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PAIN: WHERE TO DRAW THE LINE.

It was surgery day. Two patients were scheduled. Same type of surgery. The same anesthesia was to be administered to both in the same dose. The procedure was almost the same on the doctor’s end. Their individual reactions, however, were as far as the east is from the west.

Patient A squirmed and screamed and swore he was in serious pain even after a generous dose of local anaesthetic. Patient B, whom we had assumed earlier would be in more discomfort and may need deeper anaesthesia, barely groaned all through the surgery. Why do you think that was so?

In the World Health Organization’s definition of pain there is this phrase: a subjective experience. That statement forms a huge portion of pain assessment. It is what the person tells you it is. If I ask a 20 year-old male to rate his abdominal pain from 1 to 10 and he says 8, it is an 8 for him. I have to respect that 8. I may have managed several people with the same condition that describe the same pain as a 4, but the present 8 that the young man says should not be brushed aside.

It is common knowledge that people tolerate pain differently. But in this truth therein lies the dilemma: for person with low threshold to pain, when do we begin to take a more indepth consideration to their pain ? When do we know when the condition shifts from status quo, from “he/she just likes to shout everytime” to something more sinister?

I wish the answer was straightforward, but it is far from a one-size-fits-all approach. Yes, pain is subjective to the person bearing it. However, objective clinical evidence has to come into play in order for the healthcare providers to strike a balance and get a larger picture. In simpler terms, it goes like this:

-you walk into the hospital complaining of pain in your leg,

-the doctor listens to you talk about the pain in your leg. This is the subjective part.

-the doctor proceeds to examine your leg; touching it, feeling it, moving it. This is objective.

-doctor then asks you to do some tests and/or prescribes some drugs for you to begin using. The tests further aid the objective part.

All these steps are important in pain treatment. Those tests that your good doctor told you to do are not just a mere waste of money, they are in your best interest.

Speaking of things that are in one’s best interest, it is not a safe option to request for over-the-phone consultations when in pain (and any other thing really) . Please. The healthcare provider that you are calling cannot assess you physically, the only information on the pain is subjective. Hence, there is a high risk that the pain will be over or under estimated. The outcome of both scenarios can be grievious. You truly are doing yourself a disservice.

If you were to ask for a rule-of-thumb from me, it would be this: take pain seriously all the time. Even if something similar has occurred in the past and it wasn’t “that serious”, the ongoing pain should not just be brushed aside. People have come close to death and even lost their lives from conditions which begun with pain that “was not that serious”.

At the other end of the spectrum, if you’ve made a habit of downplaying your pain to others, please leave this behavior behind in 2019. No one gets any yearly medal for Most Enduring Man or Woman. You know your body, you know when things begin to shift off course. Lie to yourself/others less and express the genuine extent of your pain more.

By Ada & Her Tune.

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