Chronic illness flare log
A one-minute daily check-in of energy, pain, symptoms and spoons, every dose taken or skipped and what helped; a month that rolls the days into patterns; the care team, medicines, conditions and allergies and a flare plan at the front.
People with a chronic illness who need a record their doctors can read.
Order as is goes straight to the order form, where you choose the days, binding and address and see the price before you pay. Change it first opens the whole book in the editor. No account needed for either.
Front pages
Your care team, medicines, a flare plan, questions for appointments, a record of flares, and conditions and allergies.
- Care Team (table)A table headed Care Team, with columns for name, role and phone.
- Medicines (table)A table headed Medicines, with columns for medicine, dose, when and for.
- My Flare Plan (questions)My Flare Plan: early signs, what helps, who to tell and when to call the doctor, with lines to answer.
- Questions for Appointments (table)A table headed Questions for Appointments, with columns for date, question and answer.
- Flares (table)A table headed Flares, with columns for started, ended, trigger and what helped.
- Conditions & Allergies (note box)A box headed Conditions & Allergies, ruled with lines, to write in.
Every month
Good days, hard days, questions to ask, a mood chart, flare days marked, the month's patterns, a monthly review and medicine changes.
- Good Days (note box)A box headed Good Days, ruled with lines, to write in.
- Hard Days (note box)A box headed Hard Days, ruled with lines, to write in.
- Questions to Ask (note box)A box headed Questions to Ask, ruled with lines, to write in.
- Mood Chart (month)The five-face mood chart across a whole month, for patterns a single week hides.
- Flare Days (Mini month)A small calendar of one month, for marking days at a glance.
- Patterns (table)A table headed Patterns, with columns for week, spoons, on average, worst symptom and notes.
- Monthly ReviewA few questions at the end of each month, with lines to answer them. It starts with what worked, what did not and what changes next month, and the questions can be your own.
- Medicine Changes (note box)A box headed Medicine Changes, ruled with lines, to write in.
Every day
A page a day: symptom severity, what helped, a food diary and what made it worse beside the hours, then spoons, energy, pain, mood and sleep from 0 to 10, and every dose taken or skipped.
- Symptom SeverityRate each symptom every day from 0 for none to 3 for severe. It takes a few seconds on a bad day and builds a record of patterns to bring to an appointment.
- What Helped (note box)A box headed What Helped, ruled with lines, to write in.
- Food DiaryWhat you ate and how you felt after. Writing both is a simple way to notice which foods suit you.
- What Made It Worse (note box)A box headed What Made It Worse, ruled with lines, to write in.
- SpoonsTwelve spoons a day to cross off as your energy goes, from Christine Miserandino's spoon theory: a way to count the limited energy a chronic illness leaves for each day.
- Energy & Pain ScaleRate energy, pain, mood and sleep each day by filling in a circle, on a scale you can set, such as 0 to 10.
- Medication DosesWrite each dose with its time and amount, then tick whether you took it or skipped it. Doses taken only as needed get a tick under PRN, so a skipped dose never looks like a taken one.
The whole book, laid out.
Every page dated and ready to print at home or as a bound book. Move, resize or take out anything, and Memari lays out every page after.