[HN Gopher] Researchers search for more precise ways to measure ...
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       Researchers search for more precise ways to measure pain
        
       Author : Petiver
       Score  : 52 points
       Date   : 2025-03-24 03:57 UTC (19 hours ago)
        
 (HTM) web link (www.washingtonpost.com)
 (TXT) w3m dump (www.washingtonpost.com)
        
       | dkenyser wrote:
       | https://archive.is/kgtlw
        
       | perching_aix wrote:
       | I've been recently wondering if this is a "thing" in medical
       | research, and I'm extremely glad to hear that it is. Especially
       | in tech I think we all know how frustrating it is to only ever
       | get vague, pre-interpreted reports of issues, particularly when
       | those issues are non-deterministic or otherwise tough-to-
       | reproduce.
       | 
       | I can only hope that once these methods mature to everyday use
       | levels, people will keep in mind the gap between the measurement
       | and the phenomenon. Just like how a GPS tracker doesn't track the
       | object (or pet, or whatever) you put it on but itself, these
       | methods will also only detect pain they're compatible with
       | detecting, and miss others. I can already imagine the
       | conversations with various parties insisting that a patient isn't
       | actually feeling pain because whatever devices are not reporting
       | so (or the opposite!). Still, I don't think this should keep
       | these devices from existing.
        
         | PaulKeeble wrote:
         | They might miss a type of pain that the current trials aren't
         | measuring because healthcare doesn't believe that group of
         | patients and further entrench that prejudice into the measure.
         | It's a very real risk of such a device.
        
       | PaulKeeble wrote:
       | In the meantime if you are actually in chronic pain it's worth
       | knowing research has shown that 6 out of 10 is the best number
       | for patients to use. Below 6 and insurance doesn't pay out and
       | healthcare workers consider it normal and if your not writhing
       | and scream on agony right now you can't possibly be above. 6 has
       | the best chance of success.
       | 
       | Alas even the best is not a high chance there are millions
       | suffering chronic pain, because in the absence of a biomarker and
       | withdrawal of opioids, many probably most sufferers are left
       | without any relief and suffer the consequences. It's not about
       | you it's about the doctor there was nothing you could have done,
       | prejudice and stigma over pain is rife within healthcare.
        
       | j_bum wrote:
       | I have a PhD in neuroscience, where I studied circadian rhythm
       | disruption and its effect on pain behavior. So I feel qualified
       | to discuss this.
       | 
       | In humans, pain has two primary components [0]:
       | 
       | 1. The sensory-discriminative component: where on my body, what
       | type (hot? cold? chemical?), and how _intense_ is the noxious
       | stimulus?
       | 
       | 2. The affective-emotional component: how much does the pain
       | _hurt_ , and how does it affect emotional state?
       | 
       | Very importantly, both #1 and #2 are considered "pain", and they
       | can be experienced both simultaneously and independently. Pain is
       | _entirely_ subjective, as TFA highlights.
       | 
       | It does sound valuable to search for biomarkers of the sensory-
       | discriminative component. But I'm doubtful that biomarkers for #2
       | are readily observable, beyond fMRI. The "Nociometer" may capture
       | this, but what if it doesn't in a reliable way, since it's
       | designed to test #1? TFA discussed how this could save money for
       | health-care system money; this gives me an awful feeling.
       | 
       | Relying on "biomarker-based pain measurements" worries me that
       | patients who are primarily experiencing affective-emotional
       | components of pain will only further be doubted or not trusted by
       | physicians.
       | 
       | There are already far, _far_ too many examples of physicians not
       | trust patients about pain. Re: women at Yale undergoing IVF
       | treatments without fentanyl injections due to a drug misusing
       | nurse stealing the fentanyl. Physicians responded to the
       | unanesthetized women in excruciating pain by saying, "maybe you
       | are immune to fentanyl!" [1*].
       | 
       | I think we should tread lightly.
       | 
       | --
       | 
       | [0] https://pmc.ncbi.nlm.nih.gov/articles/PMC6676053/
       | 
       | [1] https://www.nytimes.com/2024/09/09/health/yale-ivf-egg-
       | retri...
       | 
       | *There is a heart breaking podcast on this scandal, which is how
       | I originally learned about it [2]. Of course when I was in horror
       | telling my wife about the story, the news came as no surprise to
       | her, as she's experienced pain disbelief from physicians her
       | entire life.
       | 
       | [2] https://www.thisamericanlife.org/804/the-retrievals
        
