For a year my answer to “how often does the pain happen” was “quite a lot, hard to say”. That’s a useless answer and I gave it to three different doctors.
The fix took ten minutes to set up. A note on my phone with five fields, filled in only on bad days.
The five fields
- Date and time it started. Time matters more than you’d think, because a pattern of late evening pain points somewhere different than pain an hour after lunch.
- Pain, 1 to 10, and where. Front, back, band around the middle, right shoulder blade. Location is a clue and most of us never mention it.
- What I ate in the 8 hours before, with a fat estimate in grams. This is the field that earns the whole log. Without it, “I ate normally” is what you tell yourself, and it’s usually not true.
- Enzymes: dose, and when I took them relative to the meal. Timing errors show up here fast.
- What happened next. Passed in two hours, lasted all night, ended in the emergency room. Plus anything else going on: bad sleep, a stressful week, a missed dose, a new medication.
What I stopped tracking
Weight daily. It moves for reasons that have nothing to do with the pancreas and it made me anxious. Weekly is enough, and unexplained weight loss is worth flagging.
Every single meal. Logging good days too made the whole thing collapse within a fortnight. Bad days only. It’s sustainable and it’s the data anyone actually wants.
Bristol stool chart scores every day. I track stools only when something changes, particularly pale, greasy, floating, or hard to flush, which are the ones connected to fat absorption.
Turning it into something an appointment can use
The night before a specialist visit I spend ten minutes summarising. How many bad days in the period, the three worst with their details, any pattern I spotted, and two questions.
Two questions, not ten. In a fifteen minute slot, two specific questions get answered properly. Ten get a leaflet.
Bring it printed. Handing over a page beats scrolling your phone while the clock runs.
The pattern I found
Mine showed up after about six weeks. Two of my worst episodes followed meals I’d have sworn were fine, and both had hidden fat in the sauce. That’s how I ended up weighing and calculating rather than guessing, and it changed how I cook more than any advice I was given.
Stepan’s Rule: log bad days only. A log you keep for a year beats a perfect log you abandon in two weeks.
I’m a patient, not a doctor. A symptom log is for spotting patterns and asking better questions, not for diagnosing yourself. New or severe pain needs a professional, not a spreadsheet.
In the PancreasZen community we compare logs and the triggers people find. Somebody else’s pattern is often the clue to your own. Come and join us.