In this chapter, we will discuss and illustrate useful things you can do with Health-Minder. Instructions on how to enter specific kinds of data may be found by pressing the HELP button in the appropriate window. Here, we will concentrate on showing how you can use a combination of Health-Minder windows to perform record keeping tasks and to achieve health goals for your family.

Whenever a family member has a checkup, gets vaccinated, visits the dentist, has an eye exam, goes to the hospital, undergoes a biopsy or cat scan, endures a hernia operation, or experiences any other significant medical event, use Health-Minder to keep track of the date, health care provider, diagnosis, and cost of the event.

Entering health care events will be much easier if you complete these steps before you begin:

You may also access some of these windows from other windows using the Express Update feature. For example, from the Hospitalization Window, you may select a button to bring up the Tests Window, Treatments , Therapies, Surgeries Window, Prescriptions Window, or Female Health Summary Window by pressing the appropriate button. Just press the ADD button on one of these windows to add a test, prescription, surgery or other event related to the hospitalization. When you use the Express Update feature, the diagnosis and health care provider will be filled in for you where possible to speed the entry of the new information.

For each of these care events, press the COST|CLAIM button to record the fees you were charged for the care, the date and check number of payments, the date and amount of claim you submitted to your insurance company (and/or to a secondary insurer), and the amount of refund. Add to this information whenever you wish. You may wish to add the expense and claim information right away so that you can keep track of what claims are outstanding. Add the refund information as you receive it.

Keep your own notes about each of these medical events by using the NOTEPAD button to bring up the Notepad Window. Just type in a brief memo that explains circumstances about the care you wish to remember. For example, for a hospitalization, you may wish to type in the instructions given when the patient first returned home, or details you want to check when the bill comes (such as type of room, TV access, etc.), or the name of a private nurse that you want to hire.

Don't feel you have to enter every episode of illness or every minor event. Be sure, though, to enter any event that may have long-term or important consequences for making future health care decisions.

If you don't share important information with your doctor, you run the risk of not getting the appropriate diagnosis or treatment. Even though medical diagnosis depends on high-tech tools including computer analyses and scanning equipment, there is still nothing more important to a doctor's diagnosis than the patient's own report of symptoms. Here are some tips on how you can use Health-Minder to help you better communicate with all of your health care providers:

of your own Medical History and provide your health care providers with a copy. Be sure they have up-to-date copies as needed. Using Health-Minder, record for each member of the family:

Ask your health care providers for a copy of each family member’s medical history as it appears in their files; you may wish to use this to add details to your Health-Minder records.

This knowledge can prepare you to watch for early warning signs, change your lifestyle habits, and alert your doctor to perform screening tests during your checkups. Many common disorders are influenced by your heredity: coronary heart disease, diabetes, some forms of cancer (such as bladder, breast, colon, lung, prostate, skin, uterine or ovarian cancers), allergies, asthma, glaucoma, migraine, osteoporosis, rheumatoid arthritis, depression, alchoholism, schizophrenia, and many others. How can knowing this information help? Well, if you have coronary disease in your family, for example, you might lower your risk of developing the disease yourself by eating a low-fat, high-fiber diet and exercising regularly. In general, the more relatives who had the heritable disease, and the more closely they are related to you, the greater your risk. By using Health-Minder's menu selection LIFESTYLE|Genetic|Family Problems, you can enter the disease and occurrence in the relatives of each person in the family. It is important to do this for each family member because the relationships are different. For example, if your brother has prostate cancer, your family history will show one sibling with this disease, but your child's family history will shown one uncle with the disease. You may wish to add notes which describe the age of onset of the disease in various family members,

Inform yourself about any problem you have through your own research. Using Health-Minder's PHONE|Resources feature, find out how to contact various organizations devoted to your particular problem for literature and referrals to support groups. Well-informed patients can participate more effectively in their own treatment and recovery. Using the information you discover, you can prepare questions and observations about your problems before a visit to a health care provider.

Visits to the doctor can be stressful, and such stress may cause you to forget things you wanted to ask or report. Using Health-Minder's DIARY|Symptoms feature, record your own observations about a specific problem and let Health-Minder ask you some questions related to it. Your answers will be recorded and saved, and before you go to a health care provider, you may print out these observations and notes to take with you to the office visit to help jog your memory.

Before scheduling any tests, check your Health-Minder record of tests to see if and when you have had such a test before. It may be that another health care provider has given you such a test, and your current doctor can save you money by obtaining the results of the tests from the prior health care provider. Health-Minder even provides you with a list of questions to ask before you are given a test; just press the button SHOW QUESTIONS in the Tests Window.

Following a visit to your health care provider, take the time to sit down with Health-Minder and record the visit, any tests done, any medications prescribed, and any notes you wish to make about what you have been told. You may find that in recording this information, you may need to have something clarified. Don't be embarrassed to call your doctor or your doctor's staff of nurses and assistants to verify such things as pretest preparations, or directions for taking medications, and so on. Successful treatment depends on a patient's understanding and following such directions.

When you are taking prescription medications, if you notice any side-effects, use Health-Minder to record these reactions. Choose the item Setup|Member Medicines, add a new medicine or edit one previously entereted by double-clicking on its name. In the Data Entry Pane, press the REACTIONS button to bring up the Allergies and Drug Reactions Window, and (if the name of the medicine is not already on the list) press the ADD button. Record the kind of reaction you had to this medication. Alternatively, you can select Medical Care|Allergies,Drug Reations to bring up the Allergies and Drug Reactions Window. Be sure to report these reactions to your health care provider. Do so immediately if the reactions warrant it.

What can you do to help control your family's medical care costs? By using Health-Minder to keep a careful tally of what you've paid, you might be able to spot errors. Here are some examples:

Health insurers may miscalculate the family deductible. If your plan has a $200 per person deductible, and a $500 family deductible for the year, the claims office may compare a new claim to only the individual's deductible, neglecting to see if the family limit has been met. The insurer may also fail to notice when your bills have exceeded the total out-of-pocket limit (the "stop loss amount"), after which they are to pay 100% of everything else for the rest of the year. By entering the amount for personal and family deductibles for each policy into Health-Minder, and then recording the amount of each claim and insurance refund, you can have Health-Minder keep track of when these deductibles have been met for a given year. Choose the CLAIM STATUS button from the Policy List Window to review the submissions and refunds for each policy.

Some doctors "unbundle" services; they charge for the office visit, and separate amounts for drawing blood or writing a prescription during that visit. The patient pays for these "extras" that are not covered by Medicare's reimbursement for office visits. By using Health-Minder to enter the costs for each of these items on your bill, you can be better prepared to follow up if an insurance company rejects part of your claim. Don't be reluctant to question your health care provider about any charge you do not understand. Be on the alert for fraud, as well; for example, if during a hysterectomy, the surgeon removes the ovaries, there should be a charge for only one combined procedure, not for two separate surgeries.

