST NOTE LOCATION
Phone Number:   000-000-0001
Note:           This appointment has pre-appointment activity scheduled:
                Lab:    15 Mar 2011 @ 0930

Date/Time:      06 Mar 2011 @ 1000
Location:       PORTLAND
Status:         NOT APPLICABLE
Clinic:         111A TEST NOTE LOCATION
Phone Number:   000-000-0001
Note:           This appointment has pre-appointment activity scheduled:
                Lab:    06 Mar 2011 @ 0900
                EKG:    06 Mar 2011 @ 0930

Date/Time:      03 Jan 2011 @ 1300
Location:       PORTLAND
Status:         NOT APPLICABLE
Clinic:         111A TEST NOTE LOCATION
Phone Number:   000-000-0001

Date/Time:      30 Aug 2010 @ 1400
Location:       PORTLAND
Status:         NOT APPLICABLE
Clinic:         111A TEST NOTE LOCATION
Phone Number:   000-000-0001


-------------------------- VA MEDICATION HISTORY ----------------------

Source: VA
Last Updated: 07 Jun 2011 @ 1445

VA Medication History includes up to two years of medication history
unless you select a different date range in your download request.

Medication: ACCU-CHEK AVIVA (GLUCOSE) TEST STRIP #50 
Instructions: USE 1 STRIP FOR BLOOD GLUCOSE TESTING AS DIRECTED 
Status: Active
Refills Remaining: 2
Last Filled On: 03 Jun 2011
Initially Ordered On: 03 Jun 2011
Quantity: 200
Days Supply: 50
Pharmacy: PORTLAND PHARMACY
Prescription Number: 11181484

Medication: AMLODIPINE BESYLATE 10MG TAB 
Instructions: TAKE ONE-HALF TABLET BY MOUTH EVERY DAY FOR BLOOD PRESSURE -- 
AVOID GRAPEFRUIT JUICE -- 
Status: Active
Refills Remaining: 3
Last Filled On: 03 Jun 2011
Initially Ordered On: 03 Jun 2011
Quantity: 45
Days Supply: 90
Pharmacy: PORTLAND PHARMACY
Prescription Number: 11181487

Medication: COLONIC LAVAGE SOLUTION (4 LITER) 
Instructions: MIX 1 GALLON IN WATER AND DRINK AS DIRECTED FOR 1 DAY DISSOLVE 1 
BOTTLE 
Status: Active
Refills Remaining: 0
Last Filled On: 03 Jun 2011
Initially Ordered On: 03 Jun 2011
Quantity: 1
Days Supply: 2
Pharmacy: PORTLAND PHARMACY
Prescription Number: 11181488

Medication: IBUPROFEN 600MG TAB 
Instructions: TAKE ONE TABLET BY MOUTH FOUR TIMES DAILY WITH MEALS AS NEEDED 
FOR PAIN 
Status: Active
Refills Remaining: 3
Last Filled On: 03 Jun 2011
Initially Ordered On: 03 Jun 2011
Quantity: 240
Days Supply: 60
Pharmacy: PORTLAND PHARMACY
Prescription Number: 11181491

Medication: INSULIN NOVOLIN NPH 100U/ML INJ 10ML VL 
Instructions: INJECT 16 UNITS SUBCUTANEOUSLY EVERY MORNING AND INJECT 18 UNITS 
AT BEDTIME EACH VIAL EXPIRES 30 DAYS AFTER FIRST OPENING. 
Status: Active
Refills Remaining: 1
Last Filled On: 03 Jun 2011
Initially Ordered On: 03 Jun 2011
Quantity: 3
Days Supply: 30
Pharmacy: PORTLAND PHARMACY
Prescription Number: 11181492

Medication: INSULIN,GLARGINE 100U/ML INJ 10ML VIAL 
Instructions: INJECT 25 UNITS SUBCUTANEOUSLY AT BEDTIME * DO NOT MIX OTHER 
INSULINS IN SAME SYRINGE AS GLARGINE. DISCARD VIAL 28 DAYS AFTER OPENING.  EACH 
VIAL EXPIRES 28 DAYS AFTER FIRST OPENING. 
Status: Active
Refills Remaining: 2
Last Filled On: 03 Jun 2011
Initially Ordered On: 03 Jun 2011
Quantity: 3
Days Supply: 30
Pharmacy: PORTLAND PHARMACY
Prescription Number: 11181494

