My Pain Crisis Tracker

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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
		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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