Questionnaire

Friday, 17 August 2007 16:35
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So Here are the questions:

You can just Copy and Paste the questionnaire into the Contact Me email or just print out the questions and then answer 1 - 10. The Doc will know what you mean.

Firstly: Please state you gender M/F and then your age....(To the Doc age matters)!!

Optional: County/State - Country

  1. Do you have a definite diagnosis? Y/N
  2. Is this a clinical diagnosis or based on MRI or CT scan?
  3. What do you think/have been told is the cause? If there was a specific event, how long ago did it happen?
  4. How long have you been ill (this may be a longer time than since you have been diagnosed)? How long have you been diagnosed?
  5. Do you have any other medical conditions e.g. diabetes etc.?
  6. Do you think Arachnoiditis is progressive?
  7. What sort of pattern of symptoms do you have e.g. constant intermittent, deteriorating?
  8. What factors change the symptom pattern (e.g. falls, viral illness, stress etc.)?
  9. Have you had any experiences of surgery/injections etc since becoming ill with arachnoiditis? (were they positive or negative)?
  10. Have you had any experiences of feeling life is not worth living and if so, have you acted on those feelings?

All answers will be strictly confidential

Sorry the writing went small!

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