Not that needle!
November 13, 2008 10:36 AM Subscribe
What is the most painful hospital test?
I've been watching alot of House lately, and on the show the patient typically gets his/her bone marrow drawn, brain biopsied and spine tapped, usually with a nominal level of grimacing.
Just how painful are these tests? I've heard that donating bone marrow is exceedingly painful. What is the #1 procedure that I most want to avoid?
Thanks-
cgs
I've been watching alot of House lately, and on the show the patient typically gets his/her bone marrow drawn, brain biopsied and spine tapped, usually with a nominal level of grimacing.
Just how painful are these tests? I've heard that donating bone marrow is exceedingly painful. What is the #1 procedure that I most want to avoid?
Thanks-
cgs
I've had a bone marrow biopsy from the sternum. They gave me a local anesthetic so the pain wasn't as bad as it could have been, but the terrible sensation of having something drill into my bones was above and beyond the worst dentist visit I've ever had (and I've had a lot of dental work done). It wasn't "exceedingly painful," but was not something I'd ever like to repeat (and not just because I was waiting to find out if I had leukemia).
If I could guess, I'd think spinal tap is the most "painful" because the brain itself doesn't experience pain (though drilling through your skull is probably pretty painful).
posted by cosmic osmo at 10:50 AM on November 13, 2008
If I could guess, I'd think spinal tap is the most "painful" because the brain itself doesn't experience pain (though drilling through your skull is probably pretty painful).
posted by cosmic osmo at 10:50 AM on November 13, 2008
Spinal tap, is what I've heard. From people who have had them, and from people who have administered many painful tests.
posted by paisley henosis at 10:52 AM on November 13, 2008
posted by paisley henosis at 10:52 AM on November 13, 2008
(1) Bone Marrow harvesting for donation involves multiple large-bore needle pokes, and is pretty uncomfortable.
(2) Bone Marrow biopsy for a diagnosis is a big needle crunching through a bony layer, but is numbed by local anesthetic.
(3) Spinal tap (lumbar puncture) is a thin but long needle sliding between bones, inserted through numbed-up skin. This can be a smooth, painless procedure.
(4) Brain's have no sensory nerves, so once you get to it, through nose or skull, no pain. But, of course, the devil is in the detail of how you get to the brain.
For my money, most painful: open body surgery with no anesthesia. Ever see a Civil War amputation re-enacted? That looks pretty bad, too.
posted by cameradv at 10:52 AM on November 13, 2008
(2) Bone Marrow biopsy for a diagnosis is a big needle crunching through a bony layer, but is numbed by local anesthetic.
(3) Spinal tap (lumbar puncture) is a thin but long needle sliding between bones, inserted through numbed-up skin. This can be a smooth, painless procedure.
(4) Brain's have no sensory nerves, so once you get to it, through nose or skull, no pain. But, of course, the devil is in the detail of how you get to the brain.
For my money, most painful: open body surgery with no anesthesia. Ever see a Civil War amputation re-enacted? That looks pretty bad, too.
posted by cameradv at 10:52 AM on November 13, 2008
That's probably way up there. The procedure for marrow biopsies generally involves a bone marrow biopsy and a bone marrow aspiration. The former takes out an approximately 2cm sample of hard bone and marrow, while the latter involves sucking some of the liquid marrow out with a syringe. Neither is likely to be particularly pleasant.
Thing is though, the procedure can be done under general anesthesia, so the torture-like experiences portrayed on House aren't exactly representative.
In terms of other procedures, there are tons of really unpleasant ones, but they frequently sedate you for those. For example, trans-esophageal echocardiograms are taken by sticking a sizable probe down one's throat and taking pictures from that angle rather than from the chest wall. Very useful. But because most people have a rather reflexive reaction to large objects being shoved halfway down their throats and then wiggled around, they usually knock you out. Not so that you're completely unconscious, but enough that you're cooperative and won't remember a thing.
If you're male, visiting the proctologist is probably one of the more unpleasant things you're likely to experience. Whether it's examining your genitalia or anus, both are pretty sensitive, and "riding the silver pony," i.e. going in for a colonoscopy, isn't something most people enjoy.
But in general, medical tests are largely intended to be relatively painless. A certain amount of discomfort is probably unavoidable--getting something shoved up your ass may not be the high point of your week, but you will neither die nor be too discomfited to cooperate--but if it's likely to really hurt, they generally just knock you out.
posted by valkyryn at 10:57 AM on November 13, 2008
Thing is though, the procedure can be done under general anesthesia, so the torture-like experiences portrayed on House aren't exactly representative.
In terms of other procedures, there are tons of really unpleasant ones, but they frequently sedate you for those. For example, trans-esophageal echocardiograms are taken by sticking a sizable probe down one's throat and taking pictures from that angle rather than from the chest wall. Very useful. But because most people have a rather reflexive reaction to large objects being shoved halfway down their throats and then wiggled around, they usually knock you out. Not so that you're completely unconscious, but enough that you're cooperative and won't remember a thing.
If you're male, visiting the proctologist is probably one of the more unpleasant things you're likely to experience. Whether it's examining your genitalia or anus, both are pretty sensitive, and "riding the silver pony," i.e. going in for a colonoscopy, isn't something most people enjoy.
