AIBU to think that HCPs are allergic to the word pain??

[OwlBeThere]

This is only semi-serious, but actually sometimes it’s really unhelpful and makes a situation worse.
Every time I see any kind of health care professional they will use words like ‘sore’ and ‘discomfort’ when what they mean is ‘painful’ and ‘it fucking hurts’.
I heard it when I had a hysterectomy, when I’ve had biopsies, when I had my wisdom teeth out, when I broke my femur(?!?). None of those things were uncomfortable they hurt like fuck and not acknowledging that either makes you think it’s not going to be so bad (ie lumbar puncture) or makes you feel like you’re causing a fuss about nothing (definitely bloody not with a snapped thigh bone or a raging infection in my hysterectomy scar).
So why does it happen? Do they imagine it helps people? Because it doesn’t.

Completely agree, OP. YANBU.

I was explaining my chronic pain to the specialist who was reviewing my scans.
He could see the disc degeneration in my spine and the fact that one of my hip joints is bone on bone.
He said 'Yes, I imagine you must be in slight discomfort'

SLIGHT DISCOMFORT.
No. Say it how it is. I'm in hideous amounts of pain. It fucking hurts.
And if you're trying to use the 'slight discomfort' buzzword to prevent me from taking stronger medication, you are wasting your time.

Makes my blood boil.

An HCP told a relative that because they have autism, the pain they think they feel isn't pain, it's just a different sensation so they should just tell themselves it's not pain, it's a different sensation.

I puzzled about that for ages until I thought the HCP possibly meant sensory issues, like a light touch being experienced as pain.

The thing is, the pain my relative has which they described to the HCP could in no way be a sensory issue, sensory issues have a cause, these pains " like an electric shock" but much, much more intense than static (I wonder if it's some sort of nerve pain) in arms or legs come out of absolutely nowhere, they happen when standing, sitting, lying down, all times of day and night, in all weathers and temperatures. There is no cause before the 'electric shocks' are felt, but they can reduce the relative to tears because they are so intense.
Sometimes they occur as just a few 'shocks', sometimes they last sporadically all day. They can come and go, sometimes there will be several days of them, other times there will be none for months. They have been occurring since childhood and so far no-one has explained what they may be or how to treat them.

If you have pains like this, please let me know what you've been told about them and any diagnostics or treatment you've been offered. If you're an HCP have you had this type of pain explained to you and what did you decide it was?

Ah yes patients lie.

I was saying I was at 8 when in labour. The midwife told the dr I was hysterical and needed to calm down. Dr came and said he would examine me to see how long I had left. Baby was crowning.
Midwife was apologised and said I seemed to calm and in control to be that far along. I was talking and in control so she didn’t think I was even at the pushing stage.
So I am sure patients lie but patients aren’t robots who will behave exactly like the textbook say.

@Iamworst, when I was in labour I had a doctor say about me, not even TO me ‘she isn’t in that much pain is she? She has an epidural, she can’t feel or move that leg’ because I was screaming in pain st the cramp in my calf.
So I kicked him with my leg I couldn’t move. (I’m not proud of this, but desperation does things to you). When they checked the epidural wasn’t sited correctly.

I don’t at all think it’s ALL hcp’s that do this, nor I’d this a bashing of the health service, without it I’d be dead, but I do think there is a lot of truth in what the pp (sorry I can’t remember your name) said about the pain being almost secondary to some doctors.

What a bloody ridiculous thing to say. Are you in any way qualified, or just bored on a Sunday morning?

Very qualified, thank you.

How would you suggest I handle the situation, if I am supposed to believe every patient who tells me their pain is a 10, but does not act in any way like that is true? Their symptoms, their diagnosis, their actions, do not in any way show an agonising, could not get any worse, shark biting off a limb kind of pain. How do I proceed?

And it works the other way too. Patients in agony, screaming, sweating, unable to eat or drink, tachycardia, telling me their pain is a 5.

We are trained to assess physiological signs of pain for these exact reasons.

