For each question CIRCLE the number that best applies to your experience with that symptom over the past 3 months.

0 - Never or rarely – It is rare to experience this symptom.

1 - Occasionally – Once in awhile you may experience this – maybe once or twice a month.

2 - Often – You experience this 1-2 times a week, enough that it bothers you.

3 - Regularly – You are constantly aware of this as it occurs almost every day or weekly.

170. Heart pounds after retiring

171. Joint stiffness after arising

172. Breathing irregular

173. Difficulty swallowing

174. Circulation poor, sensitive to cold

176. Fatigue, eating relieves

177. Afternoon headaches

178. Failing Memory

179. Awaken after few hours sleep/difficult getting back to sleep

180. Hands and feet go to sleep easily, numbness

181. Sigh frequently, “air hunger”

182. Aware of “breathing heavily

183. High altitude discomfort

184. Need to open windows in closed room

185. Frequent yawning in afternoon

186. “Drowsy” often

187. Swollen ankles, worse at night

188. Muscle cramps, worse during exercise

189. Shortness of breath on exertion

190. Dull pain in chest or radiating into left arm, worse on exertion

191. Bruise easily, “black and blue” spots

192. Tendency to anemia

193. Perfumes, scents irritate

194. Tension under breast bone, or feeling of “tightness”, worse on exertion

195. Dizziness when getting up

196. Pain in hips or hip sockets

197. Pain in shoulders or frozen shoulders

198. Noises in head, or “ringing in ears

199. Cough, no cold

Total Score for Group 7