美国国家公共电台 NPR Words Matter When Talking About Pain With Your Doctor

 

RACHEL MARTIN, HOST:

If you go to the doctor with a painful problem, you will likely be asked to rate that pain on a scale of zero to 10, with zero meaning no pain at all and 10, the worst pain imaginable. But many doctors and nurses say rating by numbers isn't working, and patients may not be getting the proper treatment for their pain. NPR's Patti Neighmond reports.

PATTI NEIGHMOND, BYLINE¹: Thirty-three-year-old Adam Rosette knows the numeric pain scale quite well. He suffers a painful bone disorder².

ADAM ROSETTE: It's a tricky³ question - what your pain level is.

NEIGHMOND: Just over a month ago, Rosette had brain surgery to remove benign⁴ tumors that stopped him from chewing or speaking. He was in severe pain but felt uncomfortable rating it too high and never rated it over a seven.

ROSETTE: Higher than that is, like, oh, I'm missing half of my body or a limb or something, you know? And I wasn't in that level of pain.

NEIGHMOND: But he wonders if lowballing his pain level meant he got less medication to control it.

ROSETTE: The medicine wears off and you realize you took less medicine and it's been eight hours and they're not allowed to give you any more for a while.

NEIGHMOND: Now, full disclosure, I was recently in the same boat. I was in the hospital for back surgery and I also lowballed my pain. I know patients in pain need medication, but I've done lots of stories about opioid addiction⁵ and was very wary⁶ of getting too much medication. Neurologist John Markman with the University of Rochester says the numeric pain scale may just be too simple and may lead to both over- and under-treatment.

JOHN MARKMAN: The focus on pain intensity⁷ has led to a sort of paint-by-numbers, if you will, or treat-by-numbers approach.

NEIGHMOND: Instead of focusing on the intensity of pain, Markman says it might be more useful to also look at what the pain is preventing the patient from doing. Can they walk, exercise, focus? Is the pain preventing them from sleeping?

MARKMAN: The way it interferes⁸ with particular activities are really what should be the focus of trying to treat them and take care of them because that's what's most important to them.

NEIGHMOND: Markman recently did a study analyzing⁹ data from patients who rated their pain by the numbers but also answered this simple question.

MARKMAN: Is your pain tolerable?

NEIGHMOND: It turned out three-quarters of the patients in the study who rated their pain as moderately intense - four to seven on the pain scale, a range typically resulting in higher doses of medication - also described their pain as tolerable, a description that normally means no more pain treatment is needed.

MARKMAN: If the patient tells you my pain is a six but, you know, I understand that I have osteoarthritis and I'm accustomed to it, and it's tolerable for me, it changes the discussion you're having with them to, well, what's making it tolerable for you? How are you able to work around it? Rather than thinking, well, I need to give them something or do something for them to reduce that number.

NEIGHMOND: Markman says this is why it's important not to rely only on a number.

MARKMAN: If you were just treating by the numbers, you might say, well, someone has a pain which is a six over 10, I feel obligated to do something about that to reduce that number, just like you might try and fix their blood pressure or their blood glucose¹⁰.

NEIGHMOND: Now, pain is subjective¹¹. Dr. William Maixner, president of the American Pain Society, says people respond to pain differently.

WILLIAM MAIXNER: Everyone has sort of their own internal gauge¹² with respect to how they perceive pain.

NEIGHMOND: So Maixner says patients need to be really descriptive when talking with their doctor about pain. UCLA pain management physician Dr. Chrystina Jeter agrees. She says, the more words, the better.

CHRYSTINA A. JETER: It's perfectly¹³ OK to be a little more flowery with your description of your pain. My pain is aching, it's burning. What does it feel like to you, you know? Where is it? Does it move? It's helpful for us, as health care professionals, to triage your pain and assess, how severe is this? How aggressive do I need to be?

NEIGHMOND: And Jeter says, share with your doctor anything that's helped reduce your pain in the past - massage¹⁴, acupuncture¹⁵, exercise. All these details will help your doctor come up with the most effective treatment for your pain. Patti Neighmond, NPR News.

