Tuesday, February 15, 2011

The pain business

I was talking to my mother yesterday. She knows about pain as she has had Rheumatoid since 1989, I have only had back pain for 2 years so she is a little bit ahead of me. We aren't medical people at all. We have very useful liberal arts degrees from good colleges. We are experienced patients who have heard to much 'with your condition, blah, blah, blah..." from doctors and know the best back way to the hospital which goes by the cheap full serve gas station and never need to look at the hospital directory to know which way to head for our next appointments.

She told me about studies on pain and how little is known. We were talking about it. A little pinch can hurt a lot - ask any parent who's ear lobe has been twisted by an energetic toddler - but not mean much at all. The child lets go and the pain goes away. But a big tumor can be painless and kill you off with no signs. So pain is not relatively.

Pain is not local either. Just because my hips hurt doesn't have anything to do with my hips. Its referred pain from my SI joints. Basically pain radiates and moves around and doesn't always tell you where the pain starts.

Little people suffer as much pain as big people. I saw something recently about until the 1960's babies were not given much pain medication as it was assumed that they didn't feel as much pain as adults because they were so small. My father talks about leg surgeries in the 1930's where he would wake up post op in a ward full of screaming children who weren't given any post op pain meds.

My mother and I can compare pain meds. I am still transitioning from my medication changes last week. I had a BAD week last week. This week has started a little better but my leg and foot cramps were back last night. A banana eaten at 3 am seemed to help but now they are back. I am not sure if these are new or simply a side effect from my Femara and were disguised by my other pain meds. Either way, I have a topic for my oncologist in a few weeks if they continue. These days I travel with my little pharmacy as I go through the transition.

The pain business is a difficult one. A patient says I hurt here and the doctor looks at another place. The nurse asks 'how is your pain level on a scale of 1-10?' and the patient replies 'its a 15'. Um, you are not off scale,your scale is distorted. I think of pain level 10 as being the one where you are lying completely still because any little move sets off a wall of pain through my back. If that was a 10, a 15 means I would be unconscious. I think I am familiar with all the levels from 1-10 on my scale. But how does that translate to the doctor's scale? Its not like taking your temperature - your pain levels is a 3.5 today. Its subjective. Its a guess. In the pain business that is what they are treating - guesstimates. I am glad I am on the patient end of this one instead of the doctor's side who is trying to translate it.

And then there was the migraine that tried to sneak up on me yesterday... I was cooking dinner when it started so I headed up for our bedroom for darkness and quiet and drank water. It is lurking a little today but I never got its full effects. Yet. I never get migraines. I have no migraine meds. I just make lists for my next doctor's visit. Pain is complicated.

Just when you control it in one body part, it shows up in another one. How did I get tennis elbow while on pain meds and anti-inflammatories - the most common initial treatments for it? That meant I got to skip the part of the diagnosis which said take anti inflammatories and pain meds for a few weeks and go straight to the cortisone injection, PT, and wrist brace.

The pain business is complicated. I'll just stick with being a patient.

2 comments:

Judie said...

I'm sorry about the migraine. Reading about it started me noticing that my head was hurting and I need to take some meds with me to work just in case. I would say another thing about pain - how depressing it can be...as in depression the medical condition. Your readers probably already know this...

ars said...

just be strong, keep the spirit, hope you'll get better