stepping on the scale

[the_siobhan]

I called Tele-Heath the other night to discuss whether or not I should be concerned about just how much my gallbladder hurt. (Their conclusion; in the absence of vomiting, fever or jaundice take some painkillers and see a doctor during business hours.)

One of the questions they asked me was, "On a scale of 1 to 10, how much does it hurt?"

And I had to think about how to answer that. Because my pain scale changed completely from the experience of having adenomyosis for six years. On a scale of 1 to 10, the adenomyosis was a 12. Childbirth was a 4. If my gallbladder wakes me up in the middle of the night but I'm still capable of having a conversation on the phone - that rates about a 2.

So I said 6.

I still have no idea whether or not that was the right answer.

Comments

[kat1031.livejournal.com]

I understand this completely. Having a high pain tolerance is how I almost died. By the time it hurt bad enough for me to actually realize that something was seriously wrong, I was home alone and was pretty much bleeding to death internally.

I still walked in to the clinic. And almost walked all the way back to the examining room.

I don't think there's a "right answer" for pain. It's not a scientific thing, it's a feeling thing and people feel pain very, very differently.

[djwookie.livejournal.com]

When I went in for my gall bladder I had the same question, mostly to see if we needed to take it out right then and there or if it could wait a day or two to schedule a surgeon.

On a one-to-ten, I thought long and hard and came up with four. The doc almost sent me home, but my mother was with me and she reminded the doctor that I suffered from cluster headaches.

"This is a four on a cluster-headache scale?" he asked.

"Yes" I spit out between grit teeth.

He immediately shot me up with morphine and had the nurse call the on-call surgeon.

I'll always remember to let them know that in the future.... some of our pain scales are way out-of-sync with the average Joe.

[unagothae.livejournal.com]

I don't even have a high tolerance for pain. I can't answer this question because I've had deep second degree burns that covered my legs from my ankles to my knees debrided without painkillers.

I have learned to stop comparing my pain to that. In fact, if I'm in pain, I tell them that its a 10 so that they will take it seriously. If it turns out that nothing it wrong, then at least I got everything properly documented. If something is wrong, then it got taken care of immediately instead of when it was almost about to kill me. Either way, I don't die.

[the-siobhan.livejournal.com]

I assume that having an accurate measure of how much pain I'm in will help them diagnose the cause. It also means I don't spend hours in a hospital waiting room in the middle of the night unless I really have to.

[unagothae.livejournal.com]

If I'm in enough pain to seek medical attention, it's probably a 10 by average standards.

I've found that saying, "It's less intense than having burns debrided, but more intense than a Tylenol level headache," helps those who are used to dealing with pain while it just makes others look at me like I'm talking Greek, so I say it's a 10 and they get off their asses and do something.

Generally, the type and location of pain helps them more than intensity. All intensity tells them is whether or not they need to give you a pain killer and what level of pain killer.

That's the way it works here. Other places it might be different.

[the-siobhan.livejournal.com]

In this case I wasn't in enough pain to seek medical attention. I was trying to find out if the pain was an indicator that I should seek medical attention earlier rather than later. I had no desire for anybody to get off their ass, especially me.

[liz-lowlife.livejournal.com]

I think what you need to think about is if it gets any worse your worrymeter should go up accordingly.
Hope it simply goes away Hun...I have had a dicky gallbladder for years but it seems to always settle down just when I think I might have to do something about it.
Stay off the French Fries and see how it goes!

[dreadeddragon.livejournal.com]

Right after my car accident I was taking 2 percocets and a valium every 4 hours and was still in tears. I said a 9 just so they would realize I was in a decent amount of pain and they could address it. But the whole 10 is the worst pain imaginable thing bugs me. I can imagine that crushing all my ribs or having a bone poke through my skin would hurt a lot more, so in that case my pain might be a 5. I agree with Wookie, if you tell them what the pain is in relation to your worst pain, maybe that would help.

[xiphias.livejournal.com]

I suppose you could have said, "about half as much as childbirth."

[the-siobhan.livejournal.com]

Why didn't I think of that?

"Less than a migraine but more than standing on a nail."

[shnells.livejournal.com]

i have to ask my patients this all the time and it is definately a very hard question to ask mainly because it can be so subjective. i think comparing your functional status is a good way to go. ie how bad has your function been affected? pain definately can be a very subjective thing. telling the clinician that you are comparing it against the pain of say migraines or childbirth will tell them a lot! :)

i usually tell people: "tell me how your pain is right now if 0/10 is no pain and you feel fine. 10/10 pain means take me to the emergency room and chop off the offending part and 5/10 means i'm really uncomfortable and i need to do something about it."

that usually seems to help folk.
since pinching my nerve this past month, i have seriously revised my 10/10 scale and i recognize how my worry/anxiety plays into it so i also observe to see how worried/anxious people seem to be about their pain.

i don't know. this is the problem with treating pain. it's not just physical, it's also so emotional.

[blackgrrr.livejournal.com]

I still have no idea whether or not that was the right answer.

Stupid questions like that do not deserve answers.

re: stepping on the scale

[betonica.livejournal.com]

The whole pain on a scale thing is very problematic. We're trained to use it in emergency medicine, but I can't say that the answers I've been given over the years would fit on a linear scale. Some people have said "10" when I wouldn't have thought they were in a huge amount of pain, and others have said "4" when I can see they're extremely uncomfortable.

Asking the patient for a benchmark is a good idea. So comparing current pain to childbirth, migraines, a nail-through-the-foot, etc., are probably much more helpful to your doctor. They'd certainly be more helpful to me.

Though I have to say that how much pain someone is in doesn't really change what I do, because I can do so very little and have to call in the big guns for anything serious (grrrr - local politics of EMS). But a 10-on-10 pain, with some benchmark that makes sense to the patient and tells me it really is a 10, will get me calling the paramedics for intercept with pain meds.

[ash-pixie.livejournal.com]

I'm sorry to hear about the gallbladder pain. :S I can understand the pain scale being off thing, I've never been good at that 1-10 thing. I never seem to give them the right answer they always think I'm not telling the truth.

[firecat]

At least they didn't ask you to fill out this:

http://en.wikipedia.org/wiki/McGill_Pain_Questionnaire