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It's not that I care what the worst pain is to you...because the order for the medication doesn't change based on your answer..it's when I reassess in 1 hour and ask you the same question and hopefully the number will have gone down. That tells me the med is doing what it should and I don't have to get the drug changed or give it more frequently. Everyones pain threshold is different and who am I to judge if you are a wimp or not...

. I just care that what I am doing is making it better.

Asleep? Or passed out from the pain?

I don't doubt that there are a lot of drug seekers out there. My experience with a morphine drip was wonderful, and I could easily see how people become addicted to it.

Kirra wrote:

. I just care that what I am doing is making it better.

This. It's also noted if the patient requests pain med for 10/10 pain, and the nurse gets the meds ready...only to go into the room to give them and finds the patient sound asleep.

Maybe I'm getting cynical, lots of drug-seekers admitted to my unit lately :p

The ER docs told me I just pulled some muscles or strained in weeding and I told them those type of back aches don't keep me up at night and they get better as time goes on - this started with a numbness and tingling and then a spreading dull ache.

Turns out that the curve in my lumbar went away and it was pulling nerves in odd directions.

Author:	Micheal [ Sun Jun 12, 2011 7:47 pm ]
Post subject:	Pain
Not mine for once. Like most of you I've had the question asked to rate my pain, with 10 being the worst I could imagine. I've almost always felt they had to be kidding, do they know my imagination? Do they understand what I know, what I've read and what levels of pain are possible. what they are really saying is "Lie to us if you want your pain meds."

Author:	Shelgeyr [ Sun Jun 12, 2011 10:30 pm ]
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Yeah, I totally loved that strip. Have always had a hard time with that question. Trying to quantify something that's so subjective is just ... wrong.

Author:	Kaffis Mark V [ Sun Jun 12, 2011 10:42 pm ]
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I've always felt that they should work to standardize that scale. "Rate your pain on a scale of 1-100. This is a 10." /cuts you with a knife

Author:	Kirra [ Mon Jun 13, 2011 12:00 am ]
Post subject:	Re: Pain
It's not that I care what the worst pain is to you...because the order for the medication doesn't change based on your answer..it's when I reassess in 1 hour and ask you the same question and hopefully the number will have gone down. That tells me the med is doing what it should and I don't have to get the drug changed or give it more frequently. Everyones pain threshold is different and who am I to judge if you are a wimp or not... . I just care that what I am doing is making it better.

Author:	Jasmy [ Mon Jun 13, 2011 12:02 am ]
Post subject:	Re: Pain
Was just asked that question by my doctor a couple of days ago...how do you number your pain when it varies from minute to minute??

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Pain https://gladerebooted.net/viewtopic.php?f=2&t=6482	Page 1 of 2

Author:	Rynar [ Mon Jun 13, 2011 12:23 am ]
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Much enjoyed.

Author:	Colphax [ Mon Jun 13, 2011 1:23 am ]
Post subject:	Re: Pain
Kirra wrote: It's not that I care what the worst pain is to you...because the order for the medication doesn't change based on your answer..it's when I reassess in 1 hour and ask you the same question and hopefully the number will have gone down. That tells me the med is doing what it should and I don't have to get the drug changed or give it more frequently. Everyones pain threshold is different and who am I to judge if you are a wimp or not... . I just care that what I am doing is making it better. This. It's also noted if the patient requests pain med for 10/10 pain, and the nurse gets the meds ready...only to go into the room to give them and finds the patient sound asleep. Maybe I'm getting cynical, lots of drug-seekers admitted to my unit lately :p

Author:	Micheal [ Mon Jun 13, 2011 2:09 am ]
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Asleep? Or passed out from the pain? I don't doubt that there are a lot of drug seekers out there. My experience with a morphine drip was wonderful, and I could easily see how people become addicted to it.

Author:	Colphax [ Mon Jun 13, 2011 2:43 am ]
Post subject:	Re:
Micheal wrote: Asleep? Or passed out from the pain? I don't doubt that there are a lot of drug seekers out there. My experience with a morphine drip was wonderful, and I could easily see how people become addicted to it. Asleep. My unit has almost everyone on a cardiac monitor. Loss of consciousness like that results in codes being called and trips to the icu. Figuring out someone is drug-seeking is usually pretty easy, there are patterns they all exhibit. One of the biggest clues is that a drug seeker knows to the minute when their next dose can be given. Pain meds are very rarely given on a hard schedule, they are overwhelmingly ordered on an "as needed" basis, so if the patient doesn't ask for it, it's not given. Treating pain for an addict can be a challenge. There are situations where there's no question that pain meds need to be given- but other times you just feel like you are enabling the addiction and not treating them.

Author:	Kirra [ Mon Jun 13, 2011 4:02 am ]
Post subject:	Re: Pain
Colphax wrote: Kirra wrote: It's not that I care what the worst pain is to you...because the order for the medication doesn't change based on your answer..it's when I reassess in 1 hour and ask you the same question and hopefully the number will have gone down. That tells me the med is doing what it should and I don't have to get the drug changed or give it more frequently. Everyones pain threshold is different and who am I to judge if you are a wimp or not... . I just care that what I am doing is making it better. This. It's also noted if the patient requests pain med for 10/10 pain, and the nurse gets the meds ready...only to go into the room to give them and finds the patient sound asleep. Maybe I'm getting cynical, lots of drug-seekers admitted to my unit lately :p Interesting...we are told not to judge what someone's pain is, that it is an individual thing for each person. If the patient states 10/10 they get pain medication. The only time you withhold it is if respirations are <12. I have never charted that a patient was asleep, some people with chronic pain are able to fall asleep, if you don't give the pain medication because they are asleep..when they wake up their pain can be out of control and it is hard to get it back under control. Evidence based practice supports scheduled pain meds instead of PRN with certain patients. Drug seeking is a fact, but who am I to judge. It's the physicians job to determine the patients need for medication. I can discuss my opinion with the primary care physician, but ultimately they are the most familiar with the patients history.

