Pain scale

[twirlgrrl]

A funny thing about being in the ER, writhing around on a hospital bed with tears running down my cheeks from the pain in my center: When they asked me to rate my pain on a scale of 1-10, I had no idea what to say. I mean, OK, it hurt so much that I couldn't help but cry a little, and I couldn't stay entirely silent when it ramped up intermittently. So is that a 6? 7? 8? On the written pain scale, tears appear at the 9-10 mark. The thing is, compared to labor, all other pain is a 1. Or if regular pain--even my blinding migraines--approaches a 9 or a 10 on occasion, then labor is a 50. Or even a 100. Unfortunately, even though I knew the pain wasn't even in the same universe as labor, I still didn't tolerate it well. I need to develop a better, more controlled pain response, hopefully before I get pregnant again. I am such a wimp.

Comments

[eac.livejournal.com]

Why all this self flagellation these last two days? You're not a wimp. Things hurt. I don't see why you can't show that, especially when you're in the hospital trying to figure out why you're in so much pain. Labor is a whole other thing...

Me, I'd rank tears an 8, so that when the pain ramps up and you can't stay silent, that's a 10.

[canetoad.livejournal.com]

Even though I have used pain scales in a limited way in my practice, I find them mostly dumb and useless.

I think what's called for here isn't so much a pain scale but a fear scale. Pain is... relative. Some things hurt more, some less. What's always most important is, how much does this particular pain scare you?

[nea0613.livejournal.com]

What KIND of pain is it exactly?? and where? Just wondering, cause you make it seem like it's not always severe. Hope you get answers soon.

[gen-here.livejournal.com]

This is so weird (not the pain - I'm sorry about that). But this is the second post on the pain scale in the last few days on my FL. And the third or 4th I've read on all the different blogs that I read, too.

[artemis-rich.livejournal.com]

I finally figured out the way the pain scale works. See, I have a very high pain threshold, so I always put myself fairly low on the scale...and had to wait forever in the ER in pain but too proud to say anything about it.

Now, if I am in bad enough shape to have to go to an ER, the pain scale is automatically an 8 to 9 for whoever asks. It's a good rule of thumb.

Call if you need anything. We're always here, you know.

[twirlgrrl.livejournal.com]

LOL at you pointing out *my* self flagellation. :-)

Thanks.

[twirlgrrl.livejournal.com]

Yes, I've heard you say that before, and I partially agree in that it is helpful for me to calm myself and remove fear and emotional distress from the equation when I'm having a migraine. I tell you, though, labor didn't particularly scare me, but it suuuuuuuure was painful and I did not handle it well. It was just completely overwhelming, and overrode all reason or rational thought for me. I guess I don't separate pain and fear the same way you do--you certainly are a champ at handling labor!

[twirlgrrl.livejournal.com]

It seems to have disappeared. It was really intense, a bit crampy, but mostly very steady pain, I guess like a really REALLY bad stomach ache, except not specifically in my stomach, and it radiated out to my back between my shoulder blades like a tight muscle spasm, with sharper jolts of pain to the right and left just under my diaphragm.

Thanks for the good wishes. It looks like they aren't going to figure it out this time. Let's hope there's not a next time!!

[twirlgrrl.livejournal.com]

That *is* weird. I know you can probably relate to this pain because it was most likely a gallbladder thing.

[twirlgrrl.livejournal.com]

Thanks so much. You're lucky to have such a high pain threshold. I'm pretty wimpy when it comes to pain of the physical variety, though I can handle an immense amount of emotional pain and stress.

[eac.livejournal.com]

Well, I know it when I see it. ;)

[canetoad.livejournal.com]

A couple of things:

First, I think that if your particular labor didn't scare you, you're either in serious denial or... I don't know what! :) You, girl, had a LOT to be worrying about, and I think you managed your health issues and that fear really really really well. No one else could have done what you did and gotten your way so thoroughly! But I don't believe for a minute that the fear wasn't there.

Second, all that said -- labor is hands-down the most painful thing I've ever experienced, and raw pain scales can be useful. I just think that understanding how great a patient's fear is almost always much more useful in the care and healing process.

