MSEC 4 – Three months into study

Welcome to the Myasthenia Gravis Symptom Evaluation Checklist (or MSEC).

Currently this is only available to study participants.
This is your 4th MSEC. You have now completed three months of the study.

Please choose the option that best describes your current symptoms. Be as honest as possible.

In terms of the word “daily” that means if you were to do this activity daily, would you have symptoms?  For example: Some MG patients are not physically able to shower daily. But every time they shower, their symptoms are severe. That person would choose “Daily – severe” because if they were able to perform the activity daily, their symptoms would be severe.

If you have any questions, don’t hesitate to ask.

This form is for informational purposes only and is not intended to diagnose or treat any patient.

SECTION I: SYMPTOMS

SECTION II: ADDITIONAL INFORMATION

If you have questions about how to do a Single Breath Count, or haven’t had a reminder on how to do one recently, please view this short demonstration given by Alice White-Kaminski.

For the next 3 questions, please ONLY list any changes you have made. (For example, if you begin to need less medication.) If you have not made any changes, please answer “no changes”.

SECTION III: ACCOMMODATIONS/ASSISTIVE DEVICES

For the following questions please choose the option that best represents your frequency of use/need.

For example:  You may not go out everyday. But if you did, would you need to use your handicapped parking pass every time? If so, choose Daily.

SECTION IV: ADDITIONAL FOLLOW-UP INFORMATION

Thank you so much for your time and participation in this study.