Wednesday, June 13, 2012

On a scale from 1 to 10

As a nurse, I have popped the question an obscene amount throughout my career. "What's your pain level - on a scale from one to ten?" This I chirp, while pointing to a familiar laminated series of smiley faces that progressively become more and more embittered.  A "10" relays about as much emotion as an M&M chopping onions. 

Here is the problem with pain scales - It's all subjective.  There are dramatic patients who rate their pain as "an 11 at least" while chatting it up on their cell phone and ordering takeout.  There are also stoic patients who may rate their pain as a "1 or 2" while clenching their jaw,  breathing shallow and refusing to get out of bed.  Numbers and crying M&M's just don't do an adequate job of describing pain.

Thanks to personal interests that weigh heavily in the "nerd" department I have not had a great deal of experience on the "other side of the table".  No broken bones, no stitches - I had a thyroidectomy a few years ago (notably after this experience I nearly recorded "flirty" as a side effect to Versed this time around) which was not terribly painful.  But I've given birth naturally twice and consider my pain tolerance to be decent.  So, while I knew going in to this mastectomy the procedure would be painful - I was not prepared for what I experienced post operatively.

I awoke to a pain so thick and heavy I found myself paralyzed beneath it - drowning in a bath of scalding butter.  I couldn't breathe, I couldn't see and there was no escape.  It lasted for what felt like eternity but was probably only seconds after I awoke from anesthesia.  Finally, somehow, I found the magic words. Ten - it's a ten.  And relief came in the form of the greatest invention of all time - Fentanyl.  Eventually, I began to get a stronger grasp on pain control and was transitioned to a PCA (patient-controlled-analgesic, It's the machine that gives a steady dose of narcotic and allows the patient to give an additional dose when they need it).  But even with this - and being fairly opiate naive (The most I usually take for pain is ibuprofen for an occasional headache) the pain has been significant.  And by the time I left the hospital three days later with prescriptions for percocet and muscle relaxers clutched in my hand, I had been asked my pain level enough times to realize the absurdity of assigning a numerical value to the experience.

This is why I feel the pain scale should be replaced with something more relevant - movie clips. 

 For example, on my proposed scale a pain level of 1 could be correlated with a clip from a Chuck Norris movie because as we all know, Chuck Norris feels no pain.  

Chuck Norris' tears cure cancer - Too bad he's never cried.
A 10 on my scale would clearly be the scene from "The Princess Bride" where Wesley is tortured with the life-sucking machine by the 6-fingered man in the Pit of Despair. 

This is how I picture PACU before they gave me fentanyl.

Today, it's been a week since I left the hospital and I'm not going to kid you - I've had better weeks. I'm still taking pain medication around the clock and am unable to lift or even move my arms much yet which gives me the appearance of a tiny feeble Tyrannosaurus Rex.  I'm getting stronger every day though and my pain level at this point overall I would rate a 4 or 5.  Which would correlate with this scene from one my favorite Monty Python movies:

I'm not dead yet people!  I think I'll go for a walk.