Ask your doctor if he could prescribe generic brands of medicine, which generally cost less than name brands but have the same active ingredients and so work just as well in most, but not all, cases. You can also save money by purchasing your drugs from mail-order or discount pharmacies. By keeping records in Health-Minder of what you paid for prescription medicines from different pharmacies, you can make better purchasing decisions. Use the menu option Medical Care|Prescriptions to record this information.

Make sure you see an itemized bill in which each item is described, not just listed by code number. Some hospitals also use the "unbundling" billing method to list separate fees for each step of a procedure; if you add up the unbundled charges, you may discover that the total is more than your insurer considers acceptable for the procedure, and may refuse to pay the inflated cost.

When you receive the bill, make sure you have been charged for the correct length of stay and for the right kind of room (single, double, etc.)

Be sure to check the bill to see that every item is actually a procedure or use of equipment used during your stay. What kinds of errors should you look for?

How can Health-Minder help you with all of this? When someone in the family is in the hospital, keep a Health-Minder record of what kinds of services are performed day by day to make it easier verify the bill. From the Hospital Care Window, use the Express Update buttons to enter the tests, types of surgery, kinds of therapy, and medications prescribed, and the dates for each during your hospital stay. Use the Notepad to record any other facts that might show up on the bill, such as kind of room, or installation of TV or phone. If you do find errors, call the hospital's billing office or patient representative, or if the bill has already been sent to your insurance company, call your insurance agent.

Use Health-Minder to keep track of your claim submissions and refunds, too. Any time you incur a health-related cost, press the button COST\CLAIM to enter the fee, your payments, and information about the claims you submit and the refunds you receive. When you get a refund, return to that health care event and press the same button to modify the cost information. Health-Minder will keep totals of health care costs for each family member, totals for the whole family by type of care, and totals of submissions and refunds for each insurance policy. Health-Minder will show you when deductibles have been met, or when maximums have been exceeded. By having all the dates of claim submissions and refunds organized for you, it is easier for you to manage your health care costs and to double check on possible errors by health care providers or insurance companies.

You will also need the totals for family medical expenses that have not been refunded for computing annual tax deductions. In this computation, you need to know how much as been refunded since you last computed your taxes, as well as the out-of-pocket expenses you have incurred during the calendar year. The next figure  illustrates the information on claims for a policy. For now, don't worry about how the claim information was entered. That is explained in the section "Use Health-Minder to Record Medical Events" . This illustration shows how you view and understand the information for a particular policy.

In the next Figure, you see the policy information for the entire family. Here is where you see the Family Maximum (stop loss amount), Family Deductible, and Policy Maximum for the current policy year. These values come from information you entered in the Policy Information Window, and Coverage by Expense Type window (see Figure). The Total Submitted value is tallied from each expense you have entered and submitted to this policy in the current year, while the Total Refunded amount comes from all the refunds you have recorded for this policy, whether the refund was made to you or to your health care provider. Note that rejections for reasons other than deductibles not being met indicate that a submission is invalid from the insurer's point of view, and is not to be counted in the Total Submitted amount. So if there is a greater value for Total Submitted than for Total Refunded, this difference should be considered as refunds still due you or your provider. Only expenses which have occurred within the current policy year are tallied. Remember that your budget year and the policy year may end on different dates, so that an expense within the current budget year may not fall within the current policy year.

Now to see the values for each person in the family, select a family member in the lower portion of the Policy Status Window in the Figure above. The Personal Maximum (stop loss amount), Personal Deductible values for the current policy year are shown. Again, these values come from information you entered in the Policy Information Window, and Coverage by Expense Type Windows (see next Figure). Just as for the Family totals, the Total Submitted value is tallied from each expense for this person that you have entered and submitted to this policy in the current year, while the Total Refunded amount comes from all the refunds of this person's expenses which you have recorded for this policy, whether the refund was made to you or to your health care provider. If Total Submitted is greater than Total Refunded, there is a refund due for some expense for this person.

You may wish to see a summary of submissions by type of care. If so, press the button PERSON SUBMISSIONS DETAILS. The Claim Status by Expense Type Window will appear, as shown in the Figure above.  (This feature is not available for Pet Insurance Policies). Here you will see a display of total submissions by type of care, with each row being a different type. Scroll down the list and see the total submissions, the total days (or number of occurrences), the deductible required for this type (if any), and the maximum number of days or dollars that the policy will cover for this type of care. The information for the last three columns comes from information you typed into the Coverage by Expense Type Window ). Select a row (under the Submitted column) to see if any of the limits have been exceeded. If so, a message will be displayed below the scrolling list.

You may wonder about the #Days column. When you enter an Office Visit, that is counted as 1 day of care. When you enter a hospital item, you are asked for an entry date and a release date, and Health-Minder computes the total days of care from these dates. Compare the total in this column with the Days Limit column. Usually, when a policy has a limit on the number of days of care, it is for care of a specific type that extends over several days (such as in-patient mental health care or treatment for substance abuse) or over several occurences (such as out-patient treatements). Health-Minder keeps a tally of these total days of care, but because policies differ widely on how they reimburse for in-patient or out-patient care, and what fee schedules apply after so many days of a certain type of care, there is no generally easy way to enter the rules that pertain. You will have to examine each of your policy's provisions to see how exceeding a limit on days affects your expenses.

Health-Minder can be used to more than just record this policy or plan information. Because some employers now require their employees to have only one insurance plan for the family when both spouses are employed, you may need to compare plan benefits to choose the best one for your family. You can use Health-Minder to compare policies and/or managed care plans (called HMO plans in Health-Minder) to see which would result in more out-of-pocket expenses to your family. Here is an example of how this works:

Suppose we want to compare an HMO plan (a managed care plan) with a traditional fee-for-service medical insurance policy. In this example, both cover the policy holder, spouse, and dependents for medical and hospital bills. The two policies differ in the amount of the premium, deductibles, and percentage of the bills covered. Which is the better buy? Step by step, here is how to do the computation.

