To document or not to document? That is the question

Living with a chronic illness, it's easy to push the little symptoms under the rug. When you're dealing with the basic problems of arranging medical care and somehow still managing to live your life, the task of devoting even more time to documenting symptoms and changes is daunting. It's hard to know exactly how updated you should keep your doctor.

One way of monitoring symptoms is to keep a pain or symptom journal. For people whose disease may cause times of visible change (say, a rash or swollen joints during a flare) taking photos is one option for keeping your doctor up to date. Keeping symptom journals or taking photos during symptom outbreaks has some benefits and (unfortunately) some drawbacks. Here are some pros and cons of keeping documents of your symptoms.

pro: A daily log shows changes over time. This information showing improvement or decline can be helpful when addressing your needs with your doctor. It can also provide a lot of information about whether or not a treatment plan is working.

con: Our methods of quantifying symptoms in self-report change as we adapt to them, so the information may not be valuable. I remember the first real flare I had: my chest just ached and I would have rated it 10/10 pain. However, when it didn't go away, and as it still hasn't, I adapted. Since I'm used to that pain on a daily basis, it might now only register as a 4/10, but that doesn't mean the pain has really improved.

pro:  Documentation can help show patterns in your symptoms that you weren't aware of. For example, if you track pain and food, you may find that a certain type of food makes you flare, or that your pain is correlated with times of high-stress.

con: Doctors are quick to accuse patients of catastrophizing when they appear too proactive in their healthcare. This is a major problem because it rejects the notion of patient and doctor as partner, but it still happens. I don't have any answers, and I've been jilted by this in the past, so I know it was worth a mention.

pro: Logs can be helpful reminders of infrequent symptoms. If you write down new of puzzling experiences, you can refer back to your log when you discuss it with your physician to keep the details straight in your mind.

con: Tracking your symptoms can be depressing! This is ultimately why I decided to discontinue my pain log; too many days of writing down high pain really make me start questioning my whole chronically ill existence. Because I don't have a whole lot of new symptoms and I'm not currently receiving any real treatment, the monotony of recording my pain started dragging me down.