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Re: Online survey
In a message dated 98-01-09 07:30:37 EST, you write:
<<
1. Sex: 1. Male 2. Female
____2_________________________________
2. Nationality __US_______________________________
3. Age 1. below 55 _x__ Born 8/5/54, diagnosed 4/1/89
2. 55-65 ___
3. above 65 ___
4. How long ago were You diagnosed with PD?
1. 0-5 years ago ___
2. 6-10 years ago __X_
3. 11-15 years ago ___
4. over 15 years ago ___
5. What medications are You taking at the moment?
1. amantadine
___________________________________________
2. anticholinergics
_________________________________________
3. selegiline
________________x (Eldepryl)____________________________
4. dopamine agonist
_________________
5. levodopa
___________________x (as Carbidopa/Levadopa)-Sinemet
6. COMT inhibitor
__________________x_(arequip)____________________
7. something else:
___________________x (Nortryptilinne)_____________________
6. In general, are You satisfied with the effectiveness of Your
medication?
Hell no_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
7. How often are You troubled by the following symptoms (on a scale from
1 to 5, 1=all the time 5=never):
tremor __5_
rigidity _5__
slowness of movement __5_
postural instability __5_
dyskinesia __9_
hallucinations _0__
dementia __0_
depression _0__
dystonia __4_
sexual problems _9__
8. How disabling are the following symptoms (on a scale from 1 to 5,
1=extremely disabling 5=no disability):
tremor _3__
rigidity __1_
slowness of movement __2_
postural instability _2__
dyskinesia _4__
hallucinations _5__
dementia __5
depression _5__
dystonia __4_
sexual problems __4_
9. Have You ever been hospitalized due to PD symptoms? Which symptom(s)?
>>
no
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