Pain

I have my first nursing school tests on Monday and they cover a ridiculous amount of information. Of the million chapters we had to read in our one ton basic nursing book, the hardest for me was the chapter on pain.

I knew going into nursing school would bring back memories of my long-term hospitalization in high school. I didn't expect my first tears to be from reading about pain. It's a funny thing, but reading about the differnt pains people experience brought up all the terror I went through.

 The God-awful, scary pain started the night before I was to be seen at UCLA. I was in the hotel room with my parents when the pain started. As the hours passed the pain got worse and worse. Every time I moved it felt like my bones were shattering into a million pieces and my skin was on fire and everything was wrong. I couldn't move without pain, but not moving hurt so bad too. For hours my parents tried to help me as I cried. For hours we waited for the medications to help, for me to get some relief. Finally, they called 911 and I was brought across the street in an ambulance (our hotel was associated with the hospital and therefor it was a ridiculously short ambulance ride). In the ER all I remember is a black guy telling me they had to take my shirt off me. I was 17 and had to be topless in front of however many people were around me, but I didn't even care because I wanted the pain to stop. I don't know if he was a nurse or a nursing assistant or a doctor, I just remember it hurt to take off. I got relief when they gave me IV medications, but that was shortly followed by a lumbar puncture (if my memory serves me correctly). The doctors diagnosed me with post-viral optic neuritis (the reason I had gone blind in both eyes) and said the etiology of my pain was withdrawals from steroids too quickly. We went home happy that I didn't have Devics and that the pain wouldn't come back as long as the steroids were tapered correctly.

I don't recall how long I was back home in Las Vegas before I ended up in another ambulance and back at the hospital. The pain came back there. I remember that everything hurt so badly that if someone moved the air above my skin it felt like I was being beat. I had one doctor who didn't seem to care and would always sit on my bed. My mother and I told him over and over again that that caused me pain but he didn't seem to care. He's one of the major reasons I am not a huge fan of neurologists.

There was one night in that the pain medications stopped working. Before they were keeping the pain manageable, but usually by hour three (I got a dose every four hours) I was starting to get very uncomfortable. This particular night, by the time I got my dose I was in agony. I eagerly waited for it to kick in (which IV meds do pretty darn fast), but it never did. Getting through the next four hours was miserable, and once I got my next dose, it was again ineffectual. At one point I remember I was screaming because the pain was so bad. My mom was pleading for me to be quiet but I just wanted to die. I was so overwhelmed by how I felt like every molecule of my being was tearing apart. She tried telling me that there was another lady a few doors down who had broken a bunch of her bones in a terrible car accident and it wasn't fair to her or anyone else that I was screaming. I couldn't control myself, I just wanted someone to help me, to save me from what my body was doing to me. I don't remember my nurse from that night, I just remember that she kept apologizing because she couldn't do anything else for me seeing that it was in the middle of the night. As soon as she could in the morning she called my opthomologist and he immediately ordered a stronger medication for me. The pharmacy would not dispense it because they thought it was an error and waited to confirm it with him. I understand the pharmacist making sure everything was correct, but it was misery waiting that extra half hour for them to get in touch with him and get the medication to my nurse. Once my doctor made his hospital rounds he gave my mom his personal cell number and told her to call him in the middle of the night if that ever happened again. He was the best.

Eventually I was moved up to the rehab floor. I was going to be released after just a few days until I had a meltdown on the pain doctor. I was so scared to come off the IV medications and go home and end up in the pain again. He decided to keep me a few more days to make sure I was okay with the PO regumine that he had prescribed to me. Luckily the liquid morphine was enough to keep me from any major trouble.

Months and months later, I had been getting at home healthcare visits for IVIg infusions and I had a new nurse who administered the medication wrong and caused me to end up back in the hospital for a few days. While I was there I had a male nurse who was a giant asshole. He labeled me as looking for pain medicine and convinced the doctor to release me. He did all this while my mom was not in the hospital. I was so mad because the last thing I wanted to do was be in the hospital, but I know that was where I needed to be at that point. The next day I collapsed outside my general physicians office because I was so unwell.

In my reading of the chapter it says that pain is whatever a patient says it is. Most of my experiences in the hospital, I was treated that way. I was treated with respect that I was not a drug addict looking for medication, but a child going through a terrible sickness who needed help. The few instances where I was treated as a drug seeker, well, all I have to say about those people is I hope they found a different profession because you can't help people if you are judging them.

My nursing textbook says that chemical dependence to an opioid medication is expected and treatable and different than addiction. For years I have been saying that I had an addiction to the drugs I was on, not because.I wanted the high, but because I couldn't help it. Now I know that I really wasn't addicted. I know that I just had a chemical reaction, one that my mom and I overcame so that I could get my head back. I didn't care about the high, I hated it. I hate hearing about the dumb things I said when I was on pain medications. I hate hearing about the things I did when I was on pain medications. I hate that there is almost a year of my life that I don't remember much of because of the pain medications. I wish the people who treated me like an addict had remembered that even if I was, being an addict is not a reason to throw someone out of a hospital because it doesn't meant that they don't really have pain. My textbook was clear about that. It is important to notice addictive behaviors, but it is also important to treat a patient. My book also said that while addiction is a problem, only 1% of people who take opioid medications get addicted to it, so addiction shouldn't be the first thought in a healthcare providers mind.

 One of my biggest fears in life is that that pain will come back. I never want to feel like that again. I don't wish that anguish on anyone, and I think having experienced it will make me a better nurse. So many people in my class talk about how they have medical personelle in their family or they saw a loved one get sick which made them want to be a nurse. I don't think most of them have felt the pain and fear like I have, which will give me an upper hand in taking care of patients in pain.  

Sorry for the rambling, thank you for reading.

XOXO,
KABO