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Modified KIP scale? (Read 5497 times)
Langa
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Re: Modified KIP scale?
Reply #25 - Jun 2nd, 2009 at 10:50pm
 
E-Double wrote on May 23rd, 2009 at 1:42pm:
The reality is that PAIN is relative to the INDIVIDUAL.

The explanations are very good in that not all curse, run, rock or bang.

Some can be at a very high level and zone out.

A few saw me get wholloped while out at a nightclub a few years back during a convention. I geared back and zoned and pumped my leg while they ran for ice and other shit.
My eye was like kwasimoto but if I tried to say that I was at a 8 or a 9 someone would have said no way.

So whether it be tolerance levels are different or coping mechanisms are different,  a little verbiage can not hurt and it doesn't disrespect Kip either.

E


Yes, I remember that time.  Between Pepa, Sandra and myself we did get some ice.  I think I might have whisperd in your ear "If you wanna go, we're out of here, just say the word" 

Well, after about 10-15 minutes you wanted to dance so I knew all was well.

Love ya,
Maria 
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wildhaus
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Re: Modified KIP scale?
Reply #26 - Jun 3rd, 2009 at 2:44pm
 
Ted.......

Loudness is the quality of a sound that is the primary physiological correlate of physical strength (amplitude) as sensed by the individual.   Therefore, unlike sound levels that can be objectively and accurately measured in physical terms expressed in decibels (dB), as a sensory input perceived by an individual’s ears, loudness is a subjective measure!  

Pain is somewhat the same as loudness, a very subjective sensation.

Pain, in the sense of physical pain is a typical sensory experience that may be described as the unpleasant awareness of a potentially harmful stimulus such as heat, cold, pressure, etc.

Individuals perceive and express pain differently, so it to is a highly subjective measure.

A definition that is widely used was first given as early as 1968 by Margo McCaffery to describe pain in the following:  
"Pain is whatever the person experiencing it says it is, existing whenever he says it does".


Bob Kipple went to a lot of effort and was very clever in the way he developed the Kip Scale.  He developed it as a method of describing cluster headache pain levels that expresses the magnitude of the physical “stimulus” and “quantity” of pain in terms relative to a reaction to the pain rather than it’s specific acuteness and intensity or it’s exact location.   He did this because he knew we each experience pain differently.

In a way, pain levels are almost logarithmic nature ( like the Richter scale) that enables a very large range of ratios to be represented by a convenient number in a manner similar to scientific notation.  This allows one to clearly visualize huge changes of some quantity.

Now to the CHANGES you have put in..... or to your subjective interpretation of the scale and pain, carving your experience onto stone.....

Original example from Kip Scale

“Time to scream, yell, curse, head bang, rock, whatever work's”


your interpretation and change

“Time to scream, yell, curse, head bang, rock, whatever work's
Pain is reaching an unbearable plateau. The burning sensation continues to intensify, and now feels as if the eye-ball is being pushed out from its socket. The pain to the cheek and jaw area now feels like a severe toothache!”

you have taken the paradigm and put your experience to explain the “formula” and with that you have limited the ability to adjust the scale to the individual perception….. I never experience toothache! or any cheek pain! but I do rock….. and I curse….. and
“HUG” MY O2 TANK……


with your “expansion” you try to frame and explain the level as seen trough your “glasses” ignoring the possibility that for the same level some might experience different sensations……..

And that is a change…. that is reinventing…..  that is rewriting!!


I believe Bob Kipple was very claver and thoughtful by staying away from explaining pain or describing it, he rather used the reaction to the pain.... in terms we all understand and can relate to.


Now to your some what questionable or poor use of words……
“Pain -  relative? Please, give me a break here, huh?”

Pain is relative! you might possess some knowledge that most, or all of us
have missed, and I would love to get some insight to that knowledge…….
but until then pain is still very individual and very subjective, and there for
relative…….

In closing, I'd say the Kip-scale as Bob Kipple developed it is just fine and good enough.  I say that because in many cases, better is the evil of good enough...  in trying to make it better, you may have fallen short.

Michael
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Re: Modified KIP scale?
Reply #27 - Jun 3rd, 2009 at 3:11pm
 
wildhaus wrote on Jun 3rd, 2009 at 2:44pm:
Now to your some what questionable or poor use of words……
“Pain -  relative? Please, give me a break here, huh?”

Pain is relative! you might possess some knowledge that most, or all of us
have missed, and I would love to get some insight to that knowledge…….
but until then pain is still very individual and very subjective, and there for
relative…….