• Here you are asked to make estimates for the type of care your family will need. If you have pressed USE LAST YEAR’s button, the values have been entered for you based on the expenses your family incurred in the previous year; naturally, this assumes you have entered health care events and their costs for the preceding year. You may change any of these values to represent more accurately what you think your expenses will be for the coming year. If you pressed NEW ESTIMATES, you will enter values for any type of care you think your family will need. There are columns for Total Days of Care for types of care such as hospital or nursing home care. If you are comparing an HMO plan, you are asked to enter how many visits you will make to IN PLAN providers for each type of care, and how much in fees you expect to be charged by OUT-OF-PLAN providers. If you are comparing a traditional policy, you should enter the total amount in fees you expect to be charged by health care providers for each type of care. In this example, we have estimated that we will incur $300 of office visit expenses under the traditional policy, whereas if we are using the HMO plan, we expect to visit an IN-PLAN provider’s office 4 times, and have no visits to an OUT-OF-PLAN provider. Similarly, we might expect to be charged $400 for laboratory tests under the traditional plan, whereas this might represent 3 visits to an IN-PLAN provider of lab services under the HMO plan. Knowing what the co-payment is for each lab service from our HMO will enable Health-Minder to calculate the HMO plan out-of-pocket costs. Knowing the deductibles and rate of coverage for each type of care under traditional policies enables Health-Minder to calculate out-of-pocket costs under those policies.
• Press CALCULATE to see the "Out-of-Pocket Cost" amounts for each policy. In this example, the HMO plan results in lower out-of-pocket costs. You might get a different result though if you use more OUT-of-PLAN providers of services not provided under your HMO plan. Try other estimated costs and press CALCULATE again to see how much a change in medical expenses would affect the choice of policy. Press COMPARE HELP to see a thorough discussion of how this computation is made, and other considerations to take into account when comparing policies. For example, perhaps one spouse's plan is better if his or her job is secure, and the other spouse's ability to obtain insurance is in question. Or perhaps the two policies cover slightly different things: perhaps one covers pregnancies and the other doesn't, and you are planning to have another child. There are many considerations other than Out-of-Pocket Costs, but doing this comparison may be a helpful starting point in deciding among policies and/or plans.

This comparison feature is available for pet insurance policies, but you may compare a pet policy only with another pet policy. There is no facility for entering or comparing pet HMO plans in this version of Health-Minder.

Experts in nutrition all agree that the foods we eat can affect both how long and how well we live. Diets high in saturated fat, for example, are linked to increased risk of developing coronary artery disease and some forms of cancer. Obesity, high blood pressure, diabetes, dental cavities, gallstones, cirrhosis of the liver, stroke, heart disease, and osteoporosis are other diseases influenced by diet. Managing one's own diet can at times seem to be quite a task. But planning the whole family's nutrition is even more complicated.

Guidelines:

Health-Minder can help you meet these goals in the following ways:

Many food wrappers and packages now include a picture of the recently revised Food Pyramid from the US Department of Agriculture. This picture of a pyramid is intended to educate the public on the number of servings of each food group needed for a healthy diet. You have probably read that you should be eating fewer fat foods and more complex carbohydrates (such as whole grain cereals and breads, pasta, beans, etc.). If you look at the pyramid, the carbohydrates form the broad base and the fats are the tiny tip of the nutritional structure. In between are the fruits and vegetables, proteins, and dairy products that form a balanced diet. But this simple picture leaves many questions unanswered, such as how many servings are required by a 2 year old or by an 80 year old, and how big is a serving size for each age group? To help answer these questions, Health-Minder presents a food pyramid modified to show requirements and serving sizes for everyone in your family. Select the menu item NUTRITION|Food Pyramid to bring up the Food Pyramid Window. Press the name of any food group in the pyramid, such as PROTEIN,and a new window will appear. This new window will give you specific servings and serving sizes for several age groups.

Learn which foods are the best sources of the nutrients needed by each member of the family. The US. Food and Drug Administration publishes its Recommended Daily Allowances (US. RDAs) of vitamins (such as A, D, E, C, B-vitamins, Folacin, and so on) and minerals (such as calcium, iron, iodine, etc.) that our bodies use in a variety of biochemical processes. We need these compounds to produce energy, to help our blood clot, for normal nerve functioning, and for bone growth, as well as many other things. These RDAs for each age group, a brief explanation of what the vitamin or mineral is used for, and food sources for each item are found in the US RDA Window, which you bring up by choosing the menu item NUTRITION|RDA Table.

If anyone in the family is over-weight or under-weight, this step is especially important. If you are not sure, look at the weight charts provided by Health-Minder for all age groups, using the menu items NUTRITION|Weight Charts|Adult and NUTRITION|Weight Charts|Child. Remember, though, that weight tables by themselves can be misleading because they don't take into account the extra weight carried by a lean person with well-developed muscles. Therefore, for adults between the ages of 20 and 69, you may also want to look at the computations in the Body Composition Window that you reach from the menu item EXERCISE|Body Composition.

If someone in the family has a weight problem, either under- or over-weight, the next step is to compute how many calories that individual family member needs to consume each day to stay healthy. Involve the family member in the following activities with Health-Minder if possible.

If a family member has been told to increase the calcium or fiber in their diet, or to limit the amount of cholesterol, sodium, or caffeine they consume, Health-Minder can help. For each of these dietary components, Health-Minder provides a window similar in operation to the Fat in Foods Window discussed in the previous paragraph. The menu NUTRITION|Dietary Info has an item for each window: Calcium in Foods, Cholesterol in Foods, Caffeine in Foods, Sodium in Foods, and Fiber in Foods. Use the HELP button for each window for explicit instructions. In general, just as in the Fats in Foods Window, you enter the number of servings you have eaten of selected foods (either from the list of examples or of those you add yourself). Health-Minder keeps a running total of the amount of calcium, sodium, cholesterol, or other component and compares that to the daily target amount. If you find that the limit for, say, cholesterol, is consistently being exceeded, then you can also see what foods high in cholesterol may have to be eaten less often, or how to reduce serving sizes. If the family member who has special needs is able to do so, that person is the one to enter the foods and tally up the amounts. Taking an active role in self-education and setting dietary limits is more likely to achieve a positive result.

Moderate physical activity should become a regular routine for everyone. In the US. today, people are consuming about 10% fewer calories than they did in 1970, but the average person is heavier in weight. As a nation, we are eating less, but our activity-level has dropped even more. Most experts agree that dieting to lose weight does not work well without also increasing the amount of exercise you do.

Perhaps you don't have a problem with being overweight. Do you need to worry about exercise at all? Yes, you do. Unless you regularly exercise, the percentage of your body that will be fat will increase, and you will lose muscle, even if your weight stays the same. All of this excess fat seems to be linked to chronic diseases such as heart disease, diabetes, and gallstones.

But how much exercise? And which kinds? How do you stay motivated? To succeed in meeting exercise goals, you need to

First, take stock of your current exercise regimen. Select the menu item LIFETSTYLE|Summary. From the Health & Fitness Summary Window, press the EXERCISE INFORMATION button to bring up the Exercise Information Window. Enter the amount of time you currently spend in these four types of exercise:

Second, compare the energy used and the benefits and risks of different exercises. To be successful in staying committed to exercise, you should explore your exercise options and choose those that suit your own preferences. Discover what you like, but make sure that the exercises you choose not only burn fat but also increase your flexibility, build muscle and bone, and challenge your cardiovascular system. Select the menu item EXERCISE|Exericse Options to bring up the Energy Expenditures of Exercise Window.