But in general, medical tests are largely intended to be relatively painless. A certain amount of discomfort is probably unavoidable--getting something shoved up your ass may not be the high point of your week, but you will neither die nor be too discomfited to cooperate--but if it's likely to really hurt, they generally just knock you out.
posted by valkyryn at 10:57 AM on November 13, 2008
Response by poster: cameradv: open body surgery w/o anesthesia... this is done? or are you talking like battlefield situations...
posted by cgs at 10:57 AM on November 13, 2008
posted by cgs at 10:57 AM on November 13, 2008
Response by poster: I've also heard that donating eggs is pretty rough...
posted by cgs at 10:59 AM on November 13, 2008
posted by cgs at 10:59 AM on November 13, 2008
It's a little tough to answer this not only because pain is subjective, but also because if you're at the point where the doctor is recommending a spinal tap, the last thing you want to be thinking is "oh shit, this is going to hurt like hell...." because there's a good chance you'll need it and in my experince dread exacerbates pain. I haven't had any of these procedures. My sister had a spinal tap. The procedure itself wasn't pleasant but it wasn't horirble, but she was one of those people who had a severe spinal headache after the procedure that was horribly bad. It's a side effect, not part of the procedure, but also worth avoiding.
posted by jessamyn at 11:03 AM on November 13, 2008
posted by jessamyn at 11:03 AM on November 13, 2008
I had a spinal tap when I was 12. The doctor looked me in the eye and said, "Son, this is going to hurt." Not "you may feel some pressure" or "this may be uncomfortable."
He was not kidding. It was like every square inch of my skin hurt at the same time. The thought of it gives me the willies.
posted by DWRoelands at 11:05 AM on November 13, 2008
He was not kidding. It was like every square inch of my skin hurt at the same time. The thought of it gives me the willies.
posted by DWRoelands at 11:05 AM on November 13, 2008
A lumbar puncture hurts a lot when the person performing the test screw up.
The nerve transmission speed test, where you get zapped with electricity many times, is no fun either, so I'm told.
posted by zippy at 11:06 AM on November 13, 2008
The nerve transmission speed test, where you get zapped with electricity many times, is no fun either, so I'm told.
posted by zippy at 11:06 AM on November 13, 2008
nthing that this is subjective. An ordinary xray can be astonishingly painful if you have broken bones. At least that's what my screams signified the night I shattered my leg and the resident was twisting my leg into just the right position on the xray table. And I was already over the max advisable dose of morphine.
posted by ImproviseOrDie at 11:07 AM on November 13, 2008
posted by ImproviseOrDie at 11:07 AM on November 13, 2008
Pain is subjective, and closely associated with anxiety. Tests hurt more when people are afraid of them or anxious about the results. You're going to get a whole lot of very subjective, anecdotal information in response to this question. Here's mine:
My spinal tap was completely painless. It sure felt weird, no question, and there's a sensation of pressure and general oddness that can't really be explained, but it didn't hurt.
The most painful test I've ever had was a nerve conduction study, in which a technician applied electrodes to various body parts (in my case it was arms and legs) and sent gradually-increasing levels of current through my nerves in order to test how well the nerves were conducting the signal. The current was eventually strong enough that my arms and legs were jerking around like a marionette and it was impossible to control. I have a pretty high pain tolerance--I've comfortably read a book while getting a several-hours-worth-of-work tattoo--and this made me cry.
posted by jesourie at 11:09 AM on November 13, 2008
My spinal tap was completely painless. It sure felt weird, no question, and there's a sensation of pressure and general oddness that can't really be explained, but it didn't hurt.
The most painful test I've ever had was a nerve conduction study, in which a technician applied electrodes to various body parts (in my case it was arms and legs) and sent gradually-increasing levels of current through my nerves in order to test how well the nerves were conducting the signal. The current was eventually strong enough that my arms and legs were jerking around like a marionette and it was impossible to control. I have a pretty high pain tolerance--I've comfortably read a book while getting a several-hours-worth-of-work tattoo--and this made me cry.
posted by jesourie at 11:09 AM on November 13, 2008
cgs: not intentionally. There's ongoing discussion about mid-operative awareness: you wake from the sedative aspects of anesthesia to be paralyzed, but able to feel everything happening. How much (if ever) that actually occurs is debatable.
posted by cameradv at 11:10 AM on November 13, 2008
posted by cameradv at 11:10 AM on November 13, 2008
It isn't a test, but of the most painful things routinely done to patients in hospitals is debriding of burns.
That's because they often do it without anesthetic. Why they don't juice the patient to the gills with morphine first is one of those great mysteries of life, but they often don't.
So when you have someone with 3rd degree burns over most of their body, debriding the dead skin is one of the most painful things you can imagine. They put the burn patient into a bath, and then the attendant scrubs the burned area to break loose all the little charred dead pieces of skin.
I gather that a lot of screaming goes on.
posted by Class Goat at 11:12 AM on November 13, 2008
That's because they often do it without anesthetic. Why they don't juice the patient to the gills with morphine first is one of those great mysteries of life, but they often don't.
So when you have someone with 3rd degree burns over most of their body, debriding the dead skin is one of the most painful things you can imagine. They put the burn patient into a bath, and then the attendant scrubs the burned area to break loose all the little charred dead pieces of skin.