[canetoad.livejournal.com]

And you know, basically what I'm saying here is, You Rock.

[twirlgrrl.livejournal.com]

Honestly, I wasn't scared! I mean, I was probably scared of having to feel more pain--i.e. the next contraction, and I got hung up on *that* fear I think. But I wasn't scared of my body failing or of permanent damage or of anything truly scary happening during labor and birth. I pretty much never worry about health issues unless it appears I'm in imminent danger, and even that takes a while to sink in. Because overall, in a day-to-day way, my body functions amazingly well for what I've put it through. I think this sangfroid comes from the fact that I come from hardy stock--my grandfather smoked his whole life, for instance, and lived to be 86, which was even farther past the average life expectancy then than it is now. And I can hike, and my pregnancy was amazingly normal and healthy considering the threat of my pre-existing hypertension. And I had no idea that I had pre-eclampsia until AFTER the birth.

When I had sarcoid last year, and they were throwing around all sorts of possibilities involving severely compromised heart function, I was worried. But when that was ruled out and it was just down to enlarged lymph nodes and shadows in various organs, I wasn't worried anymore. After my doctor read the CT scan to me in her office, she looked at my impassive face and said "So, do you go home and freak out about this stuff later, or is the fact that you may have cancer just not bothersome to you?" I just laughed. I knew I didn't have cancer, the same way I knew that Blue and I would make it through labor and birth OK.

This is helpful to sort out, actually. I never really saw my fear of the pain of labor for what it was until I wrote the first paragraph above. I mean, I *guess* it was fear--it was pretty much like "No no no NO I don't want to feel this ANY MORE!!! Oh here it comes again ARARAUWEHAWERJASERASDF SCREAM LOSE CONTROL SCREAM SOME MORE!!!!!!!" Now the question is, how to deal with that feeling next time I am in labor? Do you have any thoughts?

[twirlgrrl.livejournal.com]

Oh, is *that* what you were saying? ;) Well thanks. YOU rock, actually. I've personally seen you rock most mightily in exactly the sort of situation we're discussing. Twice. I seriously admire you for that!

[canetoad.livejournal.com]

"...the question is, how to deal with that feeling next time I am in labor? Do you have any thoughts?"

Surrender. It's a natural physical process. It only lasts so long. Unless you want to take a bunch of drugs, it's just going to be whatever it is. So surrender. Move with the pain, not against it. And that's not just some philosophical mumbo-jumbo. I mean it quite literally, quite *physically*. Do you remember early on with Rosie's labor, when we were all sitting on the couch, a contraction hit, and I said "Ooof!" and dropped right to the floor on hands and knees with my butt in the air? I was moving with the pain, finding THE best position for reducing the intensity.

Cindy really wanted to tell me that she thought it would be "better" for the progress of the labor if I didn't tilt my pelvis that way -- she started to, in fact. But I caught her eye, and she let it go. When I'm in labor, I don't try to "manage the pain." I let it manage ME. If it tells me to put my butt in the air, I put my butt in the air! Or I torpedo out over the edge of the bed, suspended on the shoulders of friends. Because when I move WITH the labor and the pain like that, it gives me the mental peace of mind and calmness to crack simple jokes and amuse myself during transition/pushing. [Paul to Calvin: Mama's making a baby." Me to Paul: "No... I did that part already..."]

Also, with every labor of mine, a funny mental thing happened during the first part of labor. There was always a point, after the initial excitement of "Oh, finally! I'm in labor" wore off, when I would feel a moment of dread. True dread of the pain and work ahead of me, dread of the weeks of sore nipples and sleepless nights to come, all of it. And then I would say to myself, "Well, too bad! Here it comes, you can't stop it, you might as well go with it." And then I could spend a lot of mental effort simply focused on resting between contractions. When you focus on the space *between* the contractions, and on relaxing during that time, that time seems longer and the contractions seem much shorter (and they are, in fact, until the very end).

Really. It's the one place and time in your life when it's more than okay to stop being a control freak, when in fact it may be required. I don't understand surrender to a god but I understand surrender to a birth, and maybe in the end it's the same thing. ? I don't know, but the thought occurred to me, so I figured I'd blurt it out. :)