Chronic Pain Whatever the cause, support for managing long term or intractable pain.


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Old 02-18-2015, 11:13 AM #1
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Cool Smirk Numeric Pain Rating Scales

All of us who suffer Chronic Pain have been asked by our GP, PM Team or Neuro to quantify our pain on a scale of 0-10.
Not only is this a difficult question, but I have found that there are numerous Scales out there with widely different examples/descriptions of the pain suffered for each numerical value. For example, childbirth ranges from 5 to 8, and 10 can mean - Worst imaginable - Bedridden and in need of medical aid - So bad slipping into unconsciousness. Some Scales give NO intermediate examples, just 0 = No pain - 10 = Worst imaginable.
So how do you know - when you say you are at a 7 - your Doctor isn't hearing '4/5'? My advice - which I will be following myself as my Pain Management Team is now split between NHS and Private Clinics - is to choose a Scale that best describes your pain, download and print multiple copies and mark those up to give to your PM Team.
Having multiple injuries, neurological conditions, Neuropathic Facial Parasthesia, TN and Cluster Headaches adding to my total pain score, I will opt for filling in Pain Quality Assessment Scales. These break down types of pain - hot/cold/electric/stabbing… - frequency - duration - then Overall Score.
Appointments go by alarmingly quickly. With this forward planning, not only can you convey your problems in a manner both sides can understand, but you are unlikely to miss something you wanted to bring up.

Dave.
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Old 02-19-2015, 12:05 AM #2
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hi Dave,
I agree you should bring a copy of the scale you are using yourself.

I have seen scales where 10 is the worst pain YOU have ever experienced
versus 10 is the worst pain you can IMAGINE. These are vastly different things depending on life experiences. To me, a 10 is so bad, you cannot function at all, are bedridden but you make a good point about the various kinds of pain, burning,stabbing, neuropathic. There have been a few creative folks here on the forum who created their own pain scales and I thought they were excellent. They linked pain to how activity has been affected.

In hospitals rooms here in the US, they use what I think is stupid, the one with faces in various degree of grimacing.
http://www.partnersagainstpain.com/p.../A7012AS6b.pdf

This is the one my pain doc uses:
http://www.partnersagainstpain.com/p...s/A7012AS8.pdf

it is too bad there is not a universal pain scale.

Hope you are doing ok today. I have been in bed with migraine and unbearable neck pain these past few days, just starting to rally...called doc for an ESI this week and taking Soma(muscle relaxer) like crazy.

Wishing you all well.. D



Quote:
Originally Posted by EnglishDave View Post
All of us who suffer Chronic Pain have been asked by our GP, PM Team or Neuro to quantify our pain on a scale of 0-10.
Not only is this a difficult question, but I have found that there are numerous Scales out there with widely different examples/descriptions of the pain suffered for each numerical value. For example, childbirth ranges from 5 to 8, and 10 can mean - Worst imaginable - Bedridden and in need of medical aid - So bad slipping into unconsciousness. Some Scales give NO intermediate examples, just 0 = No pain - 10 = Worst imaginable.
So how do you know - when you say you are at a 7 - your Doctor isn't hearing '4/5'? My advice - which I will be following myself as my Pain Management Team is now split between NHS and Private Clinics - is to choose a Scale that best describes your pain, download and print multiple copies and mark those up to give to your PM Team.
Having multiple injuries, neurological conditions, Neuropathic Facial Parasthesia, TN and Cluster Headaches adding to my total pain score, I will opt for filling in Pain Quality Assessment Scales. These break down types of pain - hot/cold/electric/stabbing… - frequency - duration - then Overall Score.
Appointments go by alarmingly quickly. With this forward planning, not only can you convey your problems in a manner both sides can understand, but you are unlikely to miss something you wanted to bring up.

Dave.
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Old 02-19-2015, 12:42 AM #3
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I like the ones that have a description of how the pain is affecting you - seems clearer for patient & doctor..
http://40.media.tumblr.com/84d513405...dato2_1280.png

http://37.media.tumblr.com/tumblr_mc...sbn1o1_500.jpg
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Old 02-19-2015, 08:26 AM #4
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Cool Smirk

Diandra,
I came across the 'Smiley-Grimace' Face charts. I would feel patronised confronted by one of those.
My GP and PM Teams are the best, although the individuals I see differ, and the Scales used have never been explained. The Private Drs ask verbally, with NO written cues at all. Sometimes I want to hire a retired wrestler, get a load of Medaeval torture devices and give them a physical demonstration of what I go through.
Yesterday was the first day since Boxing Day that I didn't have a Cluster Headache attack - does that warrant a Smiley Face?
Jo*mar,
I like the Mankoski Scale with painkiller effectiveness. I will modify that with negative weekly values for my Lidocaine Infusion relief, and keep it for my other pain meds.

Dave.

Last edited by EnglishDave; 02-19-2015 at 08:37 AM. Reason: Addendum
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Old 02-19-2015, 01:15 PM #5
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thnx jomar...agree with Dave,,,the mangoski is right on the money.....leaves very little room for misinterpretation.
what is your avatar photo? ....it is lovely, Diandra




Quote:
Originally Posted by Jo*mar View Post
I like the ones that have a description of how the pain is affecting you - seems clearer for patient & doctor..
http://40.media.tumblr.com/84d513405...dato2_1280.png

http://37.media.tumblr.com/tumblr_mc...sbn1o1_500.jpg
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Old 02-19-2015, 03:19 PM #6
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Some practices now have a rule that if you reach a 10 on their face chart, then you must be taken to ER; if you refuse then you can't be in that much pain...
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Old 02-19-2015, 10:55 PM #7
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Quote:
Originally Posted by Enna70 View Post
Some practices now have a rule that if you reach a 10 on their face chart, then you must be taken to ER; if you refuse then you can't be in that much pain...
Here going to the ER from pain is just an exercise in being completely disrespected, being an obvious drug addict and an overall demoralizing experience.

Cant go to the ER anymore since I have been labeled as demoralizing and local Neurologist told me that small fiber neuropathy did not have an ER visit need.

I know...more ignorance with the doctors that not.

Take care all.

Wish some people in pain were actually treating those that have pain.
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Old 02-20-2015, 12:03 AM #8
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Quote:
Originally Posted by Diandra View Post
thnx jomar...agree with Dave,,,the mangoski is right on the money.....leaves very little room for misinterpretation.
what is your avatar photo? ....it is lovely, Diandra
Not sure what kind of plants or flowers they are , I just loved the colors and the composition..

I found some nice avatars on both of these -
http://www.free-avatars.com/
http://avatarmaker.net/free-avatars/
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Old 03-15-2015, 01:51 PM #9
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Seeking an actual journal type log book that has a pain scale inside it, with many other sections to note pain such as this page i found looking around. And thanks to English Dave for directing me to his thread here. No faces or dumb little charts for me.
See the diary page below in link:

http://www.webmd.com/migraines-heada...headache-diary
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