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?"

The thing I hear most often 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.

What made the bad day was 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

The daily swing isn't signal. It is noise.

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.

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Going better then worse doesn't mean the treatment isn't working.

The answer is usually in the good day. Knowing what you did that day is enough to start flattening the teeth.

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Written by Dr. Heo Ji-young (PhD in Korean Medicine Pathology, Kyung Hee University · former Research Professor of Herbology, Kyung Hee University)