How to Use a Daily Journal to Track Psoriatic Arthritis

by Casey Nilsson Patient Advocate

The first page in my psoriatic arthritis journal is more of a confession than an entry.

Handfuls of M & M’s from the office candy bowl; fast food burgers and fries; bagels slathered in butter: If it’s an inflammatory food, I was eating it. A lot of it.

It wasn’t always so. When I was first diagnosed with psoriatic arthritis, I went all-in on an extreme elimination diet that cut out nightshade vegetables, eggs, most spices, grains, refined sugar, dairy, nuts, and legumes.

I lost a good deal of weight. The stiffness in my hands and feet diminished to only 15 minutes in the morning. The plaques on my legs disappeared. I felt awesome.

But I missed bread and sugar. Naturally, I caved. And I caved again. Permanently. And here I am, several months later, with all-day stiffness in my hands and feet, pinky fingers that lock up at random, and a growing map of lesions where they’d never been before. So last month, I purged all the junk I’ve eaten over the past year and started a fresh white page in a small black notebook.

My psoriatic arthritis journal is a twist on the traditional food journal kept by dieters and health nuts; it has entries on joint health, too. My day begins and ends with a stiffness update. Then, throughout the day, from the first beverage to the last meal, I take notes. I also track physical activity and stress levels, and I’ve begun to note any new patches of psoriasis that crop up on my body, and where.

Since chronicling my every mood and bite, I’ve found that certain things hurt more than others. If I don’t drink enough water and I eat a lot of triple threats – meals with dairy, gluten and meat packed into one neat sandwich – I’m stiff all the next day and, very likely, the day after that. Food hangovers are real.

If I stick to whole foods and incorporate anti-inflammatory herbs like turmeric and ginger into my meals, I’m stiff for about a quarter of the day. A glass of red wine on a good day doesn’t seem to affect me.

Clearly, my entries aren’t always stellar. I’m a stress-eater, and the journal makes that painfully obvious. At several points, I’ve felt like abandoning the practice altogether. It’s a confidence-booster to write down that morning smoothie or lunchtime salad; that doughnut from the office kitchen, less so. I often think, if I’m not doing it exactly right, what’s the point of doing it at all?

The point is: It’s an improvement from where I was before. I have proof, right there on the first page. And writing it all down makes me want to be better. I may never choose to try a strict elimination protocol again, but a well-balanced diet with minimal inflammatory foods and moderate exercise? That, I can do.

The little black notebook keeps me accountable. Unlike the tracker on my phone, which is buried behind dozens of other applications at the bottom of my purse, I can’t avoid my notebook’s sharp edges or what’s detailed on its first page. Do I want another fast food meal that’s devoid of nutrients, or do I want something that feels as good to write down as it does to eat?

For the last two weeks, I’ve chosen the latter more than the former.

Can I get back to where I was a year ago, when I could wake up without remembering I had an autoimmune disease ravaging my skin and joints? Ask me again in a few months.

Tips for starting your own psoriasis journal:

  1. Start by spilling your guts. It may seem masochistic, but I find that it’s helpful to have a reminder of the way I ate all the time, without accountability, pre-journal. It makes me feel like a superhero on the good days and less like a zero on the bad ones.

  2. Track stiffness in detail. I’ve started to check in on my joints mid-morning and in the afternoon, too. It’s validating to write down that I’m not experiencing joint stiffness later in the day.

  3. Take your stress levels into account. If you wake up and feel stressed about the day, write it down. It’ll help remind you why you’re heading for the vending machine instead of the fruit you packed for a mid-morning snack.

  4. Be accountable. You’re not going to eat, drink and move just the right way every day. The point is to see which foods make your body feel good and which foods don’t.

Casey Nilsson
Meet Our Writer
Casey Nilsson

Casey Nilsson, an award-winning journalist and magazine editor based in Rhode Island, writes about autoimmune disease for HealthCentral. Casey is a 2018 Association of Health Care Journalists fellow, and her reporting on unfair labor conditions for people with disabilities was a finalist for the City and Regional Magazine Association Awards. Diagnosed with psoriatic arthritis in 2016, Casey enjoys digging into rheumatologic news, research and trends.