Medication: METFORMIN HCL 1000MG TAB 
Instructions: TAKE ONE TABLET BY MOUTH TWICE DAILY WITH MEALS FOR DIABETES. 
Status: Active
Refills Remaining: 2
Last Filled On: 03 Jun 2011
Initially Ordered On: 03 Jun 2011
Quantity: 180
Days Supply: 90
Pharmacy: PORTLAND PHARMACY
Prescription Number: 11181499

Medication: SIMVASTATIN 40MG TAB 
Instructions: TAKE ONE-HALF TABLET BY MOUTH AT BEDTIME TO LOWER YOUR 
CHOLESTEROL. AVOID CONSUMING GRAPEFRUIT PRODUCTS.  CALL YOUR PROVIDER IF YOU 
HAVE UNEXPLAINED MUSCLE PAIN, TENDERNESS OR  WEAKNESS. 
Status: Active
Refills Remaining: 2
Last Filled On: 03 Jun 2011
Initially Ordered On: 03 Jun 2011
Quantity: 45
Days Supply: 90
Pharmacy: PORTLAND PHARMACY
Prescription Number: 11181502

Medication: LISINOPRIL 10MG TAB 
Instructions: TAKE ONE TABLET BY MOUTH EVERY DAY FOR BLOOD PRESSURE 
Status: Expired
Refills Remaining: 3
Last Filled On: 03 Jun 2011
Initially Ordered On: 03 Dec 2010
Quantity: 30
Days Supply: 30
Pharmacy: PORTLAND PHARMACY
Prescription Number: 11181497

Medication: BACITRACIN OINTMENT 1 OZ 
Instructions: APPLY SMALL AMOUNT TOPICALLY TO AFFECTED AREA TWICE A DAY TO 
THREE TIMES A DAY FOR 30 DAYS 
Status: Expired
Refills Remaining: 1
Last Filled On: 03 Jun 2011
Initially Ordered On: 03 Dec 2010
Quantity: 10
Days Supply: 45
Pharmacy: PORTLAND PHARMACY
Prescription Number: 11181529

Medication: DEXAMETHASONE 4MG TAB 
Instructions: TAKE TWO TABLETS BY MOUTH HOUR FOR 2 DAYS -- TAKE WITH FOOD -- 
Status: Expired
Refills Remaining: 2
Last Filled On: 03 Jun 2011
Initially Ordered On: 03 Dec 2010
Quantity: 96
Days Supply: 30
Pharmacy: PORTLAND PHARMACY
Prescription Number: 11181530

Medication: NAPROXEN 500MG TAB 
Instructions: TAKE ONE TABLET BY MOUTH TWICE A DAY -- TAKE WITH FOOD IF GI 
Status: Expired
Refills Remaining: 3
Last Filled On: 03 Jun 2011
Initially Ordered On: 03 Dec 2010
Quantity: 60
Days Supply: 90
Pharmacy: PORTLAND PHARMACY
Prescription Number: 11181531

Medication: SODIUM CHLORIDE 0.65% SOLN NASAL 
Instructions: SPRAY 2 SPRAYS MOUTH MINUTE FOR 30 DAYS 
Status: Expired
Refills Remaining: 3
Last Filled On: 03 Jun 2011
Initially Ordered On: 03 Dec 2010
Quantity: 10
Days Supply: 30
Pharmacy: PORTLAND PHARMACY
Prescription Number: 11181532


-------------------------- MEDICATIONS AND SUPPLEMENTS ----------------------

Source: Self-Entered

Category: RX Medication
Drug Name: Aspirin EC
Prescription Number: 010101B
Strength: 81mg
Dose: 1 tab
Frequency: daily
Start Date: 15 Jun 2005                         Stop Date:  
Pharmacy Name: My Local Drugstore               Pharmacy Phone: 000-010-0000

Reason for taking: Daily regimen for heart health 

Comments:  

Category: OTC
Drug Name: Cough Medicine
Prescription Number:  
Strength: 1000mg
Dose: 2 TBS
Frequency: morning and night
Start Date: 01 Feb 2010                         Stop Date: 21 Feb 2010
Pharmacy Name: My Local Drugstore               Pharmacy Phone: 000-010-0000

Reason for taking: Cough was keeping me up at night 

Comments: Cleared up after a few weeks 

Category: Herbal
Drug Name: Ginkgo biloba
Prescription Number:  
Strength:  
Dose: 2 capsules
Frequency: once a day
Start Date: 08 Mar 2008                         Stop Date:  
Pharmacy Name: My Local Drugstore               Pharmacy Phone: 000-010-0000

