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My Pain Crisis Tracker
Date of Pain Incident | Time of Pain Incident | Weather Tracker: How was the weather when your symptom(s) started? | How was your hydration at time of symptom onset? | What was your mood before pain? | What were you doing when this symptom occured? | What other activity triggered this pain? | Will you be tracking any Vital Signs today? | Blood Pressure: Systolic | Blood Pressure: Diastolic | What is your pulse oximeter reading? | What is your pulse/heartbeat for 10 seconds? | Do you have more than 1 symptom to track at this time? | How many symptoms do you want to enter at this time? | What is your symptom? | What other symptom are you experiencing? | What part of the body is the pain? | Rate your Pain for this Symptom Pre-treatment (1-Low, 10-High): Drag or tap on bar below | Symptom #1 | What other symptom are you experiencing for Symptom #1?? | What part of the body is the pain for this Symptom #1? | Rate your Pain for this Symptom #1 Pre-treatment(1-Low, 10-High): Tap on the bar to set value if slider not working | Symptom #2 | What other symptom are you experiencing for Symptom #2? | What part of the body is the pain for this Symptom #2? | Rate your Pain for Symptom #2 Pre-treatment (1-Low, 10-High): Tap on the bar to set value if slider not working | Symptom #3 | What other symptom are you experiencing for Symptom #3? | Rate your Pain for Symptom #3 (1-Low, 10-High): Pre- treatment | Symptom #4 | What other symptom are you experiencing for Symptom #4? | Rate your Pain for Symptom #4 (1-Low, 10-High): Pre- treatment | What part of the body is the pain for Symptom #4? | Treatments | What kind of prescription medicine did you take? | Rate your Pain 1 hour after treatment (1-Low, 10-High) | Rate your Symptom #1 Pain hour after treatment (1-Low, 10-High) | Rate your Symptom #2 Pain hour after treatment (1-Low, 10-High) | Rate your Symptom #3 Pain hour after treatment (1-Low, 10-High) | Rate your Symptom #4 Pain hour after treatment (1-Low, 10-High) | Mood After Pain Treatment | Additional Notes | Entry Date | User | User IP | Entry ID |
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Mild (61°F - 90°F) | Fully Hydrated | Not so Good | Relaxing | Yes | 98 | 70 | Yes | Bruising | Arms/Hands | 7 | Pain | Stomach | 5 | Relaxation Technique | 3 | Ok...feeling decent | Test number 1 | 12/21/2023 09:43 AM | 174.175.204.124 | 20 | |||||||||||||||||||||||||
12/07/2023 | 5 | 01/04/2024 10:07 AM | 174.175.204.124 | 25 | |||||||||||||||||||||||||||||||||||||||||
01/04/2024 | 11:00 AM | Sort of hydrated | Not so Good | Working at computer | Yes | 97 | 5 | 01/04/2024 09:44 AM | 174.175.204.124 | 23 | |||||||||||||||||||||||||||||||||||
01/04/2024 | 11:59 AM | Cold (60°F or below ) | Sort of hydrated | Not so Good | Exercising | Yes | 140 | 80 | 97 | 15 | Yes | 2 symptoms | Tired | Legs | 2 | Headache | Head | 10 | Rest | 5 | Ok...feeling decent | Headache persists | 01/04/2024 10:06 AM | 174.175.204.124 | 24 | ||||||||||||||||||||
Date of Pain Incident | Time of Pain Incident | Weather Tracker: How was the weather when your symptom(s) started? | How was your hydration at time of symptom onset? | What was your mood before pain? | What were you doing when this symptom occured? | What other activity triggered this pain? | Will you be tracking any Vital Signs today? | Blood Pressure: Systolic | Blood Pressure: Diastolic | What is your pulse oximeter reading? | What is your pulse/heartbeat for 10 seconds? | Do you have more than 1 symptom to track at this time? | How many symptoms do you want to enter at this time? | What is your symptom? | What other symptom are you experiencing? | What part of the body is the pain? | Rate your Pain for this Symptom Pre-treatment (1-Low, 10-High): Drag or tap on bar below | Symptom #1 | What other symptom are you experiencing for Symptom #1?? | What part of the body is the pain for this Symptom #1? | Rate your Pain for this Symptom #1 Pre-treatment(1-Low, 10-High): Tap on the bar to set value if slider not working | Symptom #2 | What other symptom are you experiencing for Symptom #2? | What part of the body is the pain for this Symptom #2? | Rate your Pain for Symptom #2 Pre-treatment (1-Low, 10-High): Tap on the bar to set value if slider not working | Symptom #3 | What other symptom are you experiencing for Symptom #3? | Rate your Pain for Symptom #3 (1-Low, 10-High): Pre- treatment | Symptom #4 | What other symptom are you experiencing for Symptom #4? | Rate your Pain for Symptom #4 (1-Low, 10-High): Pre- treatment | What part of the body is the pain for Symptom #4? | Treatments | What kind of prescription medicine did you take? | Rate your Pain 1 hour after treatment (1-Low, 10-High) | Rate your Symptom #1 Pain hour after treatment (1-Low, 10-High) | Rate your Symptom #2 Pain hour after treatment (1-Low, 10-High) | Rate your Symptom #3 Pain hour after treatment (1-Low, 10-High) | Rate your Symptom #4 Pain hour after treatment (1-Low, 10-High) | Mood After Pain Treatment | Additional Notes | Entry Date | User | User IP | Entry ID |
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