One thing I want to add to that:
Not only is pain relative between individuals it even is relative compared to our own experiences since these lead to changing pain thresholds.

Oliver
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Re: Modified KIP scale?
Reply #28 - Jun 3rd, 2009 at 3:38pm
 
wildhaus wrote on Jun 3rd, 2009 at 2:44pm:
Now to your some what questionable or poor use of words……


Michael you sound like the old boring, pompous teacher whose classes we all loved to skip at school. I really hope you are not employed in PR.

Your post seems to imply that this thread is a direct attack on the work of Bob Kipple. I didn't know the man but from listening to others on this board he sounded like a true gentleman. I used to think I suffered from Kip 10's on a regular basis until I read a post from Chuck stating that they are a rare and unique experience. From listening to Chuck and Ted on the same thread discuss a Kip 10 I  realised that maybe I haven't suffered a kip 10, in actual fact, I know I haven't. I have  probably only peaked at kip 9.


I am one of the people who has found that this discussion on the revamped kip scale has clarified a few queries that I may have had. I would like to thank Ted and Chuck for highlighting what a real kip 10 is like to experience.


Lefty...!

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Re: Modified KIP scale?
Reply #29 - Jun 3rd, 2009 at 4:57pm
 
Lefty,

I am not picking a side in this argument, but I must take issue to a degree with your characterization of Michael as "boring".  I don't for a minute think you were trying to attack him, but I think you were a bit off base.

Michael has not been posting a lot lately, and I recognize you are fairly new to the board, so you have not had the opportunity to know him nor from whence he speaks.  He is one of the deep thinkers on this board, and when he does post you can count on it having a great deal of thought behind it.  Intellectually he puts me way in the dust, and I can usually learn something from his posts even when we disagree, which is somewhat frequently, but rarely will you hear that from me on this board.  In my estimation, for what that is worth, I rank him up with Bob Johnson and a couple of others.

That said, Ted, I don't disparage your clarification of the scale.  As far as I'm concerned if it helps someone express their situation more power to them.  I was quite happy with Kip's scale, and that is what I will use as a reference point myself, but then that is what I've grown accustomed to for several years now.

As another member who hardly ever posts anymore (and I miss him!) said, "Take what you need, and leave ther rest."
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Re: Modified KIP scale?
Reply #30 - Jun 3rd, 2009 at 7:00pm
 
Callico wrote on Jun 3rd, 2009 at 4:57pm:
 He is one of the deep thinkers on this board, and when he does post you can count on it having a great deal of thought behind it.  Intellectually he puts me way in the dust.


Jerry

Michael may very well be articulate and intelligent but I do find he uses these gifts in a very condescending manner. He has previously stated on this thread how he feels about the concept of a new kip scale. Why did he feel the compulsion to come back for seconds and in my mind have a go at Ted for daring to initiate a discussion on a revamped kip scale.

On other occasions I have seen this condescending tone and in his first reply to one of my earlier posts he began his reply by insulting me and my fellow country men. Not exactly what I would call the hand of friendship as we all suffer from the same infliction. Yes we may not all agree on certain issues, but state your objection and move on, it doesn't have to become personal.

Jerry you are correct,  I am a newbie to this site and I am still learning how to interpret posts properly as it can be a mine field at times. Michael has every right to post his thoughts and feelings and I know that it is my problem that I take umbrage with his manner. I will learn to ignore his posts as it is impossible for us all to get along like some Disney film.

And Jerry there are not many people on this board that can put you intellectually in the dust, OK, maybe Bob Johnson, but hey, were all in there with you.


Lefty...!
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Re: Modified KIP scale?
Reply #31 - Jun 3rd, 2009 at 7:14pm
 
I'm okay with it as it is.  I've had enough change for now.

Oops.

They hurt like something from hell.

Steve G
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Re: Modified KIP scale?
Reply #32 - Jun 3rd, 2009 at 7:20pm
 
I like that the additional words describe things a little bit more objectively and less subjectively...as best as you can do this anyway.  The new wording is certainly more helpful to me.  It describes the different levels and I like how they are grouped too.  Sometimes I'll have trouble getting an exact number and I'll be like...6? no 5...no...7?  because I am just so tired of it all...but I think the fact that it is in that category is more important because the symptoms occuring at that level are important...they only get worse or whatever by certain degrees. 
The grouping and objective descriptions also helps me know exactly what to do when...since getting under better control I have had far more lower level and shadows than before...and its a question of whether or not to treat.  I don't like to if I don't have to, but this tells me that maybe if I am putting my hand to my eye, can't really function great more than saying a few short sentances....yeah that isn't a shadow even if I say it is.  Like Eric said...pain is related to the individual.  I will...out of sense of denial or whatever reason I may have, say that I am not doing whatever Bob Kipple's scale said.  But if I am hurting so bad that I am not speaking well, cannot resist putting my hand up, etc....I go to a 4 and (according to how I treat myself) really should hit the o2 for a bit. 
Just my humble opinion of course...but this is great for me, thanks!  Smiley
Lisa
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Re: Modified KIP scale?
Reply #33 - Jun 3rd, 2009 at 7:37pm
 
I think the added notes to the kip scale help to better understand each level of pain.  Thank you Ted and Chuck.

