How would you rate your pain on a scale of 0 - 10?

Based on my recent hospitalization and orthopedic rehab for quadriceps tendon repairs in both legs, an expertise has been developed on my part with pain scales.

Following my surgery on 8/29/24  opioids were prescribed for the pain and the nurses were constantly asking me to rate my pain. I guess I tolerate pain fairly well so at first my answer to the  1 to 10 scaling question was  "Oh, I don't know, maybe a 5 or 6." 

I had no idea how to rate the pain, never having had to do this before as a way of determining the need for pain meds. They were giving me hydrocodone and once Dilaudid. I overheard one nurse tell the other nurse in the hall outside my room, "We don't give opioids unless the pain is 8 or above. When she came back the next time, my reply to the question about the intensity of my pain was "8! It's definitely an 8".

After a couple of months, bedridden in rehab, I wondered why they didn't ask me other scaling questions pertaining to my well being besides my pain level. So I came up with three other scales that I thought were just as relevant.

Energy level - "On a scale of 1 -10 what is your energy level today? Many days it was 2 to 3.

Clarity of thinking - "On a scale of 1-10 how clearly are you thinking and organizing your thoughts?" Many days it was 2 to 3 and a couple of days when my gallbladder perforated and my abdominal infection sent my white blood count into the septic range I was 1 but would have had a hard time answering if even comprehending the question. Another way of putting this same idea is "On a scale of 1-10 to what extent are you back to your old self?" I am still not at 100% but getting there. Currently I would say I am at an 8 but clearly have a way to go.

Optimism/pessimism -  "On a scale of 1 - 10 to what extent are you optimistic as compared to pessimistic?" There was days I was a 1 and wanted to kill myself. Had MAID been available in New York State I might have chosen it, but I am much more optimistic now, maybe about a 7.5.

So, I wonder why health care staff, in addition to the pain scaling question, don't ask the other three questions which seem to me just as important. The answer probably is that there is no pill that can be given to immediately ameliorate a low score on the scale so why bother to ask.

I don't like pain any more than anyone else, but I think I can tolerate pain better if my ratings on the other three scales are at least above 5 or 6.