Is there any point asking about the pain scale anymore? Everyone is a ten. And even when our patients are moving through life with prescriptions for Fentanyl and Methadone for ‘chronic pain,’ they still come to the emergency department pleading that they can’t help that they’re out of their narcotic a few days earlier. Stating that they called their physician who wouldn’t refill them, but said, ‘if you need pain medicine, you’ll have to go to the ER.’
Pain being, allegedly, the 5th vital sign, we are encouraged to treat it, not disbelieve it. And thus, emergency department patients with a ‘high tolerance’ for pain medication end up with enough narcotic to put down a bull elephant, all the while whispering and slurring the words, ‘can I have something else…my pain is so bad.’
To accomplish this, they have abdominal pain that (despite multiple surgeries and enough CT radiation to revisit bomb experiences at Bikini Atol) never turns out to have any real etiology. And their multiple back MR studies show (wonder of wonders) ‘degenerative disc disease.’ Which everyone who works in medicine for long enough probably has as well.
I know I beat this drum all the time, but people, let me break it down. We are a nation of addicts. We are a nation where too many individuals use any excuse to obtain narcotics, obtain disability and sleep their lives away. We are a nation of ‘benefits,’ wherein a small number demands their ‘benefits’ and ‘rights’ to endless slumber, ceaseless medical evaluations and lifelong disability…which is supplemented by income they obtain by working (a thing they are allegedly too broken to do). Benefits that others pay for by ignoring their back pain, ignoring their own desire to plop down before the big-screen and stay home on someone else’s dime.
We will collapse. We will be buried under a cataclysmic flood of prescriptions and disability forms. We will stop producing anything and spend all our best productivity, all our children’s futures to provide solace for those who do not shout loudest, but moan loudest.
Unless someday, for moral and financial reasons, we finally say no.
This has been the case for some time in NYC. A paper a few years ago by the pain researchers at Montefiore (Bronx) noted that the average initial pain score in their abd pain study was 9.9 — and that’s the average! Other pain researchers assure me that there’s still value in the delta — the amount that pain score drops upon medication (going from 10 to 5 is better than 10 to 9…) But just like anything, we adapt to the noise. With time, I’ve become more attuned (and appropriately concerned) about the 45 year old with chest pain… Read more »
CG
13 years ago
I’m glad I didn’t come across you in the hospital last year–I did have unexplained, severe abdominal pain (after a major surgery). A combination of Valium, Morphine and Percocet hardly touched it. After I was released, I went to see a Healing Touch practitioner. She worked on the painful area and over the next 4 days it slowly went away and never came back. You have decent points in your post (I’m an RN, so I see these things too). But your obvious disgust for these people will hinder your practice, not to mention the fact that you openly profess… Read more »
Pattie, RN
13 years ago
CG…I believe in the healing power of prayer and the strength of our God, but it is sad to see another nurse believe in new age “non-touch-touching” and “energy fields” to cure anything. Frankly, maybe you need not stand in a glass house with so many stones in your hands. Especially since you seem to confuse Christian compassion with being an enabling doormat.
Thank you, Pattie, for your eloquent defense of my post.
Dr. J
13 years ago
I agree the mid-range pain score is a red flag.
I recently saw a 30’s army serviceman for chest pain, he was calm and polite but hypertensive and sweaty. The nurse asked his pain score, he reflected for a moment and said ‘Miss I believe it is about 6 of 10 right now.” I asked him if he wanted pain meds but he said he just wanted to know if he was okay. He was not, he had an aortic dissection but luckily did very well.
I just needed to state thanks but all over again. I am not certain what I might have completed from the absence of such ideas discussed by you concerning that concern. Entirely was an absolute scary circumstance in my circumstances, but encountering a professional style you treated it forced me to cry with gladness. I am just happier for your function as nicely as have high hopes you recognize what an wonderful work your are performing teaching individuals today through your websites. A lot more than likely you might have never bought to grasp all of us.