*would have thought as an HCP you'd recognise the risk associated with generalising and turning "all patients" into a homogenous blob.

How patronising is that. Just becauseonepatient is eating a sandwich does not mean you should make sweeping statements about how patients describe their pain, across the board.*

Except that I never said all patients, because that is not true, and WOULD be a worrying statement.

*janethat attitude is very problematic for the 99% of patients who are not drug abusers.

Pain IS what the patient rates it at.*

It's not just about being drug abuses though. Many people feel if they say a higher pain score they get seen faster, treated better. Which is of course not true.

I'm not saying people are not in pain, I'm saying that if HCPs solely went by patients own pain score we could very easily miss something, or treat someone unnecessarily.

Pain isn't what the patient tells you, because patients lie.

And this is why I don't trust HCPs. If you're so thick you can't judge who's a drug abuser and who isn't, you're too stupid to be in the job, unless you're a sadist, which wouldn't surprise me.

Totally agree with PP who wasn't deemed to be in pain because she was so calm.

I'm a physio, I'm obsessed by pain. I want to know exactly how it feels, what words describe it, where it is etc.

I think it's also incredibly unhelpful to say that patients 'lie'. Maybe HCP don't explain the scales properly?

My description of a '10' on the pain scale is 'pain so bad it kills you'. This makes patients think, because if they say a 10 and are still alive..... Or if they say a 9 and the pain then worsens..... It's all in the explanation.

I also think many patients (sadly, with good reason) believe they won't be taken seriously unless they exaggerate their pain. So again, I explain about how pain (apart from immediate traumatic pain that triggers reflex withdrawal) is ALL a construct of the brain, and doesn't correspond to how serious a problem is, but it does give me vital information about how the treatment is working or not working, and so I need them to be honest. I also give the example of how a paper cut can be agony, but someone can have a serious condition and be in no pain - I use the example of the Cup final goalie who broke his neck but continued with the match.

On the other hand, there is research that suggests that if you tell someone that an experience will be painful, it is more likely to be painful. I suspect this is behind the 'this may be uncomfortable' approach. When someone is in pain though, there is no evidence to suggest that downplaying it is helpful.

Where HCP could really help is in pointing out the difference between 'painful' and 'serious'. Sometimes just understanding that nothing life-threatening or long-term damaging is going on can decrease pain, because of the complexity of the causes of pain. Pain is not the simple 'tissue damage = pain' that patients believe it is.

As for pain in labour, forget it! 'In sorrow shalt thou bring forth children' seems to be MO in labour units.

And this is why I don't trust HCPs. If you're so thick you can't judge who's a drug abuser and who isn't, you're too stupid to be in the job, unless you're a sadist, which wouldn't surprise me

Oh do grow up.

I think hcp’s need to offer context for the pain scale e.g. if 5 is stubbing your toe what’s your pain? Even that isn’t foolproof since if I had pain like that in my toe constantly that’s pretty bad but it’s all about context.

Oh do grow up.

Oh do try not to be so patronising, it's incredibly unprofessional and indicative of an extremely unpleasant attitude towards life.

One thing that is so very obvious to me now. Mumsnet seems to really hate NHS staff. There are multiple threads daily from people complaining about the most minor of inconveniences, the tiniest of percieved slights. And yet when one HCP tells you that maybe your fellow NHS users contribute to a problem people seem to be having, they couldn't possibly be at fault, it's all the NHS staffs fault.

In this very thread the OP admits to purposely being violent to NHS staff and not one person has even batted an eyelid. Its truly ridiculous.

JaneTheVirgin

God, I missed that. That is awful.

Oh do try not to be so patronising, it's incredibly unprofessional and indicative of an extremely unpleasant attitude towards life.

You do know my job would be 10x easier if no one was in pain ever, right? Like personally i would truly love to give every patient morphine, or codeine, or tramadol. Makes my exam easier, makes patients happier, makes my day smoother. This isn't about withholding pain medication. Its about having to use my professional judgement to accurately assess who needs what kind of medication, or if its needed at all. Because people do lie - I'm glad you haven't come across that in life, but I have. The pain score of 10 for a cold? That's real. The patient wasn't even drug seeking, just wanted to be seen faster.

