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Pain is NOT subjective



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No. 10
from llg
Old Jan 09, 2009, 09:07 AM

Default Re: Pain is NOT subjective
When I am a patient, I have the opposite problem. Apparently, I have a fairly high pain threshold. So, I don't report pain as being very severe and I don't request "enough" pain relief for people to take me seriously as a patient.

I frequently find myself saying things like, "It doesn't hurt all that much, but I do thinK there is something wrong here. Could you please take a closer look at this?" The doctor and/or nurses brushes me off because I don't seem to be suffering much ... and then we all have to deal with a more serious problem later because my little problem was not sufficiently treated and it grows to become a big problem.

Even when I was a child, my father (who was also my doctor) would say things like, "She's not a complainer. If she says something's wrong, there probably is." whenever he had to refer me to someone else for treatment.

I drives me crazy. I am often tempted to "over-dramatize" my report of pain just to get taken seriously.
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No. 11
Old Jan 09, 2009, 03:04 PM

Default Re: Pain is NOT subjective
Originally Posted by I love my cat! View Post
Sad, seeing it is Doctors that are providing an individual with the diagnosis of Fibromyalgia! Docs tell a chronic pain patient that this is what their specific complaints of pain/fatigue/IBS/etc..... are known as within the Medical Community, then the patient tells others and then people turn around and laugh, roll their eyes and discredit them!
Nice.
No wonder these people feel like they are going crazy. Look how they are treated.

Dont forget the drug companies. How many companies are offering their drugs to those with Fibromyalgia on TV. I do take exception to a lot of these medicine commercials on TV. They affect everyone who sees them also
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No. 12
Old Jan 09, 2009, 06:59 PM

Default Re: Pain is NOT subjective
Thanks for letting me vent. I WILL continue to document what the pt. says, doing an objective assessment as well because that is what is required. ALL of our documention is narrative style, which I'll step up. One of the computer systems I learned on had the objective information in one area, with pain assessment in another area, thus it was easy to cross reference without having to question what the pt. stated like this.

I'm still shaking my head...why on earth would I use a faces scale (she was referring to the dementia pain scale we use) on someone who is A&O?

UGH!!
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No. 13
from Josh L.Ac.
Old Jan 10, 2009, 09:38 PM

Default Re: Pain is NOT subjective
Methadone for fibromyalgia?


Wonderful.
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No. 14
from morte
Old Jan 11, 2009, 07:09 AM

Default Re: Pain is NOT subjective
Originally Posted by llg View Post
When I am a patient, I have the opposite problem. Apparently, I have a fairly high pain threshold. So, I don't report pain as being very severe and I don't request "enough" pain relief for people to take me seriously as a patient.

I frequently find myself saying things like, "It doesn't hurt all that much, but I do thinK there is something wrong here. Could you please take a closer look at this?" The doctor and/or nurses brushes me off because I don't seem to be suffering much ... and then we all have to deal with a more serious problem later because my little problem was not sufficiently treated and it grows to become a big problem.

Even when I was a child, my father (who was also my doctor) would say things like, "She's not a complainer. If she says something's wrong, there probably is." whenever he had to refer me to someone else for treatment.

I drives me crazy. I am often tempted to "over-dramatize" my report of pain just to get taken seriously.
OH, do i hear you, i have a fairly high tolerance for pain, and i have been treated similiarly......i have taken to informing practioners that i can tolerate having my teeth drilled without novacaine, please include that in your judgement when i complain of pain......
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No. 15
from eriksoln
Old Jan 11, 2009, 10:48 AM

Default Re: Pain is NOT subjective
I went to the ER once with food poisoning. I was hurting. But, I knew what it was and was willing to just "wait it out". I only went to make sure it wouldnt get worse.
I got a lot of "oh yeah, your here with abd. pain, OK" sort of pat answers. I hadnt told them I was a nurse. Next thing I knew, the nurse was bringing 2mg of dilaudid to me. I was like "hecks no, I dont want that. I never asked for that." The doctor hadnt even seen me yet. I guess they thought they were just going to feed the beast and let me lay in the ER for awhile until I felt I had gotten my fix. Funny. They didnt know what to do with me when I said I wasnt interested in dilaudid and was just there to make sure things didnt get worse.
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No. 16
from shrinky
Old Jan 12, 2009, 11:19 AM

Gavel Re: Pain is NOT subjective
It is so easy for some people to be judgemental (?SP) about another person's pain. Everyone reacts differently to pain and we function at different levels. So someone could be smiling at an 8 while another person cries at an 8. Our tolerance levels are different and our ability to carry on ADLs with pain vary. If this is not subjective, then I would like your boss to explain to me how she or he perceives pain. I ask my patients at what level are they able to perform usual ADLs and what is a comfortable level for them, that sounds subjective to me. And yes, pain is very subjective.
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No. 17
from Josh L.Ac.
Old Jan 12, 2009, 06:10 PM

Default Re: Pain is NOT subjective
That's why I like pain scales that illustrate the patient's functional ability instead of the patient's "perception" of what their pain should rate (look under "Activity Tolerance Scale") :




While all the advocacy literature states we should completely believe the patient's report of their pain, we need to have some way to verify what we are being told. If the patient can walk and talk without any distress, then they aren't a "12 out of 10".
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No. 18
Old Jan 12, 2009, 06:51 PM

Default Re: Pain is NOT subjective
Based on this, then she was an 8. While she didn't have the facial characteristics, she still couldn't get out of bed and repositioning caused her pain as well.
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No. 19
from sewnew
Old Jan 18, 2009, 12:39 PM

Default Re: Pain is NOT subjective
Originally Posted by Iam46yearsold View Post
Dont forget the drug companies. How many companies are offering their drugs to those with Fibromyalgia on TV. I do take exception to a lot of these medicine commercials on TV. They affect everyone who sees them also
Yep, I can't even count how many times I have seen commercials for Lyrica on TV the last couple of months. And I don't even watch TV that often...The drug reps definitely do make an impression on the public whether they realize it or not.
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