My Pain Diary
the simple chart I keep, and why

For ten years, when a doctor asked me about my pain, I said "it's really bad." That's not much to go on, and I think it made it easy to wave me off. When I started seeing Dr. Schindler, she asked me to keep a pain diary for three months before my laparoscopy. I walked into my next appointment with three months of dates and numbers, and the whole conversation changed. You can't argue with a chart. Well, you can, but it's harder.

I still keep it. It takes about a minute a night. I keep it in a little notebook in my nightstand, with a pen clipped to it so I have no excuse.

Date. Obvious, but write the day of the week too. Patterns hide in there (I had a lot of bad Mondays).

Cycle day. Day 1 is the first day of your period. Count up from there until the next Day 1. This is the column that shows your doctor whether your pain lines up with your cycle.

Pain, 0 to 10. Your worst pain that day. See my scale below.

Where. Lower belly, one side or both, low back, down the legs, anywhere else. Be specific.

What I took or did. Medicine, heating pad, bath, lying down. And whether it helped.

What I missed. Work, school, plans, sleep. This is the column that finally made people understand it wasn't "just cramps."

Your scale can be different. What matters is that you use the same one every day.

Here's a real week from my notebook, so you can see what it looks like filled in. This is a good month, by my old standards.

After three months, Dr. Schindler and I could both see things I had never noticed:

• My pain started two or three days before my period, every single month, and was worst on days 1 and 2.
• When I waited until the pain was bad to take anything, it didn't help much. Dr. Schindler had me start my pain reliever at the first twinge instead, the way she directed, and my numbers dropped.
• I was having pain in the middle of my cycle too, which I'd stopped noticing because it was "only" a 3 or 4.
• I was missing two or three things a month. Seeing that written down, in my own handwriting, made me stop telling myself it wasn't that bad.

Now I bring the notebook to every appointment. It's how we decide whether the treatment is working. Before my diary, I had a feeling. Now I have evidence.

Print this as many times as you like. Or copy the columns into a notebook, which is what I do.

From Not Just Cramps by Crystal Landon, [email protected]. I'm a dental assistant, not a doctor. Take your diary to yours. Last updated September 20, 1999.