Hi everyone.

I've been lurking on this site for many years, and recently I came up with something I thought I should share with you.

Like many of you I keep a headache diary, and until last week I've been using the Kip scale to record the level of pain felt. I did feel there were some problems with that scale however. For one thing I felt the resolution was too high, which meant I could never figure out if, for example, my pain was a 4 or a 5. Another problem was that it seemed that there were too many levels at the bottom of the scale compared with at the top (consider - sleep is "not an option" up at level 7).

So, here is my (hopefully easier to use and better balanced) 5 point scale:

Level 1: Minor (shadows). Can be ignored. (Kip 1 - 3)

Level 2: Starting to get bad - want to be left alone. Can be slept through. (Kip 4 - 5)

Level 3: Considerable pain. Rationed medication (eg Sumatriptan) should be considered. (Kip 6 - 7)

Level 4: Whimpering, sobbing, rocking. "Why me?" Nose running/eye tearing. (Kip 8 - 9)

Level 5: Major pain, screaming, head banging, ER trip. Depressed. Suicidal. (Kip 10)

One can convert a score from the Kip scale to my 5 point scale by:

• Dividing the Kip score by 2
  
• Rounding down
  
• Having a minimum of 1

Or for computer programmers: max(1, floor(kipScore / 2))

What does everyone think?

Nick

Interesting first post.

For me, I go from your KIP 1 thru 4 in about 2 minutes. I always go to at least a 4. The only variable was whether I was using an abortive or not. I never could sleep thru one because it never stopped at your level 2.

Tell us a little about yourself and welcome to the board. :)

Why fix what isn't broken. ::)

Cheers
Barry

Welcome. Sorry you had to find us, but glad you did.


Quote:

One can convert a score from the Kip scale to my 5 point scale by: Dividing the Kip score by 2 Rounding down Having a minimum of 1

What's the point? Balance? Phooey.

That would be like removing the algorithm from the Richter scale so it becomes just a straight line.

I'm with Barry. It ain't broke, and your new proposal does nothing to improve it.

In fact, a better proposal would be for you to use your new scale and multiply by 2 any time you report on it.

Hiya Nick...welcome aboard.

For me, it's a matter of the "language" spoken. Here in clusterville we speak "kip"...and have for 10+? yrs. Changing what works holds no allure for me.

...it aint universal...have yet to meet a doc who was fluent in kip...they believe in 1-10 (with smiley/frowny faces).

When in their presence...and describing pain...I speak "1-10". Since ch tends to skew pain perception, I have learned to double what I think and subtract 1...YMMV......

Best,

Jon

The KIP Scale works just fine for me.

God Bless Bob Kipple, May him R.I.P

-Gregg in Las Vegas

Hi Nick

Don't worry too much if any particular CH is a 4 or a 5, what matters most is the trend, not any individual estimate of the pain scale.

Also remember that the pain scale shows the impact to you, not anyone else. It's perfectly possible that what one person would count as a 7, someone else could count as a 4 and someone else as a 9.

I also wonder how many people looked at your code to determine your conversion function (like I did) compared to your text description.

I also expect that for anyone who doesn't get CH, a 10 on their scale is likely to be something like a 4 on the Kip scale.

So for your own use, feel free to use any pain scale you like, what will matter is that it is consistent for your own use and that you can explain it to any doctor treating you.

Brew wrote on Jan 17^th, 2012 at 8:15pm:

That would be like removing the algorithm from the Richter scale so it becomes just a straight line.

My point about balance is that the Kip scale is like an inverse Richter scale - it has a lot of points for the low pain levels when it should have them at the high levels.

I believe the Kip scale can be improved upon, which is why I spent time thinking about it. My scale works for me, and maybe it can work for other people too.

Brew wrote on Jan 17^th, 2012 at 8:17pm:

In fact, a better proposal would be for you to use your new scale and multiply by 2 any time you report on it.

