Page 35 - Changes and Challenges

Dementia
Changes and Challenges
caused at least a stinging sensation or a short stabbing pain such as having a
needle inserted to draw blood now rarely it at all cause any pain-like
sensation. Even though I can feel the pressure of the needle on my skin, the
sensation of it piercing may skin and it being stirred around in my arm, in an
attempt to find a good vein, I don’t feel the pain. The only pain I feel is when I
remove the dressing latter. For that reason, I generally decline adhesive
dressings as my blood will generally do a good job of clotting within about a
minute or so (it gets a lot of practice!).

As I also have arthritis, I am often asked about pain levels. Health
professionals now all use an imaginary scale of pain, 1 to 10, where 10 is the
most severe pain you can imagine. I find this a little amusing because a
supposed commonly occurring symptom of Dementia is a reduced or impaired
imagination.

I often confuse them by asking them, “how do I compare two different types
of pain”? One being a very intense but short duration pain such as hitting your
thumb with a hammer, and the other being a very low intensity pain just
above the threshold of feeling, that persists for long periods of time. The
following diagram (Figure 9: Pain Intensity and Time, page 31) illustrates this
idea.

The blue line illustrates a short (15 to 30 minute) high intensity pain episode.
In this example I’ve repeated twice it at reducing intensity after 4 to 5 hours.
Compare this to the orange line that fluctuates over a very low level but
continues for 24 hours. The higher intensity pain us approximately 10 times
the level of the low intensity pain, similar to the concept of the pain scale.
Now if we integrate the areas under both curves, the area of long acting low-
level pain is 20% more than that of the short intense pain.

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