Medical Eye Examination Patient History Questionnaire: Fill & Download for Free

First of all, no, it is not true.What is true is that there is a rumor, apparently widespread among obstetricians, that a normal birth process can cause problems with those with certain eye conditions. The problems would be damage to their eyes, not in giving birth normally.I've not found the origin of this rumor. Obstetricians -- and other specialists -- are often vulnerable to ideas accepted by other obstetricians, creating what is called an information cascade. Something is believed because others, trusted, believe it. Obviously, this is not "evidence-based medicine," but those who accept an information cascade may be completely unaware that this is what they are doing. They are just following normal human practice: people tell us stuff and if they are reputable or it seems "reasonable," it's accepted.Is it reasonable that normal birth could cause retinal detachment? Well, I'd be suspicious, enough that I'd be very reluctant to undertake a major surgical intervention like C-section based on something like this idea. But obstetricians are not opthalmologists, nor are opthomologists obstetricians, and the latter might not know what is normal with birth. Somewhere someone may have suffered a detached retina at the same time as they gave birth, and there it started.The effect of normal childbirth on eyes with abnormalities predisposing to rhegmatogenous retinal detachment. (1995)BACKGROUND:Pregnant women who have high myopia, a history of retinal detachment or retinal holes, or have known lattice degeneration are frequently referred to an ophthalmologist for advice concerning the management of pregnancy and labor, i.e. whether a spontaneous vaginal delivery can be allowed and whether prophylaxis for high-risk retinal pathology is indicated. Many obstetricians still believe that pregnant women with ocular abnormalities predisposing to rhegmatogenous retinal detachment should have an instrumental delivery, and a few even advocate cesarian section. Very little has been written about the management of pregnant women with high-risk retinal pathology, and opinions differ considerably. Patient data on this subject are scarce.METHODS:We studied 10 women who had 19 deliveries (10 prospective and 9 retrospective) and who had a history of retinal detachment, had been diagnosed as having extensive lattice degeneration, or had been treated for symptomatic retinal holes or breaks. The women were followed from the third trimester of pregnancy through labor and delivery into the postpartum period, looking for changes in the retinal status.RESULTS:We found no changes in the retinal status in the postpartum examination.CONCLUSION:We conclude that prenatal treatment of asymptomatic retinal pathology is not indicated and that spontaneous vaginal delivery may be allowed to take place in women with high-risk retinal pathology.[Severe myopia and delivery] (1996)AIM: There has been concern that patients with high myopia are at a risk of developing retinal tears as they go through a spontaneous delivery. Therefore the aim of the paper was to examine retinal changes in the group of female patients with high myopia before and after deliverMATERIAL AND METHODS: Eye examinations were performed before and after delivery in two groups of patients: 42 patients with high myopia and 4 patients with high myopia and retinal detachment surgery in one eye.RESULTS: There was no progression of retinal changes and development of retinal tears, but in some patients retinal hemorrhages and macular edema were observed.CONCLUSIONS: High myopia is not the indication for the cesarean section, but the patients should be examined after the delivery.Obstetric opinions regarding the method of delivery in women that have had surgery for retinal detachment (2011)2011, 74 obstetricians at a conference filled out a questionnaire.ResultsThe majority of respondents (76%) would recommend assisted delivery (either Caesarean section or in[...] The majority (58%) based their decision to alter the management of labour on their personal opinion of standard of care.ConclusionThe literature shows that there is little evidence to support the belief that previous retinal surgery increases the risk of re-detachment of the retina during spontaneous vaginal delivery. This short survey shows that the majority of an international sample of obstetricians questioned does not share this viewpoint. Therefore, unnecessary interventions may be occurring in otherwise fit women with a history of retinal detachment.What is going on here? It's clear that in the journals, the rumor is not substantiated, is considered an error. But it's also clear that enough obstetricians consider this a problem -- and recently -- that they would do c-sections, and they think of this as "standard of care."This is utterly unsurprising. It may come as a shock, but medical practitioners do not necessarily read the journals, and don't necessarily have informed opinions. I've found this so many times, where I had some issue, got advice that I checked out, and it was seriously deviant from the best opinions. Then I asked a good practitioner, one willing to talk to an "ignorant patient," and found, yes, I was right. As a result I still have a major part of my body that would have been "standard of practice" to remove, in spite of expected complications, not to mention disability for a time and maybe forever. And I am actually at low risk, using sensible risk factors instead of what is based only on the cheapest tests.There is no substitute for becoming informed about your own condition. Yes, you can and should find practitioners you can trust, and one sign is that they will encourage you to become informed. Those that were not so well-informed themselves considered me ignorant and resistant to their "expert advice." Which was often dead wrong, completely contrary to what could be found with some research into the literature.Is there an increased risk to eyes for some patients from normal delivery? Maybe.However, what is the basis for considering this? I found no research cited. One paper cited above showed some observable changes (not pathology), and that could possibly indicate some increased risk. But having a C-section is also risky. If your obstetrician recommends a section, carefully investigate it. I've developed relationships with doctors where they will tell me what the standard of care is, but not push it. Because they tell me, I can't sue them for not telling me! Just remember that doctors may be under legal pressure to tell you this or that. If you become informed, you make it easier for them to be open with you. And you will find out whom you cannot trust.Good doctors don't know everything! If you research your particular condition, in some ways you may know more than your doctor. In others, not, so the trick is to listen to advice, check it out. Have faith in your doctor, but not blind faith.

Both psychiatrists and clinical psychologists can diagnose personality disorders.The Psychological Assessment ProcessPsychiatrists, like psychologists assess the patient over three one-hour face to face sessions in an attempt to make a diagnosis.However, due to the complexity of personality disorders, both the above-mentioned clinicians may request to see the patient over a longer period of time.Experienced mental health clinicians often use a combination of their clinical judgement and assessment results. Clinical psychologists in particular, may administer personality tests to obtain detailed information that will either regulate or support their diagnostic hypothesis.Psychiatrists may conduct medical tests and refer the patient to allied health clinicians for further testing.The use of streamlined psychological assessment formsOver the years, mental health services have streamlined the psychiatric assessment process. Psychiatric assessment forms have been developed that consists of 10 or so pages of questions. The clinician must complete and sign the assess forms and file them in the patients medical records.The assessment forms prompt the clinician to ask questions related to cognitive and emotional functioning. Recent graduates find the assessment forms more useful than experienced clinicians.The mental health clinicians must also closely observe the patient during the assessment sessions. In particular, they have been trained to observe the patients body language, gait, eye contact, grooming and so on.The majority of mental health clinics develop their own psychiatric assessment forms. However, the majority of psychiatric assessment forms are very similar (an attempt to adhere to best practice guidelines).Specifically, a psychiatrist or clinical psychologist would collect the following information during a psychiatric assessment:presenting problems,demographic information,the patients medical and mental health history,the prevalence of mental illness in the client’s family (develop a Genogram),information regarding the client’s childhood,the number and duration of friendships the patient has had,the number of intimate relationships the client has had, in particular long-term relationships,clients current living conditions,a more detailed examination of current symptoms,a risk assessment, andother relevant areas.Please click on the link below to view a psychiatric assessment form developed by the Behavioural Healthcare Group:http://www.bhicares.org/wp-content/uploads/2016/12/NEW-Mental-Health-Assessment-Form.pdfIn additional to basically going through the assessment form, the psychiatrist or clinical psychologist must formulate a diagnostic hypothesis based on the information they collect from the assessment, previous assessments of the patient (from their file), and their clinical judgement.The clinician then weighs up all the information they have collected from the patient against the criteria for a specific DSM diagnosis (in this case, a personality disorder).Different Possible DSM Diagnoses For People With Personality Disorder’sIf after completing their assessment, a psychiatrist is not absolutely sure that the client meets DSM criteria for a specific personality disorder, they can offer a provisional or preliminary diagnosis that can be changed in future. However, they must assess the client again (several times) before making a formal diagnosis