         | odyssey7 wrote:
         | Maybe this explanation is intentionally simplified, but what
         | it's telling me is that medical science is just lost.
        
           | j_bum wrote:
           | Well, I wouldn't go that far. The brain is incredibly
           | complicated, and frankly we are still very far from
           | understanding much about how it works.
           | 
           | But this doesn't mean we aren't making incredible
           | advancements. Discoveries are constantly being made in the
           | background and are continuing to build up over time.
           | 
           | For example, a non-addictive pain medication was just
           | approved by the FDA [0]. This will undoubtedly improve
           | millions of lives and prevent uncountable numbers of people
           | from misusing opiates in the future.
           | 
           | [0] https://www.fda.gov/news-events/press-announcements/fda-
           | appr...
        
             | Spivak wrote:
             | But it's listed for acute pain, don't opiates already work
             | well for that use-case? My understanding is that the time-
             | limited nature of them and lack of continued access makes
             | dependence unlikely and that the holy grail is a solution
             | for chronic pain.
        
               | rqtwteye wrote:
               | The lack of continued access leads a lot of people into
               | fentanyl and other drugs.
        
           | debacle wrote:
           | The problem is that, despite medical science making advances
           | abound, doctoring as a profession changes exceptionally
           | slowly, and most doctors (especially male doctors IME) take
           | an adversarial approach to patients who have questions.
           | 
           | I have a relatively common autoimmune disease. I have had
           | much better experiences with NPs than doctors in explaining
           | that certain medications are contraindicated for people with
           | my disease.
           | 
           | Ego has always been a massive issue in medicine. I wonder if
           | this is exclusive to the US, or if we see it everywhere.
        
             | rqtwteye wrote:
             | You need to have a big ego to take on the responsibility of
             | a doctor. A lot of people can't handle it emotionally so
             | the job selects for people with narcissism or psychopathy.
             | This is a very rough generalization but from my
             | interactions with surgeons it fits pretty well.
        
           | toast0 wrote:
           | Judging pain is philosophy more than science.
           | 
           | How do we know what is in someone else's head?
        
             | intrasight wrote:
             | We will soon enough know what's going on in people's heads.
             | While it may help us better understand pain, it will
             | probably cause all kinds of other unforeseen consequences.
        
         | Spivak wrote:
         | Like it's a pretty interesting research question to see if this
         | very major component of the human experience can be seen and
         | measured, but I'm not entirely sure what the medical value of
         | such a thing could be if what you get is basically just yes no
         | in pain or not and a rough intensity because you can already
         | get that and more from the patient.
         | 
         | My experience was/is annoyingly the opposite where I developed
         | chronic neck pain on a relatively fast timeframe and I can't
         | find a physician across all different disciplines that's
         | actually interested in finding out the source. They almost
         | immediately throw up their hands and want to send me to a pain
         | management doctor.
        
           | intrasight wrote:
           | I too suffer chronic neck pain after an overstretch injury.
           | It's been life-changing. And immensely frustrating that no
           | diagnosis can be done.
        
