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Review the MS symptoms below and mark the level of severity of your experience with each.

Emotional Burden No symptoms ordisability

Have symptoms but no limits on my activities

Mild limits on myactivities

Moderate limits on my activities

Severe limits on my activities

Depression

Anxiety

Review each of the below statements and indicate which have changed for the better, for worse, or did not change since being diagnosed with MS.

Changed for the Better Did Not Change Changed for the Worse

My ability to process information

My ability to concentrate

My ability to remember things

Review the MS symptoms below and mark the level of severity of your experience with each.

Tracking Your Symptoms

No symptomsand/or disability

Have symptoms but no limits on my activities

Mild limits on myactivities

Moderate limits on my activities

Severe limits on my activities

Trouble concentrating

Trouble multitasking

Issues with memory

Mood swings

Ability to understand or learn new things

Speaking clearly

Cognitive Symptoms

MS can be measured by more than a neurological exam or brain scan. This symptom tracker and discussion guide will help you track the impact MS has on your daily life, as well as evaluate your overall understanding of MS. We hope this resource will help you communicate a full picture of your MS with your care team - because

when you and your care team know more, you can do more.

Complete the below assessment and discuss the results with your care team.

© 2017 Genzyme Corporation. All rights reserved. GZEMEA.MS.17.01.0023e 11/2017

The World vs.MS Symptom Tracker & Discussion Guide

© 2017 Genzyme Corporation. All rights reserved. GZEMEA.MS.17.01.0023e 11/2017

Perceived Disease Knowledge

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My time for family activities

My relationship with friends

My relationship with my family

Relationship problems

Decreased sex drive

Change in genital sensations

Difficulty getting aroused

Other sexual problems

Relationships & Intimacy No symptoms ordisability

Have symptoms but no limits on my activities

Mild limits on myactivities

Moderate limits on my activities

Severe limits on my activities

Changed for the Better Did Not Change Changed for the Worse

Review the MS symptoms below and mark the level of severity of your experience with each.

Review each of the below statements and indicate which have changed for the better, for worse, or did not change since being diagnosed with MS.

Review the MS symptoms below and mark the level of severity of your experience with each.

No symptoms ordisability

Have symptoms but no limits on my activities

Mild limits on myactivities

Moderate limits on my activities

Severe limits on my activities

Physical Symptoms

Fatigue (tired even though you had enough sleep)

Trouble sleeping through the night

Physical weakness

Trouble swallowing

Trouble moving / muscle stiffness

Problems with balance and coordination

Numbness and tingling

Muscle spasms

Sensitivity to heat or cold

Dizziness

My self esteem

My future outlook

My ability to cope with stress

My emotional well-being

Changed for the Better Did Not Change Changed for the WorseEmotional Burden (cont)

Review each of the below statements and indicate which have changed for the better, for worse, or did not change since being diagnosed with MS.

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My level of energy

My physical functioning

My ability to exercise

My ability to care for children

My ability to have children

Radiating pain, like a mild electrical shock

Stabbing pain

Burning and pricking sensations

Pins and needles sensations

Bladder or urinary problems

Bowel problems

Double vision

Vision loss

Other vision problems

Physical Symptoms (cont)

Review the MS symptoms below and mark the level of severity of your experience with each.

Review each of the below statements and indicate which have changed for the better, for worse, or did not change since being diagnosed with MS.

No symptoms ordisability

Have symptoms but no limits on my activities

Mild limits on myactivities

Moderate limits on my activities

Severe limits on my activities

Changed for the Better Did Not Change Changed for the Worse

Which statement do you agree with more?

When weighing the benefits and risks of an MS treatmentwith my neurologist, I am most concerned about the risksand side effects associated with it

When weighing the benefits and risks of an MS treatmentwith my neurologist, I am most concerned with how effectiveit is in slowing disease

How knowledgeable are you abouteach of the topics listed below? Not at all Somewhat Very Extremely

The benefits of MS disease modifying therapies

The risks associated with delaying thestart of MS treatment

The long term risks of having MS

The risks and side effects associatedwith MS treatments

Perceived Disease Knowledge

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continuation

I sometimes purposefully skip a dose ofmy disease modifying therapy

I am hesitant to switch to a new treatmentbecause I am concerned about the potentialnew side effects I would have to experience

What matters to me most is whether myMS treatment conveniently fits intomy day-to-day lifestyle

My doctor and I chose my MS disease modifyingtherapy based on its safety profile

I feel informed about the risks associated withMS, as well as the treatments available

I have had instances when I stopped taking myMS treatment against the advice of my doctor

How much do you agree or disagreewith the statements below? Strongly Disagree Strongly AgreeNeither

Agree or Disagree AgreeDisagree

www.theworldvsms.comFor more information on The World vs.MS, visit

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