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The Survey That Ate Manhattan Discussion of the giant demographic poll being created for Guild research purposes.

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Old 01-02-2009, 08:12 PM   #11
Redregon
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1: do you have or have you had any of the following :

[ ]Asthma
[x]Arthritis (Very mild)
[ ]Epilepsy
[ ]Diabetes
[x]Heart Conditions
[ ]Heart Disease
[ ]Kidney disorders
[ ]Chronic Fatigue Syndrome
[ ]Anemia
[x]High Blood Pressure
[x]High Cholesterol
[ ]Cancer
[ ]Autoimmune disorders
[ ]STD's
[ ]Osteoporosis
[ ]Stroke
[ ]Vision problems (not counting glasses)
[x]Wear glasses
[ ]Auditory problems
[x]Dental problems (including need for braces)
[ ]Hydrocephalus
[ ]Cerebral Palsy
[ ]Spina Bifida
[ ]Other birth defects
[ ]Anything else you think should be listed

(further information on any check marks)

2: Do you have a family history of any of the following:

[ ]SIDS
[ ]Asthma
[x]Arthritis
[ ]Epilepsy
[x]Diabetes
[x]Heart Conditions
[x]Heart Disease
[x]Kidney disorders
[ ]Chronic Fatigue Syndrome
[ ]Anemia
[x]High Blood Pressure
[ ]High Cholesterol
[x]Cancer
[ ]Autoimmune disorders
[ ]STD's
[ ]Osteoporosis
[x]Stroke
[x]Vision problems (Not counting glasses) {do lazy eyes count?}
[x]Wear glasses
[ ]Auditory problems
[x]Dental problems (including need for braces)
[ ]Hydrocephalus
[ ]Cerebral Palsy
[ ]Spina Bifida
[ ]Other birth defects
[ ]Anything else you think should be listed

(list family relation of any with checkmark, and further information)


3: Do you have any of the following:

[x]Mental illness {Does a stress induced nervous breakdown count? lasted a couple months.}
[x]Depression {mild, but it comes and goes sometimes... maybe SAD}
[ ]Learning disabilities
[ ]Mental Retardation
[ ]Autism Spectrum Disorders (including Aspergers syndrome)
[x]Alcoholism or other substance abuse {i would count cigarettes}
[ ]Any other addictions
[ ]Exceptionally intelligent

Anything else you want us to know about

4: Do you have a family history of:

[x]Mental illness
[x]Depression
[x]Learning disabilities
[ ]Mental Retardation
[ ]Autism Spectrum Disorders (including Aspergers syndrome)
[x]Alcoholism or other substance abuse
[ ]Any other addictions
[ ]Exceptionally intelligent

Anything else you want us to know about

5: Do you smoke? Yes
How much per day: about a half pack on average.

6: DO you drink? VERY rarely

How much per week (more like how much per year.)

7: Do you use any other recreational drugs? Yes

which and how much: MJ, no chemicals will i touch... i trust mom-nature over some slimeball HS dropout in the garage

8: Are you on any long term medications? Yes
which? Atacand (Blood pressure)

9: How often and what kind of over the counter medications? Tylenol occaisionally... sometimes cold medication if it's a nasty cold.

10:How much caffeine?
(per day)
used to be 2-3 pots, now about 4-5 cups

11: DO you drink energy drinks? HELL no... they're incredibly bad enough for you when you're healthy... with high BP, that's like playing russian roulette imo.

12: Qualify your diet (poor, ok, good, excellent)
could certainly use a better diet but i've been able to reduce the amount of pre-made crap.

13: How many times a week to you work out?
... short walks here and there daily... no more than 30 minutes per day though (not strenuous enough to consider healthful imo.)

14: How active are you?
not all that active, though i do have my moments where i'm more active and energetic (physically.)

15: Generally, how healthy are you?
not bad, but certainly could be doing better.

16: Have you ever broken, sprained, strained or torn any bones/muscles/ligaments/tendons
no.

