What’s Your Pain Number?

If you have fibromyalgia, suffer from migraines, or have some other chronic pain illness, I think you can develop a skewed view of pain. Then when you go to the doctor because of some new or acute pain, and they ask “What’s your pain level on a scale of 1 to 10?”, I wonder if the answer is the same as it would be from someone who is otherwise healthy. I think that it may not be. I think when you deal with chronic pain what level of pain you consider tolerable – because there is no choice but to tolerate it – is much different than the person who is accustomed to living with a zero pain level.

It used to frustrate me when doctors would ask what my pain level was because I had no frame of reference for what was a 3 and what was a 9, or anything in between. Finally, several years ago, a pain specialist gave me a pain chart that I found very helpful in that it provides a description of each number on the pain scale. (I had to chuckle that they include “0 – No Pain” on the chart because I have no idea what that is like and wondered what the point of including this on the pain scale, except maybe to torment those of us who can never honestly say we are at 0.)

Anyway, I thought I would share this pain scale here, for those of you who have never had a doctor who was kind enough to give you a somewhat objective frame of reference. (I say somewhat objective because, as I said above, I think chronic pain can skew your view of what is tolerable pain.)

  1. Minimal = Pain is hardly noticeable.
  2. Mild = Feel a low level of pain; aware of pain only when paying attention to it.
  3. Uncomfortable = Pain is troubling but can be ignored most of the time.
  4. Moderate = Constantly aware of the pain but can continue normal activities.
  5. Distracting = Pain is barely tolerable; some activities limited by the pain.
  6. Distressing = Pain preoccupies thinking; must give up many activities due to pain.
  7. Unmanageable = Constant pain that interferes with almost all activities; often must take time off work; nothing seems to help.
  8. Intense = Severe pain makes it hard to concentrate on anything but the pain; conversations difficult.
  9. Severe = Can concentrate on nothing but the pain; can do almost nothing; can barely talk.
  10. Immobilizing = Pain is excruciating; unable to move except to seek immediate help for pain in emergency room, etc.; bedridden.

I recently experienced a pain in my side and abdomen that was different than and in a different place than any pain I have ever felt before. After talking to an advice nurse on the phone, I went to urgent care because she said I needed to be seen right away. She was concerned that it might be appendicitis or gall stones.

Once at urgent care, the doctor asked me the million dollar question, “What’s your level of pain on a scale of 1 to 10, with 10 being the worst pain you’ve ever felt?” I really wish I’d had my handy pain scale with me. If I compared the pain I was in that day to the worst pain I’ve ever experienced (which happens to be a 10 on the above scale), it really wasn’t that bad. I think I told him it was a 3 or 4. But based on the above scale it was more like 6 or 7.

It turned out I don’t have appendicitis, though they still haven’t figured out what is wrong. But as I thought about my experience with this urgent care doctor, a guy who didn’t know me at all, I wonder how seriously he took my complaint of pain since it was only at a level of 3 or 4. I wonder if someone else coming into urgent care whose “worst pain ever” was only a 5 on this scale would have answered his query much differently.

Reducing pain to a number doesn’t seem that helpful to me. Does a subjective number that is skewed by the patient’s prior pain experience really help a doctor with a diagnosis? I don’t know that it does. So I think I’m going to print off this pain scale on a small piece of paper that I can easily carry in my purse so that the next time I’m asked that question, I can pull it out and have an objective description of my pain for the doctor.

Safe in the Mouth of Danger

In my dream, I had a vision.

An angel of the Lord led me down to the depths of the sea.

“What do you see?” the angel asked.

I said, “I see a boy, a child, in the mouth of a shark!”

“Yes,” the angel said.

“But, he is terrified!” I said.

“He will be grateful,” the angel said. “Watch.”

As I gazed upon the frightened child, a great white suddenly attacked the shark. The child began to climb out of the mouth of the shark, but he had set his leg upon its jaws and the shark bit down and took off his leg. The child, however, was able to swim away safely because the great white was devouring the shark.

“How is this possible?” I asked the angel.

“Do you not know?” the angel responded. “Have you not heard? With God, all things are possible.”

“But,” I said. “Why was the child not spared this danger in the first place?”

“You will see,” the angel said. “Come.”

A moment later, we were on dry ground.

“Was that real?” I asked. “I am disillusioned.”

“What do you see?” the angel asked.

“My leg is gone!” I proclaimed. “I was the child!”

“Yes,” the angel said.

“But,” I said. “How can I live without my leg? I lost my leg!”

