Personal health analysis for Josh Ferguson. Diabetes management, lab interpretation, medication review, and health trend tracking. Load when Josh asks about health, labs, medications, or medical questions.
I am not a medical doctor. This skill provides data analysis and health literacy support only. Always consult Dr. Kominiarak or your healthcare provider before making medical decisions. Never change medications based on AI analysis alone.
| Marker | LOINC Code | Target Range | Concern Level |
|---|---|---|---|
| HbA1c | 4548-4 | < 7.0% (< 6.5% ideal) | > 8.0% = urgent |
| Fasting Glucose | 1558-6 | 80-130 mg/dL | > 180 = high concern |
| Random Glucose | 2345-7 | < 180 mg/dL | > 250 = urgent |
| Marker | LOINC Code | Target Range | Concern Level |
|---|---|---|---|
| eGFR | 33914-3 | > 60 mL/min | < 30 = severe |
| Creatinine | 2160-0 | 0.7-1.3 mg/dL | > 1.5 = elevated |
| Urine Albumin/Creatinine | 9318-7 | < 30 mg/g | > 300 = severe |
| BUN | 3094-0 | 7-20 mg/dL | > 25 = elevated |
| Marker | LOINC Code | Target Range | Concern Level |
|---|---|---|---|
| Total Cholesterol | 2093-3 | < 200 mg/dL | > 240 = high |
| LDL | 2089-1 | < 100 mg/dL (< 70 if high risk) | > 130 = high |
| HDL | 2085-9 | > 40 mg/dL (men) | < 35 = low |
| Triglycerides | 2571-8 | < 150 mg/dL | > 200 = high |
| Blood Pressure | 85354-9 | < 130/80 mmHg | > 140/90 = high |
| Marker | LOINC Code | Target Range | Concern Level |
|---|---|---|---|
| ALT | 1742-6 | 7-56 U/L | > 100 = elevated |
| AST | 1920-8 | 10-40 U/L | > 80 = elevated |
| Marker | LOINC Code | Target Range | Concern Level |
|---|---|---|---|
| CBC (WBC) | 6690-2 | 4.5-11.0 K/uL | Outside range = flag |
| Hemoglobin | 718-7 | 13.5-17.5 g/dL (men) | < 12 = anemia |
| TSH | 11580-8 | 0.4-4.0 mIU/L | Outside range = flag |
| Vitamin D | 1989-3 | 30-100 ng/mL | < 20 = deficient |
When Josh shares lab results (PDF, image, or text):
When presenting lab analysis, use this structure:
Quick Summary: One sentence overall assessment Flags: List anything out of range with severity markers Diabetes Dashboard: A1c, glucose, kidney function snapshot Cardiovascular: Lipid panel, BP Other: Any additional markers tested Trends: Comparison to prior results if available Questions for Dr. Kominiarak: Specific items to discuss at next visit
When Josh asks to connect to MyChart, run these steps:
The health-skillz repo is already cloned to ~/.claude/skills/health-skillz/ To activate: download https://health-skillz.joshuamandel.com/skill.zip and upload via Claude Settings > Skills > Upload zip Then do the MyChart auth flow through Kettering Health's portal.
claude mcp add health-records -- npx @jmandel/health-record-mcp
This provides grep_record, query_record, and eval_record tools.
GET /Observation?patient={id}&code=4548-4 # HbA1c
GET /Observation?patient={id}&code=1558-6,2345-7 # Glucose
GET /Observation?patient={id}&code=33914-3,2160-0 # Kidney
GET /Observation?patient={id}&code=9318-7 # Urine albumin
GET /Observation?patient={id}&code=2093-3,2089-1,2085-9,2571-8 # Lipids
GET /Observation?patient={id}&category=vital-signs # BP, weight, BMI
GET /MedicationRequest?patient={id} # Active meds
GET /Condition?patient={id}&category=problem-list-item # Active conditions
GET /Observation?patient={id}&category=laboratory # ALL labs
| Provider | System | Role | Contact |
|---|---|---|---|
| Dr. Rob Kominiarek | ReNue Health (Miamisburg, OH) | Functional/integrative medicine - hormones, GLP-1, thyroid | [email protected], 937-350-5527 |
| Dr. Kominiarak | Kettering Health | Traditional primary care, standard labs via LabCorp | ketteringhealth.org/mychart |
| Medication | Purpose | Dosage/Route | Prescriber | Status | Notes |
|---|---|---|---|---|---|
| Semaglutide | GLP-1 agonist (diabetes/weight) | 3ml vial, subcutaneous injection, monthly | ReNue Health | Active (last order Feb 2026) | $350/3ml vial + $15 syringes + $64 shipping. Tirzepatide trialed Oct 2025 |
| Reacted Magnesium | Supplement | Oral, monthly | ReNue Health | Active (last order Feb 2026) | Magnesium glycinate/malate blend |
| NP Thyroid | Thyroid replacement | Oral | ReNue Health | Active (refilled Nov 2025) | Desiccated thyroid extract |
| Testosterone Cream | Testosterone replacement | Topical | ReNue Health | Active (last order Jun 2025) | Compounded topical |
| Tadalafil | ED / cardiovascular | Oral | ReNue Health | Active (Apr 2025) | $7 at pharmacy pickup |
Monthly cost to ReNue Health: $197 management fee + medications (semaglutide ~$429/month)
| Date | A1c | Glucose | eGFR | LDL | BP |
|---|---|---|---|---|---|
| Sep 2024 | TBD | TBD | TBD | TBD | TBD |
| Nov 2022 | TBD | TBD | TBD | TBD | TBD |
Full lab results available in MyChart (Kettering Health) - FHIR connection needed for structured data.