Reason for taking: Wife suggested to improve concentration 

Comments: Take in the morning with breakfast 

Category: Supplement
Drug Name: Multi-vitamin
Prescription Number:  
Strength: 100% RDA
Dose: 1 tablet daily
Frequency: morning
Start Date: 18 Mar 2010                         Stop Date:  
Pharmacy Name: My Local Drugstore               Pharmacy Phone: 000-010-0000

Reason for taking: To stay healthy 

Comments: Feeling more energetic since I started taking vitamin 

---------------------------- VA ALLERGIES -------------------------

Source: VA
Last Updated: 11 Jul 2011 @ 0523


Allergy Name:        TRAMADOL
Location:            PORTLAND, OREGON VA MEDICAL CENTER
Date Entered:        03 Jun 2011
Reaction:            RETENTION OF URINE 
Allergy Type:        DRUG 
VA Drug Class:       NON-OPIOID ANALGESICS 
Observed/Historical: HISTORICAL
Comments:            gradually worsening difficulty emptying bladder -- might
try tramadol again cautiously because pt. reported pain
relief 

Allergy Name:        TRIMETHOPRIM
Location:            PORTLAND, OREGON VA MEDICAL CENTER
Date Entered:        03 Jun 2011
Reaction:             
Allergy Type:        DRUG 
VA Drug Class:       ANTI-INFECTIVES,OTHER 
Observed/Historical: HISTORICAL
Comments:            the reaction to this allergy was MILD (NO SQUELAE) 

Allergy Name:        METHOCARBAMOL
Location:            PORTLAND, OREGON VA MEDICAL CENTER
Date Entered:        03 Jun 2011
Reaction:            DELIRIUM, DROWSY 
Allergy Type:        DRUG 
VA Drug Class:       SKELETAL MUSCLE RELAXANTS 
Observed/Historical: OBSERVED
Comments:            Drowsiness and hallucinations while on methocarbamol plus
carbamazepine and other sedatives 

Allergy Name:        BACTRIM
Location:            PORTLAND, OREGON VA MEDICAL CENTER
Date Entered:        03 Jun 2011
Reaction:             
Allergy Type:        DRUG 
VA Drug Class:       SULFONAMIDE/RELATED ANTIMICROBIALS 
Observed/Historical: HISTORICAL
Comments:            Causes Swelling of the Extremities 

Allergy Name:        TERAZOSIN
Location:            PORTLAND, OREGON VA MEDICAL CENTER
Date Entered:        03 Jun 2011
Reaction:            DIZZINESS 
Allergy Type:        DRUG 
VA Drug Class:       ALPHA BLOCKERS/RELATED 
Observed/Historical: HISTORICAL
Comments:             

Please contact your health care team with any questions about your VA
Allergy information.



-------------------------- ALLERGIES/ADVERSE REACTIONS ---------------------

Source: Self-Entered


Allergy Name: Peanuts
Date:         01 Aug 1980
Severity:     Moderate
Diagnosed:    Yes

Reaction: Hives 

Comments: Avoid peanuts and peanut based foods.  Foods cooked with 
peanut oil also cause the reaction 

Allergy Name: Pollen
Date:         18 Mar 2011
Severity:     Mild
Diagnosed:    Yes

Reaction: Watery eyes, itchy nose 

Comments: Took an over the counter antihistamine 


------------------------------ MEDICAL EVENTS -------------------------------

Source: Self-Entered

Medical Event:   Colonoscopy
Start Date:      18 Mar 2000
Stop Date:       18 Mar 2000

Response: Colonoscopy went well 

Comments: Polyps were removed.  Doctor said these were benign 

Medical Event:   Broken right arm
Start Date:      04 Jan 2010
Stop Date:       17 Feb 2010

Response: Placed in cast from my hand to my elbow 

Comments: Went to community hospital emergency room since I was on 
vacation. Followed up with my VA doctor when I returned home. 


----------------------------- IMMUNIZATIONS ---------------------------------

Source: Self-Entered

Immunization: Measles + Rubella (German Measles)
Other:  
Method: Injection
Date Received: 01 Mar 1950

Reactions:
---------------------------------
Pain

Comments: Received as a child 

Immunization: Flu
Other:  
Method: Inhalant
Date Received: 01 Sep 2009

Reactions:
---------------------------------

Comments: Had no reaction 

Immunization: Tetanus
Other:  
Method: Injection
Date Received: 18 Jul 2010

Reactions:
---------------------------------
Pain

Comments: stepped on a rusty nail 


-------------------------- VA LABORATORY RESULTS ----------------------------

Source: VA
Last Updated: 11 Jul 2011 @ 0523
Sorted By: Date Specimen Collected (Descending)

VA Laboratory Results includes up to two years of history
unless you select a different date range in your download request.

