Life is a pain in the ...

[melannen]

Question for the collective wisdom of Dreamwidth:

If switching rapidly between cold, dry, dim air conditioning and bright, humid, 90 deg F outside air reliably gives you a pounding headache that settles in for 4+ hours and feels like your eye sockets are being slowly ground away by a belt sander and pooling in your teeth and jaw, with bonus mild nausea, light sensitivity, and the desire to rain down destruction on anything making even as much noise as a vibrating phone except that would require rapid motion so no, and standard painkillers don’t help noticeably but you spend the next day feeling like your brain is balanced on a fresh breezy mountaintop over a miasmatic swamp of pain - is that a migraine?

Because ever since I was tiny I’ve assumed it was just that America’s relationship with air conditioning is bad for humans and all other living things, but in my age I’m starting to think it’s 90% that America’s relationship with air conditioning was borrowed from one of the circles of hell, and 10% maybe you have a migraine trigger, sweetheart.

Anyway, in honor of my lost yesterday afternoon and evening, here is a poll about pain I’ve been meaning to post for a long time. Somebody did one like this ages ago on LJ and it was super interesting to see how everyone’s pain baseline was different, and I would love to see everybody’s answers now. Also, I keep playing with an OC who can sense others’ pain, and I feel like I don’t even have a good idea of, say, what percent of a crowd of people she would sense at any given time.

Poll is anon; comments can be anon or signed, if you want to elaborate. Feel free to share it around - I’m more interested in lots of answers than in a balanced sample, or I wouldn’t be posting on DW. And these are all going to be very subjective answers, because what I’m interested in is peoples’ subjective experience of pain, so don’t think too hard about accuracy if there’s an answer that seems more or less right.

For all pain scale questions we are using either the Hyperbole and A Half Pain Scale, or the Mankoski Pain Scale, your choice, so please read over those if you aren’t already familiar with them.

Poll #22103 Pain.

This poll is anonymous.
Open to: Registered Users, detailed results viewable to: All, participants: 87

What is your pain level right now as you begin to fill out this poll?

View Answers
Mean: 1.93 Median: 2 Std. Dev 1.55

0 0		14 (16.1%)
1		27 (31.0%)
2		20 (23.0%)
3		12 (13.8%)
4		10 (11.5%)
5		1 (1.1%)
6		1 (1.1%)
7		2 (2.3%)
8		0 (0.0%)
9		0 (0.0%)
10		0 (0.0%)
11 11		0 (0.0%)

What has been your highest pain level over the past week?

View Answers
Mean: 4.38 Median: 4 Std. Dev 1.76

0 0		0 (0.0%)
1		1 (1.1%)
2		11 (12.6%)
3		19 (21.8%)
4		21 (24.1%)
5		11 (12.6%)
6		12 (13.8%)
7		6 (6.9%)
8		6 (6.9%)
9		0 (0.0%)
10		0 (0.0%)
11 11		0 (0.0%)

What has been your lowest pain level over the past week?

View Answers
Mean: 0.86 Median: 0 Std. Dev 1.19

0 0		44 (50.6%)
1		26 (29.9%)
2		8 (9.2%)
3		5 (5.7%)
4		3 (3.4%)
5		0 (0.0%)
6		1 (1.1%)
7		0 (0.0%)
8		0 (0.0%)
9		0 (0.0%)
10		0 (0.0%)
11 11		0 (0.0%)

What has been your highest pain level you can recall in the past year?

View Answers
Mean: 6.41 Median: 6 Std. Dev 1.83

0 0		0 (0.0%)
1		0 (0.0%)
2		0 (0.0%)
3		2 (2.3%)
4		13 (14.9%)
5		15 (17.2%)
6		19 (21.8%)
7		10 (11.5%)
8		16 (18.4%)
9		9 (10.3%)
10		1 (1.1%)
11 11		2 (2.3%)

What has been your lowest pain level you can recall in the past year?

View Answers
Mean: 0.62 Median: 0 Std. Dev 1.10

0 0		57 (65.5%)
1		17 (19.5%)
2		6 (6.9%)
3		5 (5.7%)
4		1 (1.1%)
5		0 (0.0%)
6		1 (1.1%)
7		0 (0.0%)
8		0 (0.0%)
9		0 (0.0%)
10		0 (0.0%)
11 11		0 (0.0%)

What has been your highest pain level you can recall over your lifetime?

