Health Assessment | Institute for Functional Health

Before we get to the in-depth questions that will really challenge you for an honest assessment of yourself, let's start with an easy one . . . what's your gender?

Male Female

Our first series of questions focus on your physical stamina and regular physical activity: Is it difficult for you to touch your toes while standing?

I haven’t been able to touch my toes since I was a kid. I struggle too, but some days I can touch my toes better than on other days. Most of the time I can touch my toes. No problem, I can always touch my toes.

Which of the following best describes your reaction to being asked to climb 10 flights of stairs?

I don't think I could make it up even 4 flights of stairs without losing my breath or hurting too bad to continue. I could probably make it up 10 flights of stairs, but I would probably be short of breath and hurting. I can definitely climb 10 flights of stairs, but I would be a little winded. Just give me a minute to recover ... 10 flights? Let's go 20 flights! No problem, Doctor.

How many hours a week would you estimate that you spend working out? This does not have to be Lifting heavy weights. This may include jogging, a brisk walk, or playing sports. In general, we're trying to gauge how often you get your heart rate up.

I really don't do anything to get my heart rate up. Maybe I'll go for a walk once in a blue moon. I am pretty consistent about some form of exercise at least one day a week. I make it a point to do something active 2-3 days a week. I would define myself as a pretty active person. Either through a couple of long workouts or by consistently doing something active everyday, I tend to have at least 5 hours of physical activity each week.

Okay, aside from the previous question about "working out" (or maybe deliberate physical activity) ... on a daily basis, how much time would you say that you are up and moving around? I understand that every day can be different, but you know your typical weekday routine so just make your best estimate for this question.

I am retired or my job requires a lot of sitting at a desk, and when I get home I like to relax in front of the TV or catching up on my tablet. I am probably actively walking no more than 1 hour a day. I sit a lot for my job, but I still make time to get up and walk around. Whether it is running errands or squeezing in a walk, I'm probably active at least 2 hours a day. My job requires me to be up and around all day. I may walk miles a day just around the office or visiting with customers. I would guess l'm active at least 3 hours a day.

Excellent job on the 'Physical Activity' questions. Now let's go over any pain you may be having: Do you ever experience headaches?

I never get headaches. I occasionally get a headache, but I can usually tell what caused it (for example: something that I occasionally get a headache, but l'm not sure why. It can be painful but I wouldn't say it is debilitating. Yes! I get MIGRAINES!

Do you ever experience neck or shoulder tension?

Not that I notice. I will occasionally feel tension in my neck and shoulders but I can go on with my day. I definitely get tense in my neck and shoulders. This may be specific to headaches as well. Yes! I am in neck and shoulder pain often and it can be really debilitating depending on what I'm doing that day.

How often do you get lower back pain? Maybe this pain even extends down to sciatic pain or into the back of your legs (hamstrings)?

I don't generally have issues with my lower back or hamstrings. I sometimes feel pain in my lower back or hamstrings but generally it is after l've lifted something heavy and it goes away on its own. I experience frequent pain in my lower back or hamstrings. It isn't so bad that I can't function, but its awfully uncomfortable when it comes on. I have a rather constant pain in my lower back or hamstrings. It's bad enough that it keeps me from doing what I need to do some days. l'd definitely say it can be debilitating.

This can be a tough question to answer honestly.. • how's your memory treating you? Don't hold anything back here. Just pick the multiple choice answer that seems most reasonable.

I am really struggling with my memory. I've noticed it for some time, but it's getting to the point where it is affecting my everyday activities. I may struggle with some long-term memories, but overall l'd say my mind is as sharp as ever. I've noticed that I'm forgetful sometimes. I wouldn't say that it really hinders my everyday life, but I can tell I'm not as sharp as I once was. I am really struggling with my memory. I've noticed it for some time, but it's getting to the point where it is affecting my everyday activities.

This next section will focus on our mental and emotional state: two critical areas to ensure you are truly living your best health. How would you define your current emotional state?

I haven't really noticed any changes to my emotional state. I occasionally notice that l'm a bit more emotional than I used to be. I am noticing a more frequent change in my emotional state, but it is not yet affecting my everyday activities. I can definitely notice that I am more emotional than I once was, and it is beginning to affect my relationships and daily life.

