Logging FAQ

Logging has helped me in so many ways, I couldn’t possibly list them all.

The biggest benefit has been with my sleep. I’ve had sleep problems since I first got sick. Using data from my log, I was able to make a sleep chart. When I showed it to my doctor, she used the information to give me a new combination of medications. My sleep improved markedly, and so did my health. Without it, I might have been bedbound forever. That one change had a huge effect on my quality of life, and it wouldn’t have been possible without logging.

Here are a few of the other ways it helps me on a daily basis:

1. Accuracy
   Keeping a log means I know precisely how much time I spend on every activity each day. This gives me a much more accurate picture of my overall health and limits, and it also means that it is very clear when I overdo it.
   
   This accuracy helps with getting the right medical treatment, because I can give my doctors an accurate picture of my health and my limits. I can give care services graphs and charts if I need to, to give them a clear idea of the areas where I need help. This has been invaluable in getting better medical treatment and care.
   
   It also helps me with pacing and target setting. The goals I set now are far more realistic than the ones I made in the past, when I was keeping less precise logs.
   
   
2. Consistency
   Accuracy also means I’m far more consistent with my rest and activity, because I can see the variation from day-to-day clearly in my log. I’ve been able to use my log to figure out very accurate energy envelopes, and I aim to stay within these limits every day. I don’t always get it right, but overall, my rest and activity has become a lot more consistent since I started logging.
   
   
3. Accountability
   Keeping a log every day has become a way of being accountable to myself for what I’m doing. It’s much harder to spend two hours on the computer, or go a whole hour without rest, when I need to put it down in black and white.

It depends on the log you’re using. Logs such as the Activity Log take just a few minutes a day. Additional logs, such as one for sleep, may take longer.

My own Detailed Activity Log is a combination of symptom log, sleep log and activity log. I keep it a few minutes in the morning when I wake up, a few minutes in the evening when I go to bed, and for about 30 seconds whenever I switch activities during the day (usually a couple of times an hour). In total, it’s about 15 minutes per day.

So the Detailed Activity Log definitely takes longer than other forms of logging, but there’s a payoff for the extra work. My log gives a very detailed snapshot of my life and, with that amount of data, I can learn a lot. My log helped me to identify and treat a sleep disorder. With the years of data I now have, it also allows me to go back and look at how my energy envelope, schedule and symptoms have changed over time.

For me, it’s an invaluable tool that I’ll probably continue using for the rest of my life. But most people prefer to keep the Detailed Activity Log for a short time (1-2 months). They use it to identify areas of concern, then use subsequent, less intensive logging to focus on those areas of concern.

Above all, your logging practice should be simple, easy, and useful. It should not be a stressful experience. If your log is taking too much time and energy, then consider logging in a simpler way that focuses on areas that are important to you.

My philosophy is that logging should be useful, easy, and enjoyable (or at least not stressful). It should not add to your illness burden. If logging feels burdensome, then I suggest keeping a simpler log, or experimenting with the format, time and place you keep it. Less detailed logs have been just as helpful in navigating my illness as my Detailed Activity Log.

People who’ve taken our logging class have been very creative in coming up with logs that suit them, and I’m sure you will, too. The important point is to figure out a form of logging that is both achievable and useful for you. How a log looks, how often it’s kept, and what things are logged, is a bit different for everyone.

Many people find the logging forms we use in the course a great starting point. You can see some samples on the *Logs, Forms and Worksheets* page.

In my experience, experimentation is the key to success with logging. I spent over a year experimenting with keeping an activity log in different ways, before I found one that felt right to me. And before that, I’d experimented with many other kinds of logs. Discovering one kind of logging is not working for you is not a failure, it’s valuable information that will help guide you in future.

If I try something and it doesn’t work, I remind myself that all my experiments are steps on a journey, and a failure is a sign that I need to experiment more, or put on my thinking cap to find a way of doing things that fits me better . As Samuel Beckett says, “Fail again. Fail better.”