{"id":null,"mode":"form","open_style":"in_place","currency_code":"USD","currency_symbol":"$","currency_type":"decimal","blank_flag_url":"https:\/\/edwinleap.com\/wp-content\/plugins\/tip-jar-wp\/\/assets\/images\/flags\/blank.gif","flag_sprite_url":"https:\/\/edwinleap.com\/wp-content\/plugins\/tip-jar-wp\/\/assets\/images\/flags\/flags.png","default_amount":100,"top_media_type":"none","featured_image_url":false,"featured_embed":"","header_media":null,"file_download_attachment_data":null,"recurring_options_enabled":true,"recurring_options":{"never":{"selected":true,"after_output":"One time only"},"weekly":{"selected":false,"after_output":"Every week"},"monthly":{"selected":false,"after_output":"Every month"},"yearly":{"selected":false,"after_output":"Every year"}},"strings":{"current_user_email":"","current_user_name":"","link_text":"Leave a tip","complete_payment_button_error_text":"Check info and try again","payment_verb":"Pay","payment_request_label":"EdwinLeap.com","form_has_an_error":"Please check and fix the errors above","general_server_error":"Something isn't working right at the moment. Please try again.","form_title":"EdwinLeap.com","form_subtitle":"If you enjoy the content you read here, please consider dropping something in the tip jar!","currency_search_text":"Country or Currency here","other_payment_option":"Other payment option","manage_payments_button_text":"Manage your payments","thank_you_message":"Thank you so much! I appreciate the tip!","payment_confirmation_title":"EdwinLeap.com","receipt_title":"Your Receipt","print_receipt":"Print Receipt","email_receipt":"Email Receipt","email_receipt_sending":"Sending receipt...","email_receipt_success":"Email receipt successfully sent","email_receipt_failed":"Email receipt failed to send. Please try again.","receipt_payee":"Paid to","receipt_statement_descriptor":"This will show up on your statement as","receipt_date":"Date","receipt_transaction_id":"Transaction ID","receipt_transaction_amount":"Amount","refund_payer":"Refund from","login":"Log in to manage your payments","manage_payments":"Manage Payments","transactions_title":"Your Transactions","transaction_title":"Transaction Receipt","transaction_period":"Plan Period","arrangements_title":"Your Plans","arrangement_title":"Manage Plan","arrangement_details":"Plan Details","arrangement_id_title":"Plan ID","arrangement_payment_method_title":"Payment Method","arrangement_amount_title":"Plan Amount","arrangement_renewal_title":"Next renewal date","arrangement_action_cancel":"Cancel Plan","arrangement_action_cant_cancel":"Cancelling is currently not available.","arrangement_action_cancel_double":"Are you sure you'd like to cancel?","arrangement_cancelling":"Cancelling Plan...","arrangement_cancelled":"Plan Cancelled","arrangement_failed_to_cancel":"Failed to cancel plan","back_to_plans":"\u2190 Back to Plans","update_payment_method_verb":"Update","sca_auth_description":"Your have a pending renewal payment which requires authorization.","sca_auth_verb":"Authorize renewal payment","sca_authing_verb":"Authorizing payment","sca_authed_verb":"Payment successfully authorized!","sca_auth_failed":"Unable to authorize! Please try again.","login_button_text":"Log in","login_form_has_an_error":"Please check and fix the errors above","uppercase_search":"Search","lowercase_search":"search","uppercase_page":"Page","lowercase_page":"page","uppercase_items":"Items","lowercase_items":"items","uppercase_per":"Per","lowercase_per":"per","uppercase_of":"Of","lowercase_of":"of","back":"Back to plans","zip_code_placeholder":"Zip\/Postal Code","download_file_button_text":"Download File","input_field_instructions":{"tip_amount":{"placeholder_text":"How much would you like to tip?","initial":{"instruction_type":"normal","instruction_message":"How much would you like to tip? Choose any currency."},"empty":{"instruction_type":"error","instruction_message":"How much would you like to tip? Choose any currency."},"invalid_curency":{"instruction_type":"error","instruction_message":"Please choose a valid currency."}},"recurring":{"placeholder_text":"Recurring","initial":{"instruction_type":"normal","instruction_message":"How often would you like to give this?"},"success":{"instruction_type":"success","instruction_message":"How often would you like to give this?"},"empty":{"instruction_type":"error","instruction_message":"How often would you like to give this?"}},"name":{"placeholder_text":"Name on Credit Card","initial":{"instruction_type":"normal","instruction_message":"Enter the name on your card."},"success":{"instruction_type":"success","instruction_message":"Enter the name on your card."},"empty":{"instruction_type":"error","instruction_message":"Please enter the name on your card."}},"privacy_policy":{"terms_title":"Terms and conditions","terms_body":null,"terms_show_text":"View Terms","terms_hide_text":"Hide Terms","initial":{"instruction_type":"normal","instruction_message":"I agree to the terms."},"unchecked":{"instruction_type":"error","instruction_message":"Please agree to the terms."},"checked":{"instruction_type":"success","instruction_message":"I agree to the terms."}},"email":{"placeholder_text":"Your email address","initial":{"instruction_type":"normal","instruction_message":"Enter your email address"},"success":{"instruction_type":"success","instruction_message":"Enter your email address"},"blank":{"instruction_type":"error","instruction_message":"Enter your email address"},"not_an_email_address":{"instruction_type":"error","instruction_message":"Make sure you have entered a valid email address"}},"note_with_tip":{"placeholder_text":"Your note here...","initial":{"instruction_type":"normal","instruction_message":"Attach a note to your tip (optional)"},"empty":{"instruction_type":"normal","instruction_message":"Attach a note to your tip (optional)"},"not_empty_initial":{"instruction_type":"normal","instruction_message":"Attach a note to your tip (optional)"},"saving":{"instruction_type":"normal","instruction_message":"Saving note..."