My 360° Health Trackers How to Use your Trackers Tutorial Time of Incident Hours : Minutes AMPM AM/PM Date of Incident What would you like to track today? Pain Crisis Weather Tracker Mood Tracker Hydration Treatment Tracker Medications Tracker Vital Signs Allergy My Lab Results Select All Pain Crisis What type of Pain Crisis did you have? Tired Cramping Pain Headache Leg Swelling Bruising Sharp Pain Dull Pain Other What other symptom are you experiencing? What part of the body is the pain? Full Body Ache Head Eyes Shoulders Arms/Hands Upper Back Lower Back Chest Stomach Pelvic Region Legs Feet What were you doing when this symptom occured? Sudden Change of temperature Working at computer Exercising Relaxing Dealing with Stress Dehydrated Sleep Deprivation Other What other activity triggered this pain? Rate your Pain for this Symptom Pre-treatment (1-Low, 10-High): 1 – Little to no pain23 – Slight Pain4 5 – Moderate Pain67 8 – Severe Pain910 – Extreme Pain Weather Tracker Weather Tracker: How was the weather when your symptom(s) started? Hot (91°F or more) Mild (61°F – 90°F) Cold (60°F or below ) Hydration Tracker How was your hydration at time of symptom onset? Fully Hydrated Sort of hydrated Poorly hydrated Overly Hydrated Mood Tracker What was your mood before pain? Happy Decent Neutral Not good Very tired Terrible Vital Signs Tracker What is your Blood Pressure: Systolic mm Hg (Upper Number) 0123456789101112131415161718192021222324252627282930313233343536373839404142434445464748495051525354555657585960616263646566676869707172737475767778798081828384858687888990919293949596979899100101102103104105106107108109110111112113114115116117118119120121122123124125126127128129130131132133134135136137138139140141142143144145146147148149150151152153154155156157158159160161162163164165166167168169170171172173174175176177178179180181182183184185186187188189190191192193194195196197198199200201202203204205206207208209210211212213214215216217218219220221222223224225226227228229230231232233234235236237238239240241242243244245246247248249250250251252253254255256257258259260261262263264265266267268269270271272273274275276277278279280281282283284285286287288289290291292293294295296297298299300 What is your Blood Pressure: Diastolic mm Hg (Lower Number) 0123456789101112131415161718192021222324252627282930313233343536373839404142434445464748495051525354555657585960616263646566676869707172737475767778798081828384858687888990919293949596979899100101102103104105106107108109110111112113114115116117118119120121122123124125126127128129130131132133134135136137138139140141142143144145146147148149150151152153154155156157158159160161162163164165166167168169170171172173174175176177178179180181182183184185186187188189190191192193194195196197198199200201202203204205206207208209210211212213214215216217218219220221222223224225226227228229230231232233234235236237238239240241242243244245246247248249250250251252253254255256257258259260261262263264265266267268269270271272273274275276277278279280281282283284285286287288289290291292293294295296297298299300 What is your pulse Oximeter Reading? 0123456789101112131415161718192021222324252627282930313233343536373839404142434445464748495051525354555657585960616263646566676869707172737475767778798081828384858687888990919293949596979899100 IMPORTANT NOTICE – HYPERTENSIVE STAGE You are receiving this message because your systolic blood pressure reading over 180 is considered Hypertensive. Please seek medical attention as soon as possible. IMPORTANT NOTICE – HYPERTENSIVE STAGE You are receiving this message because your diastolic blood pressure reading over 90 is considered Hypertensive. Please seek medical attention as soon as possible. What is your pulse/heartbeat per minute? Please enter a number from 4 to 25. What is your body temperature? Please enter a number from 80 to 110. MyTreatment Tracker What pain treatment did you use? Prescription Medicine Nonprescriptive Medicine Exercise Psychological Counseling Physical Therapy Prayer or Meditation Herbal Remedies Massage Relaxation Technique Hot Packs Cold Packs Rest Sauna Other What other treatment did you do? What kind of prescription medicine did you take? Hydroxyurea L-glutamine Oral Powder (Endari) Antibiotics (e.g., Penicillin) Crizanlizumab (Adakveo) Voxelotor (Oxbryta) Other What other prescription did you take? What kind of non-prescription medicine did you take? Tylenol (acetaminophen) Aspirin (ASA) Advil (NSAID) Vitamin Other What other non-prescription did you take? Rate your Symptom Pain 1 hour after treatment (1-Low, 10-High) Please enter a number from 0 to 10. On a scale of 1-10, what is your pain level now, one hour after your self-treatment? Mood After Pain Treatment Excited and happy Ok…feeling decent Neutral – not ecstatic, but not down at all Angry Tired Upset or Stressed My SCD Medication Tracker What prescription medicine did you take? Hydroxyurea L-glutamine Oral Powder (Endari) Antibiotics (e.g., Penicillin) Crizanlizumab (Adakveo) Voxelotor (Oxbryta) Other What other prescription medicine did you take? When did you take your medicine? Morning Afternoon Evening Bedtime Other What other prescription did you take? My Allergy Tracker What would you like to do today? Add a known allergyLog an allergic reaction (or side effect) What are you Allergic to? Medication Food Insect Stings Pets Dust Mold Latex Blood Transfusion Other What other item are you allergic to? What medicine are you allergic to had a side effect? Hydroxyurea L-glutamine Oral Powder (Endari) Antibiotics (e.g., Penicillin) Crizanlizumab (Adakveo) Voxelotor (Oxbryta) Other What foods are you allergic to? Almond Cow’s milk Egg white Egg yolk Peanut Shrimp/Shellfish Soy Tuna Wheat Other Type of Reaction Itchy Eyes Rash Facial Swelling Difficulty breathing Anaphalaxis Stomach Upset Other What other prescription did you take? What medicine caused an allergy? Hydroxyurea L-glutamine Oral Powder (Endari) Antibiotics (e.g., Penicillin) Crizanlizumab (Adakveo) Voxelotor (Oxbryta) Other What other medicine caused the allergy? Rate Severity of Reaction (1-low and 10-high) Please enter a number from 1 to 10. My Lab Results Type of Lab Test White Blood CellHemoglobinHematocritPlateletsReticulocyte (Retic) CountAbsolute NeutrophilINR (blood thinner measurement test)Other Numeric Results Additional Notes about this Pain Incident? Upload photo Max. file size: 100 MB.
