Explain briefly what caused your RSD - surgery, broken bone, injection etc.

Your age when injury etc occurred.

Are you Male or Female?

DOCTORS

Explain your experience with General Practice doctors whilst you were trying to find out what was wrong.

How did your GP doctor initially react to your pain when you first mentioned it?

Did he/she ever suggest it might be RSD?

Did you have to see more than one doctor to get any help?

How long after the onset of your condition did it take your doctor to start looking at the possibility of RSD?

How long did it take to get diagnosed?

Who diagnosed your RSD? Doctors name, location and what type of doctor.

How many doctors have you seen before finding a knowledgeable RSD doctor?

What specific tests have you had to confirm RSD or how was it diagnosed?

RSD INFORMATION

Did you get information about RSD when you were diagnosed?

Who gave you your first explanation?

How accurate and in-depth was that information compared to what you have learned since?

Where did you find the best source of RSD information?

RSD PAIN

What would you compare the intensity of your RSD pain to?

How would you best describe your pain?

Is your pain always the same or does it change?

Do you have more than one type of pain at the same time?

RSD MEDICATION

What medication are you taking for the pain? Please try to be exact and

state the amount you take, the name of the medication and how often you take it.

Have you taken other medication and since stopped?

What was it and why did you stop taking it?

Does your medication get rid of all of the pain?

With this pain, are you able to function in daily life in the *exact* same way you did before?

When reading, or watching TV, in conversation, instances that require some

form of attention or focus:

Are you able to concentrate well, despite the pain.

Or do you have trouble keeping concentrated because of the pain.

Do you need to rest during the day?

Please use one of the following.

A. Nearly all the time (you barely function)

B. Frequently (3 times or more a day)

C. Sometimes (approximately once a day)

D. Never (you have the same energy level)

What do you do to help relieve your pain in a way unrelated to any form of

pain medication or treatment. This is an important question that might help

others. Is there anything you do on top of everything else to alleviate your

pain?

What makes your pain worse?

RSD CONSEQUENCES

Where is your RSD pain located?

What effect does this have on your body? Please include everything you have

experienced/noticed even though your doctor may have given other explanations

for these symptoms rather than RSD.

What effect does RSD have on your life?

Related to RSD what's your biggest concern for the future?

What would you like to say to new patients?

What would you like to say to doctors?

What best describes your attitude towards RSD?

RSD TREATMENT

How long have you had RSD?

Were you given treatment options?

How many months after onset of RSD were you first treated?

Are you constantly taking medication? (each day)

If you've had TENS or if you've had a Spinal Cord Stimulator implanted or

anything else, please also mention it. Mention anything doctors gave you to help you get

rid of your pain. This can include alternative medical treatment.

How many times have you undergone procedures and other forms of treatment,

besides taking medication? Physical therapy, blocks, I.V. treatment with a

certain product, etc.

Are you better or worse since you started treatment? Long-term - not shortly after treatment.

How long did it take to make you better or worse?

Has your condition spread from the original site?

Did anything happen which may have made it spread?

RSD AWARENESS

What do we need?

How can we promote RSD awareness?

RSD HELP

Is it easy to get help (financially, medically, socially or on any other level you may think of) for your RSD?

If you answered no. Please tell us about the difficulties you have encountered in this area.

FOR YOUR FAMILY MEMBERS AND/OR CARER.

Is it easy to help or stand by an RSD patient?

What makes your life hard?

What else is difficult for you, that we haven't mentioned.

Is there anything else that we forgot to include?

When completed return to me at loribyn@corplink.com.au or loribyn2@hotmail. com

Many thanks for your help

Baker & Robyn