         | light_hue_1 wrote:
         | Even neuroimaging isn't enough. fMRI doesn't have a great track
         | record for predicting pain. It works to an extent, but it's not
         | like there's a simple area that lets you accurately and
         | directly decode the pain level someone is experiencing. And
         | there's no new neuroimaging in the pipeline that would let us
         | do this in a clinically relevant setting. There's a lot of hype
         | around various optical methods, but it'll be a long road even
         | if they work.
         | 
         | In the meantime, we should take much more advantage of the gap
         | between the sensory and the affective components!
         | 
         | There are many other science-based pain management methods than
         | just drugs. These other methods don't change the sensory part,
         | the pain is there, but they can dramatically change the quality
         | of your life with how you feel the pain.
         | 
         | CBT is very effective for pain management. Even something as
         | simple as distracting yourself from a painful stimulus like a
         | medical procedure can make a huge difference.
         | 
         | For example, your doctor doesn't routinely tell you to show
         | your kids a fun video while they get a shot. But it makes a
         | massive quality of life difference. Without Elmo, my daughter
         | will cry for 5-10 minutes and just be miserable for half an
         | hour. With Elmo, the shot comes, she's annoyed, there are tears
         | for a 5-10 seconds, and then she's fine. There's no reason to
         | not make this routine, except that we think of pain as
         | something entirely objective instead of something that is
         | largely subjective.
         | 
         | I think this research falls into that trap of "This is an
         | important problem, this solution is obviously bad, but we have
         | no good ones, so let's do it." This is likely to cause far more
         | pain than to help anyone.
        
         | oersted wrote:
         | I remember that after I had surgery on my finger (the bone
         | healed wrong so they had to cut it and rotate it), a nurse
         | asked me to rate my pain 1-10, and I said: "it's alright, like
         | a 7?", and she was like "that's not alright, let me give you
         | some meds".
         | 
         | It did actually feel like a 7/10, it really hurt, but somehow
         | it didn't bother me. And it was like that for weeks after the
         | surgery, I didn't really end up taking any pain meds when I got
         | home.
         | 
         | And I wouldn't say my pain tolerance is generally particularly
         | high, pain does usually bother me as much as anyone. Not sure
         | what that was about.
        
           | Filligree wrote:
           | That sounds a bit like pain asymbolia. I'm surprised it would
           | happen in just one instance, but I don't know much about it.
        
           | short_sells_poo wrote:
           | I think mental disposition is a huge component of perceiving
           | pain, and it can be entirely sub-conscious. I can't speak for
           | your case of course, but perhaps you were "ready" for the
           | pain in your finger and what is to come and thus the panic
           | inducing element was gone. You could be almost just an
           | observer of the pain rather than the subject.
           | 
           | Fear of the pain can make things much-much worse. If that
           | fear is removed, you won half the battle.
           | 
           | Of course, there are levels of pain where all of the above
           | goes out the window and it is absolutely debilitating, but
           | maybe that's the 13/10 pain level that hopefully most of us
           | never have to experience.
        
           | reginald78 wrote:
           | I never understand those charts. To me a 10 is a state that
           | only briefly exist before I passed out from agony. If I was
           | at a 7 pain scale you wouldn't need to ask me, it would be
           | obvious.
        
             | CookieCrisp wrote:
             | I've had what was told to me is a 10, you don't always pass
             | out, unfortunately
        
         | andrewla wrote:
         | > There are already far, far too many examples of physicians
         | not trust patients about pain.
         | 
         | I am friends with a couple of ER doctors, who are probably the
         | worst offenders (self-acknowledged) in this space. It's based
         | on a real phenomenon, though, of drug-seeking behavior.
         | 
         | As people with chronic pain communicate with each other
         | (through things like Reddit) on the best way to communicate to
         | doctors that their pain is legitimate, those techniques are
         | also inadvertently taught to other people who are seeking pain
         | medication for recreational purposes.
         | 
         | I think the cause of widespread drug legalization has been
         | weakened by a couple of real world efforts in that direction,
         | but I still stubbornly cling to the belief that if people are
         | allowed to make their own choices, then you can partition the
         | recreational users from the chronic pain sufferers and maybe
         | let medical science have a slightly better change of addressing
         | the latter case. That said, given factors like cost and
         | insurance coverage, it may just be a realigning of incentives
         | rather than fixing the problem itself.
        