View Answers
Mean: 8.15 Median: 8 Std. Dev 1.57

0 0		0 (0.0%)
1		0 (0.0%)
2		0 (0.0%)
3		0 (0.0%)
4		2 (2.3%)
5		3 (3.4%)
6		9 (10.3%)
7		11 (12.6%)
8		23 (26.4%)
9		25 (28.7%)
10		8 (9.2%)
11 11		6 (6.9%)

What has been your lowest pain level you can recall over your lifetime?

View Answers
Mean: 0.16 Median: 0 Std. Dev 0.45

0 0		76 (87.4%)
1		8 (9.2%)
2		3 (3.4%)
3		0 (0.0%)
4		0 (0.0%)
5		0 (0.0%)
6		0 (0.0%)
7		0 (0.0%)
8		0 (0.0%)
9		0 (0.0%)
10		0 (0.0%)
11 11		0 (0.0%)

What would you consider an “ordinary” level of pain for you, on a day that is neither a good pain day or a bad pain day?

View Answers
Mean: 1.60 Median: 1 Std. Dev 1.42

0 0		19 (21.8%)
1		29 (33.3%)
2		21 (24.1%)
3		11 (12.6%)
4		4 (4.6%)
5		0 (0.0%)
6		2 (2.3%)
7		1 (1.1%)
8		0 (0.0%)
9		0 (0.0%)
10		0 (0.0%)
11 11		0 (0.0%)

Do you currently have any type of chronic disability, illness, injury or other condition of which pain is a symptom (i.e., migraines, fibromyalgia, idiopathic back pain, rsi)?

View Answers

Yes
51 (58.6%)

No
21 (24.1%)

Maybe/Not Sure
15 (17.2%)

Do you currently have any type of acute disability, illness, injury or other condition of which pain is a symptom (i.e., strep throat, sunburn, broken leg, gunshot wound)?

View Answers

Yes
14 (16.1%)

No
65 (74.7%)

Maybe/Not Sure
8 (9.2%)

Are you, or have you ever been, menstruating?

View Answers

Yes
84 (97.7%)

No
1 (1.2%)

Maybe/Not Sure
1 (1.2%)

Are you, or have you ever been, pregnant?

View Answers

Yes
15 (17.4%)

No
71 (82.6%)

Maybe/Not Sure
0 (0.0%)

Are you currently, as you fill out this poll, using any pain management strategies that have noticeably reduced your pain levels?

View Answers

Yes
34 (39.1%)

No
48 (55.2%)

Maybe/Not Sure
5 (5.7%)

Do you use any of the following techniques for pain management at least once a month?

View Answers

Pharmaceutical/drugs (including OTC, prescription, herbal, self-med with 'recreational' chemicals, etc.)
70 (84.3%)

Movement (physical therapy, massage, chiropractic, exercise, etc.)
62 (74.7%)

Mind-body techniques (Meditation, biofeedback, classical conditioning, counseling, etc.)
16 (19.3%)

Lifestyle changes (dietary, environmental or exercise changes, deliberate distractions, avoiding triggers, etc.)
47 (56.6%)

Electrical stimulation (TENS, spinal implants, violet wand,etc.)
6 (7.2%)

Alternative therapies (acupuncture, spells, crystals, energy work, etc.)
8 (9.6%)

Treating an underlying cause
30 (36.1%)

Something else you forgot
7 (8.4%)

Right now, are you experiencing detectable (level 1-2+) of pain anywhere in your:

View Answers

Feet and toes
20 (27.0%)

Lower legs
8 (10.8%)

Knees
19 (25.7%)

Thighs
11 (14.9%)

Hips
22 (29.7%)

Groin
5 (6.8%)

Butt
9 (12.2%)

Digestive tract
16 (21.6%)

Reproductive organs
9 (12.2%)

Abdomen generally
11 (14.9%)

Lungs
1 (1.4%)

Heart
1 (1.4%)

Breasts
6 (8.1%)

Chest generally
3 (4.1%)

Shoulders
29 (39.2%)

Upper arms
9 (12.2%)

Elbows
8 (10.8%)

Lower arms
5 (6.8%)

Wrists
17 (23.0%)

Fingers
15 (20.3%)

Neck
23 (31.1%)

Jaw, mouth, or teeth
22 (29.7%)

Nose or sinuses
13 (17.6%)

Ears or inner ears
6 (8.1%)

Eyes
7 (9.5%)

Face otherwise
5 (6.8%)

Head
18 (24.3%)

Scalp or skin
4 (5.4%)

Right now, are you experiencing distressing (3-4+) pain anywhere in your:

View Answers

Feet and toes
1 (4.0%)

Lower legs
1 (4.0%)