Yes! There are a number of spreadsheet apps you can use if you want to log on a mobile device:

Google Sheets (free, available on Android, iOS)
Apple Numbers (paid, iOS)
Microsoft Excel (paid, Android, iOS)
WPS Office (free, Android, iOS)

In addition, people taking our course have used other apps to help them with logging, including:

Evernote (free, iOS, Android), Google Keep (free, iOS, Android) — note-taking apps. There are many other similar apps. Good for jotting down notes and creating tables. They upload your notes to the cloud so they can be on your computer, your phone and your tablet at the same time. I’ve used Evernote to keep my Activity Log in the past.

Optimized (paid, iOS), ATracker (free, iOS), and ATimeLogger (free, Android) — apps for logging activity. These apps are probably the closest thing to the Activity Log that we use in the course. ATracker is particularly popular with our students.

Fitbit (free, iOS, Android) — paired with a Fitbit device, it tracks your activity and sleep. You can also use it to track your meals.

MyFitnessPal (free, iOS, Android) — a food and exercise tracker. Especially good for tracking meals. Data can be imported from Fitbit.

Sleep Cycle (paid, iOS only), SleepBot (free, Android) — sleep-tracking apps that use the accelerometer in your phone to measure the quality of your sleep.

Medisafe (free, iOS, Android) — keeps track of your medications and gives you reminders about when to take it (you can always add in ’rest’ as one of your medications too!)

Our students use a range of devices to monitor their health. The most common types are continuous heart rate monitors, pulse oximeters, pedometers, and fitness devices.

Note: Some of these devices are very expensive. Although they can provide useful information, it’s possible to manage your illness effectively without any special devices. A device that’s helped one person might not help another. You should use your own judgement about what tools to use when managing your illness.

Continuous heart rate monitors — First, let me explain why you would want to monitor your heart rate. It’s because we each have a heart rate limit beyond which symptoms are intensified. Many people are surprised to find how often they exceed their threshold just doing normal activities. So we can reduce symptoms by keeping our heart rate below our limit.

The second type of heart rate monitoring is morning resting heart rate. A small increase in your heart rate measured shortly after waking up can be a sign that a crash is coming, or a warning that you’ve already overexerted yourself. You can read more about both monitoring heart rate during activity and checking heart rate early in the day in the article Pacing by Numbers: Using Your Heart Rate to Stay Inside the Energy Envelope.

You can monitor heart rate by observing your pulse in your wrist or neck. You can also do so using a continuous heart rate monitor. As the name implies, continuous heart rate monitor is a device that continuously monitors your heart rate while, and provides alarms if you go outside your safe heart rate zone.

Continuous heart rate monitors come in two types: monitors with chest straps, the most common and cost-effective type (e.g. Polar heart rate monitors); and strapless wrist monitors (e.g. the Alpha Mio). Both can be used for taking morning resting heart rate, and can be worn throughout the day to help stay below your aerobic threshold during activity.

Pulse oximeters — A small device you clip to your finger, which measures heart rate and oxygen saturation. They’re often used to take morning readings to track health over time.

Pedometers — A pedometer or step counter can be a useful way to track activity. They are clipped to the belt, or worn on the ankle or wrist. One use of a pedometer is to create a baseline of activity. By correlating steps per day with symptoms, you can get an good idea of your present activity limits. Once you have found your limits, you can use the pedometer to help you stay within them. For more, see the article Pedometers: A Tool for Pacing.

Fitness tracking devices — These are usually a pedometer with more complex equipment included, like an accelerometer and a heart rate monitor. They usually interface with an app or website, providing data about your activity during the day and sleep at night. The most popular in our groups is the Fitbit. Another popular option is the Basis Peak, which measures a huge variety of things, including skin temperature, heart rate, sleep, and activity.

(Note: The heart rate monitor in most fitness trackers is not accurate enough for the kind of heart rate tracking done by participants in our course).

