Even the word "pain" hurts to those of us who endure levels of pain
each day. Pain management is what the doctors tell us to do. This
sounds great in theory, but what does it mean, and how does one go
about doing it? These are excellent questions. It probably sounds
"logical", but the better you are at describing your pain to others,
the better you can get help in managing pain. And, pain management is
the key!
The best way to document and comunicate pain is to use
what I call a "pain" scale. I set this up in what I call a "matrix",
where I have a chart with four columns as follows: The left column is
for pain "level", from "0" being "NO PAIN" (right, like that's gonna
happen!) and "10" being so painful that NOTHING YOU DO seems to
decrease the pain level.
In the next column, you describe the
pain at different levels. I use the following: 0 = No pain; 02 = low
levels of pain, an Over the Counter (OTC) remedy can get rid of it; 04
= moderate pain, need double the strength of the OTC remedy to dull the
pain; 06 = heavy moderate pain, need double the strength of OTC remedy,
but the pain isn't dulled, and activities are curtailed (decreased); 08
= heavy pain, need something stronger than an OTC remedy, and one must
sit/lie still; and, finally, level 10.
The next column is the
most important one, where you describe specifically what the pain feels
like, and use many VERY SPECIFIC examples of how this specific level of
pain impacts your "normal daily living activities". I cannot stress how
important it is to be as specific, and as complete with your examples
as you can be. Also, you need to "guesstimate" the % of time a day/week
that you "routinely" have this pain.
Here are some examples that I use:
02
- The low levels of pain are primarily headaches and backaches. I can
take an OTC remedy, and rest for about 30 minutes, and the pain goes
away. This level of pain comes about 2X a week, and only lasts for the
30 minutes until the OTC remedy kicks in. This level of pain does not
keep me from doing my daily activities. BUT, I need to get on this
level of pain immediately, or it will increase in level if not
addressed and removed.
04 - This level of pain occurs in my
hands, arms, legs, feet, and head. It is like the muscles are hurting,
and the joints hurt. This level gets my attention; I take double the
advised level of OTC remedy, and get some hot tea, and rest lying down.
This level usually takes about an hour to "manage", and I have to stop
whatever I am doing to lie down until I get it under control. This
level occurs about 10% of the time, every other day, usually in the
evening. This level makes me depressed, and when depressed, the level
of pain often increases to the 08 level.
08 - I usually go
straight from 04 to 08, skipping the 06 level. This level is
incapacitating. It feels like the worst flu you have ever had, where
EVERY muscle and joint in my body hurts! Even my teeth and scalp hurt.
Light hurts my eyes; sound hurts my ears; movement makes me nauseous. I
take triple the OTC remedy, and a hot shower. I have a stool in the
shower where I can sit and let the hot water shower down on me until I
run out of hot water (I do this after I take the meds, and try to stay
in the shower until I feel the pain beginning to receed). When out of
the shower, I have room temperature ginger ale (hot or cold liquids
hurt my head), and lie down with soft music - no words; with a cool
washcloth over my eyes in a darkened room. This level of pain occurs 2
or 3 times a week, and lasts for about 20 - 30% of the day. I cannot
function in any activity at this level of pain. When the meds kick in,
the pain is only reduced to the 04 or 02 level.
10 - at this
level, no OTC remedy helps; the shower doesn't help; nothing helps; the
pain is just reduced to the 08 level. Need greater help than an OTC
remedy. This level occurs about one time each week, and literally
knocks me out. Now for the last column, and, this one is very important
for long term pain management. In this column, you document what,
SPECIFICALLY you were doing just before this level of pain was
triggered! This will help both you and your Doctor determine what will
help you.
For
me, the doctor really noticed the comment about depression linked with
pain, and the comments about taking "above recommended" levels of an
OTC remedy. He prescribed for me an anti-depressant, and a pain
medication in lieu of the OTC remedy. These meds, in conjunction with
the meds for joint pain and for the tingling pains, allows for me to
regain some of the normal daily living activities.
Good luck for you in documenting your pain levels!
