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    <p>
        <b>Monoclonal Gammopathies Symptom Questionnaire</b>
    </p>
    
    <p>
        <u>Symptoms which can be associated with disease activity:</u>
    </p>
    
    <p>
        <i>
            Bone pain: aching or other discomfort in one or more bones.
            This does not include arthritic or muscular aches and pains.
            Bone pain associated with disease activity would be persistent,
            i.e. it would not come and go.        
        </i>
    </p>
    
	<p>
        Do you have any bone pain   YES [ ]   NO [ ]
	</p>
    
    <p align="right">
        If yes, is the bone pain: Long-standing but stable [ ]   
        New, or  long-standing but getting worse [ ]
    </p>
    
    <p align="right">
        If yes, is the bone pain in the: Ribs [ ]    Back [ ]    Upper Arms [ ]   
        Upper Legs [ ]    Other [ ]
    </p>
    
    <p>
        If you develop one of these symptoms, or a pre-existing symptom becomes
        significantly worse, please contact us (details above)
    </p>
    
    <p>
        <i>
            Symptoms that are extremely rare but need to be dealt with urgently
            include: numbness, loss of feeling or paralysis of lower limbs;
            urinary and fecal incontinence and/or urinary retention. Any of these
            symptoms should be reported immediately to your GP or contact NHS Direct.        
        </i>
    </p>

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