=============================================================================
Lab Test: INR
Lab Type: Chemistry/Hematology
Ordering Provider: ZZZAATESTPHYSICIAN, EIGHTEEN
Ordering Location: PORTLAND, OREGON VA MEDICAL CENTER
Specimen: Plasma
Date/Time Collected: 03 Jun 2011 @ 1024

-----------------------------------------------------------------------------
Test Name: COAGULATION TISSUE FACTOR INDUCED.INR
Result: 0.7 Low
Units: 
Reference Range: (0.90-1.20)
Interpretation: Therapeutic ranges may differ with individual
clinical circumstances.
INR therapeutic ranges for full anticoagulation:
INR for venous thromboembolism, 2.0-3.0;
INR for most patients with mechanical valves, 2.5-3.5. 
Performing Location: PORTLAND, OREGON VA MEDICAL CENTER 3710 SW US VETERANS 
HOSPTL RD , PORTLAND, OR 97239 
Status: Final
-----------------------------------------------------------------------------
Comments: PT. reported incorrectly as 9.0 by [104353-VA648].
Changed to 9.9 on Jun 06, 2011@12:08 by [87277-VA648]. 

=============================================================================
Lab Test: Prothrombin Time
Lab Type: Chemistry/Hematology
Ordering Provider: ZZZAATESTPHYSICIAN, EIGHTEEN
Ordering Location: PORTLAND, OREGON VA MEDICAL CENTER
Specimen: Plasma
Date/Time Collected: 03 Jun 2011 @ 1024

-----------------------------------------------------------------------------
Test Name: COAGULATION TISSUE FACTOR INDUCED
Result: 9.9 Low
Units: SEC
Reference Range: (11.9-14.5)
Interpretation: SEE INR FOR CRITICAL VALUE CUT-OFF. 
Performing Location: PORTLAND, OREGON VA MEDICAL CENTER 3710 SW US VETERANS 
HOSPTL RD , PORTLAND, OR 97239 
Status: Amended
-----------------------------------------------------------------------------
Comments: PT. reported incorrectly as 9.0 by [104353-VA648].
Changed to 9.9 on Jun 06, 2011@12:08 by [87277-VA648]. 

=============================================================================
Lab Test: Hemogram+Platelet
Lab Type: Chemistry/Hematology
Ordering Provider: ZZZAATESTPHYSICIAN, EIGHTEEN
Ordering Location: PORTLAND, OREGON VA MEDICAL CENTER
Specimen: Whole blood
Date/Time Collected: 03 Jun 2011 @ 1024

-----------------------------------------------------------------------------
Test Name: ERYTHROCYTE DISTRIBUTION WIDTH
Result: 10 Low
Units: %
Reference Range: (11.5-14.5)
Interpretation:  
Performing Location: PORTLAND, OREGON VA MEDICAL CENTER 3710 SW US VETERANS 
HOSPTL RD , PORTLAND, OR 97239 
Status: Final
----------------------
Test Name: ERYTHROCYTE MEAN CORPUSCULAR HEMOGLOBIN
Result: 32.2 
Units: pg
Reference Range: (27-33)
Interpretation:  
Performing Location: PORTLAND, OREGON VA MEDICAL CENTER 3710 SW US VETERANS 
HOSPTL RD , PORTLAND, OR 97239 
Status: Final
----------------------
Test Name: ERYTHROCYTE MEAN CORPUSCULAR HEMOGLOBIN CONCENTRATION
Result: 33.3 
Units: g/dL
Reference Range: (33-37)
Interpretation:  
Performing Location: PORTLAND, OREGON VA MEDICAL CENTER 3710 SW US VETERANS 
HOSPTL RD , PORTLAND, OR 97239 
Status: Final
----------------------
Test Name: ERYTHROCYTES
Result: 4.44 
Units: M/cmm
Reference Range: (4.3-5.6)
Interpretation:  
Performing Location: PORTLAND, OREGON VA MEDICAL CENTER 3710 SW US VETERANS 
HOSPTL RD , PORTLAND, OR 97239 
Status: Final
----------------------
Test Name: HEMATOCRIT
Result: 47.0 
Units: %
Reference Range: (41-51)
Interpretation:  
Performing Location: PORTLAND, OREGON VA MEDICAL CENTER 3710 SW US VETERANS 
HOSPTL RD , PORTLAND, OR 97239 
Status: Final
----------------------
Test Name: HEMOGLOBIN
Result: 15.5 
Units: g/dL
Reference Range: (13-18)
Interpretation:  
Performing Location: PORTLAND, OREGON VA MEDICAL CENTER 3710 SW US VETERANS 
HOSPTL RD , PORTLAND, OR 97239 
Status: Final
----------------------
Test Name: LEUKOCYTES
Result: 20.0 High
Units: K/cmm
Reference Range: (4.4-10.8)
Interpretation:  
Performing Location: PORTLAND, OREGON VA MEDICAL CENTER 3710 SW US VETERANS 
HOSPTL RD , PORTLAND, OR 97239 
Status: Final
----------------------
Test Name: MEAN CORPUSCULAR VOLUME
Result: 90 
Units: fl
Reference Range: (82-98)
Interpretation:  
Performing Location: PORTLAND, OREGON VA MEDICAL CENTER 3710 SW US VETERANS 
HOSPTL RD , PORTLAND, OR 97239 
Status: Final
----------------------
Test Name: PLATELET MEAN VOLUME
Result: 9 
Units: fl
Reference Range: (7.4-10.4)
Interpretation:  
Performing Location: PORTLAND, OREGON VA MEDICAL CENTER 3710 SW US VETERANS 
HOSPTL RD , PORTLAND, OR 97239 
Status: Final
----------------------
Test Name: PLATELETS
Result: 240 
Units: K/cmm
Reference Range: (150-400)
Interpretation:  
Performing Location: PORTLAND, OREGON VA MEDICAL CENTER 3710 SW US VETERANS 
HOSPTL RD , PORTLAND, OR 97239 
Status: Final
-----------------------------------------------------------------------------
Comments: Comments about the result for this test name 

