Wednesday, March 20, 2013
All pain is tolerable
as long as its somebody else's.
Pain, even by definition, is subjective. "It is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage," or "an unpleasant sensation occurring in varying degrees of severity as a consequence of injury, disease or emotional disorder."
How can we adequately describe pain?
Well, we can try to describe it using medical jargon. Let's see....there is allodynia. That's pain due to a stimulus that normally doesn't cause pain. I can't see going to the doctor and telling him my allodynia is off the charts.......
Hyperalgesia.....this is like turning up the volume on stimulus that does cause pain. Basically, pain in hyper drive.
Again, I can't see going to the doctor and using medical jargon. They may understand the meaning but they'd look at me like I was a wackadoo. My doctor would tell me to get my nose out of the medical books and just talk to him. My feeling, and this is just MY opinion, is that if we use too many medical terms the doctor may feel like we're looking for something to justify something that he will qualify as an imaginary illness.
Then there's the pain chart. The smiley faces and the words don't go together. If 10 is the worst possible pain then should I be standing there or should I be rolling around and screaming in pain? If that's the worst then is 8 that far behind and, if so, what does it mean? I think childbirth was a 10 but would that make the pain I experience every day a 5? I don't know how to go from a 5 to 10 and really make sense of what I feel.
I've become pretty good at management but having said that am I sabotaging myself? I can take a lot of pain; I'm used to it, unfortunately. How do I accurately convey the level of pain? They don't know me so they have to take my word for it. Sometimes I underplay it because I don't want to be thought of as a baby. I also think there is a credibility issue, not just with me, but with anyone who has chronic pain.
There are so many people that fake the pain so they can get medication. I was at the pain management doctor a couple of weeks ago and I was waiting for the nurse to bring the prescriptions and my appointment card. I could hear the doctor in the next room and he was telling the person that he wouldn't be refilling the medications that another doctor had given. Basically, they were doctor shopping. The list was extensive and I was shocked that a doctor would prescribed sleeping pills, anti-anxiety medication and two STRONG pain pills. I would think you'd go to sleep and not wake up. If I asked for that I'd get locked up......how does someone walk out with that kind of narcotic protocol? Of course, the voices were getting pretty loud and the patient was escorted off the premises.
This is why we walk such a fine line. If we are in too much pain and mention it we run the risk of being denied medication because doctors are just plain afraid of liability. If we underplay the pain then they figure we don't need anything. If we say we need it for breakthrough pain they think we're recreational users.
What will it take to get adequate multi-dimensional care?
I have my own pain scale.
There's OW. There's OW squared. Then there's the pain I call voodoo pain. Remember in Indiana Jones and the Temple of Doom the pain that he had when the pins in the voodoo doll was more then he could bear?
That's the pain.....Voodoo.
It's the old joke.......
Does this hurt?
Then don't do it anymore.........