PAG: Overview

Pain Assessment Grids (PAGs) are a discomfort-measurement system I developed to help understand and get through the numerous tests and procedures of the transplant process.  They are the heart of my pain management strategy.

There are a lot of tests and procedures done throughout the transplant process, and one of the things I think is most worrisome to a transplant patient is the fear of pain throughout those numerous tests.  It helps a lot to know what to expect, which in turn can help a patient manage and often reduce discomfort.


As I list the tests and procedures used throughout the transplant process, I'm going to start by describing the test, then end with two PAGs.  A PAG is a table which lists all the line item components of a test, and gives it three pain or discomfort measurements.  The first bit of information is a simple one or two word description of the pain, the second a rating of the pain (on a scale of 0-10), and the third the duration of the pain/discomfort/anxiety.


Obviously each of these things is subjective depending on the patient, their particular fears/anxieties, and tolerance for pain.  One of the PAGs will be filled out with my own assessment, and the other will be left blank in case you'd like to use it for your own assessment.  After a while you'll be able to map your own expectations based on how your experience differs from my own.


An Example:


Here's what my PAG looks like for basic lab work, where two to three vials of blood are to be collected for analysis:

Lab Work – Teri	Type	Rating	Duration
Tourniquet	Pressure	3	1-2 min.
Insert Needle to vein	Sharp Sting	2	1-5 sec.
Collect Blood	None	0	1-2 min.

First of all look at the far left column.  I've broken down the test of drawing blood for lab work into three different elements.  The first is the application of the tourniquet to your arm, the second is the needle stick, and the third is the actual blood collection step.  The three columns to the right of this one are the measurements associated with those three line items: Type, Rating and Duration.


You’ll notice that for me the pressure of the tourniquet is more painful than the needle stick.  If you don’t like needles your response may be the opposite.  But even if you fall into this ‘fear of needles’ category, you can take comfort in the knowledge that the duration of discomfort for the needle stick is rarely more than 5 seconds, even if the actual collection time is 1-2 minutes.  Knowledge really is power.


In addition to the PAGs, you will find several other forms and grids to fill out to document your doctors’ appointments, test schedules, in-patient events, prescription list, and after-effects, among other things.  Using these forms will provide a good record both for yourself and your physicians during your follow-up reviews.  Put them in a journal if you can, so that you can keep a log of your daily activities during the transplant.