Virtual Medicine Conference

Question 1 of 16When you try to open a new twist-off jar (e.g., pasta sauce), what usually happens?

A. Opens on the first try without effortB. Opens after a second try or using a trick (rubber grip, hot water)C. Usually need a tool or someone else's helpD. Can't open new jars without help; avoid twist-offs

Question 2 of 16Walking up four flights of stairs at a normal pace, how does it typically feel? (Okay to use the handrail for safety—answer based on overall difficulty.)

A. Easy; I could keep going without needing a restB. Noticeable effort, but I don't need to stopC. Hard; I'd likely slow down or stop to catch my breathD. I avoid stairs or would need to stop before finishing four flights

Question 3 of 16Over the past 3 months, how often have you had back pain (anywhere in the back)?

A. Rarely or neverB. Occasionally; mild and manageableC. Frequently; sometimes limits activitiesD. Daily or nearly daily; clearly limiting

Question 4 of 16If you had to stand in place for around 20 minutes (e.g., in a line or waiting for a bus), how would it typically feel?

A. Comfortable; I could keep standing without a breakB. Noticeable effort; some back/leg discomfort but manageable without a breakC. Uncomfortable; I usually need to shift, lean, or take a brief sitD. I avoid standing this long or usually need to sit down within a few minutes

Question 5 of 16When you stand up quickly from sitting or lying down, how often do you feel lightheaded, woozy, or faint?

A. NeverB. Rarely; brief and mildC. Sometimes; I may need to pause or steady myselfD. Frequently; I usually need to pause or steady myself

Question 6 of 16Please enter your height and weight so we can calculate your Body Mass Index (BMI).

US (ft / in, lb)Metric (cm, kg)

Height

Weight

Question 7 of 16When standing up from a standard chair (no armrests) without using your hands, how does it typically feel?

A. I stand up on the first try without using my handsB. I usually stand without hands but need a little extra effort or momentumC. I often need my hands/armrests or push off my thighs to standD. I need assistance or avoid low/soft chairs

Question 8 of 16By the end of a typical day, do your ankles or lower legs look swollen (e.g., sock marks or puffiness)?

A. NeverB. Occasionally (after long sitting/standing; mild sock marks)C. Frequently (noticeable most days)D. Daily, clearly visible swelling or deep sock indentations

Question 9 of 16How often do you feel dizzy, off-balance, or like the room is spinning (vertigo)?

A. NeverB. Rarely; brief and mildC. Sometimes; noticeable or bothersomeD. Frequently; limits activities or I avoid triggers

Question 10 of 16When putting on pants or socks while standing, how do you typically manage your balance?

A. I do this easily without holding onB. I can do it, but I prefer to be near support just in caseC. I usually hold on to something for balanceD. I sit to do this or avoid trying while standing

Question 11 of 16How sensitive to cold are you (e.g., getting into a cold pool or taking a cold shower)?

A. Not sensitive; I adapt quicklyB. Mild sensitivity; brief discomfortC. Noticeable discomfort; I sometimes avoid cold exposureD. Very sensitive; I often avoid cold environments/activities

Question 12 of 16How much do you agree with this statement: "I'm the 'sensitive type' physically—very aware of and responsive to my bodily senses and movements."

A. Not at allB. SlightlyC. ModeratelyD. Very much

Question 13 of 16Over the past 2 weeks, how often have you felt weighed down by stress, worry, or low mood—like life itself feels heavy?

A. Rarely or neverB. Occasionally; mildC. FrequentlyD. Almost always / persistent

Question 14 of 16How do you usually respond to roller coasters, airplane turbulence, or the sudden jolt of a descending elevator?

A. Calm and comfortableB. Slightly uneasy but manageableC. Somewhat anxious; the sensations are bothersomeD. Very anxious; the sensations are intense and may feel overwhelming

Question 15 of 16When you face setbacks, failures, or unexpected drops, how quickly do you regain your emotional balance and resume your usual activities?

A. Quickly; I bounce back and move forwardB. Moderately; I need some time but get back on trackC. Slowly; setbacks linger and affect my mood/behaviorD. Very slowly; I can feel stuck or avoid activities for a long time

Question 16 of 16How often do you feel light, uplifted, or deeply absorbed in an activity (flow)—as if you're carried upward by joy, awe, or inspiration?

A. Very often (weekly or more)B. Occasionally (a few times a month)C. Rarely (a few times a year)D. Almost never