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Health Log
Health Log Example
Health Log Example
Example of the first 10 days of concussion
Daily Condition and Activity Journal
Date
Day
Key Events
School Communication
Hospital Communication
Physical Activity
Cognitive Activity
School Attendance
Screen Time
Nap
Bed time night before
Wake time
Night Time Sleep
Kaiser Return to Play Stage
Kaiser Return to Learn Stage
Total Symptoms Mild 0-1, Moderate 2-3, Severe 4+
Headache - Mild .5-1, Moderate 2-3, Severe 4-6
Pressure in Head
Neck Pain
Nausea or Vomiting
Dizziness
Blurred Vision
Balance Problems
Light Sensitivity
Noise Sensitivity
Feeling slowed down
Feeling "in a fog"
Don't feel right
Difficulty concentrating
Difficulty remembering
Fatigue or low energy
Confusion
Drowsiness
Trouble falling sleep
More emotional
Irritability
Sadness
Nervousness or anxiousness
1
Wed, Jan 15
1
Patient got concussion at _ o’clock
Called Hospital to set up appt on 1/16, 930am
None
None
Full
0
1/14/2020, 10:00 PM
1/15/2020, 7:30 AM
9 hrs 30 mins
1. No activity
1. Complete cognitive rest
29
5
3
2
1
2
0
3
3
1
1
0
2
2
0
2
0
1
0
0
0
0
1
2
Thu, Jan 16
2
Visited Kaiser at 930am
Emailed Chemistry Teacher
Met with Doctor Name at 930 am.
None
None
Out
0
6 hrs
1/15/2020, 10:00 PM
1/16/2020, 9:00 AM
11 hrs
1. No activity
1 - Complete cognitive rest
19
2
2
1
1
1
0
2
2
1
1
0
1
1
0
2
0
1
0
0
0
0
1
3
Fri, Jan 17
3
Emailed Attendance Office
None
None
Out
0
3 hrs
1/16/2020, 10:00 PM
1/17/2020, 1:00 PM
15 hrs
1. No activity
1 - Complete cognitive rest
3
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
Sat, Jan 18
4
Patient pushed himself too fast
Rearranged Room
60m - Drawing
NA
0
4 hrs
1/17/2020, 10:00 PM
1/18/2020, 12:00 PM
14 hrs
1. No activity
1 - Complete cognitive rest
4
1
1
0
0
0
0
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
Sun, Jan 19
5
None
None
NA
0
3 hrs
1/18/2020, 10:00 PM
1/19/2020, 12:00 PM
14 hrs
1. No activity
2 - Intro of cognitive tasks
5
1
1
0
0
0
0
0
1
0
0
0
0
0
0
1
0
0
0
0
1
0
0
6
Mon, Jan 20
6
Emailed School Sports Trainer
None
None
NA
0
2 hrs
1/19/2020, 10:00 PM
1/20/2020, 1:00 PM
15 hrs
1. No activity
1 - Complete cognitive rest
2
1
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
7
Tue, Jan 21
7
Language Teacher said not to worry
None
30m - Audio
Out
0
3 hrs
1/20/2020, 11:00 PM
1/21/2020, 1:00 PM
14 hrs
1. No activity
1 - Complete cognitive rest
3
1
0
0
0
1
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
8
Wed, Jan 22
8
1st Day Symptom Free
Contacted school counceler about possible IEP
None
None
Out
0
3 hrs
1/21/2020, 11:00 PM
1/22/2020, 1:00 PM
14 hrs
1. No activity
1 - Complete cognitive rest
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
9
Thu, Jan 23
9
light from window caused mild headache/pressure in head
None
4m relaxing music
Out
0
3 hrs
1/22/2020, 11:00 PM
1/23/2020, 1:00 PM
14 hrs
1. No activity
2. Intro of cognitive tasks
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
10
Fri, Jan 24
10
freeway travel 20min each way, family dinner caused headache and had to isolate with sunglasses
Requested meetings with teachers.
None
3hrs low social interaction
Out
0
3 hrs
1/23/2020, 11:00 PM
1/24/2020, 1:00 PM
14 hrs
1. No activity
2. Intro of cognitive tasks
2
1
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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