Monday, May 21, 2012

Can you rate your pain from 0 - 10 please?

What is pain? In nursing school we are taught that pain is subjective. Pain is what the patient says it is. There is no "pain-o-meter" so we cannot objectively measure pain. So why do so many health care workers claim to know if a person is really in pain or not?

If you're not familiar with pain scales here is one to give you an example of what I'm talking about. I find the faces helpful because the numbers are completely arbitrary to me.

Recently, unfortunately, I have been dealing with my own episode of unrelelnting pain. Actually I think it's improving, but it's sporadic and unpredictable. Some days are really good, my pain hangs out around a 1 or 2. but it can easily and without warning spike to a 5 or 6. The main medication I'm taking (gabapentin) does nothing for immediate pain relief. When I called the doctors office about getting a prescription for something short acting for this kind of pain I was reluctantly given a prescription for a low-dose hydrocodone and told to "Use it sparingly. This is not a long term fix." I was also "cautioned" about narcotic dependancy, and over use.

Uhhh... hello? My pain is a freakin' 8!

At that point I'd been off work 4 weeks and was consistently rating my pain a 4-6 and NOTHING had been prescribed. At about this time (2 or 3 days before) they gave me a prescription for gabpentin which has to build up in your system and be titrated for a while to be effective. In other words it provided no relief. I toughed it out with ibuprophen and acetaminophen until I just couldn't take it. When my pain was in the 7-8 range for about 48 hours I called, crying. I felt like a drug seeking junkie after talking to the nurse.

It is now about 7 weeks in. My pain is really improving, however as I said, there are times when it just gets bad for no discernible reason. I have 4 1/2 our of 30 hydrocodon left. I'm thinking about calling for a refill just in case I need it. I'm really uncomfortable about it though.

As a nursing student I understand the problem of addiction. I understand there are people who are, what we call, "drug-seekers". I understand that doctors just can't prescribe any ol' thing we want when ever we want it, but the additude of some health care professionals really stinks around this subject.

What I'm going to try to take away from this is that pain really is what people say it is. Nerve pain is insidious and unpredictable. While I can't prescribe medication I can advocate for patients for more effective medications, for alternative therapies, and for attention from the doctors I work with to patients with unrelieved pain. I can be sympathetic and compassionate. I can refrain from snide comments to co-workers, I can check my additude, I can use some discernment and common sense, and hopefully I will be a blessing and a help to someone who is really hurting.

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