I regularly hear from Heart Sisters readers who contact me because they’re having distressing symptoms that might be heart-related, and they want me to help solve the diagnostic mystery. (Please don’t do this, by the way. I’m not a physician so cannot comment on your specific symptoms. That’s all I will be able to tell you if you ask me for a medical opinion). But besides my standard “See your doctor!” advice, there’s one thing I do recommend to readers worried about strange new symptoms, and that is simply to start a Symptom Journal.
Here’s how it works: .
When puzzling symptoms appear, start monitoring the following:
- Time of day
- How long symptom(s) lasted
- Descriptions of symptom(s): e.g. location(s) in the body, severity, quality of pain, etc.
- Triggers (what you were doing/eating/drinking/feeling in the hours leading up to the onset of symptoms – and even weather changes)
This little list might begin to offer surprising hints to share with your physician. Often, a pattern begins to emerge that just might help to solve the mystery.
A small example: I recently developed weird, random stomach cramps out of the blue (as if I really need one more thing to worry about!) Sometimes they happened while out with my walking group, other times when I was driving the car or writing an article, but it was through my Symptom Journal that the clues started to make sense: these cramps would predictably flare up only on the days I’d had oatmeal for breakfast.
But was it the oatmeal itself? The pumpkin seeds? The blueberries? It was only when I started experimenting with eliminating, one by one, and finally substituting almond milk for my regular milk on the oatmeal one morning, that the mystery was solved. The only milk I consumed was with oatmeal. So now, no more problems eating oatmeal! (By the way, if you’ve recently been hearing that this traditional breakfast favourite of grandmothers and dietitians alike is now our enemy, read this).
North Carolina family physician Dr. Bryan Hodge also recommends tracking symptom details, as he wrote in the journal, Family Practice Management:
“Making sense of the disorganized details of the patient’s history is often limited not only by time available at the appointment, but also by the patient’s insight, recall bias, and anxiety. One strategy for improving information-gathering during the patient encounter is the use of symptom diaries.
“A general symptom diary can also allow more focus on the patient by obtaining critical aspects in a presentable, concise format.
“Fatigue and pain symptoms are unique and personal experiences for patients. Reviewing the diary directly with the patient validates his or her complaints, demonstrates caring and trust, and provides an excellent foundation for setting reasonable expectations.
“This enhances the therapeutic relationship with these patients, who may be perceived as being difficult. Identifying the ups and downs associated with their problem can also help illustrate the course of illness and promote patient resiliency.
“The amount of time it takes a physician to review a one-page diary is substantially less than the time it takes to verbally interview a patient for the same information. Symptom diaries can create a more thorough history, which also has the potential to limit unnecessary lab and medical imaging testing.”
Recently, I heard from a blogger at Sick With Optimism who is living with a number of serious autoimmune disorders. One of her sanity-preserving (and possible lifesaving) tools is her own notebook.
While some patients may choose to record medical notes on a phone, she prefers writing in an old-fashioned notebook – and not just for recording symptoms, but for all kinds of important health-related issues.
Consider her To-Do advice before each medical appointment, published originally on her blog:
“I was using my phone for these notes, but in the end, they weren’t easy to organize. And if you have an advocate helping you out, it might be difficult for them to understand and use the applications on your phone. That being said, the phone has been a great place to calendarize appointments and lab tests with advance notification reminders — It can get very confusing if you don’t keep careful track.
“Keep a specific notebook that you or whomever you ask to help you can keep chronological notes in. Keep the notebook with you. That way when you think of a question, you can write it down rather than relying solely on your memory.”
The “Sick With Optimism” blog post includes one more useful tip for starting your own journal:
“Your notebook is the reality: questions, symptoms, test results, diagnoses, appointment dates.
“Now do one more thing to help yourself. Write down things that inspire you towards optimism: quotes, the title of a book or blog that is recommended to you, a website or Youtube channel you want to explore later, or a good deed that you did or plan to do.”
Q: Do you use a journal or other item to record your medical notes?
NOTE FROM CAROLYN: I wrote much more about cardiac symptoms in my book, “A Woman’s Guide to Living with Heart Disease”. You can ask for it at your local library or favourite bookshop, or order it online (paperback, hardcover or e-book) at Amazon, or order it directly from my publisher, Johns Hopkins University Press (use their code HTWN to save 30% off the list price).
ANOTHER NOTE FROM CAROLYN: Please do NOT leave a comment here telling me about distressing symptoms you might be experiencing (re-read the first paragraph to learn why).