When It Keeps Going Better Then Worse — What Did You Do on the Good Day?
The short answer
If you feel better and then worse the next day, does treatment not work? Overdoing it on a good day can be one cause, so track the previous day's activity and symptoms over weeks; new or severe worsening needs separate assessment.
Contents
When It Keeps Going Better Then Worse — What Did You Do on the Good Day?
"It's alright for a bit and then it's back. Is the treatment not working?"
Something I often hear while mending a long illness. And people say it while counting only the bad days.
I ask about the other side. "What did you do on the good day?"
Usually the answer is right there
On a day the body feels lighter, people do what has piled up.
The cleaning that got put off, the friend not seen in months, and — "today I can manage it" — a longer walk than usual. Of course they do. It has been piling up.
And the next day it collapses.
Repeat that and the graph turns into saw-teeth. But what made those teeth is often not the illness — it is the speeding on the good day. Use only what has come back and you carry on; use more than has come back and you are in the red again.
The clue to a bad day often lies in the day before it.
And each part comes back at a different speed
There is a second reason.
A long illness is never one thing collapsed alone. Sleep, digestion, pain and energy are all shaken together. And they don't return at the same speed.
There is a stretch where sleep has settled and digestion hasn't. That week becomes "sleeping well but bloated." The person can't tell whether they're better or worse. One part is climbing while another sits still.
Overall it is going up; day by day it looks like it's swinging.
So I look at weeks, not days
There is a lot of noise mixed into the day-to-day swing.
Look in stretches of weeks and the direction shows. Whether the floor of the bad days is lifting; whether the gaps between good days are closing. If the floor is lifting, it is going the right way — even with bad days still in it.
And having a swing at all isn't only bad news. It means there is a response. Better than nothing moving.
In the consulting room
We set a ceiling for the good day. On a day that feels like "I can manage," only a fraction of your usual. This is the hardest part — holding back when the body seems willing.
And I look at the day before a bad day. The cause is usually there.
I count each part separately. Sleep as sleep, digestion as digestion. Otherwise you can't see what's climbing and what's sitting still.
Going better then worse doesn't mean the treatment isn't working.
The answer is usually in the good day. Once you can see what you did that day, a place opens up to flatten the teeth.
Written by Dr. Heo Ji-young (PhD in Korean Medicine Pathology, Kyung Hee University · former Research Professor of Herbology, Kyung Hee University)
IF YOU NEED CARE
Have a symptom that's been on your mind?
Choose a time on Naver, or send your concerns before your first visit.