Pain and the Perfect 10

“How would you describe your current level of pain on a 1 to 10 scale?” The nurse pauses with her pen over the clipboard awaiting a response. Simple enough questions, but what’s a 10?

Would that be like the migraine I had in my 20s that put me in bed for days—when a relentless deep throbbing pressure made the back half of my head feel like it would literally blow off and when the pain needle stabbed from the base of my skull to my eyeballs until I threw up—and then continued to stab with every movement of my head? Was it the so-deep-you-can’t-rub-it-better gut pain of that kidney stone and infection when I spent the night on the floor of the bathroom, trying not to wake my husband and finding some measure of distraction from the cold tiles on my feverish body? Was it those long-ago clenches of labor that began in my back and radiated to my swollen belly and made me yearn to sit down and double over?

No, the winner has to be the time when the myelogram needle left my dura torn and leaking spinal fluid—for a month—and they finally had to do an epidural patch. The male nurse, no doubt chosen for his strength, murmured comforting apologies while he pinned me to the table in a fetal position. I dared not move, even reflexively, while the doctor injected 10ccs of my own blood torturously slowly into the epidural space to patch the leaking hole. Years later, an anesthesiologist friend was surprised to hear that this had been so painful, but it was the winner of the perfect 10 for me. For months afterwards, if I curled up during sleep into that fetal position, my dreams would awaken me in tears from the remembered pain.

How can the 1 to 10 question have any meaning if the inquiring nurse or doctor doesn’t know what you’ve experienced before? And how can you explain in that 3-second interview what you are equating it to? And, then of course, the big question—what can you do with the pain.

Some say it’s best to deny it. Some say to embrace it until it passes like a rip tide that’s best not to fight lest it exhaust you. Those with chronic pain caroom from denial to acceptance and stop at all points along the way. Sometimes it seems I even taunt it, dare it to come out of its hidey-hole so I can deny it—and its power over me.

These last decades of acute episodes, physical therapy and spinal surgery must all be a bad dream or at least a lack of will on my part. After all, who’s in charge here – me or the body I would be master of? If I choose to pull those offending weeds for a meager ten minutes, how dare my neck launch a thousand spasms, wake me at night or seize up so I can’t turn my head?  It’s humiliating to look like an otherwise healthy person who must re-pack grocery bags to make them lighter or duck a fair share of labor around the yard or tell a beloved toddler I can’t lift her.  Sometimes the humiliation of the moment overcomes the little voice yammering in my mind’s ear, “Don’t do that. Use your head, you fool. Remember how you’ll pay for this.” And then when the ol’ body asserts its primacy over my will, along with paying the pain price, there’s a simmering resentment of my body’s betrayal.

Of course, there are always drugs, especially muscle relaxants and anti-inflammatories.  I’ve learned to save the muscle relaxants—they make me too dopey to function at work, so only use them when I’m desperate and when it’s bedtime. I learned never to be without the OTC drugs—a few in my desk, the car, overnight travel bag, briefcase, pocket. It’s much cheaper to buy them in bulk. But, what do you do when your body completes the betrayal and gives you heartburn, stomach pain and diarrhea? You forego any relief for as long as possible, and then you begin the next grand bargain.

Maybe, if I take only one instead of two …. Maybe if I take it with an antacid and plenty of food instead of alone …. But, after years of practice, the body’s learned a thing or two about negotiating its mastery over my will. The balancing act moves to an Olympic level, and the cranky body applies all its well-learned tricks.  And, in this competition, pain may not win style points, but it scores a perfect 10.