Knees
4 (16.0%)

Thighs
1 (4.0%)

Hips
5 (20.0%)

Groin
2 (8.0%)

Butt
0 (0.0%)

Digestive tract
2 (8.0%)

Reproductive organs
0 (0.0%)

Abdomen generally
2 (8.0%)

Lungs
0 (0.0%)

Heart
0 (0.0%)

Breasts
0 (0.0%)

Chest generally
1 (4.0%)

Shoulders
9 (36.0%)

Upper arms
3 (12.0%)

Elbows
4 (16.0%)

Lower arms
3 (12.0%)

Wrists
8 (32.0%)

Fingers
6 (24.0%)

Neck
11 (44.0%)

Jaw, mouth, or teeth
5 (20.0%)

Nose or sinuses
4 (16.0%)

Ears or inner ears
1 (4.0%)

Eyes
0 (0.0%)

Face otherwise
2 (8.0%)

Head
5 (20.0%)

Scalp or skin
1 (4.0%)

How to you think your lifetime experience of pain compares to most people?

View Answers

I have experienced a lot more pain than most people.
8 (9.2%)

I have experienced somewhat more pain than most people.
25 (28.7%)

About the same.
18 (20.7%)

I have experienced somewhat less pain than most people.
22 (25.3%)

I have experienced a lot less pain than most people.
9 (10.3%)

Not sure / no idea
5 (5.7%)

What level of pain do you think most people without a pain condition would consider an “every day” level of pain that isn’t worth worrying about?

View Answers
Mean: 1.50 Median: 1 Std. Dev 1.14

0 0		15 (17.4%)
1		35 (40.7%)
2		20 (23.3%)
3		12 (14.0%)
4		2 (2.3%)
5		2 (2.3%)
6		0 (0.0%)
7		0 (0.0%)
8		0 (0.0%)
9		0 (0.0%)
10		0 (0.0%)
11 11		0 (0.0%)

What is your pain level right now as you finish filling out this poll?

View Answers
Mean: 1.98 Median: 2 Std. Dev 1.51

0 0		13 (14.9%)
1		24 (27.6%)
2		23 (26.4%)
3		15 (17.2%)
4		8 (9.2%)
5		1 (1.1%)
6		1 (1.1%)
7		2 (2.3%)
8		0 (0.0%)
9		0 (0.0%)
10		0 (0.0%)
11 11		0 (0.0%)

One more question.

View Answers

TIL that filling out polls about pain is bad for pain levels.
15 (19.2%)

Heat waves are the worst.
37 (47.4%)

Tickybox feels my pain.
33 (42.3%)

Yes that's a migraine that's not normal pain!!
50 (64.1%)

I want to alpha read a story about an OC who does pain wizardry.
14 (17.9%)

Anything else you want to say?

View Answers

(responses to responses to the freetext question: a) "Back" is not listed as an option because I forgot it. Oops? Pick the closest one?
b) There's no good way to compare the experience of pain, but one of the things I like about the Mankowski scale is that it talks about effect on your life rather than some sort of 'how bad does it hurt' - everybody may hit "I can't sleep" at a different pain level, but "I can't sleep" is fairly a measurable standard.)

Comments

[cathexys]

As someone who suffers from migraines and that crazy change in weather/temperature that you're describing (often with a heavy dose of allergies) I can differentiate between the two. Moreover, I think the treatment (beyond pain relief) may be somewhat different: migraine is the opening of blood vessels in the brain that have been too restricted (if I recall correctly), which is why coffee is both a trigger but also can treat an impending migraine... Personally, my sinus/weather/allergy pain often reacts well to Mucinex (I didn't get at first that is was mucus thinner meant for your chest only and used it habitually for my sinuses and have yet to learn that I should cease my off-label use :)

[melannen]

It's not really related to weather or allergies or sinus, though? Like, it doesn't happen if the weather swings naturally, and I can be out in the heat/pollen all day or week and it's fine, or move from the upstairs warm house to the cool basement - it's just specifically the moving between A/C and parking lot repeatedly over a short time that does it (associated in my head with shopping centers, because 90% of the time that's what does it, since I don't have a/c at home.)

IDK - reading the descriptions of different types of headaches is always very unhelpful to me. I also get stress headaches and dehydration/blood sugar ones, and rapid barometric pressure swings give me heebie-jeebies instead of headaches. But the "summer shopping center" pain is special.

[jesse_the_k]

fucking yes that's a migraine

My doctor says, and my experience bears it out, that lots of my headaches resolve with triptans. For me, a headache can trigger a migraine: it may start with the classic cluster symptom of tight band around head, and then I get the aura, hyper sensory sensitivity, and one-sided pain.

