When the sick rule the world
"Have you often had to lower the regular dose of prescription or over-the-counter medication or herbal supplements because you were too sensitive to normal doses do you avoid caffeine in the afternoon or altogether because it can keep you up at night have you ever experienced adverse reactions to medications if so what happened do you smell odors when others can't what kinds of odors do you have a sudden onset of symptoms headaches skin rashes nausea shortness of breath etc. on exposure to chemicals mold dust pollens or other environmental allergens what symptoms please list all the chemicals you get a reaction to when do you last remember feeling really great describe your residence when your illness began type age carpets heat source paint proximity to industry etc. describe your work environment when your illness began type of building ventilation toxic exposure neighboring businesses etc. have you ever had to change your residence or job due to health reasons have you ever had a known chemical injury or major exposure have you ever been exposed to chemicals or toxic metals in the course of work of schooling when how long name them have you ever worked where adjacent businesses regularly used chemicals or toxic metals when how long name them have you ever worked in a building where the windows were always closed when how long have you ever worked where you or your co-workers complained about the air quality or smells in the workplace or were injured in any way when how long have you ever heard about any air quality incidents in your place of work when describe what you heard have you ever lived near any heavy industries that regularly emitted waste into the air or water i.e. golf course dry cleaner plant shipyard mine chemical factory dumpsite or landfill what type of pollution when how long have you ever lived in a house built before 1978 how long were you there have you ever lived on or adjacent to an agricultural area what kind of area was it when how long have you ever lived in a home where mold was a problem when how long have you ever lived in a home with a water leak or water damage when how long have you ever lived in a mobile home when how long have you ever lived in a home where turning on the central air or heat caused you or family members to feel sick when how long have you ever felt there were conditions in your home that affected your health use of aerosol sprays chemicals cleaners construction painting etc. when how long are pesticides or herbicides used inside or outside our home have you ever lived near a busy highway street or gas station when how long when were your air ducts last cleaned when were your air filters last changed is your stove gas or electric is your furnace gas or electric water heater gas or electric do you wear dry cleaned clothing if yes how frequently and in which room are they stored are there animals in your home do you have air purifiers or water filters in your home do you heat food in a microwave do you have candles in your home do you regularly get hair coloring permanents or visit a beauty salon have you ever had acrylic fingernails or been to a beauty shop where acrylic nails are done if so when have you ever used scented soaps detergents potpourri perfumes etc. do you still have you ever used fabric softener do you still have you ever used recreational drugs if so when and what compounds have you ever lived with animals that received treatment for fleas or ticks if so when have you ever lived in a home with new carpet new furniture and new construction if so when have you ever lived on or near a golf course or other areas where heavy pesticides and herbicides are used regularly if so when have you ever regularly worked with chemicals in any hobby i.e. solvents paints stains cleaners etc. if so when have you ever had silver fillings put in your teeth if so when do you still have silver fillings in your mouth if yes how many and how long have they been in your mouth have you ever had root canals implants or bridgework done on your teeth if so when have you ever had any implants stainless steel Teflon silicone etc. put into your body if so when and what kind of implants have you ever been given vaccinations if so when have you ever had reactions to any vaccinations have you ever smoked if so for how long have you ever lived with others that smoked if so for how long and how old were you how often do you eat fish what types of fish do you eat? ..."