The Shande Symptom Tracking Handbook

General health education; not individual diagnosis. Serious symptoms require conventional medical care first.

Changing Bowel Habits: A Useful Symptom Diary Before Assuming IBS

Start with what changed from your normal

There is a wide range of normal bowel frequency. Note whether your own pattern became more frequent, less frequent, looser, harder, more urgent or more painful, and whether the change followed infection, travel, antibiotics, a new medicine or a major diet change.

Use a simple two-week diary

Record stool frequency and consistency, urgency, abdominal pain, bloating, major meals, caffeine, alcohol, new supplements and medicines. The goal is to identify repeatable patterns without turning eating into a full-time investigation.

Do not diagnose IBS from one symptom

IBS can involve recurrent abdominal pain and bowel changes, but other conditions can overlap. A doctor may consider age, duration, bleeding, anaemia, fever, family history and weight change before deciding whether tests are needed.

Food experiments should be structured

Removing many foods at once makes it hard to know what mattered. If you test a food relationship, change one major factor at a time. Very restrictive diets can reduce nutrition and may be better supervised by a dietitian.

Where TCM may fit

A TCM consultation may explore food, sleep, stress and bowel patterns and may discuss acupuncture or herbs. Traditional terms should not replace medical assessment when symptoms are persistent or concerning.

Know the red flags

Blood in stool, black sticky stool, unexplained weight loss, persistent fever, severe worsening pain, repeated vomiting, night-time diarrhoea or a major new bowel change later in life needs medical review.

A Headache Diary That Is Actually Useful

Why memory is unreliable

When headaches come and go, it is easy to remember only the worst episode. A short diary creates a clearer picture. Record the date, start time, duration, location, intensity and whether the pain was pressure-like, throbbing or associated with neck tightness.

Track the context

Note sleep, missed meals, hydration, caffeine, alcohol, menstruation if relevant, work stress, screen time, exercise and unusual smells or light. HealthHub notes that headache and migraine triggers can include stress, too little or too much sleep, hunger and certain foods or drinks.

Record associated symptoms

Nausea, light sensitivity, sound sensitivity, visual changes, numbness, weakness, fever, stiff neck or dizziness can change the clinical picture. Also write down any medicine taken, the dose if known and whether it helped. Frequent painkiller use is worth mentioning to a doctor or pharmacist.

Look for change, not just frequency

A person with a familiar recurring pattern may still need review if headaches become more severe, start more suddenly, occur after an injury or behave differently from usual. A diary makes that change easier to demonstrate instead of relying on a vague impression.

How this helps a TCM consultation

A TCM practitioner may ask additional questions about sleep, digestion, stress and other symptoms. Bring the same diary. It keeps the discussion grounded in what actually happened and makes it easier to coordinate with conventional medical care when needed.

Cycle Tracking: What Changes Matter and When to Seek Care

What to record

Start with the first day of bleeding, how long it lasts, whether flow is light, moderate or unusually heavy, and whether clots are new or different. Add pain, headaches, bowel changes, sleep, mood and any medication or supplement changes. The goal is not a perfect diary; it is enough detail to notice a pattern.

Why patterns help

Sleep, stress, illness, travel, contraception, pregnancy and perimenopause can all influence symptoms. Two or three months of notes can show whether a change is repeating. This also prevents one severe but unusual day from becoming the only memory at a consultation.

How TCM may use the history

A TCM practitioner may ask about timing, colour, discomfort, temperature sensations, digestion, sleep and energy as part of traditional pattern assessment. These observations belong to the TCM framework and do not replace tests or medical assessment when abnormal bleeding, anaemia or pregnancy complications are possible.

When changes deserve medical attention

Seek medical advice if bleeding becomes very heavy, you feel faint or unusually breathless, bleeding occurs after menopause, pain suddenly becomes severe, or you may be pregnant and have pain or bleeding. Persistent changes that affect work, sleep or daily life also deserve assessment.

Questions to bring

Ask what should be checked medically, what TCM can realistically support, how progress will be reviewed and whether herbs or supplements could interact with medicines or contraception.

Heavy Periods: What to Track and When Medical Review Matters

Heavy bleeding is more than a calendar problem

Useful signs include needing to change protection unusually often, bleeding through clothes or bedding, repeated large clots, bleeding for longer than usual, or having to organise daily life around access to a toilet. A clear change from your own previous pattern matters too.

Track what a clinician can use

For two or three cycles, record start and end dates, heaviest days, flooding episodes, clots, pain, dizziness, breathlessness, fatigue and bleeding between periods or after sex. Also note medicines, contraception and pregnancy possibility.

Think about iron and anaemia

Repeated heavy bleeding can reduce iron stores and cause anaemia. Symptoms can include unusual tiredness, light-headedness, breathlessness on exertion, palpitations and reduced exercise tolerance. These symptoms deserve assessment rather than automatic self-treatment.

Medical causes should stay visible

Fibroids, adenomyosis, hormonal changes, bleeding disorders and pregnancy-related problems can contribute to heavy bleeding. Traditional TCM labels do not establish whether a fibroid, anaemia or another condition is present.

