Thursday, November 26, 2009

Do Re Mi Fa So La Ti Do

I was faxed some forms to fill out in anticipation of my doctor's appointment on Monday and it contained a scale that I am already finding useful. It's a pain scale which allows me to describe my level of pain at any given time. I made a copy for me to carry around in my pocket because I am often asked to describe my pain on a scale of 1 to 10 but my scale is likely different from the person who is asking so this will allow me to be more consistent with my answers.

It will also allow me to keep track of my pain. I've been tracking my drug intake since they were first prescribed on 10/17/09 but not my pain levels. (As of this moment, I've taken 214 pills of one variety or another.) I've only kept sporadic notes about the treatment I've received so far and the activities I've undertaken or avoided.

So today I got a spiral notebook and I'm keeping track of everything. I left some blank pages so I can go back and fill in as much as I can of what's happened since this began, as well as some relevant history. (I've been having acute back issues for almost two years - which, I guess, now qualifies as chronic.)

I suppose my doctors never anticipated I would be having pain this long. I know I didn't. But I think this scale - or something like it - should be "standard" when a patient calls or comes in complaining of pain. It would provide for much clearer communication upon which all health care is based.

Keeping a log should also be standard advice. I'm not just seeing one doctor, I'm seeing several. In a perfect world, my log would be online, secure, and available for viewing by any doctor I see. Even on paper, it gives the patient the ability to monitor progress and setbacks somewhat more objectively and, again, allows for clearer communication between doctor and patient. This seems like a "Do!" concept.

Another item which should be standard for patients complaining of pain, is a list of questions regarding activities that are limited by the patient's pain. This seems obvious to me but I wasn't given such a questionnaire until November 20th (after almost seven weeks of suffering) by a chiropractor from whom I have been seeking treatment.

I have to mention, this chiropractor has given me the most thorough exam to date with regard to testing reflexes and range of motion, as well as this questionnaire regarding activities which may be limited by pain. I am most grateful for his careful attention. He gave me his cell phone number and he called me over the weekend after my first treatment to see how I was doing. I understand that compared to the hospital with which my health insurance is associated he is just a little guy. And my doctor, as part of this huge organization, doesn't have the time to contact her patients for follow up. But I really appreciated his attention.

Anyway, my point with the questionnaire is that such a tool would offer another means of clearer communication between patient and doctor.

It probably would have been a good idea for my doctor to do a more thorough exam, come to think of it. She interviewed me, moved my leg around some, and judged my hip pain to be related to my back, not my hip. (This will be subject of a different entry - the name back(b)log is something of a misnomer as I don't actually have back pain.)

Finally, here's the pain scale:

0 = No pain
1 = Some pain but OK
2 = Mild pain worse
3 = Annoying pain
4 = Distracting pain
5 = Pain can't be ignored for long
6 = Pain can't be ignored at all
7 = It's hard to think and sleep
8 = Pain limits activity; nausea
9 = I cry out in pain
10 = Passed out

I'll write some more later about where I've been hanging out on this scale. I'm just thankful for the day, the ability to get out of bed, and (relatively speaking) my health.

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