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LIVING WILLS

1.  WHAT IS A LIVING WILL?

  • IT IS A TYPE OF ADVANCE DIRECTIVE.
  • IT IS A WRITTEN LEGAL DOCUMENT.
  • IT IS THE DOCUMENT TO WRITE OUT WHAT YOU DO AND DO NOT WANT IN TERMS OF MEDICAL CARE IF YOU ARE UNABLE TO SPEAK FOR YOURSELF.
2.  WHAT DOES A LIVING WILL PROVIDE?
  • DESCRIBES THE TYPES OF MEDICAL TREATMENTS OR LIFE-SUSTAINING TREATMENTS YOU WOULD WANT IF YOU WERE SERIOUSLY OR TERMINALLY ILL.
  • COMMUNICATES YOUR WISHES TO FAMILY, FRIENDS AND HEALTHCARE PROFESSIONALS.
  • AVOIDS CONFUSION CONCERNING YOUR HEALTHCARE DECISIONS.
3.  DO I NEED A LAWYER TO PREPARE A LIVING WILL?
  • IT IS NOT REQUIRED THAT AN ATTORNEY PREPARE THIS DOCUMENT.
  • FORMS ARE AVAILABLE ON THE INTERNET.
  • CONTACT YOUR LOCAL HOSPITAL.
  • WRITE YOUR OWN WISHES.
4.  WHO SHOULD RECEIVE COPIES OF MY LIVING WILL?
  • YOUR DOCTOR
  • HOSPITAL
  • FAMILY MEMBERS
  • HEALTHCARE POWER OF ATTORNEY, IF YOU APPOINT ONE.

PREPARING FOR LABS AND THE RESULTS:

How to prepare for your lab test:

Do I need to be fasting for my lab tests?

Fasting is required for some tests. Common tests that require fasting are CMP (Comprehensive Metabolic Screening), Fasting Glucose, Glucose Tolerance Tests, Lipid studies (Triglyceride, HDL/LDL), Iron and Iron Binding studies, Insulin and Vitamin levels. For most tests an eight hour fast is long enough, but for Lipid studies, it is best if you fast 12 hours.

When I am fasting, may I drink water?

Yes, when you have fasting lab tests, please drink water. You may brush your teeth, take your medications (unless specifically told by your doctor not to).  Please do not consume anything with calories.

Do I need a doctor's order to get a lab test done?

Yes, your doctor can give you an order to bring in with you or fax an order to our facility. Our fax number is 402-382-3284

Do I have to make an appointment?

An appointment is not necessary. The laboratory at the Brown County Hospital outpatient phlebotomy station is open Monday through Friday 8 a.m. to 4 p.m.   We serve our outpatients on a first come, first serve basis. After hours or weekend blood draws may be arranged. Please contact the laboratory for this service at 402-387-2800.

Can I come directly to the lab to have my blood drawn?

When you come to the Brown County Hospital you will be asked to register prior to your sample being obtained. If you have been to see us recently, and your information (insurance, address, phone number, emergency contact information) is current in the computer system, registration should only take a few minutes. If you are new to us or your information has changed, registration may take a few more minutes.


Why are so many tubes of blood needed?

Though the amount of blood may appear to be a lot, most tubes hold less than one teaspoon. The different colored caps on the tubes indicate what additive is in the tube. These additives are anticoagulants or preservatives. Different tests need to be drawn in different additives.


Can I obtain a copy of my results?

Yes, you may pick up a copy of your results at the laboratory (be prepared to show us a picture ID) or we may mail them to you at the address you supply at the time of registration. To protect your privacy, we will not give lab results over the phone or fax them to a non-secure (personal) fax number. We will ask you to sign a release of information form, so that we have record of disclosure of your results.


When will my doctor get the results?

Your doctor will receive your results as soon as they are complete. For most tests that will be the same day the sample is taken. Some tests, particularly cultures, require several days. Again, these results will fax or print to your doctor's office via our computerized automated fax system when they are complete.


Will you call me if my results are abnormal?

No. Your results will go directly to the physician who ordered them.


Can you tell me what my blood type is?

Your doctor needs to specifically order blood typing to be done. This probably will not be done unless it is medically necessary for your situation.


Lab Test Result Guide:


HEMOGLOBIN A1C

(HgbA1C) checks the long-term control of blood glucose levels in people with diabetes. Also known as Glycohemoglobin, this test checks the amount of sugar (glucose) bound to hemoglobin. Normally, only a small percentage of hemoglobin in the blood (4%-6%) has glucose bound to it. People with diabetes or other conditions that increase their blood glucose levels have more glycohemoglobin than normal.


GLUCOSE

(GLUC) is a measure of blood sugar and is one of the tests for diabetes. Glucose will often be high if you have eaten or had anything, other than water, to drink before your blood was drawn. If the value is more than 180 mg/dL you should consult your physician, even if you know you have diabetes. Low values may be a cause of weakness or dizziness.


