Sometimes, our wellness (or level of wellness, or at least the extent to which we hurt) depends on our ability to adequately communicate our answer to a seemingly simple question: “How are you feeling?”
Why It’s So Hard To Talk About Pain
It’s not so easy to answer when you hurt all the time. There’s the often-used and completely inadequate “scale of 1 to 10″ frequently trotted out by doctors and nurses. It’s a start, certainly, and it’s better than having them ignore your pain altogether or treat your pain as inconsequential. But it’s wholly inadequate to convey fully the nature, scope, and quality of your pain, nuanced as it is.
And then there’s this: how many people really want to hear your description, even when they ask? Think about it. Pain is one of those incredibly complex and highly personalized experiences that defy true explanation. And on top of that, human nature is such that when we start talking about our pain to others, we often get in response blank stares, followed quickly by fidgeting, casting about visually for something - anything - to “rescue” the conversation away from talk of pain, and generally demonstrating a high degree of discomfiture.
Responding To People Who Are Uncomfortable Hearing About Your Pain
Why does hearing about someone else’s pain make us so uncomfortable? That’s probably subject enough for a separate post. But for purposes of this one, let’s focus on you, the patient, the person describing the pain. If you’re faced with this kind of reaction, what do you do?
It might seem incumbent upon you to change your approach. Some would speak more quickly, edit out their words, wrap it up quickly, or even minimize the pain itself in an effort to “fix” the other person’s reaction. This is a highly dangerous approach, and it’s the wrong one to take.
A better way to handle it? There are two, depending on the purpose of the conversation. If you’re speaking to a medical professional, and you’re getting a response that indicates disinterest or discomfort, you need to stop talking for a second. Just pause, get the medical professional’s attention, and say with as much of a “smile in your voice” as you can muster, “It seems to me I’m making you uncomfortable but I really need you to hear me all the way through on this. Do you need a second to regroup and let’s try again?” They have ethical duties to treat you, and you have a right to expect proper treatment of ALL your symptoms, including pain. They cannot do that job appropriately without hearing you out fully, so you’re doing them a favor. (And, of course, yourself.)
If it’s a casual or work acquaintance who’s asked “How do you feel?”, well here we have some more room to play. You have to decide for yourself how much to say. You don’t owe them a full explanation, and personally, I never even get into the details of my pain with casual acquaintances. For family and friends - I mean real friends, who honestly care - it’s a judgment call on a case-by-case basis. If I feel I have their attention, and intuitively feel it’s right to tell them, then I’ll describe the full gamut but as generally as possible. For instance, I’ll say “My back is hurting quite a bit in the SI area, but the other trigger points are OK, thankfully. No other major symptoms today. And how are you?” instead of going into the fact that the IBS acted up last night, and that made sleep next to impossible, etc.
The Four Aspects of Pain
Back to the medical pros, though, for a second. It’s really crucial to explain the fullness of your pain to these folks and to do it in such a way as to communicate four major aspects of your pain:
- The situs - the physical location of your pain
- The quality - burning, throbbing, stabbing, aching, tenderness, sharp, stinging, dull?
- The severity - 1 to 10 might not be enough. Use a 1-100 scale to give better detail.
- The pervasiveness - is it constant? Come and go? If so, give a range (again, 1-100) as to each end of the spectrum you’re experiencing.
Other Important Information
Don’t forget that you need to explain to your doctor and nurse other vital information about your pain. When did it start? Does it get worse or better with any particular method of treatment, position, or activity? Does it radiate anywhere, or is it highly localized? How long have you been dealing with it? What about your pain prompted you to seek treatment?
And then there’s this - consider using your intuition. Depending on how receptive your treatment professionals are, they may be interested in knowing your input on what you think is up with your body. They may not be - but if not, and there’s some aspect of your pain that you feel pretty strongly about, there’s a way to include that in the conversation without triggering any super-scientific-types’ “New Age Meter” (you know, that little alarm system that goes off in a doctor’s head that makes them tune out anything you say that’s the least bit holistic or mind-body?). Just attribute it to the other side of your brain - “I wonder if … ” or “I was thinking that …” Alternatively, enlist the aid of a family member who can speak up and ask, “Doctor, I was reading about _______- do you think that could be at play?” or, if they’re not in the room with you, “My sister read about ______ and wanted me to ask you about it.”
Knowledge: The Most Powerful Weapon
Bottom line: it’s your pain, and it’s a highly personal experience. Communicating it fully and adequately to your medical team is crucial for proper care, and communicating it to loved ones can be crucial for your relationships. It can be hard to think of new words when things really go south for you, so spend some time when you’re feeling better thinking of your pain, and the right words that describe it. That way, when you do experience a flare-up, you’ll be armed with the most powerful weapon of all - knowledge.
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