Defining Pain

Every time you go to the hospital or a Dr's office they ask you to quantify pain. " On a scale of 0 - 10 what level pain do you feel right now?" There is even a chart with cute little smiley /sad faces to help you decide. So if the chart is the key to it why cant they look at your face and match up the expression for themselves? Some people I am certain believe their pain always qualifies as a 9 or 10. I having had the benefit of several years of near constant pain at some level or another find it relatively simple to assign a "number" to physical pain - how is it compared to yesterday or last week - better or worse? How is it compared to the last visit to the emergency room - better or worse? Then it becomes lie the guessing game you do at the eye Doctors as they switch from lens to lens and ask "better or worse?" At first it is easy to answer bit as you go on suddenly you are not sure if it is really better or worse. That is where I find myself most days now. The wife asks how I am feeling and I try to decide if it is better or worse. And then I have another set of questions of my own - which is better or worse - 48 hours of a "5" on the pain scale or 4 hours of a "9" on the pay scale? If I had the option of choosing which would I choose? Well- since I do not have the option of choosing it is not really a valid question but it does bring up a valid idea - does 3 days at a 5 or 6 still qualify as a 5 or 6 or can you justify calling it a 7 or 8 based on the long term wear down effect of the pain? I think every 12 hours of continuous discomfort should automatically add 1 or 2 to the pain scale actually felt at a given time due to the nature of it wearing down your tolerance. So maybe my pain is not "worse" today then it was yesterday or the day before but I feel worse because it is the third day of it.

Then the truly abstact and subjective begins - the pain is actually a 6 but it prevents me from doing something I enjoy making me feel worse then I already did. If I am home alone in bed with a migraine but the family is all out doing something like a picnic then I no longer feel like a 6 - it is much worse. The physical pain can be dealt with - mental pain and anguish are not so easy to deal with - the demerol does not have a pronounced effect on it whatsoever. So when you are asked "how much pain relief did you get from the demerol?" it is hard to accurately determine - I no longer wanted to drill a whole in my head with a power drill to try to resolve the headache but I still could not do most activities outside the home........If I still can not do the things I want to do is it really much relief at all?

Now more to the point of this blog - quality of life. At what point do you get to decide that your quality of life is being so adversely affected by pain or illness that it is no longer of a sufficient quality to continue? At what point is it ok to to start contemplating the call to Dr Kevorkian? Well - he is also dead now so that would be a pointless call to make but you get the idea I presume. I certainly am not in worse pain mentally or physically than somebody with stage 4 cancer... I am not yet reduced to depending on physical supports to remain alive - so some may think this is really silly. I do not presume to be "worse" or "better" than anybody else - but the point remains that I am not always certain that my life contains enough joy, pleasure, happiness, or relief from pain to bother continuing at all. Three years is a long time to not feel well. Though life still has the occasional moment of happiness or pleasure - the majority of the time I feel pain and discomfort and unable to control my own destiny or not in control of my own life. I ask myself - if tomorrow is the same as today do I want to have a tomorrow? And the answer is "no" an alarmingly high percentage of the time.