Question 1
"On a scale of one to ten, what is your pain?"
How often have you been asked this question by a healthcare professional? How confident were you that the person asking that question clearly understood your answer?
For this question to be accurate, there needs to be a defined base. For example, what pain number indicates that all you can do is lay down and not move? What number is your pain when you decide to head to the emergency room?
For me, the laying down and not moving pain is six. The "take me to the E.R. as fast as you can" pain is eight. Nine is, "I wish I would die." Level ten pain is, "Please kill me now!"
But the pain number scale could be different for other people. I know a few people that wouldn't head to the emergency room until their pain level was ten. Does that mean they're just stubborn and should have gone to the hospital sooner? Does it mean that they have a higher tolerance for pain? Or does it mean that pain level numbers are open to interpretation?
Two people could be sitting in adjacent beds in the E.R. in the exact same pain, but when asked what level of pain they're experiencing, their answers could be very different.
So what, exactly, does it mean when someone says their pain level is five? Eight? Ten?
That is why I think the question, "On a scale of one to ten, what is your pain?"is impractical and needs to be reworked so patients' answers are understood more accurately.
Question 2
Then there is the question: "Is your pain a dull ache or a sharp pain?"
I absolutely acknowledge that this is a needed question that helps medical professionals narrow the possibilities of their patients' pain. However . . .
My own colitis pain journey does not come close to falling into only those two categories.
These are descriptions of "outside the bathroom" pain I've experienced when my stomach was having trouble:
Creature with fingernails - This is when it feels like something is meandering its way through my intestines with its arms outstretched so its fingernails scrape along the sides as it moves. Sometimes it feels like those fingernails are barely touching and sometimes it feels like those fingernails are digging in with a vengeance. At those times I picture the creature with an evil grin on its face as it inflicts pain throughout my innards.
Bloating - You've probably experienced normal bloating. Your stomach feels a little uncomfortable and you may have trouble zipping up your pants. You may feel kind of blah. This is not that kind of bloating. This is where you feel like your stomach is going to explode. And it hurts like almighty heck. One of the times I experienced my worst, writhing pain (level 7.9 which is THIS close to "we're going to the hospital now!") was because of bloating.
Dull
ache - Yes, I have that dull ache. But sometimes it is in one spot and
sometimes it covers my entire stomach area. Sometimes it is barely there
and sometimes it is quite painful, but still not a sharp pain.
Overall pain through the stomach region - This is hard to describe. It is not an ache. I was punched in the stomach once (childhood sibling fight) and that is what it feels like. Not the initial hit, but the pain you feel after a few minutes. Only it doesn't subside. It just hurts.
I know that being a doctor or a patient can be frustrating. Often we communicate differently. The patient may say one thing but mean something else. The doctor or patient may say one thing but the other hears something different. Sometimes a patient holds something back or may just forget to mention something or not consider something important. Asking questions are the best way for two parties to learn and understand each other, which is vital in the patient/doctor relationship. I hope questions keep being asked, on both sides. But those questions need to have a common base to be understood accurately.
© Colitis Senioritis 2023
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