It might simply be this list of symptoms:
I already got an e-mail back from him.
ME/CFS Fatigue Types Questionnaire
INTRODUCTION:
There are many types of fatigue, but current medical terminology does not differentiate between them. We need to develop new terms that identify the many different types of fatigue, such as:
Energy Fatigue (feeling of heaviness and immobilization without energy to do anything for long periods of time)
Wired Fatigue (feeling of over-stimulation with extremely low energy)
Brain Fog Fatigue (mental impairment with confusion, disorientation, and inability to function in daily activities)
Post-Exertional Fatigue (feeling extreme weakness, discomfort, or sick after minimal amounts of activity)
Flu Fatigue (feeling weak with flu symptoms, such as a high temperature)
We would like to ask you several questions to allow us to better understand these different types of fatigue. But first, we would like to find out some information about you. Please do not write your name on this questionnaire so that your responses remain anonymous. All of your answers will be kept confidential.
For all of the following questions, please provide or circle only one answer.
1. What is your age now?........................................................................................... _______________
2. To which of the following race(s) do you belong?
Black, African-American........................................... 1
White.......................................................................... 2
American Indian or Alaska Native............................. 3
Asian or Pacific Islander............................................ 4
Some other race (
Please write-in below)............... 5
___________________________________________
3. Are you of Latino or Hispanic origin?
........... Yes............................................................................. 1
No.............................................................................. 2
4. Are you male or female?
........... Male........................................................................... 1
Female....................................................................... 2
5. What is your current marital status?
Married....................................................................... 1
Separated.................................................................. 2
Widowed.................................................................... 3
Divorced.................................................................... 4
Never married............................................................ 5
6. Do you have any children?
No (
Go to Question 7)............................................. 1
Yes (
How many children do you have?)............... 2
___________________________________________
7. What grade or degree have you completed in school?
Less than high school................................................ 1
Some high school...................................................... 2
High school degree or GED...................................... 3
Some college (at least one year)
or specialized training................................................ 4
Standard college degree............................................ 5
Graduate professional degree................................... 6
8. What is your current and most recent occupation?
a. Current occupation.......................................................................... _______________
b. Most recent occupation................................................................... _______________
9. Have you been diagnosed with chronic fatigue syndrome by a physician?
........... Yes............................................................................. 1
No.............................................................................. 2
10. Do you currently have chronic fatigue syndrome?
........... Yes............................................................................. 1
No.............................................................................. 2
11. Please indicate whether you are a:
Yes No
a. Student............................. 1 2
b. Homemaker..................... 1 2
c. Retired............................. 1 2
d. Disabled........................... 1 2
12. What is your current work status?
On disability (
Go to Question 13)............................ 1
Unemployed (
Go to Question 14)........................... 2
Working part-time (
Go to Question 14)................... 3
Working full-time (
Go to Question 14).................... 4
13. For what condition do you receive disability compensation?
______________________________________________________
14. Which of the following statements best describes your abilities during
the last month?
I am not able to work or do anything, and I am bedridden............................... 1
I can walk around the house, but I cannot do light housework........................ 2
I can do light housework, but I cannot work part-time..................................... 3
I can only work part-time or perform some family responsibilities.................. 4
I can work full-time but I have no energy left for anything else....................... 5
I can work full-time and perform family responsibilities but
I have no energy left for anything else............................................................. 6
I can work full-time and perform family responsibilities
without any problems with my energy.............................................................. 7
15. Do you have any thoughts or suggestions about the need to develop better terms on the different types of fatigue?
__________________________________________________________________
_________________________________________________________________
TYPES OF FATIGUE QUESTIONNAIRE
In the first column, for the symptoms that you have experienced, please list the date when the symptom first occurred, including the month and year. If you cannot remember the month, please try to write the season (winter, spring, summer, or fall)
In the second column, during the past 6 months, for the symptoms that you have experienced, please indicate how often the symptom occurred using the following choices:
N = Never (Did not occur)
S = Seldom (Once or twice, with each episode lasting no longer than a week)
O = Often (At least two or more times for at least several weeks)
U = Usually (At least 50% of the days of each month)
A = Always (Everyday)
In the third column, if you have experienced the symptom during the past 6 months, for the symptoms that you have experienced, please rate how bad or how much of a problem the symptom has been for you using a 0 to 100 scale, where 0 = no problem, 25 = minimal problem, 50 = a moderate problem, 75 = severe problem, and 100 = the most severe problem possible using the scale below:
No Problem Moderate Problem Most Severe Problem
0 10 20 30 40 50 60 70 80 90 100
Start Date
Frequency
Month
or
Season
Year
N=Never
S=Seldom
O=Often
U=Usually
A=Always
Severity 0 to 100
Symptom
Limbs feel heavy when not moving them
Do not have physical energy to do anything
Muscle weakness even after resting
Lack the energy to talk to anyone
Mind racing when exhausted
Body feels over-stimulated when very tired
Hard to sleep due to body and mind feeling tense and agitated
Very hard to relax or reduce muscle tension
Thinking is hard work and muddy
Misplace items and cannot remember things
Mentally tired after the slightest effort
When talking, much difficulty with words
Physically drained or sick after mild activity
Dead, heavy feeling that occurs quickly after starting to exercise
Minimum exercise makes you physically tired
Next day soreness or fatigue after non-strenuous, everyday activities
Flu-like symptoms such as nasal congestion, sinus pain, cough, etc.
Muscle ache or pain all over body.
Feel like have a high temperature or fever
Headaches and nausea
Overwhelming sleepiness
Dizziness
It does not quite translate in a copy/paste so I will try to download the atual chart and upload it here. Also, he sent me 2 other docs and if you want me to e-mail them to you ping me with your e-mail address.