How does one answer this question? One to ten compared to what? Ten being birthing an 11 pound six ounce baby without meds? That would make almost anything else like a four, including partially hacking off my finger. Ten being an infection in a molar, because that’s a feeling that makes you want to take a steak knife to your cheek and perform emergency surgery on yourself.
I think we need a new pain chart, that is perhaps more condition specific. For example, for a long time headache sufferer (mine have been old enough to drink for a while and just turned old enough to rent a car) perhaps the scale should be more like this:
1. It’s a normal headache day. There is a slight persistent presence in the back of your mind, like someone leaving the t.v. on the snow channel. It’s irritating, but for the most part doesn’t interfere with your ability to live, work, play.
2. Some asshole decided to turn the snow channel up. Apparently they thought it would be funny. It takes a little more energy and effort on your part to keep living, working, playing.
3. The snow channel has been turned down, but is now replaced with that annoying sounds the emergency broadcast system (EBS) sends out when they want you to know they are testing. If you focus fairly hard, you can still push it to the back ground and live, work, and play.
4. Someone just gave you a noogie, while the EBS sound is playing in the background. The place they affectionately noogied you is now throbbing a bit. Now you have to concentrate very hard to ignore both the background screech of the EBS and the throbbing in order to focus on work. It is getting harder to multi-task at all, and likely any interruptions in work will result in your needing to recapture your flow. Living and playing are starting to sound less possible, but you are reserving a bit of energy to play a board game, help with homework, cook dinner.
5. Now in addition to all of the above, you just managed to stub your toe really hard against the stairs. You somehow manage to do this every 30 minutes to an hour, and it takes a good ten minutes to get you back to a place where you can work, live, or play. The EBS channel is now turned up loudly enough to make any other sound irritating, and the place that affectionate noogie happened is starting to feel like you were hit with a ball during dodge-ball.
6. You are now choosing between work, live, play. You have no ability to handle sound or much light, dark sunglasses, turning off the lights in your room and dimming your monitor are now the only way you can really work. Also, locking the door and turning off the phone and all IM mechanisms are the only way you are going to maintain any focus whatsoever. Further, the asshole who is playing the EBS in the other room just turned it up higher. You are still somehow banging your toe against the stair, but now you are managing to also slam your elbow intermittently into things.
7. Tears. You want to cry. So you do. You discover crying brings on heavy headache pain monster in way not even noogie man or the EBS sound has. So, distraction time. What can you do that doesn’t require too much thought or concentration, can be done mostly in the dark, and ideally still manages to help you earn a living of some kind. (For you dirty birds, hooking is out, too much physical exertion is bad.) You are now also trying to decide which delivery place you can afford that will resemble healthy food for your children or you are thankful you have taught them to make sandwiches and soup without setting the kitchen on fire. You are no longer interested in eating anything.
8. Someone has walked in off the street, grabbed your head, and is now screaming full tilt into your face. In addition, they are occasionally slamming it into the floor. You can’t do anything but lie there and be screamed at. You need help caring for other living beings in your house, because you are currently checked out. If approached by a child or small pet, it is likely you will be able to stumble through helping with homework, making food, opening a can and dumping wet glop into a bowl. However, unless you set alarms to remind you of the caring things that you need to do, you will forget all about it. (I set alarms) All lights and sounds you encounter during this process will make you instantly aware of how in bed buried under covers you should really be.
9. Your whole head begins to feel like a bad 1950’s atom bomb experiment. Movement likely makes you throw up. You begin to consider filling the bathtub with blankets and pillows so you can be close to the toilet and turning out the lights forever. Upon occasion, some invisible force stabs you in the eye or cheek or temple. You barely notice, because that previous background pain is no longer in the background. Darkness is your friend. You will either need silence, or distraction while you wait it out.
10. Kill me. Please. However you want to, just make it stop.
So when I go to an ER and I am asked about the pain scale, I have a horrible time associating my pain with their chart. For example, when I was in labor with Ollie and he was crowning, I remember leaving my body behind while my conscious mind tried to escape the pain. I also remember trying to crawl away from my own vagina. So was that a ten? An eleven? A feeling no chart can quantify?
When I had an infected molar, I remember thinking it might be worse than labor, if for no other reason than it felt like my tooth was trying to give birth. Teeth are tiny and not at all designed for birth giving. Was that a ten?
A ten is supposed to be the worst pain you have ever felt. I don’t think this really helps medical professionals evaluate the individual currently suffering before them. The worst pain compared to what? We have different experiences with the pain in our lives, pain you can live with but that sucks energy from you, like headaches, back pain, knee pain etc. We have pain that is instant and incapacitating, then goes away fairly soon, like stubbing a toe, slamming your finger in a car door, etc. We have pain that incapacitates you for hours, weeks, even years.
We need a new pain chart. Something that allows you to tell your medical personnel that you, the patient, are at or nearing the end of your rope. That your pain is bad enough that you dragged your migraine affected ass into an ER in the middle of the night to hang out in uncomfortable chairs for god knows how long until someone can ask you to repeat your history 37 times before they begin to treat you.
I get that ER staff have a hard job, and the staff I encountered last night were more caring and responsive than any of the doctors currently assigned to treat me on a daily basis. I would love to trade with the staff I had.
I just never know how to answer that question. Worse, I am one of those smiling people who only like to let myself cry and clutch my head when no one is around, so I will sit up and do my best to communicate and be kind while the doc is in the room, and then curl into a ball of head clutching sorrow when they leave. In part, this is because it’s impossible to get any information out of a sobbing hysterical person, but in part it’s due to my upbringing. We are make-doers. We deal and smile, and try not to complain too much.
So I invite all your artists out there to turn my descriptions into a new pain chart for headaches. Then we can start a campaign to add that chart to the current ER walls. Maybe it will help them get a better, faster understanding, as to where a migraine sufferer is when they voluntarily enter a well lit, loud, and bustling environment for medical care.
3 thoughts on “Please number your pain from one to ten.”
Hyperbole and a Half has the proper pain scale:
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