I use a Detailed Activity Log, which is similar to the Weekly Diary Log. I keep one week on a spreadsheet, with activities on one page, and symptoms on another. On the activities page, I write the activities for each hour on the left, logged in 5 minute segments, then I put them into different categories on the right so the spreadsheet can add them up. Activities are grouped into different categories so I can figure out my energy envelopes more easily.

I log symptoms using a high/med/low system. I use the spreadsheet to turn these ratings into percentages, which makes it easier to compare symptoms day to day and week to week.

I keep the spreadsheet on my smartphone (because it’s always handy). I update it once or twice every hour. I made everything I could automatic so I have as little work to do as possible day to day.

I tailored the Weekly Diary Log specifically to suit me. You may want to experiment to find something that works for you. Some class members respond well to color, others might prefer graphs or charts.

My log was a lot simpler when I first started. It took at least a year before I was consistently logging every day. I’ve added each new feature in slowly, when I felt like I could handle it. And I experimented a lot.

There are links to a sample of a Weekly Activity Log and a Weekly Log Tally sheet on Our Logs, Forms and Worksheets page. This page also has several other logs available for downloading and printing, including an activity log, an envelope log, and a symptom log.

Don’t worry about missing some days, especially in the beginning. When I started logging, I often missed days at a time, but I still got something out of it. It actually took me about a year of practice before I was logging every day!

I encourage people to find a level of logging they can do every day over the long term. Some people keep a log that is just one word summing up the day. Others highlight their “bad” days on a calendar. We use the Weekly Diary Log in our Logging Tutorial and there are others on our website. I’m sure you can find some form of logging that will suit you :)

To log consistently, you need to make logging a habit. In starting a new habit, it often helps to think about possible obstacles and how to get around them. The little trick that helps me is called If/Then planning.

First we think of a possible obstacle to our goals. One of mine is misplacing my smartphone, where I keep my log. The “If” in that case is: If I misplace my smartphone. Then I think of possible solutions, such as: I’ll write my log on the computer or a piece of paper until I locate it again.

Here’s are a few more:

If: I get busy and forget to log a few hours
Then: I’ll estimate what I did during that time; or I’ll leave them blank and forgive myself

If:I’m not logging my symptoms because my method is too complicated
Then: I’ll keep a simpler symptom log

You may also find unanticipated obstacles coming up. If/Then planning can be employed for unexpected obstacles as well, as they arise. Here’s one that came up for me recently:

If: I get a migraine (making it hard to look at my smartphone screen)
Then: I’ll wear blue-light blocking glasses when filling out my log; or write it on a piece of paper until the migraine passes

I can really relate to that! I used to struggle with my log too, until I figured out a way to keep it that just clicked with me. You may never love logging, but I encourage you to experiment until you find a way of logging that works for you.

Something that’s helped me generally, not just in logging, is choosing the next best option. For example, I just couldn’t make myself rest this morning, so I did the next best thing — lying down quietly watching tv. This is not as good as resting, but much better for me than spending that time in strenuous physical or mental activity.

When I first became housebound (and then bedbound) was the hardest. My health and what I was able to do had deteriorated so much. I thought it was impossible to find a way to be happy. So I started making a list of all the fun activities I could do in bed. I started a project that I cared about (watching all the films of the AFI’s list of top 100 films from the last 100 years). It helped. And then over time, I adjusted to my new level, and then that level improved.

All of which is to say, that there’s joy and meaning to be found in life no matter what your level of health. Logging and pacing can seem restrictive, but really they enable us to live the fullest life we can with this illness.

It’s helped in so many ways I don’t think I can list them all! The biggest one is probably my sleep. I’ve always had sleep problems, but none of the treatments I’ve tried have worked. Using data from my Weekly Diary Log, I was able to create a sleep log for an entire year. This helped me figure out the exact sleep disorder I was suffering from, and when I showed it to my doctor I was able to finally get the right treatment.

