The Secret of Great Health Care
This section will describe what important information you need to report to your health care provider for a variety of common conditions.
Abdominal pain
Onset: When did it start?
Location: Where is the pain located? Is it located all over the stomach or is the pain localized in one area of the stomach? Has the location of the pain changed over the course of the pain?
Duration: How long has the pain lasted? Is the pain constant or does it come and go?
What is the pain like? Dull, sharp, burning, etc.
Are there any other symptoms (nausea, vomiting, poor appetite, fever, chills, heart burn, etc.)?
Does the pain radiate anywhere else?
Timing: Is the pain worse at any given time such as worse after meals, in the morning? Does anything make it better such as having a bowel movement or sleeping?
Severity: How bad is the pain on a scale of 0-10? 0 being no pain and 10 being the most severe you can image.
Back Pain
When did it start?
Where is it located?
How long has the pain lasted? Is it constant or does it come and go?
Describe the pain? Sharp, dull, burning etc.
Does the pain radiate? Where?
Timing? What makes the pain worse or better?
Severity: How bad is the pain on a scale of 0-10? 0 being no pain and 10 being the most severe you can image.
Are there any other symptoms (changes with urination/bowel function, fever, numbness in the legs, etc.)?
Cough
Onset: When did it start?
Is the cough dry or moist?
Is the cough productive or non-productive? When is it worse (morning)?
What is the color of the sputum? Does the color clear as the day progresses? Is the mucus thick/thin?
Is there any wheezing or shortness of breath?
Is there any fever, chills, poor appetite, chest pain, burning in the chest?
Are you short of breath when you are lying down?
Chest pain
Onset: When did it start?
Location: Where is it located?
Duration: How long has it lasted?
Describe the pain? Pressure, sharp, stabbing, aching etc.
Are you having any other symptoms such as shortness of breath, nausea, sweating?
Does the pain radiate? Where? (Jaw, arm, neck, back etc.)
How bad is the pain on a scale of 0-10? 0 being no pain and 10 being the most severe you can image.
Constipation
When did it start?
How often do you have bowel movements?
Is the stool hard?
Have there been any changes in your eating habits?
Do you have abdominal pain?
Have there been any changes in medicines?
Have you noticed any blood in your stool?
How much fluid do you drink?
Diarrhea
When did it start?
How many times a day do you have diarrhea?
Do you notice diarrhea after eating certain foods?
Do you have diarrhea at night?
Do you have any abdominal pain?
Do you have a fever?
Have you noticed any blood in your stool?
Have you had any changes in your diet?
Have you traveled recently?
Dizziness
When did it start?
Describe the dizziness. Does it feel like the room is spinning? Do you feel like you are going to pass out? Do you feel unsteady when you walk?
Have you had any loss of consciousness?
Have you had any chest pain, shortness of breath, visual changes, hearing changes or ringing in the ears?
Edema/Swelling
When did it start?
Where is the swelling (both legs/arms, one leg/arm, stomach, face etc.)?
Do you have a fever or chills?
Do you have any shortness of breath when lying down?
Have you noticed any skin changes?
Do you have any shortness of breath or chest pain?
Have you had any changes in your urination?
Have you had any changes in your appetite?
Fatigue
When did it start?
What makes it worse? Better?
Is the fatigue worse in the morning or later in the day?
Has there been any change in your sleeping patterns?
Have you had any weakness?
Have you had any fever?
Are you depressed, sad or blue?
Has your eating habits changed?
Have you had any weight loss?
Have you had any pain?
Headache
When did it start?
Where is it located?
How long has the pain lasted? Is it constant or does it come and go?
Describe the pain (sharp, dull, numb, band-like, etc.)?
Timing? What makes the pain worse or better?
How bad is the pain on a scale of 0-10? 0 being no pain and 10 being the most severe you can image.
Are you having any other symptoms (nausea, vomiting, neck pain, dizziness, numbness, visual changes, eye tearing, nasal congestion, etc.)?
Joint Pain
When did it start?
Where is it located?
How long has the pain lasted? Is it constant or does it come and go?
Describe the pain (sharp, dull, numb, etc.)?
Does the pain radiate? Where?
When does the pain occur? What makes the pain worse or better?
How bad is the pain on a scale of 0-10? 0 being no pain and 10 being the most severe you can image.
Are you having any other symptoms?
Runny nose
When did it start?
Describe the discharge? Thin/Thick. Small/medium/large amount.
Are there any other symptoms (cough, sneezing, sore throat, earache, fever, headache or body aches)?
Shortness of breath
When did it start?
When does it occur (during exertion, when lying down at night, etc)?
Do you have any chest pain or leg swelling?
Have you been coughing?
Have you been wheezing?
Have you had a fever?
Sore throat
When did it start?
Are there any other symptoms (fever, runny nose, cough, sneezing, itchy eyes or itchy nose, headache, nausea or eye discharge)?
Has there been a change in your appetite?
Is there any drooling or difficulty swallowing?
How bad is the pain on a scale of 0-10? 0 being no pain and 10 being the most severe you can image.
Urinary incontinence
When did it start?
Do you need to urinate urgently?
Do you leak after you void?
Do you urinate frequently at night?
How many times a day do you urinate?
Do you have any burning with urination?
Do you leak urine?
Have you birthed any children? Vaginally? C-Section?
Do you have any genital itching/discharge/rash/pain?
How long can you hold urine after you feel the urge?
Do you need to strain to void?
What color is the urine? Is there a strong odor?