           | Aurornis wrote:
           | > but I still stubbornly cling to the belief that if people
           | are allowed to make their own choices, then you can partition
           | the recreational users from the chronic pain sufferers
           | 
           | I can empathize with this thought (having had an episode of
           | pain disbelief in a hospital myself) but the idea of
           | partitioning recreational users from chronic pain sufferers
           | isn't reflective of the reality.
           | 
           | They aren't two mutually exclusive groups. In fact, many
           | recreational users get their start from over-prescribed
           | opioids. Some people experiencing pain and all of the
           | associated emotional difficulties will see the sudden access
           | to opioids as an opportunity or even an excuse to indulge in
           | opioid excess.
           | 
           | Self-medication with opioids also produces a very quick on-
           | ramp to dependence in average users. If you're anything like
           | me, you prefer to use the minimum dose of any medication and
           | get off as quickly as possible. I'd rather have mild
           | lingering headache pain than take an extra Ibuprofen.
           | 
           | Not so with the much of the general public. I have friends in
           | medicine who believe even Tylenol should be prescription only
           | because of how frequently they see people destroying their
           | livers by taking excessive amounts. Look at simple drugs like
           | Afrin nasal spray and people who become severely dependent
           | for months or years because they can't even read the
           | directions on the bottle. Open this same door to something
           | euphorically reinforcing like opioids and the number of
           | people walking themselves straight into addictions because
           | they wanted something stronger for the occasional headache
           | would be massive.
        
           | sandworm101 wrote:
           | >> you can partition the recreational users from the chronic
           | pain sufferers
           | 
           | Except that you can't. There is no bright line between those
           | two groups. Many recreational users/abusers started their
           | journey when prescribed drugs for legitimate pain. Steady use
           | becomes dependency, then you look for other sources, and
           | quickly you are crawling dark web for a dealer in your
           | neighborhood.
        
         | Palomides wrote:
         | why do you think psychological types of pain won't cause
         | discernible biomarkers? well known, for example, that stress
         | has lots of effects on the immune system
         | 
         | it's all part of the same biological soup!
        
         | neverokay wrote:
         | _2. The affective-emotional component: how much does the pain
         | hurt, and how does it affect emotional state?_
         | 
         | I am going to add the spiritual aspect to this. I read a post
         | on Reddit asking if Jesus truly suffered more than anyone else
         | on earth, given that more people suffer for longer than his 24
         | hours ish on the cross.
         | 
         | Without believing the story of Christ at all, I was still able
         | to do the mental exercise to see that the nature of the pain
         | had nothing to do with the duration. For example, watching your
         | mother watch you get crucified is heart stopping (or to watch
         | another mother have to go through that).
         | 
         | So, what is the purpose of a human feeling that pain as an
         | experiencer or as an observer? Why would our body elicit that
         | psychic pain, why wouldn't we just focus on the physical and
         | ignore these other things? In that moment, your only concern
         | should be the physical, but it's not just physical.
         | 
         | The psychic pain almost has no use in a state of physical
         | torture other than to inform the conscious of its duty to
         | morality. Unfortunately, I do not believe science can _ever_
         | conclude this is the answer (in no possible way, I'm open to
         | being wrong).
        
         | technotony wrote:
         | I've found meditation very useful in this regard. If you focus
         | on observing in detail #1 type pain, you find that the #2
         | becomes much more managable. The technique is to get curious
         | about the pain, ask what type it is (hot/cold/electric etc),
         | where exactly is the pain. what shape is it? how does it change
         | over time? It sounds counter-intuitive but by focusing on it it
         | becomes easier to manage (because I think a lot of #2 is story
         | and mental reactions to the pain rather than the actual pain
         | itself and the mental reactions are self-fulfilling in a
         | negative way).
        