Beth
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Re: Modified KIP scale?
Reply #34 - Jun 4th, 2009 at 12:06am
 
Ahem! This seems to be getting personal. Is there truly a need for that? Frankly, I don't have the time, nor am I willing to make any to do that sort of thing - I WON'T go there!
I rested my case in my earlier post (to which I got quoted, but not answered - how interesting!). I have nothing further to add.


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Re: Modified KIP scale?
Reply #35 - Jun 4th, 2009 at 4:53am
 
Ted and Laefty,

I am sorry if you feel I have attacked you personally!
In no way I have the interest or the desire to engage in personal
mud slugging........ nor did I think that this thread is a direct attack
on the work of Bob Kipple!

If my post has invoked in one of you that impression, that I am on some sort
of personal vendetta crusade, I do apologize!

All I was trying to express is simply my objection to the suggested changes!

I am all for a discussion, for better understanding, and searching for better ways
to convey what we feel, and go trough......

My objection is simply based on the simplicity and cleverness of the way Bob Kipple developed the Kip Scale.  He developed it (the way I see it) as a method of describing cluster headache pain levels that expresses the magnitude of the physical “stimulus” and “quantity” of pain in terms relative to a reaction to the pain rather than it’s specific acuteness and intensity or it’s exact location.

Bob Kipple (I believe) intentionally took the subjectivity and used objective reaction to the various pain levels we experience….

The way Ted (and Chuck), describe the sensations’, and translate the deferent levels might reflect what they feel and sense, which is very subjective, and there for apply in a very limited way, where as the Kip scale by avoiding subjectivity and there for applies to a broader “audience”, if not to all…….

I do find the effort to explain the kip scale as an interesting effort, and engaging in a
discussion is very important, we all can benefit, learn, and understand better what we all
go through…….


Quote:
“Michael you sound like the old boring, pompous teacher whose classes we all loved to skip at school. I really hope you are not employed in PR….. “

No, I am not in PR…..  

I do go very often over the various boards and read and try to
learn…. try to find deferent angels and thoughts, try to educate my self, regardless if I agree or understand the post, no post is ridicules’ or stupid or useless! (yes, some of the
“I have a cure”, by venders of dubious remedies are ridicules….)
Every bit of knowledge, know how and experience is important, and needs to be posted, if I don’t understand I will ask, if I disagree I will voice my opinion….. and try to present my opinion in a mannerly way, backed by facts, my personal understanding….. or personal experience…..

The times I allow my self get carried away are when politics, Israel, and racism are involved! and that is why I mostly try to avoid the topics…. and limit my self to CH…


Ted and Chuck, as I said your initiative is interesting! but I do find my self, still objecting
and “I feel the compulsion to come back for seconds” to voice my objection, and to try and convey my thoughts and arguments……

It is the way I understand and perceive intellectual discussion and healthy exchange of thoughts and opinions…..


Michael
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Re: Modified KIP scale?
Reply #36 - Jun 7th, 2009 at 3:55pm
 
I found the original KIP scale to be quite good but somewhat confusing in places.  The ammendments are a helpful step I think and surely not intended to disparage the original efforts.
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Re: Modified KIP scale?
Reply #37 - Jun 8th, 2009 at 9:10pm
 
I’ve been watching this thread for a while and have come to the conclusion there are some folks responding with entirely too much time on their hands…  The way I see it, they’re wasting their time and the time of others opining on matters of relative unimportance when there are other far more pressing issues affecting folks with our disorder to contend with at this time.

The Kip Scale, as Bob Kipple developed it, has served the majority of the cluster headache community who frequent CH.com and OUCH websites more than adequately since he first posted it.  I support Michael’s assessment and support of the Kip Scale as written…  It’s simple, direct, and easy to read.  It also leaves room for each cluster headache sufferer to identify his or her own reactions relative to the same pain scale used by others.

