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Rate your chest pain

Posted Monday, February 27, 2012, at 1:40 PM

What has come to be one of the most irritating questions nurses ask, have to ask is, "How would you rate your chest pain on a scale of 1 to 10, 10 being the worst pain you've ever experienced?" Usually this is asked at a time when the pain makes thinking of numbers a major mental task.

Let me start with the caveat that a life-long problem with nerve damage has led to addiction to codeine based drugs. That, for the record can definitely be a "10." Very few mere chest pains have come close to "10" territory.

Also, I'd really gotten used to the 1 to 5 scale used by Union Hospital for the first 12 years we've lived in Indiana. They even gave me (ok, I scrounged it) a nifty 1-5 Pain Assessment Ruler with 0-smiley to 5-crying faces with descriptive definitions. At some point Union changed to the 1 to 10 criteria to be in line with everyone else. Everyone else but me.

Having most recently been asked for a rating, and assuming need will again arise, I've decided it's time to update my Chest Pain Assessment Ruler (as compared to nerve damage pain):

0 -- Indomitable. Take my pulse, I feel so good I must be dead and in heaven,

1 -- Indifferent. Truthfully, I've had an itchy nose that felt worse,

2 -- Irritation. I think it was Joan Rivers who said the bad thing about a cold is you're sick enough to die, but not sick enough to get any sympathy,

3 -- Indigestion. Okay, it's in my chest; but there're a lot of other causes for this level discomfort,

4 -- Indecisive. Hey, I've experienced heartburn, stress, and injury; this ain't that,

5 -- Informative. As in, maybe its time to admit it hurts and "tell an adult you trust,"

6 -- Indisputable. Now it's obvious to any passing stranger -- any one of whom knows the number for 9-1-1,

7 -- Intervene. Never ask someone if they want to go to the hospital (who does?). Just ask, "Which hospital,"

8 -- Incoherent. Please feel free to administer any desired quantity of morphine, oxy, or that stuff of which Michael Jackson was so fond,

9 -- Incomprehensible. Never tried it myself, but think this is point at which it hurts only for a short time, followed by being unconscious, and

10 -- Infinite. Take my pulse, I feel so bad I must be dead and not in heaven.

So, dear as yet unmet future nurse, if its chest pains this patient with 15 years of chest pain experience is describing, don't wait for a number. Just pop two nitro pills in me and I'll call Dr. Dalloul in the morning.

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David L. Lewis
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