Keeping a diary

I’m an advocate for keeping a diary of health symptoms – it’s something I often recommend when someone asks me for advice in the pharmacy. Sometimes it’s hard to know exactly what’s wrong and how to treat a condition. A diary is a good way to track symptoms and provide other really useful information. Recording details such as frequency and severity of symptoms might ultimately lead to providing clues for how best to treat those symptoms and manage the health issue.

Whether your symptoms are specific, such as a headache, or a combination of symptoms such as ‘stomach issues’, keeping a diary might be a good starting point.

Typically a diary involves recording symptoms over a period of time – ideally every day for at least a week so you can see if there are patterns as to when symptoms occur and the impact of those symptoms on your daily activities.  Depending on the symptoms you might need to record events several times during a day.  The longer you can keep the diary the better.

Let’s look at a pain dairy as an example. Ideally you would make notes about as many aspects of the pain as possible. For example,

• Site of pain – use a diagram of the body to mark where pain is felt. This is particularly relevant if pain occurs in more than one place.
• Describe the pain – is it dull, sharp, stabbing or like pins and needles? Use whatever words seem right to you.
• Other symptoms e.g. joint stiffness, nausea, dizziness, indigestion.
• Timing of the pain – is it worse at night or in the morning? Does it keep you awake at night? Does it come on after eating (if so what foods) or after drinking alcohol?
• Anything that makes the pain better – management strategies such as what helped you get through the day and any medicines you took.
• Anything that makes the pain worse e.g. clothing or sheets touching it or specific movements
• Severity of the pain. There are a variety of pain scales used to record pain and its impact on a person. A good one is the number scale from from 0 = no pain to 10 = the worst pain imaginable.

Other pain scales use faces where a smiley face would show no pain and a sad or crying face would relate to severe, debilitating pain.

• Record anything else that you notice or think is relevant e.g. work and social activities or stress you’re under.

Another example would be a headache diary.  As well as recording when you get your headache, what part of your head is affected and describing the pain it might also be relevant to record details relating to the hours or days before your headache occurred.  This might include what you’ve eaten, any alcohol you’ve had to drink, how much sleep you’ve had or exercise you’ve done.  For women recording details of your menstrual cycle might also be relevant.

Gathering all this information together can help you and your doctor or other healthcare person understand your symptoms and how they are impacting your life.  Ultimately this will help with deciding how to treat it.

You might be able to find a template for a symptom diary on the web.  Support agencies or groups such as those for asthma, migraine or irritable bowel syndrome might also provide dairies you can use. These days there are apps available too.

The bottom line is to write it down! I know when I’ve been asked to recall symptoms, I’ve sometimes found it hard to be specific.  Writing this information down provides a clear objective picture and as I said before it can allow you to see if there are patterns to when symptoms occur.  Having this knowledge can also help to quantify the impact of the condition on your everyday life –perhaps it doesn’t occur as often as you think it does,  or perhaps it occurs more often and stops you doing things you enjoy.  Having a clear picture might help you feel more in control of your health and enable you to take action to prevent or better manage a health condition.

And when you need to see a doctor or other health professional, having a diary will enable them to better assess the condition and decide on a specific treatment plan just for you.

Written by: Jenny Cade

This blog pro­vides gen­eral infor­ma­tion and dis­cus­sion about med­i­cine, health and related sub­jects. The information contained in the blog and in any linked mate­ri­als, are not intended nor implied to be a substitute for professional medical advice.