},"success":{"instruction_type":"success","instruction_message":"Note successfully saved!"},"error":{"instruction_type":"error","instruction_message":"Unable to save note note at this time. Please try again."}},"email_for_login_code":{"placeholder_text":"Your email address","initial":{"instruction_type":"normal","instruction_message":"Enter your email to log in."},"success":{"instruction_type":"success","instruction_message":"Enter your email to log in."},"blank":{"instruction_type":"error","instruction_message":"Enter your email to log in."},"empty":{"instruction_type":"error","instruction_message":"Enter your email to log in."}},"login_code":{"initial":{"instruction_type":"normal","instruction_message":"Check your email and enter the login code."},"success":{"instruction_type":"success","instruction_message":"Check your email and enter the login code."},"blank":{"instruction_type":"error","instruction_message":"Check your email and enter the login code."},"empty":{"instruction_type":"error","instruction_message":"Check your email and enter the login code."}},"stripe_all_in_one":{"initial":{"instruction_type":"normal","instruction_message":"Enter your credit card details here."},"empty":{"instruction_type":"error","instruction_message":"Enter your credit card details here."},"success":{"instruction_type":"normal","instruction_message":"Enter your credit card details here."},"invalid_number":{"instruction_type":"error","instruction_message":"The card number is not a valid credit card number."},"invalid_expiry_month":{"instruction_type":"error","instruction_message":"The card's expiration month is invalid."},"invalid_expiry_year":{"instruction_type":"error","instruction_message":"The card's expiration year is invalid."},"invalid_cvc":{"instruction_type":"error","instruction_message":"The card's security code is invalid."},"incorrect_number":{"instruction_type":"error","instruction_message":"The card number is incorrect."},"incomplete_number":{"instruction_type":"error","instruction_message":"The card number is incomplete."},"incomplete_cvc":{"instruction_type":"error","instruction_message":"The card's security code is incomplete."},"incomplete_expiry":{"instruction_type":"error","instruction_message":"The card's expiration date is incomplete."},"incomplete_zip":{"instruction_type":"error","instruction_message":"The card's zip code is incomplete."},"expired_card":{"instruction_type":"error","instruction_message":"The card has expired."},"incorrect_cvc":{"instruction_type":"error","instruction_message":"The card's security code is incorrect."},"incorrect_zip":{"instruction_type":"error","instruction_message":"The card's zip code failed validation."},"invalid_expiry_year_past":{"instruction_type":"error","instruction_message":"The card's expiration year is in the past"},"card_declined":{"instruction_type":"error","instruction_message":"The card was declined."},"missing":{"instruction_type":"error","instruction_message":"There is no card on a customer that is being charged."},"processing_error":{"instruction_type":"error","instruction_message":"An error occurred while processing the card."},"invalid_request_error":{"instruction_type":"error","instruction_message":"Unable to process this payment, please try again or use alternative method."},"invalid_sofort_country":{"instruction_type":"error","instruction_message":"The billing country is not accepted by SOFORT. Please try another country."}}}},"fetched_oembed_html":false}
This has been the case for some time in NYC. A paper a few years ago by the pain researchers at Montefiore (Bronx) noted that the average initial pain score in their abd pain study was 9.9 — and that’s the average! Other pain researchers assure me that there’s still value in the delta — the amount that pain score drops upon medication (going from 10 to 5 is better than 10 to 9…) But just like anything, we adapt to the noise. With time, I’ve become more attuned (and appropriately concerned) about the 45 year old with chest pain… Read more »
I’m glad I didn’t come across you in the hospital last year–I did have unexplained, severe abdominal pain (after a major surgery). A combination of Valium, Morphine and Percocet hardly touched it. After I was released, I went to see a Healing Touch practitioner. She worked on the painful area and over the next 4 days it slowly went away and never came back. You have decent points in your post (I’m an RN, so I see these things too). But your obvious disgust for these people will hinder your practice, not to mention the fact that you openly profess… Read more »
CG…I believe in the healing power of prayer and the strength of our God, but it is sad to see another nurse believe in new age “non-touch-touching” and “energy fields” to cure anything. Frankly, maybe you need not stand in a glass house with so many stones in your hands. Especially since you seem to confuse Christian compassion with being an enabling doormat.
Thank you, Pattie, for your eloquent defense of my post.
I agree the mid-range pain score is a red flag.
I recently saw a 30’s army serviceman for chest pain, he was calm and polite but hypertensive and sweaty. The nurse asked his pain score, he reflected for a moment and said ‘Miss I believe it is about 6 of 10 right now.” I asked him if he wanted pain meds but he said he just wanted to know if he was okay. He was not, he had an aortic dissection but luckily did very well.
I just needed to state thanks but all over again. I am not certain what I might have completed from the absence of such ideas discussed by you concerning that concern. Entirely was an absolute scary circumstance in my circumstances, but encountering a professional style you treated it forced me to cry with gladness. I am just happier for your function as nicely as have high hopes you recognize what an wonderful work your are performing teaching individuals today through your websites. A lot more than likely you might have never bought to grasp all of us.