[melannen]

My pain is usually more-or-less symmetrical the whole time (although sometimes it moves, or is worse on one side than the other) so maybe it's not a migraine? The sensory sensitivity sucks, though.

I'm not sure it's worth messing with special meds since it only happens a couple times a month in the summer, and it's not debilitating - I can grit my teeth and get through it without anybody noticing I'm in pain as long as I don't have to do anything that takes a lot of concentration. (Uh. Is that the level at which most people think they need meds? I'm bad at this.)

[jenett]

I am a person who gets migraines that are mostly not about pain - there's a lot of fairly recent research on migraines that notes that some of them are headaches that include neurological weirdness, and some off them are neurological weirdness that sometimes include pain, and these may need different approaches.

Indoor climate doesn't usually trigger me, but I am exceedingly intolerant of heat and especially mugginess, and weather pressure changes are one of my most reliable triggers these days (and the one I can do least to avoid.)

My doctor recommended a supplement called Migrelief (mostly for the B2 and magnesium combo, but it's easier as a single pill, and sometimes the feverfew doesn't hurt...) which is an easy thing to try out if it won't mess with other meds (and those things probably won't, but check first anyway, etc.)

I've been on it for a couple of years, and it's gotten me down from migraines every couple of weeks to a few wibbles every few weeks, but not enough to disrupt what I'm doing. Disruption level stuff is only every 4 months or so now unless I hit another trigger (sleep debt is a huge one for me, or certain kinds of background noise/vibration/light combos.)

This is good, because most of the migraine meds do a lot more for the pain-type symptoms than for the aura ones.

[melannen]

I've never really had any symptoms other than pain (+ sensory sensitivity), which is part of the reason it never really occurred to me that it maybe wasn't just 'normal' headaches! I read a lot of Oliver Sacks' stuff on his aura migraines, though - sounds like both a really cool thing brains do and really annoying to live with.

I could usually avoid the A/C to outdoor temperature shifts by not living in a place with A/C and not going to A/C places on really hot days, but now I work in an air-conditioned building so I have to leave the building sometimes. I guess I'm lucky it's so specific that it only happens a few times a year in the summers.

[ellen_fremedon]

Yeah, I get a visual migraine every 6 months to 2 years. I don't get pain with them, unless I try to keep reading or working and give myself eyestrain, but I get an aura that expands to fill half my visual field with pulses and sparkles for 30 minutes to an hour, and I'm light-sensitive for a couple of hours afterwards.

I've never been able to figure out what triggers them, but as they happen so rarely and don't cause pain I haven't really tried.

[lannamichaels]

Because ever since I was tiny I’ve assumed it was just that America’s relationship with air conditioning is bad for humans and all other living things, but in my age I’m starting to think it’s 90% that America’s relationship with air conditioning was borrowed from one of the circles of hell, and 10% maybe you have a migraine trigger, sweetheart.

I don't know if that's a migraine, but I'm pretty sensitive and I don't have that intense long-lasting reaction just from switching between temperatures, so that's a data point?


re: the pain scale: I am reminded of that time I was chatting with someone who had an acute injury that went away and she was complaining about the stuff she couldn't do while she had the injury, all the life changes she had to make, the accomodations, the changes to her plans and how she lived her life, and I was just ...you ever could do any of that stuff? because my entire life experience since I was a child has not ever allowed me to do any of that. Because pain. Lots of pain.

Sometimes it's hard for me to believe that healthy people exist? But I wonder if the reason $relative doesn't take my medical problems seriously is because he has never encountered this kind of thing ever and doesn't have the empathy to listen to anyone tell him he's wrong.

[jenett]

Oh, that thing, yeah.

(I've done six months of persistent migraine aura issues, and I've had years of a day or two of 'so much pain I can't move' menstrual cycles, and ... a couple of years of "Everyone just hurts like this, right, aching is a thing?" that turned out to be thyroid and vitamin D related and largely fixable?)

And ... no. Most people apparently don't get that. Who knew?

[mecurtin]

Pain management strategy not mentioned: heat, cold.

All those options, and nothing for back pain! Clearly you don't have back pain (I'm currently dealing with an acute outbreak).

Chronic & acute pain really do require different scales. Labor, for instance, is an acute pain, where the problem is to get you (and passenger) through a comparatively brief but *intense* experience.

Chronic pain can be "only" a 5 but still seriously debilitating because of the way it drains your ability to think and function.

