Guides
Practical guides for families navigating medical records.
These are the long-form guides we write for families who are trying to get a handle on a serious diagnosis, an aging-parent situation, or just years of scattered paperwork. Practical. No fluff. Written the way we wish someone had explained it to us when we needed it.
Medical records
How to organize medical records
The step-by-step guide for getting every scan, lab, and discharge summary into one place, and keeping it current.
Published May 13, 2026
How long do doctors keep medical records?
What HIPAA actually requires, how state laws layer on top, the special rules for pediatric records, and what happens when a practice closes.
Published May 13, 2026
How to find old medical records
The practical guide for actually finding old medical records: prior providers, HIPAA's right of access, closed practices, health information exchanges, state archives.
Published May 13, 2026
Advance directive vs living will vs medical power of attorney
A living will is instructions. A medical power of attorney names a person. "Advance directive" is the folder both go in. A plain-English comparison built around timing: the clinical finding that switches each one on, why a living will is silent in most hospitalizations, what the agent can and cannot decide, which document wins when they disagree, why neither works in an ambulance, who decides when nothing was signed, and the research showing only 4 percent of admitted patients who had a living will had it in the chart.
Published August 23, 2026
Making sense of results
How to read your lab results
A plain-English guide to reading lab results. The parts of the report, what a reference range really means, the common panels decoded, and which flagged values warrant a call today versus a question at the next visit.
Published June 20, 2026
How long do test results take?
How long CT, MRI, biopsy, and blood results really take, why the timing varies so much, why you often see results in your portal before your doctor calls, and what to do while you wait, including when a quiet stretch warrants a follow-up.
Published June 22, 2026
How to read a radiology report
A plain-English guide to reading a CT, MRI, or other scan report. Read the Impression first, decode the phrases that sound scarier than they are, and understand a cancer follow-up scan (stable, NED, progression, and "compared to prior").
Published June 23, 2026
How to read a pathology report
A plain-English guide to reading a biopsy or pathology report. Find the diagnosis line first, decode grade, margins, lymph nodes, and stage, tell the precancerous words from the cancerous ones, and hold the base rate that most biopsies come back benign.
Published June 23, 2026
What 'unremarkable' means on a medical report
A plain-English guide to the reassuring-but-confusing words on a scan or pathology report. What 'unremarkable' and 'grossly unremarkable' mean (and why 'grossly' is not the alarming word it looks like), how the phrase reads differently in radiology versus pathology, what 'no acute findings' does and doesn't cover, and the honest limits of a normal result. Written for the family member reading it first.
Published June 28, 2026
Reading your test results before your doctor calls
Since 2021, your test results reach your patient portal before your doctor has called, and the report was written for the doctor, not you. This is the manual the rule forgot: why immediate access is right and worth keeping, the honest cost it created for the most serious results, and a plain four-part method for reading a result in the gap before the call. Read the bottom line first, ask new-or-old before good-or-bad, tell the routine words from the alarm words, and never sit alone with a hard result.
Published July 3, 2026
What 'clinical correlation is recommended' means
A plain-English guide to the phrase that scares people most on a scan or report. What 'clinical correlation is recommended' actually means (a request to your doctor, not a red flag), why you are reading a note written for your doctor, the three situations it usually points to, how the same phrase reads on radiology, pathology, and lab reports, and how to tell routine from worth-a-call. Written for the family member reading it first.
Published July 2, 2026
What 'scattered fibroglandular densities' means on a mammogram
A plain-English guide to the phrase on so many mammogram reports. What 'scattered fibroglandular densities' means (category B, the second-lowest of four density levels, and officially 'not dense'), why your report now spells out your density at all, how to tell your density letter apart from the BI-RADS number that is the real verdict, and the honest answer to 'is this good, bad, or cancer?' Written for the family member reading it first.