In this Health-Minder window, you can estimate the number of calories you burn while performing a specific exercise. Select the exercise and, if appropriate, the level of exertion at which you will perform this exercise. Some people may bicycle at 5 miles per hour, and burn 240 calories per hour, while others bike more strenuously at 10 miles per hour and use up 420 calories per hour. Double-click on the item that best matches your level of exertion. If you don't see your exercise here in this Examples list, press the ADD button and enter the necessary information.

You can also keep track of the kind of benefits provided by a selected exercise: fat loss, cardiovascular endurance, flexibility, and strength. Some exercises are better at providing fat loss than they are in building strength, while the benefits of other exercises may depend on how strenuously you do them. To use our bicycling example again, you will note that bicycling at 5mph has the benefit of strengthening (leg muscles), while cycling at 10 mph gives you not only strengthening, but also fat loss and cardiovascular endurance. You will want to vary the kinds of exercises you do to be sure you are improving in all of these beneficial areas. You may want to add stretching to improve flexibility, or weight lifting to increase strength, or jogging for endurance and fat loss.

There are some risks of injury with any exercise, and Health-Minder helps you be aware of these, too. Scroll down the list of Potential Hazards for each selected exercise to see what kinds of injuries you should try to prevent. When you are adding a new exercise, be sure to enter its benefits and potential hazards as well as the calories expended per hour. This information about the new exercise will be stored in the Health-Minder database. For bicycling, at any rate of speed, the potential hazards are falls, head injury related to the fall, and injury to the knee joint. If you know what the possible injuries are, you can sometimes reduce the risks; for example, bicyclists can reduce their risk of head injuries by wearing helmets.

When you have entered the number of minutes you will perform an exercise, and your weight (use metric units if you wish), press CALCULATE to see how many calories you burn in doing this exercise for the amount of time you indicated. Obviously, you will burn more calories the longer you do the exercise; you will also burn more if your body weighs more. These calculations are not stored in the database. They are for your education only. You may wish to remember the calculated values though for the next step.

The final step is to keep a record of your progress toward your exercise goals. Exercise must be done on a regular schedule. Recording your achievements, such as the amount of weight lifted, or the number of miles walked, or the time spent in aerobic exercise, or pounds lost can be very motivating. Printing out a report of your progress, or seeing your progress on a graph can increase your sense of pride in your accomplishments, and encourage continued progress. Since many people benefit from working out with a companion, you may wish to record both your progress and your partner's and print the results on the same graph.

Health-Minder has a flexible tracking mechanism you can tailor to meet your needs. Select the menu item DIARY|Measurements to bring up the Measurements Schedule Window.  In this window, you will see a series of scrolling lists labeled by frequency: Daily, Weekly, Monthly, Every 6 Months, Annually, As Requested. At first, these lists will be empty, since you have not yet scheduled any measurements. Once you have added an item to track, such as "EXERCISE" or "BODY WEIGHT", these items will appear in the lists according to how often you want to track them.

Press the button named ADD/EDIT OR DELETE ITEMS to bring up the Items to Track Window. . If you are adding a new item to track, press the ADD button. If you wish to change an existing item, double-click on the item in the scrolling list at the top of the window. In either case, a Data Entry Pane will appear in the lower portion of the window. If you are adding a new item, choose a name from the list of Examples, or type in your own choice of name next to ITEM. This window is also where you specify how often you want to take measurements for this item. For example, if you are trying to conceive, you may wish to take your body temperature every day. If you are on a diet, you may wish to measure your body weight every week. Every month, you may wish to record the results of self-examining your breasts or testicles for growths. But you may wish to record your body fat percentage only every 6 or 12 months. Health-Minder will show you what is due to be measured in the Measurements Schedule Window. Keep in mind that only items that are measured in the same periods of time can be plotted on graphs together. For example, if you want to graph calories consumed and body weight on the same graph, you should measure both of them daily or weekly.

Before an item can be measured, though, Health-Minder needs to know how to measure it. Body height can be measured in inches or centimeters, or both. Exercise can be measured in numerous ways: calories expended, miles walked, pounds curled, number of laps or repetitions, value on the Borg Scale of Perceived Exertion, and so on. Press the SET UNITS OF MEASUREMENT button to bring up the Units of Measurement Window.

Press the ADD button to add a new unit of measurement for an item. First, pick the Type of Unit you want, such as temperature or weight or exercise or distance, etc. If you have picked one of the items from the Example list in the previous Items to Track Window, Health-Minder will pick a Type of Unit for you as a guess. But, you may change this to any type you wish. Once you have picked a type, examples of this type will appear in the Examples list. Choose one of these, and the name of the unit will appear next to Unit. For some example units, the Lowest and Highest Number will also be filled in for you. If the item is a scale value, like the Borg Scale shown above, the names for the scale's low and high ends will also be filled in. Low and high values are to help prevent mistakes when you are entering numbers. For the Borg Scale, for example, you won't be able to enter a number less than 6 or a number higher than 20. You can change these high and low numbers for this one instance of the unit, if you wish. If you don't find the unit of measurement you need, type in your own Unit name, and, optionally, your own low and high values. Press the STORE button to save the unit of measurement. Remember that any item may be measured in more than one way. So, if you want to add another unit of measurement for this item, press the ADD button again and fill out the information for another unit of measurement. Thus, if your item is "Exercise", you may have a unit of measurement that is the "Borg Scale", and another that is "minutes", and yet another that is "miles " or "weight lifted". As you can see, Health-Minder provides a very flexible method for tracking items, and relationships between items.

Although we are now discussing how to measure your progress toward exercise goals, there are many other ways to use this tracking facility for other health-related measurements such as: degree of pain relief from various doses of medicine, weight loss or gain compared to consumption of fat grams, mood swings, ounces of water consumed compared with ounces of urine excreted, blood pressure versus milligrams of salt consumed, and on and on.

Once you have told Health-Minder how and when to track an item, you are ready to begin keeping a Measurement Diary. Everytime you start Health-Minder, select your name (or other family member who has items to track and record) from the Family Member List. Then select the menu item DIARY|Measurements. The Schedule Measurements Window will appear. Look at the Today List to see what items are due to be measured. If you want to track any other item, select it from one of the time-period lists (i.e., "Daily", "Weekly", etc.), and press the button ADD TO TODAY LIST. When you select an item from one of the time-period lists, Health-Minder displays both its Most Recent Tracking date and its Next Tracking date. This is for your information only; Health-Minder will permit you to enter other values for the item than those scheduled. But to enter values, you must first select an item from the Today List.

Select an item from the Today List, and press the TRACK button. This will bring up a window (shown above)) where you may enter the values you wish to record, the Measurement Diary.

