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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.

SURNAMEDates FIRST NAMESAllison
ADDRESSAcredales, Bridgethorpe
D. O. B.30/4/79 SEXf MARITAL STATUSmarried
OCCUPATIONbank clerk
Presenting complaintC/o severe, boring in nature, mainly in and around R eye. Can radiate to forehead. Comes on at time and can vary in duration 1-2 hts. No precipitating or relieving factors. Has noticed haloes around lights with some blurry vision in R eye.
       

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


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