Thursday, December 3, 2009

The Pain Game

Every time I visit with a doctor, nurse, physical therapist, chiropractor, acupuncturist or go to an emergency room I groan when asked this question, “On a scale of 1 to 10 what is your level of pain?” I despise this question. Pain is incredibly subjective; a hang nail may be a level 5 for one person and a gun shot wound a 2 for someone else. I pride myself in having an unusually high pain tolerance and my interpretation of the pain scale is accordingly skewed.
In my mind, a 10 is reserved for an incredibly horrible injury or illness I hope never to experience, and up until recently most of my ailments have hovered in the 4 or 5 range, maybe a 6 in the acute phase.

When you come off your bike at high speed and smack the ground so hard it reverberates in your ears, pain takes on a new meaning. In Clearwater, after I crashed, I was sitting on the curb actually having a discussion with someone about trying to finish the race. I really did consider it! That is, until I realized I had a broken collar bone and could not move my arm and ribs that hurt so much I couldn’t breathe. I was in so much pain that I was afraid to be touched. The first inning of the pain game started when the ambulance arrived. Instead of being put on a backboard and stretcher to be moved, I walked there and climbed in, which was somewhat like watching a fish squirm on dry land. I was offered some kind of pain-killer they would administer through an IV. I am wary of all narcotics and generally decline offers of them as they have caused nausea and other unpleasant symptoms in the past. Instead, I requested the King of all drugs, Motrin (AKA ibuprofen or Advil). Motrin really is a wonder drug. It alleviates the pain from just about everything, spanning the entire body! It can cure headaches, muscle aches, tooth aches and menstrual aches so surely it would relieve the various aches from my crash. Amazingly, they don’t carry Motrin in an ambulance. I suppose it is much too wimpy of a drug if you are being carted away in an ambulance. And, I must digress a little longer. If you are going to the ER, I highly recommend traveling there by ambulance. It is far from luxurious, but it saves you from wasting time in the waiting room.

The second inning of the pain game began in the emergency room when an extraordinarily bitchy nurse (Really, she was. Everyone agreed. She even had a permanent scowl embedded on her face.) asked me to rate my level of pain. A gasp came from Mark and my father when I replied that it was an 8. They could not believe I was rating it that high. By then, I had acquiesced to the pain meds with a chaser of anti-nausea medicine. All it really did was take the edge off, though. The pain I experienced in the ER was like nothing I had ever felt before. I could not even stand up for the X-rays. They finally managed to take them, with me hunched over on the bed. Then, just to make my day even better, they fitted me with this antiquated device called a Figure 8, which goes over your shoulders and pulls them back (only to find out later they are not helpful for recovery). Ouch, that really hurt! Then, I had to beg the bitchy nurse for a sling. Seriously, where was I meant to put my arm without it? Gee, maybe I’ll just lift it over my head. They gave me a prescription for Percocet and anti-nausea medicine and sent me on my way. All the while, I was still in my race kit which was curiously not ripped or shredded. That is, until we had to cut it off of me later that day.

The third inning of the pain game lasted for a week. My father accompanied Mark and me back to Boulder. We knew that surgery was imminent and had to work out the details. We wanted to do this quickly. The pain was constant but certain things made it worse, like moving. And, I could actually feel the bones clicking, gross. My father pestered me every 10 minutes with my most hated question, “What is your level now?” We bickered incessantly all week about taking the Percocet. I adamantly did not want to take it and he was just as steadfast that my recovery would be better with less pain. I was certain though, the pain would not last very long, that I could beat it, that I was stronger than the pain. I even dealt with the pain with humor and sarcasm. I felt like taking the Percocet was weak. I dug in my heels and was stubborn. Unfortunately, my favorite drug, Motrin was disallowed because it inhibits bone healing. In the end we compromised on taking a half pill instead of a full one. It certainly helped, but not without consequences. You see, I am not at all worried about developing some kind of drug habit. The side effects of the Percocet are terrible – skin so dry it looks like I am molting and constipation that required copious amounts of Milk of Magnesia (FYI, cherry is far tastier than plain). People really take these drugs recreationally? I prefer exercise. It is a much better high and the only side effects of swimming, biking and running are tiredness, hunger, muscle soreness, occasional GI distress, and potential bodily injury in unexpected places. I also began to comprehend the ludicrousness of my self imposed pain scale. I kept insisting my pain was a 3, but I soon began to realize that once the pain was gone entirely I would have to be a -4 according to my scale!

I am now in the fourth inning of the pain game. I am two weeks post-surgery and beginning to use my arm more and have started physical therapy. Now, the pain has diminished markedly and is really mostly discomfort (although the ribs still ache, very slow to heal) and my use of pain medicine is relegated to evenings if needed to sleep. But, I must track the pain during my PT exercises and not let it get above a 4. That is a lot of leeway!

Pain took on a whole new meaning these last few weeks. I was humbled by it and have much more compassion for those suffering from chronic pain. Fortunately, it seems that the human brain forgets about how much something hurt fairly quickly. How else do you explain the fact that we go to race after race, and even look forward to it, despite the fact it hurts so darn much?

Race hard, have fun.


  1. Love reading your posts so far! I have been dealing with an injury (torn hamstring) for nearly four months now so I truly feel for you. Heal fast!

  2. Great post Joanna..I had surgery 5 days ago to repair a clavicle fracture as well (bike accident:(()...pain is soo subjective and ER care is horrendous nowadays---our stories are identical, except I didn't "half" the percocets ;)) Thanks for's great to read your story and give others insight.