For someone of your age and sex, is your muscular strength...?
Very poor
Poor
Average / don't know
Great
Very great
207.
How is your muscle tone, compared to others of your age?
Very poor (hypotonia)
Poor
Average / don't know
Good
Excellent
208.
Do you tend to have a thick musculature, even without working out? Please answer this question as though you were not working out.
No, very light musculature by nature
Tends to be light
Average / don't know
Tends to be thick / heavy
Yes, very thick / heavy by nature
209.
Is your reaction time / reflex...?
Very slow/poor
Slow/poor
Average / don't know
Fast/good
Very fast/good
210.
Do you have pain between the shoulder blades?
No / don't know
Yes, some
Yes, significant
211.
Do you experience shoulder pain?
No / don't know
One or both hurt, due to an injury
Minor problem / comes and goes
One hurts most of the time (not related to injury)
Both hurt most of the time (not related to injury)
212.
Have you had any problems with your muscles? This includes any muscular disease or specific problem like muscle loss, weakness, pain, spasms, cramping, tremors, tightness, rigidity, soreness, etc., but does not include seizure activity.
Don't know
No
Yes, I have muscular problems or disease More questions later...
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SYMPTOMS: SKELETAL
213.
Are you shorter than you used to be?
No / don't know
Yes, an inch (2.5cm) or less
Yes, more than one inch (2.5cm)
214.
How would you or others rate your posture? The shoulders and head are usually hunched forward and the back bent forward in poor posture. Your ears, shoulders, hips, knees, and ankles should make a straight line, when viewed from the side.
Don't know
Very poor
Poor
Average
Excellent
215.
Have you had a sideways curvature of the spine called scoliosis?
Don't know
No
Yes, but corrected now
Current minor problem
Current major problem
216.
Does / did your breastbone protrude outward (pigeon breast) or inward (funnel chest) more than it should?
Don't know
No, positioned normally
Pushes / pushed inward
Pushes / pushed outward
217.
What is the length of your fingers and toes?
Very short / stubby
Short / stubby
Average / don't know
Long / slender
Very long / slender
218.
Are the length of your arms and legs proportional to your torso?
Don''t know
Shorter than they should be
Average / typical
Longer than they should be
Much longer than they should be
219.
Is one leg shorter than the other, and not compensated for by the regular use of a heel lift or custom made shoe?
Don't know
No, they are of equal length
Compensed for with heel lift / raised shoe
1/2 inch or less
Greater than 1/2 inch
220.
Have you ever broken any bones?
No / don't know
Once
Twice
Three times
Four times or more
221.
Have you ever had any dislocations?
No / don't know
Yes, one
Yes, more than one
222.
Have you had Bursitis (painful inflammation of joints, usually caused by overuse and/or excess pressure)?
Have liver / gallbladder cleanses helped you? Generally these involve drinking olive or other kinds of oil.
Never tried one / don't know
No, there was no benefit
There was some benefit
Moderate benefit
Significant benefit
249.
Do you have pain under the right side of your rib cage?
Never / don't know
Occasional moderate discomfort
Frequent moderate discomfort
Occasional severe pain
Frequent severe pain
250.
Do you have pain beneath or near your shoulder blade (scapula)?
Don't know
No
Both shoulder blades
Left side only
Right side only
251.
Hepatitis A. Have you ever been diagnosed with it?
Never had it / don't know
Probably had it/minor episode
Major episode, now resolved
Current minor problem
Current major problem
252.
Have you had any problems with your gallbladder that you know of? This includes having had your gallbladder removed.
Don't know
No
Yes / probably More questions later...
253.
Do you have any known problems with your liver? This includes cirrhosis, infection such as hepatitis, enlargement, Gilbert's syndrome, etc…
Don't know
No
Yes More questions later...
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Please mention the question number(s) if possible.
SYMPTOMS: GASTRO-INTESTINAL: GENERAL
254.
Do you suffer from belching (burping) within 1 hour of a meal?
Don't know
No
Occasionally
Often
255.
Do you suffer from bloating or digestive disturbances after eating?
Don't know
No
Occasionally
Often
256.
Do you feel as though food remains in your stomach too long? The stomach usually retains food for 3-4 hours before releasing it to the small intestine.
