All kinds of pain and a good sale

He was very young.

He wore a white coat with an official looking badge with his picture and his title, Physician Assistant.

“On the scale of one to 10, how is your pain today,” he asked with that serious but friendly look that hospital staff have.

I thought about this.

Full of a derivative of opium or something like that, I could not really answer him.

He said, “One to 10.”

He didn’t say zero. I felt fine. I said two. I lied. I think it made him feel better.

I mean, how can you judge something as personal as pain?  My two could very well be your 10 or vice-versa.

That does pose a problem for studying pain, how it’s generated, measured and how it may be treated.

Pain is physical, psychological and social, mediated by your nervous system and context.

Pain is perceptual. Athletes will tell you that they often do not notice pain until after they stop playing and any mother will tell you that she can kiss away a booboo that started out with giant cataclysmic wails.

Even I, as a volunteer in the Emergency Department, can engage a patient who has reported discomfort in a conversation which, for a time, lessens the perception of that pain.

I’ve had some very interesting conversations about kitchens,  roof repairs, wineries and crochet stitches.

We have all sorts of pharmaceuticals to control pain.

There are those which you can buy over the counter, each with a warning label telling of calamitous consequences to your innards if you use it incorrectly.

There are those that can only be obtained legally by prescription, which also come with similar dire warnings about addiction. The media is full of stories about the latter and how the use of opioids has become an epidemic.

Recently several magazines did pieces on pain and opioids. The magazine also recognized the dual nature of pain perception and based on that gave a list of things other than medications that person feeling pail could try.

Among those suggestions were things we might consider to be non-traditional fixes including guided imagery, yoga, massages, acupuncture, biofeedback, meditation, chiropractic, even making new friends.

Pain meds were to be reserved for the initial treatment with a healthy combination of activities on the list to follow. Each of the pieces made reference to the powerful relationship between the patient and the care giver. The role of the care giver was paramount in not only guidance but in provoking positive responses and lessening the perception of pain. We may want to call this what we’ve always called it, “bedside manner.”

They might just be on the right track.

Yesterday, when it was my birthday and I, deciding that I would spend my day doing something other than my daily list of “to dos,” went shopping.  Armed with a hefty gift certificate and a $20 off pass, I headed out to the BonTon.

I haven’t been shopping for myself for clothing in quite some time as anyone who has seen me in the last 15 years will attest. Shopping is painful for me. All that trying on of stuff that doesn’t fit. All of that disappointment! Still, I was determined to overlook the anticipatory discomfort.  Who knew?  I might find something. Talk about the triumph of hope over experience.

After about an hour of what bordered on physical pain as I found that pants tagged as the same size of the jeans  I was wearing wouldn’t fit my arm let alone my legs, I took a break. I had to buy something.  After all, my spouse had actually stopped at the store and picked up the gift certificate. That must have been quite discomforting for him.

I headed to the lingerie section. Here I was sure of size. Sort of.  And then there was the fact that there was a big sale going on.

They seemed huddled tightly together.  The racks of female undergarments intertwined like invasive vines so that you needed strength to work your way through a jungle of Olga’s, Warners, Bali  and  Playtex bras and panties.

Determined, I pushed, moved and pulled my way through to the display on the wall that displayed the name of the garment I wanted … to find a remarkably  telling example of both physical and psychological discomfort.

A white haired gentleman was sitting on a chair surrounded by taupe, white and violet brassieres. He was holding his wife’s purse. It is difficult to describe his face. Think of knowing that an asteroid was about to hit the spot on earth where you were sitting. I wondered whether guided imagery would have helped.

One a scale of one to ten?  Eleven.