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After Surgery in Germany, I Wanted Vicodin, Not Herbal Tea

nytimes.com

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Re: After Surgery in Germany, I Wanted Vicodin, Not Herbal Tea

#201

Post by dpark »

trhway wrote: post #175
dpflan wrote: post #67

This passage feels like it is premise of the article; the author eventually comes to terms with her tea-sipping and resting as recovery, and this doctor explains the reasoning behind the medical decision-making which is very clear (and mindful/thoughtful) I think. “To paraphrase him [German anesthesiologist], he said: ‘Pain is a part of life. We cannot eliminate it nor do we want to. The pain will guide you. You will…

A similar reasoning of a (military) Russian dentist refusing to apply even local anesthetic that a friend seen once - "I prefer to not lose contact with the patient"

My dentist in California said he had several patients from Eastern Europe and Russia who had dental treatment like this, and their teeth were all mangled from treatment without anesthesia. He had done numerous re-drilling’s and re-fillings and root canals on these patients to deal with decay in teeth that had already been treated in their home countries. They had decay underneath fillings because the original treatment had essentially only gone as deep as the patient could stand. The dentist would drill until the patient screamed stop and then fill the hole, even if that left continued decay underneath.

I can only assume that the second round of treatment in their home countries would be either another round of drill torture or tooth extraction.

Re: After Surgery in Germany, I Wanted Vicodin, Not Herbal Tea

#202

Post by tomohawk »

Johnny555 wrote: post #95

Related: some studies have found that opioids are no better than ibuprofen+acetaminophen: https://arstechnica.com/science/2017/11/as-epidemic-rages-er... And I believe it. My wife had somewhat involved oral surgery (1 regular extraction plus removal of 2 impacted molars embedded in her jaw - it was difficult enough that they said a broken jaw during the procedure was a possible complication. The doctor prescribed a w…

Not to put a fine point on it, but you don't know what you're talking about. Have you ever seen someone who is in so much pain that they're projectile vomiting just because of the pain? I have.

There is pain, and there is PAIN. If you can get by with some NSAIDS, then you're just in mild pain. This is not likely to interfere with healing. This is the kind of pain the person is talking about in the article. It's scary for most people because they're not experienced with pain.

I was with a loved one who underwent a very serious surgery. This person has a very high pain theshold and thought that they would ignore the doctor's advise and take something a lot less strong than what was provided.

They ended up back in the hospital on a morphine drip to recover from their pigheadedness. Not taking the prescribed opioids had let their pain get out of control. Severe pain is very serious and can greatly interfere with the healing process.

By way of comparison, this same person had a minor surgery (a couple of years after the very painful one) and the doctor was shocked at how they didn't seem to really be any pain, because their pain threshold was much higher than before.

Re: After Surgery in Germany, I Wanted Vicodin, Not Herbal Tea

#203

Post by pantalaimon »

serf wrote: post #177
freyir wrote: post #117

Earlier quoted context omitted.

> the only thing worse than overprescribing necessary medications is underprescribing them. There are only three categories: overprescribing, underpresribing, and prescribing the correct amount. In the case of opioid-based painkillers, overprescribing leads to unnecessary addiction, in turn leading to heroin or fentaynl abuse, breakup of families, overdose, etc. If you’re underprescribed opioid painkillers, you just…

>If you’re underprescribed opioid painkillers, you just feel temporary pain (or not, since non-opioid painkillers exist). Without taking a political stance on regulated pain killers, I'd like to point out that the concept of 'temporary pain' is largely a myth. There has been much work done (mostly with chronic pain sufferers) to show that pain (and more generally over-excitation of nerves) can cause permanent nervous…

> Much of this research originated from the correlation between chronic pain sufferers and un-treatable (or difficult to treat) depression.

How do you conclude from results involving chronic pain to the effects of temporary pain?

I think there is a pretty obvious difference.

Re: After Surgery in Germany, I Wanted Vicodin, Not Herbal Tea

#204

Post by danieltillett »

eropple wrote: post #182
syshum wrote: post #174

Earlier quoted context omitted.

This is the wrong question. The question should be is their a compelling reason to make it Rx Only, and people that support making it Prescription only have the requirement to provide evidence to support making it RX only. The fact that is "addictive" is also not enough IMO

People are neither medically qualified to evaluate opioid use nor, when in a situation where they may be necessary, personally capable of evaluating their situation. This is why trained professionals exist. This is literally why. Asking whether there is an argument for an addictive opiate with significant health impacts and the opiate-consistent tolerance growth that leads to self-medication and increased dosage to b…

This is why you could only buy OTC codeine at pharmacies after you talked to the pharmacist about your condition and they checked and recorded your details in a database to see if you had been buying excessive amounts of OTC codeine.

We are moving from a system where we recorded who was buying codeine and making sure they were not needing help, to a system where there are no controls. The GPs in Australia lack any database on who has been prescribed codeine so it is now possible to doctor-shop around and abuse the system where previously it was regulated. About the only “winners” out of this change are the GP’s as they will now get more business from people like me.