Published June 29, 2026
What a 'sclerotic lesion' means on your scan
A plain-English guide to the word that turns a routine scan into a midnight search. What a 'sclerotic lesion' actually is (a dense, whiter spot of bone, not a diagnosis), why it is most often a harmless bone island, the one thing that has to be ruled out, how to read the words next to it to tell routine from worth-a-call, and how your doctor actually settles it. Written for the person reading the report first.
Published July 4, 2026
What a 'hypoechoic' finding means on your ultrasound
A plain-English guide to the ultrasound word that turns a routine scan into a midnight search. What 'hypoechoic' actually is (a spot that looked darker on the image, not a diagnosis), where it sits on the brightness scale, the honest answer on cancer, the TI-RADS or BI-RADS number on your report that is the real verdict, and how to read the features next to the word. Written for the person reading the report first.
Published July 10, 2026
What 'bibasilar atelectasis' means on your scan
A plain-English guide to the CT phrase that turns a routine scan into a midnight search. What 'bibasilar atelectasis' actually is (a small patch of lung at both bases that did not fully inflate, usually from lying still during the scan, not a disease), the honest answer on cancer, the one distinction that matters (a blocked airway), rounded atelectasis as a benign mass-mimic, when it matters after surgery, and how to read the words next to it. Written for the person reading the report first.
Published July 20, 2026
What a 'calcified granuloma' means on your scan
A plain-English guide to the CT and X-ray phrase that sends people into a midnight search. What a 'calcified granuloma' actually is (a small, hardened scar where your body walled off an old infection, usually histoplasmosis or old TB, not a disease and not cancer), why calcium points away from cancer, the one thing that decides how a radiologist reads it (the pattern of the calcium), how to tell routine from worth-a-call, and why the best news is that it has not changed. Written for the person reading the report first.
Published July 22, 2026
What 'small vessel ischemic disease' means on your brain MRI
A plain-English guide to the brain-MRI phrase that sends people into a midnight search. What 'small vessel ischemic disease' actually is (common, age-related wear on the brain's tiniest vessels, not a stroke and not Alzheimer's), why 'ischemic' does not mean a stroke happened, how common it is with age, the one word that decides how worried to be (mild and scattered versus confluent and extensive), how it differs from a lacune, a mini-stroke, and dementia, and why comparing to an older scan is the most reassuring thing you can do. Written for the person, often an adult child, reading the report first.
Published August 7, 2026
What 'anterolisthesis' means on your spine MRI
A plain-English guide to the spine-report word that reads like a spine coming apart. What 'anterolisthesis' actually is (a measured position, one vertebra sitting slightly forward of the one below, with 'retrolisthesis' the reverse), what grade 1 measures and why the millimeters are not a scorecard, how common the finding is in people with no back pain at all, the cause words next to it, the one clause that matters most, and the honest answer on whether it slips further. Written for the person reading the report first.
Published August 18, 2026
What 'foraminal stenosis' means on your spine MRI
A plain-English guide to the spine-report phrase that sounds like a verdict. What a foramen is and what 'stenosis' or 'narrowing' means there, where 'mild, moderate, severe' actually comes from (a visual grade of the fat around the nerve, not a pain score), how often symptom-free adults carry the finding, the two-way mismatch between pictures and pain, the clauses that matter more than the headline word, and the short list of red flags that change the timeline. Written for the person reading the report first.
Published August 21, 2026
What 'facet arthropathy' means on your spine MRI
A plain-English guide to the spine-report phrase that sounds like a diagnosis. What a facet joint is, why 'arthropathy,' 'arthrosis,' and 'hypertrophy' mean the same thing, where 'mild, moderate, severe' comes from, why nearly everyone over 60 has it, the honest cases where it matters, and which clause in the sentence your doctor reads first.
Published August 22, 2026
What 'disc desiccation' means on your spine MRI
A plain-English guide to the spine-report phrase that sounds like a spine drying out. What a disc is, what 'desiccation' literally describes on the MRI picture, where 'mild, moderate, severe' comes from, why most pain-free adults have it by 50, the honest answer on rehydration, and the companion phrases that matter more.