Don't know
No
Possibly / occasionally
Frequently
Frequently, confirmed by testing
257.
Have you been diagnosed with rapid gastric emptying? This is also known as gastric dumping or gastric dumping syndrome.
Don't know
No, it has been ruled out
It has been suggested but not confirmed
Occasional confirmed problem
Frequent confirmed problem
258.
Have you had a portion of your small bowel removed?
Don't know
No
Less than 50cm (20 inches)
More than 50cm (20 inches)
259.
Do you have difficulty swallowing? This is apart from the pain felt from a simple sore throat.
Do you suffer from nausea that is not part of a known condition, like motion sickness, pregnancy and gallbladder disease?
Never / don't know
Probably had it/minor episode(s) now resolved
Major episode(s) now resolved
Current minor problem
Current major problem
263.
Do you suffer from vomiting that is not part of a known condition such as food poisoning?
Never / don't know
Occasionally
Often - several times per week
264.
Is your stomach upset by taking supplement tablets?
No / don't know
Yes
265.
Does your anus itch?
Never / don't know
Occasionally
Often, mostly at night
Often
266.
Do you have a rectal discharge of mucous or pus. This does not include fresh blood.
Don't know
No
Slight
Significant
Significant with blood
267.
Have you experienced any form of abdominal or groin pain, discomfort or bloating within the past 3 months? This includes upper abdominal pain such as experienced in heartburn or ulcers.
Don't know
No
Yes, but fully resolved now
Yes More questions later...
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SYMPTOMS: GASTRO-INTESTINAL: CONDITIONS This section asks specifically about conditions that you are already aware of. If you are unsure of an answer, leave it as "don't know" - you will be asked about individual symptoms elsewhere.
Have you had any bacterial infections in your stomach or intestines? This would include such things as Helicobacter pylori, Clostridium difficile, etc..
Don't know
No
Yes More questions later...
276.
Have you had any physical / inflammatory problems with your large intestine / lower small intestine? This would include inflammatory bowel disease, polyps, diverticulosis, etc..
Don't know
No
Yes More questions later...
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Please mention the question number(s) if possible.
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GLOSSARY
Abdominal Hernia: An abdominal hernia occurs when there is an area where the muscles are weak, and this allows the internal organs to bulge through the abdominal wall. Signs include a lump (soft bulge of tissue) or a small, localized swelling on the abdomen.
Arthritis: Inflammation of a joint, usually accompanied by pain, swelling, and stiffness, and resulting from infection, trauma, degenerative changes, metabolic disturbances, or other causes. It occurs in various forms, such as bacterial arthritis, osteoarthritis, or rheumatoid arthritis. Osteoarthritis, the most common form, is characterized by a gradual loss of cartilage and often an overgrowth of bone at the joints.
Atrophic Gastritis: Chronic inflammation of the stomach that causes the breakdown of the mucous membranes and a reduction in the number of functioning stomach cells. Seen mainly in the elderly.
Bell's Palsy: One-sided facial paralysis of sudden onset and unknown cause. The mechanism is presumed to involve swelling of the nerve due to immune or viral disease, with ischemia and compression of the facial nerve in the narrow confines of its course through the temporal bone.
Bursitis: The bursa is a fluid-filled pad that allows your muscles to easily slide over other muscles and bones. Bursitis occurs when this pad becomes inflamed. It usually occurs when you overuse or injure a specific joint, but it can also be caused by a bacterial infection. Symptoms include pain and inflammation around joints such as the elbow, hip, shoulder, big toe, ankle or knee.
Carpal Tunnel Syndrome: A common, painful defect of the wrist and hand. It is caused by pressure on the middle nerve in the carpal tunnel. The syndrome is seen more often in women, especially in pregnant and in menopausal women. Symptoms may result from a blow, swelling, a tumor, rheumatoid arthritis, or a small carpal tunnel that squeezes the nerve. Pain may be infrequent or constant and is often most intense at night.
Chronic: Usually Chronic illness: Illness extending over a long period of time.
Cirrhosis: A long-term disease in which the liver becomes covered with fiber-like tissue. This causes the liver tissue to break down and become filled with fat. All functions of the liver then decrease, including the production of glucose, processing drugs and alcohol, and vitamin absorption. Stomach and bowel function, and the making of hormones are also affected.
