Ugh.
I hate that damn pain scale. I understand its merits. It helps patients think more objectively and rationally about their pain. It also helps health professionals determine the effectiveness of treatments. But, it kinda sucks. Whenever I'm asked this question, I go into a long complicated self-talk session before giving away my response, "Like 10 minutes ago, when I had a shock, it was a 9, but then the shock settled and it's a 5...so I do I take the average? I don't want to overestimate my pain, but I need my doctor to know that this legit pain. What do I pick? aggggghhhh!"
If I am in quite a bit of pain, I usually go with a 7. It's a solid number. It gives me room to grow - you know, if the pain gets worse - In retrospect, 7's a good call. I have vivid memories of laying in room 406 of the hospital yelling, "It's a 10. The pain is now a 10 people. For real!"
Sometimes, I hear outpatients in our therapies department, patients who've dressed themselves, driven themselves to therapy, and participated in idle chitchat in the waiting room respond with outrageous pain claims.
"Oh the pain is terrible. I'd say at least a 15."
Ok. Wait just a minute. 15 is not an option. And if your pain was worse than the worst pain you could ever felt, than how the hell did you just scarf down that Tim's breakfast sandwich? Ya, I saw you. I call bullshit. Funny enough, that statement is usually followed by, "And I have a really high tolerance for pain." REALLY? And who decided that one?
But maybe that person actually believed his pain was 5 points worse than the worst pain he's ever felt? Who am I to say? Pain is personal. Pain is subjective.
This past week, I've been struggling with pain. "The shocks" came back with a vengeance. They caused me to drop my clipboard, grab my knee and yell, "SHIT!" on an hourly basis. Super inconvenient. I finally gave up on attempting to be a productive member of society and went home and laid in bed for a week. It sucked. When I began feeling a bit better later on in the week, I decided to sort out why the hell this is happening. After numerous knee inspections by both my fabulous ortho and my stellar family doc (both of whom I trust completely), it would appear that although my knee is swollen and slightly "angry," all the tests that indicate my cartilage is damaged, a tear exists, or anything really sinister came back negative. Which is a relief; yet, makes me question why I am feeling such intense pain, and how the hell do I ease this debilitating pain (other than drugging myself into that drooling, mindless state).
Then I saw a video. It was a really awesome explanation of pain and the brain's role in pain. You see, the brain is smart. Duh, it's a brain. When something is aggravated in your body, your peripheral nerves send a message to your brain, "Hey, brain, we've got a situation here. The knee is angry. Please advise." The brain's job is to collect all the information - it evaluates every piece of credible information including past experiences - to determine if you are in danger. In my situation, my brain would see that in the past, an angry knee indicated danger, typically resulting in ripped cartilage and surgery to repair. My brain immediately sends a message back to my peripheral nerves, "This is bad! I repeat, bad. THREAT!" (After all, it's in my brain's best interest to keep me safe and alive). My nerves respond by sending the message back to my knee, resulting in a sharp, attention-getting pain. My brain wants me to notice so it's amping up my signal!
So simple, yet so complicated. My brain is conditioned, given my past experience, to signal severe pain when my knee may just be slightly angry.
I'm not saying that the pain is "in my head." That's not the message here. Oh, I can tell you that the pain is real. It causes my teeth to clench and my eyes to tear. What I am saying is that although my brain is merely trying to protect me, it's a bit misled...and I have the power to help change that. And anything that puts the control back in my corner is music to my ears. But..it's easier said than done. I can't just tell my brain to stop, although awareness is definitely a good first step. My anxiety has definitely decreased simply by knowing that my knee cartilage is fine and that I do NOT require more surgery.
The literature recommends that you create a "safe" environment for your nervous system. Initially, it sounded like a bunch of hokey bullshit to me, but hey, I have nothing to lose. I determined that for whatever reason, heat eases my knee pain. So I've taken approximately 12 hot baths this week (sorry environment!) and constantly keep a heat pack on my knee. Basically, I'm telling my brain, "Heat helps. We're heating. We're safe."
Haha, you think I'm crazy, don't you? Ya, so the big question is: Has it helped? Is this helping? Um....not, yet. But I'm gonna keep going with this. I'll let you know. I mean, the brain's not a dog. It can't be trained in 3 days, people!
Now when I receive "the shocks," not only do I drop my clipboard, grab my knee and yell, "SHIT!" but I also follow it up with, "Brain, we're safe. This is not a threat. I repeat, this is NOT a threat." Oh man, I'm gonna get locked up for sure.
Anyways, it's an interesting theory and worth a good 'ol college try (what does that mean? Did you try harder in college? I didn't.)
I highly recommend that you check out this video. Not only is it extremely informative if you are experiencing pain or living with someone in pain...but it's pretty entertaining as well (and I love a good Aussie accent!)
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