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Multiple Chemical Sensitivity Poll

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One of the greatest challenges in diagnosing MCS is finding a pattern in this syndrome. This poll attempts to ask some questions based upon the assumption that are some unique patterns to this illness. This poll is only for those with MCS as a primary disorder.
Do you have a crack, split or line about half an inch from the tip of your tongue (on top) that runs down the middle about an inch? (Please look at your tongue in a mirror.)
Yes (Shy, reserved responder)
Yes (Outgoing, extrovert responder)
No (Shy, reserved responder)
No (Outgoing, extrovert responder)
Do you have food intolerances?
Yes
No
Which chemical set is your most powerful environmental trigger (least tolerated)?
Pesticides
Formaldehye
Perfumes(Scents)
Solvents
Do you have cold hands and feet?
Yes (sometimes)
No (never)
Do you feel fatigued?
Yes (sometimes or often)
No (rarely or never)
Have you been diagnosed with Multiple Chemical Sensitivity?
Yes
No, but I believe I am
No, I am not
Have any members of your family been diagnosed with either diabetes or hypertension?
Yes
No
Have you been diagnosed with High LDL cholesterol and/or Triglycerides, and low HDL cholesterol?
Yes
No
Have you been diagnosed with hypoglycemia?
Yes
No
Suspected but no ojbective tests to document the condition.
Have you been diagnosed with stomach or intestinal disorders of any kind?
Yes
No
Suspected but no documentation
Do you have a "normal" sleep pattern [Sleep 8 hours of restful sleep]?
Yes
No
If you tend to put weight on, do you put it on in your trunk (abdominal fat) rather than all over?
Yes (abominal)
No
Would you consider your self an extrovert (out going) or an introvert (reserved or shy)?
Extrovert
Introvert
Considering others with MCS, how would you rate your level of severity of chemical intolerance?
A. Mild (can function in society with some minor accommodations).
B. Moderate (need many special accommodations but still can function in society)
C. Severe (cannot tolerate many environments because they make me ill).
Do you have a normal body temperature (98.6)?
A. Normal
B. Below normal
C. Not sure but I am cold
D. Not sure but I feel normal
If you exercise, do you mostly feel better or become more fatigued after it?
A. I feel more fatigued
B. I always feel better
Do you have yeast infections or fungal infections?
Yes
No
Do you have blurred vision, brain fog, or poor concentration?
A. Sometimes
B. Never
Do you have low, dull level pain in your abdomen, lower back or shoulders?
Yes
No
Do you have twitching of leg muscles, spasms or cramps?
Sometimes
Never
What is your age?
1 to 18 years old
19 to 24 years old
25 to 39 years old
40 to 55 years old
Over 55 years old
What is your sex?
Female
Male
What is your highest level of education?
Elementary
Middle school
High school
College (2 & 4 year)
Post graduate
What is your Marital Status?
Single (never married)
Single
Married or partnered
This poll was created on 2000-03-16 03:24:35 by sunergos
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