10/10 pain..venting!

teeituptom, BSN, RN · Mar 30, 2004

what do you mean by that? are you saying that i'm different just because i live somewhere else?by the way, are you a nurse? at all?

no flaming allowed here

humour only

FutureNrse · Feb 14, 2005

for those who tell me toradol doesn't work - that is a sure sign they are seeking (to me at least) because it always works - i mean you may need something more - but it helps AT LEAST a little
harry krischna - droperidol was black-boxed....but was a great drug....

Well, I'd have to say that I agree, and disagree. Once, I was given Toradol when I broke a tooth and it worked okay, brought me down from a 9 to 4. Another time I was given Toradol when the herniated disks flared up and I felt like my neck was broken. Didn't do a thing. They gave me a second shot of it, didn't do a thing. Well, that's not entirely true, it did make me itch like crazy because I'm allergic to it. But even before I knew allergies were some kind of red flag, I never refused a medication just because of mild adverse reactions. Itching was a small price to pay when I broke that tooth.

FutureNrse · Feb 14, 2005

Oh yeah. Had one the other day who proceeded to tell me that i should mix 2mg dilaudid with "whats the stuff that keeps you from throwing up, begins with a 'p'?" (phenergan) in one syringe and push it fast becuase that always works to aleviate her pain. Guess what? 3mg of haldol did too!

I have to ask...what is the deal with pushing it fast? Is that a druggie thing, like a rush or something? Is it real or just imagined? I would assume that it would make no real difference but I'm not totally caught up on my druggie learnin yet.

teeituptom, BSN, RN · Feb 14, 2005

I have to ask...what is the deal with pushing it fast? Is that a druggie thing, like a rush or something? Is it real or just imagined? I would assume that it would make no real difference but I'm not totally caught up on my druggie learnin yet.

They always come up with new ways

FranEMTnurse, CNA, LPN, EMT-I · Feb 14, 2005

I have to ask...what is the deal with pushing it fast? Is that a druggie thing, like a rush or something? Is it real or just imagined? I would assume that it would make no real difference but I'm not totally caught up on my druggie learnin yet.

Definitely sounda like a druggie thing to me. They say the faster they get it in the body,The better their high. I say no thank you. I'm already on 25mcg Fentanyl duragesic, Soma 350mg qid, and dilaudid 4mg q4h foer pain control, and I don't get high, but I definitely get tired with all that stuff. And besides, I'm aanemic too.

I was given versed IV by an anesthesiologist once, rapid IV push, and it hurt like crazy. no fun:o

Nesher, BSN, RN · Feb 14, 2005

I think pain is a fascinating concept - my current example concerns myself - I would not have thought I had a high tolerance, but based on these two incidents I will share with you - clearly I do.

The first incident occured while I was on vacation in Plam Springs with my husbands family. We were out playing hide and seek with the kids on some of the jumbo rocks in the Joshua Tree National Park. I had been found and was walking down a slight hill strewn wtih tiny pebbles. I slipped and being the star skier that I am (never fall when I ski:)) I stayed upright, but saw my ankle twist in a manner quite unnatural and heard the snap of my bone. That is not a sound one should ever hear in their lifetime. IF you have heard it you know what I mean. I said,' Oh no I did something really bad to my ankle." Interestingly I felt immediate shocky type symtoms. I felt nausea followed by a need to pass out.

I hobbled to the car - it really hurt! But hey we were on vacation. Put all the ice from the cooler in a bag and on the ankle, took 800mg Advil and off we went. I guess it had a lot to do with the reaction of my husbands family - I'm afraid they believed my brother in law who is an ICU nurse and he thought being the expert that he is that I had a sprain. I knew better - I heard it after all and it hurt like pass out hurt.

Anyway I finally went to a hosptial in LA - this was the next night - I had at this point learned how to walk and live with the pain. It was also our last night in town and we were planning to go out to dinner - when I got back from the hospital. Needless to say the wait was going to be a lifetime so I left without being seen.