Do you feel as though your libido, or desire to be more intimate, has decreased?

No, my libido is as good as it's ever been. Maybe it has decreased a bit with age, but the desire is still frequent. I have definitely noticed a less frequent desire, but it definitely still exists. At this point I would say that my libido is nonexistent.

Do you ever find yourself more irritable than in the past?

No, l'd say l'm the same temperament as l've always been. I may occasionally be a bit more irritable than in the past... but it sure feel like I normally have a good reason. I am aware that I am frequently more irritable than in the past and it is affecting my relationships and my own well-being.

Do you ever feel like you have "brain fog"? In case you are not familiar with that term, it is a commonly used phrase that sums up feelings of confusion, forgetfulness, and lack of focus and mental clarity.

No, I feel as sharp as ever. Occasionally I may feel like I have a bit of brain fog but it doesn't impact my everyday activities. YES! I didn't know how to describe it but I almost always feel Like I have brain fog.

The last question was specific to "brain fog". For this question, do you ever feel sluggish or tired even after you've rested?

No, a good night's sleep keeps me going strong all day long. I get a bit tired as the day wears on, but overall I don't notice an unusual level of fatigue. I do feel like I wear out pretty quickly. I often rely on a pick me up like coffee or tea to keep me going. I can have the best night of sleep ever, but I still struggle to get through the day. I feel so tired and lethargic that it really hinders my daily activities.

Which of the following best describes the frequency that you feel stress?*

I am stress free! I am occasionally stressed out, but its usually for a good reason. I stress out rather frequently. I am aware of when I start to stress but it still difficult to control. I am always so, so stressed. I'm so stressed that it really is hindering my personal relationships and everyday tasks.

As a followup to that last question about stress... do you ever feel overwhelmed and anxious?

Never. Occasionally, but I can generally control flashes of overwhelm and anxiety. I get overwhelmed and anxious pretty frequently. I've got so much of life going on that it is hard not to become overwhelmed. I am often overwhelmed and anxious. Even when my day is in order and everything's going my way, I will still feel a wave of anxiety overtake me.

How excited do you get these days about your interests and hobbies?

I can't get enough politics, gardening, and horseback riding. Ok, maybe not those, but I do love my interests and hobbies. Nothing has changed here. I still enjoy spending time with my interests and hobbies, but it is tough to find the time and sometimes I'm not real motivated after a long day or week. Lately, I've had trouble getting excited about my interests or hobbies. Even when I have time, I just feel unmotivated. Not to sound be a downer, but I just don't have any motivation for the things I used to love. It is really affecting my personal Life and self-esteem.

Let's talk about your digestion. This is a topic that most people don't like to discuss, but your gut is just as important as your brain when it comes to regulating all of your body systems. Be honest with this assessment and you will be shocked at what you learn. After having a bowel movement, do you ever feel as though your bowels have not completely emptied?

All the time! Frequently, yes. Sometimes, but not often. I never have that feeling.

Do you ever notice undigested food in your stool?

All the time! Yes, frequently. Sometimes, but not often. I never find this to be the case.

After you eat greasy or high fat foods, do you ever experience bowel distress? This may include diarrhea, indigestion, constipation, abdominal pain, nausea, vomiting, or flatulence.

Yes, I always suffer one or more of these consequences. Frequently I suffer from one or more of these. Sometimes I suffer one of these, but it is not very often. No, I never have a problem after eating fat or greasy foods.

After meals, do you experience heartburn or excessive belching?

All the time! Frequently I do, but not always. Sometimes I do, but not often. I never have these issues after eating.

And finally... last question: How would you categorize your cravings for salty or sweet foods?*

I really enjoy snacking on salty or sweet treats. I find myself snacking between meals to feed my craving. I enjoy salty and sweet snacks on a regular basis, but I generally only have them at mealtime. I am not a big snacker. I enjoy salty and sweet foods, but I enjoy them rarely. I wouldn't say I have "cravings". I really don't care for salty or sweet foods. I may have a dessert for special occasions but other than that, I just don't make an effort for sweets.

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