I gather that a lot of screaming goes on.
posted by Class Goat at 11:12 AM on November 13, 2008
Personally I'd have to put having a urinary catheter inserted while you're in labor, but 1. YMMV, and 2. I don't think they show that on tv.
posted by nax at 11:22 AM on November 13, 2008
posted by nax at 11:22 AM on November 13, 2008
Class Goat, you're right; there's a lot of misery. A medication cocktail is used, so at least the person's memory of the procedure is somewhat blunted. This makes it possible for them to go back the next time. I usually weep right along with the burn victim.
nax, i'd say that anything invasive while in labour can be exceptionally noxious. Most women experience only a slight "pinch" feeling with a urinary cath insertion. Many men have more trouble with discomfort; their urethra is much much longer, and there's sometimes an enlarged prostate to get past. The psychological factor plays a big role with that one.
People experience things differently. It's not usual for a Lumbar puncture for spinal fluid collection to be exceptionally painful, but it is for some. There's topical anaesthesia used. The crunching sound is really rough for some to handle, and is subjectively experienced as pain.
Having a nasogastric tube inserted is pretty bad. When the tube is advanced past the turbinates and then around the corner down the nasopharynx; it scrapes those tender tissues.
Overall, from my observations...for fairly routine tests, I'd say most people experience Arterial Blood Gas sampling as exceptionally painful. It is over fast, though.
posted by reflecked at 11:31 AM on November 13, 2008 [1 favorite]
nax, i'd say that anything invasive while in labour can be exceptionally noxious. Most women experience only a slight "pinch" feeling with a urinary cath insertion. Many men have more trouble with discomfort; their urethra is much much longer, and there's sometimes an enlarged prostate to get past. The psychological factor plays a big role with that one.
People experience things differently. It's not usual for a Lumbar puncture for spinal fluid collection to be exceptionally painful, but it is for some. There's topical anaesthesia used. The crunching sound is really rough for some to handle, and is subjectively experienced as pain.
Having a nasogastric tube inserted is pretty bad. When the tube is advanced past the turbinates and then around the corner down the nasopharynx; it scrapes those tender tissues.
Overall, from my observations...for fairly routine tests, I'd say most people experience Arterial Blood Gas sampling as exceptionally painful. It is over fast, though.
posted by reflecked at 11:31 AM on November 13, 2008 [1 favorite]
Response by poster: what is involved in ABG, reflecked?
posted by cgs at 11:34 AM on November 13, 2008
posted by cgs at 11:34 AM on November 13, 2008
What is the #1 procedure that I most want to avoid?
I would assume that in general most painful procedures are medically necessary. Anything that ISN'T medically necessary should be avoided, whatever the amount of pain it inflicts.
posted by blue_beetle at 11:36 AM on November 13, 2008
I would assume that in general most painful procedures are medically necessary. Anything that ISN'T medically necessary should be avoided, whatever the amount of pain it inflicts.
posted by blue_beetle at 11:36 AM on November 13, 2008
Somewhat similar to a spinal tap, I've had a myelogram performed on me. I simply have no concept of an adequate word for the pain. Simply off-the-charts. True please-let-me-die pain.
And, as an added bonus, once the myelogram was done, I had to remain as horizontal as possible, or the dye would migrate to my head and cause a headache that would make the worst migraine feel ticklish in comparison. Yeah...I failed to stay horizontal enough.
posted by Thorzdad at 11:38 AM on November 13, 2008
And, as an added bonus, once the myelogram was done, I had to remain as horizontal as possible, or the dye would migrate to my head and cause a headache that would make the worst migraine feel ticklish in comparison. Yeah...I failed to stay horizontal enough.
posted by Thorzdad at 11:38 AM on November 13, 2008
cgs, it's a fast vertical poke straight down into the artery on the thumb side of your wrist. The walls of the artery are rich with receptors. If it needs to be done very very frequently, as for a person who needs ventilator assistance, there's usually an arterial (think big IV) line placed. That line has many reasons for use, but it also saves the pain of getting your blood gas sampled. Everyone else gets a big ouch, but like i said, it's over fast.
Thorzdad, many people experience the myelogram as mild discomfort/noxious stimulus. That migraine is terrible, though, and to be avoided at all costs.
posted by reflecked at 11:45 AM on November 13, 2008
Thorzdad, many people experience the myelogram as mild discomfort/noxious stimulus. That migraine is terrible, though, and to be avoided at all costs.
posted by reflecked at 11:45 AM on November 13, 2008
Removal of a ureteral stent through the male urethra. Hits the prostate and the penis at the same time and feels like you're pissing a chainsaw. The upside is you pass air when you urinate for a few voids after the procedure, which is hilarious and messy.
posted by Inspector.Gadget at 11:45 AM on November 13, 2008
posted by Inspector.Gadget at 11:45 AM on November 13, 2008
Getting a scleral buckle installed to repair my retina after a detach is the hands-down most painful thing that's ever happened to me. Not a test, but man, I spent six days chowing Darvocet and waiting to die. My ophthalmologists tell me the recovery is about as painful as childbirth and passing kidney stones, and I have no reason to doubt that.
The fact that I managed to walk into the doctor's office under my own power at the follow-up appointment and remain straight enough to ask and answer questions was apparently something of a surprise to the staff and the doc.
(Imagine that a poster on your wall has torn and buckled outward... and instead of taping the poster back up or getting a new poster, you instead opt to move the entire wall forward and shove everything back together until the poster's mostly flat against the new location. Yeah. Only inside your eye.)
posted by fairytale of los angeles at 11:47 AM on November 13, 2008 [2 favorites]
The fact that I managed to walk into the doctor's office under my own power at the follow-up appointment and remain straight enough to ask and answer questions was apparently something of a surprise to the staff and the doc.
