Pain scales

For @puncroaker, and anyone else who might find it useful.

Pain is an incredibly difficult thing to describe, and there’s always the worry that what seems obvious to you, may not mean the same thing to someone else, so I have my own way of describing pain levels, using fire as a scale. Why fire? Well, pain can be useful. Back when we lived in caves and slept around huge roaring fires to keep wild animals at bay, pain signals helped stop us rolling too close while we were asleep.

0 – You’re a safe distance from the fire. Close enough to benefit from the warmth but experiencing no discomfort whatsoever.

Pain – there is no pain. You’re fine.

1 – The heat is making your skin prickle a bit, but you can make it stop again by moving away.

Slight discomfort, but it’s not stopping you from doing anything, and may well stop if you rest and pace yourself.

2 – Intense prickling, to the point you wonder if you will singe hairs or damage the skin.

You can still carry out daily tasks but with a little difficulty, and the pain feels more permanent, doesn’t always go away when you rest. Occasional pain killer use that may or may not help.

3 – You’re now at the edge of the fire, and your clothes are starting to catch alight. (Side note: this is the sort of pain you might be prepared to put up with temporarily, to rescue a much-loved possession from the fire)

Daily tasks are now seriously impacted, you’re on painkillers almost all the time and they’re taking the edge off. (Side note: sort of pain you’d expect post-surgery, and can sort of put up with if you have to, so long as it’s temporary)

4 – In the outer ring of fire. You are now risking losing extremities. You need to be OUT NOW (Side note: You’d risk a quick run through to rescue someone who’s fallen in, but that’s it)

Childbirth without drugs level. You’d only do this voluntarily for the most desperate of reasons, and only because you know it will be over quickly. If you’re living like this, then you’re probably on all the drugs.

Painkiller example – daily doses of 8 x 30mg Dihydrocodeine at this point.

5 – You’re right at the heart of the fire. Everywhere you turn is fire. 

Pain now rules your life. Daily activities have stopped. You are housebound, pain is permanent with extra waves of super-intense pain if you dare move. The painkillers are helping to some extent, but you are zombified.

Painkiller example – daily doses of 8 x 30mg dihydrocodeine, plus 150 mg amitryptiline (for nerve pain), plus 4 x 5 ml oramorph.

6 – a huge rock from the roof has fallen and pinned you into the heart of the fire.

You start to worry that the pain itself will kill you, you wonder if your heart can cope with the intensity. You’re no longer functioning as a human being; you can’t eat, you can’t sleep, even with all the painkillers. You don’t even know if you’re thirsty or not.