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Opening Arguments


Asking patients to rate their pain is not that helpful:

It may be a painful truth, but a new study suggests that attempting to measure pain on a scale of 0 to 10 may not help doctors effectively treat the suffering.

The findings, published in the October issue of the Journal of General Internal Medicine, claim the commonly used numeric rating system failed nearly a third of the time to identify patients whose pain was serious enough to impair their day-to-day functioning.

Researchers attributed the results to the subjective nature of pain, the reluctance of some people to admit their suffering, the propensity of others to exaggerate, and limiting the scale to measuring patients' current pain level.

"There are a lot of different influences on the numbers people give," said lead researcher Dr. Erin Krebs, an assistant professor at the Indiana University of School of Medicine.

"Some people are really very stoic and may be in obvious pain but give a low number because they can imagine a much more severe pain.

Other patients might give a higher rating because they're anxious and they want the doctor to pay attention."

I can give you both the 10 and the 0, at least from my subjective perspective.

The 10 is from something called cluster headaches, which I have suffered from since college (though not in the last few years, thank God). They come about once a year and last for about three weeks, one or two a day, about a half hour to 45 minutes in duration. They consist of a stabbing pain behind my left eye, from the top of my head all the way down my neck. There is no way for you to understand the intensity of the pain unless you've experienced it. The only way to get through it is just to curl up in a ball and whimper like a baby until it goes away. Nothing rational or remotely productive is possible. Whenever it happened at work, there was no option but to go into the restroom and hang out in a stall until the episode passed. People do not want to see a co-worker curled up in a ball and whimpering.

The 0? When an episode passes. If pain completely consumes you, there is nothing like its abrupt departure. It's the best you can ever feel -- just the return of normalcy.

Extrapolate that to the macro level, and it probably explains a lot about the history of the world.


Bob G.
Wed, 09/19/2007 - 1:56pm

Leo....I feel your pain...no, really, I do.
Honest to God.

It ain't easy being arthritic.
This "old" thing is way overrated.