17: Have you ever needed stitches?
yes

18: Any significant early childhood trauma, emotional or physical?
well, details are hazy, but i apparently had a tumble when i was young enough and i think i may have had a concussion (i was 3-4)

19a females:
age of menarche (age of first period)
Do you have a regular cycle
Have you ever been pregnant
Number of
Abortions
miscarriages
stillbirths
vaginal live births
C sections
Age of menopause (if appropriate)
Age you became sexually active

19b males:

Age of puberty onset: about 12-13
Erectile dysfunctions: none natural (side effect of medication occaisionally.)
Age you became sexually active: first time, 12... (don't ask.)
normal sperm count (if known) unknown, but i'm sure it's low given that i smoke cannabis occaisionally and tobacco.
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Old 01-03-2009, 02:29 AM   #12
Phoenix
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WPS

1: do you have or have you had any of the following :

[ ]Asthma
[ ]Arthritis
[ ]Epilepsy
[ ]Diabetes
[ ]Heart Conditions
[ ]Heart Disease
[ ]Kidney disorders
[ ]Chronic Fatigue Syndrome
[ ]Anemia
[ ]High Blood Pressure
[ ]High Cholesterol
[ ]Cancer
[ ]Autoimmune disorders
[ ]STD's
[ ]Osteoporosis
[ ]Stroke
[X]Vision problems (not counting glasses)
[ ]Wear glasses
[ ]Auditory problems
[ ]Dental problems (including need for braces)
[ ]Hydrocephalus
[ ]Cerebral Palsy
[ ]Spina Bifida
[ ]Other birth defects
[ ]Anything else you think should be listed

(further information on any check marks)

2: Do you have a family history of any of the following: N/A

[ ]SIDS
[ ]Asthma
[ ]Arthritis
[ ]Epilepsy
[ ]Diabetes
[ ]Heart Conditions
[ ]Heart Disease
[ ]Kidney disorders
[ ]Chronic Fatigue Syndrome
[ ]Anemia
[ ]High Blood Pressure
[ ]High Cholesterol
[ ]Cancer
[ ]Autoimmune disorders
[ ]STD's
[ ]Osteoporosis
[ ]Stroke
[ ]Vision problems (Not counting glasses)
[ ]Wear glasses
[ ]Auditory problems
[ ]Dental problems (including need for braces)
[ ]Hydrocephalus
[ ]Cerebral Palsy
[ ]Spina Bifida
[ ]Other birth defects
[ ]Anything else you think should be listed

(list family relation of any with checkmark, and further information)


3: Do you have any of the following:

[ ]Mental illness
[X]Depression
[ ]Learning disabilities
[ ]Mental Retardation
[ ]Autism Spectrum Disorders (including Aspergers syndrome)
[ ]Alcoholism or other substance abuse
[ ]Any other addictions
[ ]Exceptionally intelligent

Anything else you want us to know about

4: Do you have a family history of: N/A

[ ]Mental illness
[ ]Depression
[ ]Learning disabilities
[ ]Mental Retardation
[ ]Autism Spectrum Disorders (including Aspergers syndrome)
[ ]Alcoholism or other substance abuse
[ ]Any other addictions
[ ]Exceptionally intelligent

Anything else you want us to know about

5: Do you smoke? N/A
How much per day

6: DO you drink? N/A

How much per week

7: Do you use any other recreational drugs? N/A

which and how much

8: Are you on any long term medications? N/A
which?

9: How often and what kind of over the counter medications? N/A

10:How much caffeine? about two to three cans of soda worth
(per day)

11: DO you drink energy drinks? No

12: Qualify your diet (poor, ok, good, excellent) ok

13: How many times a week to you work out? None

14: How active are you? OK

15: Generally, how healthy are you? Average

16: Have you ever broken, sprained, strained or torn any bones/muscles/ligaments/tendons. Yes

17: Have you ever needed stitches?

18: Any significant early childhood trauma, emotional or physical?

19a females:
age of menarche (age of first period)
Do you have a regular cycle
Have you ever been pregnant
Number of
Abortions
miscarriages
stillbirths
vaginal live births
C sections
Age of menopause (if appropriate)
Age you became sexually active

19b males:

Age of puberty onset
Erectile dysfunctions
Age you became sexually active
normal sperm count (if known)[/QUOTE]
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Old 01-03-2009, 08:50 AM   #13
sindan
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Location: Raleigh, NC
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1: do you have or have you had any of the following :

[ ]Asthma
[ ]Arthritis
[ ]Epilepsy
[ ]Diabetes
[ ]Heart Conditions
[ ]Heart Disease
[ ]Kidney disorders
[ ]Chronic Fatigue Syndrome
[ ]Anemia
[ ]High Blood Pressure
[ ]High Cholesterol
[ ]Cancer
[ ]Autoimmune disorders
[ ]STD's
[ ]Osteoporosis
[ ]Stroke
[ ]Vision problems (not counting glasses)
[ ]Wear glasses
[ ]Auditory problems
[ ]Dental problems (including need for braces)
[ ]Hydrocephalus
[ ]Cerebral Palsy
[ ]Spina Bifida
[ ]Other birth defects
[ ]Anything else you think should be listed

