Posted by: Kate | July 15, 2010

Redefining Ten

“How would you rate your pain right now?  One means no pain at all, and ten being the worst you’ve ever felt.”

For a long time, I didn’t know how to answer, because I didn’t think I had really experienced a ten.  I’d given birth at 22, and of course that had its moments, but I’d had a successful epidural and comparatively minimal things to deal with in the recovery phase, so that didn’t stand out in my mind as a painful thing.  Plus, I tend to forget pain fairly quickly after it goes away; a habit I did not deliberately cultivate but for which I am deeply grateful, because I think it’s quite adequate to remember that something was painful without reliving it.

Then I had appendicitis, with a non-laparoscopic surgery because they weren’t quite sure when it might burst, and spent several days in the hospital, followed by several weeks of recovery at home.  When I realized that I couldn’t cough without rushing to clutch a pillow to my midsection and sneezing seemed like a particularly cruel and unusual cosmic punishment, then I thought, “Oh, here.  Here is what a ten feels like.”  Those early days were punctuated by sharp bursts of misery, and that became the milestone to which I compared other pain.

A year or so later, a C-section reminded me of just how difficult abdominal surgery is, and reaffirmed that definition of “ten.”

In the past four months, I have given birth without the benefit of medication, though that certainly wasn’t in the plan: two failed epidurals plus a quick labor meant this baby was coming out the natural way, like it or not.  (I don’t think I’ve ever told Isaac’s birth story here, have I?  Too busy almost-dying in the weeks following, I guess… I’ll get around to it sometime, he deserves his little moment in print).  Immediately afterward, my whole world became shaded with different styles and shapes and colors of pain, from the initial “lower right quadrant discomfort” that started it all, to waking up with one 10-inch-diameter wound in front and a 5-inch-diameter hole all the way through my abdominal wall on the side and trying to roll over in bed so that my linens could be changed when I couldn’t sit or stand by myself, to the white-hot agony that was a VAC dressing change (or, rather, two at once, but who’s counting?)… I’ve had lots of new tens, each one replacing the last as a new pinnacle for “worst ever.” I hadn’t even realized there was a contest; I would much have preferred to abstain from that particular sort of competition, given the choice.

I’ve also had the constant background noise of the spondylitis, the nasty ache and grind of my lower back, which has effectively erased my memory of the one-through-three zone.  I simply cannot remember the last day in which I had no pain at all, and have learned to function through – sometimes ignoring, sometimes white-knuckling through, sometimes medicating into submission – this constant background pain.  I consider a three or four to be acceptable; not likable, but livable.  It crunches my pain scale down, and makes me wonder if I should start calling my normal day a one, now, just to give myself a little more descriptive space when other stuff pops up.

The problem is, when other stuff pops up, as it has a few times this summer, it seems to blow through the roof very quickly.  I don’t know if that’s because the events – ongoing wound care issues, and two seromas in the past two weeks – truly are independently, seriously painful, or if, as some doctors clearly believe, I have just destroyed my pain tolerance through ongoing opiate usage.  I suppose they could be right, I could be pathetically incapable of handling the slightest insult to my body now… but somehow I tend to think that having a scalpel pushing through to open an inflamed pocket of fluid a full inch inside my abdominal wall, suddenly and unexpectedly beyond the reach of the surface-level lidocaine numbing and thus a shock to the system, qualifies as actually painful.  Somehow I think that waking up the morning after an inch-long incision was carved deep into my flesh without benefit of systemic anesthesia (i.e., no Ativan, no Versed, just some topical numbing and a shot of Dilaudid before it started) would be associated with a serious spike in pain, especially when the surgery was unplanned and carried out when I was alone, and scared, and confused, and sad.

Or maybe I’m just delusional, allowing my psyche to completely overstate the intensity of the situation, playing it up for the audience, perhaps just med-seeking in the first place.  Maybe I somehow willed these seromas into being just so I could have the singularly delightful experience of begging for medication and receiving that judgmental, head-shaking attitude while they begrudgingly doled out medication.  Don’t get me wrong, psychology does matter – says the former psychologist – and I am certain that my mindset plays a huge role in my ability to mediate pain… but apparently taking daily doses of an opiate simply destroys my ability to accurately perceive my own experiences.

I don’t know.  I do know that I have, once again, redefined “ten,” because the combination of a scalpel reaching past the numbness, an inch into my body, to abruptly collapse a cavity that had spent the prior several days swelling and inflaming the tissue around it… plus a day of aloneness and fear in the ER… those add together to create yet another high, in a contest I would really, really like to stop entering.