Published August 22, 2026
What 'immature granulocytes' mean on your blood test
A plain-English guide to the CBC line that sends people straight to a leukemia search. What immature granulocytes actually are (young white blood cells from the marrow's normal assembly line, not blasts), why the line suddenly appears on modern lab reports, the units trap that makes 0.2 mean two different things, the ordinary causes from infection to pregnancy to Neulasta, what a genuinely worrisome CBC looks like instead, and the short honest list of situations that deserve a same-day call. Written for the person reading the report first.
Published August 20, 2026
What a high BUN/creatinine ratio means on your blood test
A plain-English guide to the flagged lab line that is not even a test. What the BUN/creatinine ratio actually is (division between two numbers already on your panel), why it gets flagged when both ingredients are normal, the kidney plumbing that makes it move, why a quarter of healthy American adults sit above the classic cutoff, the low-creatinine artifact that inflates it in older parents, what large studies found when the ratio was put to the test, and the three situations where it genuinely matters. Written for the night the flag shows up.
Published August 20, 2026
CT scan vs MRI: what each one shows, and why your doctor picked one
A plain-English comparison of the two big scans, written for the family reading the order in the portal. What each machine actually sees, body part by body part; the radiation numbers the ranking pages skip; why the scheduler asked about kidneys before the contrast dye; why cancer care so often orders both scans in the same week; the honest answer to "can I ask for an MRI instead," including the insurance version; what each costs under Medicare; and what the report will say when it lands.
Published August 21, 2026
What 'sinus rhythm' means on your EKG
A plain-English guide to the most common phrase on any EKG result, and the one your watch prints constantly. What sinus rhythm actually is (the heartbeat starting in the heart's own pacemaker, which is the good answer), why a 'borderline' or 'abnormal' verdict can sit under a perfectly normal rhythm line, the 'sinus rhythm with...' qualifiers decoded, real numbers on how often the computer's scary garnish gets downgraded by a human reader, and Apple's own fine print on what a watch's sinus rhythm result can and cannot promise. Written for the person reading the printout first.
Published August 21, 2026
What a 'T wave abnormality' means on your EKG
A plain-English guide to one of the most common reasons a normal-rhythm EKG comes back stamped 'abnormal.' What the T wave is, what 'nonspecific' actually means with real base rates, the EKG computer's own printed rule for 'consider ischemia' quoted from the manufacturer's guide, why the leads matter more than the word, what anxiety and fast breathing do to a tracing, the patterns a doctor will not wave away, and why an old EKG usually ends the workup. Written for the person reading the printout first.
Published August 23, 2026
What a 'tubular adenoma' means on your colonoscopy report
A plain-English guide to the most common phrase on a colonoscopy pathology report. What a tubular adenoma actually is (the most common polyp type, already removed when you read about it), the numbers behind 'precancerous,' the report decoded line by line including 'fragments of' and 'low-grade dysplasia,' where the follow-up interval comes from, and what the finding means for the rest of the family. Written for the person reading the report first.
Published August 21, 2026
What a 'tortuous colon' means on your CT or colonoscopy report
A plain-English guide to 'tortuous colon' and 'redundant colon' on a CT or colonoscopy report. What it is (a longer colon with extra loops, same width, usually from birth), why nobody knows how common it is, how to read it differently on a CT versus a colonoscopy report, the one question to ask after a difficult exam and the completion numbers behind it, the unsettled constipation question, and the rare emergency with the people it happens to. Written for the person reading the report first.
Published August 23, 2026
Appointments & questions
How to get a second opinion
A practical guide to getting a second medical opinion. When it is worth it (the data is striking), how to ask without straining the relationship or skip the referral entirely, and how to actually get your records, scans, and biopsy slides released and sent, for yourself or for someone you are caring for.
