Monday, December 14, 2009
Health Journal:
Date: Monday, December 14, 2009:Name the area(s) that have pain: Hip, Back, Right Leg
Pain intensity: 4
Physical Symptoms:
Overall Morning Pain Level: (9am) 1-10 / 4
How Well Did You Sleep: 1-10 / (7) 6 ½ hrs.
You Woke Up Feeling: 1-10 / (7)
Overall Afternoon Pain Level: (Noon): 1-10 / (2)
What is your fatigue level: 1-10 / (4)
How is your appetite: 1-10 / (5)
How is your walking ability: 1-10 / (6)
Overall Evening Pain Level: (7pm) 1-10 / (2)
What is your fatigue level: 1-10 / (7)
How is your appetite: 1-10 / (5)
How is my walking ability: 1-10 / (6)
Mental, Cognitive & Emotional:
How is my ability to think: 1-10 / (8)
How anxious do I feel: 1-10 / (3)
How depressed do I feel: 1-10 / (2)
How angry do I feel: 1-10 / (0)
How irritable am I: 1-10 / (0)
How happy am I: 1-10 / (8)
How is my relationships with others affected: 1-10 / (1)
How is my enjoyment of life affected: 1-10 / (3)
Exacerbating Symptoms:
Family/Home Stress Level: 1-10 / (2)
Job stress level: 1-10 / (0)
Other: 1-10 / (4) (Blue Cross invoice)(Holidays)
Current weather conditions: partly sunny 40 degrees
Medications:
30mg morphine(s) 10am. – 8pm.
10/650mg vicoden(s) – 10pm.
Overall day : 8