The Kip Scale is what it is…  It’s not a diagnostic tool, nor is it an ICHD-II definition...   It’s merely a way of relating the pain you feel in simple terms to others who suffer from the same cluster headache disorder.

Yes, there are questions frequently asked by newcomers to this forum on the nature of the Kip Scale and they deserve good answers.  I’ve not done a query on the database but “What are shadows?” would appear to be the question asked most frequently.  Rather than reinvent or change the existing Kip Pain scale in reaction to these questions, just answer the questions.  Shadows are a term Bob used to describe reactions to the pain of cluster headaches that occur between Kip-1 and Kip-3.

Accordingly, until a compelling requirement can be stated to change or amend the Kip Scale with clearly identified supporting rationale agreed upon by the majority,  posting comments to open the Kip Scale up to change amounts to little more than pole vaulting over mouse turds.  You cold be spending your time and efforts on far more pressing issues relative to our disorder.

For the folks here in the United States, if you want to spend time as an activist posting, faxing, sending email, and making phone calls on an issue/cause celeb that should be a major concern to all of us, take a look at Medicare and the fact that it will not cover the expense of home oxygen therapy for the cluster headache disorder.

Consider the following factoid…  Medicare paid out nearly $1.5 Billion dollars to cover home oxygen services and contents in 2006 for COPD sufferers, but not one penny to cover these same home oxygen services and contents for cluster headache sufferers 65 years of age and older .  The Medicare estimate for home oxygen therapy expense for 2009 is $1.69 Billion and…   the bureaucrats…  not physicians…  already have a plan in motion to ration home oxygen therapy by cutting the total amount payable to a maximum of $724 Million by 2012.

While this will not have an impact on those of you 65 and older paying for your own medical insurance or those fortunate enough to have your employer pay these expenses, for the rest of you who plan on using Medicare and who don’t have a supplemental medical insurance to cover these expenses, unless you plan on assuming room temperature on or prior to your 65th birthday, this is going to jump up and bite you…

Moreover, while you’re reading this, the same idiots in the US Senate that passed the porculus Bill without reading it are busy letting their “healthcare scientists” and lobbyists write a bill for Government run “Universal” Healthcare that’s essentially patterned after Medicare so it too will not cover the expense of home oxygen therapy for cluster headache sufferers 65 and older…

What’s even more concerning is the idiots responsible for this bill freely admit they don’t know how to pay for it…  

Now…  It that doesn’t get yer knickers in a bunch, it should…  If it does, and you can see where all this is heading, don’t let a day go by without sending faxes, email, and phone calls you your two Senators telling them cluster headaches are far more painful and debilitating than the enhanced interrogation techniques (EIT) used on the three terrorists at Club GITMO…  

Also tell them, when they write a bill that denies oxygen therapy to a cluster headache sufferer, they are guilty of fostering legislation that enables state run torture far more painful and debilitating than the EITs.

Having been through SEER training on two separate occasions at Eglin AFB, FL, and Warner Springs, CA prior to deploying to the Tonkin Gulf and the Air War over North Viet Nam, I can say that from personal experience…

Take care,

V/R, Batch
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Re: Modified KIP scale?
Reply #38 - Jun 25th, 2009 at 1:59pm
 
If it ain't broke don't fix it. Elaboration of symptoms are subjective, it creates more confusion than it eliminates. IMHO
all the best
RIP Kip and Judy
the bb
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Re: Modified KIP scale?
Reply #39 - Jun 28th, 2009 at 10:40pm
 
Quote:
If it ain't broke don't fix it.....

RIP Kip and Judy
the bb


You sir, took the exact words I was going to type right out of my fingers.
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Re: Modified KIP scale?
Reply #40 - Jun 30th, 2009 at 12:33pm
 
We all have our opinion... And maybe I miss read something; But I don't see where Ted changed the original KIP Scale. Nor do I see where KIP (or his memory) was disrespected in any way.

Had any wording in the original KIP Scale been changed, omitted or modified; than I would have a problem. but it wasn't. The original Scale is there; with an added explanation from Ted.

So as I said before, if there's something there that I'm missing, I apologize. But I see no harm in a more define clarification of anything.

I thank God for the Skip Scale... but I would also like to thank Ted for writing his addendum and Chuckie for sharing it.

For those of us who fine Ted's explanation useful, use it, for those of us that don't, don't use it...

I see no intent of discrediting KIP, his memory or the Scale he wrote.

I for one have copied Teds info and passed it on to family, co-workers and friends.

Have a Blessed Day Family, and lets move on..

Peace & Blessings
Ruthie
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