(Imagine that a poster on your wall has torn and buckled outward... and instead of taping the poster back up or getting a new poster, you instead opt to move the entire wall forward and shove everything back together until the poster's mostly flat against the new location. Yeah. Only inside your eye.)
posted by fairytale of los angeles at 11:47 AM on November 13, 2008 [2 favorites]
Seconding Inspector.Gadget regarding having anything removed through the male urethra.
The #1 procedure to avoid is any procedure where the doctor or technician is not mindful of the pain they're going to cause. Surgeons are famous for this.
If you need a prostate biopsy, do not believe anyone who says you'll just feel a brief stick or pinch, even if they promise you an Advil afterward. The pain is major. You should provide your own opiate painkillers and take them before you go in for thetorture procedure.
posted by JimN2TAW at 12:06 PM on November 13, 2008
The #1 procedure to avoid is any procedure where the doctor or technician is not mindful of the pain they're going to cause. Surgeons are famous for this.
If you need a prostate biopsy, do not believe anyone who says you'll just feel a brief stick or pinch, even if they promise you an Advil afterward. The pain is major. You should provide your own opiate painkillers and take them before you go in for the
posted by JimN2TAW at 12:06 PM on November 13, 2008
Somewhat similar to a spinal tap, I've had a myelogram performed on me. I simply have no concept of an adequate word for the pain. Simply off-the-charts. True please-let-me-die pain.
I'm with thorzdad on this one. It is pretty painful as it goes on; luckily I have the strength of ten men. And as he points out, there is a bonus anxiety-based followup around it; the fact that you cannot really sit up for some time after lest the little plug get dislodged and your cerebrospinal fluid start dripping down your back, with generally poor outcomes.
I have been hit with an axe; I have had a head wound serious enough that onlookers could see my skull through my forehead; I have driven a rusty spike into the sole my foot; I have been in car accidents and bike accidents; I have twice had to have shards of glass removed from alarmingly close to my right eye (and once had to have a chunk of plastic removed from the sclera); I have dislocated joints and broken bones and had dental treatment without anesthetic; I have been kicked in the balls at least six times and fallen off a second story balcony; I have had a postage-stamp size section of skin peeled off by a metal doorframe; and I have had my heart broken by Caroline Meyer. The myelogram was the worst of all.
posted by ricochet biscuit at 12:34 PM on November 13, 2008 [15 favorites]
I'm with thorzdad on this one. It is pretty painful as it goes on; luckily I have the strength of ten men. And as he points out, there is a bonus anxiety-based followup around it; the fact that you cannot really sit up for some time after lest the little plug get dislodged and your cerebrospinal fluid start dripping down your back, with generally poor outcomes.
I have been hit with an axe; I have had a head wound serious enough that onlookers could see my skull through my forehead; I have driven a rusty spike into the sole my foot; I have been in car accidents and bike accidents; I have twice had to have shards of glass removed from alarmingly close to my right eye (and once had to have a chunk of plastic removed from the sclera); I have dislocated joints and broken bones and had dental treatment without anesthetic; I have been kicked in the balls at least six times and fallen off a second story balcony; I have had a postage-stamp size section of skin peeled off by a metal doorframe; and I have had my heart broken by Caroline Meyer. The myelogram was the worst of all.
posted by ricochet biscuit at 12:34 PM on November 13, 2008 [15 favorites]
I had a spinal tap and while it wasn't painful (they anesthetized the area), it was certainly weird and made me feel incredibly vulnerable--you can feel the pressure of the needle poking around. And I had the joy of a new resident who attempted 4 sticks in my spine before she was able to get some fluid.
posted by mandymanwasregistered at 12:44 PM on November 13, 2008
posted by mandymanwasregistered at 12:44 PM on November 13, 2008
I damaged a disc in my back and was having severe pain in my right leg. A neurologist perfomed a series of tests using an electrical device weird to my spinal region that, gosh darn it, caused the most peculiar and, for me, painful sensations I have ever experienced.
It wasn't as bad as a kidney stone but far worse than any oral surgery except maybe a poorly anesthetized root canal.
posted by bz at 12:46 PM on November 13, 2008
It wasn't as bad as a kidney stone but far worse than any oral surgery except maybe a poorly anesthetized root canal.
posted by bz at 12:46 PM on November 13, 2008
My spinal tap was uneventful. In fact, I left saying that I'd willingly go through that again to just get the day off work. But when I sat with my boyfriend during his (yes, apparently, we're a neurological mess, both of us...) he had an absolutely horrible time.
