Patient Education
Gastroparesis Daily Log
Record Date | MON | TUE | WED | THUR | FRI | SAT | SUN |
(mo/day/yr) | / / | / / | / / | / / | / / | / / | / / |
VOMITING | |||||||
NAUSEA HOURS |
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EARLY SATIETY (Fullness) |
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BLOATING | |||||||
GENERAL WELL-BEING |
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HYPOGLYCEMIC ATTACKS (if diabetic, also record your lowest measurement) |
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MARINOL | |||||||
ANTIEMETICS (yes or no) COMPAZINE, ZOFRAN, PHENERGAN, TIGAN |
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PROKINETICS (yes or no) ERYTHROMYCIN, DOMPERIDONE, REGLAN |
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PAIN MEDICATIONS (PLEASE LIST) |