         | dkarl wrote:
         | I'm fascinated by the athletic side of all of this.
         | 
         | I have a friend who has had the aspiration to become a regular
         | exerciser for years, but he says everything he tries just hurts
         | too much. I exercise regularly myself, but we haven't found a
         | way to talk about it, because it's so hard to share subjective
         | sensations of pain. In some sense, everything I do hurts, too,
         | and everyone who works out or plays a sport acknowledges a lot
         | of pain. People differentiate routine pain from pain that
         | requires effort to endure and distinguishes both of those from
         | pain that indicates an injury happening or being aggravated,
         | and people value and hone their ability to distinguish the
         | second two from each other, because they don't want to get
         | injured but also don't want to let pain hold them back from
         | doing something that makes their body healthier and stronger.
         | 
         | I've known people who have endured through pain and suffered
         | terrible consequences from it. Five years ago, my wife's aunt
         | loved to say "I'm a tough old bird," and she has since lost a
         | leg unnecessarily, because she thought that having high pain
         | tolerance was a viable alternative to going to a doctor. Now
         | she's in a wheelchair and does everything the doctors say.
         | 
         | Other people have had opposite experiences, where learning to
         | disregard pain led to breakthroughs for them. One woman I know
         | set a big triathlon PR a year after having a kid, and when
         | people asked her how she was able to do that, she said, "After
         | having a kid, the pain just wasn't a big deal to me anymore."
         | She's big into the science, so I expected to hear something
         | about hormones, but for her, her expanded pain tolerance was
         | the entire explanation for her better performance.
         | 
         | Personally, just doing normal exercise presents me with an
         | incredibly rich variety of "painful" sensations and a lot of
         | difficult decisions. Right now I have a nagging shoulder
         | injury, and every time an exercise generates a "painful"
         | sensation in my shoulder, I have to decide, is this reflective
         | of something making this injury worse? better? neutral impact?
         | Should I stop right away so I don't aggravate the injury, or
         | should I do this exercise more often because it's stimulating
         | the tissue in just the right way? There's so much said and
         | written about it, but it often seems frustratingly
         | tautological. You have to know what the sensations mean before
         | you can figure out which words refer to which sensations.
        
           | nottorp wrote:
           | It's complicated. Do any kind of sports and muscle pain will
           | just mean you worked hard, which is generally good.
           | 
           | Do a martial art and you'll learn to ignore pain from hits to
           | non sensitive areas too.
           | 
           | But if you have a brain you'll still care about joint pain
           | and pain from hits to areas where it could cause serious
           | damage.
           | 
           | I'd let that shoulder heal a bit :)
        
         | jrgoff wrote:
         | I'm not sure how this fits in, but in my experience a further
         | complication as someone with chronic pain/illness is that often
         | the thing that bothers me the most isn't what I would describe
         | as painful. I would describe it as very uncomfortable but on a
         | different axis than pain. As a simple example that I think most
         | people can relate to - I do not think of being dizzy as
         | painful, but it's very impactful if you are dizzy all of the
         | time. I had an episode of vertigo that was one of the most
         | miserable experiences of my life but I don't think I
         | experienced much pain during it.
         | 
         | I guess if the goal is to tell whether the person needs pain
         | meds that complication may not matter as much since they don't
         | help (afaik) with those symptoms. But I do sometimes feel like
         | my health problems get taken less seriously if I report on my
         | pain levels rather than my discomfort and/or how it impacts me.
         | Eventually I found a migraine pain scale that focuses on how it
         | affects your life rather than directly how physically painful
         | it is and that helped me have a normalized system for
         | reporting.
        
       | INTPenis wrote:
       | True scifi will be when the doctor can use a machine to feel what
       | the patient feels.
       | 
       | "Ah, now I see Mr. K. Dilkington. You clearly have old cold belly
       | badness."
        
