How Functional is Functional?

This questionnaire provides information on how pain impacts your ability to manage everyday life. Please answer every section. Only select the ONE statement that applies to you at this time. Two (or more) statements in any given section may relate to you, but please only select the ONE that closely describes your current condition.

Pain Intensity

• I can tolerate the pain without using pain medication.

• The pain is bad, but I manage without pain medication.

• Pain medications offer complete relief from pain.

• Pain medications offer moderate relief from pain.

• Pain medications offer little relief from pain.

• Pain medications don’t impact the pain, so I don’t take them.

Modern medicine created a double-edged sword when it embraced the magic available from the poppy. The body’s mu receptors looked at opioids with the same gleam as a child eyeing an unguarded paint palette and a white wall. And physicians welcomed the silence of previously endless choruses of moaning and screaming along hospital wards. But in the rush to “revolutionize” pain control, no one bothered to pay attention to the centuries of addictive side effects that tagged along for the ride.

Medicine was slamming the door on an invisible nemesis; as long as they checked that box, nothing else mattered. That included anything a patient might report outside of, “Thanks, my pain is zero.”

No one wanted to hear, “The pain hasn’t changed.” Not after throwing Dilaudid and fentanyl at a gall bladder full of sludge. (Sludge not warranting the same concern as stones) Or after they covered my skin in lidocaine patches.

How dare I deny their miracle cure? Medication was the be-all and end-all!

The doctor stared in horror when I refused the discharge prescriptions. Did I not realize there’d be pain post-op?

I stared. Hadn’t listened to me for the past six months?

Personal Care

• I can look after myself without causing additional pain.

• I can look after myself, but it causes additional pain.

• It’s painful to look after myself. I’m slow and careful.

• I need help, but I manage most of my personal care.

• I need help every day with most of my self-care.

• I don’t get dressed. It’s too difficult, so I stay in bed.

Until you spend significant time hospitalized, you don’t understand the level of helplessness inflicted upon your mind, soul, and body.

Monitoring equipment creates a Gordian knot of cords that entangle your arms and legs. Fluid lines wait for a single drop to get hindered by your movement or position, gleeful at the opportunity to scream alarms. (Particularly when you’re finally comfortable enough to drift asleep or when visitors feel the need to comment on your interfering with equipment) Nurses grow weary of you shambling around the room and lock the bed rails in place, requiring you to call for assistance every time you need to pee (something that happens with alarming frequency on IV fluids).

It’s a level of dependence that grates on sanity.

Within hours of regaining consciousness, I make it my mission to master the dance of my hospital room. Even if it requires putting my teeth through my bottom lip to hold in screams, I curl forward to examine the water wraps around my legs that stave off blood clots. (No two are ever the same. I suspect the industry reinvents them specifically with me in mind) Years in the veterinary profession taught me to be fearless at manipulating IV pumps, ensuring I need only resort to a call button when bags run empty. And I earn every “Fall Risk” band and “Extreme Fall Risk” notice posted outside my door, exercising acrobatics to climb out of my bed and navigate the obstacle course of chairs to the bathroom.

I’m a terror for nurses and assistants (to say nothing of loved ones).

Lifting

• I can lift heavy weights without additional pain.

• I can lift heavy weight, but it causes additional pain.

• Pain prevents me from lifting heavy weights from the floor. But I can manage if objects are positioned higher (i.e., on the table).

• Pain prevents me from lifting heavy weights. But I can manage light or medium weights if they’re positioned higher.

• I can lift light weights.

• I can’t lift or carry anything.

Doctors expect pain to equate with drama. Bleeding wounds should come from horrific knife accidents. (Or obligatory mandolin incidents in the kitchen) Broken bones are preceded by unplanned stunts involving roller skates, skateboards, and bicycles - accompanied by a healthy dose of alcohol and peer pressure. And back pain must result from overestimating an ability to lift a couch single-handedly. A crate of library books. An Irish wolfhound.

SOMETHING of significance - minus a helpful reminder to “lift with your legs.”

No one takes you seriously or believes an inability to walk/stand/sit if you tell them you picked up a loaf of bread.

Not even a FULL loaf of bread; a partial, missing at least six slices.

The skepticism was as painful a slap as the twisting agony imprisoning my spine. Followed quickly by humiliation as the doctor - a medical professional dangling treatment and relief just out of reach - suggested I revise my story to something more substantial.

Two loaves of bread, perhaps.

Sleeping

• Pain does not prevent me from sleeping.

• I can sleep well, but only by using medication.

• Even when I take medication, I sleep less than 6 hours.