The next day our trip from LA to Seattle which should have been quick was made more fun by having to change planes in Oakland - so I had the thrill of walking through three airports - limping heavily. I was too stubborn to use a wheelchair. While in one of the airports I made an appointment for the next am to see a doc - yes I could have gone to the ER...but I didn't want to wait and this doc had an Xray machine.

The doc looked at my ankle the next am - it was black- the whole foot and wide as a double wide trailer. SHe too thought it was a sprain, but I insisted on a xray. Walked over there - had the ray and was waiting to make sure it was OK when the tech came out and said "I would feel better if you used this wheelchair." I asked what's up - but she commented that she isn't trained to read the xrays. I then asked to see it - teling her I was a nurse. SHe left it sitting next to me. Now I am not trained to read xrays either, but there was NO mistaking the fact that one of the bones no longer was connected.

Second story involves my wrist - I was out running with my dog and near the end of our run when he was usually done stopping to sniff and pee, he suddenly came to a complete halt in the middle of the sidewalk to check out a pile of grass clippings. In order to not land on top of him I went flying over him - landing instead on my left hand, left boob and right knee. Blood and guts everywhere. The obvious boo-boos were pretty darn big and nasty - but the one I lived with for years was the torn ligament in my wrist. Went along for 5 years with the pain of that until this past spring when it became impossible at times to even lift a piece of paper with that hand. Finally the pain got bad enough for me to have checked out. Three surgeries later ta da!

I guess my point through all these long winded stories is that we are all different. MY tendency is to not trust or believe the guy with 10/10 pain, who is calmly going about his day - but the other part of me recognizes that a person can be in severe pain yet is able to tolerate it. SO I guess everything is not quite as cut and dried as it may appear.

z's playa · Feb 14, 2005

I think pain is a fascinating concept - my current example concerns myself - I would not have thought I had a high tolerance, but based on these two incidents I will share with you - clearly I do.
The first incident occured while I was on vacation in Plam Springs with my husbands family. We were out playing hide and seek with the kids on some of the jumbo rocks in the Joshua Tree National Park. I had been found and was walking down a slight hill strewn wtih tiny pebbles. I slipped and being the star skier that I am (never fall when I ski:)) I stayed upright, but saw my ankle twist in a manner quite unnatural and heard the snap of my bone. That is not a sound one should ever hear in their lifetime. IF you have heard it you know what I mean. I said,' Oh no I did something really bad to my ankle." Interestingly I felt immediate shocky type symtoms. I felt nausea followed by a need to pass out.
I hobbled to the car - it really hurt! But hey we were on vacation. Put all the ice from the cooler in a bag and on the ankle, took 800mg Advil and off we went. I guess it had a lot to do with the reaction of my husbands family - I'm afraid they believed my brother in law who is an ICU nurse and he thought being the expert that he is that I had a sprain. I knew better - I heard it after all and it hurt like pass out hurt.
Anyway I finally went to a hosptial in LA - this was the next night - I had at this point learned how to walk and live with the pain. It was also our last night in town and we were planning to go out to dinner - when I got back from the hospital. Needless to say the wait was going to be a lifetime so I left without being seen.
The next day our trip from LA to Seattle which should have been quick was made more fun by having to change planes in Oakland - so I had the thrill of walking through three airports - limping heavily. I was too stubborn to use a wheelchair. While in one of the airports I made an appointment for the next am to see a doc - yes I could have gone to the ER...but I didn't want to wait and this doc had an Xray machine.
The doc looked at my ankle the next am - it was black- the whole foot and wide as a double wide trailer. SHe too thought it was a sprain, but I insisted on a xray. Walked over there - had the ray and was waiting to make sure it was OK when the tech came out and said "I would feel better if you used this wheelchair." I asked what's up - but she commented that she isn't trained to read the xrays. I then asked to see it - teling her I was a nurse. SHe left it sitting next to me. Now I am not trained to read xrays either, but there was NO mistaking the fact that one of the bones no longer was connected.
Second story involves my wrist - I was out running with my dog and near the end of our run when he was usually done stopping to sniff and pee, he suddenly came to a complete halt in the middle of the sidewalk to check out a pile of grass clippings. In order to not land on top of him I went flying over him - landing instead on my left hand, left boob and right knee. Blood and guts everywhere. The obvious boo-boos were pretty darn big and nasty - but the one I lived with for years was the torn ligament in my wrist. Went along for 5 years with the pain of that until this past spring when it became impossible at times to even lift a piece of paper with that hand. Finally the pain got bad enough for me to have checked out. Three surgeries later ta da!
I guess my point through all these long winded stories is that we are all different. MY tendency is to not trust or believe the guy with 10/10 pain, who is calmly going about his day - but the other part of me recognizes that a person can be in severe pain yet is able to tolerate it. SO I guess everything is not quite as cut and dried as it may appear.