“But, you did not lose you,” the angel said. “And that is precisely what would have happened had you not lost your leg. If the shark had not swallowed you whole, the great white would have attacked you from the side. You would have been devoured and destroyed. Instead, you have been spared.”

“Why?” I asked. “Why have I been spared? Why am I still here? Why must I suffer so much?”

“You suffer,” the angel said. “Indeed, you exist, to give hope. Now, go. And teach God’s children how to walk with a limp. Strengthen your brothers. Encourage your sisters. Show them how to survive A Dark & Stormy Night.”

“Yes, my lord,” I said, bowing my head in respect as the angel vanished from my sight.

When I woke up, I recorded my vision, that my brothers and my sisters may yet understand why they, too, must walk with a limp.

“Do you not know? Have you not heard?
“With God, all things are possible.”

A Statement of Dedicated Ministry

My calling is sure.  My challenge is big.  My vision is clear.  My desire is strong. My influence is eternal.  My impact is critical.  My values are solid.  My faith is tough.  My mission is urgent. My purpose is unmistakable. My direction is forward.  My heart is genuine.  My strength is supernatural.  My reward is promised.  And my God is real. ”

“I refuse to be dismayed, disengaged, disgruntled, discouraged, or distracted.  Neither will I look back, stand back, fall back, go back or sit back.  I do not need applause, flattery, adulation, prestige, stature or veneration.  I have no time for business as usual, mediocre standards, small thinking, normal expectations, average results, ordinary ideas, petty disputes or low vision.  I will not give up, give in, bail out, lie down, turn over, quit or surrender.  I’m dedicated to doing the work of the ministry. God help me.”

 There is such a thing as a “Seal of Good Housekeeping” that is given as a mark of approval.  As I read the above quotation, I thought of all the men and women that could make this declaration.  So many that we could approve of and to put a definitive seal of Kingdom approval on. 

I have friends in ministry in Mexico, India, China, Italy, Peru, Kazakhstan, San Francisco and so many other places.  They stand boldly and minister lovingly.  We must pray for them, all the time.  People like you and me who suffer with a mental illness are poor candidates for this level of intense ministry.  But we make great prayer warriors!

As we pray, standing in the gap for others, often we will experience a release from our own issues.  They just melt away.  I focus on you, and I won’t hurt as much.  I have to reach out, so God can reach in. This is what Jesus intends for me as His disciple; “in training.”

Lonely, or Just Alone?

“Loneliness was the first thing that God saw that was not good”

John Milton

Are you lonely? It really doesn’t matter if you are married or single. Frankly, those who have a spouse can be powerfully affected by a sense of loneliness. (They obviously are pressured to suppress this.) But they truly feel very much alone.

When we find ourselves affected by this issue, we think a lot about being alone. We become an ‘island,’ isolated and separate, and the intense figure of this is the ‘castaway’ of those who, somehow end up completely alone on a deserted beach. 

There is nothing ‘romantic’ or ideal about this experience.

After a week, we start to feel the isolation. It creeps in on us, expands, and begins to ‘feed’ on our perceptions. And that can poison us.

To define it, to be lonely is the absence of human relationships. But to be alone is to be without connections.  They can overlap sometimes, but they are very separate issues. The unmarried 40-year-old could be free from loneliness, and the person who is married (with several kids) feels quite lonely.

We cannot attribute our ‘heart issues’ to our response to isolation.

Some will thrive, and others chafe. Many derive a sense of well-being by becoming married. Essentially they choose the fallacy that this may just solve their feeling of loneliness.  If I cut my hand, a band-aid will not heal the wound, it can only help (on a superficial level,) but the healing comes from within us.

There is a definite need to see the unique situation and understand how it does fluctuate. Things will move and our attitudes may change. We can cross back and forth, and that is quite understandable. But embedded sadness over being alone can be disastrous to a full and amazing life with Jesus.

“And I will ask the Father, and He will give you another Helper, that He may be with you forever.”

John 14:16, NASB.

We certainly need each other. That is ‘how we roll.’ But what is necessary and for certain is, “We are not alone, never.” The deep presence of Jesus can be profoundly close, and all we need is His nearness and our awareness, and it’s going to be ok.

There is so much we can do.

The first is to get real about the issues that are involved.  Go ahead and acknowledge the struggle you encountering.  Secondly, we need to admit the sin of harboring this, and even letting it to take control of our thinking. Thirdly, to actively turn away from sin, and then focus on Jesus as our dear companion and friend.

These three are just focal points. They will often take very different adjustments for each person. But they are definitely a starting point. Even as you work through this, allow the Holy Spirit to be your faithful guide.