Progress Diary

Subgroup
Kaposis’ Sarcoma Symptoms:(yeast, fungal and other secondary

Wasting Syndrome infections)
Candidiasis
Dementia
P.Carinii Pneumonia
Major Secondary Diseases:(Cancer,Tuberculosis,Hepatitis)
Blood Count
14-30 Days Before 7-10 Days After 90 Days After

Date: / / Date: / / Date: / /
CD4 Cell Count CD4 Cell Count CD4 Cell Count
CD8 Cell Count CD8 Cell Count CD8 Cell Count
HIV Viral Load HIV Viral Load HIV Viral Load
White Blood Cell Count White Blood Cell Count White Blood Cell Count
Progress Diary - Before Treatment
Week 1
Date / /
Ability to exercise Temp Fatigue

Yes / No (1 being energetic, 10 being very weak)
1 2 3 4 5 6 7 8 9 10
Strength Appetite Depression
(1 being strong, 10 being very weak) Gain / Loss (1 being hopeful, 10 being very depressed)
1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10
Overall wellbeing Weight Mental Clarity
(1 being very well, 10 being very sick) (1 being focused, 10 being very unfocused)
1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10
Comments:
Week 2
Date / /

1 2 3 4 5 6 7 8 9 10
1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10
1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10
Comments:
Progress Diary – After Treatment
Week 3
Date / /

1 2 3 4 5 6 7 8 9 10
1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10
1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10
Comments:
Week 4
Date / /

1 2 3 4 5 6 7 8 9 10
1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10
1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10
Comments:
Week 5
Date / /

1 2 3 4 5 6 7 8 9 10
1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10
1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10
Comments:
Week 6
Date / /

1 2 3 4 5 6 7 8 9 10
1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10
1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10
Comments:
Week 7
Date / /

1 2 3 4 5 6 7 8 9 10
1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10
1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10
Comments:
Week 8
Date / /

1 2 3 4 5 6 7 8 9 10
1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10
1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10
Comments:
Week 9
Date / /

1 2 3 4 5 6 7 8 9 10
1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10
1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10
Comments:
Week 10
Date / /

1 2 3 4 5 6 7 8 9 10
1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10
1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10
Comments:
Week 11
Date / /

1 2 3 4 5 6 7 8 9 10
1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10
1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10
Comments:
Week 12
Date / /

1 2 3 4 5 6 7 8 9 10
1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10
1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10
Comments:
Week 13
Date / /

Yes / No (1 being energetic, 10 being vey weak)
1 2 3 4 5 6 7 8 9 10
1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10
1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10
Comments:
Week 14
Date / /

1 2 3 4 5 6 7 8 9 10
1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10
1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10
Comments:
Week 15
Date / /

1 2 3 4 5 6 7 8 9 10
1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10
1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10
Comments:

Progress Diary

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Subgroup

Kaposis’ Sarcoma Symptoms:(yeast, fungal and other secondary

Major Secondary Diseases:(Cancer,Tuberculosis,Hepatitis)

14-30 Days Before 7-10 Days After 90 Days After

CD4 Cell Count CD4 Cell Count CD4 Cell Count

CD8 Cell Count CD8 Cell Count CD8 Cell Count

HIV Viral Load HIV Viral Load HIV Viral Load

Ability to exercise Temp Fatigue

Ability to exercise Temp Fatigue

Ability to exercise Temp Fatigue

Ability to exercise Temp Fatigue

Ability to exercise Temp Fatigue

Ability to exercise Temp Fatigue

Ability to exercise Temp Fatigue

Ability to exercise Temp Fatigue

Ability to exercise Temp Fatigue

Ability to exercise Temp Fatigue

Ability to exercise Temp Fatigue

Ability to exercise Temp Fatigue

Ability to exercise Temp Fatigue

Ability to exercise Temp Fatigue

Ability to exercise Temp Fatigue

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