First of all, if you notice any contradiction between this post and one a few days ago, you are cordially invited to shut the hell up about it. Anything you read on my blog is correct at the moment you’re reading it. (Yeah, you heard that right! This blog’s accuracy is fully dependent on the moment when you are reading it, not the moment when it was written. Live with it.)
I got my first pair of eyeglasses when I was three or four years old. (Why, yes, I was adorable, thank you very much.) At that appointment and at every other optometrist's appointment since then, I’ve gone through the portion of the exam where they keep flipping back and forth between two lenses and asking “Is this one better…or this one”? And I’m always sure I’m going to get it wrong. I mean, they’re the ones who went to Eye-Doctor School. Who the hell am I to tell them when they’ve got it right?
I complained a few days ago about doctors who, more or less, ignored my presence in the room so they could discuss me like a specimen under a slide. Today, I’m going to complain about the ones who care too much about my opinion in the whole thing. (I’m contrary that way. Live with it.)
Let’s start with the part where they’re pressing and patting and prodding different parts of you and asking, “Does it hurt here?” Well, everything is fine as long as you keep expressing pain where they expect you to. Then, all of a sudden, you rebound and cringe from one particular prod and they say “It hurt there?” And their look utterly screams, “OMG, OMG, OMG, it’s not supposed to hurt there and there…is it?” And you’re left lying there thinking, “Oh, crap. I failed the test.”
It’s my understanding that during my first few days in the hospital, they just kept me doped up on morphine and I may have missed a lot of what was going on. Then, they switched me to another pain medication and the instruction was that I could have it as often as once every four hours, but only if I asked for it. These were both fine situations as far as I was concerned. Then they switched me to yet a different pain-killer, but the new wrinkle was that when I requested it, I was asked to rate my pain on a “one-to-ten” scale. WTF? I was supposed to study?
The truth is, I had a whole lot of difficulty rating my pain on a “one-to-ten” scale. I mean, just think about it! That’s an awful lot of pressure for some schmuck whose gut hurts and all he wants is to get back to sleep.
Well, as a public service, I’m going to advise you on how to react to these questions if you find yourself in a similar situation sometime down the road.
First, and most importantly, you need to be aware that it’s totally a trick question. Let’s dispense with the top of the pain chart.
TEN is reserved for situations in which someone with access to heavy-duty painkillers takes one look at you, says, “Oooh gross! I don’t think that really belongs there”, and decides that anyone with their parts rearranged thusly, is probably in pain. You will receive painkillers with nobody's request or explanation required.
NINE is reserved for people screaming incoherently. Once again, it's likely you have some parts in places or positions not usually considered correct. The major difference here is that someone in charge requests enough pain-killer to quiet you down. Altruism is not the major consideration here, but once again, your own expressed wishes are not required.
EIGHT is reserved for people similar to William Wallace at the end of Braveheart, being shown his own entrails. In a modern version of the movie, he would have screamed “Morphine”, not “Freedom”. (Note: This is the only Mel Gibson movie where he scores a solid Eight. In the Lethal Weapon movies, I doubt he ever gets higher than a Six.) This is the lowest level of pain where you can express a need for the the heavy artillery and be believed without question.
Note that in each of the above cases, standing with a nurse and contemplating your pain level is neither an option, nor anything that might be expected of you. You’ve made it clear that you are in great pain, and the pros just want to alleviate it. Yay, pros.
At the other end of the scale, is what I’ll call, S.I.U.A.Y.G.A, or Suck It Up Asshole. You Get Aleve. This is what happens if you respond that your pain should be rated a One, Two, or Three. I won’t describe One and Two, but Three is pretty much Homer Simpson hitting his thumb with a hammer. No Percocet for you!
Which leaves us with Four through Seven. These are the only answers available to you when you’re asked about your pain level. Use too low a number, and you get an Advil…too high a number, and you’re clearly faking.
SEVEN is the most important one to be aware of. Think Dustin Hoffman in Marathon Man. Laurence Olivier has been drilling your teeth without any anesthetic and asking you questions to which you don’t know any answers. This is a pain you can imagine. You can also imagine looking pleadingly at the nurse while begging for morphine. I think she'll believe you.
FOUR, FIVE AND SIX are actually variations on the same theme and somewhat interchangeable. Any Looney-Tunes cartoon in which one of the following occurs, rates one of these numbers:
a.) Daffy Duck’s bill ends up spinning around his head and or lands at his feet.
b.) Any character is hit in the face with a cast-iron pan which takes on the shape of his face.
c.) Any character is fired from a cannon and leaves a perfect silhouette-shape of their body in the wall. (Note: Only counts when fired from cannon. Purposeful escapes through a wall that leave the same shape do not inflict the same pain.)
So, basically, when a nurse asks you to rate your pain before giving you your meds, you’re limited to Four through Seven…and only use Seven if you’re having trouble articulating it.
P.S. Kindly refrain from sending me rabid comments about how I don’t know pain and I shouldn’t be making fun of people who might have chronic or acute pain. That’s kind of the point, after all. If I want to know how firm of a bed I should be sleeping on, I can check out that “Sleep Number” bed that Lindsay Wagner’s always hawking and figure out what my sleep number is. (And who doesn’t want a bed sold by the Bionic Woman?)
I’m not aware of (nor would I want to participate in), some test at the hospital that lets me more accurately rate my pain so that my charts can be filled in more accurately. "You say, that level of slamming a door on my foot rates a Six? OK, put me down for 5.75."