Monthly Archives: October 2015

Pain score

“Numbing the pain for a while will make it worse when you finally feel it.”
~This post is dedicated to one of the reader for his kindness in supporting the post, yose may~

I used to remember back to my first posting, I always saw a group of people, carrying a paper bag which pack with all sort of medications and a handful of colorful charting with scoring on it. They are the Acute Pain Service team. They will go to certain patients and ask for the rating of pain. Well, what do they know about pain? Pain is such a subjective experience. Often, these rantings pop in my mind. 
It was until my recent rotation to Acute Pain Service that I started to realize the nature of their work. It turn out to be a meaningful one. Remember how we always ask, what’s your pain score, 8?! With some rolling of eye balls and the back of our mind will be saying, what a pretentious person. So I am starting to feel embarrass for doing that previously. Yes, no doubt pain is a subjective unpleasant experience, but you will be surprise with how much you can do in helping them to reduce the pain. Lesson number one, do not underestimate the colorful pain scoring chart. That is what I learnt in the first day of my tagging. I got so thrilled and relieve to see the wrinkling, frowning and suffering facial expression wiped off with adjustment on the pain medications. It works! The truth is nobody is this world would like to experience pain, isn’t it? 

Pain has quite a complex mechanism. Every pain tell a story. There is no such thing as pain without a reason. There was this patient with below knee amputation. Every night he will be suffering from a tremendous amount of pain over the limb which was being amputated. The fact that the limb is no longer there yet he could still feel the searing pain of it. Analgesic medications was titrated and adjusted according to his pain score. It was until the commencement of anti depressants along with drugs for neuropathic pain, his is finally able to wear a smile across his face. Phantom limb is what we call it as. After few session of desensitization, his symptoms improved and he came to accept the fact that his limb was no longer there. I remember a useful way of explanation given by my consultant. The body couldn’t process the limb was being amputated out of the blue just like when someone important to you was taken away. It amuse me, truly. 

Well, pain derived mentally is something which we can never truly understand. It’s tricky because we are able to recognize it but the only way to reduce the pain lies within the patient. You can never tell a depress cancer patient at the terminal stage to take opioids to make them happy. There are several painful moment in my life. However, no matter how painful it is, the highest scoring I could rate for the pain was 6. Probably because I am reserving the 10. Pain score of 3 was when the I got my finger stucked between the doors. Pain score of 4 was when a heavy wooden chopper board fell to my leg. Pain score of 5 was when the patient that I’ve taken care of passed away. Pain score of 6 was when I realize the reason behind that decision, something that will be bury deep inside where no one else will ever know. 

I remember how close I was to give up on medical schools, my dreams. Fortunately, grateful as I am with you all around, I made it through. Out of difficulty, I guess there is where miracles come from. Let the pain be the guidance, be the reason to move on. 

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