Re: After Surgery in Germany, I Wanted Vicodin, Not Herbal Tea

#205

Post by ams6110 »

lispm wrote: post #142
ams6110 wrote: post #121

Earlier quoted context omitted.

You are splitting hairs. "people/companies who pay into the German universal health insurance system" are effectively being taxed, whatever the wording is.

No, they are insurance membership contributions in Germany. The contributions are specifically used to finance the health system, here the specific health insurer. Taxes generally are not paid for a person, but for things and values, etc.. Taxes are also not bound to a specific purpose, but are going into the general budget of the country/state/town. Taxes and insurance fees are different finance models. In Germany t…

Is it mandatory? If so, it's a tax in my book.

Re: After Surgery in Germany, I Wanted Vicodin, Not Herbal Tea

#206

Post by eropple »

danieltillett wrote: post #198
eropple wrote: post #165

Earlier quoted context omitted.

Is there a compelling reason for codeine to be OTC in the first place? It's an addictive opiate.

Codeine at the dose available over the counter is not very addictive. On top of this the pharmacists record your details so that anyone addicted is picked up and helped. As far as I can determine there has not been a problem with OTC codeine in Australia. As for why to not make it prescription only is we have universal healthcare in Australia. Shifting low dose codeine to prescription only will cause a massive increa…

If it's sufficiently low dose and it's tracked at a level that can detect and alert about potential abuse, that makes a lot of sense to me; thank you for the (much better) explanation.

Re: After Surgery in Germany, I Wanted Vicodin, Not Herbal Tea

#207

Post by Havoc »

bambax wrote: post #94

> Stool softeners Never heard of those. What are they exactly? Orange juice? I had a minor operation last year, also via laparoscopy. Didn't take any painkillers afterwards, and all was fine. I think pain has a lot to do with fear: if we don't expect it and we don't know why it's there, it's horrible, but if we know where it comes from and how it's supposed to evolve it's a lot more bearable (within limits of course)…

>Never heard of those. What are they exactly? Orange juice?

Psyllium husks work. They make the business more slimy for lack of better description.

https://en.wikipedia.org/wiki/Psyllium#Constipation

Re: After Surgery in Germany, I Wanted Vicodin, Not Herbal Tea

#208

Post by davycro »

trhway wrote: post #175
dpflan wrote: post #67

This passage feels like it is premise of the article; the author eventually comes to terms with her tea-sipping and resting as recovery, and this doctor explains the reasoning behind the medical decision-making which is very clear (and mindful/thoughtful) I think. “To paraphrase him [German anesthesiologist], he said: ‘Pain is a part of life. We cannot eliminate it nor do we want to. The pain will guide you. You will…

A similar reasoning of a (military) Russian dentist refusing to apply even local anesthetic that a friend seen once - "I prefer to not lose contact with the patient"

Different concept. Anesthesia for an operation leads to better outcome and more comfortable for the patient. Sucicide was common in people who needed a surgery prior to the advent of anesthesia.

Re: After Surgery in Germany, I Wanted Vicodin, Not Herbal Tea

#209

Post by [deleted] »

ams6110 wrote: post #205
lispm wrote: post #142

Earlier quoted context omitted.

No, they are insurance membership contributions in Germany. The contributions are specifically used to finance the health system, here the specific health insurer. Taxes generally are not paid for a person, but for things and values, etc.. Taxes are also not bound to a specific purpose, but are going into the general budget of the country/state/town. Taxes and insurance fees are different finance models. In Germany t…

Is it mandatory? If so, it's a tax in my book.

[deleted]

Re: After Surgery in Germany, I Wanted Vicodin, Not Herbal Tea

#210

Post by eropple »

danieltillett wrote: post #204
eropple wrote: post #182

Earlier quoted context omitted.

People are neither medically qualified to evaluate opioid use nor, when in a situation where they may be necessary, personally capable of evaluating their situation. This is why trained professionals exist. This is literally why. Asking whether there is an argument for an addictive opiate with significant health impacts and the opiate-consistent tolerance growth that leads to self-medication and increased dosage to b…

This is why you could only buy OTC codeine at pharmacies after you talked to the pharmacist about your condition and they checked and recorded your details in a database to see if you had been buying excessive amounts of OTC codeine. We are moving from a system where we recorded who was buying codeine and making sure they were not needing help, to a system where there are no controls. The GPs in Australia lack any da…

Makes total sense. In the United States, despite their training pharmacists are mostly considered to be pill monkeys rather than meaningful medical professionals--what you get instead is an emoji shrug as the their-definition-of-freedom-lovers (the GP is a good example) froth out at the idea that their medical data should be available to medical professionals, leaving it an ongoing pain in the rear to try to get one pharmacy chain to talk to another (or to an independent pharmacist).

I sometimes forget that other countries have systems that actually work because the incidence of people trying to destroy societal systems is generally less; in that context what you describe certainly seems like an own goal to me.

Thanks!

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