(further information on any check marks)

2: Do you have a family history of any of the following:

[ ]SIDS
[ ]Asthma
[ ]Arthritis
[ ]Epilepsy
[ ]Diabetes
[ ]Heart Conditions
[ x]Heart Disease
[ ]Kidney disorders
[ ]Chronic Fatigue Syndrome
[ ]Anemia
[ ]High Blood Pressure
[ ]High Cholesterol
[ x]Cancer
[ ]Autoimmune disorders
[ ]STD's
[ ]Osteoporosis
[ ]Stroke
[ x]Vision problems (Not counting glasses)
[ x]Wear glasses
[ ]Auditory problems
[ ]Dental problems (including need for braces)
[ ]Hydrocephalus
[ ]Cerebral Palsy
[ ]Spina Bifida
[ ]Other birth defects
[ ]Anything else you think should be listed

(list family relation of any with checkmark, and further information)


3: Do you have any of the following:

[ ]Mental illness
[ ]Depression
[ ]Learning disabilities
[ ]Mental Retardation
[ ]Autism Spectrum Disorders (including Aspergers syndrome)
[ ]Alcoholism or other substance abuse
[ ]Any other addictions
[ ]Exceptionally intelligent

Anything else you want us to know about

4: Do you have a family history of:

[ ]Mental illness
[ ]Depression
[ ]Learning disabilities
[ x]Mental Retardation (aunt)
[ ]Autism Spectrum Disorders (including Aspergers syndrome)
[ x]Alcoholism or other substance abuse
[ ]Any other addictions
[ ]Exceptionally intelligent

Anything else you want us to know about

5: Do you smoke?
How much per day
none
6: DO you drink?
yes (2-4 times a week about 4-7 beers)
How much per week

7: Do you use any other recreational drugs? none

which and how much

8: Are you on any long term medications?
which? adderall (sp)

9: How often and what kind of over the counter medications?

10:How much caffeine?
(per day)
about a soda or two
11: DO you drink energy drinks?
occasionally (when i study)
12: Qualify your diet (poor, ok, good, excellent)
excellent
13: How many times a week to you work out?
4-5
14: How active are you?
very
15: Generally, how healthy are you?
very
16: Have you ever broken, sprained, strained or torn any bones/muscles/ligaments/tendons
yes (broken about every finger and toe and my left arm 3 times) yay wrestling
17: Have you ever needed stitches?
yes
18: Any significant early childhood trauma, emotional or physical?
nope


19b males:

Age of puberty onset 15
Erectile dysfunctions none
Age you became sexually active. 1st time 18
normal sperm count (if known) *shrug*
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Old 02-24-2009, 09:57 PM   #14
Echo
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Location: Raymond, MS
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1: do you have or have you had any of the following :

[ ]Asthma
[ ]Arthritis
[ ]Epilepsy
[ ]Diabetes
[ ]Heart Conditions
[ ]Heart Disease
[ ]Kidney disorders
[ ]Chronic Fatigue Syndrome
[ ]Anemia
[ ]High Blood Pressure
[ ]High Cholesterol
[ ]Cancer
[ ]Autoimmune disorders
[ ]STD's
[ ]Osteoporosis
[ ]Stroke
[ ]Vision problems (not counting glasses)
[x]Wear glasses
[ ]Auditory problems
[x]Dental problems (including need for braces)
[ ]Hydrocephalus
[ ]Cerebral Palsy
[ ]Spina Bifida
[ ]Other birth defects
[ ]Anything else you think should be listed

(further information on any check marks)

2: Do you have a family history of any of the following:

[ ]SIDS
[ ]Asthma
[ ]Arthritis
[ ]Epilepsy
[ ]Diabetes
[x]Heart Conditions
[ ]Heart Disease
[ ]Kidney disorders
[ ]Chronic Fatigue Syndrome
[ ]Anemia
[ ]High Blood Pressure
[x]High Cholesterol
[x]Cancer
[ ]Autoimmune disorders
[ ]STD's
[ ]Osteoporosis
[ ]Stroke
[ ]Vision problems (Not counting glasses)
[x]Wear glasses
[ ]Auditory problems
[ ]Dental problems (including need for braces)
[ ]Hydrocephalus
[ ]Cerebral Palsy
[ ]Spina Bifida
[ ]Other birth defects
[x]Anything else you think should be listed

(list family relation of any with checkmark, and further information)
My dad's side of my family has a lot of problems with heart things, high cholesterol, and cancer. My grandfather on my dad's side was schizophrenic.

