On screwing with the pain scale...

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brandtrn
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Joined: 27 Feb 2015, 10:27

On screwing with the pain scale...

Post by brandtrn » 03 Oct 2017, 03:35

I honestly don't get this. Truly! Even as a chronic pain patient myself, who frequently busts ass for patients in pain when I, personally, am hurting so bad that I feel like crying. WHAT is it about the pain scale that your average patient DOESN'T understand?? Honestly, it sounds pretty simple: the scale goes from 0 (no pain whatsoever) to 10 (the worst pain that you can possibly imagine). I don't know about the rest of you, but the worst pain that I can possibly imagine is that which I might endure while being burned alive, mauled by a bear, having a particularly ugly attack of kidney stones, etc. I'm talking about some freaking SERIOUS pain, here!! I, personally, have NEVER experienced a pain rating of "10," thank you, Jesus! Yes, I've had major surgery, had broken bones, and been through childbirth. Many of these experiences WERE painful as Hell, but nothing I've ever endured has even come CLOSE to the worst pain I can possibly imagine. So, can somebody please tell me how it's possible to rate one's pain at a "10" while one is simultaneously chatting on Facebook, playing games on one's cell phone, or complaining about the hospital's Netflix selection, and demanding ANOTHER sandwich and one's tenth Mountain Dew of the evening?? Honestly? I don't get it...is it because one thinks that one's pain won't be taken "seriously" unless it's being rated as a 10? Trust me, people...if your Doc has ordered it, and if you are awake and still breathing, I WILL GIVE YOU YOUR PAIN MEDS. So WHY do you find it necessary to throw your dignity (and integrity) out the window, along with insulting my intelligence?? Just wondering...
"The miracle is this: the more we share, the more we have." -- Leonard Nimoy (1931-2015)

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pilvikki
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Re: On screwing with the pain scale...

Post by pilvikki » 03 Oct 2017, 08:01

interesting.

i'm thinking it's due to these people for one, having no experience with said 10 pain, nor the imagination to grasp anything beyond their own, limited, scope.

reminds me of the time i was asked by a specialist about my pain level and i said i'd rate as a 7... i said it was the worst pain i'd ever had, barring a cut cornea, but most likely nothing compared to broken body parts.

"you know", said the doctor, "we'll get along fine! i like honest answers without drama; most people would have trotted out an 11." as i'm trying to keep my face from collapsing.

on the other hand, mother (who was on palfium) was comparing hospitals in finland and sweden: in finland you got whatever the doc gives you and it's what they deem appropriate, like it or not. and they were not stingy. in sweden they try you on something like a tylenol to see if you're ok with it. no? try tylenol 1... etc. unless you scream bloody murder and Then they bring out the heavy guns.

which reminds me... mother had a nasty case of bursitis popping up every few years. as she also had a bad case of fibro (maybe polymyalgia rheumatica, which i have, neither of which had been diagnosed yet), painkillers tended not to be effective. so, one day father goes to get her script and the bit of a twit pharmacist gives him a long look: "where did you get this?"

"what does the signature say?? that's where!"

"i need to make a call."

yeah, whatever....

he comes back and says "this has been illegal for 2 years, so you need to go back for something else."

"no, you need to call him and GET something else!"

which he grumpily did. father rarely lost his cool, but when he did, dry ice would not be a match for his demeanor.

the prescription was for heroin, so....

brandtrn
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Re: On screwing with the pain scale...

Post by brandtrn » 03 Oct 2017, 09:06

If the prescription was for heroin, and if the shit is legal where you are, I've got no problem with it. There ARE people out there in severe pain, and they should be able to obtain decent relief. I've had patients for whom the current regimen wasn't working, and I'd call the Doc to ask for something stronger (or for current meds to be increased or given more frequently) for them. But here's the catch...if you're not able to stay awake long enough to finish a sentence or aren't capable of staying awake long enough to be cooperative with a nursing assessment, don't even THINK I'm gonna call the Doc to ask for "better stuff" for you. Yes, I understand that MANY chronic pain patients are used to being on a boatload of narcotic pain meds, and when one builds up a tolerance like that, controlling one's acute pain response following surgery can be a REAL challenge. And, while I'm all for dealing with said challenge, too many folks will try to play you...in my line of work, the mantra of patients to their nurses seems to be "MOAR drugs!"
"The miracle is this: the more we share, the more we have." -- Leonard Nimoy (1931-2015)

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pilvikki
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Re: On screwing with the pain scale...

