ZHANG CLINIC LYME DISEASE
TREATMENT SURVEY
Please
enter your age
Male
Female
1) How long were you treated on the protocol?
1-2
months
3-4
months
5-6
months
More
than 6 months
2) Did you
take Allicin (garlic capsules) ?
Yes
No
Don’t
know3)
If you did NOT take Allicin, which other herbs did you take? (You
may choose more than one)
Coptis
HH
R5081
4)
Did you take Artemisea ?
Yes
No
Don’t
know
5) Did you experience any Herxeimer’s reaction?
Yes
No
Don’t
know
6) Those who experienced
the Herxeimer’s reaction, when did it start?
Between
1st to 2nd week of the protocol
Between
3rd week to 1st month of the protocol
In
the 2nd month of the protocol
In
the 3rd month of the protocol
Did
not experience Herxeimer’s reaction
7) If you did experience the Herxeimer’s reaction, how long did it
last?
A
few days
1
week to 2 weeks
More
than 2 weeks
Comes
and goes periodically
8) How severe was Herxeimer’s reaction?
Mild,
symptoms are sometimes noticeable
Moderate,
symptoms are constantly noticeable, but manageable
Severe,
barely manageable
Very
severe, could not conduct daily life
9) Did
you take the AI#3 formula?
Yes
No
Don’t
know
10) If you took the AI#3 formula, do you think it helped control
the Herxeimer's reaction?
Yes
No
Don’t
know
11) Did you take the Circulation P formula?
Yes
No
Don’t
know
Part B
Below is a list of common Lyme Disease symptoms. Please let us know
which ones you experienced before and after treatment. |
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