Medicines and contraception matter

Hormonal contraception, anticoagulants and other medicines can change bleeding. Bring the complete medicine list and do not stop prescribed anticoagulants or hormonal medicine on your own.

Know when to seek help

Very heavy ongoing bleeding, fainting, marked weakness, shortness of breath, severe pelvic pain or possible pregnancy needs prompt conventional medical assessment.

Better Sleep Habits for Busy Singapore Adults

Start with your actual schedule

Many sleep plans fail because they assume an ideal day. Begin with the time you realistically need to wake for work or family. Work backwards to create enough opportunity for sleep, then keep that wake time reasonably stable even on weekends.

Watch the “Singapore late night” pattern

Late dinners, supper, work messages and scrolling can all push sleep later. Caffeine can also appear in kopi, tea, energy drinks and chocolate. You do not need to remove everything at once; identify the one or two habits most likely to keep you awake and adjust them first.

Make air-conditioning work for you

A comfortable, cool room can support sleep, but very cold or dry air may be uncomfortable for some people. Adjust the temperature, airflow and bedding so you are not waking because you feel too cold, dry or congested.

Use TCM as an addition, not an excuse

If you choose acupuncture, Tuina or a TCM consultation for stress or sleep concerns, still keep the basic sleep habits in place. Traditional care works best as part of a sensible overall plan, not as permission to ignore routines that are clearly disrupting sleep.

Persistent fatigue deserves attention

If you regularly get enough time in bed but remain exhausted, or if you snore loudly, wake gasping, have morning headaches or struggle to stay awake during the day, speak with a doctor. These can be clues that the problem is more than simple sleep hygiene.

Make the next conversation more useful

Before your appointment, note the timing and frequency of the problem, sleep and waking times, caffeine and alcohol, medicines, stressors and any symptoms such as snoring, breathlessness, pain or reflux. Useful questions include: What ordinary causes should I rule out? Which changes are worth trying first? How will we know whether the plan is helping? When should I seek conventional medical assessment instead?

Dizziness and Light-Headedness: What to Observe Before Calling It “Weakness”

Use more precise words

Ask whether the room feels like it is spinning, whether you feel about to faint, whether you are simply unsteady, or whether vision seems to jump or blur. These descriptions point clinicians toward different possibilities.

Notice timing and triggers

Record whether symptoms happen when standing up, turning the head, getting out of bed, exercising, skipping meals, being in hot weather or after taking medicines. Also note vomiting, hearing changes, headache, weakness, palpitations and recent illness.

Hydration may matter, but it is not the whole answer

Singapore heat, diarrhoea, vomiting and poor fluid intake can contribute to dehydration. However, persistent dizziness should not automatically be treated with drinks or tonics without considering blood pressure, heart rhythm, inner-ear problems, anaemia, medicines and other causes.

TCM language should stay in its lane

A practitioner may describe a traditional pattern such as deficiency, phlegm-dampness or wind. Those terms should not be treated as proof of the biomedical cause. Important symptoms still deserve conventional assessment.

Sit down and reduce immediate risk

If you suddenly feel faint or unsteady, sit or lie down somewhere safe and avoid driving or climbing. If symptoms are recurrent, bring a medicine list and a clear timeline to a doctor or practitioner.

Know the urgent warning signs

Call 995 for life-threatening symptoms such as collapse, severe breathlessness or suspected stroke. New one-sided weakness, facial droop, speech difficulty, severe sudden headache, chest pain, fainting or inability to walk safely needs urgent medical attention.

Taking Several Medicines? How to Discuss Herbs and TCM Safely

The combination is often the issue

People may receive medicines from several clinics while also buying supplements or traditional products. Each item may have a purpose, but combinations can change bleeding risk, blood pressure, glucose, alertness, stomach irritation and kidney or liver handling.

Build one useful medication list

Write the product name, strength if known, how often you take it, why you take it and who recommended it. Include creams, inhalers, eye drops, painkillers, vitamins, herbal teas used medicinally and “health tonics”. Photograph labels when names are unclear.

Bring the same list to TCM appointments

A TCM practitioner needs to know about blood thinners, diabetes treatment, blood-pressure medicine, steroids, seizure medicines and other therapies. This information can affect needling, massage pressure, heat therapies, herbal formulas and aftercare.

Natural does not mean harmless

Natural ingredients can cause allergies, stomach irritation, sedation, bleeding or medicine interactions. Concentrated extracts are not the same as ordinary food amounts. Be especially cautious with products that promise rapid cures or tell you to stop prescribed medicine.

Older adults need extra attention

Ageing can change kidney function, balance, hydration and sensitivity to sedating medicines. New appetite loss, confusion, dizziness or unsteady walking after a medicine or supplement change should be reviewed rather than dismissed as normal ageing.

Treat new symptoms as information

If unusual bruising, bleeding, rash, breathing difficulty, severe stomach upset, confusion or profound sleepiness appears after a product change, note what changed and when. Severe reactions, major bleeding, collapse or breathing difficulty require urgent care.