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Re-thinking the Pain Scale

This week I was at the doctor’s office and inevitably the question came up…. On a scale of 0 to 10, how would I rate my pain that day. Like every other time I am asked this inane question, I struggled. The problem? The philosophical question of what is pain? You see doctors came up with this idea of the pain scale to judge whether someone was seeing a lot of pain or not. The problem is each person’s idea of what pain is, is wildly different.

0 seems like the easiest number to understand… Absence of pain… this has nothing to do with me. I talked to another doctor on the phone today and said it bluntly. The only way for me to achieve this is to be on Oxycodone and to be fairly lucky with my issues. That number is non-existant…

The rest? What do they mean exactly. I can assure most readers that a 1 to me is NOT a 1 to you. Very little pain is still likely a 5 or a 6 to you. If I’m at 4, you are most likely at 8. A 9 or 10 to me is something most people don’t experience more than a couple times in a lifetime and I experience it probably once a month if not more.  This creates an issue for me. Do I tell a doctor that I am at a 1 or 2 when I am experiencing a small amount of pain relative to me? It’s supposed to be according to where I am normally at that I experience pain. But if I say 1 or 2, my doctor will think that my pain is small, not much, unimportant and not worth thinking about which is completely NOT true.

Let’s take this a different way. Let’s say you have someone on a Monday chop off a toe. You might rate that pain of the be-toeing to be a 10. Tuesday, another toe… it may still be a 10, and might still be a 10 on day 3 when you lose the third toe. But on day 4 or 5, you might start adjusting to that pain and might start saying 9 instead of 10. You go through this practice daily and you might eventually find yourself used to it and might lower the pain associated with it to a 4 or 5 just because it is what you know. Does this make the pain any less important? NO! YOU ARE STILL LOSING TOES! That you as a human get used to pain, doesn’t change that there is something underlying that is causing the pain even if you find it more tolerable.

I came to the conclusion this week.. I will never again use 1 through 4. EVER EVER EVER. Doing so trivializes my pain. There is NO such thing as a 3 in reality, there is just normality and my normal is way fucking higher than that and shame on the doctor who doesn’t understand that. Which yes is all of them. I am even hesitant to say that I should ever use 5, and that my scale should start at 6 and we should just accept that I am in pain and start with that.

I am in pain, and a lot of it. I live with it, it is part of my life. To a degree, i identify with it and at this point, it might be weird for me for it to be completely gone. That’s weird to say but it’s true. I’m so used to the pain that I live with on a daily basis, I am not quite sure what life would be without it.

Still… I am tired of the pain… it is draining both physically and mentally to put up with it. As I write this… I am sitting at an 8 probably, with the knowledge that it will be a 9 by the end of the night when I go to sleep. If I can sleep at all. Not much I can do about it. I am without any sort of pain meds.