3: Do you have any of the following:

[ ]Mental illness
[x]Depression
[ ]Learning disabilities
[ ]Mental Retardation
[ ]Autism Spectrum Disorders (including Aspergers syndrome)
[ ]Alcoholism or other substance abuse
[ ]Any other addictions
[x]Exceptionally intelligent

Anything else you want us to know about: I may have DID, but it hasn't been officially diagnosed.

4: Do you have a family history of:

[ ]Mental illness
[]Depression
[ ]Learning disabilities
[ ]Mental Retardation
[ ]Autism Spectrum Disorders (including Aspergers syndrome)
[x]Alcoholism or other substance abuse
[ ]Any other addictions
[ ]Exceptionally intelligent

Anything else you want us to know about

5: Do you smoke?Nope.
How much per day

6: DO you drink?Nope.

How much per week

7: Do you use any other recreational drugs?Nope.

which and how much

8: Are you on any long term medications?Yep.
which?Strattera 60mg daily

9: How often and what kind of over the counter medications?I avoid using medication of any kind unless absolutely necessary(migranes, etc.)

10:How much caffeine? I drink a lot of soda, especially root beer. I also have starbucks every morning.
(per day)

11: DO you drink energy drinks?Nope. They taste like shit and shut down all psionic ability.

12: Qualify your diet (poor, ok, good, excellent)Ok

13: How many times a week to you work out?0-2(Not nearly as much as I should)

14: How active are you?Not nearly as active as I should be.

15: Generally, how healthy are you?Decent/Good

16: Have you ever broken, sprained, strained or torn any bones/muscles/ligaments/tendons? No.

17: Have you ever needed stitches?Yes(severe laceration from glass door)

18: Any significant early childhood trauma, emotional or physical?I moved to a new house, new school, new everything when I was 12. It was such hell for a year and a half(complete social pariah) that I think that's what triggered my psionic development.

19a females:
age of menarche (age of first period)
Do you have a regular cycle
Have you ever been pregnant
Number of
Abortions
miscarriages
stillbirths
vaginal live births
C sections
Age of menopause (if appropriate)
Age you became sexually active

19b males:

Age of puberty onset 12ish
Erectile dysfunctions None
Age you became sexually active Hand(12ish), actual sex(17)
normal sperm count (if known) I'm guessing a bunch.
__________________
[09:15]<Solet>zhala: resell value
[09:15]<Solet>also... they are durrable as hell
[09:15]<zhala>ahh, well. yeah
[09:15]<Echo>Durable even
[09:16]<Solet>oh god
[09:16]<Solet>even echo's correcting me today
[09:16]<Solet>i'm going back to bed
[09:16]<Echo>lol
[09:16]<Solet>see you guys monday
[09:16]<Echo>LOL

Last edited by Echo; 02-24-2009 at 10:56 PM.
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Old 02-28-2009, 06:07 AM   #15
Eternal_Rose
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Location: a small town in a place far, far away...
Posts: 38
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1: do you have or have you had any of the following :

[ ]Asthma
[ ]Arthritis
[ ]Epilepsy
[ ]Diabetes
[ ]Heart Conditions
[ ]Heart Disease
[ ]Kidney disorders
[ ]Chronic Fatigue Syndrome
[ ]Anemia
[ ]High Blood Pressure
[ ]High Cholesterol
[ ]Cancer
[ ]Autoimmune disorders
[ ]STD's
[ ]Osteoporosis
[ ]Stroke
[ ]Vision problems (not counting glasses)
[x]Wear glasses and the weird thing is, one eye is very nearsighted, and the other is very farsighted...
[x]Auditory problems when I was little (like 3-5 years) I often had ear infections. Now, the problem is that my hearing is too good (if it's quiet, I can hear the footsteps of a small cat on carpet) but my ears often hurt because they are so sensitive.
[x]Dental problems (including need for braces) my teeth grew extremely slowly...I'm 13 and still losing teeth, because they grew in on the outside instead of on the inside, so the baby teeth weren't pushed out properly.
[ ]Hydrocephalus
[ ]Cerebral Palsy
[ ]Spina Bifida
[ ]Other birth defects
[x]Anything else you think should be listed I tend to have knee and ankle problems

