Is it worth the work?
Yes. One of the trends that we've seen with IC patients is that they often stop treatments prematurely. A subtle decrease in frequency is one sign that a treatment is working. Yet, if you aren't keeping a record of your frequency, you may not see this progress and stop what could be a successful treatment for you. Remember, your memory is not good enough. It does not help for you to visit the doctor and say "I'm not any better." You need to be able to back that up with bladder facts, such as: "I'm not feeling any better and I'm now urinating 20 times a day instead of 15 times a day."

What should it be recorded in?
A student spiral notepad works best.

What should be recorded?

1. The Date & Day of the Week - usually one side of paper will work for each day
   
2. The time of day that you urinate - i.e. 10:30AM
   
3. Pain level- if applicable, on a scale of 1-10
   
4. A rough estimate of volume - i.e. 1 cup, 1/2 cup, 1/4 cup, 1 TBS. For measurements of volume, it may be helpful the first day to use a measuring cup to get an idea of volume. After that, an estimate is all that you will need.
5. Notes - as needed

My doctor says I don't need it. Should I still do it?
We feel that it's very important for you to learn about the normal monthly fluctuations that IC patients experience. For women, it's normal to flare during ovulation and/or a few days before your period. When you actually see it and record it, it greatly minimizes the anxiety that sometimes happens when a flare begins. You'll be able to say "Oh, that's just my monthly flare." That can be very comforting.

In addition, you may have certain activities that you do during the month that contribute to flares, such as working out or sex. Your voiding diary will help you track down those hidden triggers. All in all, it takes just a little bit of time, yet offers a bounty of information. We feel that it's worth the effort.

Sample Voiding & Pain Diary
Week	Day	Time of void	Rough Volume	Pain Level (1-10)	Notes
9/30/98	Tues	2:30 am	l/4 cup	3	bladder burning
" "	" "	3:15 am	1/4 cup	3	.
" "	" "	4:30 am	1/2 cup	3	pressure & burning
" "	" "	6:00 am	1/4 cup	4	took pain meds (apple juice for breakfast)
" "	" "	8:10 am	1/3 cup	4	feeling lots of pressure
" "	" "	10:00 am	1/3 cup	4	.
" "	" "	11:20 am	1/3 cup	5	using ice-packs another pain med
" "	" "	1:10 pm	1/4 cup	4	.
" "	" "	2:15 pm	1/3 cup	3	.
" "	" "	3:45 pm	1/4 cup	2	pain med
" "	" "	5:10 pm	1/3 cup	2	feeling better
" "	" "	6:30 pm	1/4 cup	1	.
" "	" "	7:30 pm	1/4 cup	1	going to bed
" "	" "	9:30 pm	1/4 cup	1	.
" "	" "	11:35 pm	1/3 cup	1	forgot the elavil
TOTAL	.	.	.	.	Voided 15 Times
.	.	.	.	.	.
10/1/98	Wed	2:30 am	1/4 cup	1	took 1/2 pain med (no apple juice today)

SAMPLE PAIN SCALE

Level 1: I feel no symptoms of IC. I can do anything.
Level 2: I feel slight discomfort, possibly the beginning of a flare. I can do anything.
Level 3: I feel mild symptoms of IC. It is not stopping me from my daily life but I am feeling some mild discomfort.
Level 4: I feel moderate symptoms of IC. Constant feeling of moderate need to urinate, moderate level of pain, activities limited. My frequency is higher and I'm now looking for restrooms and using them. At this point, I'm on my way home to rest and begin my pain management strategies and/or medication .
Level 5: I'm very uncomfortable, perhaps biting my lip and/or holding my abdomen. I'm usually laying in bed now. Walking is more painful now. IC has limited me from doing my daily functions. I am utilizing some of my pain management medications and tools at this point.
Level 6: I'm having constant intense pelvic pain with moderate frequency and urgency. I'm worried and ready to call my doctor for advice.
Level 7: I'm in bed in severe pain. I'm using all of my pain tool kit but I may need help at this point. I'm am considering calling my doctor and may go to emergency room for help.
Level 8: I am having difficulty tolerating the pain. I am calling my doctor.
Level 9: Pain is intolerable, I am on my way to the emergency room because I need help in managing my pain.
Level 10: Excruciating pain

Here are some helpful questions to ask yourself that can help you keep an effective pain diary.

1. In what area is the pain located? urethra, vaginal area, bladder, right under the belly button, scrotum, penis etc..
2. Is the pain, aching, burning, dull, pounding, pressure, sharp, stabbing, throbbing or tingling?
3. Was there noticeable pain when you woke up? Did the pain proceed to get worse during the course of day? What do you think might of triggered your pain symptoms? (i.e., food, exercise, sex)
4. Have you used any pain techniques to help reduce the pain? (ie., pain medications, heating pad, ice, relaxation)
5. What medications are you taking for pain control? Are they prescription or OTC? Did they help in relieving your pain (never, sometimes, always)
6. Did you have trouble sleeping because of the pain? Do you have trouble eating because of the pain?