Monday, August 29, 2011

Lesson of the Day: Quit Perseverating About Your Illnesses!

Back to my blog home page:

I arrived at work to find a full caseload plus 3 evaluations....(shuffle, shuffle, shuffle my schedule...okay, I can make this work...)

My first evaluation was Rick, barely 60 years old, who could recite every little illness he had ever had. I was amazed at how enthusiastically he recounted every ache and pain.

About Pain

pain scale assesses intensity of pain on a scale of 0 to 10. These scales are at times accompanied by the continuum of smiley-to-grimacing faces. If you have a patient with cognitive issues, you can point to a picture of the faces and ask, "How do you feel?" They are more likely to be able to point to a face than rate their intensity of pain with a number.

If you have no pain at all, you're sitting at zero.

If you...
  • Think you need to go to the ER
  • Are unable to suppress a scream
  • Are writhing in pain or spasms
you're sitting at a 9 or 10.

In between is "hurts a little" to "hurts a whole lot."

This guy, like many of my patients diagnosed with chronic pain syndromes, demonstrated absolutely no nonverbal signs of pain. He was smiling and talking nonstop when he rated his pain at 8/10, then,
...6/10 in another area,
...5/10 in another,
and...9/10 in another.

In my 15+ years of experience, men generally rate pain higher. (Am not sure why, but I'm thinking, "Could they ever make it through childbirth?")

So, I want to say two things...

First, I acknowledge that for each patient, their pain is real. Whether we as health care providers believe the intensity or not, it's real to the patient.
Second, there's a line of thought that says:  What you think about, you manifest into your life. If you think about illness all the time, if you think about pain all the time, you are more likely to experience it.

What do you believe? 
And what would you tell your patients? Or your family members? 

Let me hear from you...

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