=============================================================================
Lab Test: Calcium
Lab Type: Chemistry/Hematology
Ordering Provider: ZZZAATESTPHYSICIAN, EIGHTEEN
Ordering Location: PORTLAND, OREGON VA MEDICAL CENTER
Specimen: Plasma
Date/Time Collected: 03 Jun 2011 @ 1024

-----------------------------------------------------------------------------
Test Name: CALCIUM
Result: 9.0 
Units: mg/dL
Reference Range: (8.4-10.4)
Interpretation:  
Performing Location: PORTLAND, OREGON VA MEDICAL CENTER 3710 SW US VETERANS 
HOSPTL RD , PORTLAND, OR 97239 
Status: Final
-----------------------------------------------------------------------------
Comments: GLUCOSE flagged incorrectly as normal
GLUCOSE reported incorrectly as 110 by [104353-VA648].
Changed to 150 on Jun 03, 2011@10:31 by [104353-VA648]. 

=============================================================================
Lab Test: Carbon Dioxide Content
Lab Type: Chemistry/Hematology
Ordering Provider: ZZZAATESTPHYSICIAN, EIGHTEEN
Ordering Location: PORTLAND, OREGON VA MEDICAL CENTER
Specimen: Plasma
Date/Time Collected: 03 Jun 2011 @ 1024

-----------------------------------------------------------------------------
Test Name: CARBON DIOXIDE
Result: 25 
Units: mmol/L
Reference Range: (21-32)
Interpretation:  
Performing Location: PORTLAND, OREGON VA MEDICAL CENTER 3710 SW US VETERANS 
HOSPTL RD , PORTLAND, OR 97239 
Status: Final
-----------------------------------------------------------------------------
Comments: GLUCOSE flagged incorrectly as normal
GLUCOSE reported incorrectly as 110 by [104353-VA648].
Changed to 150 on Jun 03, 2011@10:31 by [104353-VA648]. 

=============================================================================
Lab Test: Chloride
Lab Type: Chemistry/Hematology
Ordering Provider: ZZZAATESTPHYSICIAN, EIGHTEEN
Ordering Location: PORTLAND, OREGON VA MEDICAL CENTER
Specimen: Plasma
Date/Time Collected: 03 Jun 2011 @ 1024

-----------------------------------------------------------------------------
Test Name: CHLORIDE
Result: 105 
Units: mmol/L
Reference Range: (95-108)
Interpretation:  
Performing Location: PORTLAND, OREGON VA MEDICAL CENTER 3710 SW US VETERANS 
HOSPTL RD , PORTLAND, OR 97239 
Status: Final
-----------------------------------------------------------------------------
Comments: GLUCOSE flagged incorrectly as normal
GLUCOSE reported incorrectly as 110 by [104353-VA648].
Changed to 150 on Jun 03, 2011@10:31 by [104353-VA648]. 