[jesse_the_k]

Heat & Cold are my #1 strategies, because they're so effective, and cheap.

[stellar_dust]

Please tell me you have tried wearing sunglasses consistently? (Not trying to minimize, it very well might be migraines -- I just don't think I've seen you wear sunglasses even one time in the last 20 years, and if you get headaches when moving from a dim room to bright sunlight, sunglasses should be your first step.)

[melannen]

I am not a person who can wear sunglasses consistently because I cannot keep track of sunglasses consistently, so unless I want a weekly "buy new glasses" budget it never lasts very long. :P Sun hats don't help, though, and the eye doctor said if I wear sun hats consistently (which I do) I shouldn't need sunglasses. Admittedly, I didn't mention the headaches to him. But it's not just a brightness thing, because going from bright to dark without the A/C factor doesn't do it, and I'm pretty sure it has happened when I was wearing sunglasses at least once or twice.

[recessional]

So I'm answering while including answers to stuff I've seen in threads because that way I'm not going in like twenty threads. Also ironically I'm currently having a migraine while being stuck being in a Starbucks out in Surrey for a long series of reasons, and won't be able to go home for another hour or more, so since I know that can make me unaware of my own sharpness I want to preface this by saying that there is none intended, in case that happens.

1. No, that is not a universal, or even remotely common, response to AC. To the point where despite a social circle comprised of 40%+ migraineurs maybe two of them I know get it, but at WAY less than what you describe.

1a. So yeah: that's a migraine trigger. In fact it's a known one. You can actually mitigate it if you take that into account.


2. You literally have all of the classic signs of the migraine bar two (aura, and one-side-only). Literally:

a pounding headache that settles in for 4+ hours and feels like your eye sockets are being slowly ground away by a belt sander and pooling in your teeth and jaw, with bonus mild nausea, light sensitivity, and the desire to rain down destruction on anything making even as much noise as a vibrating phone [aka: noise sensitivity] except that would require rapid motion so no, and standard painkillers don’t help noticeably but you spend the next day feeling like your brain is balanced on a fresh breezy mountaintop over a miasmatic swamp of pain

That is classic migraine bar aura and hemispheric specific pain.

2a. Those two things are not diagnostically significant in absence. (They're diagnostically significant in PRESENCE: if you've got auras and headaches you've either got migraines or brain cancer, and it's probably migraines, for example. But not in ABSENCE.) I have never, ever gotten hemispheric-specific pain (the characteristic nature of my migraine pain is that it sets into my cheekbones and eye-sockets); I used to get auras but traded them for Huge Catastrophic Mood Drop and a stiff neck somewhere in my late twenties. (Probably because by that point I'd had major depression for, oh, fifteen years and it started being a more "natural" nerve misfire, but that's speculation on my part.)

2b. The "heebie-jeebies" from weather are probably also migraines, just not as significant a trigger - or they're linked to the same nerve overstimulation at a lower level than actually required to trigger the pain episode. (See also: my current biggest and most inconvenient migraine symptom is mood collapse.)


3. There are no guaranteed triggers/lack of triggers. Migraine is a neurological condition, not actually a pain disorder. It most frequently manifests as pain! That's how we came to know about it. But that's not actually It's Fundamental Nature. That means literally any nervous stimulus can trigger it, and it can also literally manifest as ANY nerve based fuckery.

Pressure, humidity, etc, are fairly COMMON triggers, probably as they basically involve a lot of nerves being stimulated all at once quite close to the actual brain and without a reliable way to actually notice consciously or to make it stop. However, even with these, different DEGREES of the above will shift in different ways.

3a. Triggers can also be psychosomatic/psychological and mutually reinforcing (because the brain hates us). . . . which means that if you already strongly associate those conditions with getting a migraine? And then experience those conditions? It may also reinforce it as a migraine trigger. But if you lack the same direct conscious connection between lesser versions of humidity/temperature/pressure switch it may not be getting that reinforcement.

3b. Also if you haven't tracked it with the idea of migraine in mind, there may be more overlap than you think.


4. Yes, "I can suffer through it as long as I don't need cognitive function although it is definitely Suffering and it impacts my life" is a good threshold for treatment, especially if the treatment doesn't come with side-effects WORSE than that. :P

4a. It is also a level of pain that most people only have very rarely and for very short periods of time. Much like the most common BDI score is "0", the most common pain level is "0". :P


tl;dr yes you have migraines triggered by repeatedly going through significant heat/humidity shifts, and if anything your numbers are the other way around. ;)

[melannen]

Augh, yeah, that all sounds like mine. I guess it's good to at least be able to say that I get migraines instead of just trying to hide my headaches? But augh.