and note why they made such a decision.Alternatively, a client may be given a differential diagnosis if they appear to meet the criteria for two or more disorders. Differential diagnoses are made when patients present with a complex condition.The DSM classification system also allows a clinician to make a Not-Otherwise-Specified diagnosis if the patient doesn't appear to meet the criteria for any specific disorder. For example, Personality Disorder-Not Otherwise Specified.Clinical Psychology: Psychometric, Personality & Projective TestingIf a psychiatrist is not sure of a patients' diagnosis, they should refer the patient to a Clinical Psychologist for psychometric, personality and projective testing and an opinion.A clinical psychologist would generally use psychometric testing to test their hypothesis about a client’s diagnosis and personality structure. Many psychiatrists do not refer their patients to a clinical psychologist unless the client presents with a diagnostic dilemma.Most Western countries have laws that limit psychometric & personality testing to psychologists. The laws were passed because these tests require competent clinics such as psychologists to be administered correctly.Psychologists undergo extensive training that focuses on the administration, scoring and interpretation of these tests. Moreover, it is important that an experienced clinician sit with the client and explain the rest results.In fact, the Church of Scientology forced the Australian government to pass specific legislation pertaining to the administration of such psychological tests several decades ago. The Church of Scientology developed their own personality and IQ tests (unreliable and invalid) and encouraged people to sit their tests as a way of engaging potential followers.Psychometric tests include IQ tests such as the Wechsler Intelligence Scales (children, adults).Personality tests include the Psychological Inventory, Eysenck Personality Questionnaire, MMPI, Myers Briggs Personality test.Projective tests include the House Tree Person drawing test, Thematic Apperception Test, the Rorschach and others.These tests provide detailed information about the person. The psychologist examines the test results, the psychiatric assessment results and use their clinical judgement to formulate a diagnosis and treatment regime. The above-mentioned tests add another layer to the psychological assessment and hopefully increase the probability that the diagnosis is accurate.DSM Multi-Axial Diagnostic SystemI believe that psychiatrists and psychologists really should use the DSM Multi-Axial diagnostic system. The previous versions of the DSM used this system. However, the DSM 5 (current version) has done away with the system.They provided multiple reasons for the change, however, I do not believe that they made a good decision. I believe that the Multi-Axial diagnostic system provided a more in-depth understanding of a persons functioning.The Multi-Axial diagnostic system was designed to assist the mental health clinician to make a more detailed assessment of the patients function and life in general. For example, instead of making a Major Depressive or Personality disorder diagnosis, the clinician was able to make five Types of Axes By Disorder.The following information briefly outlines the five types of Axes:Axis 1: Major Depressive Disorder (acute clinical disorders);Axis 2: Personality Disorder/Intellectual Disability;Axis 3: Medical/Physical Conditions;Axis 4: Environmental/ Psychosocial Factors;Axis 5: Global Assessment of Functioning.I believe that it is important for experienced psychiatrists, clinical psychologists and other mental health clinicians to work with people that may have a personality disorder. I also believe that many inexperienced or unsuitable clinicians should not be working with people that have personality disorders (they only make matters worse).Kamal

No. I’m not happy. Just 5 weeks ago I was on top of the world. At 47 I had a very rewarding job and I went back to school to become a P.A. (Physician Assistant). I had a beautiful fiancé that was half my age and on her way to becoming a doctor and we just moved together 10 months ago. At my age I reflected back on my life. I survived child abuse. I survived being kicked out of my house at 16. I survived 9 years in the army, 5 of which I spent as a special operations medic. Five of my friends, including my best friend at the time didn’t survive. I survived 15 years of traveling the country living at different cities 3 to 6 months at a time making a whole lot of money, saving children and having a lot of sex with different woman. I survived having had protected sex with about 200+ woman and, at the worst, I contracted a yeast infection. I survived diabetes (so far). Everything was in place for my future until September 22nd of 2017.Earlier that week my doctor called and wanted to see me asap. On the morning of the appointment I just finished a 12 hour shift at the hospital (I work with critical babies in a not so safe or educated community). I was her first patient. I imagined my blood sugar was probably high. She walked into the exam room and handed me the lab