Table 1 Questionnaire documenting upper extremity symptoms of acute and chronic neuropathy experienced during or after oxaliplatin-based chemotherapy.
Upper Extremity Symptoms | Â | Â | If you had symptoms during the last cycle.... | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Â | Â | Â | How much of the symptoms did you have? | Did the symptoms affect your daily activities? | ||||||||
Do you have.... |  |  | Hardly any → Very much | Hardly at all bothered → Extremely bothered | ||||||||
Tingling (pins and needles) | Yes | No | 1 | 2 | 3 | 4 | 5 | 1 | 2 | 3 | 4 | 5 |
Numbness | Yes | No | 1 | 2 | 3 | 4 | 5 | 1 | 2 | 3 | 4 | 5 |
Difficulty telling the difference between rough and smooth surfaces | Yes | No | 1 | 2 | 3 | 4 | 5 | 1 | 2 | 3 | 4 | 5 |
Difficulty feeling hot things | Yes | No | 1 | 2 | 3 | 4 | 5 | 1 | 2 | 3 | 4 | 5 |
Difficulty feeling cold things | Yes | No | 1 | 2 | 3 | 4 | 5 | 1 | 2 | 3 | 4 | 5 |
A greater than normal sense of touch (i.e. putting on gloves) | Yes | No | 1 | 2 | 3 | 4 | 5 | 1 | 2 | 3 | 4 | 5 |
Burning pain or discomfort without cold | Yes | No | 1 | 2 | 3 | 4 | 5 | 1 | 2 | 3 | 4 | 5 |
Burning pain or discomfort with cold | Yes | No | 1 | 2 | 3 | 4 | 5 | 1 | 2 | 3 | 4 | 5 |
Difficulty identifying objects in your hand (i.e. coin) | Yes | No | 1 | 2 | 3 | 4 | 5 | 1 | 2 | 3 | 4 | 5 |
Do you have involuntary hand movements | Yes | No | 1 | 2 | 3 | 4 | 5 | 1 | 2 | 3 | 4 | 5 |