Without getting my sleep right, I think I would’ve been bedbound forever. It’s had a huge effect on my life, my symptoms and my wellbeing, and it wouldn’t have been possible without logging.

It’s not enough just to keep records. To use logging to improve our lives, we need to follow three steps, summarized in the words in bold below:

1) Write Make entries in a log.

2) Analyze Tabulate and analyze the data to gain understanding.

3) Apply Use your insights to better manage your CFS/FM. (The big challenge!)

The key is using averages. I usually use four weeks of data to find my energy envelope in any given area, but even one week is helpful for getting a rough energy envelope. I find my energy envelope for an activity (e.g. computer) or category (e.g. mental activity) in three steps:

1. Add up the total amount of time spent on that activity each day
2. Add together the totals for each day
3. Average that total by the number of days I’m analyzing

For example, here is a recent week of computer use, from Sunday to Saturday: 0, 4:15, 4:25, 1:05, 6:45, 7:00, 3:40. That totals to 26 hours and 20 minutes. Then I divide it by 7 and get 3 hours and 45 minutes. So a rough envelope for my computer use is 3:45.

I do this for every activity, and for every category of activities (e.g. mental activity which includes all screen time, reading, logging and other mental tasks). In the beginning I did it with a pen and paper, but now I’ve set up my logging spreadsheet to calculate my energy envelope for me automatically.

Let me give you two examples:

1) Insight into the push-crash cycle
When one class member did her weekly tallies, she realized that her days of high activity were much more frequent than she thought. Because she now had concrete evidence of the push-crash cycle, she was able to change her behavior. She wrote:

“I just finished analyzing my logs using the weekly tally forms. My first reaction is ‘yikes!’ No wonder my recovery seems stalled. The past two weeks had back-to-back days of high activity followed by mini-crashes followed by at most 1 day of low activity as I geared up for the push cycle. Logging & the analysis makes it clear: what I need to work on is scheduling things with my energy envelope in mind.”

2) Recognizing Overdoing & Inconsistency
Some common realizations from logging include becoming aware that we are more active than we knew, having varying activity levels from day to day (push and crash), and not having a balance between light, moderate and heavy activities.

One person wrote: “I’ve learned through logging that I spend a LOT more time on a computer than I imagined. That’s not what I want. I’ve consciously started trying to spend less time at the computer.”

I find my energy envelope for an activity (e.g. computer) or category (e.g. mental) by looking at the average for it. Usually I use four weeks of data to find my energy envelope rather than one week, but one week is helpful for getting a rough energy envelope.

I’ve found I need about 9 1/2 hours sleep, about 3 hours rest each day and I have a limit for screen time of 3 hours or less. This gives me a good sense of my limits, and I can use these as targets for my day-to-day pacing in future.

Often, a good starting place is to investigate what was going on before symptoms increased. For example, one time when I slept a lot more than usual, I looked at my log for the day before and saw I did almost double my usual physical activity – no wonder I needed so much sleep!

Another way I use to find how well I’ve been pacing is by looking at my weekly totals and comparing the average (mean) and the median. The closer they are together, the better I paced. A recent week looked pretty good overall, apart from screen time, which means I probably had one day where I spent way too much time on the computer.

Looking back over the week, yep, on Tuesday I spent almost double my usual time on the computer. Looking at my symptoms page, I can see the symptoms for the two days after that were much higher than usual, especially my weakness and fatigue. My resting heart rate was high too. All classic signs of overdoing it.

So what I’ve got from my analysis is that my problem areas are physical activity and computer use. One or two days a week I go way over my limit with them, and that’s increasing my symptoms and causing a push-crash effect.

Now I know that, I can look at solutions, which might include target setting, using timers, or using my log to keep track of those activities during the day.

There could be a number of factors that are making it difficult for you to find connections between symptoms and activity. It helped, for example, when I broke down activity into light, medium and hard.