Published June 25, 2026
Questions to ask your oncologist
A plain-English checklist of what to ask your oncologist at the first appointment: the diagnosis and stage, the goal of treatment, your options and clinical trials, the testing still to come, side effects and who to call, and the harder questions about second opinions and prognosis.
Published June 29, 2026
Questions to ask your doctor
A caregiver-friendly playbook for any appointment: triage your questions to the three that matter, bring the two documents that make a doctor faster, ask the questions that change by visit type, and use teach-back and the after-visit summary to make the answers stick.
Published June 30, 2026
Cancer & treatment
What to say to someone with cancer
If you're not sure what to say to a friend, parent, sibling, or coworker who just got diagnosed. A warm, practical guide to showing up: what lands wrong, what lands right, and how to keep showing up after the news fades.
Published May 13, 2026
Low blood counts during chemo
A plain-English guide to low blood counts during chemotherapy. What the white cells, platelets, and red cells each do, when a dip is expected and when it is an emergency, the short list of numbers that mean call your team today versus go to the ER now, and how to track the trend across cycles. Written for the family member doing the tracking.
Published June 27, 2026
How to tell your kids you have cancer
The one conversation no parent wants to start, with the actual words to start it. Age-by-age scripts for telling your children you have cancer, from a toddler to a teenager, plus the phrases to avoid, how to answer "Are you going to die?" honestly, and where to find help. Grounded in what the research and child-life specialists actually say.
Published July 9, 2026
Anticipatory grief
The grief that starts before the loss does, explained honestly: what anticipatory grief feels like, whether grieving early actually makes the end easier (the research says no, and that is oddly freeing), why the caregiver who reads the results carries the most, and what genuinely helps. For families grieving someone who is still here.
Published July 12, 2026
The death rattle and the last days of life
The wet, rattling sound is not drowning. What it actually is, how long it usually means, what the medicines do and do not do, and the other changes that come in the last days.
Published July 27, 2026
Terminal agitation and restlessness
The restless, confused delirium of the last days is one of the hardest things families watch. What causes it, what can be reversed, what the medicines really do, and the difference between agitation and a person reaching for something.
Published July 29, 2026
Palliative care vs hospice
A plain-English comparison of palliative care and hospice, written for the family who met both words in a hallway on the day of a discharge. What each one actually is (a type of care versus a Medicare benefit you elect), who pays and what you owe, the room-and-board bill hospice does not cover, what you really give up, who is in the house at 3am and the four levels of care that let you ask for more, how to leave hospice or appeal being pushed out, and how to check a specific agency before you sign.
Published August 11, 2026
What 'comfort care' actually means
A plain-English guide to the phrase families meet in a hallway: what comfort care actually is (a goal, not a program), the three concrete forms it takes, what physically stops and continues when the order is written, honest timelines with data instead of eligibility rules, a direct answer to "do they feed you," and the morphine question answered with the actual evidence in both directions. Written for the person deciding, or second-guessing, at the bedside.
Published August 21, 2026
DNR vs DNI
DNR means no CPR if the heart stops. DNI means no breathing tube. Neither means no treatment. A plain-English comparison of full code, DNR, DNI, and comfort measures: the exact moment each order applies, why the ventilator decision is separate from the CPR decision, the research showing a DNR quietly changes other care, the real survival odds, who signs, why the hospital order does not follow you home, and what to say in the conversation.
Published August 22, 2026
How to qualify for hospice
Two doctors, a six-month forecast, and a signed election. What Medicare actually requires, the disease-by-disease criteria in plain English, where the evidence already sits in your paperwork, and what to do when the doctor says not yet.
Published August 23, 2026
What a nurse navigator does, and how to get one
A nurse navigator is a registered nurse whose job is the system, not the disease. What they do, what they cannot, how to get one when nobody calls, the Medicare billing change to know about, and what the evidence says they change.
Published August 23, 2026
Need a guide we haven't written yet?
We publish new guides as families tell us what they were stuck on when they found KeptWell. If the situation you are in is not on this list, email hello@keptwell.org and we will write the guide.