[kool-aidman]

1. State you reside in
New York



3. Do you live on a lake, by the ocean or pond?
Lake Erie
4. Do you have city or well water?
City water
5. Do you live in a heavily treed area?
no but I always camped
6. Age at onset
29

7. Number of years affected
not really sure might have always had it but may have progressed, all major symptoms started 2004.
8. Any other family members affected? My brother

9. Your occupation at onset?
can’t disclose at this time

10. Do you own pets? Cat? Dog? Other?
a family Dog

11. Have/had you traveled to California, Florida or Texas? Europe? Other?
yea, I have been to Florida many times, Orlando, Coco beach, Daytona, Palm Beach, and Jacksonville.


12. Do you/have you garden, hike, camp or spend allot of time outdoors?
Camped, hike, use to garden with my parents

13. List your activities and hobbies.
Camping, snowboarding, ice hockey, history research,

14. Have you used a public whirlpool or pool?
yes,
15. Please provide your medical history (i.e.: do you or have you had any other diseases? Cancer, Lyme, Thyroid, AIDS, other?).
Jaundice, colic, cellulites, Vertigo, acid reflux, Parvo-viric 5th disease
16. Do you smoke?
no
17. Any medications you have taken or are taking?
Kalflax
18. Do you drink more than 8 cups of coffee a day?
no coffee

19. As far as lesions, have you had more than 10 at a given time?
no,

20. What part of your body did the lesions start?
back of the neck, lower back, ankles, forhead, near ground

21. Is there any area that they are most prevalent? If so, where?
any earia where there is no hear, mostly on back
22. Is one side of your body/face more affected than the other (i.e.: left vs. right)?
Stomic, sholders, arms and lags: hives, bug bits, lesians, red skin, yellow blisters.
23. Please list your current symptoms (brain fog? vision disturbances? fatigue? nausea? weight loss/gain etc?)
Brain fog, memory loss, fatigue weight loss 160 to 145 with in a month digestive problems diariah, vomiting, acid reflux, insides burn, bones burn, crackng joints, itching, crawling, stinging, all over body.

24. What did other doctors diagnose you with (i.e.: folleculitis? Scabies? DOP - delusional parasitosis)?

Vertigo, acid reflux, Parvo-viric 5th disease, Scabies, lice, cellulites.