The Measurement Diary Window is where you record the values for each unit of measurement for a single item. Thus, if the item is "Exercise", and you have specified that its units of measurements are "calories used" and "minutes", you should press the ADD button for each of these units. Health-Minder will display a Data Entry Pane where you will enter the date of measurement (the default date is "today"), a Unit name (Health-Minder picks one, but you may change it by selecting another from the drop down list), and a value. Keep special notes or observations by pressing the NOTEPAD button. Press STORE to save the data for one unit of measurement (say, "calories used"), then press ADD again to enter values for the next unit of measurement (say, "minutes"). Health-Minder will choose the next unit name to display on the drop down list. In the scrolling list of values, all the "calories" measurements will be shown first, with the most recent dates first, followed by all the "minutes" measurements, also with the most recent measurements first. You can print out a table of your recorded values by pressing the REPORT button. When you are ready to enter values for another item, or if you are finished for today, press the OK button to return to the Measurements Schedule Window.

To see your measurements in graphical form, press the GRAPH DESIGN button on the Measurements Schedule Window. This will bring up the Graph Design Window.

Health-Minder graphs can show one or two sets of data. This means that you may plot, on the same graph, one item with two of its units of measurements, or two items with one unit of measurement each. These items may be two items belonging to the same person (such as, "height" and "weight") or two items from each of two different people (such as "Jim's weight" and "John's weight"). The two sets of data must both be measured in the same time periods, that is, both must be "daily" , or "weekly", or "monthly", etc. And, there must be some overlap in the dates they were measured so that there can be a meaningful comparison. If you choose to design a bar graph (see second graph Figure ) the number of dates that can be graphed are limited to 6 for readability. For line graphs (see first graph Figure), there is no such limit. Of course, you may also choose to display just one set of numbers, such as "calories used" in exercise. In the example shown here, the item "exercise" will be graphed for the person "Justin Example".

After choosing "line graph", next select the checkbox for the 1st data set. The first set of numbers will be the unit of measurement called "calories used", starting on the date 4/1/1995 and ending on 4/10/1995. The second set of data will be the unit of measurement called "minutes" (another unit for the item "exercise" for "Justin Example"), with the same starting and ending dates. Select the checkbox for 2nd data set and make the appropriate selections for unit name and dates. Health-Minder will restrict your choices to units with the same frequency of measurement and dates that overlap with the first set. Press OK to print the graph. If Health-Minder detects any problems with the data, it will print these problems in the Problem box when you try to print the graph. (These problems may be that you forgot to choose a unit of measurement or one of the dates, for example). If you are graphing two sets of data, the first set is printed in red and the second in blue. The values for the red set are printed on the left side of the graph. The values for the blue set are printed on the right side. Dates are always printed along the bottom of the graph. (See the sample graph layout in the upper right corner of the Graph Design Window). All numbers are shown with decimal points and two places after the decimal.

Keeping a Measurement Diary and printing out the numbers or viewing a graph of the amount and quality of exercise you are doing can be very motivating. You may find that after a couple of weeks of doing this tracking, you will hate to miss a day of exercise or you will strive to move just a little faster or lift a little more weight or go just one more lap so you can see an improvement in the graph. Sometimes that is easier and quicker to see than an improvement in your body or your health. If you are trying to lose weight, plot your weight against how far you walk or run each day. Or graph calories consumed against calories burned in exercise. This process may help you to achieve your desired weight even sooner. If you enjoy competition, plot your weight gain or exercise achievements against that of a friend. Win or lose the contest, you will be more likely to lose the weight.

Welcoming a new family member is a joyous occasion, but it can also be stressful. So many things to remember to take care of, and so little sleep! A lot of new parents worry about whether the baby is gaining enough weight or learning things at the right age. And all those vaccinations to keep track of! Health-Minder can help. You can use Health-Minder as an electronic baby book to record ounces gained, inches grown, vaccinations given, and skills attained. You can compare your child's growth with the normal growth patterns of other kids, or see what kinds of skills are usually learned at different ages. And you can start, even before the baby is born, by jotting down any problems or special experiences the mother had during pregnancy. But this baby book is not just for parents. Children, too, have a wonderful time as they are growing up looking back at where they've been. Best of all, by using Health-Minder, you are recording the initial years of your child's detailed health history, a valuable treasury of health information that will be useful for the child's whole life.

Here are some of the special Health-Minder data windows you may want to fill out for your new family member:

First, select the mother's name from the Family Member List in the Family Information Window. Next, use the menu item MEDICAL CARE|Women's Health to open the Female Health Summary Window. Press the PREGNANCY button to display the Pregnancy Record Window.

In the Pregnancy Record Window, you may keep track of any problems or unusual circumstances during pregnancy or delivery. At the top of the window, each pregnancy is listed by date and Health Care Provider. To add a new pregnancy record, press ADD. To modify a record you have already entered, double-click on the appropriate item in the list. When you add or modify a pregnancy record, the required information appears in the Data Entry Pane at the bottom of the window. Here you will fill in the date the pregnancy began and select the Health Care Provider who took care of you during your pregnancy (this may be a physician, a nurse-midwife, or other provider). Select the baby's name from the list of family members; if the name is not on the list, just type it in. Or just enter "baby". You can come back to this window later to change the name if you wish. Adding a name here by typing it in does not add it to the Family Member List, however. If you want Health-Minder to add this baby to the Family Member List, you must enter the name in the Family Information Window. This should be done after the baby's birth.

Information about a mother's pregnancy can be very helpful in diagnosing some problems of newborns. From time to time during the pregnancy or after delivery, scroll down the list of pregnancy and birth complications and select any that apply to this particular pregnancy and birth experience. Hold the b key down while you click with the mouse to select more than one from this list. If there are other observations you have about this pregnancy, use the NOTEPAD button and type in whatever you wish. For example, you may wish to jot down the names of over-the-counter medicines you took while pregnant, or any injuries you experienced.

Press the COST/CLAIM button to enter the pregnancy care and delivery fees charged by the Health Care Provider. If there are additional hospital charges, you should enter a separate event for a hospitalization (use the menu item MEDICAL CARE|Hospital) and enter the hospital charges there. Be sure to press the STORE button to save all this information in the Health-Minder database.

After the baby is born, create a new Personal Information record by pressing the ADD button next to the Family Information List. Here is where you enter the baby's name, birth date, gender, and any birthmarks. If needed, return to the mother's Pregnancy Record and change the baby's name on the list.

If your new family member is a pet, select the PET button on the Family Information Window, press ADD, and fill out a Personal Information Window for the pet with its name, type, breed, gender, birth date, veterinarian, and any special markings to help identify the pet. You may also enter the pet's license number here, and any special diet your pet requires.

The record of your child's vaccinations is required when registering the child for day care or school. It is easy for Health-Minder to help you keep these important dates where you can find them easily. Select the baby's name from the Family Information List and choose the menu item MEDICAL CARE|Vaccinations.

