Monday, July 13, 2009

TRUTH, LIES, and the SEVERITY OF PAIN

by Gina Sestak

There are three basic principles of lying.

The first, and most important, principle is this: NEVER LIE.

The second: IF YOU DO LIE, DON'T LIE ABOUT ANYTHING THAT ANYONE CAN CHECK. In other words, you may be able to get away with making untrue subjective statements such as, "I think your hair looks fine." You shouldn't say, "Penn Avenue doesn't run through East Liberty." Someone will pull up a map and catch you every time.

The third basic principle of lying is: IF YOU DO LIE, NEVER ADMIT TO ANYONE THAT YOU HAVE LIED.

I am about to violate that third principle.

I recently required hospital treatment. During the tornado warning a few weeks ago, I was sitting on my cellar steps, watching empty laundry detergent bottles float around in the water that was flooding into my basement, when I began to experience severe chest pains, accompanied by shortness of breath and nausea. I stayed where I was until the tornado warning was over, then I went upstairs and vomited for awhile. When it became clear that this was not going to resolve itself on its own, I called 911 and was taken to Shadyside Hospital by ambulance.

One of the first questions I was asked upon arrival in the ER concerned the severity of pain: "On a scale of one to ten, with ten being the worst pain you can imagine, how severe is your pain?"

That's a trick question if I ever heard one.

I am a writer. The worst pain I can imagine is really, really bad. Level 10 pain would definitely cause me to lose consciousness. In descending order, the levels of pain, as I imagine them, are:

9 Fall to the floor screaming and writhing uncontrollably.

8 On the floor, moaning and shaking.

7 In fetal position, whimpering.

6 Unable to think of anything except how bad this hurts.

5 Able, with concentration, to form a coherent thought.

4 In severe pain, but generally rational.

3 Able to push the pain into the background.

2 Able to ignore the pain some of the time.

1 Able to ignore the pain most of the time.

0 Not in pain.

My level of pain was around a 5 on my scale, but I know from when I tore my Achilles tendon that if you tell medical personnel your pain is around a 5, they respond, "It's not too bad, then." They must not be able to imagine very severe pain.

I admit it. I lied. I told the ER staff that my pain was at level 8 or 9 and they admitted me.

After extensive testing, which included a cardiac scan and the removal of what seemed like gallons of my blood, one vial at a time, they determined that I hadn't had a heart attack. It turned out that a gallstone had gotten stuck in a duct; they were able to go down my throat with an endoscope and unstick it. Problem solved. Still, I'm convinced that if I had characterized my pain as level 5, I might have been sent home with instructions to take Tylenol. Sometimes, imaginative writers really have to lie.

So, fess up. What have you lied about? And how do you feel about pain?

9 comments:

Annette said...

I've been pondering the pain scale thing myself lately. I threw my back out several weeks ago and am still trying to fix it. Most of the time it hovers at 0-3, but when I move certain ways, there is a jolt of pain that takes my breath away. Nine. Definitely nine.

As for lying, as fiction writers, don't we lie for a living? That is IF we're lucky enough to make a living at it. Which I am not. No lie.

Joyce said...

Annette, go to the chiropractor!

I'm not a good liar, so I'll stick with lying in fiction.

I have a pretty high tolerance for pain. I even walked around on a fractured knee for three weeks without knowing it. In my defense, the fracture didn't show up on an x-ray--only on an MRI that was ordered three weeks later when the swelling wouldn't go down. The only thing I took for pain was Advil. It worked fine.

Gina said...

I'm like you, Joyce. I walked around on a broken ankle for two weeks, although it didn't hurt really really bad until the swelling began to go down, allowing the broken bone to move.

I generally avoid taking pain medication because, as far as I can see, removing the pain has the effect of cutting off your body's natural communication system. You may not be able to tell what you're doing to aggravate the injury without pain feedback, and so you end up taking pills and feeling pain for years instead of resolving the problem in a week or two.

PatR said...

I have a fairly high pain tolerance as well, which sometimes confounds the doctors. But I can tell when a bone is broken or an appendix is about to burst because I almost pass out. Still, when I shattered my big toe in 14 places on cement stairs while walking into church (no lie), I managed to hobble to the car and drive home. I think most women have high pain tolerances, don't you? But this blog makes a good point -- think about the medical world's definitions of the pain scale....and you're more likely to get cared for!

Annette said...

I HAVE been to the chiropractor, Joyce. And I'm going back tomorrow. It's one of those things that is aggravated by sitting too long. As long as I keep moving, no problem.

This makes it difficult to get my writing done.

Pat, I don't want to talk about appendicitis. That was one of those cases of the hospital not thinking I was in enough pain, so they delayed surgery for almost 36 hours and by then gangrene had set in.

Yes, everyone. LIE about your pain if you want medical attention!

Wilfred Bereswill said...

I have degenerative disc disease. As horrible as that sounds, I think it's more of a generic term. In other words, the discs in the cervical area of my spine are thinning out.

From 1998 to December 2000 I had severe headaches. They originated in my neck and radiated to my right shoulder. I actually thought it was a shoulder issue from playing softball and had several cortizone shots. They didn't help.

Finally, I found the right doctor and he diagnosed the problem. I did a year of physical therapy to no avail. I was getting crabby and hard to live with and decided on the surgery to remove the disc and fuse the area. Best thing and worst thing I could have done.

Let's say that the neck pains are returning. The disc below the fusion is starting to thin, putting pressure on the nerves. It's not severe enough to have surgery, yet. My research has found that they now have disc replacement which I inquired about. However the insurance companies won't [ay for the procedure. It seems fusion is cheaper. However fusion causes loss of mobility and for an avid golfer who has already lost some mobility and shortened his backswing, that is a big issue.

So yeah, I know about pain. And Annette, go to a real doctor. Sorry Joyce, not a fan of chiroprators. Bad experience for me.

Annette said...

Ouch, Will.

I've been going to my chirpractor for almost 20 years, ever since I got bucked off my horse and landed in a shoulderstand. Between him and my yoga practice, I can usually keep my spine in good shape. But, yeah, I get seriously crabby when something slips out of whack.

Joyce said...

The problem I had with going to a medical doctor when I herniated a disc (I tried to kick higher than my leg wanted to go) was that the first thing they want to do is put you on muscle relaxers and pain meds. Muscle relaxers are the absolute WORST thing to take for back pain and spasms. Back spasms are your body's way of protecting your spine!

Going to a chiropractor was the only thing that helped my back. He was gradually able to keep the disc from slipping out of place. I also have degenerative disc disease, but daily back stretches and weight training keeps it from getting worse. Condroitin and glucosamine are supposed to work very well but I haven't felt the need to try them yet.

Will, have you looked into Vax-D? I don't know much about it, but someone told me once that it was a good alternative to surgery.

queenofmean said...

I hate when they ask that question about your rating your current pain. First off, if I'm in enough pain to go to the ER, then it's pretty high up on the scale. Second, any pain I'm CURRENTLY feeling is worse than any pain I've had in the past (the memory of which has faded by this point).