3.08.2011

The Scale

Oh, the old gray mare, she ain't what she used to be,
Ain't what she used to be, ain't what she used to be.
The old gray mare, she ain't what she used to be,
Many long years ago.--Old Folk Song
Mares, hens, whatever....

**Personal disclosure: I get a wee bit more agitated by things when I am ill....shocking, I know.**

There is this ridiculous thing going through medical offices and hospitals these days. (No, not referring to MRSA or anything viral, well not in the biological sense anyway...) This "thing" must have been conjured up by some academic sitting in his office or possibly some young doc going through his psych rotation, lacking much of a clue as to actual practice. What I am referring to is the perceived pain scale, or whatever they call it. (You know the one: Walk into any doctor's office with a complaint and one of the first questions you will be asked is, on a scale of 1 to 10 how do you rate your discomfort?) Why, you might ask, do I think this is one of the most bogus tools used by medical teams?

Take person A: He comes into Urgent Care with, let's say, congestive heart failure. They ask him where he rates his discomfort. After thinking about the city bus that hit him last month, breaking two of his vertebrae, half his ribs and the majority of the left side of his body, leaving him with only one working lung and a bag to collect his urine, he feels pretty darn good. He gives his discomfort level a 3 on the scale. Nurse sees it, shrugs her shoulders a little perhaps and tells him the doctor will be right in.

In walks person B: Little Miss Priss hasn't had as much as an insult to her emotions in her fourteen years of life, much less any bodily harm. She is starting her menstrual cycles unbeknownst to her and is experiencing mild cramps. She is asked of her discomfort and dramatically says it's a ten, would be higher if possible. Nurse gets right to work and maybe even steers the doc her way since she is in obvious misery.

Person A dies. At a 3. Little Miss Priss goes on out into the world, feeling better with a little Motrin, to lead a long, rosy life. Great scale.

So, upon my visit to Urgent Care a few days back, my irritability was running a wee bit higher than usual. I know this because when the snot-oozing kid across from me dropped his goldfish crackers all over the floor and his dad started reprimanding him, I had to really bite my tongue lest I go into a diatribe (see current blog post) about the fact that there are at least a dozen signs in the waiting room that say "No food or drinks"...there's one on each wall, on every side table, hanging from the fish tank, two on the receptionist's desk....I mean really, they have all but tatooed it to their foreheads telling you NOT TO HAVE FOOD in the waiting room. And it ain't your illiterate kid's fault, pop, that he has a bag of goldfish with which to spill all over the germ covered floor. And you know what really gets me? It isn't like this is the only doctor who has such a policy! I have yet to be in a doctor's office, at least those serving sick patients, where this isn't the case. You can see, I had to bite down hard...(so hard I almost had to change the reason for my visit to ROTT: Rapid-Onset Tongue Trauma.)

At any rate, it was while being consumed by these burning feelings that I decided there is only one way to really understand the perceived pain scale. I now view it as the "How serious do you want the medical staff to take you" scale. (As a first rule of thumb, they may take you more seriously if you can FOLLOW THEIR RULES, goldfish dad! And we wonder what's wrong with the world today....mumble mumble....) So when asked about my level of discomfort, instead of wasting time on questions like "Do you mean during the coughing fits that have convinced me to be seen or right this very second as I am calmly and quietly sitting here with a breastfeeding baby who by all accounts is helping my body release 'feel good' hormones as we speak?" I decided to take the approach of wanting them to take my concerns seriously and gave her a simple "I am probably around an 8, maybe a 9 during a really big fit." (Please make note, I'm not certain I hit an 8 or 9 on the pain scale during my last baby delivery and he wasn't exactly delivered by the stork!) While I wanted to make the joke that assuming no 8 or 9 pound bowling bowl was about to exit one of the tiny holes in my body, say a nostril, I actually felt pretty good; I didn't want to offend the sweet and reserved Somoli nurse who had already twice failed to get an accurate blood pressure reading with an electronic cuff (when did they start using wrist bands?)

At any rate, after almost two hours of really great bonding time with Jane Austen (thank you for that Urgent Care!), I was seen by the doctor, who confirmed that my decision to skip out on playing in my indoor soccer league's first game that night was a good one because, in fact, I had pneumonia. Really? That's it? Phew, because for a second there I thought you were going to tell me it was Tuberculosis, or Ebola, or worse yet, a terrible case of "lazy parent using their kid's little cold as an excuse to not parent" syndrome....oh, wait, I confused myself with your next patient....

But in all seriousness, what could be more fun than a big helping of flu followed by a side of pneumonia?! Yay me! (I think I will skip dessert if you don't mind though....feeling a bit, er, full.) Oh wait, I said I was going to be serious....well, in that case, all I have to say is: the old gray mare she, ain't what she used to be, ain't what she used to be, ain't what she used to be....and right now, neither is this little hacking hen.

Now, I bet you're glad you didn't ask how I was feeling on the Perceived Irritation Scale.... ;)

Enjoy your Fat Tuesday! (As for me, I think I somehow skipped ahead to the ashes.)

Laissez les bon temps rouler!

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