I’m home now, and able to smile at my children and walk myself to the bathroom – skills I temporarily lost, over the past two days – so I can, once again, start the recovery process.  And maybe this will be the time that I can actually advance farther along that road, from “healing” into “better.” Maybe.

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Responses

  1. I have no words, Kate….I’m sorry for all you’ve been thru.

    Hugs.

  2. “And maybe this will be the time that I can actually advance farther along that road, from “healing” into “better.” Maybe.”
    —–
    Dear Lord, I hope so. This is getting ridiculous. I feel stupid for saying this over and over, but I truly don’t know what to say, except to tell you that I love you and am thinking of you a lot. Still. Your descriptions are painful just to read. It just makes me angry … angry that you had to fight death in the first place, angry that you’re continuing to have complications, and angry at the treatment some of the medical professionals – using that term lightly – are giving you. I have a thing about unfairness, and your experience is certainly at the top of things unfair.

    But … you ARE strong, and a fighter, and I’m glad you’re still here.

  3. Kate, I’m thinking of you, and hoping the next time you think of a ten it’s because there are ten margaritas lined up at a bar on the beach. Hugs!

  4. Excuse my language but FUCK those ASSHOLES who even think they can judge you or your pain. Who the HELL do they think they are making you feel bad for asking for adequate pain management while they are cutting you open. Sorry, but you use every ounce of anger in you and you tell them to medicate you thoroughly or you will not consent to them doing any medical procedures on you. Tell them that you have the right to be out of pain, pain is something you have lived with for far to long and DAMN them if they even for a second think you cannot tell real pain from what they think may be exaggerated because of the daily opioid use. I am about to go off on some stupid medical personnel. Why is it that drs and nurses always think they know what is best, and that they know what you are feeling, and that if you are on opiates for chronic pain that they will cause you to hurt more. Bullshit…sorry, but I know you better than that, which means I know damn well that you only take those horrid meds when you cannot bear the extreme pain any longer. I know that you resist taking those meds as long as you can because you want to be the mom and wife you used to be, but then you find that the pain is too much to bear and that is what those meds are for. DONT you ever let those jerks make you feel like you should not be taking pain meds, and definitely dont you let them ever do another procedure on you without at least conscious sedation. It is the least they can do to someone who has been to hell and back. Seriously I am ready to catch a plane and start beating people up. Kate, I love you so much, and I am so proud of you for being such a fighter, but please sweetie…make them help you, speak up and tell them you have suffered enough, that you will not go through any more painful procedures unless the proper meds have been given first…sorry, I had to get that out….of course when you get home you have the best pain relievers ever waiting for you at home, the love of your children is very powerful…..I hope you heal quickly, and I also hope that any more encounters with the medical community include proper pain control. It is the least they can do. Love you so much, take care, and dont you forget about that ass kicking policy of yours….use it next time they try to cut you open without more than lidocaine…lol

  5. Holy crap woman, you have been through enough. I can’t even express how much I want this to end for you.

    As far as feeling paranoid about the skyrocketing pain, one thing I have learned with my IH, is I am SUPER sensitive to any kind of headache, and one that might have been manageable before, even without advil is NOT durable anymore. I think your body is just really sensitive (JESUS how could it not be?) which really does make it hurt worse. It’s not your imagination.

    Thinking a lot of thoughts over here.

  6. Just when you think we’ve become so much more enlightened and scientific than those who had to amputate on the field in the civil war. I’m sorry you had to go through that.

  7. I’m with Kelly. Basically, you took a shiv to the gut. I think everyone would find that extremely painful, even with an opiate or two (vicodin or something similar?). Personally, vicodin only lessens that constant aching pain – I don’t think it’s even meant to eliminate the pain of a sharp stab to the gut. You are not a drug-seeking, out-of-touch-with-reality woman!!!! Ask any one of those medical types if they would be willing to be stabbed with the same amount of “pain relief”. You absolutely won’t get any takers! Ridiculous!

    But I’m glad you’re home again, and I’m praying you won’t need to see the inside of an ER for a very, very, very long time.

  8. They are f*ing lucky you didn’t go into shock!

  9. I have faced this same attitude from dr’s, and I am so sorry you are. All I can do is send lots of (((hugs))) and positive thoughts your way. Also, *even if*, the pain is more in your head than in your body (which is stupid because all pain is in the head) it is still pain that you are feeling and it is their jobs as doctors to relieve it.

  10. HUGS and I am here for you if you ever need me…..

  11. Found you through a friend of a friend
    I work in healthcare and LOVED this redefined pain scale, thought you might too:
    http://hyperboleandahalf.blogspot.com/2010/02/boyfriend-doesnt-have-ebola-probably.html


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