Monday, June 9, 2014

Why I hate the pain scale.

"On a scale of 1 to 10, how much pain are you in?"

I hate that question. I think I'm beginning to hate it more than, "Is there any possible way you could be pregnant?" (I had a hysterectomy in 2008, and it's in my chart. "Oh yeah, it says that right here!")

If you live with chronic pain, the pain question comes up all the time. I really do understand why we are asked at every visit. Medical staff need to know how much pain you're in so they can figure out if a current treatment is working, if you need better pain control or what they can do to help you feel better. And, it is YOUR JOB to be HONEST! I have Pirformis Syndrome in addition to all of the other fun stuff. (Piriformis syndrome is a condition in which the piriformis muscle, located in the buttock region, spasms and causes buttock pain. The piriformis muscle can also irritate the nearby sciatic nerve and cause pain, numbness and tingling along the back of the leg and into the foot (similar to sciatic pain).) I've been suffering for a very long time and I've always said I was never, EVER, getting any kind of a steroid injection into any part of my body. Well, after years of pain, things were getting worse. My left SI joint was angry and the pirformis muscle just wouldn't let up. I was getting shooting pain down my left leg and sitting for any length of time was getting harder. I called my pain doctor, asked him several questions, cried, debated the pros and cons with friends, cried some more, then finally made the appointment to get both the piriformis and my SI shot up. At the end of March I had the injections done. Within about 10 days, I was bending over without hesitation -- something I hadn't done in years. I felt so much better and I was wondering why I was so afraid to do this for so long.

Six weeks went by and I was good. Very little pain, at all, for those 6 weeks. I don't remember when it happened, but at some point the piriformis injection wore off, and soon I was limping, feeling that familiar shooting pain when I sat down. I could only get comfortable laying down. I saw my pain doctor and I was honest, the injections were AWESOME! The SI has never felt this good but the other... it's back, and it's bad. He examined me, touched that one spot and I jumped. He checked the rest of my back, noticed I was tender in some other spots but it was nothing compared to the one area. It's funny, he made a comment about me being dressed. Not that I go to appointments naked, but when I'm in a lot of pain, I wear as little as possible. I have gone in wearing a tube dress and a jacket with Uggs in the middle of winter. I have fibromyalgia and sometimes clothing hurts. Do you know that throbbing feeling you get when you wrap a piece of string around your finger really, really tight? Some days that's the feeling I get when I wear a bra. And buttons and zippers don't always go well with RA hands. You make do with what you have to make yourself comfortable. I guess when you have a patient who typically comes in looking a mess, and this time looks somewhat together, you notice.

Dr. L offered me another piriformis injection and I jumped all over it. He said he doesn't usually like to inject fibro patients but overall I'm doing really well and the last set didn't send me into a flare, I really did benefit from it so he felt it was the best thing to do for me. I made the appointment for the following Tuesday before I left. 

Last Tuesday was injection day. I was in bad shape. We went to the Arthritis Walk on Saturday, I was miserable there, I miserable on Sunday and Monday. By time Tuesday came around, I was more than ready to get this done. I was unable to walk from my car into the hospital, it was that bad. Rick registered me, we sat for a few minutes and I couldn't get comfortable. The nurse called me back, I slowly got out of my wheelchair, hobbled to the chair so she could get my vitals. Then she says, "You're at a 10 pain wise." Really? Because I don't remember saying I was. I was in a lot of pain but I was still carrying on a normal conversation. My vitals were perfect. I wasn't crying or screaming. I was very fidgety and I was practically lying in the chair, but we were still joking around. 

I told her no, I was maybe a 6. I don't think she believed me. But here's the thing.... MY 6 can be YOUR 10. Pain isn't something another person can judge. I don't ask my kids, "On a scale of 1-10...." when they fall. When J snapped her arm, she cried for a few minutes. Matthew falls off his bike, he cries for HOURS. The worst pain I ever felt was after my hysterectomy. At the time I had undiagnosed interstitial cystitis and obviously, they need to cath you. Inflamed, angry bladder + catheter for 14-16 hours is not good. All of my insides were adhered together so they had to un-stick everything. Not to mention, they took out my uterus, which was also stuck to everything. I could not push that morphine button fast enough and they had to order me more because I went through an entire vial faster than expected. I remember wanting to die. I was wondering if I did the right thing and if the pain was ever going to stop. That's MY 10. I compare everything to that and I don't ever want to come anywhere close to that kind of pain again. The birth of the kids, both were c-sections, doesn't even come close to my hysterectomy. 

Just believe me when I say that my pain is really only a 3-4, or whatever low number I spout off, when to you I look like I should be close to death. As long as I'm not crying and screaming, "BRING ME DRUGS!" I think I'll live.