Reverse Emphysema Self Test REVERSE EMPHYSEMA – SELF TEST Instructions: Enter your numerical responses in the score sheet at the end of the test. Once you complete each section total your score for each section. Finally, add the scores for Section 1, 2 and 3 together in the Total Score blank. SECTION 1: HISTORY
1. Have you taken tetracyclines (Sumycin®, Panmycin®,
Vibramycin®, Minocen®, etc.) or other antibiotics for acne for 1 month (or longer)? Enter 35 for Yes, 0 for No
2. Have you, at any time in your life, taken other "broad spectrum"
antibiotics* for respiratory, urinary or other infections (for 2 months or longer, or in shorter courses 4 or more times in a 1- year period)? Enter 35 for Yes, 0 for No
*Including Keflex®, ampicillin, amoxicillin, Ceclor®, Bactrim®,
and Septra®. Such antibiotics kill off the "Good Bacteria" or probiotics while also killing the “Bad Bacteria” or Pathogens which cause infection.
3. Have you taken a broad spectrum antibiotic drug* - even a
single course? Enter 6 for Yes, 0 for No
4. Have you, at any time in your life, been bothered by persistent
prostatis, vaginitis or other problems affecting your reproductive organs? Enter 25 for Yes, 0 for No
5. Have you been pregnant? (enter only 1 answer)
*2 or more times? Enter 5 for Yes, 0 for No *1 time? Enter 3 for Yes, 0 for No
6. Have you taken birth control pills? (enter only 1 answer)
*For more than 2 years? Enter 15 for Yes, 0 for No
*For 6 months to 2 years? Enter 8 for Yes, 0 for No
7. Have you taken prednisone, Decadron® or other cortisone-type
*For more than 2 weeks? Enter 15 for Yes, 0 for No *For 2 weeks or less? Enter 6 for Yes, 0 for No 2010 Optimal Health Protocols. All Rights Reserved. Unauthorized Duplication Prohibited.
8. Does exposure to perfumes, insecticides, fabric shop odors or
other chemicals provoke? (enter only 1 answer)
*Moderate to severe symptoms? Enter 20 for Yes, 0 for No *Mild symptoms? Enter 5 for Yes, 0 for No
9. Are your symptoms worse on damp, muggy days or in moldy
places? Enter 20 for Yes, 0 for No
Have you had athlete's foot, ring worm, "jock itch" or other
chronic fungal infections of the skin or nails? Have such
infections been. (enter only 1 answer) *Severe or persistent? Enter 20 for Yes, 0 for No *Mild to moderate? Enter 10 for Yes, 0 for No
Do you crave sugar or sugar containing foods like desserts
and candy? Enter 10 for Yes, 0 for No
Do you crave breads, rolls, muffins or any other grains or
foods made from grains? Enter 10 for Yes, 0 for No
a. Do you crave alcoholic beverages including beer or wine?
Enter 10 for Yes, 0 for No
Does tobacco smoke really bother you? Enter 10 for Yes, 0 for No
2010 Optimal Health Protocols. All Rights Reserved. Unauthorized Duplication Prohibited. SECTION 2: MAJOR SYMPTOMS
Instructions:
For each symptom that is present, record the appropriate score.
*Record a “0” if a symptom does not apply to you. *Record a “3” if a symptom is occasional or mild. *Record a “6” if a symptom is frequent and/or moderately severe.
*Record a “9” if a symptom is severe and/or disabling.
Feeling "spacey" or "unreal"
10. Pain and/or swelling in joints 11. Abdominal pain
12. Constipation 13. Diarrhea 14. Bloating, belching or intestinal gas 15. Troublesome vaginal burning, itching or discharge
16. Prostatitis 17. Impotence 18. Loss of sexual desire or feeling 19. Endometriosis or infertility
20. Cramps and/or other menstrual irregularities 21. Premenstrual tension 22. Attacks of anxiety or crying 23. Cold hands or feet and/or chilliness 24. Shaking or irritable when hungry
2010 Optimal Health Protocols. All Rights Reserved. Unauthorized Duplication Prohibited. SECTION 3: ADDITIONAL SYMPTOMS Instructions:
For each symptom that is present, record the appropriate score. 1 = If a symptom is occasional or mild. 2 = If a symptom is frequent and/or moderately severe. 3 = If a symptom is severe and/or disabling.
Pressure above ears.feeling of head swelling
10. Chronic rashes or itching 11. Psoriasis or recurrent hives 12. Indigestion or heartburn
13. Food sensitivity or intolerance 14. Mucus in stools 15. Rectal itching 16. Dry mouth or throat
17. Rash or blister in mouth 18. Bad breath 19. Foot, hair or body odor not relieved by washing 20. Nasal congestion or post nasal drip
21. Nasal itching 22. Sore throat 23. Laryngitis, loss of voice 24. Cough or recurrent bronchitis 25. Pain or tightness in chest
26. Wheezing or shortness of breath 27. Urinary frequency, urgency, or incontinence 28. Burning on urination 29. Spots in front of eyes or erratic vision
30. Burning or tearing of eyes 31. Recurrent infections or fluid in ears 32. Ear pain or deafness
2010 Optimal Health Protocols. All Rights Reserved. Unauthorized Duplication Prohibited. Section 1 Score Sheet
10. __________ 11. __________ 12. __________ 13. __________ Section 1 Total: __________ 2010 Optimal Health Protocols. All Rights Reserved. Unauthorized Duplication Prohibited. Section 2 Score Sheet
Section 2 Total: __________ 2010 Optimal Health Protocols. All Rights Reserved. Unauthorized Duplication Prohibited. Section 3 Score Sheet
17. __________ Section 3 Total: __________ 2010 Optimal Health Protocols. All Rights Reserved. Unauthorized Duplication Prohibited. Total Your Score
Section 2 Score ________ Section 3 Score ________
TOTAL SCORE ________ (Add Section 1, 2 and 3 together)
2010 Optimal Health Protocols. All Rights Reserved. Unauthorized Duplication Prohibited. Understanding Your Score The Grand Total will provide a strong indication as to whether you would benefit from the information in the book, “How I Reversed My Mom’s Emphysema.” Scores in women will run higher since 7 items in the questionnaire apply exclusively to women, while only 2 apply exclusively to men.
It is extremely likely you would benefit
It is probable you would benefit from the
would not benefit from the information in the book, it just means it was not evident from the results of this test.
When I did this test for my mother she scored 264!
*The book, “How I Reversed My Mom’s Emphysema” is available
at: http://www.OptimalHealthProtocols.com.
If you have further questions please review our FAQs (Frequently Asked Questions) located on our web site. If you still do not find your
answer call our Customer Service Department at: 386-308-5395.
2010 Optimal Health Protocols. All Rights Reserved. Unauthorized Duplication Prohibited.
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Reverse Emphysema