results of a test I took last week. I take this test at least every 6 months because I’m exposed to a lot of disease, tissue and body fluids. My A1C (my blood sugar) was 7 which is one increment higher than it was 3 months ago. That wasn’t bad, she really could have waited another 3 weeks for my next schedule visit to tell me that. I looked at the bottom of the same paper. It said “Positive For HIV1”. My first thoughts went straight to my sleeping fiancé who was at home waiting for me to cuddle up next to her as I do every morning after I get off work. I walked out of the exam room with my results and my doctor asked me where I was going and that we still needed to talk. I replied, “I’m going to go get my fiancé tested”. I left without even getting my insurance or debit card back from the receptionist.I woke her up and gave her the news. She looked at me waiting for a punch line (We loved to joke around with each other). I can’t remember who started crying first. We got dressed and we went to get her a rapid HIV test. I waited nervously outside the exam room where she was getting tested. I wasn’t allowed in. She walked out crying. I thought to myself, “I always promised her that I would kill anyone who did her any harm… That includes myself”. When she spoke it was almost religion to me. “It’s ok baby. I’m negative”. I can’t remember who cried first then either. That day we talked and she said she was going to stay and help me through this. I didn’t know it back then but she was my rock that planted my sanity firmly into the earth. Alone I was always resilient. With her by my side I was unstoppable.That was on the 22nd of September. On the 25th of October, just 4 days ago, she left me. I’m not a big crier. In fact, I don’t really cry at all. Not even when my 3 close friends were blown to pieces or my best friend who just 7 months earlier I was the best man at his wedding had died in Afghanistan. But that morning, that morning of the fucking 25th of October I cried until I literally was choking and vomiting in the kitchen sink. I cried like I’ve never cried before. How could she do this to me? I would never have left her. Sick, burned, mutilated, disfigured, paralyzed or comatose I would not leave her. My devotion was for her and only her. Where her mother, 2 closest friends and even the therapist that I paid for all told her to leave me. I didn’t ask or beg for her to stay. That’s because my devotion was and still is only to her. When I look in the mirror I remind myself that I said that I would always put myself in harms way to protect her. Gazing into my own reflection I also still tell myself, “if she stays with you, you would be the greatest danger to her in her life”.I am now alone. My future of getting my masters and becoming a P.A., marrying the love of my life that I waited so long for to find, and maybe even having a child were all gone. Just like that. It was fore told that day, that fucking morning, my doctor gave those results. I have no one to be angry at. I can’t blame her, her mother or her friends. I would possibly have given her the same advice. I wish I had someone to be angry at besides myself. I even tried to pick 2 different fights at the gas station down the street. The truth is I most likely got this from an innocent baby or even a mother. I don’t have any other life style that I could have contracted this “life destroyer” from. I’ve certainly been faithful. In 2016 of October I tested negative for HIV. Everything is now gone. EVERYTHING! I want to scream at her to stay but that would be selfish of me. So as everyone around her continuously advises her to leave me while I stand idly by hoping she would not. I cried the hardest the morning she took the last of her belongings that she could fit into her car and left me all alone.So yeah. I’m not happy. I’m nothing of what I was the day before my 8:15 appointment on that day, September 22nd of this year. Want to know what I’m doing now besides bleeding my heart out on the internet? I’m in the process of joining a private military contractor to go back out in the shit that I never thought I would ever have to see or do again after I left the military. Well, at least someone needs me. I guess the private military has a high need for medics with my skill set and past security clearance. Being HIV+ doesn’t even matter to them as long as I can keep it at undetectable levels. It angers me that the only two things in my life that I was ever truly really good at was: healing people and killing people. Before that faithful day that so ever changed my life I dedicated myself to taking care of babies and children once I left the military. I even went back to school so I can play a greater role in healing critically sick children and babies. How did karma repay me? By giving me FUCKING HIV and taking away my future and the woman that I prayed for for so long to find. I’m on the opposite side of the spectrum of happy. If depression, hopelessness and pure-senseless-unrelenting rage could have a baby that would be fucking ME!Updated 11 November 2017As I write this it’s been 33 days since I’ve received the worse news of my life. It’s been 11 days since I’ve been back