Flare-Ups Also Have Their Reasons
The short answer
It flares up two or three times a year — but do those two or three times really come at random? For some, it is around when the first cold wind blows; for others, it is near the end of the monsoon; for others, it is three or four days after a stretch of packed workweeks. There is a pattern that does not show up in a single episode but only becomes visible after several — and the one to compare against is not someone else, but yourself last time. If it comes in a different shape than usual, checking comes before establishing a pattern.
Contents
Some people go through this two or three times a year. But those two or three times do not come at random. For some, it is always around when the first cold wind blows; for others, it is near the end of the monsoon; for others, it is three or four days after a week of packed work.
From the person experiencing it, this pattern is hard to see. Each time it happens, it gets attributed to whatever was going on then. There are things that only become visible after several rounds.
It Narrows Down From the Second Time On
Ask what was happening on the day of a flare-up, and there is never just one thing. There is the food eaten that day, a night of poor sleep, something that weighed on the mind, a change in the weather. Which of these actually caused it cannot be sorted out from a single instance.
Once a second and third instance accumulate, things change. Among the things present each time, a few show up every time and the rest are one-off. As the one-off items fall away, the remaining list narrows. This is why, when you listen closely, it turns out that a flare-up almost never comes at truly random times.
And the list that remains differs from person to person. There are many things that can shake the body, and which one gives way first differs from one person to the next. So someone else's list cannot become your own. This is where repetition does its work — because the one to compare against is not someone else, but yourself last time. It is the same perspective as in Why I Ask About the Good Days When Things Repeatedly Improve and Worsen.
Some Patterns Lie Outside the Body
Some people are affected by the season — around when the cold wind starts, or near the end of the monsoon. There is data that makes it hard to dismiss that seasonal pattern as a matter of mood.
This means the season outside shifts the baseline inside the body along with it. Pooled across many people, the immune baseline differed by season. This alone, however, cannot attribute one person's flare-up to the season. For someone whose flare-ups follow the season, that season is not a condition that can be changed. Every year, that season passes through the body once.
Triggers and Early Signs Get Mixed Up
Trace back the day of a flare-up and something usually catches your attention — unusually frequent yawning the day before, a stiff neck, an unexplained craving for something.
This kind of finding comes from long observation of recurring pain. In data on migraine, an attack has already begun internally a day or two before it becomes apparent, and during that time, one sign or another different from usual shows up. But the person experiencing it later places that sign on the trigger side of the ledger. What was a sign that appeared after onset gets recorded as the cause.
At the same time, there are also things that genuinely make it more likely to come on — a stretch of lost sleep, a backlog of stressful matters, a shift in hormones. The two are mixed together, which makes them hard to tell apart while you are living through them.
So if you go looking, day by day, for something you did that caused each flare-up, you can end up inventing a fault that was never there.
Knowing in Advance Changes That Day
Knowing when it is coming does not stop it from coming. But two things do change.
One is what that day means. If you treat the day it comes back as a return to square one, all the days that came before it are wiped out at once. If you know it came for a reason, that day ends as just that day.
The other is that the field of what to look at narrows. Once only the recurring few remain, what to check first the next time is decided from within that list.
And there are also days it comes with nothing catching your attention at all. Saying a pattern exists is different from saying it holds every single time. Even something that is almost always right but not always right is still a pattern. A day that does not fit just remains a day that does not fit.
Somewhere Else First
Sometimes it comes in a different shape than usual. This is when the way it starts differs from before, or something that was never there before comes along with it.
The fact that it has always happened before is no guarantee that this time is the same. In that case, checking comes before establishing a pattern of recurrence.
A single day of flare-up holds too many things within it. So looking only at that one day, the cause does not come into focus. Not coming into focus is different from not existing.
Repetition is what separates the two. There is an answer that only emerges from you as you go through it again and again.
That is why I do not listen only to the story of this one time. I listen to the stories of the times before it as well.
Written by Dr. Heo Ji-young (PhD in Korean Medicine Pathology, Kyung Hee University · former Research Professor of Herbology, Kyung Hee University)
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