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Keeping a Symptom Journal

Mar 2, 2021

6 min read

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Have you ever left a doctor’s appointment feeling like you didn’t get the answers you were looking for? I know I sure have. This past November, I had an unexpected health crisis spring upon me. A week before I was scheduled to go in for surgery, I went against my intuition to hold off on any gastrointestinal (GI) stuff until after my surgery. My GI doctor had recommended a barium swallow x-ray. It sounds pretty harmless, right? I thought so too. What could possibly go wrong? Well… I was about to learn what could go wrong and more.

I had such a severe reaction to the barium swallow contrast that my doctor sent me to the emergency room. I not only had to cancel my surgery, but I would also have four more trips to the ER after the medicine my doctor prescribed made me sicker and sicker. With no definitive answers and my symptoms continuing to worsen; I didn’t know what was going on with my body and knew I needed answers. Instinctively, I began to record my symptoms filling notebooks with my symptoms, time, date, etc. hoping to gain insight as to what was going on in my body. I am so glad I did as this played a vital role with my Integrative Nutritionist/Functional Medicine doctor being able to properly identify what was going on in my body and provide proper treatment so I could begin to heal and recover from the atrocities and adverse effects western medicine had on my body.

Medical conditions can be tricky to diagnose and often require many trips to the doctor (or telemed video visits which have become more of the normal since the appearance of covid-19 last year), and different tests and procedures to properly identify and diagnose what is going on. It can be very time-consuming, expensive, and so frustrating.

Some conditions such as digestive and gut disorders, food allergies and sensitivities, and chronic pain can be especially difficult to identify as there are often subtle differences between similar conditions. This is where keeping a symptom journal can come in handy.

Keeping a written record of your symptoms or recording them in a mobile app can help your healthcare providers properly diagnose your condition. The more information you can provide, the more accurate the diagnosis and treatment will be. Keeping a symptom journal can be one of the most valuable tools in maintaining your health and wellness.

What is a Symptom Journal?

A symptom journal is simply a record of the observations you collect about your health or things that cause you concern and alarm that something isn’t quite right.

How do I Keep a Symptom Journal?

I knew instinctively what to record which was very detailed and helped my Functional Medicine doctor be able to diagnose what was going on and how to begin addressing the issues once we identified them. I continued to email her a daily log for a few weeks then a weekly log then as needed.

Vague information isn’t very helpful to your healthcare providers. They need to know details to make the best decision about your care but you also don’t want to present them with a notebook with all the information as I learned with my primary care physician as he didn’t have the time for me to read and go over every detail with him during telemed and office visits. He preferred a brief summary of the details like my Functional Medicine doctor had after she was able to determine what was going on and what the root cause was.

Before you begin recording your symptoms, you may want to ask your healthcare provider what specific pieces of information he/she would find most helpful. Here are some things you may want to consider while recording your symptoms in your journal.

What?

What is happening in your body? Describe your symptoms in words in as much detail as possible.

As my doctor reassured me, don’t worry about being embarrassed, providing too much information, or being too graphic that’s what they do and talk about. (I was extremely embarrassed to talk about my bowel movements with my doctor). They have seen it all and the more details you can provide the better. Sometimes the little things we think are insignificant are actually the most helpful and can determine the difference between different medical conditions.

When?

When do your symptoms occur? Note the date and time you experience the symptom and remember to record how long the symptom lasts. Pay attention to other factors, like your environment, do they occur only in certain situations such as only after eating, when you’re walking, sitting up, or laying down?

Where?

Where exactly are the symptoms occurring in your body? Pay attention to where in your body the symptoms are showing up. Being able to isolate where the area of concern is very helpful to your healthcare providers. Also, pay attention to your physical location when your symptoms appear. Do they appear at home, at work, or while out going for a walk in the neighborhood

Numbers

This is where you will want to include any measurable data such as blood sugar values, blood pressure readings, body weight, temperature, and pain levels (using a scale from 1-10 for severity. You may also want to describe how the pain feels throbbing, sharp, etc.). Remember to record any medication and supplements you take here with the timing and dosages as this can be extremely helpful in determining whether or not the medication or treatment is working for you. You may also want to record the amounts of food and beverages you consume.

Photos

Photos can be extremely helpful for conditions with physical symptoms as well as when it is difficult to describe your symptoms in words. Take photos, find images on the internet, or even draw a picture of your symptoms. 

Comparing swollen male Caucasian hands isolated towards white background

What makes it worse?

What makes your symptoms worse? Notice any factors or conditions that cause your symptoms to worsen. Knowing your triggers and what makes them worse is important information to provide your medical team. For example, are your symptoms more severe when you move around or laying down? Apply ice or heat? Do you only experience pain when you move, bend, or reach a certain way? Eat a particular food? Pay attention to how your symptoms ebb and flow throughout the day but please be cautious about becoming hyper-focused on your symptoms.

What makes it better?

What makes your symptoms better? Think about the factors that cause your symptoms to improve and feel better? Which medications, therapies, self-care strategies tend to improve your symptoms? For example, do your symptoms get better when you’re lying down compared to sitting or standing up? Do your symptoms feel better when you apply heat compared to ice? These subtle differences can help your provider zone in on the most effective treatments.

Summarizing your data

Once you’ve collected and recorded your data for several days, you will want to start organizing your findings. As I learned with my primary care physician, most health care professionals don’t have the time to go through your records and prefer a summary. I was blessed that my Integrative Nutritionist was one of the few providers that do as she was able to pick up things my primary care physician did not and together with my primary care physician, we were able to determine the issue and root cause of what was going on. It is much more helpful to your doctor when you tell them for example you had acid reflux 28 times in 14 days, and it was worse when laying down after eating spicy food rather than handing him a stack of hand-written notes or reading your notes on a telemed visit. Take some time to look over and review your data before your visit with your healthcare provider.

It’s important to know that keeping a symptom journal is not meant to self-diagnose yourself. It is an easy way to get to become aware of and get to know your body on a deeper level as well as provide important information.

Information contained in this article is for educational purposes only based on my personal experiences and should not be interpreted as providing or replacing medical advice, diagnosis, or treatment.

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Mar 2, 2021

6 min read

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