📓 Symptom Journal

Track your symptoms daily to share with your care team. Print multiple copies for ongoing use.

💡 Tips for Using This Journal

  • Be consistent: Fill it out at the same time each day
  • Be honest: Don't minimize symptoms - your team needs accurate information
  • Bring it to appointments: Review trends with your doctor
  • Note patterns: Do symptoms occur at certain times or after certain activities?
  • Include positives too: Good days matter for tracking overall trends

Daily Symptom Journal

GBM Hope Project

⚡ Energy & Overall Wellbeing

Overall energy level today
1
2
3
4
5
6
7
8
9
10
1 = Unable to get out of bed 10 = Full energy
Overall mood
1
2
3
4
5
6
7
8
9
10
Hours of sleep last night
Sleep quality
1
2
3
4
5

🧠 Neurological Symptoms

Rate severity: 0 = None, 1 = Mild, 2 = Moderate, 3 = Severe

Headache
0
1
2
3
Confusion / Disorientation
0
1
2
3
Memory problems
0
1
2
3
Word-finding difficulty
0
1
2
3
Vision changes
0
1
2
3
Weakness (arm/leg/face)
0
1
2
3
Balance / Coordination
0
1
2
3
Seizure activity today?
Yes
No

If yes, describe type/duration: _________________________________

🤢 Treatment Side Effects

Rate severity: 0 = None, 1 = Mild, 2 = Moderate, 3 = Severe

Nausea
0
1
2
3
Vomiting
0
1
2
3
Loss of appetite
0
1
2
3
Constipation
0
1
2
3
Diarrhea
0
1
2
3
Mouth sores
0
1
2
3
Skin rash / Irritation
0
1
2
3

💊 Medications Taken Today

Medication Dose Time Taken?

📝 Notes & Observations

Activities, food intake, emotional state, questions for doctor, anything noteworthy

Weekly Summary

Review before appointments

📊 This Week's Trends

Average energy level (1-10)
Best day this week
Worst day this week
Number of seizures

⚠️ Symptoms to Report to Doctor

❓ Questions for Next Appointment

✨ Positive Moments This Week

Activities you enjoyed, things you're grateful for, small wins

⚠️ When to Seek Immediate Help

Contact your care team or go to the ER immediately if you experience:

  • New or worsening seizures
  • Sudden severe headache ("worst headache of your life")
  • New weakness, especially on one side
  • Sudden confusion or difficulty speaking
  • High fever (over 100.4°F / 38°C) during chemotherapy
  • Uncontrollable vomiting