(further information on any check marks)

2: Do you have a family history of any of the following:

[ ]SIDS
[ ]Asthma
[ ]Arthritis
[ ]Epilepsy
[ ]Diabetes
[x]Heart Conditions my grandpa
[not sure]Heart Disease
[ ]Kidney disorders
[ ]Chronic Fatigue Syndrome
[ ]Anemia
[ ]High Blood Pressure
[ ]High Cholesterol
[ ]Cancer
[ ]Autoimmune disorders
[ ]STD's
[ ]Osteoporosis
[ ]Stroke
[ ]Vision problems (Not counting glasses)
[x]Wear glassesmost of my family
[ ]Auditory problems
[ ]Dental problems (including need for braces)
[ ]Hydrocephalus
[ ]Cerebral Palsy
[ ]Spina Bifida
[ ]Other birth defects
[ ]Anything else you think should be listed

(list family relation of any with checkmark, and further information)


3: Do you have any of the following:

[ ]Mental illness
[ ]Depression
[ ]Learning disabilities
[ ]Mental Retardation
[ ]Autism Spectrum Disorders (including Aspergers syndrome)
[ ]Alcoholism or other substance abuse
[ ]Any other addictions
[x]Exceptionally intelligent

Anything else you want us to know about

4: Do you have a family history of:

[ ]Mental illness
[ ]Depression
[ ]Learning disabilities
[ ]Mental Retardation
[ ]Autism Spectrum Disorders (including Aspergers syndrome)
[x]Alcoholism or other substance abuse my dad
[x]Any other addictions again, my dad (he smoked)
[x]Exceptionally intelligent eh, a few random relatives

Anything else you want us to know about

5: Do you smoke? no
How much per day

6: DO you drink?no

How much per week

7: Do you use any other recreational drugs? NO

which and how much

8: Are you on any long term medications? no
which?

9: How often and what kind of over the counter medications? no

10:How much caffeine? none
(per day)

11: DO you drink energy drinks? no

12: Qualify your diet (poor, ok, good, excellent) okay/good, most of what i eat is fruit

13: How many times a week to you work out? 2

14: How active are you? not a lot...

15: Generally, how healthy are you? pretty good/ok

16: Have you ever broken, sprained, strained or torn any bones/muscles/ligaments/tendons yes, i broke my arm when i was 4

17: Have you ever needed stitches? no

18: Any significant early childhood trauma, emotional or physical? nothing life-changing

19a females:
age of menarche (age of first period) 11
Do you have a regular cycle most of the time
Have you ever been pregnant no
Number of everything n/a
Abortions
miscarriages
stillbirths
vaginal live births
C sections
Age of menopause (if appropriate)
Age you became sexually active n/a

19b males:

Age of puberty onset
Erectile dysfunctions
Age you became sexually active
normal sperm count (if known)
__________________
"I am like a rose, and will always be like a rose. Most people only see the fragile petals, and underestimate me. Some only see the thorns, and avoid me. Only those who can see past the obvious will truly know me." ~ Me

"When Life gives you lemons, squirt them in Life's eye, and see how much Life likes lemons then. ~ unknown

"and this is what i call smapping." ~ Akesouku
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Old 03-04-2009, 07:27 PM   #16
Ryujin
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Posts: 24
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1: do you have or have you had any of the following :

[ ]Asthma
[ ]Arthritis
[ ]Epilepsy
[ ]Diabetes
[ ]Heart Conditions
[x]Heart Disease
[ ]Kidney disorders
[ ]Chronic Fatigue Syndrome
[ ]Anemia
[ ]High Blood Pressure
[ ]High Cholesterol
[ ]Cancer
[ ]Autoimmune disorders
[ ]STD's
[ ]Osteoporosis
[ ]Stroke
[ ]Vision problems (not counting glasses)
[ ]Wear glasses
[ ]Auditory problems
[ ]Dental problems (including need for braces)
[ ]Hydrocephalus
[ ]Cerebral Palsy
[ ]Spina Bifida
[ ]Other birth defects
[ ]Anything else you think should be listed

Tissue around heart was damaged, caused electrical impulses to be blocked. Doctors wanted to put a pacemaker in. Healed upon meditation.

