Right After a Chronic Disease Diagnosis: The First Week, First Three Months, and After

Unofficial English translation of docs/刚确诊慢性病之后.md. In case of discrepancies the Chinese original takes precedence.

This checklist is for people newly diagnosed with chronic conditions such as hypertension, diabetes, high blood lipids, or gout. Related entries in the book are spread across several sections; here they are ordered by time. Each line states only the action; reasons, numbers, and sources are in the entry cited. Skip items that do not apply to your condition.

The week of diagnosis

1. If the illness is serious, have someone go with you when you get the report; do not stay alone at home that day. Put off resigning, selling a home, and similar steps. See Section 29, item 2 (the week after a serious diagnosis).
2. If the doctor prescribed medication, start today and follow the prescription; do not stop because you feel better. See Section 16, item 1 (take medication as prescribed).
3. For hypertension and high blood lipids, take medicine regularly; do not stop on your own. See Section 2, item 12 (hypertension and high blood lipids: take medicine as prescribed).
4. If you have hypertension, buy a home blood-pressure monitor and measure at home until readings reach target. See Section 1, item 7 (measure blood pressure and treat to target).
5. When getting prescriptions, ask whether centralized-procurement or generic drugs are available. See Section 5, item 12 (generics and centralized procurement).
6. At diagnosis of type 2 diabetes, have a dilated eye exam once; for type 1, start five years after onset. See Section 16, item 7 (eye exam at diabetes diagnosis).
7. At diagnosis of gout, start long-term urate-lowering therapy and keep serum uric acid below 360 µmol/L. See Section 16, item 9 (long-term urate-lowering for gout).
8. Before allopurinol in people of Han ethnicity, ask whether to test HLA-B*5801 genotype. See Section 16, item 9 (long-term urate-lowering for gout).
9. High uric acid on a check-up alone, with no gout attacks ever, is not gout; do not start urate-lowering drugs yet. See Section 6, item 19 (high uric acid without gout pain).
10. If you smoke, set a quit date and stop completely that day. See Section 2, item 4 (set a quit date).
11. Do not rely on willpower alone for quitting; go to a smoking-cessation clinic or respiratory medicine for medication. See Section 2, item 3 (get medication to quit).

The first three months

1. Keep a notebook: at each follow-up, record date, test results, drugs, and doses. See Section 16, item 3 (one notebook for all readings).
2. After each visit, keep your own copy of records, lab reports, and imaging. See Section 24, item 5 (keep your own medical records).
3. In your insurance locality, apply for outpatient chronic/special-disease designation; if you often seek care elsewhere, also file for cross-region treatment. See Section 16, item 2 (chronic outpatient designation and cross-region filing).
4. If a family member has employee medical insurance, ask them to link family pooling so their account can pay for your care and medicine. See Section 5, item 13 (family pooling).
5. Before signing with a community family doctor, ask what is covered by insurance and what is self-pay. See Section 16, item 6 (ask before signing with a family doctor).
6. Switch household salt to low-sodium salt. If you have kidney impairment or take potassium-sparing drugs, ask the doctor first. See Section 2, item 9 (low-sodium salt).
7. Start walking daily; aim for 7,000–8,000 steps or 150–300 minutes of brisk walking per week. See Section 2, item 11 (7,000–8,000 steps a day).
8. Drink less alcohol; best is none. See Section 2, item 19 (less or no alcohol).
9. If you drink daily and get shakes or palpitations when you stop, do not quit alone; go to the hospital first. See Section 2, item 20 (do not quit alcohol cold turkey alone).
10. If someone urges you to stop meds for folk remedies, do not stop; tell your treating doctor before any supplement. See Section 16, item 4 (do not stop treatment for folk remedies or supplements).
11. Do not spend heavily on health products or tonic formulas to “condition” the body. See Section 6, item 10 (expensive health products and tonics).
12. When starting urate-lowering therapy for gout, attacks are more common in the first 3–6 months. If pain flares, add anti-inflammatory medicine as directed; do not stop urate-lowering drugs. See Section 16, item 9 (long-term urate-lowering for gout).
13. Before buying cold or pain medicines yourself, read ingredients; acetaminophen should appear in only one product. See Section 34, item 1 (acetaminophen in only one product).
14. If you take anticoagulants or steroids, ask the doctor before ibuprofen-type pain relievers. See Section 34, item 3 (ibuprofen with anticoagulants or steroids).

After the condition is stable

1. When stable and medications unchanged, get up to 12 weeks of medication in one community visit. See Section 16, item 5 (12-week prescriptions at community clinics).
2. Follow the follow-up interval your doctor set; record every visit in the same notebook. See Section 16, item 3 (follow-up on schedule).
3. After switching to centralized-procurement drugs, watch the notebook metrics; if they truly worsen, see the doctor—do not stop on your own. See Section 5, item 12 (generics and centralized procurement).
4. With diabetes, have a foot exam yearly and eye exams at the interval your doctor gives. See Section 16, item 7 (eye exam at diabetes diagnosis; annual foot exam).
5. With gout, keep taking urate-lowering medicine even after uric acid reaches target. See Section 16, item 9 (long-term urate-lowering for gout).
6. After kidney stones, drink 2.5–3 liters of water daily and keep salt under 6 g. See Section 16, item 8 (water after kidney stones).
7. With cardiovascular disease, get one flu shot each autumn. See Section 1, item 20 (annual flu vaccine).
8. For common illnesses, start at community level; for hospitalization, go up through referral so the inpatient deductible continues. See Section 24, item 1 (community first, tiered referral).
9. Within the same insurance pool, each higher hospital tier lowers reimbursement by about ten percentage points—do not climb tiers without need. See Section 24, item 2 (lower tier, higher reimbursement).
10. For specialist care at a major hospital, use community referral or the hospital referral center; do not use scalpers. See Section 24, item 3 (referral center).
11. Before cross-province care, ask locally how much will be reimbursed back home—it may be less than treating locally. See Section 24, item 4 (ask before cross-province care).