         | kevlened wrote:
         | This is a Black Mirror episode based on a short story by Penn
         | Jillette (of Penn & Teller)
         | 
         | https://en.wikipedia.org/wiki/Black_Museum_(Black_Mirror)
        
         | petercooper wrote:
         | Poor misunderstood Karl. I knew what he meant when he said that
         | glass ashtrays hold cold.
        
       | Fin_Code wrote:
       | Pain is relative to experience and tolerance. Using patient input
       | is inherently flawed.
        
         | taneq wrote:
         | I'm unsure how to interpret this statement. Are you saying that
         | the amount of pain experienced depends on the patient's prior
         | exposure and some 'tolerance' stat? And that we should ignore
         | their actual statements about, and reactions to, stimulus when
         | assessing the effect of that stimulus on them?
        
           | debacle wrote:
           | My son had a testicular torsion. Normally, this is 10/10 pain
           | and vomiting and fever and shock. All sorts of awfulness. If
           | you didn't know it, you would have assumed his pain was no
           | more than 4/10. It took an insistent pediatric nurse to
           | convince us that something very serious was going on and that
           | he needed to go to the ER right away.
        
           | kulahan wrote:
           | I would agree with him if I think about it. Pain is a side
           | effect. You are never trying to treat pain, you're trying to
           | treat whatever is causing pain.
           | 
           | This doesn't even get into the fact that people might
           | experience diminished or increased pain for a myriad of
           | reasons which could completely throw off the severity
           | assessment.
           | 
           | There are probably better methods to determine the
           | seriousness of a scenario? I'm not a doctor.
        
       | gaoshan wrote:
       | Probably not exactly the same but I remember trying to describe a
       | type of pain I felt to a doctor in the US. I called it "sour"
       | (which is how it would be described in Chinese) and the doctor
       | laughed saying that didn't mean anything to him. I think it is
       | extremely accurate and descriptive but to him it didn't even
       | register as having meaning.
        
         | elric wrote:
         | I am often baffled by how some people are able to articulate
         | how a specific pain feels or even where exactly the pain is.
         | Describing pain intensity is hard beyond "not very painful" and
         | "very painful". But adding a dimension of pain type is
         | something I struggle with. Sour pain makes as much sense to me
         | as piercing pain, which is to say: no sense at all.
         | 
         | I've been pierced (not for fun or aesthetics) by large nails in
         | an accident, and it felt nothing like the icepick headaches I
         | get, which my doctor tells me are a piercing pain.
         | 
         | Human internal experience is weird as fuck. If it can help
         | diagnostics in any way, I'm all for more precise pain
         | measurements. But I'm sure someone will abuse that research for
         | torture.
        
           | BurningFrog wrote:
           | I think it's entirely possible that different people
           | experience pain very differently.
           | 
           | If true, that makes it fundamentally impossible to fully
           | communicate about it.
           | 
           | I read an SF story where telepaths were as doctors. They'd
           | enter the patient's mind, feel what they feel, and recognize
           | the symtoms, because they had actually _felt_ how all common
           | conditions feel.
           | 
           | Maybe we can get to something similar with AI and brain
           | scanning one day?
        
             | kulahan wrote:
             | It would be wild if everyone experienced pain differently
             | despite having pretty much identical tools for experiencing
             | it. That would probably open so many cans of worms...
        
             | ALittleLight wrote:
             | Even without telepathy I think AI will get there. Doctors
             | don't have that much time or access with a patient. Imagine
             | telling ChatGPT what you feel, what your symptoms are, it
             | asks follow up questions, gives some suggestions on changes
             | or over the counter remedies, and comes to a diagnosis.
             | 
             | Once ChatGPT has done that 10 million times, and can learn
             | from or search those records, vague descriptions of
             | symptoms will likely sound pretty similar.
        