2: Do you have a family history of any of the following:

[ ]SIDS
[ ]Asthma
[ ]Arthritis
[ ]Epilepsy
[x]Diabetes
[ ]Heart Conditions
[ ]Heart Disease
[ ]Kidney disorders
[ ]Chronic Fatigue Syndrome
[ ]Anemia
[ ]High Blood Pressure
[ ]High Cholesterol
[x]Cancer
[ ]Autoimmune disorders
[ ]STD's
[ ]Osteoporosis
[ ]Stroke
[ ]Vision problems (Not counting glasses)
[x]Wear glasses
[ ]Auditory problems
[ ]Dental problems (including need for braces)
[ ]Hydrocephalus
[ ]Cerebral Palsy
[ ]Spina Bifida
[ ]Other birth defects
[ ]Anything else you think should be listed


3: Do you have any of the following:

[ ]Mental illness
[ ]Depression
[ ]Learning disabilities
[ ]Mental Retardation
[ ]Autism Spectrum Disorders (including Aspergers syndrome)
[ ]Alcoholism or other substance abuse
[ ]Any other addictions
[ ]Exceptionally intelligent

Anything else you want us to know about

4: Do you have a family history of:

[ ]Mental illness
[ ]Depression
[ ]Learning disabilities
[ ]Mental Retardation
[ ]Autism Spectrum Disorders (including Aspergers syndrome)
[ ]Alcoholism or other substance abuse
[ ]Any other addictions
[ ]Exceptionally intelligent

Anything else you want us to know about

5: Do you smoke?

No.

How much per day

6: DO you drink?

No.

How much per week

7: Do you use any other recreational drugs?

No.

which and how much

8: Are you on any long term medications?

No.

which?

9: How often and what kind of over the counter medications?

10:How much caffeine?

No.

11: DO you drink energy drinks?

No.

12: Qualify your diet (poor, ok, good, excellent)

Good.

13: How many times a week to you work out?

Everday.

14: How active are you?

Varies.

15: Generally, how healthy are you?

Pretty good shape.

16: Have you ever broken, sprained, strained or torn any bones/muscles/ligaments/tendons

No.

17: Have you ever needed stitches?

No.

18: Any significant early childhood trauma, emotional or physical?

Parents fighting and splitting.
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Old 03-07-2009, 11:46 AM   #17
flabbyguy
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Location: Rotorua, New Zealand
Posts: 184
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1: do you have or have you had any of the following :

[ ]Asthma
[ ]Arthritis
[ ]Epilepsy
[ ]Diabetes
[ ]Heart Conditions
[ ]Heart Disease
[ ]Kidney disorders
[ ]Chronic Fatigue Syndrome
[ ]Anemia
[ ]High Blood Pressure
[ ]High Cholesterol
[ ]Cancer
[ ]Autoimmune disorders
[ ]STD's
[ ]Osteoporosis
[ ]Stroke
[ ]Vision problems (not counting glasses)
[ ]Wear glasses
[ ]Auditory problems
[ ]Dental problems (including need for braces)
[ ]Hydrocephalus
[ ]Cerebral Palsy
[ ]Spina Bifida
[ ]Other birth defects
[ ]Anything else you think should be listed

(further information on any check marks)

2: Do you have a family history of any of the following:

[ ]SIDS
[ ]Asthma
[ ]Arthritis
[ ]Epilepsy
[ ]Diabetes
[ ]Heart Conditions
[ ]Heart Disease
[ ]Kidney disorders
[ ]Chronic Fatigue Syndrome
[ ]Anemia
[ ]High Blood Pressure
[ ]High Cholesterol
[ ]Cancer
[ ]Autoimmune disorders
[ ]STD's
[ ]Osteoporosis
[ ]Stroke
[ ]Vision problems (Not counting glasses)
[ ]Wear glasses
[ ]Auditory problems
[ ]Dental problems (including need for braces)
[ ]Hydrocephalus
[ ]Cerebral Palsy
[ ]Spina Bifida
[ ]Other birth defects
[ ]Anything else you think should be listed

(list family relation of any with checkmark, and further information)


3: Do you have any of the following:

[ ]Mental illness
[ ]Depression
[ ]Learning disabilities
[ ]Mental Retardation
[ ]Autism Spectrum Disorders (including Aspergers syndrome)
[ ]Alcoholism or other substance abuse
[ ]Any other addictions
[x]Exceptionally intelligent (define exceptionally... I am an abnormally good at maths)

Anything else you want us to know about

4: Do you have a family history of:

[ ]Mental illness
[ ]Depression
[ ]Learning disabilities
[ ]Mental Retardation
[ ]Autism Spectrum Disorders (including Aspergers syndrome)
[ ]Alcoholism or other substance abuse
[ ]Any other addictions
[ ]Exceptionally intelligent

Anything else you want us to know about

5: Do you smoke? no
How much per day

6: DO you drink? rarely

How much per week: about 1-4 per year

7: Do you use any other recreational drugs? no

which and how much

8: Are you on any long term medications? no
which?