Yes, that's a good idea. Use my scale for my own notes and multiply it by 2 for people who want a score from 1 to 10. I think doctors can use both - the Wong Baker faces scale has 5 levels of pain (plus one for no pain) which correspond quite well with mine.

jon019 wrote on Jan 17^th, 2012 at 8:37pm:

...it aint universal...have yet to meet a doc who was fluent in kip...they believe in 1-10 (with smiley/frowny faces).

You're right, the Kip scale is not known by doctors (many of which don't know what cluster headaches are in the first place :(). The faces scale (Wong Baker scale) has 5 faces showing pain (plus one for no pain), and corresponds quite well with my levels 1 to 5.

Mike NZ wrote on Jan 18^th, 2012 at 2:09am:

Don't worry too much if any particular CH is a 4 or a 5, what matters most is the trend, not any individual estimate of the pain scale.

That's the point. If I have identical levels of pain but give it a 4 on one day and a 5 on the other it makes it harder to analyse any trends.

NickG wrote on Jan 18^th, 2012 at 3:26am:

Mike NZ wrote on Jan 18th, 2012 at 2:09am: Don't worry too much if any particular CH is a 4 or a 5, what matters most is the trend, not any individual estimate of the pain scale. That's the point. If I have identical levels of pain but give it a 4 on one day and a 5 on the other it makes it harder to analyse any trends.

Once you've a reasonable data sample it doesn't make too much difference if a single data point is a 4 or a 5, however the more you reduce the size of the scale, i.e. from a 0-10 scale to a 1-5 scale, the more significant the impact of a value just above or below the actual intended value.

The field of error analysis is very interesting and sometimes non-intuitive. A good primer can be found at START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE.

Head got belted, eye melted,
Temple is on fire.
Ear got shot by a bullet white hot,
Brain's a funeral pyre.

Tears pouring, temp roaring,
Risk of personal harm.
Cluster lump resembles the hump
On the hunchback of Notre Dame.

Mind frying, psyche crying,
Words quite obscene.
Got too hot, lost the plot,
There is a Kip-15.

Pressure goes up, eyelid has a pup,
Nose give birth to a melon.
Brain aflame, government to blame,
Welcome to Kip-27.

To speak is to shriek, here's the peak,
Kip-94 and a bit.
Erratic, sporadic, almost orgastic,
The joys of a really big hit.

Pain diminishing, problem finishing,
Reserves totally plundered.
I used to cope but now just hope,
There is no Kip-100.


(From the archives)

I like the Kip scale.  Hell, I liked Kip and Judy, too. 


With clusters, I reduce it to two.

1.  It might be.

2.  It is.  Do something now, you know the ladder of numbers describing short time.




From your scale:

Level 1: Minor (shadows). Can be ignored. [not a great idea]

Level 3: Considerable pain.

Beyond:  I was stupid again.  How long have I been on this site?

Of course this is just my take on me.


When it's felt, description resides in familiarity.

Quote:

With clusters, I reduce it to two. 1.  It might be. 2.  It is.  Do something now, you know the ladder of numbers describing short time.

Kevin, just perfect! I find any pain scale to be useless. Chs have elevated my awareness of the human body's capacity to experience such an exotic variety of pain, that normal pain is a laugh. I agree. For me, it's on or it isn't. And if it's on, let's rock, because if I don't, whatever scale I'm using will automatically hit the top o' the chart. Blessings. lance

I typically classify the pain in two ways:

1- I can take it.

2- Oh crap...

i agree with mike, recently broke my shoulder, had a large labral tear also, Dr. just treated it as just a break, no mri was done, 3 months later found out i needed major surgery. Said he would of never suspected i had tore it up that bad, because of my pain levels that i showed. Must of been the kip 9 and 10's from the previous 12 to 14 years. lol

I agree with Mike on this one.  The important thing is the trend.  When one finds the trend is getting worse it is time to start taking steps to improve on the abortives and to look into increasing the preventatives.  The numbers are helpful if you are tracking, but beyond that are somewhat useless.

Jerry

Edited for proper attribution.

japanzaman wrote on Jan 19^th, 2012 at 9:33am:

I typically classify the pain in two ways: 1- I can take it. 2- Oh crap...

Amen! :-*