(SOUNDBITE OF TEEN DAZE'S "YVR")

1 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

2 disorder   

n.紊乱，混乱；骚动，骚乱；疾病，失调

参考例句：

• When returning back,he discovered the room to be in disorder.回家后，他发现屋子里乱七八糟。
• It contained a vast number of letters in great disorder.里面七零八落地装着许多信件。

3 tricky   

adj.狡猾的，奸诈的；(工作等)棘手的，微妙的

参考例句：

• I'm in a rather tricky position.Can you help me out?我的处境很棘手，你能帮我吗？
• He avoided this tricky question and talked in generalities.他回避了这个非常微妙的问题，只做了个笼统的表述。

4 benign   

adj.善良的，慈祥的；良性的，无危险的

参考例句：

• The benign weather brought North America a bumper crop.温和的气候给北美带来大丰收。
• Martha is a benign old lady.玛莎是个仁慈的老妇人。

5 addiction   

n.上瘾入迷，嗜好

参考例句：

• He stole money from his parents to feed his addiction.他从父母那儿偷钱以满足自己的嗜好。
• Areas of drug dealing are hellholes of addiction,poverty and murder.贩卖毒品的地区往往是吸毒上瘾、贫困和发生谋杀的地方。

6 wary   

adj.谨慎的，机警的，小心的

参考例句：

• He is wary of telling secrets to others.他谨防向他人泄露秘密。
• Paula frowned,suddenly wary.宝拉皱了皱眉头，突然警惕起来。

7 intensity   

n.强烈，剧烈；强度；烈度

参考例句：

• I didn't realize the intensity of people's feelings on this issue.我没有意识到这一问题能引起群情激奋。
• The strike is growing in intensity.罢工日益加剧。

8 interferes   

vi. 妨碍，冲突，干涉

参考例句：

• The noise interferes with my work. 这噪音妨碍我的工作。
• That interferes with my plan. 那干扰了我的计划。

9 analyzing   

v.分析；分析( analyze的现在分词 )；分解；解释；对…进行心理分析n.分析

参考例句：

• Analyzing the date of some socialist countries presents even greater problem s. 分析某些社会主义国家的统计数据，暴露出的问题甚至更大。 来自辞典例句
• He undoubtedly was not far off the mark in analyzing its predictions. 当然，他对其预测所作的分析倒也八九不离十。 来自辞典例句

10 glucose   

n.葡萄糖

参考例句：

• I gave him an extra dose of glucose to pep him up.我给他多注射了一剂葡萄糖以增强他的活力。
• The doctor injected glucose into his patient's veins.医生将葡萄糖注入病人的静脉。

11 subjective   

a.主观(上)的，个人的

参考例句：

• The way they interpreted their past was highly subjective. 他们解释其过去的方式太主观。
• A literary critic should not be too subjective in his approach. 文学评论家的看法不应太主观。

12 gauge   

v.精确计量；估计；n.标准度量；计量器

参考例句：

• Can you gauge what her reaction is likely to be?你能揣测她的反应可能是什么吗？
• It's difficult to gauge one's character.要判断一个人的品格是很困难的。

13 perfectly   

adv.完美地，无可非议地，彻底地

参考例句：

• The witnesses were each perfectly certain of what they said.证人们个个对自己所说的话十分肯定。
• Everything that we're doing is all perfectly above board.我们做的每件事情都是光明正大的。

14 massage   

n.按摩，揉；vt.按摩，揉，美化，奉承，篡改数据

参考例句：

• He is really quite skilled in doing massage.他的按摩技术确实不错。
• Massage helps relieve the tension in one's muscles.按摩可使僵硬的肌肉松弛。

15 acupuncture   

n.针灸，针刺法，针疗法

参考例句：

• Written records show that acupuncture dates back to the Song Dynasty.文字记载表明，宋朝就已经有了针灸。
• It's known that acupuncture originated in China.众所周知，针灸起源于中国。