• Even when I take medication, I sleep less than 4 hours.

• Even when I take medication, I sleep less than 2 hours.

• Pain prevents me from sleeping.

The men in my life fall asleep at the drop of a hat. My father and brothers served the country, mastering the military tactic of achieving deep sleep within seconds. (There’s no trick; you learn to catch your rest when you can, or you go insane from lack of mental and physical recuperation) My husband made a pagan sacrifice he refuses to share the details of.

Position any of them in a semi-comfortable piece of furniture and leave them for five minutes, and you hear settled, even breathing followed by the first tentative rumble of a snore. (Don’t believe their insistence that they don’t)

The women in my life? We hunt sleep with the single-minded determination of Batman persuing the Joker (with the same success rate). The genetic coding for peaceful slumber only adheres to the Y chromosome on our family tree. We’re meant as casual observers of the habit, subject to stare hungrily through the night at the restful recovery of our counterparts.

I spend hours watching Tim through the night as he snores with careless abandon. My muscles spasm in sympathy at the contorted positions his body ignores. In the final minutes of the night, as dawn considers rising over the horizon, I wonder if that’s what partnership means: One to sleep and one to feel every shifting movement.

Employment/Homemaking

• My normal homemaking/job activities don’t cause pain.

• My normal homemaking/job activities cause pain, but I can still perform everything required of me.

• I can perform my homemaking/job activities, but pain prevents more physically-demanding activities (i.e., lifting, vacuuming).

• Pain prevents all but light duty.

• Pain prevents even light duty.

• Pain prevents any job or homemaking chores.

Idle hands don’t exist on good employees. Managers adore a worker that finds tasks without prompting. (Cleaning - there’s constantly cleaning, regardless of the industry) A manager can walk away during their shift, confident everything will run smoothly and get taken care of. No concern about gossiping or the chaos produced by laziness.

Good employees are hated employees.

They create a bar no one else wants to meet. The lack of slack immediately marks them as suspect. Someone who shows up without fail - even when they have to suffer jokes and laughter on a red knee scooter - is irritating. No one in their right mind comes to work consistently (who needs a regular paycheck?). Ostracized, they’re marked for complaints and singled out as an easy target for vicious rumors.

Easier than stepping forward to assist. Or taking five seconds to recognize Newton’s first law of motion.

Stop and attempt to overcome pain’s inertia to move again? Or continue to move throughout the day, preserving motion as long as humanly possible? (Newton never incorporated pain into his equations)

There are 5 possible points for each statement: 0 for the first answer, 1 for the second answer, etc. Add up your total for the 10 sections* and compare your score to the scale below:

• 0-4: No disability Patient can cope with most activities. No treatment indicated aside from advice on lifting, sitting, and exercise.

• 5-14: Mild disability Patient experiences more pain and difficulty with sitting, lifting, and standing. Travel and social life are more difficult, and they may be away from work on disability. Personal care, sexual activity, and sleeping are not grossly affected, and the patient can be managed conservatively.

• 15-24: Moderate disability Pain remains the main problem; daily living is affected. Patient requires a detailed investigation.

• 25-34: Severe disability Pain impinges on all aspects of patient’s life. Positive intervention required.

• 35-50: Completely disabled Patient is either bed-bound or exaggerating their symptoms.

Pain is a coin.

On one side, you have a condition that blows up your life. Everything you knew, understood, and loved disintegrates in front of your eyes. Nothing looks the same. You stare at the shower and debate how badly you need to scrub your hair. Or you decide that Millenials were onto something when they adopted pajamas as streetwear. (But you have “nice” pajamas in case you need to see people) Even breathing becomes a questionable activity on certain days. If your rib cage isn’t feeling it, you argue against the necessity.

But on the other side, admitting those facts turns you into a liar. A hypochondriac. A drug addict. Because NO ONE is in that much pain. Doctors refuse to believe it (and lack the ability to test it). Social workers grow skeptical. Managers find it easier to terminate you and replace you with someone (less competent) who at least walks through the door. You’re looking for attention, medication, validation.

(I never said this was a coin you wanted to flip)

Faced with those options, you have no choice but to push through the nightmare. Without medication (it’s not like you haven’t tried all of them at some point; you’re a connoisseur). Despite your body screaming at you to put the damn table down. While your husband watches you struggle with your bra. Until mopping the floor causes you to pass out. Counting down the minutes of sleep you’ll never get.

Then watch the medical community stare in disbelief when you tell them, YES, you’re in pain.

*Based on Oswetry Disability Questionnaire and Index