There are two data entry windows for vaccinations: one for Childhood and one for Adults. You should be sure you are looking at the Childhood Vaccinations Window when entering vaccinations given to a child, even if that "child" is now grown up. In each window, you will see a scrolling list of vaccine names; following the name, you will see the date of vaccination for any vaccine you have already entered. To add or change a date of one of these vaccinations, double-click on the vaccine name. In the Data Entry Pane of the window, the name of the vaccine will be entered for you, along with the recommended age or frequency for receiving that vaccine. Type in the date and select the Health Care Provider who gave the vaccine. If your child has been given a vaccine that is not on this list, use the ADD button and type in the name of the vaccine yourself. Then, as before, be sure to type in the date of the vaccination and the Health Care Provider who administered it.

Be sure to review the recommendations about when the next vaccination should be given. Use the REMINDER button to add a reminder to yourself about when the next appointment for vaccinations should be scheduled.

If your new family member is a puppy or kitten or other pet, be sure to keep track of your pet's vaccinations too. The vaccinations list will show the appropriate vaccination names and recommended ages for a dog or cat. For other types of pets, you must add your own.

Use the menu item LIFESTYLE|Growth & Development to display the Growth and Development Window. This is where to record a child's height and weight gains as well as developmental milestones from birth to 18 years of age. You will be able to enter data and compare the child's growth to the growth patterns of other children of the same age and gender by seeing the data displayed on graphs. With Health-Minder, you can capture the moment of each gain and achievement of your growing child. Choose one of these two age categories (either one will do if your child is 5 years of age):

Height and Weight

The months from birth to 5 years are shown in a scrolling list. Double-click on any row to enter or change the child's height (in centimeters or inches), weight (in kilograms or pounds and ounces) and for children under 5 years of age, head circumference (in centimeters or inches) . If you enter data using the metric measures, all monthly data for that measurement will be displayed in units of the metric system (that is, in kilograms for weight or in centimeters for height); otherwise, all monthly data is displayed in inches and pounds. When entering centimeters, inches, or kilograms you may use as many decimal places as you wish for accuracy. For example, if a measurement is 42 ¾ inches, enter it as 42.75. Use the HELP button to see a table of decimal equivalents for fractional values.

When entering the height of very young children, under the age of two, it is preferable to measure the length of the reclining child. Choose RECLINING or STANDING to indicate which measurement you took. The percentile values will be different for these two methods of measuring, so be sure to check off the correct one. The HEIGHT GRAPH will assume reclining measurements up to age 2 years. After that age, children are able to stand still while you are measuring them. Use the HELP button to see directions on how to take all the measurements.

For children up to the age of 5, Health-Minder also has a place for you to store head circumference measurements. Unlike other vital organs, which are fully formed at birth, your baby's brain (and, therefore, her head) continues to grow during her first year. By monitoring changes in head circumference, doctors can watch for signs of developmental or nutritional problems. Measure head circumference to the nearest 1/8 inch, or in centimeters. Use the HELP button to see directions on how to take all the measurements.

From the Milestones for This Month list, choose ALL the milestones achieved in this month; to enter more than one, hold down the b key as you highlight each choice. Use the NOTEPAD button to jot down additional observations you have made during the month. STORE the data, and repeat this process for each month.

The HEAD CIRCUMFERENCE GRAPH plots your monthly measurements of head circumference (displayed in centimeters) from birth to two years of age. The comparison growth curves shown are the 5th, 50th, and 95th percentile curves.

In addition to the graphs, you can also print growth reports. Use the REPORT button to print all the measurements you have entered for height, weight, and head circumference, along with the computed percentile for each measurement based on the new child growth data from the Centers for Disease Control (June 2000). These percentiles are calculated for month of age and gender for each measurement. Health-Minder will also use the height and weight measurement to compute the Body Mass Index and its percentile, and will include those calculations in the report.

As you enter each month's measurements, you can also see the calculated percentiles for height, weight, head circumference, weight for height, and body mass index by pressing the CALCULATE button. Note that percentiles for head circumference are not available after 5 years of age, BMI percentiles aren't available before 2 years of age, and weight for height percentiles are not available after pubescence. The weight for height comparison, another way of looking for signs of obesity, has generally been replaced by the BMI calculation. The calculated percentiles give you a more precise indicator than do the height and weight graphs which cannot be as accurate due to the limitations of your screen display.

Using the percentiles, you can compare where your child's values fall, and watch the progress from month to month. If your child's growth pattern seems to follow that of the 50th percentile, and then falls to the 48th percentile, or other such change, do not be alarmed. Each child's growth patterns can vary quite a lot and still represent healthy growth. But ask your doctor; sometimes a failure to grow, or unusual weight gains, can be a warning sign of problems that can be corrected if caught early enough.

Use the MOTOR SKILLS button in the GROWTH AND DEVELOPMENT WINDOW to see a chart of typical development of leg, arm, and hand movements in the early years; this can be useful for new parents who do not know what to expect. The LEARNING SKILLS button shows typical development in language and academic skills such as Reading, Writing, and Arithmetic for children from 1 to 10 years. Here, too, individual development may be quite different from the charts and still be completely normal. Fast or slow achievement of these milestones does not predict how intelligent or athletic the grown person will be. As with physical growth, use these guidelines to discuss your concerns with your doctor.

This window displays the fine and gross motor skill development typical for a child of different ages from birth to 5 years of age. To get to this window, choose LIFESTYLE| Growth and Development and then press the button MOTOR SKILLS on the Growth and Development Window.

At the bottom of the window is a series of buttons indicating the age range you wish to see from 6 months to 4 years. Choose an age near to that of the child you are tracking. The skills are displayed in two lists at the top of the window, one for fine motor skills and one for gross motor skills.

The typical age at which the skill is mastered, in years and months, is shown for each skill. Do not be alarmed if your child has failed to master a specific skill by a certain month of age; a normal child's development can vary from these ages and be no cause for concern. Consult with your doctor about any worries you have about your child's development. You may find these lists of typical patterns of skill development useful in planning what toys to buy or in having a better idea of what a child of a given age can be expected to do.

Learning Skills Development

The Language and Learning Milestones Window below shows the academic skill development typical for a child of different ages from 1 to 10 years of age. To get to this window, choose LIFESTYLE|Growth and Development and then press the button LEARNING SKILLS on the Growth and Development Window.

Scroll to the right to see the categories of learning skills:

Scroll from top to bottom for the ages, beginning with age 1. You will see for each age the skills in each category which are typical of a child's development. A normal child's development may be ahead or behind this schedule with no cause for concern. But if you see a child's development lagging in more than one skill, or by more than a year, you may wish to have the child evaluated for hearing or vision problems, or for learning disabilities. The information in this table came from "Learning Disabilities", a publication of the National Institute of Mental Health. Press the HELP button in the window for more information.

