Lung Disease Journal: Track Symptoms, Medications, Activities and Assess Daily Changes for COPD, Chronic Obstructive Pulmonary Disease, Lung Cancer, Pulmonary Fibrosis, Asthma, Pneumonia, Asbestosis

Triggers, Symptoms

Concerns/Triggers - select from prelisted options or add in the Notes area

Notes - for insights, comments, questions

Location - mark on body where symptoms occur

Symptoms - options include chest pain, breathlessness, fatigue, cough/phlegm, wheezing, irregular heartrate, discolored skin, loss of smell/taste and more.

Pain and Breathing Tracker

Pain and Breathing Tracker - issues may occur sporadically during the day so you can enter the symptom here (along with the trigger if identified), when the symptom occurred, and circle a number to indicate the severity. This also provides the opportunity to record issues as the severity changes during the day.

Daily Assessments, Statistics and Activities

Daily Assessment - circle applicable arrow to indicate 'Increased, Same, Decreased' for pain, breathlessness, mental clarity, strength, fatigue, sleep quality, general mood, stress, energy, activity.

Enter O2 level, weight, blood pressure, heartrate, sleep

Select from prelisted options and includetime (hobbies, employment, house/yard work, self-care, childcare, socializing, commute).

* See sample completed page

Meals & Snacks, and Medications

Meals & Snacks - checkboxes available to indicate if the meal included dairy, gluten, sugar or fats.

Hydration

Medications - checkbox to indicate 'Usual daily medications' and/or 'Usual daily supplements'. Enter additional medications along with time, dose and whether it helped.

Example of completed area

Daily Assessments - note that breathlessness, pain, fatigue, general mood and activity are indicated as increased. Mental clarity, sleep quality, stress and energy are marked as no change. Strength is marked as decreased.

Example of completed page

Wheezing at 6pm - severity 5 - likely caused by perfume on the train.

Personal Information and Healthcare Team

Introductory pages have space for personal info including allergies and medical alerts.

Enter doctor and contact info.

Enter pharmacy and contact info.

Enter insurance information.

Daily Medications and Changes to Daily Medications

Page for current medications / supplements along with reason and refill due date.

Page for CHANGES to medications and supplements with reason for the change, new dose, and date effective.

Medical Appointments and Suggested Exercise Log

Test/Results and Oxygen/Blood Pressure Log

Example of page with Oxygen and other statistics