=============================================================================
Lab Test: Cholesterol Total
Lab Type: Chemistry/Hematology
Ordering Provider: ZZZAATESTPHYSICIAN, EIGHTEEN
Ordering Location: PORTLAND, OREGON VA MEDICAL CENTER
Specimen: Plasma
Date/Time Collected: 03 Jun 2011 @ 1024

-----------------------------------------------------------------------------
Test Name: CHOLESTEROL
Result: 152 
Units: mg/dL
Reference Range: (1-240)
Interpretation: DESIRABLE VALUE:     <200
BORDERLINE VALUE: 201-239
ELEVATED VALUE:      >240 
Performing Location: PORTLAND, OREGON VA MEDICAL CENTER 3710 SW US VETERANS 
HOSPTL RD , PORTLAND, OR 97239 
Status: Final
-----------------------------------------------------------------------------
Comments: GLUCOSE flagged incorrectly as normal
GLUCOSE reported incorrectly as 110 by [104353-VA648].
Changed to 150 on Jun 03, 2011@10:31 by [104353-VA648]. 

=============================================================================
Lab Test: Creatinine
Lab Type: Chemistry/Hematology
Ordering Provider: ZZZAATESTPHYSICIAN, EIGHTEEN
Ordering Location: PORTLAND, OREGON VA MEDICAL CENTER
Specimen: Plasma
Date/Time Collected: 03 Jun 2011 @ 1024

-----------------------------------------------------------------------------
Test Name: CREATININE
Result: 1.4 
Units: mg/dL
Reference Range: (0.8-1.5)
Interpretation:  
Performing Location: PORTLAND, OREGON VA MEDICAL CENTER 3710 SW US VETERANS 
HOSPTL RD , PORTLAND, OR 97239 
Status: Final
-----------------------------------------------------------------------------
Comments: GLUCOSE flagged incorrectly as normal
GLUCOSE reported incorrectly as 110 by [104353-VA648].
Changed to 150 on Jun 03, 2011@10:31 by [104353-VA648]. 

=============================================================================
Lab Test: Creatinine eGFR
Lab Type: Chemistry/Hematology
Ordering Provider: ZZZAATESTPHYSICIAN, EIGHTEEN
Ordering Location: PORTLAND, OREGON VA MEDICAL CENTER
Specimen: Plasma
Date/Time Collected: 03 Jun 2011 @ 1024

-----------------------------------------------------------------------------
Test Name: GLOMERULAR FILTRATION RATE.PREDICTED
Result: 51 Low
Units: 
Reference Range: (>60)
Interpretation: EGFR IS 5.9% LOWER THAN EGFR CALCULATIONS PERFORMED BEFORE 
2/12/08
An eGFR <60 is abnormal.
Estimated glomerular filtration rate (eGFR) results >60 are imprecise.
Many variables affect the calculated result.
Interpretation of eGFR results >60 must be monitored over time.
Units are mL/min/1.73m^2. 
Performing Location: PORTLAND, OREGON VA MEDICAL CENTER 3710 SW US VETERANS 
HOSPTL RD , PORTLAND, OR 97239 
Status: Final
-----------------------------------------------------------------------------
Comments: GLUCOSE flagged incorrectly as normal
GLUCOSE reported incorrectly as 110 by [104353-VA648].
Changed to 150 on Jun 03, 2011@10:31 by [104353-VA648]. 

=============================================================================
Lab Test: Gen Chem Specimen
Lab Type: Chemistry/Hematology
Ordering Provider: ZZZAATESTPHYSICIAN, EIGHTEEN
Ordering Location: PORTLAND, OREGON VA MEDICAL CENTER
Specimen: Plasma
Date/Time Collected: 03 Jun 2011 @ 1024

-----------------------------------------------------------------------------
Test Name: ANION GAP
Result: 10.0 
Units: mmol/L
Reference Range: (10-22)
Interpretation:  
Performing Location: PORTLAND, OREGON VA MEDICAL CENTER 3710 SW US VETERANS 
HOSPTL RD , PORTLAND, OR 97239 
Status: Final
-----------------------------------------------------------------------------
Comments: GLUCOSE flagged incorrectly as normal
GLUCOSE reported incorrectly as 110 by [104353-VA648].
Changed to 150 on Jun 03, 2011@10:31 by [104353-VA648]. 

