Home | Help | Contact Us

 MALE QUESTIONNAIRE - PAGE 2(c) 

  < You are on page 2(c) of 9


This section deals with muscular diseases and symptoms.
208.  Has the condition Fibromyalgia ever been diagnosed?
Don't know
No
Yes, but it has since resolved
Yes, it is a current tolerable problem
Yes, I can no longer lead a normal life
209.  Do you have Muscular Dystrophy?
No / don't know
Suspected
Duchene muscular dystrophy (DMD)
Myotonic dystrophy (DM), Steinert's disease
Yes, Other
210.  Do you have Myasthenia Gravis?
Don't know
No
Probably, it has been suggested by a doctor
Mild / Moderate
Severe
211.  Do your hands tremble or have a tremor?
No / don't know
Yes, but it stops while I am using them
Mild, only when I try to use them
Obvious, only when I try to use them
Constant and obvious
212.  Do you have individual muscles that are weaker than they should be?
Don't know
No
Mild / one
Moderate
Serious / several
213.  Are any of your muscles more tight and rigid than they should be? Do not include muscles that are well-developed through exercise.
No / don't know
Somewhat
Yes, very
214.  Do you seem to have less muscle mass for reasons other than exercising less than you used to?
No / don't know
Yes, somewhat less
Definitely a lot less
215.  Are your calf muscles tender for reasons other than overuse?
No / don't know
Somewhat
Yes, very
216.  Do you feel that your muscles are sorer after heavy use than they should be? (Some muscular soreness is normal a day or two after activity to which that muscle is not accustomed.)
Don't know
No
Possibly
Yes, I have noticed this occasionally
Yes, this is always the case
217.  Are your muscles in general sore or tender to the touch for no obvious reason? Do not include sore muscles that are due to flu or heavy exercise, for example.
No / don't know
Minor episode(s) now resolved
Major episode(s) now resolved
Current minor problem
Current major problem
218.  Are the muscles in the back of your neck tender?
Don't know
No
Somewhat
Yes, very
219.  Do you feel tightness across the shoulders?
No / don't know
Yes, some
Yes, significant
220.  Do you suffer from any muscle twitching or cramping?
No / don't know
In the past only
Slight, occasionally
More questions later...
Constant or obvious
More questions later...
Severe - constant and obvious
More questions later...

Add any additional information here for the questions above:

Please mention the question number(s) if possible.

 


 


GLOSSARY

Cramp (Cramping, Cramps)
A sudden, involuntary, painful muscular contraction.

Fibromyalgia (FMS)
Originally named fibrositis, it is a mysteriously debilitating syndrome that attacks women more often than men. It is not physically damaging to the body in any way, but is characterized by the constant presence of widespread pain that often moves about the body. Fibromyalgia can be so severe that it is often incapacitating.





























 

Home | Help | Contact Us
Design by: RoyalWebHosting.com