My cerebral angiogram was my worst test. I convinced them to dope me up pretty well for the anxiety, and had a local in my leg where the catheter went, so that wasn't the bad part. That came when they released the contrast in my brain. OMG. I swear to god my eyes were simultaneously being set on fire and stabbed. It only lasts 30 seconds at a time, but they had to do it so many times (more than normal because as it turns out, one of the arteries in my brain is totally blocked. Apparently they wanted to see that several times....)
posted by cgg at 12:49 PM on November 13, 2008
My cerebral angiogram was my worst test. I convinced them to dope me up pretty well for the anxiety, and had a local in my leg where the catheter went, so that wasn't the bad part. That came when they released the contrast in my brain. OMG. I swear to god my eyes were simultaneously being set on fire and stabbed. It only lasts 30 seconds at a time, but they had to do it so many times (more than normal because as it turns out, one of the arteries in my brain is totally blocked. Apparently they wanted to see that several times....)
posted by cgg at 12:49 PM on November 13, 2008
I have nothing to add re painful tests except to say that ovum donation is unlikely to be the top of any list (I've done it 4 times). it can be very uncomfortable, and at times painful, but nothing like "no words, off-the-charts" under typical circumstances.
posted by supermedusa at 1:09 PM on November 13, 2008
posted by supermedusa at 1:09 PM on November 13, 2008
To correct one thing: bone marrow donation (aka harvesting) is generally painless -- because you're under general anesthesia. I cannot imagine that any, any, any bone marrow harvests are done in any manner other than under general anesthesia, since they involve literally hundreds of pulls on the marrow. And the marrow cavity is very richly innervated with sensory nerves, for reasons that escape any teleologic explanation -- so each pull could be painful, and hundreds would be just plain cruel unless the person were under general.
posted by delfuego at 1:12 PM on November 13, 2008
posted by delfuego at 1:12 PM on November 13, 2008
Oh, and yes, as others have said -- in the hands of a skilled technician, a spinal tap should likewise be as close to pain-free as possible. Realistically, the patient should feel one poke: the poke of the local anesthetic being administered. Of course, if the tap is difficult for any reason -- poor spinal or disc position, chronic scarring, etc. -- then there might be more discomfort.
posted by delfuego at 1:14 PM on November 13, 2008
posted by delfuego at 1:14 PM on November 13, 2008
Weird, I didn't think the nerve transmission speed test was that painful. As someone who's irrationally afraid of needles breaking off under the skin, it was pretty horrifying to watch the doctor wiggle the needles around in my arm trying to find the right spot. And it was definitely strange and freaky to have my arms and hands move on their own, without any input from me. But I would say that even the finger-prick to check hemoglobin before giving blood hurts more than that did. Maybe it depends on exactly which nerves they're checking.
posted by vytae at 1:24 PM on November 13, 2008
posted by vytae at 1:24 PM on November 13, 2008
I'm surprised no one has answered colonoscopy, since many people have had them. In many parts of the world, this is done without anesthesia or sedatives. Ditto for upper esophagealgastroduodenoscopy, the one that sticks a fiber optic camera down the throat, into the stomach. Here in the U.S. you get fentanyl and or midazolam during the procedure, but sigmoidoscopy is often done here as a slightly safer alternative to colonoscopy and that rarely involves anesthesia.
Before the advent of CT scanning, they used to do some kind of procedure that involved injecting air into the skull and taking xrays to get a picture of the brain(maybe ikkyu2 knows what this was called) and apparently this was excruciating.
In my mind, hands down, it would be bronchoscopy, the placement of a thin fiber optic camera into the bronchial tree, usually for purposes of obtaining a lung biopsy. The few times I have seen this, the patients have been very visibly uncomfortable to the point of combativeness and I do believe they give some amount of sedation for this.
posted by Slarty Bartfast at 1:25 PM on November 13, 2008
Before the advent of CT scanning, they used to do some kind of procedure that involved injecting air into the skull and taking xrays to get a picture of the brain(maybe ikkyu2 knows what this was called) and apparently this was excruciating.
In my mind, hands down, it would be bronchoscopy, the placement of a thin fiber optic camera into the bronchial tree, usually for purposes of obtaining a lung biopsy. The few times I have seen this, the patients have been very visibly uncomfortable to the point of combativeness and I do believe they give some amount of sedation for this.
posted by Slarty Bartfast at 1:25 PM on November 13, 2008
This probably isn't the most painful test there is but when I was about 14 I had to get an ECG or EKG or whatever, the ultrasound thing on my lungs b/c they thought I had a heart murmur. Every time I've seen this on tv w/ pregnant women it seems fine, they put gel on and they use a nice flat device to run on your stomach, mine for some reason was a blunt pole that the nurse would jab into my neck and ribs and it hurt bad. She was not gentle at all and I remember that test sucking really bad.
posted by BrnP84 at 1:37 PM on November 13, 2008
posted by BrnP84 at 1:37 PM on November 13, 2008
I have been through a lot . I have been through spinal taps and more. (3 comas will do that). The worst procedure pain was that was ever done was the procedure where after i got my acl repaired (full tear and replaced with a tendon) where he bent my kneee to break up the scar tissue .
The problem was iwas suposed to get a machine sent home with me that would bend my knee little by little.
HE took my knee said so hows the machine going and bent it. I litterally screamed so loud that the whole office building heard me.
After every test that i have had done that was the worst.
posted by majortom1981 at 1:59 PM on November 13, 2008
The problem was iwas suposed to get a machine sent home with me that would bend my knee little by little.
HE took my knee said so hows the machine going and bent it. I litterally screamed so loud that the whole office building heard me.