=============================================================================
Lab Test: Glucose Quant
Lab Type: Chemistry/Hematology
Ordering Provider: ZZZAATESTPHYSICIAN, EIGHTEEN
Ordering Location: PORTLAND, OREGON VA MEDICAL CENTER
Specimen: Plasma
Date/Time Collected: 03 Jun 2011 @ 1024

-----------------------------------------------------------------------------
Test Name: GLUCOSE
Result: 150 High
Units: mg/dL
Reference Range: (71-109)
Interpretation:  
Performing Location: PORTLAND, OREGON VA MEDICAL CENTER 3710 SW US VETERANS 
HOSPTL RD , PORTLAND, OR 97239 
Status: Amended
-----------------------------------------------------------------------------
Comments: GLUCOSE flagged incorrectly as normal
GLUCOSE reported incorrectly as 110 by [104353-VA648].
Changed to 150 on Jun 03, 2011@10:31 by [104353-VA648]. 

=============================================================================
Lab Test: Potassium
Lab Type: Chemistry/Hematology
Ordering Provider: ZZZAATESTPHYSICIAN, EIGHTEEN
Ordering Location: PORTLAND, OREGON VA MEDICAL CENTER
Specimen: Plasma
Date/Time Collected: 03 Jun 2011 @ 1024

-----------------------------------------------------------------------------
Test Name: POTASSIUM
Result: 4.5 
Units: mmol/L
Reference Range: (3.5-5.0)
Interpretation:  
Performing Location: PORTLAND, OREGON VA MEDICAL CENTER 3710 SW US VETERANS 
HOSPTL RD , PORTLAND, OR 97239 
Status: Final
-----------------------------------------------------------------------------
Comments: GLUCOSE flagged incorrectly as normal
GLUCOSE reported incorrectly as 110 by [104353-VA648].
Changed to 150 on Jun 03, 2011@10:31 by [104353-VA648]. 

=============================================================================
Lab Test: Sodium
Lab Type: Chemistry/Hematology
Ordering Provider: ZZZAATESTPHYSICIAN, EIGHTEEN
Ordering Location: PORTLAND, OREGON VA MEDICAL CENTER
Specimen: Plasma
Date/Time Collected: 03 Jun 2011 @ 1024

-----------------------------------------------------------------------------
Test Name: SODIUM
Result: 140 
Units: mmol/L
Reference Range: (131-142)
Interpretation:  
Performing Location: PORTLAND, OREGON VA MEDICAL CENTER 3710 SW US VETERANS 
HOSPTL RD , PORTLAND, OR 97239 
Status: Final
-----------------------------------------------------------------------------
Comments: GLUCOSE flagged incorrectly as normal
GLUCOSE reported incorrectly as 110 by [104353-VA648].
Changed to 150 on Jun 03, 2011@10:31 by [104353-VA648]. 

=============================================================================
Lab Test: Triglycerides w o extract
Lab Type: Chemistry/Hematology
Ordering Provider: ZZZAATESTPHYSICIAN, EIGHTEEN
Ordering Location: PORTLAND, OREGON VA MEDICAL CENTER
Specimen: Plasma
Date/Time Collected: 03 Jun 2011 @ 1024

-----------------------------------------------------------------------------
Test Name: TRIGLYCERIDE
Result: 250 High
Units: mg/dL
Reference Range: (35-160)
Interpretation: DESIRABLE VALUE:     <150
BORDERLINE VALUE: 150-199
ELEVATED VALUE:   200-499
Patient should be fasting at time of specimen collection for
valid interpretation of triglyceride level. 
Performing Location: PORTLAND, OREGON VA MEDICAL CENTER 3710 SW US VETERANS 
HOSPTL RD , PORTLAND, OR 97239 
Status: Final
-----------------------------------------------------------------------------
Comments: GLUCOSE flagged incorrectly as normal
GLUCOSE reported incorrectly as 110 by [104353-VA648].
Changed to 150 on Jun 03, 2011@10:31 by [104353-VA648]. 

=============================================================================
Lab Test: Urea Nitrogen
Lab Type: Chemistry/Hematology
Ordering Provider: ZZZAATESTPHYSICIAN, EIGHTEEN
Ordering Location: PORTLAND, OREGON VA MEDICAL CENTER
Specimen: Plasma
Date/Time Collected: 03 Jun 2011 @ 1024

-----------------------------------------------------------------------------
Test Name: UREA NITROGEN
Result: 12 
Units: mg/dL
Reference Range: (7-23)
Interpretation:  
Performing Location: PORTLAND, OREGON VA MEDICAL CENTER 3710 SW US VETERANS 
HOSPTL RD , PORTLAND, OR 97239 
Status: Final
-----------------------------------------------------------------------------
Comments: GLUCOSE flagged incorrectly as normal
GLUCOSE reported incorrectly as 110 by [104353-VA648].
Changed to 150 on Jun 03, 2011@10:31 by [104353-VA648]. 


