13075 US Highway 19 N Clearwater, FL 33764


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Welcome!

We invite you to participate in the 2020 Dysautonomia Project Patient Survey.  The information gathered will help us spread hope to others through updated and improved research and education.

By completing this survey you agree to share your personal medical information with The Dysautonomia Project.

A handful of responses will be summarized and featured in an a 2020 educational blog post of patient stories.  All information will be kept anonymous.

Thank you for your participation and support

TDP Patient Survey

Difficulty standing for long periods of time
Nausea
Palpitations
Fainting
Difficulty maintaining body temperature
Abdominal pain
Diarrhea or constipation
Flushing (Face or other turns red/warm to touch)
Shortness of breath or difficulty breathing
Anxiety or depression
Weight gain/loss
Fatigue
Brain fog or mental clouding
Exercise intolerance
Abnormal sweat
Migraine headaches
Intermittent gastroparesis
Circulation issues
Difficulty urinating
Difficulty sleeping
Panic attacks
Lightheadedness
Parasthesias (Tingling, numbness)
Heat intolerance
Abnormal tears
Vomiting
Reflux
Chest discomfort
Difficulties with lights, sounds, touch or motion
Tinnitus (Ringing in the ears)
Other
Education (Efforts to educate myself and/or others about dysautonomia)
Exercise
Fluids (Increase of oral fluid intake)
Salt
Counter maneuvers
Diet
Compression garments
Healthy sleep habits
Dietary supplements
Acupuncture
Other
Fludrocortisone (Brand name: Florinef)
Midodrine (Brand name: Promatine)
Beta-Blockers (Brand names: Propranolol, Metoprolol, etc.)
Pyridostigmine (Brand name: Mestinon)
IV Saline
Clonidine or Methyldopa (Brand name: Catapres or Aldomet)
Amphetamine or Methylphenidate (Brand name: Adderall, Ritalin or Concerta)
Ibuprofen (Brand name: Motrin, Advil, etc.)
Clonazepam (Brand name: Klonopin)
Alprazolam (Brand name: Xanax)
Droxidopa aka L-DOPS (Brand name: Northera)
Tricyclic Antidepressants (Brand name: Doxepin)
Selective Serotonin Reuptake Inhibitor (SSRIs)
Erythropoietin (Brand name: Procrit)
Yohimbine
Ivabradine (Brand name: Corlanor)
Somatostatin (Brand name: Octreotide)
Desmopressin (Brand name: DDAVP)
Bethanechol (Brand name: Urecholine)
H1 and/or H2 Antihistamines (Brand names: Zyrtec Zanntac, Claritin, etc.)
Other
Improved a lot
Improved some
Not changed
Worsened some
Worsened a lot