After every test that i have had done that was the worst.
posted by majortom1981 at 1:59 PM on November 13, 2008
A foley catheter is psychologically pretty demoralizing, and physically very unpleasant.
posted by phrontist at 2:06 PM on November 13, 2008
posted by phrontist at 2:06 PM on November 13, 2008
Spinal tap, is what I've heard.
my spinal tap wasn't bad at all if you discount that my knee went up and hit my jaw pretty hard. I was very sore where the needle had entered for a few days but that was about it. oh yeah, I remember it feeling very cold when they took the fluid.
the most direct pain I ever felt was in a dentist chair when they thought they had hit me with a larger dose of anesthesia than they actually had and hit a nerve. that was downright awful pain and even though it only lasted a few seconds I still remember it vividly.
the most uncomfortable I have ever been in a hospital was after a tilt table test I got as a result of a question I asked right here on mefi. during the test I passed out, I threw up on myself, I wanted to die and they were just getting started. did I mention I soiled myself? yeah, good times. the painful part was the walk across the hallways and the cabride home. my doorman gave me some interesting looks, too. pain, as others said, is relative, but my ego took a decent hit that day.
posted by krautland at 2:20 PM on November 13, 2008
my spinal tap wasn't bad at all if you discount that my knee went up and hit my jaw pretty hard. I was very sore where the needle had entered for a few days but that was about it. oh yeah, I remember it feeling very cold when they took the fluid.
the most direct pain I ever felt was in a dentist chair when they thought they had hit me with a larger dose of anesthesia than they actually had and hit a nerve. that was downright awful pain and even though it only lasted a few seconds I still remember it vividly.
the most uncomfortable I have ever been in a hospital was after a tilt table test I got as a result of a question I asked right here on mefi. during the test I passed out, I threw up on myself, I wanted to die and they were just getting started. did I mention I soiled myself? yeah, good times. the painful part was the walk across the hallways and the cabride home. my doorman gave me some interesting looks, too. pain, as others said, is relative, but my ego took a decent hit that day.
posted by krautland at 2:20 PM on November 13, 2008
vytae, the EMG portion of the nerve conduction study wasn't bothersome at all. In fact, I thought it was pretty cool--hey, listen, my muscles make a noise!--and I'm not at all needlephobic so the idea of the needle itself didn't bother me.
It was the part before the needle--the "here, let's run some serious amperage through those big motor nerves and see what happens" part--that was excruciating to me. It was like the worst static electricity shock I've ever had, times a billion, over and over again, coursing up and down my limbs. It took an hour and a half for them to do all the nerves in my arms and legs. Horrible.
posted by jesourie at 2:31 PM on November 13, 2008
It was the part before the needle--the "here, let's run some serious amperage through those big motor nerves and see what happens" part--that was excruciating to me. It was like the worst static electricity shock I've ever had, times a billion, over and over again, coursing up and down my limbs. It took an hour and a half for them to do all the nerves in my arms and legs. Horrible.
posted by jesourie at 2:31 PM on November 13, 2008
Ditto for upper esophagealgastroduodenoscopy, the one that sticks a fiber optic camera down the throat, into the stomach.
A friend of mine not-so-delicately refers to this as "the throat rape."
posted by fairytale of los angeles at 3:09 PM on November 13, 2008 [1 favorite]
A friend of mine not-so-delicately refers to this as "the throat rape."
posted by fairytale of los angeles at 3:09 PM on November 13, 2008 [1 favorite]
This probably isn't the most painful test there is but when I was about 14 I had to get an ECG or EKG or whatever, the ultrasound thing on my lungs b/c they thought I had a heart murmur. Every time I've seen this on tv w/ pregnant women it seems fine, they put gel on and they use a nice flat device to run on your stomach, mine for some reason was a blunt pole that the nurse would jab into my neck and ribs and it hurt bad. She was not gentle at all and I remember that test sucking really bad.
I've had this (it's an ECG, BTW) - used to have it about once a year to check for murmurs. Your tech must've been really bad at it, or something else was going on, because I've never felt pain. It was cold as heck, especially with the gel, and felt like it took forever, but no pain whatsoever.
posted by spaceman_spiff at 3:31 PM on November 13, 2008
I've had this (it's an ECG, BTW) - used to have it about once a year to check for murmurs. Your tech must've been really bad at it, or something else was going on, because I've never felt pain. It was cold as heck, especially with the gel, and felt like it took forever, but no pain whatsoever.
posted by spaceman_spiff at 3:31 PM on November 13, 2008
Pain is subjective is a correct statement from the point of view of a person who does some these tests. ABG collection can be painful or it can be almost painless if the collector does an excellent job. I have people come unglued at a simple fingerstick and others that I have done ABGs on tell they never felt the needle.
The most uncomfortable test I have ever had myself was a lung biopsy. I had a massive vagal response to the needle being withdrawn. Went out like a light.
posted by bjgeiger at 3:32 PM on November 13, 2008
The most uncomfortable test I have ever had myself was a lung biopsy. I had a massive vagal response to the needle being withdrawn. Went out like a light.
posted by bjgeiger at 3:32 PM on November 13, 2008
Sorry for the double-post ... I must be weird or something, because my endoscopy didn't bother me at all. (Even though it was unsuccessful - they couldn't numb my throat enough to overcome my gag reflex, and had to knock me out entirely.) That said, I had both fentanyl and midazolam, as mentioned above, and I'm really glad I did.
posted by spaceman_spiff at 3:33 PM on November 13, 2008
posted by spaceman_spiff at 3:33 PM on November 13, 2008
Not the hospital, but at the dentist. For a simple cleaning, I tend to build up a lot of plaque and tartar, and the scraping away of this - front and back, top and bottom - is incredibly painful, as the assistant didn't bother with anesthetic. Cavities and root canals are cake compared to that. The first time I had a really bad experience with this and the next time I insisted on a topical anesthetic - much, much better that way.