           | voidUpdate wrote:
           | I would generally describe a piercing/stabbing pain as very
           | localised and relatively painful, as opposed to something
           | like an aching pain, which is over a larger area and
           | generally less intense. I don't think I really use more
           | descriptors than that when referring to pain
        
             | intrasight wrote:
             | Once asked by a nurse if it's a stabbing pain or an aching
             | pain, I replied that I've never been stabbed so I wouldn't
             | know.
        
           | magicalhippo wrote:
           | I had a colonoscopy once, and they struggled to get around
           | the bend, so effectively jammed the probe into the walls of
           | my intestines several times.
           | 
           | It's one of the weirdest pain experiences I've had. It was
           | very painful, yet also very distinctly undefined in terms of
           | location, to the point where the pain felt surreal. Like, the
           | fact that I couldn't feel what was hurting made it feel like
           | the pain wasn't real, yet it was clearly very painful.
        
             | kulahan wrote:
             | Isn't this basically what headaches are? We have no pain
             | receptors in the brain of course, and I was under the
             | impression headaches are largely refereed pain.
             | 
             | If not all of them, it's certainly a subset, which is just
             | another interesting dimension of your experience.
        
           | xboxnolifes wrote:
           | > icepick headaches I get
           | 
           | Was the term icepick here given to you, or did you describe
           | it yourself this way? That would be a good example of a
           | description of piercing pain.
        
         | maxglute wrote:
         | I think the closest proximity to suan/sour is just sore. I like
         | the suan metaphore, like something
         | marinated/fermnated/drowning/gone slightly off in dull pain. It
         | wierd because "sour" does feel very apt descriptor, English has
         | sharp/stabbing/throbbing/burning/shooting/stinging/tingling/num
         | bing... etc lots of metaphores. But "sour" is just your default
         | sore/ache.
        
         | poulpy123 wrote:
         | There are clearly different types of pain. I use the french
         | words for high and low pitch to describe two groups of pain,
         | although I never used them.with a doctor because it would be
         | meaningless for ut
        
       | lijok wrote:
       | Any kind of accurate pain measurement mechanism would be
       | revolutionary in veterinary care.
       | 
       | We recently found ourselves in a horrible situation. Our dog
       | rapidly came down with a mystery illness that saw him go from
       | bouncy to unable to stand in the span of a few hours. 6 hours of
       | testing, 2nd opinions and specialists on the other side of the
       | planet, and noone had a clue what was going on. A ridiculously
       | primitive pain assessment was run, and we were advised that the
       | dog was suffering and we should let him go.
       | 
       | Millions of animals are put down every year on the premise they
       | are in pain, usually without strong data, with owners left to
       | wonder if it was too early.
        
       | m3kw9 wrote:
       | Pain is relative because the psychological factor can amplify
       | pain, say, someone afraid of getting a needle. The amount of hate
       | they have for it definitely makes it worse
        
       | GarnetFloride wrote:
       | I've been interested in pain and pain management since having a
       | drunk driver crash into us. I've even moderated a panel of
       | doctors who specialized in pain.
       | 
       | How people deal with acute vs chronic pain can be very different.
       | One doctor blew my mind when he described chronic pain as a
       | spousal relationship. It's something you have to live with and
       | work with. You can't ignore or bully pain.
       | 
       | Also men and women deal with pain differently. Most men describe
       | a heart attack as the worst pain ever. Many women have ignored
       | heart attacks because it wasn't as bad as their period pains.
       | Women also describe kidney stones as worse than childbirth.
       | 
       | I had a friend go in to the doctor and described the pain as a 5.
       | But the doctor noticed they were sweating because of pain, which
       | made it at least a 7 in their experience as that was an
       | involuntary physical response.
       | 
       | I've been to places not described on the pain scale, when I was
       | recovering from surgery the IV drop ran out, the pain was so bad
       | my spirit phased out of my body slightly so I was less aware of
       | the pain but could still see the nurse running around trying to
       | load another bag into the IV dispenser.
       | 
       | I can tell when a bad storm is coming because it feels like water
       | running down the inside of my leg bone, like runoff down a
       | gutter. Some days the pain is dull and I can get irritated
       | easily, but some over the counter pain medications are helpful.
       | So if I am going to the doctor I've already exhausted the
       | available options, so pain is high priority to me as I can't do
       | things.
       | 
       | I have also noticed that men's pain is taken more seriously than
       | women's pain. Redheads get less pain relief and if you are person
       | of color, especially a female, doctors take your pain least
       | seriously. It makes me wonder how they actually teach in med
       | school for that to happen.
       | 
       | Describing the pain in terms of what work I can and cannot do
       | gets more attention than anything else.
        
