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kitson 05-12-2007 11:40 AM

Pain Scale: 1..10 - Examples
 
I have/have had trouble in the present/past relating pain to dr.(s) using this scale. My end result seems to be the dr.(s) do not relate to my examples. Sorry for the long-winded story below to show an example. I do not have this threshold any longer; but still have difficulty relating the level to dr. From observing cancer patients, I call a pain level of 8 where you have copious, spontaneous sweating; I mean like you just got dunked out of the pool.

Thanks for your help and support in advance!

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Examples I would like to see and values:
Wasp stings, bee stings, metastatic cancer, amputation, sweats, uncontrolled tears, etc.


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For example: I once sprained my ankle badly and wanted x-rays; while I was still a teen-ager. I had a long relationship with this orthopedic; he was football team dr. He had told me not to bother him with sprained ankles unless I thought I had fractured/broke something and needed x-rays.

So when he was talking to me, I explained how I had folded my ankle against the outside of my calf. He wanted to know where my crutches were. I told him I had gimped in. He said I probably did not need x-rays if I was not on crutches.

He asked what I thought my pain level was on 1..10. I replied 6-7. He laughed and said probably not. Remember football! He had been a team doc for one of the pro teams about 3 - 4 years earlier. He said lets manipulate it first before x-rays.

He began a manipulation and stopped after moving foot at about 90 degree angle. He said "You need to tell me when it starts hurting". I asked "Do you just mean slight pain or discomfort or real pain starting?"

He said "Well I meant real pain. You should be experiencing a pain level of 14 on a level of 1..10 on what I just did. And you say it does not really hurt. Ok, lets get you that x-ray".

lisa3451 05-12-2007 12:26 PM

Re: Pain Scale: 1..10 - Examples
 
Pain scales can be a PAIN... My patients often get fruastrated/confused trying to answer the dreaded question. The score is really effective if patient and Dr/nurse are on the same page. I tell my patients;1-3=little pain,asparin or NSAIDS etc. 4-6=PAIN, non-narcotic meds or taking 1 narcotic when the DR.s order states take 1-2 tabs every 4-6 hours as needed. 6-8=BIG PAIN, taking two of those narcotics!!!!! 9-10=out of control PAIN, notify your DR that you meds are not effective, or your condition may have changed.
The best advice I can give is never let pain get out of control, its dangerous.
the pain level you discribed would be someone about to have a massive heart attack a definate 10++++.
I tell my Dr that pain is usually at a 6-7 level because I have to take the maximum narcotic prescibed to keep my pain level manageable. or I may say its a 3 right now I just took two lortabs an hour ago. I hope this helps...

Nikirae 05-12-2007 12:50 PM

Re: Pain Scale: 1..10 - Examples
 
My doctor breaks the pain down for me. Since I experince more then one kind of pain, it made it difficult to say on that 1-10 pain scale. So when I see him, he asks me how how my back pain is, then he asks me how my nerve pain is. Because I had so much trouble answering his question before he asked about both pains as thier own pain he started to ask this way. I feel this has helped both me and my doctor when it comes to treating my pain. My nerve pain is always worse then my back pain, and it was not easy to just say my lvl is 7 today, when in fact my back might be a 5 and my nerves could be an 8that day.


~hugs Niki

kitson 05-12-2007 04:59 PM

Re: Pain Scale: 1..10 - Examples
 
lisa3451,

You said, [I]"The score is really effective if patient and Dr/nurse are on the same page."
[/I]
I'm trying to find this page. I have tried to offer examples to dr.s like above and that does not seem to work. I ask for examples that I try to relate my numbers to. I am trying to learn a language that the dr.s can understand.

You said, [I]"I tell my Dr that pain is usually at a 6-7 level because I have to take the maximum narcotic prescibed to keep my pain level manageable. or I may say its a 3 right now I just took two lortabs an hour ago."[/I]
I tell them I have essentially the same pain 2 hours after taking 2 vicodin. If the pain level is a 7 before meds it is still a 7 after meds. The meds have an effect; it just is not that easy to discern a difference. :confused:

All info helps I just have a communications barrier that I have to break through.:)

Nikirae,

I am like you; I have multiple types of pain, not to mention locations. I think there are at least 3. It is easy to recognize 2. Everyone seems puzzled when I start talking about different pain.:confused:

Thank both of you for replying!

