Question on rating your pain

One thing I do seriously want to comment on is the pain scale, I worked on the Oncology Unit and we often had Sickle Cell Anemia patients on our unit,they are probably one of the most difficult patients to assess for pain, as their pain changes minute by minute. Anyway we always used the 1 to 10 pain scale and also the faces, I hated the pain scale charts!  Patients often under rated their pain, and to me it just added to the confusion as to how the patient was really feeling! I personally liked to just sit and talk with them about their pain as I was doing my patient evaluation (assessment), I would watch them closely as they would move, was there guarding? ( being protective of and area)what about their facial expressions?, (grimacing or wincing even crying or laughing)asking them to describe their pain to me.( in deatail) I know that method takes time but in the end it is worth it, and after finding out what the patient is really feeling then talking  with the patient about the pain scale and together putting down a number that was accurate and was at least close to what their pain level is for that time. I myself  have a real hard time describing my pain level to my Doctor using the scale, I also often under rate my pain. I do wish Doctors and Nurses had more time to spend with their patients, so they could get a mor accurate picture of the patient they are treating. Treating us more like who we really are, a real person that is in pain, not just some patient in a file with number for their pain!

White Beard

PaLady, yes her pain chart does question you about your ADL's as this issue is very important to my dr, she says it tells her alot about a patient. This chart was typed on an old typewriter and is covered in plastic of some sort to protect it and there is one in each room. I told her the 1st time I saw her and was given the chart to review to rate my pain that I was totally blown away with her pain scale. She laughed and said yes, its much better than the frowns and the smiley faces. It is so precise in each number. I told her for the 1st time I felt like someone really knew the extent of how much pain I was in and how pain had affected my life by looking at her chart. Just amazing. To answer your question, yes she does understand pain from every angle as far as I am concerned.

Last week was pump refill appt time and I got another increase in my pump which has helped. Our weather lately has been with so much rain and the barometer is jumping up & down like a mexican jumping bean which really affects our pain. Plus, I had done some other things that increased the pain and she said this is to be expected. She says as a person gets to feeling better they will do more and the pain will return and then we just do increases till we hit the magic number that holds the pain down for longer periods of time. Even with all the increases she has given me I am considered to be at a low dose.

After her nurse finished with my pump she came back and we were talking about how pain can destroy a person's life when not treated properly by the drs. She said "oh, I remember very well the shape you were in the first time you came to me". She said I look at you now and can tell such a change in your pain as it shows. I said well, not only can you and I tell but anyone thats been around me alot and knows me can tell a huge difference in how I feel. I told her how much my activity levels have increased and therefore because of that I get into trouble from overdoing and she said thats just human nature. She said that in time we will reach my magic number that will hold the pain down for longer lengths of time, but for now I am still considered on a very low dose and she knows this is important for me to know. She then asked me a question that really took me by surprise. She said well now that you are doing so much better what you think and feel about your prior PM dr. Of course she has an entire copy of his chart from his office on me. I said well, I truly thought I was a pump success because in the bginning the pain was less, however, over the past 2 yrs the pain was getting much worse and I was getting very few increases in my pump, which in turn left me with alot of pain. Some days I could deal with it half way and other days I couldn't. But, now thanks to you and your knowledge of pumps and medications yu have shown me how much I really did suffer. I said it would be very easy for me to become bitter about the 2 yrs of life I lost thanks to him not being a good dr when all along I thought he was. For this I do become mad, but I will not allow myself to dwell there very long because its not worth it to me. I have more important things to do with my life than go down that road. I told her one thing I had learned and I did learn it the hard way, was these anesthesiologists turned PM drs are not what its cracked up to be. There are far too many under-educated drs out there practicing pain mgt that don't have a clue. They can take a patient so far with treatment and then its like they run into a brick wall and cannot and will not go any further in helping the patient. Its my belief they are just not educated enough and I don't know what the fix is for that. My dr looked at me and smiled real big and simply said "I will not disagree with you one bit on that statement". She told me my very own dr many times called and consulted with her on his patients because he had hit that brick wall of not knowing what to do with a patient. She & I both knew ethically it would have been very unprofessional on her part to look at me and say I agree with you about these drs, but instead she handled it very well by agreeing with me the way she did. I had to laugh because she then said you understand that I did not disagree with you on your statement. When the nurse and her are finished with me she always stay in the room with me and we talk about various things, anywhere from the DEA on. She and I both know many of the same drs from when I worked. I told her about reading in the paper recently that they finally took away the license of an old dr here that was nothing but a pill pusher. All of his patients were cash paying and he doled out the script for any kind of a med they wanted, but you had to pay cash. She says the DEA is notorius for calling a drs office and acting like they are a patient. She said they will call and ask how much she charges for an office visit. Her staff always tells anyone calling that she does not accept cash payments from a patient.She then went on to tell me the biggest thing the DEA busts drs on is their recod keeping of prescriptions they write to their patients. I was floored by this. I hope everyone had a nice dry weekend. Mine has been wet & soggy....Susie