to work at the hospital. It’s been 19 days since she left me. It’s been 8 days since I’ve last seen her. And it’s been 15 days since I first told my story on Quora.I found Quora completely by accident. I think I Googled “I have HIV now”. Quora was one of the sites that came up and I answered my first question which was “How did you find out you had HIV” or something similar. The second question I replied to is under this topic. At the time, I didn’t know what Quora is or anything about credentials, categories or why there were so many questions and answers here. I still don’t completely understand what Upvotes are. The question “Are you happy? If not, then why” just triggered a lot of anger in me. My mind went from despair to anger in a fraction of a though. As I typed out my reply I found myself becoming angrier with each key stroke. Being a private person, even on the internet, I don’t tell people my personal issues. I did have an Instagram account but it has been almost a year since I’ve been on it. I never really thought about the repercussions of placing my thoughts onto the internet bared for all to view and evaluate.I am so very grateful by all the kind words I’ve received from strangers that have commented and messaged me. I truly believe that if I knew most of you in real life we would be friends. A handful of you would have been a “best friend”. Two of you I would have called Brother and Sister. Not all the comments were completely kind. Only one was not very friendly at all. It’s OK because I chose to display my soul onto the internet for all to witness. I did not do it to be judged. I did not do it for compassion or pity. I have a continuous lifetime supply of pity from my family and the few friends that know of my current predicament. They are a constant reminder of what I lost and what I have gained. These days my phone remains off unless I know I am expecting a call from a medical provider. The real reason why I let all the voyeurs on Quora read my story is because I did not have anyone else to tell it to, in the way I wanted, without tears. Honestly, I haven’t replied to the any of the words of kindness and encouragement you good people have given me. I started to reply to a few but I had a change of heart. There is one that I replied to and we even chatted a bit outside of Quora. The circumstance to that were really unusual but sadly I have since lost contact with my new friend. I do intend to reply to some of you. Your words did impact me in some way that respects a reply. I wish I could reply to everyone but I feel that by a certain point my words would become generic though my thoughts would be far from it. If I offended some of you that is not my intention. I truly am grateful for your support and consideration.These days I am numb. I try to stay in this state of emotionlessness. If I do not keep myself in this sort of emotional limbo I only have two other modes of being. Despair and rage. I tend to switch back between the two in a matter of milliseconds. I have a close friend at work who is the only person that knows the truth of my situation. I was on disability for 30 days and many rumors have been circulating among the nurses and doctors according to my friend. I have not entertained any of the rumors. I know everyone talks about me acting like a different person. I couldn’t agree more. I feel that the person I am now is not the same person that left work and rushed to his doctor’s appointment on morning of September 22rd. That person just wanted to get to the appointment quickly so he could come home to his fiancé. Just so he could hold her while she slept like he did every morning when he got home. The person now comes home to an empty apartment. There is no food in the refrigerator. No pictures on the wall and no one sleeps in the bed anymore. He gets home and lays on the couch and ask the same question he’s been asking himself for the past 19 days, “what the fuck do I do now”?My last five shifts have led me to the conclusion that I lost my compassion for my patients. Don’t get me wrong. I can still do my job very well. My first shift back to work started with a newborn trying leave this earth after just being here for 45 seconds. It took about an hour to stabilize her. When the family was allowed to come back into the NICU we updated the family on their newest family member’s situation. All the grandmother could say was, “Thank you Lord. Thank you Jesus Christ. Thank you Lord for saving my granddaughter”. All I can think was, “Lady, God was the one that tried to take her away. It was me and my team that fought to keep her here”. I’m not even going to tell you people what I was thinking when I looked at the crying mother knowing what I knew of her drug history during her pregnancy. I sincerely believe that this hospital is where I got HIV from. I’m not angry at a particular person or entity. I’m just angry. I know a lot of you people feel like I can use my current situation to help others but I truly feel like I am emotionally unable to show compassion to the sick now. To do this job well one must remember the humanity that people need for each other in their times of crisis. All I see at