good heaven's....

lunden · Oct 23, 2008

it still seems like she could have rated her pain. sounds like a 10

Virgo_RN, BSN, RN · Oct 23, 2008

I've encountered people with chronic pain who have difficulty rating their pain on the numerical pain scale. For these people, the pain is always there at some level, and they get used to living with a certain amount of pain, but when the pain increases, it can do so suddenly and drastically, so that they are in severe pain all of a sudden. They will often request to be medicated before this happens, because it is miserable trying to catch up to the pain once it has already become severe.

tvccrn, ASN, RN · Oct 23, 2008

I recently had to have surgery on my ankel for a chronic pain problem. I was so used to having some kind of pain constantly that unless I really thought about it, I could push the pain to the back of my mind. If I didn't ignore it, it would have overwhelmed me and made it difficult to function.

I think if you live with pain for so long that unless it's agonizing, you tend to "forget" about it. So, I can see where she is coming from.

Editorial Team / Admin · Oct 23, 2008

I've encountered people with chronic pain who have difficulty rating their pain on the numerical pain scale. For these people, the pain is always there at some level, and they get used to living with a certain amount of pain, but when the pain increases, it can do so suddenly and drastically, so that they are in severe pain all of a sudden. They will often request to be medicated before this happens, because it is miserable trying to catch up to the pain once it has already become severe.

:yeahthat:

Babarnurse · Oct 23, 2008

i've encountered people with chronic pain who have difficulty rating their pain on the numerical pain scale. for these people, the pain is always there at some level, and they get used to living with a certain amount of pain, but when the pain increases, it can do so suddenly and drastically, so that they are in severe pain all of a sudden. they will often request to be medicated before this happens, because it is miserable trying to catch up to the pain once it has already become severe.

excellent! :yeah:

NoWhereNear · Oct 23, 2008

To me a 10 is crazy mind-numbing think-you're-dying didn't-know-anything-could-hurt-this-bad pain. Basically I compare everything to the time I was recovering from major opened-like-a-trout abdominal surgery and something went wrong...I don't know if the morphine drip ran out or what, but I woke up screaming bloody murder in a kind of pain I never imagined existed. So now it turns out that when I rate something as around a 7, according to the little chart I'm actually at a 9. I'd hate to see anyone in the kind of pain I consider a "10". Pretty much anything I don't think might kill me rates below a 6.

It's all relative. Pain sucks that way.

hellerd2003, RN · Oct 23, 2008

To me a 10 is crazy mind-numbing think-you're-dying didn't-know-anything-could-hurt-this-bad pain. Basically I compare everything to the time I was recovering from major opened-like-a-trout abdominal surgery and something went wrong...I don't know if the morphine drip ran out or what, but I woke up screaming bloody murder in a kind of pain I never imagined existed. So now it turns out that when I rate something as around a 7, according to the little chart I'm actually at a 9. I'd hate to see anyone in the kind of pain I consider a "10". Pretty much anything I don't think might kill me rates below a 6.
It's all relative. Pain sucks that way.

I've had multiple knee surgeries/ dislocations since the age of 14. I've been known, on occasion, post-dislocation, to help move furniture (high off endorphins, I assume), and only realize I'm hurting a few hours later.

Needless to say, my pain threshold is pretty high. Chronic knee pain, that I have daily, is around a 3-5. I'm ok with that.

I've had epigastric pain that I'd rate at a 10, which made me so miserable that I vagal'ed down and lost a BP per monitor. That was the worst, and nothing touched it. Regardless, once awake, I only asked for (what I know now to be) low doses of pain meds. Chronic pain changes everything. The threshold increases.

oramar · Oct 23, 2008

I have met quite a few people who don't want to be bothered with pain scale. They get annoyed when I must insist. Documentation rules require it.

Farmer Jane · Oct 23, 2008

If they don't want to use a pain scale, just write what they say such as "severe" "so bad" or whatever.

mama_d, BSN, RN · Oct 23, 2008

I had been battling with chronic pelvic/abd pain for ten years. I am currently 4 weeks post-op today, and realize now that I was in much more pain constantly than I allowed myself to realize! My pelvic area feels empty now without that constant presence of pain. I also had problems trying to quantify pain when discussing it with my doc; to me anything below about a 5 was tolerable and able to be ignored if I was busy enough to not think about it. But if I did anything to aggravate it I could quickly escalate to about an 8 and have to take several Advil to deal with it. I have come to realize that chronic pain really screws with your ability to accurately convey your pain level to others.

queenjean · Oct 23, 2008

Especially with chronic pain pts, I think it is important to ascertain what an acceptable level of pain is to them. For example, when a pt says "I don't know how to rate my pain, I always have pain." then I usually reiterate the pain scale "with 0 being absolutely pain free, and 10 being the worst pain you can imagine. Where on that spectrum would you say is your usual, daily baseline of pain, and where do you think you are right now?" We also have these pain scales on the wall, so I can be pointing to it while I'm saying this.

I think for chronic pain pts it is helpful for them to know that I'm serious about wanting to understand where they usually function at and where they are right now. They know I'm not going to be able to take the pain away. I know it, too. But if I can figure out where they usually are, then it gives me and my coworkers something to aim for.