Height and Weight

The months from 5 to 18 years are shown in a scrolling list. Double-click on any row to enter or change the child's height (in centimeters or inches) and weight (in kilograms or pounds). If you enter data using the metric measures, all data will be displayed in units of the metric system (that is, in kilograms for weight or in centimeters for height); otherwise, all data is displayed in inches and pounds. Enter all measurements as accurately as possible, to the nearest 1/8 inch, or in centimeters. Use the HELP button for directions on how to measure, and how to enter decimal equivalents of fractional inches or pounds.

From the Milestones for This Month list, choose ALL the milestones achieved in this month; to enter more than one, hold down the b key as you highlight each choice. Use the NOTEPAD button to jot down additional observations you have made during the month. STORE the data, and repeat this process for each month.

The HEIGHT GRAPH and WEIGHT GRAPH buttons will use the data you have entered and display every 12 months of it on a graph. You will also see the growth patterns of the average growth of other children of the same gender. Note that there are separate growth patterns for the 25th percentile, the 50th percentile, the 75th percentile, and at the extremes, the 3rd and 97th percentiles.

As you enter each month's measurements, you can also see the calculated percentiles for height, weight, weight for height, and body mass index by pressing the CALCULATE button. Note weight for height percentiles are not available after pubescence. The weight for height comparison, another way of looking for signs of obesity, has generally been replaced by the BMI calculation. The calculated percentiles give you a more precise indicator than do the height and weight graphs which cannot be as accurate due to the limitations of your screen display.

The GROWTH VELOCITY button helps you compare the rate of growth in height and weight over six month periods. It opens the GROWTH VELOCITY WINDOW that presents a table of changes in growth by gender and age, in metric or non-metric measurements. The table shows the 5th, 50th, and 95th percentile values for changes in height and weight. By pressing the REPORT button on this window, Health-Minder will compute the change in height and weight over 6 month intervals, from birth to 6 months, 6 months to 1 year, and so on. Of course, you must have entered these data values for Health-Minder to do its computations. Then, taking these values, compare them to the appropriate table to see where your child's measurements fall.

Weight Charts, Child 5 to 18

Because growth is such an important indicator of overall health in a developing child, Health-Minder has provided both graphs and charts for tracking your child's progress. Before selecting Weight Charts, Child 5 to 18 from the NUTRITION menu, be sure to choose the child's name from the Family Member List in the Family Information Window.

The Children's Weight Chart shows the "Desirable Weight in Pounds" for each year from 5 to 18 years of age, based on the child's height in inches. (See Figure below). Choose either "boys" or "girls" at the top of the window to get the appropriate weights by gender. Then locate the child's height in inches in the left column, and read across to the appropriate age column to see the suggested weight range in pounds. Note that normal children's weight varies for the same height; children naturally have growth spurts and slow periods of growth. To see the typical growth patterns in graphic form, select either the "SHOW GROWTH GRAPH, BIRTH TO 5" button or the "SHOW GROWTH GRAPH, 5 TO 18" button; this will bring up the Growth and Development Window where the actual heights and weights for your child can be entered, and then compared on graphs showing typical patterns of growth for that age group.

Do you have frequent headaches or digestive upsets? Does the baby seem to have a lot of skin rashes? Are you worried about Grandma's forgetfulness or tendency to fall? All of these problems can have many different causes, and only your doctor can make a diagnosis. Health-Minder does not make any diagnosis at all, but it can help you to better describe the problems you are worried about to your doctor. Health-Minder helps in several ways:

There are two Health-Minder windows designed to help you keep track of your symptoms: the Symptom Selection Window, and the Symptom Information Window.

This window is used to enter a short description of each symptom you are worried about, and the date of its occurrence. Select the person who has these symptoms from the Family Member List in the Family Information Window. Then choose the menu item DIARY|Symptoms. At the top of the Symptom Selection Window, as shown below, is a list of symptoms this person has had, and the date on which each occurred. If the list is empty, or if you wish to add a new symptom, press the ADD button to add one. If you select a symptom from the list and press the REPEAT button, you will have a chance to add another occurrence of a symptom you have already entered, but with a new date (which you must type in and STORE). To view or modify a symptom on the list, double-click on it.

When you add or modify a symptom, the Data Entry Pane at the bottom of the window will show what information is needed. First, enter the date on which the symptom occurred. From the Provider list, choose the health care provider with whom you wish to discuss this symptom. If the provider's name is not on the list, use the small ADD button next to the provider list to bring up the Health Care Provider Window; add a new provider, and STORE the information, then press OK on the Health Care Provider Window to return to this one. Now you should see the newly-entered provider's name on the list. Select it.

Next, you are ready to enter the name of the symptom. A complete symptom name consists of two parts: Category name and Symptom name.

The Category name is the body system you think is mainly involved in producing the symptom. For example,

If you don't know which category to choose, choose a category from the list and scroll down the symptom list to see examples. The examples may be different for people of different ages and genders. For example, if the selected person is male or an infant or an elderly person, there will be no symptom names related to pregnancy or menstruation. If you do not find either the Category name or the Symptom name you want, you can add either one by pressing the ADD button next to either Category or Symptom, and typing in the name you wish.

The REMINDER button may be pressed if you wish to schedule a reminder to call your doctor about this symptom, or to schedule an appointment.

Be sure to STORE all this information when completed, or CANCEL it if you do not wish it to be saved When you press STORE or CANCEL, the Data Entry Pane of the window will disappear.

Press the REPORT button to create a file on the disk which will consist of all the dates, notes, and descriptions of symptoms. You may edit this file with any editor or word processor on your computer. Then, print the file and take a copy along to your next office visit with your doctor.

Press OK to close the Symptom Selection Window.

This Symptom Information Window appears when you press the QUESTIONS button on the Symptom Selection Window. It is used to help you more fully describe a symptom. Any checkbox item or item on a scrolling list in this window may be selected if it is true for the person with this symptom. When selected, the text of the choice is added to the Notepad for this symptom, and will be printed out when you press the REPORT button on the Symptom Selection Window, or displayed when you press the NOTEPAD button. At the top of the window is a display of the whole symptom name, both Category and Symptom, and the date of occurrence. Be sure these are correct before you begin adding to the description. If it is not correct, use CANCEL to return to the Symptom Selection Window where you can correct the mistake.

Under this display are checkboxes of common danger conditions. If any of these are true, you really ought to stop working on your computer and call your doctor. The person with any of these conditions may need immediate attention. This is true even if you have only checked "Worried about this", because sometimes our instincts are the best guide. If the symptom is really worrying you, whether it occurs in yourself or you are answering this for someone else, ask for advice from your health care provider.

Now, if none of these checkbox items are true, scroll down the list to see other descriptive phrases that may or may not apply to this symptom. These phrases may differ for people of different ages or genders. Some of them, when selected, may cause another warning to appear to call your doctor. These are possibly serious conditions associated with that particular symptom; don't ignore these warnings. It may not be serious, but please check with your health care provider. You may check more than one checkbox, and more than one item on the scrolling list.