=============================================================================

Test results slightly outside the reference range are not unusual.
Your provider has reviewed your test results and will contact you
for any important issues. If you have further questions, please
do not hesitate to contact your primary care provider.


----------------------------- LABS AND TESTS --------------------------------

Source: Self-Entered

Test Name: Blood Test
Date: 06 Jun 2010
Location performed: Community Center
Provider: Red Cross Blood Drive

Results: Was not able to donate blood because iron was low 

Comments: Will ask doctor at next visit 

Test Name: Colonoscopy
Date: 01 Jul 2010
Location performed: VAMC
Provider: Provider One

Results: No new polyps 

Comments: Keep high fiber diet 



----------------------------- VITALS AND READINGS ---------------------------

Source: Self-Entered

===============================================================================
Measurement Type: Blood pressure
Date: 02 Aug 2010
Time: 1720
Systolic: 130
Diastolic: 76

Comments: BP taken lying down 
===============================================================================
Measurement Type: Blood pressure
Date: 02 Aug 2010
Time: 1730
Systolic: 132
Diastolic: 76

Comments: BP taken standing.  BP continues at goal.  Doctor says to continue BP 
medications as directed 
===============================================================================
Measurement Type: Heart rate 
Date: 02 Jun 2010
Time: 1720
Heart Rate: 160

Comments: Started taking Beta-Blockers after visit with physician 
===============================================================================
Measurement Type: Body weight
Date: 02 Apr 2010
Time: 1720
Body Weight: 246
Measure: Pounds

Comments: Talk to provider about weight management program at next visit 
===============================================================================
Measurement Type: Body weight
Date: 02 May 2010
Time: 1720
Body Weight: 244
Measure: Pounds

Comments: Lost a few pounds and feel better.  Walking daily 
===============================================================================
Measurement Type: Body weight
Date: 02 Jun 2010
Time: 1720
Body Weight: 242
Measure: Pounds

Comments: still walking when I have time off from work 
===============================================================================
Measurement Type: Body temperature
Date: 02 Mar 2010
Time: 1720
Body temperature: 98.5
Measure: Fahrenheit
Method: Mouth

Comments: I wasn't feeling well but temperature is normal 
===============================================================================
Measurement Type: Pain
Date: 02 Jan 2010
Time: 1720
Pain Level: 7

Comments: Lower back pain - took 1 Ibuprofen with food for pain 
===============================================================================
Measurement Type: Blood sugar
Date: 02 Jan 2010
Time: 1720
Method: Sterile Lancet
Blood sugar count: 166

Comments: BS taken before meal 
===============================================================================
Measurement Type: Cholesterol
Date: 15 Aug 2009
Time: 2359
Total cholesterol: 142
HDL: 45
LDL: 

Comments: Lab result from community health fair. 


-------------------------- FAMILY HEALTH HISTORY ----------------------------

Source: Self-Entered

Relationship: Self
First Name: ONE
Last Name: MHVTESTVETERAN
Living or Deceased: Living
Health Issues: 
-----------------------------
Back Pain
Insomnia
>1 beer/wine a day
Hearing Loss
Pneumonia
Allergies
Chicken Pox
Current Smoker
Diabetics Type 2
Overweight
High Blood Pressure
Depression
High Blood Cholesterol
Stomach/Bowel Other
Smoking >20 Years

Other Health Issues: 
-----------------------------
trouble sleeping

Comments: I sometimes have trouble sleeping when stress is high at work 

Relationship: Mother
First Name: Four
Last Name: MHVVeteranMother
Living or Deceased: Deceased
Health Issues: 
-----------------------------
Cancer Other
Diabetics Type 2
Overweight
Joint Pain
Stroke

Other Health Issues: 
-----------------------------
Chronic joint pain

Comments: Mother died of cancer at age 40 


--------------------------- MILITARY HEALTH HISTORY -------------------------

Source: Self-Entered

Event Title: Overseas Deployment
Event Date: 07 Apr 2002
Service Branch: Army                             Rank: Captain
Exposures: Yes
Location of Service: Overseas            Onboard Ship: No
Military Occupational Specialty: Infantry
Assignment: 1st Recon 

Exposures: In Iraq, exposed to burning chemicals 

Military Service Description: Unit was in charge of security 


-------------- END MY HEALTHEVET PERSONAL HEALTH INFORMATION ------------