87 - Health Tools - Medbroadcast

Having a personalized treatment plan can help you and your doctor develop a targeted approach to treatment that helps you live life on your own terms.

Building your treatment plan is easy! Just follow the steps below, then print off your plan to bring it to your doctor's visit.

Let's get started! Click here.

Step 3 of 3: How I'm Doing

Here is a list of your symptoms of Crohn's disease. Take some time and rate how each symptom is doing.

Symptoms	How are your symptoms doing?
Abdominal tenderness or swelling	(not well)	1	2	3	4	5	6	7	8	9	10	(very well)
Diarrhea	(not well)	1	2	3	4	5	6	7	8	9	10	(very well)
Weight loss	(not well)	1	2	3	4	5	6	7	8	9	10	(very well)
Loss of appetite	(not well)	1	2	3	4	5	6	7	8	9	10	(very well)
Stomach cramps	(not well)	1	2	3	4	5	6	7	8	9	10	(very well)
Fatigue	(not well)	1	2	3	4	5	6	7	8	9	10	(very well)
Blood in your stool	(not well)	1	2	3	4	5	6	7	8	9	10	(very well)
	(not well)	1	2	3	4	5	6	7	8	9	10	(very well)

Here is a list of some daily living activities that may be affected by your Crohn's disease. Take some time and rate your ability to handle each of these activities.

Daily living activities	Rate your ability to perform daily living activities
Work	(not well)	1	2	3	4	5	6	7	8	9	10	(very well)
School	(not well)	1	2	3	4	5	6	7	8	9	10	(very well)
Housework	(not well)	1	2	3	4	5	6	7	8	9	10	(very well)
Eating	(not well)	1	2	3	4	5	6	7	8	9	10	(very well)
Exercise	(not well)	1	2	3	4	5	6	7	8	9	10	(very well)
Relaxing/socializing	(not well)	1	2	3	4	5	6	7	8	9	10	(very well)

The contents of this site are for informational purposes only and are meant to be discussed with your physician or other qualified health care professional before being acted on. Never disregard any advice given to you by your doctor or other qualified health care professional. Always seek the advice of a physician or other licensed health care professional regarding any questions you have about your medical condition(s) and treatment(s). This site is not a substitute for medical advice.
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Step 1 of 3: My Profile

Step 2 of 3: My Crohn's Disease

Step 3 of 3: How I'm Doing

Name:
Telephone:

Gastroenterologist:
Telephone:

Family physician:
Telephone:

Other (e.g., dietitian/nutritionist):
Telephone: