On a scale of 1-10

I also have problems with pain scales. I don't know that I have ever truly had a pain level of a ten. I do know and remember several times that I would definitely consider to be a nine or a nine plus.

I have had three kids and although I did eventually get epidurals for each of them, I did endure quite a bit of pain before I would consent to an epidural. The epidurals themselves were pretty acute pain. For my daughter, my first child, I was in labor for 18 hours before they had to do an emergency C-Section and I had no choice but to get the epidural. For my second child, I got the epidural fairly early in the labor. For my last child, I consented to the epidural only 20 minutes before he was born.

I have had severe toothaches that I believe were higher on the pain scale than childbirth. I know that everyone reacts to pain differently, but toothache pain is just something that I have a real problem dealing with.

I remember one instance when I was in the hospital during my bone marrow transplant. My central line got infected and in my sleep I had tried to pull it out myself because the pain was so great. After I woke up, I had a fever of 105 and my nurse insisted that my line was infected and refused to do the cultures on me because all of my veins were collapsing and if they tried I would just be a pin cushion. Finally the nurse got the doctor to agree and they sent me to surgery to remove the line and put in a new one. Since I was in there for the BMT, my cells were at their lowest and nearly non existent. When the surgeon removed my line, he was not gentle and bruised me terribly while putting pressure on my chest to stop the bleeding. When I finally got back to my room, I was crying openly and I remember the nurse asking me my pain level and I remember shouting to her a 25. After that, it was only seconds before I got injected with pain meds. I don't remember much from my BMT hospital time, but that is one memory that just will not ever go away.

I have also broken bones. This is from what my husband has told me as I do not remember it. I passed out in my bathroom in the middle of the night and fell into our porcelain bathtub, I guess when I tried to get up I must have fallen again as the bruising patterns show that I fell more than once. I got up and went back to bed, not waking my husband to tell him what happened. The next morning I was bruised horribly and in a lot of pain, so he took me to the ER. They x-rayed my arm and shoulders, both sides and found out that I had broken the top of the humerous bone in my left arm - right up by the shoulder. I had no injuries on my hands or wrists, so I never tried to break my fall, this is why they say I must have passed out cold. I have vasovagal syncope, so this has happened before. Anyway, at the hospital they gave me pain meds and a shot of toradol and called my PM doc. He immediately authorized an RX for extra meds and sent it out in the mail that day, I got it the very next day. We discovered that I must have been allergic to the toradol, because later that day, I went shopping at Dollar General by myself and I ended up being brought home by the police because I was totally disoriented and obviously on something. This is what the police told my husband. Anyway, because of the toradol, I believe that I totally lost my memory of that day. So I have no idea what my pain level was.

The other time that I broke bones was another near passout episode. I was in my kitchen and I realized what was happening and I was trying to get to a chair. I didn't make it and I ended up falling into the refrigerator and it moved a few inches and slammed into the stove and moved that a few inches and my left foot got caught under a chair and I thought it was just bruised. It turned all purple and swelled up to over 2 times the size of my other one. I was already on pain meds from the chronic pain, the pain in my foot was definitely there, but I had no idea that I had broken bones. I had an appt with my PM doctor two weeks later and she sent me for x-rays on my foot and it showed 2 broken bones, I had been walking on the broken foot for 2 weeks!

Boy, this has really turned into a book! Sorry about the length of my post guys!

One other episode that I feel was definitely a nine was being on 100mcg fentanyl patches and running out due to patches falling off. I was going through the intense pain of my normal chronic pain plus the withdrawal of the fentanyl patches. I remember crying and moaning in pain. I had to go to the ER that night and my doc gave me another RX for patches the next day. I think that the worst WD that I have ever gone through is from the Fentanyl patches. I took myself off of those patches because I realized that everytime I went out into the heat that they were dumping too much medication into my system and I think I came close to OD'ing a few times. My doc wasn't all that happy with me when I took myself off the fentanyl patches, but after I explained he understood and agreed with me. I never again want to be on those things!

Trudy

Merrida,

It does state a few cautions in the patient information sheet that comes with the patches. It does caution about no hot tubs and hot baths and hot showers. From that caution, I guess we should realize about being out and about in the heat.

I have a heat sensitivity. When I get overheated, I do not sweat like a normal person. Some of my sweat glands were damaged by the chemo and my body temperature just increases. So I probably should have realized what was happening sooner than I did.

Trudy

I'm concerned with the descriptions at the high spectrum end.

Those are quite significant.

I wonder what their idea of a 1-6 might be.

They say to me that 0 = no pain.  Well at that rate, 10 being unconscious (and thereby not able to reply), what do they consider satisfactory replies if you "look fine" to them but are using all your coping skills to suppress the pain,...or it's dental pain, (which has its own unique scale, I find),...or the pain is chronic vs. acute. 

Those situations vary greatly.  Makes me wonder if 2 would be a splinter or something?

Merrida

I thought the purpose was to allow a patient to provide a subjective number on their experience.

It would be beneficial to allow for the patient's own experiences to play a part.  When they ask me directly, and use words like "the worst pain you've experienced," then I take their cue and base it on "the worst pain I've experienced."

I have never used the number 10, though twice wish I had, because I assume things could always be worse than I perceive them to be.

But is that fair, to patient or provider?

Merrida

I simply despise those stupid little smiley face things, they are the most worthless sheet of paper I have ever seen, lol. My PM dr made her own pain scale sheet, this sheet has our normal daily activities listed and this sheet really accurately gives the correct number. Since she is retiring in December I am going to ask if I can have a copy to take to the new dr since so many of us going to him are use to this sheet over that stupid smiley face thing.

Susie

Susie, that's what I was thinking. Not to mention, those smiley face posters sure don't correspond and match with the wemsi scale descriptions....


Merrida

I think the only Smiley face would be at 0. If you wanted it to be accurate. Its really a necessary tool on peds and I cant help but feel a little insulted everytime one of them sticks the thing in my face and asks me to indicate my stupidity!!

There's far better scales and I've seen the ones with ADL's on them and even that's better.