Diverticular Disease: Some people develop small pouches (diverticula) that bulge outward through weak spots in the colon. Diverticulosis is the condition of having these pouches; diverticulitis is an inflammation or infection in these pouches. The conditions diverticulosis and diverticulitis are both referred to as diverticular disease. Diverticulosis may not cause any symptoms but could include mild cramps, bloating and constipation - all of which are common to other conditions such as IBS or ulcers. The most common symptoms of diverticulitis are abdominal pain and tenderness around the left side of the lower abdomen. When infection is the cause, fever, nausea, vomiting, chills, cramping and constipation may also occur.
Double-jointed: Having unusually flexible joints that can bend in unusual ways or to abnormally great extent.
Dupuytren's Contracture: A disease of the palmar fascia (thin but tough layer of fibrous tissue between the skin of the palm and the underlying flexor tendons of the fingers) resulting in progressive thickening and contracture of fibrous bands on the palm of the hand and fingers. The cause is unknown.
Flatulence: Abnormal amount of gas in the stomach and intestines.
Funnel Chest: Also called pectus excavatum, funnel chest is a depression or hollow caused when the breastbone, the bone in the middle of the ribcage, is pushed abnormally inward.
Gallbladder: A small, digestive organ positioned under the liver, which concentrates and stores bile. Problems with the gallbladder often lead to "gallbladder attacks", which usually occur after a fatty meal and at night. The following are the most common symptoms: steady, severe pain in the middle-upper abdomen or below the ribs on the right; pain in the back between the shoulder blades; pain under the right shoulder; nausea; vomiting; fever; chills; jaundice; abdominal bloating; intolerance of fatty foods; belching or gas; indigestion.
Gastritis: Inflammation of the stomach lining. White blood cells move into the wall of the stomach as a response to some type of injury; this does not mean that there is an ulcer or cancer - it is simply inflammation, either acute or chronic. Symptoms depend on how acute it is and how long it has been present. In the acute phase, there may be pain in the upper abdomen, nausea and vomiting. In the chronic phase, the pain may be dull and there may be loss of appetite with a feeling of fullness after only a few bites of food. Very often, there are no symptoms at all. If the pain is severe, there may be an ulcer as well as gastritis.
Gout: A disease characterized by an increased blood uric acid level and sudden onset of episodes of acute arthritis.
Helicobacter Pylori: H. pylori is a bacterium that is found in the stomach which, along with acid secretion, damages stomach and duodenal tissue, causing inflammation and peptic ulcers. Although most people will never have symptoms or problems related to the infection, they may include: dull, 'gnawing' pain which may occur 2-3 hours after a meal, come and go for several days or weeks, occur in the middle of the night when the stomach is empty and be relieved by eating; loss of weight; loss of appetite; bloating; burping; nausea; vomiting.
Hemorrhoids: Varicose disorder causing painful swellings at the anus; piles.
Hepatitis: Inflammation of the liver usually resulting in jaundice (yellowing of the skin), loss of appetite, stomach discomfort, abnormal liver function, clay-colored stools, and dark urine. May be caused by a bacterial or viral infection, parasitic infestation, alcohol, drugs, toxins or transfusion of incompatible blood. Can be life-threatening. Severe hepatitis may lead to cirrhosis and chronic liver dysfunction.
Hepatitis A: This form of hepatitis is caused by an RNA virus that is transmitted person-to-person via the fecal-oral route. This may occur through water, food or close personal/sexual contact. Most children and about 50% of adults have few, if any, symptoms. Symptoms, when present, are initially flu-like, with malaise, fatigue, muscle pain and chest pain on the right side lasting 3 to 10 days. This is followed (for 1 to 3 weeks but possibly much longer) by jaundice (slight skin yellowing), anorexia, nausea, fatigue, pale stools, dark urine and liver enlargement, but usually no fever.
Herniated Disc: A patient with a herniated or "slipped" disc can have leg and/or back pain. The most common complaint is that of shooting pain down one or, uncommonly, both legs. The pain will typically travel from the back or buttocks to below the knee. The second possible symptom is back pain. Patients often report a history of back pain that occurred before the actual herniation. Many patients recall an episode of their back "going out" or of significant pain that resolved over a period of days with rest and was usually not accompanied by leg pain.