I should probably at least start formally tracking my headaches, huh. (I wish I could find a good symptom tracker app for my phone that didn't try to force me into tracking certain things and not others.)

[recessional]

Also: on DW and even back on LJ people with chronic pain (and other health conditions) are WILDLY WILDLY OVERREPRESENTED compared to our prevalence in even generous surveys in the general population. So you know.

[melannen]

I always wonder, about the apparent overrepresentation of both queerness and disability in my online communities, whether it really is that they're overrepresented here, or they're just wildly underreported in surveys of the general population, even the better ones.

This survey is coming up around 50%-60% with a chronic pain condition, and tbh, when I think about people I know in RL who know me well enough to talk about their medical problems, that seems about right? And my RL circles aren't particularly skewed toward disability (although they do skew a bit older than DW, but so does the general population.) The RL people are a lot less likely to call what they experience a chronic pain condition, though. And you can work around that with things like asking about the pain itself, or looking at diagnosis/treatment statistics, but both of those are going to have their own massive underreporting problems.

Plus, of course, there's the fact that people with the kind of disabilities that leave them housebound, untrusting of the medical establishment, and difficult to reach by phone are probably overrepresented on DW to the same extent they're underreported in any attempt at a general survey.

Because DW is so open and welcoming about disability, DW denizens tend to be much more accurate and vocal about their pain, but I honestly would not take a bet on whether that actually reflects a substantially greater prevalence.

(We're seeing increasing evidence that the apparent overrepresentation of queer people in queer-welcoming but not queer-focused spaces - like liberal college campuses, artistic communities, and online fandom - is very likely more about underreporting, closeting, and lack of knowledge in the gen pop than clustering in the friendly communities. I would not be surprised if the same applied to invisible disability.)

[deird1]

Taking this poll as me today is totally different to taking this poll as me six years ago. I just felt totally weird because I kept ticking the "0" box and feeling like I shouldn't be...

Six years ago I had chronic back pain, along with semi-chronic knee and hip pain. These days, I have occasional knee and hip pain, with very little back pain. (Improvements brought about by intense physical therapy, followed by regular core strength exercises. I do daily planking and accordion playing to keep my back strong enough not to spasm.)

[melannen]

It is really good to get the reminder that sometimes chronic pain can end!

[petra]

Hello, fellow migraine sufferer. I don't have the energy to take your poll, but I have massive amounts of sympathy for your environmentally-induced headaches.

If you do decide to seek treatment, your PCP may be helpful. There are a lot of crappy neurologists in the world; seek recommendations before you invest time/energy/money.

Personally I have had some luck controlling nausea with meditation/mindfulness and zero luck controlling head pain with it, though self-hypnosis was helpful for lingering pelvic pain after years of menstrual-and-other abdominal crap that culminated in surgery.

[melannen]

Ugh. Yeah, hanging out together in a dark room at con.txt was part of what made me start thinking "migraine" might sometimes apply to me.

My PCP has historically been very unhelpful when it comes to "I've been experiencing this for a long time, but just recently realized maybe I should tell my doctor about it" sorts of complaints, but I'll definitely bring it up.

I have a visualization thing for pain (part of what the OC's spellwork is based on, since it's built around thinking of the pain as a physical substance I can manipulate) that I've been using for a long time that doesn't reduce or stop pain but makes it easier to tolerate, up to a certain level, as long as I have enough concentration to use it.

[extrapenguin]

My pain-related experiences are more related to martial arts, so while I've been in pain recently, it's been in a completely different context to what the chronic pain-oriented guidelines contain. (A punch in the gut is by its nature fleeting, and even the more painful holds can be made to stop.) What I have learned that might be useful to you is that people's experiences of pain differ immensely – a punch to the gut might rate a 1 on one person's pain scale but a 7 on another's, even if the punch is identical.

[melannen]

I actually included two pain scales partly because I feel like one (Mankoski) is better for chronic/long-term pain, and one (HaaH) is better for things like being punched in the stomach. Like, my headache pain yesterday was a definite 7 on Mankoski but really tough to rate on HaaH; when I jammed my elbow into a shelf right now, it was a definite momentary 5 on HaaH but really tough to rate on Mankoski.

That I am getting both people saying "I have chronic pain and the scales don't work well for that" and "I don't have chronic pain, and the scales don't work well for that" I feel like is just confirming what we already know, that there is no good way to rate any kind of pain.

