There are several levels of pain. The medical profession likes to have you rate it from 1-10. Hah! There aren’t comprehensible numbers to describe the places I’ve been. For a time, I refused to use numbers at the medical inquisitions. I am and always been a mathematician. Numbers are my friend. Why in the hell would I want to assign something so evil to the body of science I love the most and has provided me the only grain of stability in my life? Additionally, I learned that 10 was rarely high enough of a number.
When I first was introduced to the “Rate your pain 1-10” questions, I was barely cognizant of my own situation. I remember the day. It was a Tuesday. December 20th, 2016. The dates from the 17th to the 20th are burned into my existence. On the 17th, a Saturday, my youngest daughter and I were shopping for a Christmas present for her stepmother. It was the first time she insisted on getting my wife a gift. There was pain, but I ignored it and we went. At about 2/3rds of perusing the store, my back gave out. I didn’t know what was happening, I just knew we needed to complete the purchase and get home.
Driving home, the pain was excruciating.
The following is from my daughter:
I remember the 17th pretty vividly. I had just gotten home from school and dad had called or texted and let me know to get ready to go out. He pulled up as soon as I got my shoes on and went to the drug store after he had come in to take some Tylenol. On the way there, he was quiet, and I thought he was mad at me because he was so quiet. Turns out, he was just hurting, something I have come to learn in these 5 years. We went to the drugstore no problem, but the Christian store we went to for the gift was different. We went through quickly and Dad had told me after about 10 minutes that we had to leave. We hopped in the car, and he was super quiet, and his brow was super furrowed. He looked mad. He was quiet and just letting me speak. He kept muttering to himself and making hand movements. I asked if he was mad at me, and he responded with an angry sounding “no. Just thinking.” I figured he was just frustrated about work things. We got home, he laid down, and he never really got back up after that.”
Hali R. “Doc” Theriot
Somehow, on Monday, I made it to my work location about 45 miles away. I had to leave early because of the pain. Tuesday was a doctor’s appointment. I couldn’t assign a number to the pain level. The doctors sedated me until the scheduled MRI on Friday. The MRI showed nothing. That weekend was a horrible Christmas as I continued to be in incredible pain.
It was not until months later, when we finally arrived at the fact that my issue was neurological and not structural nor arthritic that caused my pain and lessoning function. In those months, I saw several groups of medical persons. The first was the family doctor, who thankfully sedated me. The second group were the “pain management” doctors. They injected sedatives into my back. That was the first time I saw someone write a 10+ on my chart. I was barely aware of reality at that point. The Propofol sedation felt great. At the date of this writing, Propofol is the only medication that takes the pain away as it forces the muscles to relax. Upon waking, there is a short time when I can function normally. I understand why Michael Jackson died from Propofol use. If the man had pain he couldn’t control, this really is the only solution.
The third group were physical therapists. According to insurance, the physical therapists were supposed to come before the “Pain Management” bit, but the office was closed for the holidays, so an exception was pleaded for and granted. Another month of excruciating pain went by. I did enjoy the warm stone massages at the end of the therapy sessions. They did give a measure of relief for a short time, about 15 minutes. But, when you are in considerable pain, you take what you can when you can. It is a survival technique.
After paying my respects to the required 6-week delay of mandated physical therapy following another insurance imposed 8-week delay of spinal injections where I developed a love for Propofol, I was given the choice of seeing either a rheumatologist or a neurologist. Considering my kin all have varying degrees of advanced osteoarthritis, my choice was obvious. I was finally going to see a specialist. Mind you, during all this time, my situation continued to be untreated. There was no medication that could be prescribed. This was 8+6+3 = 17 weeks or over 4 months of pain, that, as the nurse wrote it, 10+ pain. My wife and my hopes relied on this rheumatologist for relief.
I received what was the most comprehensive examination by a medical profession to that date. Then redirected to a neurologist. The, rather prominent, rheumatologist said, “Yes, you have osteoarthritis, but this…” as he waved his horizontally outstretched hand the length of my body, “…is neurological in nature. I don’t want to see you here until after you are cleared by a neurologist.”
For some crazy reason, the appointment to the neurologist only had about a 3-week waiting period. Never have I taken so many OTC NSAIDs. In all, I remained untreated from mid-December 2016 until April 2017, just under 5 months of incredible pain. My first Baclofen script was my savior.
Numbers attributed to pain levels are a tricky thing. The number 1 is unary. It represents the single element or object being measured. The actual object is arbitrary to the person making the assignment of the measure. Level 1 pain means nothing scientifically or mathematically. Why doctors use the 1-10 scale is beyond me. What, I presume, they really want to know is if you can function with the pain that is in your body or not. What is telling, is that if you rate your pain at 3 – 5, you are prescribed opioids for pain. I would not take opioids, or any other pain medication until I reached my definitions of 7 or 8. At seven, I would start praying that I would not get to eight. Nine, I could barely know my name and ten, wasn’t coherent thought. I figured that if I could bear it, I didn’t need pain meds. I never dropped below 5. It reasoned that if I took the medication according to the doctors’ instructions, I would be stoned out of existence around the clock. That was not who I ever was nor who I ever wanted to be.
This thinking carried with me until now. Five years later, my spine, which originally had 1 minor spot of osteoarthritis, is now destroyed. MRIs read like the following: T2-L1 bulging disks. Many times, the damage done to the vertebrae are given in ranges. I guess, to save time and ink. It is foreboding to look at a list a page long or more for each segment of the vertebrae in your spine. You spend hours looking up words you don’t know and then more time crying because you know them.
When the pain gets to this level. Your brain ceases to register it as pain. At lower levels, the pain is debilitating. At higher levels, you do things because the pain doesn’t matter anymore. However, you do become limited. At times, the limitations are mental, other times they are physically debilitating and leave your body covered in bruises from the torn muscles in spasm and in spasticity.
I’ve been in extreme pain, pushing my limits of concentration, thoughts, personality, anger, frustration, lucidity and destruction since 2016. Occasionally, I will have moments of clarity and think, “Wow, I was in a lot of pain.” I have a myriad of medications that I take to fight the symptoms. I wish I could claim that we have found something that works. However, much of the pain is caused by faulty signal processing by the various branches of the nervous system. For those, there is only meditation.
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