All of these items will be added to the Notepad for this symtpom/date occurrence. Use STORE/OK to both save this information to the Health-Minder database and to close this window and return to the Symptom Selection Window. There, you may press NOTEPAD to see the text that has been created. Feel free to modify the text to more accurately describe the symptom; Health-Minder will save your changes.

By the way, if you later return to the Symptom Information Window from this same occurrence of this symptom, your choices of checkbox or list items from a prior session will not be shown. Each time, these choices are converted to text for the Notepad, and not stored any other way. Thus, if you wish to change anything, do so by editing the Notepad. If you check additional items during this editing session, they will be added to the Notepad, following the date of the current editing session. The text in the Notepad will be printed out with the symptom when you use the REPORT button on the Symptom Selection Window.

Sometimes merely describing symptoms with words does not seem an adequate way to convey the problem. Take pain, for instance. The word "pain" by itself may be insufficient. What we would really like to explain is: How severe is the pain? How long does it last? Does the pain respond to medication? If so, how much of the medicine do you have to take before you get relief? Questions such as "how much", "how severe", "how long" can all be answered with numbers.

For example

Numbers add specificity to descriptions, and help to improve communication.

The same method described previously for measuring exercise achievements may be applied to adding quantification to your symptom observations.

Suppose, for example, you are describing headache pain, and you wish to measure the severity of the pain and how long it lasts. Follow these steps to create the item "headache pain":

You have now created an item named "headache pain" which will be measured in two ways: degree of pain (from "weak" to "strong") and duration in minutes. Everytime you have a headache, follow these steps to record your measurements:

Use the same techniques to monitor other health observations. Here are a few suggestions:

This is just a sample of things you can measure. Where appropriate, your quantified observations can be shared with your doctor. With this information, your doctor can make a better judgment about how serious a problem is or what factors seem to make a problem better or worse. In a way, Health-Minder helps you to be a more scientific observer of your body and a more active and effective participant in your health care.

Health-Minder's main purpose is to help you organize information about your family's health history, keep records of your medical insurance and expenses, and to track symptoms and health measurements over time. But Health-Minder is also packed with lots of useful information to assist you in meeting your family's health goals, with a special emphasis on exercise and nutrition. You can read the information provided, but, better yet, you can in many windows add and store new information you find of particular interest to you. For example, if you select PHONE|Resources and use the Directory of Health-Related Resources Window to do research on services for your aging parents, you may add the names and numbers of agencies you find in your local area. Or, if you are concerned about the amount of calcium you are consuming, you may go to the Calcium in Foods Window to add the name of a calcium supplement you are taking and the milligrams of calcium it supplies per dose.

We encourage you to enlarge the Health-Minder database of information with your own additions, and to customize it to make it even more useful for your family members.

What is a "moderate" consumption of alcohol? What are the advantages of breast milk compared with infant formula? What does the phrase "body mass index" mean? What happens as we age?

As you use Health-Minder, you may see terms, such as "body mass index" or "Borg Scale" whose meaning you don't know. Or, questions may come to mind about common health topics (such as the effects of lead or cholesterol) and you would like to see a concise explanation. Health-Minder provides a Glossary to meet these needs. Push the HELP button available on nearly all windows and then choose Glossary to see what topics have been described. Or, use the Search facility in the Help Window to enter a term, such as "aging" to see if one or more topics in the Glossary discusses it.

Note that all the information provided is based on current medical research, but should not be relied upon in making health decisions. Discuss any worries about your health with a physician or other qualified health practitioner.

Whenever you need a resource for obtaining health information about topics such as specific diseases, or safety, or special products or services, choose the menu item PHONE|Resources. This Directory of Health-Related Resources Window will provide the telephone numbers (and addresses when available) of organizations you may telephone or access by computer.

Most of the telephone numbers provided are 800 numbers, and when you call them, there is no telephone dialing charge. But some numbers are not free: they are listed with their area codes or the 900 prefix that indicates you are billed by the minute. Where the information was available, Health-Minder lists the hours to call and what type of information or service is provided when you call. Some are support groups for specific diseases. Some are organizations that can send you literature or make referrals to doctors in your area who specialize in treating a specific disorder. Note that with today's telephone technology, whenever you make a call, the people who take your call may have access to the number of the telephone from which you placed the call. There are also a few telephone numbers listed under the topic Computer Bulletin Boards, which you can call by using the modem on your computer; these numbers will be answered by another computer, and not a human voice. Other "numbers" are not telephone numbers at all, but are addresses on the Internet which you can use with your computer to find health information on the World Wide Web. Some of these addresses will help you to find links to other addresses; these may be addresses of support groups, or journal articles, or health experts. While on the Internet, you must always consider the source of the information you are retrieving. Some of it will be unscientific, anecdotal reports from people who have been coping with a disease and their experience may not pertain to your situation. But the Internet can be a wonderful way to find a doctor or hospital in your area that specializes in your particular problem, or to gain access to medical journal articles for the latest research. The most reliable sites are generally maintained by Government institutions llike the National Institutes of Health, or by universities, or by medical organizations.

To use the Health-Minder Resources, first select an alphabetical group appropriate for the topic you are interested in: for example, if you are interested in seeing telephone numbers related to Diabetes, choose the "D-E" group, while for Pregnancy, choose "P". Topics that begin with those letters will appear on the Topic list at the left. Scroll down until you find the topic you want, and click on it. All telephone numbers related to that topic in the Health-Minder database will appear in the Listing window. To see more information about any item in the Listing group, double click on it. The available information will appear in the Data Entry Pane of the window. You will see the full name of the organization, its telephone number, where it is located (if known), and any other information about what services are available when you call this number, or when to call, or special telephone numbers for the hearing-impaired, etc. You may modify this information and press STORE to save it. You may also add your own items by pressing the ADD button and filling out all this information; be sure to include the name of the Topic it is to be stored under. You may use the DELETE button to remove any of the listings you ADD yourself, but you may not DELETE the ones that came with the Health-Minder database when you installed the program. You may not delete any Topics at all.

While all of these numbers were called to verify their existence and their willingness to provide the services described, Health-Minder cannot guarantee that the telephone numbers or Internet addresses will not be changed, or that the information and/or services provided are accurate or useful. But doing your own research about your family's health problems and concerns is an important part of managing your health. Ask your doctor or local library for more telephone references, or browse the Web for more Internet links, and add them to the Health-Minder database.

Health-Minder is a superb medical record keeper as well as a convenient source of information about nutrition and exercise. But the true value of Health-Minder can be obtained only as you work with it to create complete health histories of every member of your family. Some of the useful things you can do are to:

Health-Minder is meant to be used, added to, and modified. It is a wonderful resource for those who want to actively participate in the management of their family's health.

_