I don't know what to think here. You walked around on an obviously busted ankle......why? You lived with a torn ligament in your wrist......also why? I don't know whether to call it brave or an extreme case of stubborness :) 5 years it took you to get to the doctor? :uhoh3:

I'm totally perplexed here.

You certainly are right about everything not appearing as cut and dry as it appears! :chuckle Hows the ankle?

Nesher, BSN, RN · Feb 14, 2005

It does sound rather stupid eh? I think I am a tad stubborn to say the least - and believe it or not don't like to visit docs...

It does seem to a tolerance issue as well - which was my point about pain.

Nurse heal thyself doesn't always work well, but I try it :)

UM Review RN, ASN, RN · Feb 14, 2005

I have to ask...what is the deal with pushing it fast? Is that a druggie thing, like a rush or something? Is it real or just imagined?

I threw my back out over a holiday weekend once, chiropractor was closed that weekend, had to go to the ER after 2 days of not being able to do anything but pace from the nerve root pain.

Happens to me about once or twice a year, but if I get to the chiro pronto, I can get it handled with a few adjustments and some Advil.

So this ER nurse pushes Demerol and Phenergan IV, no dilution, no pausing, and I darn near passed out on the spot. My first words were, "Gee, I feel REALLY WEIRD now" and there was a roaring sound in my ears so I'm sure I said it very loudly.

It took care of the pain for oh, about an hour. First time I slept in 2 days. The toradol worked a lot better for me. I got to the chiro on Monday and he had me fixed in less than 2 weeks.

And oh yeah, the ER doc insisted that despite my chronic back pain history--his dx was a kidney stone. :rolleyes:

Would he take my word for it? Oh no, only the CT scan proved him wrong.