         | kulahan wrote:
         | It is crazy to me that womens' pain is so ignored. I've always
         | (half-) joked that if men got periods, there would be 30
         | alternatives to midol by the end of the month. Maybe we're just
         | better at crying like babies?
         | 
         | As a chronic pain sufferer, I experienced the same as you,
         | explaining where I am limited in life rather than expressing
         | how much pain I'm in gets much better results.
         | 
         | A similar problem I've had is that I tell my doctors I have
         | terrible sinus pain. Often the response to that is that I
         | should consider allergy meds, as well as a confirmation that I
         | am indeed "pretty stuffed up".
         | 
         | But when I say I cannot sleep a full 8 hours due to sinus
         | blockage, suddenly we need sleep evaluations, humidifiers,
         | antihistamines prescribed, methods for lubricating my sinuses,
         | netti pots, etc.
        
         | newfocogi wrote:
         | "Redheads get less pain relief" - are there any references you
         | have so I can explore this more?
        
         | meroes wrote:
         | Chronic "pain" as a spouse is the perfect metaphor. I can't
         | push through it, I have to use patience and understanding and
         | it's always somewhere on my mind. That's the only way to make
         | progress or be sane long term. I've grown and matured because
         | of it. I've also experienced the post surgery pain that briefly
         | takes you out of this world. For a split second I was in the
         | Hell dimension a la Event Horizon the movie before I had taken
         | my first dose of opiates and had adjusted my arm too much. I
         | don't mean the pain was hellishly bad; I didn't cry out which
         | is probably what a 10/10 pain would elicit. It was more like
         | dread and "seeing" but not with vision the mutilated flesh and
         | gore inside my repaired wrist.
        
       | _DeadFred_ wrote:
       | I added a children's pain scale to some software (faces in
       | varying levels of pain that children can point to). I know my mom
       | had chronic back pain that she complained about, but I never
       | really thought about it. She functioned, she got through life.
       | She was over for dinner at the time and I must have brought the
       | scale up in discussion. I grabbed a paper copy and asked her what
       | her pain level was, and she pointed to the second worst. Even
       | after that I just kind of wrote off her pain like, she functions
       | (though sometimes I would have to go get her as she got stranded
       | in a supermarket in too much pain to move), and that's just life.
       | I can watch a movie of some random acting dog whimper and fake
       | limp and have to wipe tears from my eyes, but almost instantly
       | went to ignoring my own mother's pain because she powered
       | through. I hope it's not because acknowledging my mother's pain
       | would have created a cost for me (doing more for her,
       | acknowledging would create a long term burden on me versus the
       | quick/easy/kind of cathartic/self serving release of emotion of a
       | sad movie) but part of me thinks that's partially the case.
       | What's the point in measuring when our response is still just a
       | shrug?
        
       | metalman wrote:
       | a graduated set of instuments starting with a short, thin, very
       | pointy pin then the same, dipped in weak.acid then bigger pins,
       | and stronger acids the get them hot etc,etc sort of a micro
       | tortures starter kit, but all calibrated and then a big pile of
       | money, to attract volunteirs there is already a group that has
       | been doing this with insect stings and bites, with the worst
       | bieng some kind of mega sized japanese hornet, which the
       | description of was, as an awe inspiring combination of bieng
       | stabed with something dipped in hot acid, so.....
        
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