Chapter 4: Can You Describe the Pain?

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1. Exercise 1
Brainstorm as many words as possible related to pain. (minimally 10 words)

PAIN Aspirin

2. Exercise 2
Match the columns.
Features of Pain
1. Location
g, I, VI, VIII
2. Triggering factors
3. Duration
4. Intensity and Character
5. Onset
6. Timing
7. Alleviating Factors
8. Aggravating Factors
9. Previous Occurrence
Main Questions
a. How long does the pain last?
b. Does anything bring the pain
on?
c. Can you describe the pain?
d. Does anything make the pain
worse?
e. Have you had the pain like this
before?
f. When do you get the pain?
g. Where is the pain?
h. When did the pain start?
i. Does anything make the pain
better?
Follow-up Questions
I. Is it near the surface of your body
or deep inside?
II. Does a hot-water bottle or ice pack
help?
III. Do you feel better standing, sitting,
or lying down, for example?
IV. Does it hurt all the time?
V. Have you had to stop doing certain
activities like walking or climbing
stairs because of the pain?
VI. Does it start in one place and
spread?
VII. Does the pain make it difficult for
you to concentrate?
VIII. Is it in one part of your body or in
more than one place?
IX. Does it come on slowly or quickly?

3. Exercise 3
Write the words in the box in the correct columns.
Aching Pressing Unbearable Hot Slight Excruciating Tingling
Stabbing Blunt Throbbing Annoying Intense Dull

Intensity of Pain Character of pain

Severe Mild
4. Exercise 4
Unscramble and complete the following sentences using the word order: 1) Intensity, 2) Character, 3)
Location, 4) Duration
a. aching/in his back/for three weeks/dull/pain
___________________________________________________________________________________
b. in his chest/since yesterday/stabbing/intense/pain
___________________________________________________________________________________

c. excruciating/for two days/headache/throbbing

___________________________________________________________________________________

d. in her fingers/mild/for 2 moths/cramp

___________________________________________________________________________________

e. earache/unbearable/throbbing/for 3 days
___________________________________________________________________________________

5. Exercise 5
Make a dialogue using the sentences from Exercise 4. Use the main questions and follow-up questions
from Exercise 2 to continue the dialogue.
Example: Write your dialogue in the following.
A: Can you tell me about the pain?
B: I have had a dull, aching pain in my back
that has lasted for 3 weeks
A: Does it hurt all the time?
B: No, it comes on later in the day.
A: Does anything make it better?
B: Yes, lying down or taking a hot bath.

6. Exercise 6
Read the following conversation between Mr. Bloom and a nurse in Radiography. Replace the phrasal
verbs in italics with expressions below.
comes depressing me discuss this persevere tolerate it discover

Nurse Morning, Mr. Bloom. Here for your tests?

Mr. Bloom That’s right.
Nurse Are how are you feeling?
Mr. Bloom Oh, my back’s really getting me down. (1._______________)
Nurse If you can just stick it out (2._______________) a bit longer, I am sure they’ll
find out (3._______________) what’s wrong.
Mr. Bloom I hope so. I don’t think I can put up with it (4._______________) any longer.
Nurse OK, well you can talk this over (5._______________) with the doctor.
Mr. Bloom Yes, when he shows up? (6._______________)
Nurse He’s very busy, but he should be here in a short while.

7. Exercise 7
Dave, the radiographer, is having problems with his equipment. Read the telephone conversation and fill
in the blanks with question tags.
Dave Hi, Chuck. It’s Dave. We are having a problem with the XL45 again. The films are coming out
clear.
Chuck Oh no, and I’m really busy at this moment. Can we just run over a few things on the phone?
Dave Sure thing. Shoot.
 Chuck First, it’s plugged in, (1.) isn’t it?
Dave Give me a break. Of course, it is.
Chuck You didn’t leave the collimator shutters closed, (2.) _______________?
Dave No, I don’t think so.
Chuck You haven’t been playing with the gain control, (3.) _______________?
Dave Never touched it.
Chuck What about the footswitch? You are keeping your foot on it all the time, (4.) ___________?
Dave Sure.
Chuck OK, well it looks like I’ll have to come over. You’ll still be there in this afternoon,
(5.) _______________?
Dave I finish at 10:00 today. So, if you come as soon as possible, I would appreciate it.
Chuck I’ll do my best. See you later.

8. Exercise 8
Write five sentences using question tags. Read your sentences to a partner using either a confirmation or
a question tone.
a. ____________________________________________________________________________
b. ____________________________________________________________________________
c. ____________________________________________________________________________
d. ____________________________________________________________________________
e. ____________________________________________________________________________

9. Exercise 9
Read the referral letter and underlined the passives.

Ashville Medical Center

Primary Care Unit

To: Dr. Ruth Fendwick, Department of Psychiatry

Dear Ruth,

I would be grateful if you would do a psychiatric evaluation of the following patient:

Jame Bloom, a 34-year old engineer, presented 3 months ago complaining of a stiff, painful back and
depression. A thorough physical examination was performed, but no cause of the symptoms was found.
Radiographs were taken but no abnormalities were reported.

I have been unable to detect any physical cause of the problem but diazepam was prescribed and the
patient reported an improvement.

I would therefore like to investigate the possibility of the symptoms being of psychiatric origin.

Yours sincerely,

Bruce Murray MD

10. Exercise 10
Write another referral letter to a psychiatrist for the following cae.

Selena Hislop, Travel Agent, 56 yrs.

Presenting complaint: halitosis
Physical Examination: At time of exam, no halitosis detected. No apparent medical or dental cause.