Jack24 05-12-2007 07:05 PM

Re: Pain Scale: 1..10 - Examples
 
Just to throw in another variable, length of time pain has been present. Generally, while on meds, my back and leg pain would be quite tolerable if it only lasted a 1 day out of a month. Trouble is it has been going on now for 2 1/4 years. Think of the ole Chinese water torture, or menses with endometriosis that never stopped. Chronic pain wears you down.

pooby 05-13-2007 02:41 PM

Re: Pain Scale: 1..10 - Examples
 
I take it with a measure of salt when people describe their pain as higher than 10. Well ten is the top there is no worse. How about losing consciousness from pain! Now that is a 10 not walking around talking about how much pain you are in. I do think that dr should give patients some kind of guidance as too how they interpret the numbers.

And while we are on the subject some people consider themselves very brave because they can withstand so much pain. Meanwhile they are simply not feeling it because they luckilly possess very high levels of endorphins in their brains. So if you think you are being particularly stoic while the moaning mass on the bed beside you is sobbing think again.

There was a study done a few years ago on women in labor. Some women didn't appear to be suffering while others at the same stage of labor with contractions of the same intensity where in a great deal of pain. Researchers then injected the "stoic moms" with endorphin blockers. The change was swift and apparent the mothers now started to experience intense levels of pain the same as their sisters.

We do not become more tolerant of pain the longer we endure it in fact the opposite is true. The natural morphine like endorphins of our brains get very depleted from chronic pain and as a result we suffer to a much greater degree.

kitson 05-13-2007 03:07 PM

Re: Pain Scale: 1..10 - Examples
 
Pooby Gal,

I found you post interesting. Especially about pain becoming more effective as time goes on (chronic pain) - seems to hold true in my case.

You said "[I]I do think that dr should give patients some kind of guidance as too how they interpret the numbers[/I]. "
That's one of my problems - I believe this too; I am somewhere in the neighborhood of seeing 10 docs for this problem(s) and none seem to comprehend the pain issue is not being addressed. I tell the docs the meds I am taking just take the edge off the pain; the meds do not change the pain level at all. And then ask if they can give me something that offers just some relief; I am not even looking to be comfortable anymore. The docs seem to think this means everything is fine; just give the same meds and go away.

I am sorry if I seem short; I am just very frustrated!

pooby 05-13-2007 09:58 PM

Re: Pain Scale: 1..10 - Examples
 
I am going this week to my PM guy. Have gained 20 lbs on Lyrica and would like to change to Topamax. Lyrica does help. Well because it is helping I doubt he will want to change it. I figure I am probably always going to have to be on this stuff so why not give it a try. We'll see. Don't think he really listens. Of course he sits there nodding his head and makes the appropriate facial gestures...lol The only time he moved fast and was very attentive is when I called him on a mistake and he had to do a re read of my mri. I like the guy and he is an "expert" so I don't want to sell him short.

I got myself a rollator (walker) and it does help when I have to go into any mall or big box store. There usually isn't a seat in sight and I cannot tolerate walking or standing for very long at least now I have a seat to sit down on. On the downside I probably will herniate another disc pulling the thing in and out of the car. I never dreamt 2 1/2 years ago that a bad back attack would leave me this way. My one leg is painful when I put weight on it so a cane is vital for me to walk at all. It really does take a while for it to sink in that this is a permanent condition and I have to accept it. In the beginning I always thought I would get better but now I have pretty much accepted that this is the way it is. What ya gonna do?

Jack24 05-14-2007 05:01 AM

Re: Pain Scale: 1..10 - Examples
 
I know what you mean about catching mistakes. I will correct my PM doc from time to time about stuff he should know. His problem is he has Anesthesiology residents and pain fellows who do the bulk of the work. He will come in the room at the end, no chart in hand, and try to get by with what I call a "Howdy Round". Sometimes I don't think he even reads my chart before he comes in. Granted he is very busy and in much demand but he at least needs to know the patients name an the basics of where treatment is going.

kleeko 05-14-2007 06:53 AM

Re: Pain Scale: 1..10 - Examples
 
Hi Pooby
Your post really resonated with me. I am two years into being disabled because of back surgery, drop foot and nerve pain. I was so into denial that I was blindsided by not doing enough to help myself. Sure, I got the cane and now wear braces, but it wasn't until recently that I got the rollator, stopped trying to mall shop, etc. The things we do to ourselves while trying to believe life didn't change! Good luck to you with your recovery.


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