Talking about pain

Case notes are kept for each consultation. The Presenting Complaint section of case notes records the patient's symptoms. For example:

R. sided temporal headache, severe, throbbing. Lasts 24-48 hrs.

In this case, the patient complains of a headache. For a list of the questions the doctor asks the patient, and for patients' descriptions of other kinds of pain, see Appendix IV.

Exercises:

1. Study the case notes. Write the questions the doctor asked to obtain the numbered information. Look at Appendix IV to help you.

2. Read the continuation of the case notes for the patient in C. Write the doctor's questions.

PMH similar headaches 10 yrs, coming every 3 mths. Aggravated by eating chocolate; relieved by lying in dark room. Can have visual aura, blurred vision, nausea.

Doctor: Can you tell me what the problem is?

Patient: I've got a terrible headache.

Doctor: (1) ………………………………………………………………………………?

Patient: Just here.

Doctor: (2) ……………………………………………………………………………... ?

Patient: Well, it's really bad. And it throbs.

Doctor: Have you had anything like this before?

Patient: Yes, about every three months. I've had them for the last ten years or so.

Doctor: (3) ………………………………………………………………………………?

Patient: Usually one or two days. This one started yesterday morning.

Doctor: (4) ………………………………………………………………………………?

Patient: They usually start just after I eat chocolate. I'm not sure.

Doctor: (5) …………………………………………………………………………… ...?

Patient: If I lie down in a dark room it helps. Light makes them worse.

Doctor: (6) ………………………………………………………………………………?

Patient: If I move my head, it gets more painful.

Doctor: Apart from the headache, (7) …………………………………………………...?

Patient: Yes, my eye feels strange. Sometimes I can't see clearly, things get blurred. I feel sick.

3. Complete the sentences. Look at Appendix to help you.

1. Gastric ulcers are associated with a ………,..……pain.

2. Patients with a peptic ulcer may say they have a ………….. pain.

3. Recurrent abdominal pain (RAP) may be described as ……………or ……………pain.

5. People with osteoarthritis often complain of a deep ……………centred in the joint.

6. Kidney stone pain is sudden, severe and …………..

7. Angina is usually described as a crushing or heavy or …………..pain.

Lesson 2