Monday, 3 February 2014

Pain; out of ten

There seems to be a relatively new way of assessing pain. As I expect most people know, doctors now ask you to assess the severity of your pain by saying how bad it is by scoring it out of ten.

I have a problem with this. I suppose I know what a one is (a minor bump or scratch), but what on earth is a ten? Is it my own ten, or a general ten? Is a ten the thumb screw,  the rack, being eaten alive by hyenas? That kind of thing? I've  never experienced any of these.

And my own ten. What is that? Childbirth? Broken back (where I lay on the ground, begging for pain relief, watched in bewilderment by my son and daughter-in-law, who are, incidentally, both doctors)? Or the broken elbow? (You know that knobbly bit at the end of the elbow? Well, that came right off, and was rolling around inside my skin like  a ping-pong ball in a sock.) Or the large, full jar of peanut butter falling onto my bare toe?

Gentle reader, what is/was your ten? I'd really like to know.

31 comments:

  1. One day, when I was in a hospital recovering from a hysterectomy, with a 9-inch incision in my lower abdomen, two friends came to visit, bringing their baby son (whom I loved) to cheer me up. They sat him on my knee, facing me, and he accidentally kicked me in my incision.
    This was more painful than breaking one of the vertebrae in my back, because I couldn't scream without alerting all the doctors and nurses nearby, and besides, I'd have frightened the baby.
    On a day-to-day basis, however, I'd take that large, full jar of peanut butter as a 10 if it landed on my left big toe, which has a super-sensitive scar on its tip.
    I can't imagine how the knobbly bit came right off the end of your elbow.
    Torture, I suppose, would be excruciating if inflicted by people who have studied how to inflict pain without quite killing the victim. And hyenas...ugh.
    K

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    1. Kay, oddly, the peanut butter incident rates very highly. It was beyond excruciating. And if your toe is sore already....

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  2. I, too, have difficulty with this one Frances. I keep getting asked to give a figure for my knee that needs replacing. I am so used to the pain now that it has become almost incidental except when it stabs and make one yelp.

    I suppose that pain at the high threshold can sort of be measured by whether one remembers it. We remember pain but forget exactly what it was like. That must be the case or most of the women I know would never have had a second baby. I can recall a Spanish doctor (who spoke relatively little English) sticking a syringe through my back into my lung when I was 16 . He hit a nerve and the poor nurse who's arm had been holding me in front actually swore at him because he just left it there and started asking me what was wrong. Then there was the pain from having my bladder cut in half during a life-saving operation and having a catheter bulb sitting on it for days. That hurt. I said never again. That was 16 years ago. I'm still alive. Would I do it again? My knee? A 2 I'd say.

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    1. "We remember pain but forget exactly what it was like." That is so true, GB. When I was in mid-giving-birth to my fourth baby, I asked my husband to remind me of this, if I ever got broody again. He tried. but I simply couldn't remember how it felt. and of course, I got broody again.

      How did you manage to get your bladder cut in half? And the incident when you were 16 - was it a pneumothorax? Ouch.

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    2. I just opened myself up and with a pair of scissors.... Actually I didn't personally have much say in my bladder being cut in half Frances. It was a professional job whilst performing a radical retropubic prostetectomy using a method then new in the UK. The lung incident came after a lobectomy for bronchiectasis. You have given me today's Thankful Thursday post subject.

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  3. I did several paramedic courses and we had to fill a form in. I forget now but we scored casualties on M numbers. If they knew who they were and where they were it was one shot of morphine to shut them up. If they didn't it was the oxygen mask till they did. we were taught just to try our best to stop them leaking. Folk die leaking. They die from stagnation of the lungs as well so a wiff of COtoo can help to kick them into action.
    Fortunately I have avoided pain or at least I've avoided pain that I couldn't manage.

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    1. I love the idea of the M-rating, Adrian. Catch 22.

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  4. I don't think I'd like any of yours. Makes me feel queasy just to think about them. I try to forget about mine.

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    1. I didn't exactly like them myself, Jenny. Sometimes in life, you have no choice...

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  5. I believe that the scale is personalized to your perception. (I've been here a lot with my husband's problems). The scale is used in a relative fashion to determine how your pain changes with different treatments. The attending nurses and doctors ask repeatedly for insight and comparison.

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    1. What a sensible asnwer, ER. I guess you're probably right.

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  6. Watching, and listening to, Harriet Harman. Almost 11.