work are concerned and worried faces of mothers and fathers as they mumble inaudible prayers to whatever god they worship. I just stand there. Numb. I do not feel I am even capable of feigning compassion. That person isn’t around anymore. This person doesn’t need to be taking care of other people. He’s just there for the medical benefits and paycheck.All of you have been generous with your kindness. Some of you had given me such strong words of wisdom that I’ve been dwelling on them daily since I read your comments and messages. I even nicknamed one of you Gandalf. Currently I am on the path of joining a private military group. I am preparing for a plan B however. Plan B involves me leaving to another place to pursue solitude which hopefully will lead me to peace. I plan to be gone maybe a couple of years. I am not telling anyone I am going to leave or where I am going. I need space from everyone I know. Even my own family. They would not recognize the person I am now. I do not want them to have to deal with this new guy. This is a cross I want to bare and bare alone. Today I planned on getting a new tattoo. My second one. The first was when I was a teenager. This one is going to be special. It was a designed for the sole purpose of remembering, encouraging and hoping. This was the physical cross I would bare. When I arrived at the tattoo studio I filled out some paper work. One of the questions asked if I had HIV. I was not going to lie to anyone. I answered truthfully Within minutes of the artist taking the questionnaire away while I was already in a private room the owner came in and told me that they don’t tattoo people with HIV. He actually said, “I don’t want you endangering my employees and the other customers”. I sat there, on the tattoo bench with my legs dangling and an actual tear leaked from eye. The nice receptionist that arrived with the owner actually apologized to me and said she would call around to find a parlor that would be willing to ink my tattoo and they would forward the design that me and the artists collaborated on for the past week. The owner stood silently and firmly at the door waiting for me to leave. Everyone thought I was sad. I was fucking furious. I felt my head getting warmer and warmer. I knew my arms were shaking. It took everything I had to not unload my weapon that I took with me into this particular neighborhood. Before you ask, yes, I do have a permit for the state of California to carry a concealed weapon. I think they realized that it wasn’t a tear of sadness when I actually stood up and looked straight into the owner’s face. His stern voice became more apologetic when he said he was “sorry for the inconvenience” for the first time and offered to reimburse me $50 to another studio once I told him where I was going to get the tattoo. The drive home consisted of me mumbling plans of revenge on the owner (I’m not going to actually do it). That was the first time I admitted being HIV+ to someone that wasn’t a family member or medical provider who was taking care of me.The 2-hour drive home gave me enough time to become numb again. Now I sit here addressing a complete bunch of strangers on Quora. Quora. I don’t even know why I answered any questions here. I should be asking questions. I am not in a place where I should be giving anyone advice. I did not know I would get this kind of attention from the Quora community. I don’t really know how I feel about it. I am very grateful for you people. Now I received some kind of recognition, a title, from the Quora admin. The title is, “Most Viewed Writer in Developing and Maintaining Happiness”. I actually had my first genuine laugh since she left me alone. I could not stop laughing! Really? Me? Maintaining happiness?! Suicidal people would have issues being around me right now. I am very flattered but this is far from being deserving.I do not know what I am going to do if I don’t join a private military group. I am getting three different licenses to practice medicine in other states. I have sold everything in my apartment. When I say “everything”, I mean all the possessions except my personal ones which are my clothes, laptop and toiletries. Everything else was purchased by a coworker who is getting his first place so he literally needed everything to live. I need to get rid of everything for the same reason. He will take possession of it all in mid-December. Everything is a reminder of her and my past life. My bed, couch and even the utensils she picked out are physical manifestations of my grief and loss. I haven’t even slept in my bed since she left me alone. I think this is a good time to stop my venting on Quora. There are really so many other people that have it worse than I do. Thank you once again for spending some time hearing what I had to say. It’s almost comical that I, like so many others here, can tare our souls open for mobs of strangers to examine and judge when, sometimes, we don’t even offer family and close friends the slightest peep into our true thoughts. I am only thankful that those that examined my soul were so very kind to me at a time when I needed kindness the most. I humbly thank you and the Quora community.