Saturday, July 16, 2011

Subjective Scale

I am getting ready to take the two hour drive to my parents house and then another six and a half hour drive with them for the second time in three weeks. When we drove out to Pittsburgh the last time, for various reasons, they ended up not doing the surgery on my father. Baring any issues with the last minute testing, he should have his back surgery this week.

During our last drive, my father would talk about his pain levels being thirteen's and fourteen's. [OK, get your eye rolls out of the way now.] Being virtually trained by the best and knowing how doctors react to such levels on a pain scale of ten, we had a nice chat about the pain scale.

Don't get me wrong, I know he was in a lot of pain. For him to let me drive speaks volumes especially given that my dad did one hundred percent of the driving on my parents fifteen thousand mile driving vacation last summer. I also saw his MRI when we were in the surgeon's office the last time. He is in a lot of pain, but he/we still shouldn't go past a ten on the pain scale of ten.

To be honest with you, I have always had trouble trying to fit my pain into the scale. I kind of find it ironic that I would have given my father advice on this subjective scale as I have always found it amazing when someone can look at the chart and say what was their pain level. I remember my younger son immediately picking his pain level from the chart while looking at it after an operation. I even asked him how he picked that level and he replied that it just looked like he was feeling. I don't know, I didn't get it.

Do you have as much trouble trying to figure out your pain level by the little smiley faces like I do? I mean come on, are you still smiling at a level four? Do your tears only start at a level ten? I still don't know how my son picked out his pain level. Here is a diagram of the typical smiley faces that are associated with the pain levels:

One problem I see is that pain levels can vary from one person to the next. One person's mild pain can be a terrible pain to someone else. I think the most important thing for me is that I am consistent in recording my own pain levels and not worry about how other people rate their pain. My doctor and I have my history of pain levels which can show where I have been and where I am now which can be used as my comparison.

I remember going to an ENT for an earache one time. He didn't see anything in my ear so to appease me, he was going to do an ear pressure test. He told me he didn't expect to find anything and even wanted to bet me that he wouldn't find anything. The condescending way he was talking to me didn't go well, but I knew how much my ear hurt no matter how relaxed I may have appeared.

The ENT ended up repeating that test a few times because he couldn't believe how high the pressure was in my ear. I still question whether I should have become a little actress and exaggerated my pain to coincide with the level he thought I should have been at. I still always answer this question with I will be me and I will be misunderstood as I will give it my level of assessment. Like many of you, I have many other high pain level non Migraine stories including getting stung by about 50 bees, all around the ankles, all at once, and still being able to help someone else who was also stung, make it back down the path out or playing three quarters of an intramural college soccer game as a goalie with a thumb that was unknowingly broken in warm ups and I could go on.

Do you use a benchmark for any particular level on the pain scale?

I tend to use a level eight to be the point that I want to poke a hole in my head to let the pressure/pain out. Realistically, I know the hole won't work or help anything, but I know when I feel like putting the hole there and will purposely stay away from any sharp objects. I will then scale back for the lower levels. I can remember squeezing my head because it hurt so much which was way before I even knew I had Migraine disease and thought it was just another headache. I think that is one reason I use this as my eight benchmark.

We should never abuse the pain scale or say we have an eleven or fourteen level out of the ten pain scale. This will be met with a lot of eye rolling and not believing anything we say from that point forward.


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