Nurse: On a scale of 0 to 10, what is your pain level?

[LuckyCharms]

Me: Not too bad.

[csziggy]

1. I HATE those pain scales

While I was in the rehab hospital last time around, the physical therapist discussed the pain scale with our first group session. He went around the circle and asked the pain level from 0 to 10 of each patient. One lady insisted her pain level was 20.

The PT suggested that was an exaggeration. He said when he had been in a car wreck, broke both legs and was being burned as the car was on fire, his pain level was probably a 9. In his opinion a level of 10 would leave the patient unable to speak.

My highest pain level was when my stallion bit my breast, smashing the outer half of it to a pulp. At first I was in shock and didn't feel any pain - that let me get the stallion into his stall and start walking across the farm to the house. About halfway there I fell to my knees as the pain hit. THAT was probably a pain level of 6 to 7.

[LuckyCharms]

2. I hear you.

If 10 is supposed to be the worst pain you ever experienced, I've never had the occasion say above a 5 or 6 when asked that question.

[csziggy]

7. Since most of the time I have a high pain tolerance I say 1 or 2

Which can backfire - when a colt snatched my left arm and tore up the rotator cuff, the surgeon did not think it was very serious. He planned for a 90 minute laparoscopic surgery. It was a several hour open shoulder surgery. Loads of fun.

[discntnt_irny_srcsm]

3. That sounds excruciating

I'm so sorry that happened. I've never had anything worse than an appendicitis. It was like some really bad bowel cramps.

I knew someone who was in prison for a few months because he did some really stupid stuff. He wasn't beaten. Never had anyone threaten him or hurt him. He was reading a letter from his wife. In the background there was a newscast on a communal TV about a woman in Russia who died waiting in line for food during some rationing. Her daughter and granddaughter depended on her. I don't remember the whole story. But the contrast just got to him bad because his wife wrote about his daughter and herself being abused by his mother-in-law because of his mistakes. He said he felt powerless and haunted and couldn't sleep for days.

[hibbing]

4. My comments

The thing with me is the pain meds never got me "wasted" or high or anything like some people say they take something and are all goofy and wasted. I have always been jealous of those people. I never had oxy, but I did have dilauded (sp) and some other stuff. But I know the pain meds are in theory supposed to take away the pain and not get you high right? Worst pain I had was uh....getting hemorrhoids sliced off my sphincter. That was not pleasant. My mom was on a morphine drip after a very serious incident and it just made her sleep. My dad had some morphine tablets when he had cancer, and me being the dumbass I am, flushed almost a whole bottle down the toilet after he died. Sorry for the babbling.

On edit- Paging Aristus for his feedback.

Peace

[Aristus]

12. My feedback is simply this:

Most medical providers I know, including me, hate the pain scale as part of the vital signs.

The other vital signs, temperature, blood pressure, heart rate, respiration, and oxygen saturation, are all objective, and obtained through scientific means.

The pain scale, on the other hand, is entirely subjective, and of absolutely no use in ascertaining what level of distress a patient is in.

I am impressed neither by a patient who insists, on a scale of 1-to-10, that his pain is "Fifteen, man! Fifteen!", nor by people who insist they have a 'high pain-tolerance', but still try to shake me down for powerful opioid pain medication.

Most patients, however, are simply in the dark as to what the pain scale is for. There are people who are in pain, any pain, and figure "I'm in pain; it must be a 10". If they are otherwise in no visible distress, blood pressure, heart rate, and respiration within normal limits, I explain what '10' means:

"Ten means someone has chopped your legs off at the knees, you're jetting blood out of the stumps, and you have to go to the hospital where you are going to die."

"Oh. Okay, I think it's a four."

Often, I'll use humor to illustrate my point. When I see 10/10 pain on the chart of the patient I'm about to visit with, I'll poke my head in the door. If they are comfortable-looking, and smiling pleasantly, I'll joke: "Oh, I saw 10-out-of-10 on the chart and thought you must be on fire."

We need to get rid of the pain scale in clinical medicine. It's useless as a tool for medical evaluation.

[sarge43]

16. Wouldn't it be more helpful with a diagnosis for the patient to describe the pain?

Burning, itchy, throbbing, stabbing, etc? Still subjective, but much less than the scale.

[Aristus]

17. Oh, I always ask for a description of the pain.

In precisely the way you listed it.

A description of the pain can be very helpful. And even a simple descrption of severity, mild, moderate, severe, etc. can be clinically useful.

But a numeric scale just encourages patients to rate a hangnail as 10/10, or to report 100/10 (!) (yes, that actually happened once) as a a way to convince me he needs narcotic medications.