posted by zardoz at 4:04 PM on November 13, 2008
posted by zardoz at 4:04 PM on November 13, 2008
For long term pain the worst thing I went through was a bone graft after my broken ankle failed to heal - both synthetic and my own marrow. How bad? 6 weeks of vicodin alternating with oxycontin and oxycodone every few hours. I've had 3 kids, two without anesthesia, appendicitis, kidney stones and two ectopic pregnancies. All very painful but none as long lasting as the recovery from that surgery. Not a test though - in terms of tests the emg is high on my do not do again list.
posted by leslies at 4:30 PM on November 13, 2008
posted by leslies at 4:30 PM on November 13, 2008
I had precancerous cells removed from my cervix (LEEP- Loop electrosurgical excision procedure). An electrified wire with high voltage was used to cut into the layers my cervix and remove cross-section slices. Even w/ a local anasthetic it was barbaric and sheer torture.
This was years ago after a questionable PAP smear, no other symptons, and no HPV. I've been absolutely fine ever since and I often doubt the treatment was really necessary.
While I'm on the subject, I strongly recommend that women get more than one opinion from doctors if they have abnormal PAP smears. You don't want a LEEP if alternative treatments are available.
posted by mistsandrain at 7:45 PM on November 13, 2008
This was years ago after a questionable PAP smear, no other symptons, and no HPV. I've been absolutely fine ever since and I often doubt the treatment was really necessary.
While I'm on the subject, I strongly recommend that women get more than one opinion from doctors if they have abnormal PAP smears. You don't want a LEEP if alternative treatments are available.
posted by mistsandrain at 7:45 PM on November 13, 2008
The ABG was definitely horrific - especially when they do it while you are in the middle of an pneumonia-induced asthmatic attack and can't breathe to begin with. Nobody freaking bothers to tell you that it's going to hurt, you start screaming, and then *really* can't breathe.
Lumbar punctures are pretty awful. Put it this way. I guess I looked bad enough that somebody actually offered me their seat on the crosstown 42nd Street bus during rush hour.
I'd have to say, though, my worst experience (only slightly higher on the scale above the ABG) was an EP study of my heart, where they introduce electrode catheters via your femoral artery to record and pace abnormal rhythms. They intentionally race your heart (I have a significant tachycardia) in different locations, and the sedation didn't work at all. I screamed like a banshee the entire time and the fuckers continued on with the test because I was an 'unusual case' and they had flown in a doctor from out of state. Oh yeah. That was definitely, uh, memorable.
posted by dancinglamb at 8:24 PM on November 13, 2008
Lumbar punctures are pretty awful. Put it this way. I guess I looked bad enough that somebody actually offered me their seat on the crosstown 42nd Street bus during rush hour.
I'd have to say, though, my worst experience (only slightly higher on the scale above the ABG) was an EP study of my heart, where they introduce electrode catheters via your femoral artery to record and pace abnormal rhythms. They intentionally race your heart (I have a significant tachycardia) in different locations, and the sedation didn't work at all. I screamed like a banshee the entire time and the fuckers continued on with the test because I was an 'unusual case' and they had flown in a doctor from out of state. Oh yeah. That was definitely, uh, memorable.
posted by dancinglamb at 8:24 PM on November 13, 2008
I think bone marrow biopsy probably wins for routine elective procedures. It's not possible to fully anesthetize the bone, which must be broken for the large-bore punch needle to enter.
Spinal taps should be painless. If you are obese the doc won't be able to know where he's going and will have to poke around a lot, and that can hurt a bit because the local wears off, but generally they're not so bad.
I had a greenstick radius fracture broken and set once; that hurt like the devil. No amount of Demerol and Novocaine prepared me for that shattering moment of pain. Other really painful things I've seen done include the pap smear/pelvic on the lady with a bad bacterial STD; the rigid sigmoidoscopy with air insufflation on the guy who left a dildo up his butt all night (it had to be taken out via the abdomen; the rectum had swollen up that much around it); and the old homeless guy who came in after some gang kids had shot him in the face for kicks with a flare gun loaded with shot shells. The E/R doc decided to take off a cast this guy had that looked to be a couple years old; most of the guy's gangrenous leg tissues came off with the cast, exposing most of the femur, patella, tibia and fibula to air. The guy looked like he was in severe pain for the next few minutes, before he died screaming.
We train on nerve conduction studies by doing them to each other as residents. Of course residents don't know what the hell they're doing, and I have an aberrant course of my median nerve on my right hand, so the voltage got turned up all the way as my fellow resident poked around. It's unpleasant, but come now, the most painful procedure ever? Hardly.
posted by ikkyu2 at 9:59 PM on November 13, 2008 [2 favorites]
Spinal taps should be painless. If you are obese the doc won't be able to know where he's going and will have to poke around a lot, and that can hurt a bit because the local wears off, but generally they're not so bad.
I had a greenstick radius fracture broken and set once; that hurt like the devil. No amount of Demerol and Novocaine prepared me for that shattering moment of pain. Other really painful things I've seen done include the pap smear/pelvic on the lady with a bad bacterial STD; the rigid sigmoidoscopy with air insufflation on the guy who left a dildo up his butt all night (it had to be taken out via the abdomen; the rectum had swollen up that much around it); and the old homeless guy who came in after some gang kids had shot him in the face for kicks with a flare gun loaded with shot shells. The E/R doc decided to take off a cast this guy had that looked to be a couple years old; most of the guy's gangrenous leg tissues came off with the cast, exposing most of the femur, patella, tibia and fibula to air. The guy looked like he was in severe pain for the next few minutes, before he died screaming.
