#63 Teach your friends your pain scale

 

When I told my best friends about my personal pain scale, it really helped me function in social situations. People who know me well are always able to tell when I am in pain, but the best thing is if people can tell a little before it hurts too much, without us having to actually talk about it.

It's so much easier hanging out with people who can just ask, "Where are you at?" and I'll say "5" and they know that means we ought to be heading home soon. That way I don't have to even think about the pain, or try to convey that it hurts so much that I may need to lie down soon.

As a chronic pain patient you don't want to nag, complain or focus on your pain in any way at all. It's a matter of life, you deal with it.

Sometime I want to design my own T-shirt with a meter gauge on it, and I can just adjust the arrow to my pain level. Non verbal communication, I love it:)

#37 Write a pain journal

Have you started using the pain scale yet? If not, check it out. Today's pain-free tip is to start keeping a pain journal.

Most doctors find it very helpful, and recommend it to their patients. If you're in the position that you haven't had a chance to meet a pain specialist yet (most of us don't until we've had chronic pain for many years... I met mine by chance while I was doing a pilgrimage to Santiago), starting to keep a pain journal now will enable both your MD and any future specialist to get a deeper understanding of your symptoms and provide you better treatment.

Typical entries in a pain journal would be:

• Date and place
• Pain levels throughout the day
• List of activities with times
• Amount of medicine taken
• Effects/side effects of medication
• Reflection:
• Did the pain limit your activities today? If so, how?

Try to keep it simple, even a very short entry is better than nothing:)

Contact CT Pain Foundation (email) to receive your own detailed Pain Notebook for free. The American Pain Foundation has a detailed Pain Notebook which you can download as a pdf and use the way it is. Or you can make your own, scrap book style, where you can paste in some mementoes of your patient-career, and hopefully someday you can look in it with wonder and think "Wow... I'm so glad that part of my life is over and I have no more pain today".

#9 Create your own Pain Scale

Have you learned how to use a pain scale yet? If so: GOOD! If not: you're in for a treat:)

Doctors usually ask you to define your pain according to some scale, and if you actually make your own system and learn how to use it this can really help you deal with your pain in a more constructive way that the regular *pain increase = PANIC = pill popping* way.

I use the model that is used at the Mayo clinic, which is a numerical scale from 0 to 10. My pain clinic in Oslo used a similar one, and my back surgery clinic in Sweden uses the VAS scale: Visual Analog Scale (pain marked by placing mark on a line ranging from 0 to 10)

The visual version can look something like this:

This is the model used at the Mayo Clinic:

0-1 No pain
2-3 Mild pain
4-5 Discomforting - moderate pain
6-7 Distressing - severe pain
8-9 Intense - very severe pain
10 Unbearable pain

My personalized version looks like this:

1-2 I am A-Okay!
3-4 May need to take a couple Ibuprofen or Paracetamol. My glance is unfocused, I'm getting nervous.
5 Pain alert.. Its getting harder to concentrate, I should probably get home ASAP and cancel any plans.
6 Bad pain: I need to take prescription pain killers and lay down
7-8 Agony: I hate my life... Focus on breathing, anything that can distract me from the pain is welcome
9 I am very weak, can hardly breathe
10 There is nothing but screaming pain. Suicide is an option.

Thankfully, these days I am rarely above 5 because I've learnt how to prevent it from getting out of hand.

The key to learning that is to identify the different stages, and to know which strategies to implement at every level.

So: What does your pain scale look like?

Start by drawing it, and write out the symptoms at each separate stage to analyze your own pain behaviour. What are your strategies today, and how can you improve them to decrease the pain at an earlier level?

Have fun:)