Not sure how serious this is? Where to call, and when.

Start with a phone call. Your doctor’s office has a triage line and a nurse will talk it through with you. They are genuinely good at this, they do it all day, and it costs nothing. Most practices have a phone line where a nurse takes calls about whether something needs to be seen, and how soon. It is often not advertised — you ring the main number and ask to speak to the triage nurse. There is no charge and you do not need an appointment to use it.

If it feels more serious than that, go to urgent care. You will usually be seen faster than at a hospital, and the care is good.

If it feels life-threatening, call 911 or go to the emergency room. Do not wait until you are sure.

Which one is yours to decide, not ours. But our advice is to assume it is worse than it looks and take the more cautious road. And trust your body — if it is telling you something is wrong, it is probably right. The best possible outcome of a trip to the emergency room is walking out saying well, that was a waste of an evening — but I feel a lot better knowing it is nothing serious.

Before you call, have these ready. They are what the nurse will ask, and the call goes better when you are not working them out on the phone.

  • How bad is it, one to ten? Pick a number even if it feels arbitrary. They are not testing you — it gives them somewhere to start.
  • When exactly did it start? Within the hour, six hours, today, yesterday, this week, longer. The number matters less than which side of “today” it falls on.
  • Which way is it going? Better, worse, or the same — and if worse, over hours or over days. This is often the question that decides things, and it is the one people least often have an answer to.
  • If there is a fever, the actual number and the time you took it. “I feel hot” and “101.4 at three o’clock” are very different pieces of information.
  • Anything that affects your immune system, said early. Chemotherapy, steroids, immunosuppressants, a transplant, or a condition that affects it. It changes how they read everything else, so it should not come out at the end.
  • What you have already tried, and whether it helped. What did not work narrows things down as much as what did.
  • Anything new alongside it — vomiting and not keeping fluids down, bleeding, trouble passing urine, confusion, breathlessness. Combinations are read differently from single symptoms.
  • Your medicines, including the ones started or stopped recently.

You are not diagnosing yourself by having this ready. You are handing them the things they would otherwise spend the call extracting — and the decision stays entirely theirs.

Writing to the portal instead of calling? The same list works, in that order, in one message. Put the direction it is going and the immune-system line near the top — portal messages get read quickly, and those two change how the rest is read.

Copyright, and what you may do with this

Last updated . When we get something wrong we correct it and say what changed.

The short version is first and it is not a summary — it is the promise. The formal text follows for anyone who needs it.

In plain words

These say the same thing as the formal text below. If they ever disagree, this short version wins.

The notice

The terms

Quoted from the VSI Health Profile License, settled 24 May 2026. The wording is reproduced rather than paraphrased, because a paraphrased licence is a different licence.

Patient commitment

Commercial licensing

Reserved rights

Vermont Synergy Initiative reserves the absolute right to:

  1. Modify any and all license terms at our sole discretion
  2. Revoke commercial licenses for any reason
  3. Change pricing, terms, or conditions with 30 days notice
  4. Refuse licensing to any entity for any reason
  5. Terminate partnerships or integrations
  6. Alter the commercial licensing structure entirely
  7. Add, remove, or modify any terms or conditions
  8. Exercise any rights not explicitly granted to others

Control retention

Fred Schwacke and Vermont Synergy Initiative retain complete and absolute control over license terms and modifications, commercial partnership decisions, enforcement discretion, technology direction, and any decisions regarding this work.

No automatic rights

No commercial entity has any automatic right to license this technology, to continue using it, to favourable terms or conditions, to renewal of any licensing agreement, or to any use whatsoever without explicit written permission.

Why it is shaped this way

Two things have to be true at once, and one alone would not do it.

The commitment to patients has to survive us. A promise that only lasts as long as the current owner is not a promise; it is an intention. So it binds anyone who ever acquires this work, which is the point of writing it down rather than saying it.

And the commercial side has to stay under our control — not to extract money from it, but so that a company cannot take this, put it inside something people pay for, and leave us with no way to stop them. The reserved rights are the instrument for that and nothing else.

If those two ever pull against each other, the first one wins. It is the reason the rest exists.

What you send us

If you write to us through a page here — a correction, a question, a comment — you keep everything you wrote. You are not signing it over by sending it.

What we may do with it is set by the consent tier you chose at the time, and by nothing else. Counted and anonymous is the default and stays the default unless you say otherwise. We do not publish anybody’s words, or name anybody, without the specific permission for that.

Other people’s work

Where a claim here comes from published research, the source is named and the grade for how good that evidence is travels with it. Those authors own their own work; we quote and cite it, we do not claim it.

The site is built with open-source software, which stays under its own licences. Where we link to other services — a helpline, a government site, a patient charity — those are theirs, not ours, and we say so where we link.

Reaching us about any of this. Licensing questions, permission requests, and anything that needs a signature go to Fred Schwacke, Vermont Synergy Initiative, Bondville, Vermont. A published address for these will appear here when there is one; the comment rail in the margin reaches us in the meantime.

If we change these terms, the change is dated on this page and the previous version stays readable underneath it. A quiet edit to a promise is how a promise stops being one.

This work began because of what our own family ran into — my wife's illness, and the years of appointments, records and unanswered questions that came with it. Nothing here describes anyone's medical history. It was built around those needs, not about them, so that the next person has something we did not.