1. Lack of specificity: Early in my use of logs, the categories I used weren’t specific enough, so I didn’t capture the true variation in activity or symptoms.

2. Inconsistent logging: I used to log inconsistently, sometimes missing hours or even days, and unfortunately, the hours or days I was missing were the ones where I was either overdoing it, or recovering from overdoing it. Once I started logging consistently the connections became apparent.

3. Tracking the wrong symptoms: It could be that some of your symptoms are stable, or are not related to activity level, while others are highly responsive to activity. If you think about symptoms you get that warn you of an impending crash, these are often good ones to track.

For example, my fatigue levels are fairly steady, but the level of weakness I have in the mornings is a good indication of whether I’ve overdone it the day before. If getting out of bed to feed the cat in the morning is a struggle and everything I lift feels heavy, this is a warning sign for me. Another one is abdomen pain. I get severe pains in my abdomen when I’ve sat or stood for too long, so I always note these down.

4. Delayed reactions: It takes up to two days for my post-exertional malaise to manifest (longer if I’ve taken certain medications). You may have to look farther back in your logs for connections.

5. Activities that seem low-intensity are really high intensity: It wasn’t until I started using a heart rate monitor that I realized some of the activities I thought were easy were actually a real strain on my body. I was especially surprised at how high my heart rate got when I was brushing my teeth — it seems like a fairly easy thing, but actually my body behaved like it was like I was running a sprint the whole time! (I sit down when I brush now; it helps).

A pedometer can also be useful. My rule of thumb is no more than a 15% variation in steps from day to day. If your step count is varying more than that, it may be a sign of a push-crash cycle.

6. Constantly outside my envelope: When I was really bad at pacing, my symptoms were always intense, and I got a lot more of them. It was impossible to find a connection between symptoms and activity level because I was overdoing it so much that my body was under constant stress.

If you suspect this is the case with you, I d suggest cutting your activity in half (or more) for two weeks and seeing if your symptoms lessen. If they do, it s a sign you might need to cut back.

7. Sleep problems: Sometimes the hidden connection between symptoms and activity is sleep quality. If you re getting poor quality sleep, have insomnia some nights, or get other sleep symptoms it s worth keeping a sleep log alongside a symptom log for a few weeks to look for connections.

8. Fresh eyes: It might be that there is a connection that you re not seeing. Getting a fresh set of eyes (especially someone who’s good with data and graphs) can really help. I’ve had friends spot connections that seemed so obvious when they pointed them out, but I had never seen.

It’s helped me to think of activity in terms of light, medium and hard. Since I was mostly bedbound when I started logging, I settled on a simple system. Light activities were done lying down, medium activities were done sitting, and hard activities were done standing. (And socializing was its own special category!)

I still use this system, but now I’ve combined it with a heart rate monitor. If my medium sitting activity sets off my heart rate alarm, I know it s actually high intensity! I also keep an eye out for big blocks of time spent doing one activity in my log — recently I had 50 minutes in the kitchen in one go! Normally I don t spend more than 15 minutes in there. This is a sign of an activity becoming too high intensity, so I made sure I rested more than usual the two days afterwards.

If you’re printing your pages out, you can always color code them after they’re printed using highlighters or markers. For example, some people use different colored highlighters in their logs to indicate how intense an activity is.

If you’re keeping your log on the computer in Word or Excel, they both have tools to change the color of the background, or the color of the text itself. So you’ll be able to imitate your colored pen system on the computer.

My own spreadsheet log has what they call “conditional formatting” in some of the cells so that they change depending on what is entered into them. I use a red/yellow/green system, so I get a warning when I’ve gone outside my daily limit.

As mentioned earlier, all our logs are available for downloading and printing on the Logs, Forms and Worksheets page.

Also, we have several articles on logging:

• Limits, Logging and Better Health
• Learn to Predict the “Unpredictable”
• Health Logs: Big Payoff on a Small Investment
• More Ideas for Logging