Scribd Logo
Upload

Welcome to Scribd!

  • Fibromyalgia Charting (Doctor)

    Uploaded by

    pwiddis
    21 views3 pages
    This document contains forms for tracking sleep, pain levels, and symptoms over multiple days. It includes sections to record awakening time, time slept, sleep quality, temperature and pain in the morning and evening. There are also diagrams to indicate locations and types of pain, and a log to track hours slept, stiffness, fatigue, pain levels and other symptoms each day. The purpose is to monitor changes in sleep, pain, and overall health and well-being over a period of time.

    Original Description:

    Charting symptoms

    Copyright

    © © All Rights Reserved

    Available Formats

    DOCX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    This document contains forms for tracking sleep, pain levels, and symptoms over multiple days. It includes sections to record awakening time, time slept, sleep quality, temperature and pain in the morning and evening. There are also diagrams to indicate locations and types of pain, and a log to track hours slept, stiffness, fatigue, pain levels and other symptoms each day. The purpose is to monitor changes in sleep, pain, and overall health and well-being over a period of time.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    21 views3 pages

    Fibromyalgia Charting (Doctor)

    Uploaded by

    pwiddis
    This document contains forms for tracking sleep, pain levels, and symptoms over multiple days. It includes sections to record awakening time, time slept, sleep quality, temperature and pain in the morning and evening. There are also diagrams to indicate locations and types of pain, and a log to track hours slept, stiffness, fatigue, pain levels and other symptoms each day. The purpose is to monitor changes in sleep, pain, and overall health and well-being over a period of time.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 3

    Sleep and Pain Profile

    Date Awakening Time Time Slept Sleep Quality Temp. AM Pain AM Temp. PM Pain PM
    Energy
    Level
    Bed Time
    Mins. To
    Fall Asleep








    Body Pain Diagram
    Please indicate the amount of pain you have had over the last two days by marking a / through the line.


    0 1 2 3 4 5 6 7 8 9 10
    No Pain Excruciating Pain
    Please indicate your areas of:
    Aching - - - - - - Burning Pain x x x x x Stabbing Pain / / / / / / Pins & Needles Crushing Pain



















    Day 1 Day 7



    Symptom Log
    End of Day Analysis














    Hours Slept

    Muscle Stiffness

    Numbness / Tingling

    Fatigue

    Pain

    Fogginess

    Memory

    Poor Sleep

    Depression

    Mood Changes

    Light Sensitivity

    Sound Sensitivity

    Abdominal Pain

    Bloating

    Irritable Bowel Syndrome

    Dizziness / Balance Problems

    Headache

    Joint Pain

    Medications / Vitamins
    Marvelon

    Lyrica

    Vitamin D

    Calcium / Magnesium

    Multi-Vitamin

    You might also like