The Glade 4.0

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."

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The U. S. Constitution doesn't guarantee happiness, only the pursuit of it. You have to catch up with it yourself. B. Franklin

"A mind needs books like a sword needs a whetstone." -- Tyrion Lannister, A Game of Thrones

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.

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Go back to zero, take a pill, and get well ~ Lemmy Kilmister

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

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"Aaaah! Emotions are weird!" - Amdee
"... Mirrorshades prevent the forces of normalcy from realizing that one is crazed and possibly dangerous. They are the symbol of the sun-staring visionary, the biker, the rocker, the policeman, and similar outlaws." - Bruce Sterling, preface to Mirrorshades

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.

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Dream as if you'll live forever...
...Live as if you'll die tomorrow

Vivere Senza Rimpianti

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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"Said I never had much use for one, never said I didn't know how to use one!"~ Matthew Quigley

"nothing like a little meow in bed at night" ~ Bruskey

"I gotta float my stick same as you" Hondo Lane

"Fill your hand you son of a *****!"

Much enjoyed.

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Ezekiel 23:19-20 

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

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Women are from Hoboken, men are from Trenton. ~ Jimmy Kimmel

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.

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The U. S. Constitution doesn't guarantee happiness, only the pursuit of it. You have to catch up with it yourself. B. Franklin

"A mind needs books like a sword needs a whetstone." -- Tyrion Lannister, A Game of Thrones

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.

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Women are from Hoboken, men are from Trenton. ~ Jimmy Kimmel

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.

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Dream as if you'll live forever...
...Live as if you'll die tomorrow

Vivere Senza Rimpianti

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.

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"...but there exists also in the human heart a depraved taste for equality, which impels the weak to attempt to lower the powerful to their own level and reduces men to prefer equality in slavery to inequality with freedom." - De Tocqueville

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.

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Women are from Hoboken, men are from Trenton. ~ Jimmy Kimmel

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.

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"...but there exists also in the human heart a depraved taste for equality, which impels the weak to attempt to lower the powerful to their own level and reduces men to prefer equality in slavery to inequality with freedom." - De Tocqueville

oxycontin and work my way up from there

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Ron Paul 2012

Ok so Tylenol wouldn't have been your first choice? (thats what I got and I couldn't even feel it do anything)

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"...but there exists also in the human heart a depraved taste for equality, which impels the weak to attempt to lower the powerful to their own level and reduces men to prefer equality in slavery to inequality with freedom." - De Tocqueville

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...

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Women are from Hoboken, men are from Trenton. ~ Jimmy Kimmel

Two years ago.

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"...but there exists also in the human heart a depraved taste for equality, which impels the weak to attempt to lower the powerful to their own level and reduces men to prefer equality in slavery to inequality with freedom." - De Tocqueville

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.

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"...but there exists also in the human heart a depraved taste for equality, which impels the weak to attempt to lower the powerful to their own level and reduces men to prefer equality in slavery to inequality with freedom." - De Tocqueville

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.

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Holy shitsnacks!

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?

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Women are from Hoboken, men are from Trenton. ~ Jimmy Kimmel

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).

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"...but there exists also in the human heart a depraved taste for equality, which impels the weak to attempt to lower the powerful to their own level and reduces men to prefer equality in slavery to inequality with freedom." - De Tocqueville

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!)

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When he's underwater does he get wet? Or does the water get him instead?

what about other forms of pain managment?

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.

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.

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Les Zombis et les Loups-Garous!