If you’ve ever spent any amount of time in a hospital, or even in an emergency room (at least here in America), you may have noticed that the hospitals use a pain rating scale. There is a chart on the wall, and the scale goes from 1 (no pain) to 10 (worst pain possible). Well, as some of you may know, I had surgery on June 17th to have some kidney stones removed. It was supposed to be a simple procedure, done under general anesthetic. The plan was to go in on the 17th, have the surgery, go home on the 18th, back to full function a week later. But as I was coming out of the anesthesia (an unsettling feeling, at best), I knew something was wrong. I was cold, much too cold. I heard the nurse say to the doctor “Her temp is 103.7”. Even in my drugged haze, this registered as very bad. Have you ever spiked a high fever? Mostly, you shiver. I did. The shivering was making the incision hurt like a mad bastard, causing me to moan, cry, and beg for more morphine. Which they kept giving me. Until they had given me so much, it was getting very hard to breathe; I could not fill my lungs with air. Did I mention that I was puking, too? Turns out the root of my problems was a blood infection, which kept me hospitalized for a week.
So, about their pain-rating scale. I’ve had pain that was a 10 (usually kidney stone related). That shit (in the recovery room) was at least an 11 or a 12! I submit that the scale should be revised to reflect this type of situation!
norinew, I too am sorry you went through that and I’m glad you’re over it, but unless you’re tongue-in-cheeking me, it sounds like they almost killed you with the morphine as it was: depressing your respirations. puking, etc. are all signs that you were given an overdose, and that’s how your body reacted to it, even though it might have been unintentional.
The pain scale works pretty well for us since when someone tells us “10”, we also look for signs supporting that claim: Sweating, shivering, writhing, crying etc, are all signs that you need pain meds. Those meds need to be titrated to your weight, however, and also whether or not you may be allergic to them needs to be considered.
In short, it’s hard to give more than 100%, as Ringosays.
I miss you over in the SDMB Weight Loss Club, but I’m using your suggestions to get back on track.
Yeah, I almost OD’d on morphine. For 2 days, my blood pressure hovered around 84/47. I don’t usually run as high as some would think, given my size, but I certainly don’t run that low!!
Well, I’m back now (to the Club, I mean), and I’m glad I could be of help!
I had an ablation earlier this week. After looking at the chart with 10 different smiley faces on it, I informed my doctor that we would go with my chart. It goes from “Hey no problem” to “I grab you by the throat and scream in your face GIVE ME DRUGS NOW.”
Yeah the pain scale thing is a little odd. I broke my ankle last summer badly enough to require surgery. It took me a few hours in the ER to figure out that whole pain scale thing 'cause I kept revising it - what HAD felt like a 10 at one point was, an hour later, like, a five.
[slight hijack]
that whole post-surgical-coming-out-of-anesthesia thing has got to be reworked too. Last year, I had a total of three surgeries - the first one to fix my busted limb and install screws. The second to replace the first set of screws that I managed to rip out of the bone. The third, finally, to remove all the hardward once I had healed up. Well, that first surgery was a cakewalk as far as coming out of the anesthesia. The second time? The anesthesologist may as well have clubbed me over the head with a baseball bat as administered drugs - that’s about how I felt for 8 HOURS after that surgery. The last time was dont under just sedation so it wasn’t a big deal - just like sleeping.
[/slight hijack]
But the pain thing? Yeah, I’d vote for something else. Maybe akin to the Dewey Decimal System? Or software revs? “… yeah, doc, half an hour ago, my paid was a 5, but I’d have to say that it’s gotten to about a 6.2.2 now…”
SnoopyFan, my urologist has been taking care of my kidney stone problems for about 6 years now. He knows I’m not a junkie, but there is a clear understanding between us that I do not put up with being in pain. One of the reasons I love him is that he groks this whole concept. In fact, for two days post surgery, he had ordered morphine every two hour (which is good, because for the first two days, I needed it every two hours!)
