M.P.W.C. Organization

Medical Professionals/Persons With CFIDS

Official U.S.A. Representative of B.R.A.M.E.

M.P.W.C. Hot Links!


About M.P.W.C.

This group was formed in 1993 by Gail Dahlen and Meghan Shannon to give MPWC's an opportunity to coordinate their efforts, support each other, and make a difference for all PWC's.

MPWC keeps an updated and completely confidential registry of medical persons with CFIDS. This group includes nurses, MD's, medical technologists, physical therapists, respiratory therapists, pharmacists, psychologists, medical office personnel, and any other person who was in any way associated with a medical profession. Just as with other PWC's, some MPWC's are still able to work, some are able to work only part-time, and some are totally disabled.

MPWC participates in a variety of advocacy and awareness activities. We have successfully approached several medical magazines such as Advance/Laboratory and MT Today to do stories about CFIDS, specifically about CFIDS in the medical professions. We feel that it is extremely important that others who work in medical fields are aware of the inordinate number of MPWC's and the significant number of CFIDS "clusters" in medical settings such as hospitals, medical laboratories, and physician's offices.

Services

Below please note the questionnaire which we ask every MPWC to fill out and return as soon as possible. This information is kept strictly confidential but is essential so that we can update the MPWC Registry. At this time, there is no membership fee to join the MPWC Support Group.

We publish the Support Group's newsletter, the MPWC News, which is issued quarterly. The newsletter is edited by Lori Clovis. You can send us general correspondence, and your filled-in questionnaire, by sending postal mail to Gail Dahlen at:

Gail Dahlen
50 Cecil Avenue
Indianapolis, IN 46219

Newsletter submissions, suggestions and letters to the editor should be sent to:
Lori Clovis
P.O. Box 144
Hinsdale, NY 14743

OR

you can send anything us by e-mail at:

GailD50@aol.com

or by FAX to 1-317-899-6033


MPWC REGISTRY QUESTIONNAIRE

Print this out, fill it in, and send it to:

Gail Dahlen, R.N. 50 N. Cecil Ave. Indianapolis, IN 46219-5374

or Fax to: 1-317-899-6033 or, you can copy, paste, fill out and email to GailD50@aol.com

For membership/newsletter ($20/year), contact anitab@frontiernet.net

Note: M/PWC questionnaire is kept as confidential as possible. It is used for study purposes for the group. THANK YOU for taking the time and energy to complete this questionnaire!

M/PWC QUESTIONNAIRE


Name: _________________________________________ Date__________

Medical Title/Degree______________

AddressE-Mail Address:________________________ 

FAX#   (        )____________________________

Phone number (____) ______________ Best time of day to call ___________

Male ( ) Female ( )        Birthdate: _______________________

When did you first become ill with CFIDS/ME? _________________________

What was your age then? ___________________

In what area/unit were you working? __________________________________

When were you diagnosed with CFIDS? __________________________________

By whom were you diagnosed? _______________________________________

How many doctors have you seen for this illness? _____________________

How many doctors are you seeing now? ______________________________

What are their specialties? __________________________________________

Symptoms: List all of the symptoms you've had with CFIDS

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(If you need more room, please use the back of this questionnaire, 
or a separate sheet...)

What symptoms bothered you the most at the onset of CFIDS? ___________

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Which symptoms bother you the most now? ______________________________

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What kinds of tests have you had, 
and which were abnormal(*put a star before it)?: 
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What kinds of treatment have you had?  (* Star those most helpful)

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What kinds of medications are you taking? (* Star those most helpful)

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Are you pleased with your doctors? __________________________________

If not, why?_________________________________________________________

Did you know anyone else with CFIDS when you first got your symptoms? 

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How do you believe you got CFIDS? ___________________________________

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Do you think CFIDS is a contagious illness at some point or another?

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Do you have, or have had a pet with CFIDS/ME symptoms 
or a diagnosis of ?

______

If so, is this pet still alive?______________ 

If this pet is still alive, what symptoms does your pet have now?

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How have you learned to cope with CFIDS/ME? _________________________

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What life changes have you had to do because of CFIDS/ME? ___________

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What do your friends think of CFIDS? ________________________________

What does your family think of CFIDS? _______________________________

What do your co-workers think of CFIDS? _____________________________

Are you able to work? If so, how and in what capacity? ______________


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Are you disabled? If so, fully? _______ partially? __________

          If so, (date) did you become disabled? _____________________

Are you receiving Social Security Disability? ________________________

   If so, how long did it take for you to get it? ________________

   If you had problems, what were they?____________________________

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Are you receiving private insurance disability? ______________________

        If so, how long did it take for you to get it? __________________

    If so, where there problems in obtaining this?____________________

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Are you a member of a local support group? _____________

    If so, which one? ________________________________________________

Are you a member of a national support group?_________

    If so, which one?_____________________________________________

Did you have any type of vaccination/immunization before or during 
your initial symptoms of CFIDS? If yes, which one(s)

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What do you think of the official name of this illness, 
"Chronic Fatigue Syndrome?"

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Is there another name you prefer? Why? _______________________________

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Have you filed for or tried to get Workman's Compensation?  
If so, explain:

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Have you participated in International May 12th CFIDS/ME Awareness Day?

 _______

   If so, how?:________________________________________________________

   Do you write your Congresspersons?____Call them?____E-mail them?___

If not, why not?_____________________________________________________

*Would you like the name and address of another 
Medical Professional/Person with CFIDS/ME?

______________________

If so, are you willing to give out your address for a M/PWC "buddy?"

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Any comments you might have about anything 
(you may need to use the back or another sheet):