But for my proximate purpose - figuring out what kind of raw material my pain wizard has around them - either one is useful, and part of the purpose of the poll is to look at how different people experience pain differently. The idea of asking for things like "the worst pain you've felt in the past week" was to capture being punched in the stomach as well as other kinds of things.

[kore]

I have had migraines all my life (misdiagnosed as "bad headaches" until grad school when I got the classic floating checkerboard/nausea/tunnel vision) and fuck yeah to me that sounds like a migraine. And yeah, IIRC, if you keep getting migraines and don't treat them, they get worse because it's a chronic condition.

but you spend the next day feeling like your brain is balanced on a fresh breezy mountaintop over a miasmatic swamp of pain

That's actually what really makes me think 'migraine,' because I get that a lot - it's not like you feel good, or it's just a cessation of pain, but there's a weird cleaned-out kind of feeling.

[melannen]

Yeah, cleaned-out is a good description. Along with the sense that I could tip back over into it at any moment (although I don't think I ever do.) But that might just be because I usually end up going to bed very early and I'm better-rested than usual afterward?

I just never thought about migraines because migraines are supposed to be, like, debilitating, right? And everybody gets headaches. And I can power through if I have to and I know I can hide in a dark room in just a couple hours, as long as I can use at least 80% of my energy on powering through it. I didn't realize how bad that actually sounded until I tried to write it out for this entry.

[graveexcitement]

aside from the time last year where i had a deep cavity that required a root canal — which, now that i think about it, i only evaluated the tooth/jaw pain from the cavity (which i was not sure whether to rate a 4 or a 5) and not the briefly intense pain of the root canal itself (not actually as bad as i expected it to be based on the horror stories — once they anesthetized me it wasn’t painful at all) — aside from that, the worst pain i’ve gotten is minor headaches and minor cramps from menstruation. (minor as in, nothing i would rate above a 3 for both, using mankowski scale.)

i do feel like, compared to most people, i’ve experienced a lot less pain, and that goes 10x for people with chronic pain.

also, (NSFW warning) i’m not sure how much this is pain management vs treating underlying cause, but while my primary method for pain management from cramps is an ibuprofen, my secondary method is masturbation. it definitely provides me relief from cramps, but idk if that’s like, an endorphins thing, or if the associated cramped muscles actually loosen up as a result.

[kore]

also, (NSFW warning) i’m not sure how much this is pain management vs treating underlying cause, but while my primary method for pain management from cramps is an ibuprofen, my secondary method is masturbation. it definitely provides me relief from cramps, but idk if that’s like, an endorphins thing, or if the associated cramped muscles actually loosen up as a result.

I have actually seen that recommended in some really old medical manuals! SADLY it doesn't really work for me. But it's fascinating -- it might be endorphins, the muscles relaxing, the pain nerves getting 'distracted'....

[dragoness_e]

The persistent headache coupled with light sensitivity and sound sensitivity is a classic migraine. Or you're hungover ;-)

One thing I learned from my lovely allergist is that weather changes can induce sinus-type headaches and congestion all by themselves, without any allergies kicking in. Seems to me that going from dry A/C to hot and humid is a weather change right there.

I tend to have a problem overnight with dry A/C, because it dries out all the crude in my head and gives me a headache. However, a saline nasal rinse when I get dried out fixes that up pretty quickly. Don't let the lining of the inside of your nose and sinuses get all dried out; unhappy sinuses mean unhappy you.

[melannen]

I have never actually been hungover from drinking! I drink relatively little and slowly and picked up the trick of finish the night with a large glass of water, and that seems to work, as rarely as I need it. (I do get "hangover" symptoms fairly often on the mornings of heat waves when I've been sweating all night, though. These are definitely not that!)

Can you get sinus-type headaches without any congestion/stuffiness/actual sinus pain? Because I don't get that (and have never had anything identified as sinus issues in general.) But it would sort of match the problem too.

I get dehydrated overnight with dry A/C sometimes, I tend to have the dried-out-nose issue more with winter heating systems though (probably because I don't usually sleep in A/C for more than a couple nights at a stretch anyway.)

[primeideal]

I was too sick yesterday to even want to think about those polls, but I suffer from chronic migraines and have the confounding autism stuff of "how do? identify? bodily signals," ask me anything. Or not.

[melannen]

I will at least commiserate!

[chickiedeare]

Stray observations: The description of the painkillers on the Mankowski scale is a little bit of a wrench for me, because I often forget that OTC painkillers exist. Irritability is definitely a sign for me that oh hey have you taken inventory of that body lately. "Can't focus/hold a conversation" shows up for me earlier in the scale (5?) but is more related to acute pain (specifically headaches and menstrual cramps) rather than muscularskeletal pain.