It got to me in the hospital because they never explained it. Was 10 supposed to be “giving natural birth and passing kidney stones at the same time”? Or just “as bad as I’ve felt in my whole life”?
Not intending to make light of being in pain and begging for morphine, but from personal experience, if you can express any coherent thoughts like “OW, my leg hurts!” or “I need morphine!” it’s not a “10” - perhaps an 8 or 9. 10 is when it’s so bad you can’t speak coherently and instead, puke and pass out. Or the other way around.
When I woke up, I was in a different part of the hospital from where I thought I’d been moments earlier. What transpired was the knee surgery that was supposed to be outpatient was upgraded a tad mid-operation and neither the recovery room person, nor I knew it. With or without crutches, standing up and walking was a very, very bad idea. Apparently it was quite a scene - the reptilian part of my brain was arguing with them that I shouldn’t be walking and couldn’t manage keeping the body standing and arguing at the same time, made a poor choice and I was soon on the floor. Happily, the higher functions went off-line about a second after realizing this felt really, really bad, so I don’t know for sure what happened, except for what I’d been told.
I was suprised I wasn’t in more pain after my hysterectomy Tuesday.
I remembered to keep on top of my pain from when my son was hit by that car.
For two days after he was hit he didn’t want pain meds and the nurses kept asking him to please take them because his nerves were still alseep (in shock). His nerves decided to wake up about 3am and it was horrible.
So, when I started to feel some pain I called the nurse and took something for it even though I’m not one for taking meds. I will just never forget what my son went through.
Not taking them very often now, just when I over do things a bit. Like I said in my other thread I’m not getting much help or rest.
Norinew, I hope you get to feeling better and I’m so sorry to hear you had such a rough time.
I’m also curious as to how Gothie is doing and I hope she and the younger one are helping you around the house.
The pain scale isn’t meant to be a deadly accurate reflection of each individuals pain scale. It’s just a rough guide or indication to help the nurse to make his/her decision on whether they should give you pain relief and how much.
If the pain feels really bad to you, tell them 10, if there’s very little pain tell them 1, if it’s there but bearable tell them 5. The key is to not think too much about it, just go with your gut feeling…(unless your gut is where the pain is :))
What seems to be the most useful aspect of the pain scale is not how the individual person defines a pain of 8 or 9 but how their evaluation of the pain changes from day to day (or more often) – i.e., if a patient had told me yesterday that the pain was a 5 but now it is a 8. It also can be helpful to ask the patient to rate the pain from 0 to 100 in some cases.
You can believe that post surgery, I was not saying “My incision really hurts; can I have more morphine?” I was semi-consious and moaning “hurts. . .hurts”, which they were taking as their cue to give me more pain meds. After I threw up, I don’t know if they put something in my IV for nausea or not, but they may have.
My cancer hospital pain charts have the little smiley faces that start crying as it gets worse.
As I came out from under after the surgery where they took out half my stomach and part of my liver, the only coherent words I spoke for over 24 hours were “That bitch ain’t hurtin’ enough to do this justice.” The surgeon, who is from France, and the Senior Resident (New Yorker, native of New Dehli) turned to the guy from West Texas for translation.
That night, one of the nurses, knowing that i’d be in ICU for a minimum of 6 days, added two more levels to my chart, drawn on paper towels. 11 was “Ah’mo kill somethin’ if you don’t put that stuff in the IV NOW” and 12 was “Shoot me, shoot me NOW!!”
Because it didn’t come off 12 for over 8 hours, they caught a complication early, and in fact, I was out of ICU in only 4 days. Still another 6 weeks in the hospital, but out of ICU was good…
thatDDperson, thanks for making me laugh!! I’m sorry that you went through so much, but I’m glad that everything sounds like it’s fine now. I believe that if I ever have another experience like my last one, I may have hubby add some faces to my chart, using yours as a guideline!
Nothing is worst than being told that a patients pain level is 10 or 12 when they are sitting with not signs of pain period. no sweating, heavy breathing, screaming, ect…
