Are Your MS Treatments Working?

Editor
Question 1 of 10

Do you have muscle stiffness in your legs that affects your ability to walk?

AA little bit, but it has been stable or improving.
BNot at all.
CI am unable to walk and confined to a wheelchair.
DYes, I need a walker or cane for assistance.
AA little bit, but it has been stable or improving.
BNot at all.
CI am unable to walk and confined to a wheelchair.
DYes, I need a walker or cane for assistance.
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Question 2 of 10

Do you have loss of sensation or weakness in your legs that causes you to fall?

AI occasionally have falls.
BI frequently have falls and have injured myself.
CNot at all.
DI am unsteady and afraid of falling, but have not fallen.
AI occasionally have falls.
BI frequently have falls and have injured myself.
CNot at all.
DI am unsteady and afraid of falling, but have not fallen.
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Question 3 of 10

Do you have urinary incontinence or frequent urinary tract infections?

ANo
BI occasionally have urinary tract infections
CI have occasional accidents and frequent urinary tract infections
DI have little to no control of my urine.
ANo
BI occasionally have urinary tract infections
CI have occasional accidents and frequent urinary tract infections
DI have little to no control of my urine.
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Question 4 of 10

Do you have painful muscle spasms?

ANo
BOccasionally, but they are manageable.
CFrequently, requiring multiple pain medications for control.
DYes, uncontrolled even with multiple medications.
ANo
BOccasionally, but they are manageable.
CFrequently, requiring multiple pain medications for control.
DYes, uncontrolled even with multiple medications.
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Question 5 of 10

Have you been hospitalized for an exacerbation of MS?

ANo
BNot in the past two years.
COnce or twice in the past two years.
DSeveral times in the past year.
ANo
BNot in the past two years.
COnce or twice in the past two years.
DSeveral times in the past year.
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Question 6 of 10

Do you have side effects from your current MS medication?

AMild side effects, which are tolerable.
BSide effects which occasionally limit my ability to function.
CSevere side effects, which make it difficult to take my medication properly.
DNo
AMild side effects, which are tolerable.
BSide effects which occasionally limit my ability to function.
CSevere side effects, which make it difficult to take my medication properly.
DNo
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Question 7 of 10

Do you feel depressed or sad?

ANo
BOnce in a while.
COften
DNearly constant, such that it is difficult to function.
ANo
BOnce in a while.
COften
DNearly constant, such that it is difficult to function.
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Question 8 of 10

Do you feel like you have no energy?

ANot usually
BOnce in a while
COften
DNearly constant, such that it is difficult to function.
ANot usually
BOnce in a while
COften
DNearly constant, such that it is difficult to function.
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Question 9 of 10

Do you laugh or cry for no reason?

ANo
BRarely
COccasionally
DFrequently
ANo
BRarely
COccasionally
DFrequently
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Question 10 of 10

Do people have trouble understanding your speech?

ANo
BOccasionally
COnce in a while, but not enough to interfere with my work
DQuite a bit, such that I avoid talking to people
ANo
BOccasionally
COnce in a while, but not enough to interfere with my work
DQuite a bit, such that I avoid talking to people
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Complete all questions to see your results