As Parkinson's disease becomes more complex and patients require multiple drugs to counter the symptoms of illness, clinicians frequently request patients keep a journal.  The purpose is to note one's physical status as the day unfolds, half hour upon half hour. Though cumbersome and demanding, as one must remember to make notes every thirty minutes, the entries tend to show patterns when compiled into weeks. This data is valuable, especially from the patient who commits to recording the details, because it is not colored by recollection, but is an on- going recording of the effects of medication on physical function. With this information clinicians may be able to optimize a patient's medications to achieve the best possible level of functioning.

diary

            So slight and nearly imperceptible are the first inroads of this malady, and so extremely slow is its progress, that it rarely happens, that the patient can form any recollection of the precise period of its commencement. The first symptoms perceived are, a slight weakness, with a proneness to trembling in some particular part; sometimes in the head, but most commonly in one of the hands and arms. These symptoms gradually increase in the part first affected; and at an uncertain period, but seldom in less than twelve months or more, the morbid influence is felt in some other part. Thus assuming one of the hands and arms to be first attacked, the other, at this period become similarly affected. After a few months more the patient is found to be less strict than usual in preserving upright posture: this being most observable whist walking, but sometimes whilst sitting or standing. Sometime after the appearence of this symptom, and during its slow increase, one of the legs is discovered to tremble, and is also found to suffer fatigue sooner than the leg of the other side: and in a few months this limb becomes agitated by similar tremblings, and suffers a similar loss of power.