FranEMTnurse, CNA, LPN, EMT-I · Feb 15, 2005

I think pain is a fascinating concept - my current example concerns myself - I would not have thought I had a high tolerance, but based on these two incidents I will share with you - clearly I do.
The first incident occured while I was on vacation in Plam Springs with my husbands family. We were out playing hide and seek with the kids on some of the jumbo rocks in the Joshua Tree National Park. I had been found and was walking down a slight hill strewn wtih tiny pebbles. I slipped and being the star skier that I am (never fall when I ski:)) I stayed upright, but saw my ankle twist in a manner quite unnatural and heard the snap of my bone. That is not a sound one should ever hear in their lifetime. IF you have heard it you know what I mean. I said,' Oh no I did something really bad to my ankle." Interestingly I felt immediate shocky type symtoms. I felt nausea followed by a need to pass out.
I hobbled to the car - it really hurt! But hey we were on vacation. Put all the ice from the cooler in a bag and on the ankle, took 800mg Advil and off we went. I guess it had a lot to do with the reaction of my husbands family - I'm afraid they believed my brother in law who is an ICU nurse and he thought being the expert that he is that I had a sprain. I knew better - I heard it after all and it hurt like pass out hurt.
Anyway I finally went to a hosptial in LA - this was the next night - I had at this point learned how to walk and live with the pain. It was also our last night in town and we were planning to go out to dinner - when I got back from the hospital. Needless to say the wait was going to be a lifetime so I left without being seen.
The next day our trip from LA to Seattle which should have been quick was made more fun by having to change planes in Oakland - so I had the thrill of walking through three airports - limping heavily. I was too stubborn to use a wheelchair. While in one of the airports I made an appointment for the next am to see a doc - yes I could have gone to the ER...but I didn't want to wait and this doc had an Xray machine.
The doc looked at my ankle the next am - it was black- the whole foot and wide as a double wide trailer. SHe too thought it was a sprain, but I insisted on a xray. Walked over there - had the ray and was waiting to make sure it was OK when the tech came out and said "I would feel better if you used this wheelchair." I asked what's up - but she commented that she isn't trained to read the xrays. I then asked to see it - teling her I was a nurse. SHe left it sitting next to me. Now I am not trained to read xrays either, but there was NO mistaking the fact that one of the bones no longer was connected.
Second story involves my wrist - I was out running with my dog and near the end of our run when he was usually done stopping to sniff and pee, he suddenly came to a complete halt in the middle of the sidewalk to check out a pile of grass clippings. In order to not land on top of him I went flying over him - landing instead on my left hand, left boob and right knee. Blood and guts everywhere. The obvious boo-boos were pretty darn big and nasty - but the one I lived with for years was the torn ligament in my wrist. Went along for 5 years with the pain of that until this past spring when it became impossible at times to even lift a piece of paper with that hand. Finally the pain got bad enough for me to have checked out. Three surgeries later ta da!
I guess my point through all these long winded stories is that we are all different. MY tendency is to not trust or believe the guy with 10/10 pain, who is calmly going about his day - but the other part of me recognizes that a person can be in severe pain yet is able to tolerate it. SO I guess everything is not quite as cut and dried as it may appear.

How very true. I will be shocked though if you don't get osteoarthritis in your wrist and ankle later on in life. That's what happened to me when I injured my neck. I was on a tube ride at a waterpark with other bus drivers. When we got to the bottom, I fell off, and landed on my head. I said nothing to nobody, because we were told not to call for a backup driver since a driver had injured himself on a ride and was hospitalized a couple years earlier, and sued the park. Now I'm paying dearly for it. My neck is so messed up I have to wear a cervical collar 24/7, and qualify for a spinal fusion, but I'm not a candidate for surgery because I also have stage 3 COPD.

mattsmom81 · Feb 15, 2005

They always come up with new ways

LOL. yes...and when they try to tell you how to give it ie 'fast' you KNOW they are looking for the euphoric rush...they are addicts.

dazzle256 · Feb 15, 2005

Earlier this week I had a patient that apparently comes into the ED frequently always with abd pain, they can never find anything wrong with him. He must have thought I was an easy target because I have never seen him before. (I only started on the unit in August) Chief complaint? Constipation x 2 days. Takes multiple narcotics, hx of abuse, ect. He is complaining that he has 10/10 pain, as he is sitting up calmly, and is asking for pain meds. I went to the doc and was like, this guy claims 10/10 pain, but look at him. So he goes and does the abd exam with no tenderness on palpation. I had 9 patients that night (some of them really sick) and his wife was harrassing me every minute for something, I was like (in front of the patient too) I have a lot of patients, many sicker than him, that I need to attend to right now, I cant get a pill/give him dilaudid/get him another blanket. The nice lady in bed 2 is about to be intubated and she needs my attention right now. Give me a minute please. He starts saying to me that he is very sick and dying and that I need to focus my attention to him mainly. Than he tells me that I need to order Klonopin for him NOW because he takes it at home and he missed his dose and if he doesnt take now it its "very dangerous". (The doc was getting the d/c papers as we were speaking). He than becomes mad when he finds out he was being d/c'd, he "demanded" to be admitted. Sorry, but a clear CT and x-ray is not going to buy you a day or two free drug stay!
Thank you all for listening to my vent!! I love this site, I can vent about this and you all have been there done that and understand!

Pain is what the patient says it is.......:)

Who ever thought that up never worked in an ER but our nurse educator keeps insisting.......Pain is what the patient says it is