I have been a chronic pain patient for 2 years, 16 days, 1 hour, 10 minutes and counting — ever since I sprained my ankle at work. A simple little sprain that turned into Complex Regional Pain Syndrome (CRPS), also known as Reflex Sympathetic Dystrophy (RSD).
Since then, I have been in and out of emergency rooms, hospitals, doctor’s offices, physical therapy, and physical rehabilitation centers. Each time that I go to one of these appointments, I am asked the same question.
“On a scale of 1 to 10, 1 being no pain and 10 being unbearable, what level are you?”
For those with chronic pain, we know how pointless and subjective that question is.
As for me, a person who lives with pain every moment of every day, a 7 on the standard 1-10 scale is different than someone who fell down and injured themselves, or for a person who has never experienced true pain before.
In previous articles, I have mentioned the McGill Pain Scale, a 0-50 scale that ranks the severity of different types of pain. For example, arthritis is ranked 18. Non-terminal cancer is 24. Natural childbirth is between 35-37. Amputation of a digit is 40. CRPS, RSD, and Causalgia top the scale at 42. Right now, according to that pain scale, they are most painful thing that someone can experience.
What I do not understand is how a doctor can understand what I am experiencing when there is no special scale for chronic pain patients.
When I told the doctor at the last emergency department I went to that my pain was a 7 out of 10 — she replied, “Well, that is not bad. Why did you come to the ER?”
It took every bit of self-control I had not to yell at her, “Do you know what chronic pain is? How can you tell me that what I am feeling is ‘not that bad’?”
But the truth is that, due to lack of education and understanding, many of these doctors do not get it. They do not understand the everyday struggle that has become our lives.
The sad part of this whole conundrum is that there is no easy fix. There is no easy way for us to change society and the conception that people have of those with chronic pain.
Every day we are being let down by a system that is supposed to help and take care of us. An example of this is the increased regulations that the FDA has placed on painkillers, such as oxycodone and Vicodin, making it difficult for patients who truly need these medications to get them.
Last week, while in the emergency department for a horrible pain flare, an ER doctor asked me what normally helped when I was in this much pain. I was very honest and blunt and told her that intravenous Dilaudid was one of the few medications that would take the edge off.
She looked at me with a skeptical look in her eye and said, “There is too much paper work to give you that drug. Not only that, but I would have to have your case reviewed and I am not willing to go through the trouble to do that.”
What does it say about our medical health and society that a doctor will not give us medication that helps because there is too much paperwork? I always believed that a doctor’s responsibility was to help their patients, not to worry about how much paperwork it takes.
The Hippocratic oath says, “I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone.”
It does not say, “I will prescribe regimens for the good of my patients according to my ability as long as I will not have to face excessive paperwork or review boards.”
Amanda Siebe lives in Seattle, Washington with her husband and son. She writes about her daily battle with chronic pain and CRPS in her blog “Life in Pain.”
The information in this column is not intended to be considered as professional medical advice, diagnosis or treatment. Only your doctor can do that! It is for informational purposes only and represent the author’s personal experiences and opinions alone. It does not inherently or expressly reflect the views, opinions and/or positions of National Pain Report or Microcast Media.