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.

13 comments:

  1. Love it! Heather your writing is so good! I just read this out loud to the other women in my office and they loved it! XOXO Brianna

    ReplyDelete
  2. Keep writing! You're amazing. Thanks for the inspiration and the laughs.

    ReplyDelete
  3. Thanks for sharing Heather! I think you may have just created a new painscale app--to be used by nurses everywhere!

    ReplyDelete
  4. Just as funny and insightful as always! Any girl that can refer to a Monty Python scene is "marriage material" in MY book! Chris is a lucky man!

    As for relevant pain thresholds, I think childbirth may throw the accuracy off a bit. Years ago the New England Medical Journal published a study that showed some kind of endorphin is produced in the brain during childbirth that helps women forget the severity of the pain. The study went on to compare the same effects on the brain from marijuana use. I used this for my argument to test cyclists for THC (before it was on the banned substance list) Anyway, the study suggested childbirth may have been more painful than you remember! :)

    ReplyDelete
  5. You are so very well spoken...even on drugs! I can relate so much on the RN side. All the pre-rehearsed quotes we tell our patients about what to expect after such a surgery. That this pain is normal, you just need to push your button or take some long deep breaths. What a load of crap huh?!?! I though I was tough before I had my kids, turns out pitocin kicked my ass and I begged for an epidural. You are strong, heroic, hilarious and wonderfully human all rolled up in that tiny little body of yours! Cheers, hope the days keep getting better, and even T rex gets to roar every now and then so make sure to let it out!

    ReplyDelete
  6. susan robert 6/13/12
    we all get so wrapped up in our own little problems we just don't take the time to pass along that we are praying and thinking of you dly. Wh I go to get my chemoTX I just think that all the love amd pryers and good thoughts are covering that ugly blackness that is cruizing thru my body. My loove and prayers aare with you
    Susan

    ReplyDelete
  7. You are very inspirational! Im blessed that I know you, I can just hear your voice when reading your blog. You crack me up! Love and laughter will help the pain for sure, and I know you and your tripod of a family can help you with that :-) love and miss you homie gnomie

    ReplyDelete
  8. You are very inspirational! Im blessed that I know you, I can just hear your voice when reading your blog. You crack me up! Love and laughter will help the pain for sure, and I know you and your tripod of a family can help you with that :-) love and miss you homie gnomie

    ReplyDelete
  9. My friend Becky gave me this link.. I loved it. I will pray for you and your family. If you dont mind I would love to share it with a really good friend who just started chemo. Shes also a young mother. Good luck and god Bless.

    ReplyDelete
    Replies
    1. Heidi thanks for the accolades and please pass the blog on to whomever you would like! Writing is great therapy for me and its my hope that these experiences may help others someday too.

      Delete
  10. Love it! Seriously love it!

    ReplyDelete
  11. I feel like I shouldn't say how hilarious that was because it was entirely about your blinding agony. But it was hilarious. And touching and generally all-around awesome. Today, my friend, you win at the Internets.

    ReplyDelete
  12. So glad to have saw a link to your blog a friend's posted on FB. I'm a survivor (do I get to claim that title yet?) and just had a Phyllodes tumor (super rare breast cancer) removed from my left breast 13 months ago. I promise you the pain lessens over time... far too slowly, but it does. I say this because I know there will be a time (maybe 4 weeks, or 6 months, or a year from now) when you are desperately wondering "will the pain ever stop?!?!?!?" Hang in there!

    ReplyDelete