9: How often and what kind of over the counter medications? no

10:How much caffeine? alot..
(per day) none - up to 200 mg

11: DO you drink energy drinks? Yes.

12: Qualify your diet (poor, ok, good, excellent) ok

13: How many times a week to you work out? nothing serious.. scattered lashings of soccer

14: How active are you? meh

15: Generally, how healthy are you? surprisingly healthy :D

16: Have you ever broken, sprained, strained or torn any bones/muscles/ligaments/tendons? NEVER!

17: Have you ever needed stitches? nope

18: Any significant early childhood trauma, emotional or physical? Nope

19a females: Yeah Right
age of menarche (age of first period)
Do you have a regular cycle
Have you ever been pregnant
Number of
Abortions
miscarriages
stillbirths
vaginal live births
C sections
Age of menopause (if appropriate)
Age you became sexually active

19b males:

Age of puberty onset: 12
Erectile dysfunctions: -_- Nope
Age you became sexually active: still waiting on that.. :D
normal sperm count (if known): because I count my sperm -_-... I don't know :D
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Old 03-08-2009, 04:09 PM   #18
Antuulien
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1: do you have or have you had any of the following :

[ ]Asthma
[ ]Arthritis
[ ]Epilepsy
[ ]Diabetes
[ ]Heart Conditions
[ ]Heart Disease
[ ]Kidney disorders
[ ]Chronic Fatigue Syndrome
[ ]Anemia
[ ]High Blood Pressure
[ ]High Cholesterol
[ ]Cancer
[ ]Autoimmune disorders
[ ]STD's
[ ]Osteoporosis
[ ]Stroke
[ ]Vision problems (not counting glasses)
[X]Wear glasses(contacts)
[ ]Auditory problems
[ ]Dental problems (including need for braces)
[ ]Hydrocephalus
[ ]Cerebral Palsy
[ ]Spina Bifida
[ ]Other birth defects
[ ]Anything else you think should be listed

(further information on any check marks)

2: Do you have a family history of any of the following:

[ ]SIDS
[ ]Asthma
[X]Arthritis
[X]Epilepsy
[X]Diabetes
[X]Heart Conditions
[ ]Heart Disease
[ ]Kidney disorders
[ ]Chronic Fatigue Syndrome
[ ]Anemia
[X]High Blood Pressure
[X]High Cholesterol
[X]Cancer
[ ]Autoimmune disorders
[ ]STD's
[ ]Osteoporosis
[X]Stroke
[X]Vision problems (Not counting glasses)
[X]Wear glasses
[X]Auditory problems
[X]Dental problems (including need for braces)
[ ]Hydrocephalus
[ ]Cerebral Palsy
[ ]Spina Bifida
[ ]Other birth defects
[ ]Anything else you think should be listed

(list family relation of any with checkmark, and further information)


3: Do you have any of the following:

[ ]Mental illness
[ ]Depression
[ ]Learning disabilities
[ ]Mental Retardation
[ ]Autism Spectrum Disorders (including Aspergers syndrome)
[ ]Alcoholism or other substance abuse
[ ]Any other addictions
[X]Exceptionally intelligent

Anything else you want us to know about

4: Do you have a family history of:

[X]Mental illness (mood disorders)
[X]Depression
[ ]Learning disabilities
[ ]Mental Retardation
[ ]Autism Spectrum Disorders (including Aspergers syndrome)
[X]Alcoholism or other substance abuse
[ ]Any other addictions
[X]Exceptionally intelligent

Anything else you want us to know about

5: Do you smoke? No.
How much per day

6: DO you drink? No.

How much per week

7: Do you use any other recreational drugs? No.

which and how much

8: Are you on any long term medications? Yes.
which? Birth control.

9: How often and what kind of over the counter medications?

10:How much caffeine? None.
(per day)

11: DO you drink energy drinks? No.

12: Qualify your diet (poor, ok, good, excellent) Good.

