End Trigeminal Neuralgia

This is a survey to collect information from members of the End Trigeminal Neuralgia page. You can skip over any questions you do not want to answer. If you are not the TN sufferer (such as a caregiver, family member or friend) you can answer about that person's perspective as best as you can)
View results without submitting



         

       

Name (optional): 


  1. Where do you currently reside? (please include city/state, country)


  1. I am...
    male
    female


  1. What kind of doctor or medical professional first diagnosed you?


  1. What different kinds of doctors, therapists or other medical professionals have you ever seen regarding your TN.


  1. What medications, if any, do you currently take for TM?


  1. List all medications or procedures (including surgeries) you have ever taken for TN.


  1. List any homeopathic treatments/medications/therapies or supplements you have tried for TN (include things like "heating pad")


  1. Of all prescription medications, otc meds, surgeries, supplements, etc, what has been most helpful?


  1. Choose any of the following that are true for you:
    I suffer TN only on one side of my face
    I suffer TN on both sides
    I suffer with TN pain for months on end
    My TN flare up for a week or two and then I can go months before another flare up.
    I experience TN pain in areas other than my mouth
    I have had to miss work due to TN pain
    Before my diagnosis I had unnecessary dental procedures
    I feel the important people in my life are sympathetic to my pain
    I have suffered depression due to TN
    I miss out on many opportunities due to TN
    I am often unable to excercise due to TN
    I am often unable to eat due to TN
    I feel TN affects my self esteem
    TN sometimes makes it difficult to speak
    I feel TN has affected my friendships.


  1. Choose all of the following that describe the pain associated with your TN:
    dull ache
    sharp, shooting pain
    comes and goes
    consistant
    burning
    like an electric shock
    worse in morning
    worse at night
    worse in the night, when trying to sleeps
    greatly disturbs my sleep
    is sore to the touch
    deters chewing on side of mouth with pain
    accompanies swelling
    local fever, warm to touch
    sensitive to cold
    sensitive to heat
    improves with cold foods
    improves with heat
    worst pain ever experienced


  1. Do you have an auto-immune disease?
    Yes
    No


  1. If you have an auto immune disease, please write the name here:


  1. Please check all that you personally have or had:
    asthma
    bronchitis
    pneumonia
    scarlet fever
    chromosomal abnormality
    reflux
    diabetes type 1
    diabetes type 2
    cancer
    heart disease
    high blood pressure
    high cholesterol
    food allergies/ intolerence
    broken bones
    migraines
    sinusitis
    rheumetoid arthritis
    degenerative arthritis
    osteoarthritis
    lupus
    multiple sclerosis
    parkinson's disease
    alzheimers
    osteoporosis
    osteopenia
    tmj (temporomandibular joint)
    irritable bowel syndrome
    crohn's disease
    costochondritis
    mitral valve prolapse
    restless leg syndrome
    tinnitis (ringing ears)
    tremors
    strep throat
    hemorrhoids
    depression
    bipolar disorder
    ocd
    personality disorder
    anxiety
    agoraphobia
    other


  1. Write the first three words you think of to describe TN


  1. What is your current occupation?


  1. What is your current age?


  1. At what age were you first diagnosed with Trigeminal Neuralgia?


  1. Approximately how many years have you been suffering from Trigeminal Neuralgia?


  1. On average, how many days per year are you effected by TN?


  1. After your first TN experience, what is the longest amount of time you have gone in between flare ups?


  1. During your worst flare ups, what have you done in desperation? (For example, in order to not wake everyone else up by screaming the other night, I did silent screaming while running back and forth at top speed in the bathroom)


  1. Had you ever heard of Trigeminal Neuralgia before you were diagnosed?


  1. In the previous prior question regarding other illnesses, if any thing was not listed please write it here...


  1. When suffering the most, do you have anyone helping you? If yes, who? (parent, child, spouse,...)


  1. Think of the three most physically painful experiences in your life. Start with the very worst and label it 1.) , then write the second and third the same way.





PROFE
Profe Finaldi
Plainfield East High School
Plainfield, IL