“Please Rate Your Pain On A Scale Of 1 To 10”
Aside from actually dealing with pain on a daily basis, there are lots of things I don’t like about living with chronic pain. I don’t like the feeling I get in my stomach when people ask me how I’ve been and I just say “fine” because it’s easier than trying to explain the truth. I don’t like the way so many well-meaning friends and family always seem to be waiting for me to “get better.” And I really don’t like looking back at pictures from events and trips that were supposed to be fun and remembering how crummy I felt that day.
But I think what I hate most about life with chronic pain is when someone says this: “please rate your pain on a scale of 1 to 10.”
I hate pain scales. In my experience they are completely arbitrary and serve no practical purpose. Because here’s the thing: I deal with large amounts of painon a regular basis. That means that I have developed a high threshold for pain. My ordinary, everyday 5 might be someone else’s 9. And even if I do feel like I have gotten to my version of an 8 or a 9 that doesn’t mean I’ll be rolling on the floor crying. Since I am stuck with this pain for the rest of my life I have adapted my attitude. I don’t let pain get to me as much as someone who isn't used to dealing with it might. I’ve developed the ability to joke around and stay in a good mood despite being in large amounts of pain. It’s my coping mechanism so that I don’t end up depressed. So I can very legitimately be smiling and laughing and be in large amounts of pain.
Unfortunately, the doctor or nurse who asks me to rate my pain on a scale of 1 to 10 is usually someone who doesn’t know me very well. They generally have no context for my ordinary level of pain or my ability to cope. And, in my experience, these doctors and nurses tend to judge me not by the number I choose to answer their question, but instead by my overall demeanor when I answer.
For example, I was recently in the hospital after having a C-section. Shortly after the surgery, I developed a truly skull-splitting headache (a reaction to the anesthesia they used for surgery and a spike in my blood pressure). I told the day nurse as soon as I noticed this new symptom. She kept asking me to rate my pain on a scale of 1 to 10 and, as the day went on and the headache grew worse and worse, I kept giving higher and higher numbers – eventually getting all the way up to a 10.
However, for the sake of my newborn son and my own mental welfare, I tried not to break down over this extremely intense pain. I drew upon my years of experience dealing with pain and kept myself in as good of a mood as possible. I made an effort to joke with my husband and coo at my new baby. This was how I chose to keep going and cope with my pain. But, because I wasn’t breaking down and crying, the nurse didn’t seem to believe me about how much pain I was in, even though I honestly answered her question with a high number. So she did nothing to address my headache all day.
As the headache grew worse and worse I did eventually break down crying. I had just had major abdominal surgery after an extremely difficult pregnancy and, after trying to keep it together all day, I was frustrated and scared. The pain was so bad that I couldn't even sit up in my hospital bed to nurse my newborn. But then a new nurse came on shift and everything changed – an IV was placed and I was given morphine, my other pain medications were increased, and they called for the anesthesiologist to come evaluate me. But did these changes happen because the new nurse actually believed me when I said I was at a 10? Or did she only believe me because I was crying instead of bravely trying to smile?
In the end I had to spend a couple extra days in the hospital recovering from the headache, and I can’t help but wonder if all or most of that pain could have been avoided if the original nurse had only believed me and acted sooner. Has something like this ever happened to you? How do you feel about the pain scale?
You know you have RA when [select all that apply in your experience]: