May 17th, 2015

Pain Diary

As I’ve mentioned previously, I’m doing a bunch of stuff to try to improve and control the migraines. One part of the project is that I’m documenting them for the first time in a “pain diary” as per the title of this post. I guess you can’t say “diary” to a writer without her interpreting it as “cache of information I can later mine for stories”–at least, that’s what I’m think. It’s an interesting project, even though it does document some of my lowest moments, physical-health-wise.

Every day I’m supposed to rate the morning, afternoon and evening on a scale of 0 to 10, 0 being no pain and 10 the worst pain. Here is how I am scoring things so far, but honestly I have no idea if I’m doing it right. I’d really love to see other people’s pain hierarchies–any ideas how I would google that?

1–mild twinges of pain, maybe an incipient headache but could also be just passing through. Annoying, but doesn’t affect my day very much.
2–mild headache, a backround hum of pain. Makes me more tired than usual, but I can usually do what I planned to do despite the headache.
3–real headache, noticeable pain. At this point I would take some sort of med (but I’m starting to wonder if I should take them earlier) and consider whether my plans for the rest of the day are cancellable. If that’s not easy to do, I will continue as planned and probably still have an ok time, but be very tired and quiet.
4–serious headache, unhappy amount of pain. I’ll take the strongest drugs I have and try to just go home and rest, but if I can’t do that, I can usually muddle through whatever I have to do. I might fumble my words at this point, and my hands often shake. The last rung of functional.
5–severe headache, non-functional Rebecca. This is where I actually can’t do anything other than lie still and maybe stagger to get a drink of water. I can’t stand to be touched and I can’t talk very much, though I can say a few sentences. Some nausea, inability to eat. This has only happened to me a handful of times in my life, and thank goodness always in proximity to a bed (except once when Mark had to park the car so I could lie in the grass beside the parking area until I felt better).
6–I’ve never had a 6, but I have been close enough to see it on the horizon. I would probably vomit from the pain at this point, something I’ve never done wrt migraines but have thought about. Ditto crying.
7–I honestly think that if, with all the meds at my disposal, I got to a 7 and couldn’t get away from it, I would need to be under medical care or at least really want to be. The thing is, it is so impossible to do anything when you feel this bad, I don’t know how I could manage to say, walk to a vehicle and sit in it, then walk into a hospital and explain my problem. I’m kind of hoping that if I ever hit a 7, I’ll just lose consciousness so someone can call me an ambulance and I can be wheeled away on a gurney.

Does that sound accurate to you? I haven’t included 8, 9, and 10 because, well, I’ve never had a baby, been shot, or been run over by a car; I’ve never been deprived of oxygen–I imagine those things are what occupies the far end of the spectrum…I think. And yet the pain diary form I’ve been filling out actually specifies 10 as “the worst pain you’ve experienced”, in which case 5 becomes the new 10 for me…but then there’s no room for things to worsen, which in all honestly looks like where I’m headed. Also, it’s kind of disrespectful to those who’ve had those babies and been hit by those cars. My pain threshhold is low and I know it: I’m trouble at the dentist and sometimes if I walk into a door or stub my toe, my eyes actually fill with tears. We have to allow for a certain amount extreme reaction in my pain reporting, even though I don’t mean to do it.

So basically, I’m worried I’m doing my pain diary wrong, but also, the process is very fascinating. I had a 5 yesterday, and of course in the worst of the pain, I was just a trembling ball of nerve endings, but as soon as I started to feel a little better, I was trying examine the pain scale and see where I was. I guess that’s the writer’s instinct–as soon as we’re taking notes on the situation, we can see it from the outside and maybe analyze it a little for use in other writings.

So tell me your pain scales if you want–I’m fascinated and it’s research…