[hunter]

21. This one is better...

http://hyperboleandahalf.blogspot.com/2010/02/boyfriend-doesnt-have-ebola-probably.html

[Shrike47]

5. I have a terrible time with those pain ratings. The pain is debilitating but I can imagine worse.

I was in the hospital with cellulitis a few years ago and they weren’t giving me anything like enough pain medication. I would scream (as quietly as I could) when I had to get out of bed to go to the can. Lots of moaning if I had to move. But I would tell them 6 or 7 because I could imagine worse pain.

By the time I was finally discharged, I hated them.

I think now I would just demand more pain meds from the get-go.

[Freddie]

6. Worst pain for me

My son was born in 1990, by c-section. Because I didn’t have a good experience trying to breastfeed his sister, I chose not to try with him. (They both turned out fine). For 2 days after the birth I was given a medication to make my uterus contract which would happen naturally from breastfeeding. The cramping on top of the surgery was unreal, I remember crying and begging for Demerol, which was given every 4 hours and wore off in 2. Demerol also makes you hallucinate which is why it’s not used often anymore. Happy and joyous childbirth experience.

[tavernier]

14. Remembering labor with my first

who was sideways, and they weren’t having any luck turning her. The labor pains were so bad, it felt as though a semi truck was resting on my back, about to break it. When I couldn’t take it any longer, they gave me Demerol. The nurse came back ten minutes later and I was in the bathroom trying to climb into the toilet because I was certain if I flushed myself out of the hospital the pain would stop. Good old Demerol!

[Freddie]

15. It's amazing most kids aren't "only" children

My son was my 2nd and last, was NOT doing that again!

[tavernier]

19. Yup, I was scared to death all 9 months waiting for #2 child

but it was a piece of cake. Ya never know.

[alarimer]

8. I don't know how useful those scales really are.

I guess it's relative though and everybody's different.

I get bad headaches sometimes that make me want to cry (which would actually make it worse) or vomit and basically render me unable to do much of anything. Can't watch tv or read. Can't really even lie down because it's impossible to find a position where my head doesn't throb. Even then, I don't know that I would describe that as a 10. I have nothing else really to compare it to.

[fleur-de-lisa]

9. Have you been diagnosed with migraines?

There are lots of treatments available.

I was diagnosed about 35 years ago. I have several medications, depending on whether I need to take them at night or during the day (some make me sleepy). And I get Botox injections for migraines.

Diet can also help. Researchers ahve found a link between potassium and sodium levels and migraine. It took me about 6 months to figure out how to keep my potassium/sodium at optimum levels, but naw that I somewhat understand it, I can sometimes thwart a migraine by eating certain foods adn by avoiding others known to be triggers.

[alarimer]

10. No, but I have figured out how to prevent them (usually).

Usually I can take Excedrin Migraine and some kind of caffeinated beverage and that works to prevent or make it go away. Eventually.

I did figure out that dehydration was a major factor, so when I worked outside in Texas (with no access to a restroom), they were worse, because I limited my intake of water. I still occasionally work outside, but it is usually in the fall and I usually am better able to manage my hydration.

[hunter]

23. Migraine/Cluster headaches... let me die here now curled up on the floor in front of the toilet.

Thankfully those episodes seem to be in my past. I still go entirely blind at times and hyper sensitive to sounds, but I don't want to die.

[lillypaddle]

11. I hate that question

Is it as bad as if you were pulling my fingernails out? Is that "the" 10?

How about it fucking hurts like HELL! And where is that on the scale?

Just gimme the damn drugs!

[Ilsa]

13. My MIL says it's a 9, sitting there smiling, yacking about the weather.

Even after they explain, "... and 10 is the worst, most excruciating pain imaginable," she will say softly, "9 or 10", goes away with a Tylenol, while her body language and vital signs say 0-4.

[SCantiGOP]

18. "9 is the magic number."

I had surgery on my foot a few years ago. They put in an IV and gave me something to relax me but used a "foot block" so I was awake and conscious for the entire procedure.
Once in the recovery room they told me to let them know when the block started to wear off so they could give me something to, as they put it, "stay ahead of the pain."
A few minutes later I could start to feel where they had cut my foot open, and when a nurse came in with that "What is your pain level on 1 to 10 scale" I said that it was a nine and heading to ten.
She said "9 is the magic number" as she slid the needle into my IV. My wife said in 30 seconds I had a goofy drunk look on my face, and told the nurse "You can cut the other foot is you give me another shot of that."

Love that Demerol.

[ismnotwasm]

20. Heres how I ask the question

On a scale on 1-10, where is your pain level—then I watch the patients face, for a moment or two. Some patients say “15” while they are eating breakfast and some say “5” when they can barely move.

I tell them, “I had a patient who told me that his “10” was getting shot through the hand—that’s what a ten would look like. A two is a dull ache, like bumping your elbow”.

