No pain, no pain…

When a person comes to a health care facility one of the first things they are asked is to rate their pain on a scale from 0 to 10.  Usually an explanation is given that 0 is no pain and 10 is worst pain ever had.  As a R.N. I have given that speech to patients innumerable times and listened to numbers that I would have guessed were too high or too low for what I could see happening with the patient.  A person who is falling asleep while talking to me complaining of 10/10 pain…  A person writhing in bed after open heart surgery telling me it’s a 2/10…  The short answer is, “Pain is whatever a person says it is.”

“Pain is whatever a person says it is.”  Think about that. That is how a patient’s pain should be treated according to current nursing practices in my area.  No matter what you can see going on with the patient, this is the rule.  Now of course patients who can’t speak or indicate in an outward way are treated due to symptoms of pain. But that’s another can of worms.  The medical thinking behind this is no one except the person experiencing the pain can know how it truly feels.  Your pain from stubbing your toe may not feel the same as my pain from doing the same.  And I dare you to ask 2 women to come up with an exact definition for the pain of childbirth.

I mention all of this mostly to educate and stir up interest.  I also mention it because I have come to a point where pain has taken more of an interest in me.

Ever since childhood people have been hitting me in the arm.  Not always a bully. A lot of times it is a “Hey, How you doing?” Punch or shove to my upper arm.  My immediate response has always been to say, “Oww!”  To this I have had the never ending response of, “Oh, that didn’t hurt you.”  I was never lying or exaggerating.  It hurts every time. The same intense, sharp, searing pain comes from having my lower leg hit or grabbed. No one has listened to me for my whole life.  It finally got so bad that I couldn’t even be touched.  Yes, I’m a R.N. and yes I know the symptoms of fibromyalgia. After months of taking high dose ibuprofen, I finally saw my PCP, who drew an ESR and send me to a Rheumatologist.  Worthless appointment in that regards…  “Yes its fibromyalgia.  I don’t think you should do anything different for it other than take Naproxen.  Let’s do another set of labs that I’m SURE will be normal.”  So Aleve is going to magically take it away?…

Had labs drawn and waited a week to call Rheumatologist for results. Office says they don’t have them yet.  This is B.S. because I already have a bill for the labs. I let a few more days go by and call back. They still don’t have them, and doctor was out of town and ask the lab to fax them…  NOPE. Made a trip to medical records and got a copy of my labs. And guess what?  My labs are worse.  Now I am steaming hot angry. Luckily the doctor called back early the next morning to talk to me about labs.  My ESR and CRP are elevated with negative ANA and Rheumatoid Factors. Short hand = the labs say I have inflammation and pain but no known source.  Recommendation, take Aleve and see me in a month.  So, pain level 4/10 with intermittent spikes to 8/10 with no relief from Ibuprofen or Aleve.  Pain is whatever the person says it is…but how do you make someone understand what it is that you feel.

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