Post by pilvikki » 03 Oct 2017, 13:57

well, that story was from 60 years ago.

what baffles me is that people don't seem to grasp the simple concept of pretty much anything eventually wearing out in effect, but still damages one's system? and what about the addiction aspect?

i've an addictive system or whatever it is called, or why not just say i'm an addict - so i stay away from stuff that is addicting. i'd loooove to munch codeine all day long, takes the pain away and puts me into a good mood. or relax with glasses of whatever, but oh no, it'll come back and bite me big time.

rather sucks, when i think of it.

in sweden they now have gone bonkers with limiting drugs to the point that - especially women - are affected very seriously. but hey, it's women, they always complain....

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yogi
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Re: On screwing with the pain scale...

Post by yogi » 03 Oct 2017, 16:10

Hi Cindy. I think you know the answer to your question about perceived pain, but I'll give you my take on it anyway. :mrgreen:

Today I accompanied my wife to her orthopedic surgeon. The story behind her being there is long. Essentially she broke her leg 23 years ago, and now the ankle in that leg is worn out. It needs replacement or bone fusion. In order to do the fusion (her choice), the rod and the nails in her leg from the old break had to be removed first. That went well with only a single night in the hospital. They had to rip a tendon in order to get at one of the screws so that her knee was immobilized for several weeks. She is at the point now where the tendon is well on the road to healing, but the original ankle, bone on bone, pain still hurts. So, today, the doctor asked what level is the pain in her ankle. Wife: eleven (11).

Well, you may rightly ask, how can the worst pain imaginable be more intense? You would ask that because of your many years of medical discipline and practice as a nurse. Wife, on the other hand, hurts really really really bad. That's all she knows. It hurts so friggn bad that she is willing to fuse her bones to stop it (hopefully). Would it really have mattered to the doctor if she said it was a nine (9). And, how does a patient in pain distinguish a level nine (9) pain from, say, a level eight (8)? Coming up with a credible value is not the point of the question. The doctor asked because he envisions a day when the pain will be less and he needs a reference point to determine how effective his treatment is. It does not matter if wife has a level 8, 9, or 11 pain. It will matter if it's well below the median level five (5) after the fusion. It's all relative. When a doctor (or nurse) queries a patient about pain, they must know that the patient cannot clearly define pain to a person not experiencing it. Regardless, the point of asking the question is to set a mark for a relative measurement after treatment has been applied.

In my early thirties I had the wonderful experience of passing a kidney stone or two. Even today I'd call that a level 11. LOL Demerol helped, but it did not really eliminate the pain. It just made me too groggy to care about it.

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pilvikki
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Re: On screwing with the pain scale...

Post by pilvikki » 03 Oct 2017, 17:26

good point, yogi! but that only applies to the cases where one is to keep seeing the doctors about an ongoing problem.

still, i can't even fathom bone on bone pain, sounds like hell! my sciatica can't be even close and i'd not be able to even take that daily. :eek:

here's an interesting one for you 2: years ago i tended to get nasty muscle pains in my thighs, making it hard to walk. then one day i lost it! i stared daggers at my legs and snarled "I'VE HAD ENOUGH OF THIS! STOP IT AT ONCE!"

and it did! for months.

someone care to explain that one? and why does it not always work then?

:think:

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yogi
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Re: On screwing with the pain scale...

Post by yogi » 03 Oct 2017, 18:43

I read about an experiment with morphine. They gave a bunch of people morphine to ease their pain. However, only half of the group got the real stuff. The other half got the placebo. I don't recall the exact numbers, but at least half of the placebo group felt no pain after taking the placebo. Some of the real morphine people did not experience an easing of their pain.

The experiment proved that the brain alone can manage pain, at least in a high percentage of the population. What you did with your leg was the equivalent of what the subjects in this experiment did. They used brain power alone to manage it. The results of this experiment should not be surprising. We all know people who can "tolerate" more pain than others. I don't think it's a matter of attitude. There is something in our heads that can do whatever it is morphine does. Pain in necessary, but it's relative.

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pilvikki
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Re: On screwing with the pain scale...

Post by pilvikki » 04 Oct 2017, 03:56

just like some relatives are a pain.... :whistle:

mother was once accidentally given a deadly overdose of morphine. when they went to collect the body, well, the body was solving crossword puzzles wondering what all fuss was about.

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