13: How many times a week to you work out? 3.

14: How active are you? Moderately.

15: Generally, how healthy are you? Lately, not very.

16: Have you ever broken, sprained, strained or torn any bones/muscles/ligaments/tendons? Although undiagnosed, fairly certain I sprained my ankle in 9th grade.

17: Have you ever needed stitches? Yes.

18: Any significant early childhood trauma, emotional or physical? Not that I'm certain of.

19a females:
age of menarche (age of first period): 12.
Do you have a regular cycle? No, that's why I take birth control.
Have you ever been pregnant? No.
Number of
Abortions
miscarriages
stillbirths
vaginal live births
C sections
Age of menopause (if appropriate):
Age you became sexually active: 18.
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Old 03-10-2009, 12:12 AM   #19
Solem
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1: do you have or have you had any of the following :

[ ]Asthma
[ ]Arthritis
[ ]Epilepsy
[ ]Diabetes
[ ]Heart Conditions
[ ]Heart Disease
[ ]Kidney disorders
[ ]Chronic Fatigue Syndrome
[ ]Anemia
[ ]High Blood Pressure
[ ]High Cholesterol
[ ]Cancer
[ ]Autoimmune disorders
[ ]STD's
[ ]Osteoporosis
[ ]Stroke
[ ]Vision problems
[x]Wear glasses (left eye only)
[ ]Auditory problems
[ ]Dental problems
[ ]Hydrocephalus
[ ]Cerebral Palsy
[ ]Spina Bifida
[ ]Other birth defects
[ ]Anything else you think should be listed

(further information on any check marks)

2: Do you have a family history of any of the following:

[ ]SIDS
[ ]Asthma
[ ]Arthritis
[ ]Epilepsy
[x]Diabetes
[ ]Heart Conditions
[ ]Heart Disease
[ ]Kidney disorders
[ ]Chronic Fatigue Syndrome
[ ]Anemia
[ ]High Blood Pressure
[ ]High Cholesterol
[x]Cancer
[ ]Autoimmune disorders
[ ]STD's
[ ]Osteoporosis
[ ]Stroke
[x]Vision problems (Not counting glasses)
[x]Wear glasses
[ ]Auditory problems
[x]Dental problems (including need for braces)
[ ]Hydrocephalus
[ ]Cerebral Palsy
[ ]Spina Bifida
[ ]Other birth defects
[ ]Anything else you think should be listed

(list family relation of any with checkmark, and further information)


3: Do you have any of the following:

[ ]Mental illness
[ ]Depression
[ ]Learning disabilities
[ ]Mental Retardation
[ ]Autism Spectrum Disorders (including Aspergers syndrome)
[ ]Alcoholism or other substance abuse
[ ]Any other addictions
[x]Exceptionally intelligent

Anything else you want us to know about

4: Do you have a family history of:

[ ]Mental illness
[ ]Depression
[ ]Learning disabilities
[ ]Mental Retardation
[ ]Autism Spectrum Disorders (including Aspergers syndrome)
[ ]Alcoholism or other substance abuse
[ ]Any other addictions
[x]Exceptionally intelligent

Anything else you want us to know about

5: Do you smoke? No.

6: DO you drink? No.

7: Do you use any other recreational drugs? No.

8: Are you on any long term medications? No.

9: How often and what kind of over the counter medications? N/A

10:How much caffeine? Occaisional Soda

11: DO you drink energy drinks? No.

12: Qualify your diet (poor, ok, good, excellent) Good

13: How many times a week to you work out? N/A

14: How active are you? Depends on season. summer I'm active, winter I usually slow down a little.

15: Generally, how healthy are you? sick (not including colds) about once a year

16: Have you ever broken, sprained, strained or torn any bones/muscles/ligaments/tendons Only once. a thumb, pretty pathetic. All kinds of sprains, ad several that seemed like breaks and sprains that were completely better after about an hour or two.

17: Have you ever needed stitches? No.

18: Any significant early childhood trauma, emotional or physical? No.

19b males:

Age of puberty onset 11-ish, maybe late 10.
Erectile dysfunctions None
Age you became sexually active N/A
normal sperm count (if known) No idea
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Old 04-08-2009, 06:48 PM   #20
Winged_Wolf
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Amaya, you really should alter your post here to indicate that we are NOT yet collecting this information. The surveys aren't even complete yet. This is just a call for people to give opinions and ideas on what should be included.
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