WARNING – Graphic image

Many moons ago, when Mark was still “999” and the Project wasn’t even a thought, I relayed a personal story of mine in relation to pre-hospital pain management.

In THIS POST I told you about why I treat burn victims with the maximum safe dosage of pain meds as fast as I can justify it and why I laugh anytime someone able to walk tells me their pain is a 10 out of 10.  Have a read of that old post real quick so that what I’m about to show and tell you makes more sense.

Thanks for coming back.

I can’t feel my leg anymore.  A few weeks ago I began noticing a strange sensation whenever I crossed my right foot onto my left thigh while sitting, an odd almost itching sensation but I couldn’t narrow it down.  Each day there was less and less sensation until the way it is now.  No hot.  No cold.  No touch.  No breeze. Nothing.  The anterior aspect of my left leg is not numb or tingling but simply without sensation.  Ever sleep on your arm and have to physically move it and how funny it is to see your arm move without feeling it?  I’m there now 24/7.

Curious about the area in question I pulled up some old photos we took soon after initial treatment.  The photos immediately after the blisters began to form turned my stomach a bit, and I was there, so I won’t show those, but I wanted to share with you the pictures from my injury to reinforce what these folks are going through.

I was not … hmmm…I was about to type that I was not permanently scarred by the injury but I guess that is no longer the case.  Currently, the skin appears fine and the outline of the burn is only visible if you know where it should be and squint.  Or just poke the leg with a toothpick and when I flinch, that’s not where I got burnt.

Again, this goes back to why you should ALWAYS qualify that pain scale by comparing it to the worst pain THEY have ever felt.  Ask your patients what their worst pain was and use that as your benchmark.  Any person who tells me 10 out of 10 for a twisted ankle or headache without qualifying is treated differently than the person crying, doubled over who tells my 7 out of 10 for an ankle when their 10 was a shattered pelvis.

This is my 10 out of 10:

burnThe other leg was also burned but not as severely.  This photo was taken 2 weeks after the original injury and is in the midst of my physical therapy.

The pink area in the center with all the little white dots (hair follicles) is the area that I can no longer feel.  Whether it be the nerves, the basilar layer of the skin or simply my nervous system blocking the impulses I have no idea.

But I do know that I would have paid money for someone to dose me up when those blisters first formed and I would have killed to get more when they got tight.

Yes I cried.  I cried like my 2 year old 30 minutes after bed time.  I tried to “man up” but I couldn’t even stand up the pain was so bad.  Blurry vision, nausea, the whole nine yards.  But had the me from 2 months prior been the Medic responding to me when this happened, I may have given 4-6mg, maybe 8mg of morphine to take the edge off.

But now I would hit me with 10mg, have another 10 ready, and be on the phone to the MD for orders to dose to comfort and respiratory drive.

I wanted to be unconscious, but never got the chance.

Yes, this could indeed fall under TMI, but please remember to follow through with your pain assessments and not just do the “On a scale of 1 to 10…”

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