We train on nerve conduction studies by doing them to each other as residents. Of course residents don't know what the hell they're doing, and I have an aberrant course of my median nerve on my right hand, so the voltage got turned up all the way as my fellow resident poked around. It's unpleasant, but come now, the most painful procedure ever? Hardly.
posted by ikkyu2 at 9:59 PM on November 13, 2008 [2 favorites]
Yeah, I got the "lumbar punctures are painless" bit before mine, too. Maybe it's true for some folks but it's definitely not true for all. Needle pokes don't faze me - I've had dozens of piercings and indulge in occasional recreational needle play. My problem was that my lumbar puncture needle kept hitting peripheral nerves which caused intense back spasms and spastic leg jerks. They couldn't get any fluid out of me for some reason so they played with the needle for about 45 minutes, shouting at me every time I moved due to involuntary spasms. Oh, and a few days later I got the spinal headache and had to spend 48 hours flat on my back because it's the only way I could ease the excruciating pain.
posted by rhiannon at 11:03 PM on November 13, 2008
posted by rhiannon at 11:03 PM on November 13, 2008
The KCL test for interstitial cystitis is pretty painful.
WARNING : Graphic details ahead!
Ok, first they jam this rather thick tube up the hole in your dick until it reaches your bladder. Then they pump in this potassium chloride solution.
You see, one of the indicators of interstitial cystitis is an increased sensitivity to potassium. In particular, the presence of potassium in your bladder will cause extreme, agonizing, excruciating pain.
So, to recap :
Having potassium in your bladder will cause some of the worst pain you could possibly experience, if you have IC. So they fill your bladder with a potassium solution, just to see if it hurts.
If it hurts, GOLDMINE! You have IC! But wait - there's more! All this pushing-of-things-up-your-dickhole and pumping-in-of-chemicals actually hurts quite a bit, regardless of whether or not you have IC. Which *may* just explain why the test has an 80% positive diagnosis rate, with untold number of false positives.
So why do they even do this? Because, apparently, the only alternative is to put you under anesthetic, fill your bladder to capacity with water (like a balloon), and stick a camera up there (hello again, dickhole!) to see if you start bleeding. Which you might, anyway, since someone just filled your bladder to capacity with water!
So yeah, I'm bitter. Especially since my uro didn't adequately prepare me for how much it would hurt, and thus I didn't know to take the full day off work. And then it turns out that IC isn't even accepted as a valid explanation for my condition anymore.
Ugh. Ok, I'll stop.
posted by Jake Apathy at 11:18 AM on November 15, 2008
WARNING : Graphic details ahead!
Ok, first they jam this rather thick tube up the hole in your dick until it reaches your bladder. Then they pump in this potassium chloride solution.
You see, one of the indicators of interstitial cystitis is an increased sensitivity to potassium. In particular, the presence of potassium in your bladder will cause extreme, agonizing, excruciating pain.
So, to recap :
Having potassium in your bladder will cause some of the worst pain you could possibly experience, if you have IC. So they fill your bladder with a potassium solution, just to see if it hurts.
If it hurts, GOLDMINE! You have IC! But wait - there's more! All this pushing-of-things-up-your-dickhole and pumping-in-of-chemicals actually hurts quite a bit, regardless of whether or not you have IC. Which *may* just explain why the test has an 80% positive diagnosis rate, with untold number of false positives.
So why do they even do this? Because, apparently, the only alternative is to put you under anesthetic, fill your bladder to capacity with water (like a balloon), and stick a camera up there (hello again, dickhole!) to see if you start bleeding. Which you might, anyway, since someone just filled your bladder to capacity with water!
So yeah, I'm bitter. Especially since my uro didn't adequately prepare me for how much it would hurt, and thus I didn't know to take the full day off work. And then it turns out that IC isn't even accepted as a valid explanation for my condition anymore.
Ugh. Ok, I'll stop.
posted by Jake Apathy at 11:18 AM on November 15, 2008
Not too scientific - a sample of one (me), however I have had many lumbar punctures (spinal taps) and it's no problem. Sure, if you move too much in the hours afterwards there is a killer headache, but iit's not a bad experience. Yep, they've hit nerves and I've had spasms along the way - scary at the time, but OK.
A bone marrow biopsy through the sturnum under a local was, however not an experience I will rush to repeat. The sense of pressure as the BIG needle, inches from one's nose, is withdrawn to fill with marrow was not entirely pleasant.
posted by Flashduck at 12:12 AM on November 18, 2008
A bone marrow biopsy through the sturnum under a local was, however not an experience I will rush to repeat. The sense of pressure as the BIG needle, inches from one's nose, is withdrawn to fill with marrow was not entirely pleasant.
posted by Flashduck at 12:12 AM on November 18, 2008
This thread is closed to new comments.
1. Pain is subjective. Two people might not agree on the level of pain caused by the same procedure.
2. The probability of finding someone who has gone through a wide variety of extremely painful procedures is slim.
posted by demiurge at 10:45 AM on November 13, 2008