"On A Scale of 1 to 10"

Doctor: "What is your pain on a scale of 1 to 10?"

Me: "Honestly, 47!"

Doctor: "Let's not be dramatic."

Me: ".....That's really an understatement...but I guess on your scale an 8."

          I hate when people ask me to rate my pain. Why, you may ask? First of all I think all chronically ill people that have constant pain hate this question and the vagueness that people associate with the irrelevant charts they show you with the smiley faces ranging from smiling to crying. On a doctor's scale of 1 to 10 my ten is not me crying with a frowning face, my "ten" is me blacking out because I'm in so much pain. So when people ask me to "rate my pain" I always answer "On your scale about an 8." I say 8 because to people who have not experienced pain, and don't deal with it daily they don't understand that what they may call an 8 or 10 is my 1, my constant. So to them an 8 is pretty bad. When to me, it’s an everyday, all the time, consistent annoyance.

          Secondly I find the answer that people are looking for much more complex than the broad question.  So what's the correct way to ask this question?

Doctor: "So we will go from head to toe. What type of pain are you having in your head and how bad is it?"

Me: "Let's see, the front of my forehead feels like someone is hitting me with a hammer, that's about a 6. Then there is the pain at the base of my skull that feels like a session of acupuncture that has gone horrible wrong and the needles are stabbing my brain. I'd say that’s a 7. Oh and the vibrating and the feeling like my brains been put in a blender, that is about an 8. Then there is my light sensitivity where everything looks like I’m starring into a flashlight, then the pressure and tightness in the back of my eyes like someone is squeezing my eyeballs as if they were stress balls, that’s an 8. Then there is the phone in my ears that no one will ever answer and the feeling that I’m scuba diving underwater, that's an 8 too."

Doctor: "......Umm, okay. Any neck pain?"

To go through the whole body, this process takes about 45 minutes on a good day. I know because I have literally thought through every part of my body that hurts and what I would rate it (on a doctor’s scale). Trust me, it takes a while. It is much faster to think about what doesn't hurt. That list is pretty short. Finger nails, eyebrows, eyelashes... some day’s that sums up that list.

Another question that I was recently asked related to the 1 to 10 pain scale is what is my Pain Goal? I had a new nurse that asked me this question and to her it was very routine but I had never been asked before and had difficulty answering. Me, either suffering severely from Lyme brain that day or just being completely oblivious had to ask her what she meant. She replied that if I could have my pain be lower than what it usually is what would it be? I said, which to me is an obvious answer, zero! Clearly my pain goal would be to be pain FREE. This was apparently not the answer she was looking for. She explained to me again that if my pain could be lower what would be a level I could tolerate. Well to this my immediate answer was; I am tolerating my pain level now otherwise I would be screaming and going insane. By this point I was clearly confused by the question and the nurse was not finding my answer sufficient so after about a 3 minute conversation of trying to explain to me what the term “Pain Goal” meant I gave up and said well I guess I five, just because I have no idea what you mean. So maybe this just isn’t a question for people who deal with chronic pain or maybe I am just endlessly confused. However my pain GOAL is zero... I find that logical! 

A much more realistic pain scale!