Me and My Body

Taking stock nine days post-op:

  • I had 3.5 hours interrupted sleep last night, from 4:00 AM to 7:30 AM, the longest sleep in ages.  I felt so much better than yesterday when I was out of bed at 4:30 AM after five hours of catnaps.
  • The lack of is surprising.  The surgeon sliced through muscle to dislocate my hip, clean out the socket, install the new surfaces, relocate the head of the femur into the acetabulam, and sew me up.  That should hurt.  The surgical wound is uncomfortable, not painful, and I only feel the hip when I do something I’m not supposed to do, like roll to my side without a pillow between my knees.  That unleashes a bolt of with a simple message:  Stop What You Are Doing RIGHT NOW.  Mostly there is a dull ache and stiffness, caused in part by swelling–my right leg belongs to some old, feeble, fluid-retaining fat guy.
  • No, its not the narcotics.  My post-surgical PCA (patient controlled analgesia) involved a self-administered dilaudid drip with an eight-minute minimum interval.  Sounds great in theory but it induced vomiting and profound nausea that made the thought of food repellant.  I stopped using it about 24 hours after the surgery.  The worst pain occurred while they decided what I should take next.  Oxycodone appeared a few hours later.  It stopped the pain along with the functioning of my digestive system.  I took that for little more than a day.  For the past seven days I’ve relied on Tylenol.
  • The medical world uses a subjective 10-point comparative scale to monitor pain where 0 = no pain and 10 = unbearable pain.  I first encountered this scale when I came across the Pain Journal, kept by my late sister during her treatment for ovarian cancer, containing dates, numbers (generally between 4 and 7), and brief notes.  The subjectivity of it struck me then and struck me this week: what relationship is there between descriptions of the pain from different people?  On the wall across from my hospital bed was a chart showing the number scale with icons bearing happy smiles for 0-1 (no pain), downturned mouths for 2-3 (mild pain), and so on to the howling agony representing unbearbale pain.  How does your “mild discomfort” compare to mine? How do culture, experience, mores, and other factors color one’s perception of pain?  While in hospital the highest I rated my pain was 5 and then only once, to convince them to move faster on replacing the dilaudid.  I didn’t feel my pain was at a 5 but I could see a 5 on the horizon if I didn’t get narcotics soon.  I was between 3 & 4 for about the first 48 hours after surgery, then between 2 & 3 until I left the hospital 24 hours after that.  This week I’ve rated the pain between 1-2.  At this week’s worst I could imagine pain much more severe than what I felt.  My first night’s roommate was hospitalized for surgery connected to the loss of his thumb early this year in an industrial accident.  I’ll spare readers the details of the accident but I knew that pain had to be far beyond anything I was feeling.  Maybe imagination heavily influences one’s pain ratings.  Until you are experiencing the worst thing you’ve ever imagined in your life, how can your pain approach 10?
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  • http://www.trudalane.net David Randall

    Parents can measure their children’s pain objectively. “You aren’t that sick. Get up and go to school.” “I saw you fall. It wasn’t that bad. Here’s a lollipop, now stop crying.

  • ajgershen

    I used the 1-10 scale for my L5-S1 Microdiscectomy (back surgery) in the Fall of 07. The hardest part was remaining consistent over time with my scale. In follow-up appointments they ask for a number, but I have no clue what I felt/said the last visit I had. Can’t they just invent something to determine our pain rating objectively?