Now this is a constant question for anyone who has chronic pain.
The general rule for the general public is that if you have a brand new pain that reaches a pain scale rating of 5/10 or higher, you should at least consider going to a night clinic - if not going into the ER. Then of course there's the whole symptom check - if it includes blood from inside, vomiting, severe dizziness, chest pain, any signs of a stroke or heart attack or neurological symptoms, go in.
That being said, chronic pain sufferers are a little different. Now every single person is different, all pain is experienced differently, so I will have to be completely subjective on this one.
Normally - when all of my illnesses are 'stable', bearable, and more predictable, my pain scale rating usually sits at a 3/10 or 4/10. Since my recent issues that are still unresolved, every day is more like about a 7/10 or 8/10 (hence the reason I am required to be on codeine on a daily basis).
When I get a new pain that shoots up to a 9 or 10, I generally wait a few days. Could be caused by an internal muscle spasm around my organs, a flare-up of my Crohn's or Pouchitis, a new ovarian cyst, vomiting uncontrollably as a sign that my cycle is on the way (which is, unfortunately, a regular occurrence), a partial blockage in my intestine, a side effect of a recent medication, dizziness from dehydration, etc...
So my routine is to try and determine which one of the many reasons above it could be, do the home therapies needed for each one that I could take care of myself, and THEN if the pain continues, go to the ER.
For ER doctors, if there is no clearcut answer as to why this 'new pain' is occurring, the night usually lasts about 7 hours and the result is most commonly that my case is too complicated, that they do not feel comfortable making any kind of diagnosis or offer or change any of my medications or routine therapies, and that they can give me meds for the pain and a referral to a specialist. This is still amazing and I truly appreciate the patience of almost all ER docs for at least doing the xrays, ct scans, physical examinations, and bloodwork.
So - the situation now - my pain has been up to a 10 for the last three days. This is a pain that I have had before - at least in the general region. These are similar symptoms to a previous situation. I have already gone on full fluids and tried remedies for a partial blockage or flare up. I have tried massage therapy (the kind that goes underneath your ribs and underneath and around your hip bones) and muscle relaxants for a muscle issue. Add on some needles and some extra meds, and I have tried everything for what it might be. I am pretty certain that I know what it is. Now... The only way to be 100% certain is an ultrasound or a ct scan. BUT - if it is what I think it is, then it will likely go away within about a month - the pain continuing at a 10 the entire time.
Now, what would you do? I am debilitated with pain, unable to sleep unless I am on heavy medications (which caused hallucinations last night), and my functionality has deteriorated further. I have not found anything that reduces the pain to lower than a 9, and sometimes the fear of not knowing what it is is worse than knowing. Yes - the dreaded fear of the unknown.
Going in and ordering a ct scan myself could* be about a thousand bucks. Not possible.
Night clinic or my family doc could order one, but it might not be for a month anyways - and it could be gone by then. Emergency could do it in one visit. BUT if it is what I think it is, then there is nothing to do except monitor it anyways. If it is NOT what I think it is, it could be dangerous.
So now what?!?
These are the constant dilemmas of people with chronic pain.
Awesome right? 😉
The general rule for the general public is that if you have a brand new pain that reaches a pain scale rating of 5/10 or higher, you should at least consider going to a night clinic - if not going into the ER. Then of course there's the whole symptom check - if it includes blood from inside, vomiting, severe dizziness, chest pain, any signs of a stroke or heart attack or neurological symptoms, go in.
That being said, chronic pain sufferers are a little different. Now every single person is different, all pain is experienced differently, so I will have to be completely subjective on this one.
Normally - when all of my illnesses are 'stable', bearable, and more predictable, my pain scale rating usually sits at a 3/10 or 4/10. Since my recent issues that are still unresolved, every day is more like about a 7/10 or 8/10 (hence the reason I am required to be on codeine on a daily basis).
When I get a new pain that shoots up to a 9 or 10, I generally wait a few days. Could be caused by an internal muscle spasm around my organs, a flare-up of my Crohn's or Pouchitis, a new ovarian cyst, vomiting uncontrollably as a sign that my cycle is on the way (which is, unfortunately, a regular occurrence), a partial blockage in my intestine, a side effect of a recent medication, dizziness from dehydration, etc...
So my routine is to try and determine which one of the many reasons above it could be, do the home therapies needed for each one that I could take care of myself, and THEN if the pain continues, go to the ER.
For ER doctors, if there is no clearcut answer as to why this 'new pain' is occurring, the night usually lasts about 7 hours and the result is most commonly that my case is too complicated, that they do not feel comfortable making any kind of diagnosis or offer or change any of my medications or routine therapies, and that they can give me meds for the pain and a referral to a specialist. This is still amazing and I truly appreciate the patience of almost all ER docs for at least doing the xrays, ct scans, physical examinations, and bloodwork.
So - the situation now - my pain has been up to a 10 for the last three days. This is a pain that I have had before - at least in the general region. These are similar symptoms to a previous situation. I have already gone on full fluids and tried remedies for a partial blockage or flare up. I have tried massage therapy (the kind that goes underneath your ribs and underneath and around your hip bones) and muscle relaxants for a muscle issue. Add on some needles and some extra meds, and I have tried everything for what it might be. I am pretty certain that I know what it is. Now... The only way to be 100% certain is an ultrasound or a ct scan. BUT - if it is what I think it is, then it will likely go away within about a month - the pain continuing at a 10 the entire time.
Now, what would you do? I am debilitated with pain, unable to sleep unless I am on heavy medications (which caused hallucinations last night), and my functionality has deteriorated further. I have not found anything that reduces the pain to lower than a 9, and sometimes the fear of not knowing what it is is worse than knowing. Yes - the dreaded fear of the unknown.
Going in and ordering a ct scan myself could* be about a thousand bucks. Not possible.
Night clinic or my family doc could order one, but it might not be for a month anyways - and it could be gone by then. Emergency could do it in one visit. BUT if it is what I think it is, then there is nothing to do except monitor it anyways. If it is NOT what I think it is, it could be dangerous.
So now what?!?
These are the constant dilemmas of people with chronic pain.
Awesome right? 😉