Hiatal Hernia: Hiatal hernia occurs when the upper part of the stomach moves up into the chest through a small opening in the diaphragm (a diaphragmatic hiatus). This is a common problem and most people are not bothered by it. A hernia may allow stomach acid to flow back into the esophagus ("food pipe"), where it can cause problems. The most common symptom is burning in your chest (heartburn), especially at night when you are lying down. Other possible signs include burping and trouble swallowing.
Irritable Bowel Syndrome: (IBS) A condition that causes upset intestines for a long period of time. It is very unpleasant to the sufferer but tends to be harmless and usually does not lead to more serious complaints. The symptoms vary from person to person and from day to day. In order to be diagnosed with IBS, a person must have at least three of the following symptoms: pain in the lower abdomen; bloating; constipation; diarrhea or alternating diarrhea and constipation; nausea; loss of appetite; tummy rumbling; flatulence; mucous in stools; indigestion; constant tiredness; frequent urination; low back pain; painful intercourse for women.
Nausea: Symptoms resulting from an inclination to vomit.
Osteoporosis: A disease in which bone tissue becomes porous and brittle. The disease primarily affects postmenopausal women.
Peptic Ulcer: A general term for gastric ulcers (stomach) and duodenal ulcers (duodenum), open sores in the stomach or duodenum caused by digestive juices and stomach acid. Most ulcers are no larger than a pencil eraser, but they can cause tremendous discomfort and pain. They occur most frequently in the 60 to 70 age group, and slightly more often in men than in women. Doctors now know that there are two major causes of ulcers: most often patients are infected with the bacteria Helicobacter pylori (H. pylori); others are regular users of non-steroidal anti-inflammatory drugs (NSAIDS), which include common products like aspirin and ibuprofen.
Pigeon Breast: Also called pectus carinatum, pigeon breast is caused when the breastbone is pushed outward. Girls usually develop pigeon breast at a somewhat younger age then boys, who do not develop the condition until adolescence, usually from 11 to 14 years of age.
Polyp: A usually nonmalignant growth or tumor protruding from the mucous lining of an organ such as the nose, bladder or intestine, often causing obstruction.
Sciatica: Pain in the lower back and hip radiating down the back of the thigh into the leg, often due to herniated lumbar disk.
Scoliosis: The condition of side-to-side spinal curves is called scoliosis. On a front to back X-ray, the spine of an individual with scoliosis looks more like an "S" or a "C" than a straight line. Some of the bones in a scoliotic spine also may have rotated slightly, making the person's waist or shoulders appear uneven.
Seizure: While there are over 40 types of seizure, most are classed as either partial seizures which occur when the excessive electrical activity in the brain is limited to one area or generalized seizures which occur when the excessive electrical activity in the brain encompasses the entire organ. Although there is a wide range of signs, they mainly include such things as falling to the ground; muscle stiffening; jerking and twitching; loss of consciousness; an empty stare; rapid chewing/blinking/breathing. Usually lasting from between a couple of seconds and several minutes, recovery may be immediate or take up to several days.
Stomach: A hollow, muscular, J-shaped pouch located in the upper part of the abdomen to the left of the midline. The upper end (fundus) is large and dome-shaped; the area just below the fundus is called the body of the stomach. The fundus and the body are often referred to as the cardiac portion of the stomach. The lower (pyloric) portion curves downward and to the right and includes the antrum and the pylorus. The function of the stomach is to begin digestion by physically breaking down food received from the esophagus. The tissues of the stomach wall are composed of three types of muscle fibers: circular, longitudinal and oblique. These fibers create structural elasticity and contractibility, both of which are needed for digestion. The stomach mucosa contains cells which secrete hydrochloric acid and this in turn activates the other gastric enzymes pepsin and rennin. To protect itself from being destroyed by its own enzymes, the stomach’s mucous lining must constantly regenerate itself.
Your attitude determines your outcome. Successful people embrace this truth, whether it is a doctor going into surgery, a pastor preparing a sermon or a business-person launching a new venture. Confidence increases your chance of success every time. When you approach a task, especially one you do not relish, fix your mind on the facts, not your feelings. That will put your attitude on the right track.
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