Author:	Elmarnieh [ Mon Jun 13, 2011 5:13 am ]
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When I had a spinal injury the pain would vary - the best I could get it was a 2 when I was walking but when I stopped or sat or laid down it was a 4 and kept growing the longer I held the same position making it impossible to sleep. The best way I could describe it was pain was 4 spiking to 7.

Author:	Colphax [ Mon Jun 13, 2011 5:36 am ]
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Nah, Kirra, they still get the meds, even if we gotta wake em up, unless they actually refuse after being awakened. But the fact that they were awakened is still charted by some of the nurses I work with because of lawsuits alledging overmedicating. I dont agree with extremists who want to pull a doc's license because they wont perscribe meds to someone claiming pain when its contraindicated, but on the other had nobody wants to deny pain meds to someone who really needs it. It's complicated, and I don't think there's a single fix for every patient. Figuring that out is part of the art of medicine, one that not all docs get.

Author:	Elmarnieh [ Mon Jun 13, 2011 5:48 am ]
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I have a question for people. What pain medication would you give for someone who was in my scenario? The pain was bed enough I hadn't been able to sleep in four days.

Author:	Nevandal [ Mon Jun 13, 2011 6:14 am ]
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oxycontin and work my way up from there

Author:	Colphax [ Mon Jun 13, 2011 6:36 am ]
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Wow, how long ago was this, Elmo? Take my word for what it's worth (ie I'm not a physician and can't see your chart), but I think nowadays you'd likely be given iv narcs, if not a patient controlled pump full of narcs Edit: unless they were worried about central nervous system depression with narcs...

Author:	Serienya [ Mon Jun 13, 2011 10:35 am ]
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A far dumber thing I got from an oral surgeon was, "Call us if you have abnormal pain." Umm... Since this was the first time I'd had wisdom teeth removed, how the hell would I know what normal vs abnormal is? (I found out later that dry sockets produce abnormal pain. But I didn't know that until I'd waited for the appt to get the stitches taken out. Don't know why he ***** me out for not coming in sooner, when he ended up treating one side without anesthesia. OMG pain!)

Author:	Arathain Kelvar [ Mon Jun 13, 2011 11:21 am ]
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I've always answered this question relative to the issue at hand. For example, if I injured my arm, a "10" would not have me screaming and/or passing out, but would be equivalent to a multiple fracture scenario. Whereas if my stomach hurt, I don't think I should physically ever be able to answer "10". If it's a 10, you'll know it.

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Author:	Elmarnieh [ Mon Jun 13, 2011 6:32 am ]
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Ok so Tylenol wouldn't have been your first choice? (thats what I got and I couldn't even feel it do anything)

Author:	Elmarnieh [ Mon Jun 13, 2011 6:47 am ]
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Two years ago.

Author:	Elmarnieh [ Mon Jun 13, 2011 6:48 am ]
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The ER docs told me I just pulled some muscles or strained in weeding and I told them those type of back aches don't keep me up at night and they get better as time goes on - this started with a numbness and tingling and then a spreading dull ache. Turns out that the curve in my lumbar went away and it was pulling nerves in odd directions.

Author:	Müs [ Mon Jun 13, 2011 8:03 am ]
Post subject:	Re:
Elmarnieh wrote: The ER docs told me I just pulled some muscles or strained in weeding and I told them those type of back aches don't keep me up at night and they get better as time goes on - this started with a numbness and tingling and then a spreading dull ache. Turns out that the curve in my lumbar went away and it was pulling nerves in odd directions. If I were a doc, prolly something like Soma/flexeril, a prednisone therapy thingy, and lortab 5's to start. But then I've suffered from chronic/acute back spasms from time to time, and that's usually what I'm given.

Author:	Colphax [ Mon Jun 13, 2011 8:09 am ]
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Hmm, I thought you'd wound up admitted to the hospital. Did they tell you to go see your regular doc when they discharged you?

Author:	Elmarnieh [ Mon Jun 13, 2011 9:32 am ]
Post subject:	Re: Pain
Nope they told me to go home and the pain would go away. They did xrays and didn't see anything. When I went in later for mri after seeing the neurologist they found out I had no curve in my lumbar region. No new pain medication though. After 1 trip to the chiropractor I could sleep with the tylenol and after the second I could sleep with no meds. The only other way was to drink and take tylenol and that would let me get about 2 hours. (I had to do this after I started having hallucinations from being awake too long).

Author:	TheRiov [ Mon Jun 13, 2011 11:08 am ]
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what about other forms of pain managment?

Author:	Numbuk [ Mon Jun 13, 2011 12:19 pm ]
Post subject:	Re: Pain
Yeah, I agree that rating pain without some sort of control is stupid. When they test for "heat levels" of salsa, they have a committee rating the batch of peppers and they always have a control (which they also rate). That is a form of pain rating. I've personally always had a problem with this just because my pain threshold is quite high. Ever since I had a metal rod twisted (not pulled) out of my leg, through the bone, without any sort of pain nullifying agent.... common forms of pain rarely get more than a reaction of "Ow. That was unpleasant." from me.