If i could professionally give out every drug under the sun I would. But that also would be dangerous. Its a fine line.

Speaking as someone with chronic pain, I'm with Jane - people overrate their pain, unless they know better. I thought migraine was as bad as it got, till I had a back to back labour.

What some medical practitioners don't get though - I think - is that pain is also cumulative. So sometimes if you stub your toe with a migraine it's kind of good, because the rush of endorphins helps your head, but if your back's burning and your neck's in spasm and you stub your toe - well, all of those separately might only be a 5 but put them together and you just want to go to bed and cry.

Not I'm contributing much useful, but anyway - I don't care if HCPs say discomfort or pain, as long as they're paying attention

jane reading is a coping mechanism for me. I suspect that's the case for many.

To be fair to Jane @missminagrindlay, spotting a drug user isn’t at all easy or straightforward.

I'm a RN with 21 years experience and I never dismiss complaints of pain-if you ask for Rx pain relief you get it ASAP. If your pain is unrelieved I advocate on your behalf to your physician. Pain is whatever the patient says it is. All HCP are not alike

See? Patient chooses to kick medic - something you admit regardless of extenuating circumstances. And I as a HCP am not only at fault for calling it out, but am told to fuck off

Welcome to the life of an emergency medicine practitioner.

And FYI I'm in agreement with you and think you were treated horrifically. But very very few professionals would have to put up with physical abuse even if they weren't good at their job. With NHS staff we just have to put up.

I dont think you can tar all hcp's with the same brush. The Dr who re located my dislocated knee told me it was going to hurt like hell but only for a little bit, he was right.

I didn’t choose to, I reacted in a moment of desperation not the same thing, twisting my words to make me seem a violent anti-hcp person is why I said to fuck off as nothing could be further from the truth. I didn’t make harsh comments about hcps, in fact I said that I was wrong to do so and that I fully support the nhs. I just wanted a lighter hearted chat about why the word pain isn’t used often. Other people explained reasons why that might be whilst you just called everyone a liar. I don’t really know why you choose to come for me on this post when I’m actually agreeing with and supporting what you’ve said to others.

@Bigbunnyears no of course not all are the same. I really didn’t mean for this thread to take the nasty turn it seems to have. I was genuinely thinking it would be quite light hearted. My mistake. Can I get it deleted as the last thing I want is to bash the nhs. How would I go about that?

I had really bad pain ( gallstones though I didn't know it then) and got emergency appointment with gp who prescribed tramadol. He asked me to phone him late afternoon and when I said the tramadol had helped a little but not really dealt with the pain he said to go to A and E. The pain was bad enough that I couldn't have driven myself there and I got a friend to take me.
The A and E Dr did tests but gallstones problem didn't show up in blood test ( I believe this can happen if bile duct isn't fully blocked) and he wanted to send me home with paracetamol and codeine. I know this wasn't going to cut it if tramadol hadn't sorted things out and said I wasn't willing to leave until the pain was under better control. He actually said to me ' you just want to be admitted don't you" and was really shirty because apparently the pain couldn't be that bad because my heart rate wasn't fast enough. I was also vomiting repeatedly and going really hot and sweaty so obviously unwell.
Eventually I was admitted and given morphine which helped. I had an ultrasound the next day and the lady kept apologising while scanning because she could see just how bad the gallstones were and thought they must be causing me so much pain as she pressed down with the scanner ( though actually on the morphine, the pain wasn't that bad).
When they did my gall bladder surgery 3 days later, they very nearly couldn't do it keyhole because the gallbladder was so damaged and stuck to my liver
It still makes me angry today when I think of it, that the doctor didn't believe me and thought I was making it up deliberately to get admitted to hospital. ( I'm guessing the tramadol I'd taken had reduced the pain a little and maybe stopped my heart rate from going so high but he knew I had taken it).

Sorry, OP, but when you “react” by kicking someone, that is assault. It’s not excusable.