February 21st, 2010
Bob S
Name the area(s) that have pain: Hip, Back, Right Leg, Body
Pain intensity: 4
Physical Symptoms:
Overall Morning Pain Level: (9:am) 1-10 / (2 )
How Well Did You Sleep: 1-10 / ( 5) 6 hrs.
You Woke Up Feeling: 1-10 / (7 )
Overall Afternoon Pain Level: (Noon): 1-10 / (2 )
What is your fatigue level: 1-10 / ( 3)
How is your appetite: 1-10 / (5 )
How is your walking ability: 1-10 / ( 5)
Overall Evening Pain Level: (7pm) 1-10 / (2 )
What is your fatigue level: 1-10 / ( 4)
How is your appetite: 1-10 / (5 )
How is my walking ability: 1-10 / ( 5)
Afternoon Nap: 2 hour
Mental, Cognitive & Emotional:
How is my ability to think: 1-10 / (9 )
How anxious do I feel: 1-10 / (0 )
How depressed do I feel: 1-10 / (0 )
How angry do I feel: 1-10 / ( 0)
How irritable am I: 1-10 / (0 )
How happy am I: 1-10 / (9 )
How is my relationships with others affected: 1-10 / (9 )
How is my enjoyment of life affected: 1-10 / (2 )
Exacerbating Symptoms:
Family/Home Stress Level: 1-10 / (0 )
Job stress level: 1-10 / ( 0)
Other: 1-10 / ( ) ( )
Current weather conditions: 15 degrees
Medications:
30mg morphine(s) 7pm. –
10/650mg vicoden(s) 5pm – 9 pm
Overall day : 7
February 19th, 2010
Bob S
Name the area(s) that have pain: Hip, Back, Right Leg, Body
Pain intensity: 4
Physical Symptoms:
Overall Morning Pain Level: (9:am) 1-10 / (4 )
How Well Did You Sleep: 1-10 / (5 ) 4 hrs.
You Woke Up Feeling: 1-10 / (6 )
Overall Afternoon Pain Level: (Noon): 1-10 / (4 )
What is your fatigue level: 1-10 / ( 5)
How is your appetite: 1-10 / (5 )
How is your walking ability: 1-10 / (5 )
Overall Evening Pain Level: (7pm) 1-10 / (3 )
What is your fatigue level: 1-10 / ( 4)
How is your appetite: 1-10 / (6 )
How is my walking ability: 1-10 / ( 5)
Afternoon Nap: 0 hour
Mental, Cognitive & Emotional:
How is my ability to think: 1-10 / ( 9)
How anxious do I feel: 1-10 / (0 )
How depressed do I feel: 1-10 / (1 )
How angry do I feel: 1-10 / (0 )
How irritable am I: 1-10 / ( 1)
How happy am I: 1-10 / (7 )
How is my relationships with others affected: 1-10 / (1 )
How is my enjoyment of life affected: 1-10 / (1 )
Exacerbating Symptoms:
Family/Home Stress Level: 1-10 / ( 1)
Job stress level: 1-10 / ( 1)
Other: 1-10 / (4 )BC ( )
Current weather conditions: 25 degrees
Medications:
30mg morphine(s) 7pm. –
10/650mg vicoden(s) 5pm – 11pm
Overall day : 7
February 18th, 2010
Bob S
Name the area(s) that have pain: Hip, Back, Right Leg, Body
Pain intensity: 4
Physical Symptoms:
Overall Morning Pain Level: (9:am) 1-10 / (4 )
How Well Did You Sleep: 1-10 / ( 5) 5 hrs.
You Woke Up Feeling: 1-10 / (5 )
Overall Afternoon Pain Level: (Noon): 1-10 / ( 3)
What is your fatigue level: 1-10 / (6 )
How is your appetite: 1-10 / (5 )
How is your walking ability: 1-10 / ( 5)
Overall Evening Pain Level: (7pm) 1-10 / (3 )
What is your fatigue level: 1-10 / (5 )
How is your appetite: 1-10 / (5 )
How is my walking ability: 1-10 / (5 )
Afternoon Nap: 1 hour
Mental, Cognitive & Emotional:
How is my ability to think: 1-10 / (8 )
How anxious do I feel: 1-10 / (0 )
How depressed do I feel: 1-10 / (1 )
How angry do I feel: 1-10 / (0 )
How irritable am I: 1-10 / (1 )
How happy am I: 1-10 / (7 )
How is my relationships with others affected: 1-10 / ( 1)
How is my enjoyment of life affected: 1-10 / (2 )
Exacerbating Symptoms:
Family/Home Stress Level: 1-10 / (0 )
Job stress level: 1-10 / (1 )
Other: 1-10 / (4 ) ( )
Current weather conditions: 30 degrees
Medications:
30mg morphine(s) 7pm. –
10/650mg vicoden(s) 5pm – 7pm – 9pm
Overall day : 7
February 17th, 2010
Bob S
Name the area(s) that have pain: Hip, Back, Right Leg, Body
Pain intensity: 4
Physical Symptoms:
Overall Morning Pain Level: (9:am) 1-10 / (3 )
How Well Did You Sleep: 1-10 / (5 ) 5 hrs.
You Woke Up Feeling: 1-10 / (6 )
Overall Afternoon Pain Level: (Noon): 1-10 / (4 )
What is your fatigue level: 1-10 / (4 )
How is your appetite: 1-10 / ( 5)
How is your walking ability: 1-10 / (5 )
Overall Evening Pain Level: (7pm) 1-10 / (3 )
What is your fatigue level: 1-10 / (4 )
How is your appetite: 1-10 / ( 4)
How is my walking ability: 1-10 / (4 )
Afternoon Nap: none
Mental, Cognitive & Emotional:
How is my ability to think: 1-10 / (8 )
How anxious do I feel: 1-10 / (0 )
How depressed do I feel: 1-10 / (1 )
How angry do I feel: 1-10 / ( 0)
How irritable am I: 1-10 / (1 )
How happy am I: 1-10 / (7 )
How is my relationships with others affected: 1-10 / (0 )
How is my enjoyment of life affected: 1-10 / (2 )
Exacerbating Symptoms:
Family/Home Stress Level: 1-10 / (1 )
Job stress level: 1-10 / (1 )
Other: 1-10 / ( 4) ( )
Current weather conditions: 25 degrees
Medications:
30mg morphine(s) 7pm. –
10/650mg vicoden(s) 5pm – 10pm
Overall day : 7
February 16th, 2010
Bob S
Name the area(s) that have pain: Hip, Back, Right Leg, Body
Pain intensity: 3
Physical Symptoms:
Overall Morning Pain Level: (9:am) 1-10 / (2 )
How Well Did You Sleep: 1-10 / (6 ) 5 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 / (5 )
Overall Evening Pain Level: (7pm) 1-10 / (3 )
What is your fatigue level: 1-10 / (4 )
How is your appetite: 1-10 / (5 )
How is my walking ability: 1-10 / (5 )
Afternoon Nap: 1 hour
Mental, Cognitive & Emotional:
How is my ability to think: 1-10 / ( 8)
How anxious do I feel: 1-10 / (0 )
How depressed do I feel: 1-10 / (0 )
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 / (0 )
How is my enjoyment of life affected: 1-10 / (1 )
Exacerbating Symptoms:
Family/Home Stress Level: 1-10 / (0 )
Job stress level: 1-10 / (0 )
Other: 1-10 / (4 ) ( )
Current weather conditions: 25 degrees
Medications:
30mg morphine(s) 7pm. –
10/650mg vicoden(s) 5pm – 10pm
Overall day : 7