4 or 5 is reasonable for a post surgical patient 7 or 8 is not. I try not to let my patients get past a 6. Once I figure out how they experience pain—everybody is different—then I can medicate or intervene with heat or ice or repositioning appropriately (I am a Med-surg RN)

If someone says “not too bad”, we get to have further discussion about pain management .

[Aristus]

22. RN's rock so hard.

My Dad was an RN. He taught me proper respect for the profession.

[jalan48]

24. 1-5 though I noticed when I smoked cigarettes I was more susceptible to pain.

[lastlib]

25. Worst pain I ever had, I'd call it a 7....

Big toenail in-grown, second time. First time, I went to a competent podiatrist, no problem, very little pain. Second time, I just went to my (then-)regular doctor. Big mistake. I now think he got his medical degree from Berlin U., studying under Dr. Mengele. He started cutting into it before it was numb, and I just about went into orbit from the pain. NEVER felt anything like that! I bled like a suck pig, and before he fininshed, I'm sure I left permanent scratch marks on the table I was on. He bandaged it, and I couldn't let that foot touch the floor or anything else without excruciating pain. Bad thing was, it was my right foot, so I had to drive home with that agony. Hurt for three days.

Never went back to that doctor.

[LuckyCharms]

31. Oh man, sorry you went through that.

This past early winter, I went for a walk in the rain. I had just bought some bluetooth headphones for my cell phone, and I was walking in the pouring rain listening to music. Ended up walking 6 miles. I had on muck shoes, which were slightly too big, so my toes kept jammimg into the front of the shoe. I felt the pain, but decided to ignore it and keep walking.

When I got home, I saw that 3 of my toes were black under the nail. I had a podiatrist appointment in 2 days for routine care, so I figured I would just wait until I saw him.

Before he started cutting my nails, I told him that I messed up 3 toes. When he went to cut the big toe, he casually told me that most of the nail had separated from the bed, and he just started cutting the nail vertically down the side to the cuticle. I jumped, but just from the sight of it. It didn't hurt at all, but when he got to the cuticle, it was still attached. Now he's cutting horizontally across the cuticle, and it hurt like hell. He told me he was going to shoot some novocaine in there, but I said no, just keep cutting. I don't know how often you have had a novocaine shot into the toes or fingertips, but I've had them a lot, and I've discovered that the procedure pain is usually less than the shot pain. so he just kept cutting while I'm biting my lip, then he cut vertically up the center of the big toe nail. I'd post a pic, but DU would consider it gore.

I hope your foot is all healed up.

[lastlib]

32. Yuck! that hurt me just reading it!

My episode was over 15 years ago, so it's long healed, but I will never forget that pain. Like I said, I never went back to that doctor.

[RKP5637]

26. They are so damn subjective. I had a major 2 hr. operation. My surgeon said I would be pain free

with the medication, as I am ultra-sensitive to pain. My nurse asked my pain level, I said probably 7. She says that's too high and inferred I was trying to get more pain meds than I needed. It was stupid!!! Then another nurse gave me something and the pain went completely away. When a person is in pain after a major operation, it does NOT mean they are an addict trying to get drugs. FFS!!! My surgeon kept me on medication for several weeks after I returned home. And I am fine now.

[LuckyCharms]

30. I hear you. I have the opposite problem though.

1) Went to the ER with kidney stones once. Also, I had so much blood and clotting in my urine that it was like mud. Doc asked me my pain level. I just said "BAD". He said...we'll take care of that. He shot me up with something, not sure what it was, but it was pure bliss. I remember laying in the bed in one of those curtain cubicles, and everytime a nurse walked by I would yell Woooooooooo! lol

2) Another time when I was remodeling my kitchen, I blew out my back. I got trapped on the floor for two hours, couldn't get up. When I finally got to the ER, the doc asked me about my pain level. Again I just said "bad". She did a CT scan, came in and told me I blew out 5 disks. She gave me some muscle relaxants and some pain pills. When I got home, the combo did not sit well with me and I was higher than a kite...bad feeling. I still have most of the muscle relaxants, and I chip away at the pain pills when I need them. Still have a few of those left after a few years. I think they are percocets. The docs seem to throw pain pills at me.

[Historic NY]

27. Dr. whats your pain level.........

1-10 me 12....he looks up. I shaking, sweating and barely able to utter anything. Nurse................

[Ohiogal]

28. Anyone who's never experienced 10

........has obviously never given birth ............

[LuckyCharms]

29. Is that painful?

[JustABozoOnThisBus]

33. 8 or 9. Anything less, and the ER folks ignore you. nt

[raven mad]

34. 33 but you'll still stick that needle in my arm.