The kinds of pain can be really different for me - I've been going to a physical therapist every other week or so for over a year now who does manual/massage aspects, which is often pretty painful even though it helps in the longer term. But I've definitely noticed there are some locations/sensations where I can keep chatting and some where I definitely Can Not and have to focus on tolerating it, even if other pain is technically worse.

[sophia_sol]

In answering this poll I discovered a whole new way my memory problems affect me. I had a lot of trouble answering the questions about the worst pain I've experienced in the last week/year/life because I literally have no idea. Only two nights ago I spent the entire evening in bed because of pain and related symptoms and yet could not dredge up sufficient memory of it to rank. When I think of the worst pain I've experienced in my life, it was probably the time I got hit by a car and faceplanted the road hard enough to break teeth and give me a concussion, but I literally don't even remember it hurting. (It did hurt a lot - I had to take prescription pain pills. But I can't remember it hurting.) So I am 100% guessing in my answers to those.

[melannen]

Not remembering it hurting is probably an advantage, really! But I'm sure a lot of people were guessing on the longer-scale ones, too. (That's why I asked 'worst you can remember' - I also suspect for a lot of people, the worst they've had is something they can't remember very well.)

[satsuma]

I discovered I have an oddly high pain tolerance a few years back when I completely busted one of my fingers in a kitchen accident & accidentally convinced the ER docs I had nerve damage bc I never rated the pain above a three (Markowski, though I probably would’ve rated similarly using hyperbowl’s scale)

But it was genuinely ignorable pain! I could ignore it completely so long as no one reminded me of it (or poked my fingertip with a stylus to check for loss of sensation again) At which point I reevaluated my status as someone who has chronic pain, because if my foot/knee/hip problems are on par with an injury that required surgery....

But also I still almost never take over the counter pain meds, bc i still typically don’t feel like things are that bad. Bodies are fuckin weird

(To further confuse matters I have a lot of non-pain physical symptoms like fatigue that I WOULD rate much higher on some sort of generalized “how much negative sensations are you experiencing right now” scale, They’re just, not pain.)

[melannen]

Yeah, I have definitely had itch/nausea/etc. symptoms that were nearly as bad as my worst pain experiences.

Bodies are so weird!

[megpie71]

So, the comment I was going to leave back this morning before I got so rudely interrupted (by work) was that for me the thing which is most likely to cause me paid is a dry sinus headache, which is treated (by me) by treating the underlying cause - or in other words, drinking enough hot water to drown a cat. Hot tap water, usually. In summer I use a nasal saline spray to re-moisten dried up sinuses so that things stop going all owie.

[melannen]

Hmm, that's good to know as something to try.

[stellar_dust]

Ooh! I forgot I have a pain scale story! When I was in the hospital for my gallbladder they kept asking me how I would rate my pain from 0-10, but they didn't give me any kind of scale to look at. Usually I said like 4, which may have been under-reporting, but only slightly. However, on the day when it was really bad, they wouldn't give me morphine unless I said it was 8 or higher, and on my personal pain scale at the time I thought I was at like a 7. But now looking at Mankoski, it was definitely at 8. Luckily I had a good nurse that day who conferred with the doc and convinced him to allow me a half dose of morphine, which worked wonders. It seems like it would make sense to have some kind of pain scale prominently available in hospital rooms, though, if they're going to ask people constantly about pain levels.

The health center at school has the Improved Pain Scale posted in a lot of the exam rooms, which I find delightful (and helpful).

[melannen]

I know I've seen a lot of people talk about a scale that is just "0 is no pain, 10 is the worst pain you can imagine", which seems like it's more a test of their imagination than their pain.

...that one is super obviously based on the HaaH one, wow. (I think it probably does work better as a practical scale, though.)

[sylvaine]

... I'm not a fan of that pain scale, wow. >__> 0 pain described as "everything is perfectly normal" is... a pain scale written by someone who doesn't feel with chronic pain. Never mind the concept of taking narcotics at a mere 6. :P (And yes, I realize that it's from somewhere called "chronically awesome". That just means I'm judging them harder.)

[melannen]

I think part of the point of that scale is to make it clear to people who have chronic pain that they might need to recalibrate their scales in order to communicate with doctors - that even if a 6 by that scale is normal to you, you should describe it as if it's terrible and debilitating and should be treated when talking to the medical professionals, because it is, and they need to know that.