pain management

Pain by Numbers

Being in pain all the time is really hard.  I’m sure that sounds obvious.  But most people really don’t understand what chronic pain does to a person.  It wears you down.  It makes you tired and sad and sometimes very depressed.  The weird thing about pain at least in my experience is this: the more pain you have the less tolerant of pain you are.  Actually, that’s not entirely true.  The way it works with me is that I have a certain level of pain every day.  A level that for those who are not used to it, would be hard to take.  I am used to it though.  I have the ability to ignore it or to at least keep going when I’m in a lot of pain.  But if I have some new problem on top of what I’m already dealing with it all of a sudden becomes too much.  For instance, if I get a cold, or a hemorrhoid I might completely fall apart.  I can take a lot, but hemorrhoids always push me over the edge.

I have been to all kinds of doctors, Western, Eastern, Southern and Northern.  They have all tried to help me with my pain. Usually they give me a questionnaire with some version of the pain scale on it. If you are not familiar with this pain management tool then you are one of the lucky ones. It usually goes something like this: “on a scale of zero to ten, ten being the worst pain you can imagine, what is your pain level today?” It seems like a simple enough question but it always stumps me.  It stumps me in the same way “How are you?” and “What do you do?” stump me.   I just find the idea of a pain scale ridiculous.  For one thing, I don’t appreciate my pain being reduced to numbers.  Pain is complicated.  And when you’ve been in pain for a long time you kind of forget what “normal” is.  And if you happen to have the above mentioned hemorrhoid along with whatever else is going on then your numbers are going to be way off.  The thing that really gets me about the pain scale though, is “the worst pain you can imagine” part.  I’ve been through childbirth twice, once without drugs so I do have some experience with that kind of pain. But I am the kind of person who is always waiting for the other shoe to drop, a believer that things could always get worse and that they usually do. On my worst pain days I might admit to a 6 or 7 but never a 10. Maybe it takes an optimist to believe that their pain couldn’t get any worse. Or maybe it just takes a healthy ego.  My self esteem is just too low to ever be able to claim worst pain imaginable status.

Apparently my husband does not suffer from this problem.  Recently I was at a doctor’s appointment with him.  He has bad hip pain from arthritis.  After a brief discussion the doctor asked him the inevitable question, “What is your pain level today?”.  He answered ” A ten”.  There was no hesitation, no contemplation.  No “If I say ten I’ll sound like a total drama queen”. I wanted to blurt out something along the lines of, “Are you fucking kidding me, a ten!” But because of my tendency to want people to like me I kept my mouth shut.

As if the pain scale isn’t annoying enough, it is often accompanied by happy faces. Above the number “0” is a happy face. As the numbers increase the happy face becomes less happy until you reach the number “10” and the crying happy face. For some reason I find this insulting. It reminds me of the picture on the wall of the birthing room where I had my first baby.  The cervix was displayed in needlepoint as it dilated from 1 to 10.  My doctor kept threatening terrible things because I was not dilating at the required speed so I found the needle point very upsetting and told my husband get rid of it. I did not appreciate having my “failure to progress” shoved in my face, especially when disguised as interior decoration.

Another way doctors try to understand your pain is to give you a picture of a body, front and back, and ask you to mark on the body where you feel pain.  This sounds easy enough.  And it would be except that pain is complex.  There is burning pain, stabbing pain, aching (dull or sharp), numbness and tingling, to name a few.  They want to know exactly what kind of pain you suffer from and where you suffer from it.  At first I was encouraged by this level of detail. I assumed this meant they had some idea of how to make that particular kind of pain go away.  It turns out it’s just something to keep you busy while you wait for the doctor. On the diagram each type of pain is matched with a symbol, like an “x” or a “+”. Your job is to place these symbols on the corresponding body parts according to what type of pain you have, where.  I don’t mean to brag, but I have some kind of pain almost everywhere in my body.  So by the time I’m done filling in the picture, well lets just say it’s kind of a mess, not to mention the time it takes and the ensuing depression. What makes this even more frustrating is that I’ve never actually seen my doctors look at this picture I have painted for them.

I would be all for using these tools if they were helpful.  And maybe they are for some people.  But every time I’ve answered the pain question with a number or an “x” it’s been unsatisfying to say the least.  And it never seems to save time since it takes me forever to figure out what number to choose or where to put what symbol.  If my pain is going to come down to one single number than I’m damn sure going to give it some thought. Because I know that number will come back to haunt me at some point.  Even if it’s just in my own mind, lying in bed at night wondering why I didn’t tell the doctor my pain level was a “seven” instead of a “five” or visa versa.  (Yes, I have actually done that).  Plus, there is always the chance that the doctor will use it against me and base my progress, need for medication, or psychiatry on one stupid number. (Yes, that has actually happened.)  Speaking of psychiatry, think of all the time psychiatrists would save if they could forgo all those irritating questions about your childhood and just ask you one simple question: “On a scale of zero to ten, how crazy do you feel?”

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One response

  1. Pingback: Tweets that mention pain management « ill. humored. --

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