CHOLESTEROL AND TRIGLYCERIDES

(CHOL and TGL) are fatty substances in the blood which are evaluated together with the high density lipoprotein (HDL) cholesterol; the cholesterol to HDL ratio (RISK) gives a measure of your risk of coronary heart disease (CHD). Triglyceride values may be high if you have eaten within 12 hours of having blood drawn. You should consult your physician if the level is over 500 mg/dL. Low values of triglyceride or cholesterol are beneficial.


HDL CHOLESTEROL

(AHDL) is the "good" cholesterol. Higher values mean less risk of CHD.


LDL CHOLESTEROL

(LDL) is the major cholesterol carrier in the blood. If too much LDL circulates in the blood, it can slowly build up in the walls of the arteries feeding the heart and brain. Together with other substances if can form plaque, a thick, hard deposit that can clog those arteries. A high level of LDL cholesterol (160 mg/dL and above) reflects an increased risk of heart disease. That's why LDL is called "bad" cholesterol. Lover levels of LDL reflect a lower risk of heart disease.


TOTAL PROTEIN, ALBUMIN AND GLOBULIN

(TP, ALB, & GLOB) measure the major proteins in your blood. Low values suggest poor nutrition or kidney disease. High total protein values may be seen in some diseases with an abnormal immune response, some tumors or dehydration.


SODIUM, POTASSIUM, AND CHLORIDE

(Na, K, & CI) are mineral elements in the blood primarily controlled by the adrenals and kidneys. Abnormalities suggest dehydration, kidney disease, adrenal disease, vomiting, diarrhea, or some other metabolic disease. Abnormal potassium levels are significant. Patients taking diuretics (water pills) often get low potassium levels and should definitely contact their physician if the potassium is 3.3 mg/dL or less.


CALCIUM

(CA) is a mineral in the blood controlled by the parathyroid glands and kidneys and is mainly involved in bone formation. Calcium is affected by marked changes in albumin.


ASPARTATE AMINOTRANSFERASE

(AST) is an enzyme whose main sources are the liver, skeletal muscle and the heart. AST elevations are often seen in alcoholism. Mild elevations may be seen with aspirin usage. Low values are not of significance. You should consult your physician for elevations.


ALANINE AMINOTRANSFERASE

(ALT) is also an enzyme found in a wide variety of tissues and organs with high activity localized in the liver. Elevations are associated with liver disease, infectious mononucleosis, acute heart attack, skeletal muscle disease, acute pancreatitis and patients receiving heparin therapy. Levels greater than 400 U/L are usually associated with liver disease or skeletal muscle injury.


BILIRUBIN (TOTAL, DIRECT AND INDIRECT)

(tbil, dbil, & indbil) is a pigment formed from the breakdown of red blood cells, which is excreted by the liver. It may be elevated with increased red blood cell breakdown or liver damage. You should consult your physician for elevated values, especially if AST is also elevated. Low values are not of significance.



CREATININE, BLOOD UREA NITROGEN (BUN) AND BUN/CREATININE RATIO

(CREA, BUN, & BN/CR) are waste products primarily excreted by the kidneys. BUN may be slightly elevated in people on a high protein diet or having exercised heavily. Both tend to be elevated in kidney disease and if either is elevated, you should consult your physician. Low BUN values may be seen in liver disease. Minor abnormalities of BUN/creatinine ratio with normal BUN and Creatinine values are of no significance.


THYROID-STIMULATION HORMONE

(TSH) is a test that measures how well your thyroid gland is working because the gland can be underactive or overactive. The test measures your body's response to the thyroid hormone level in your blood. The TSH test is one of several thyroid tests and the one most often used to look for thyroid disease.


PROSTATE-SPECIFIC ANTIGEN

(PSA) is a substance released into a man's blood by his prostate gland. Low amounts of PSA may be found in the blood of healthy men. The amount of PSA in the blood normally increases as a man's prostate enlarges with age. It is also increased by inflammation of the prostate gland (prostatitis) by prostate cancer.


WHITE BLOOD CELL COUNT

(WBC) measures the number of white blood cells in the blood. They may be elevated in infection and leukemia and low in bone marrow damage due to chemicals, drugs, etc. You should consult your physician for abnormalities.


HEMOGLOBIN, HEMATOCRIT, AND RED BLOOD CELL COUNT

(HGB, HCT, & RBC) measures the amount of hemoglobin or red blood cells in the blood. Low values indicate anemia, which may have many causes, and should be evaluated. High values are seen in a few diseases and should also be evaluated by your physician.


MEAN CORPUSCULAR VOLUME

(MCV) is a measure of the size of the red blood cells. Small cells are seen in iron deficiency and some hereditary defects, both usually associated with anemia. Large cells are seen in the anemia due to some vitamin deficiencies and in the rapid replacement of red blood cells by the bone marrow. Both should be elevated by your physician.


MEAN CORPUSCULAR HEMOGLOBIN

(MCH) is a measure of the amount of hemoglobin in each cell and abnormalities will almost always be associated with other abnormal results.


MEAN CORPUSCULAR HEMOGLOBIN CONCENTRATION

(MCHC) measures the concentration of hemoglobin in the red blood cells. It is low in iron deficiency and some other anemias. Abnormalities will almost always be associated with other abnormal results.