MHS Awake Symptoms Questionnaire

The following list of symptoms were provided by MH-susceptible patients as answers to the below MHS Awake Symptoms Questionnaire, and should not be confused as clinical research.

1. Sweating
2. Night Sweats
3. Cramping
4. Fatigue
5. Nausea
6. Dizziness
7. Mottled Skin
8. Change in Diet
9. Increased Thirst
10. Headaches
11. Low Grade Fever
12. Heat Intolerance
13. Elevated Blood Pressure
14. Stress/Anxiety

To submit your answers to these questions, please cut and paste the questions into your e-mail and send to: fay at MHAUS dot org:

1. Have you experienced an MH episode?

If yes , when?
Where?

2. How old were you when you experienced your MH episode?

3. Were you treated with dantrolene?

4. Do you take oral dantrolene (Dantrium)?

5. Do you know what your CK levels were?

6. Have you had a muscle biopsy?

If yes, when?
Where?

7. Do you have mottled skin?

8. Do you experience cramping?

If Yes, when?
Where?

9. Do you sweat “excessively”?

If Yes, when?

10. Do you experience night sweats?

11. Do you experience fatigue?

12. Do you experience nausea?

13. Do you experience dizziness?

14. Do you experience excessive thirst?

15. Do you experience low-grade fevers?

16. Do you experience headaches?

17. Have you ever been diagnosed as having had heatstroke?

18. Do you suffer from heat intolerance?

19. Do you have an elevated blood pressure?

20. Have you been diagnosed with hypothyroidism?

21. What is your daily average caffeine intake? Please include soft drinks and list
them.

22. Are you or were you recently taking any medications?

23. Are you or were you treated for any illness within the last year?

24. Have you noticed a progression in your symptoms?

25. Is there a relationship between your symptoms and your diet?

26. Is there anything else you can tell us about yourself or your symptoms that
make this a unique experience?