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  7. I've read about pain and the "official" pain scale. Apparently, child birth is a "top pain", and arthritis is said to be on a par with it. Since I have never experienced either (and hopefully never will), I can't say I know what they are talking about.
    My # 10 pain (or # 1, if you rank it like music or movie charts) was when I was stung by sting ray in Florida. I cried with pain and also a bit out of fear I'd have to spend the rest of my wonderful Florida holiday in hospital. But thanks to the quick action of a nearby motel owner, the pain was soon gone and I was able to wear sandals and walk around the very next day, just a bit more cautiously than usual, since the top of my big toe where the sting had caught me was still a bit tender.

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    1. Sounds horrible, Meike.

      As for childbirth, it's different, because there is a purpose and an end. Arthritis just goes on and on for many people.

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  8. I gave birth to 2 babies without so much as a whiff of gas and air……it jolly well hurt, but as I wasn't making a fuss, they didn't give me pain relief! However, the pain killing injection given to me prior to my half knee replacement didn't work for me, and as the spinal block wore off, that was bad! I cried! It was about 5 hours before they finally got it under control with a morphine drip, having tried pills of various types first(I would say that was a 9 )

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    1. that must have been dreadful, Frances. Personally, I never rated gas and air. It made me giggly, but did nothing for the pain.

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  9. One of the problems of the 1-10 is surely that we all have different thresholds! I've had several painful experiences but the one that most sticks in my mind is AFTER breaking my elbow in Canada and returning home in plaster. Had to go to my local hospital after the flight as I was in pain and worried about a clot. They took the plaster off and I was nearly screaming the roof down (or wanted to) when the non-gentle guy was re-plastering me without pain killers (I'd only broken it a few days before)!

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    1. One of my sons had a broken arm set without an anaesthetic. It sounded appalling, and not unlike your experience, Rosemary.

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  10. My ten was when my (then) one-year-old was sitting on my lap just after I came home from hospital after having four impacted wisdom teeth removed. My gums were still bloody, bruised and full of stitches.
    My daughter was leaning forward and then sat up suddenly. The back of her head struck my jaw and it would have been quite painful in normal circumstances. My husband grabbed her, put her coat on and took her out, all in one minute flat, so that my cries of pain wouldn't terrify her.

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    1. Another pain caused by a baby, but not childbnirth (see Kay, above). Children have a lot to answer for, don't they.

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    2. I wish I hadn't read this comment. It reminded me that that is why I have a beard. The pain of trying to shave after the removal of four impacted wisdom teeth (for which I spent three days in hospital) was such that I grew a beard. That was over 40 years ago.

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  11. I have big difficulties with this scale too, having lived with chronic neck-shoulder-arm pains for over thirteen years. Pain can be very complex and for one thing I don't find it quite fair to compare chronic pain with acute pain. A short while of "No 10" might be endurable, especially if you know it will pass; while No 3 or 4 (or whatever) just going on and on and on, without any relief in sight, is a different experience. I've been told that No 10 should be 'the worst imaginable' pain, but really, that does not help at all when it comes to comparing the experience between one person and another, does it?! Actually it hardly even helps when it comes to onself. I can remember several occasions or periods that I've been in a lot worse (more acute) pain than now. At the same time, however, with every year the experience of "0" becomes more and more distant. What what THAT like?

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    1. Constant pain must be awful, DT. If you know that relief is coming, it makes all the difference. You have my sympathy.

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  12. People do have different pain thresholds. I would say mine was quite low, and thankfully, apart from childbirth, nothing really bad has happened. In fact I don't regard childbirth as pain because you know that it's a 'normal' pain and you are not ill. Unlike most men, my husband has a very high pain threshold and I wouldn't like to have gone through all the pain he has suffered from various operations in the last few years. When he had a heart attack, he 'didn't feel well' and ended up having a triple heart bypass. Pain is all relative.

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    1. That's true, Maggie, and of course you never know what anyone else's pain feels like to them. Maybe it's not just pain thresholds. Perhaps some people do feel pain more than others.

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  13. It was only when I decided to tough out the post-operative pain rather than take anything more, 12 hours after having a new hip, on the grounds that it wasn't anything worse than the arthritis, that it occurred to me how much pain I'd been blanking out for months. Labour first time round was the worst, I was given pethidine which did nothing for pain but made me unable to rise above it. Childbirth without drugs was far better. I hate questionnaires of any sort, I can't answer by ticking boxes.

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    1. I think your experience of hip replacement is common, Z. I certainly saw it - both as a nurse, and more recently, as a patient.

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    2. I'm sure it is - probably, in part, because pain and disability increases gradually, over months and even years, but we have to keep our lives going and adjust to the situation.

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  14. My gall bladder rupturing was my ten. I'm so pleased it's not a thing we have two of, so I know I'll not have to go through that again.

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