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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

#271

Post by flukus »

freyir wrote: post #117
wendyjreichert wrote: post #75

I have no doubt that pills are overused, and Europe is a rather ahead of America in terms of natural remedies and a less pill-pushing approach. That said, doctors should take care: the only thing worse than overprescribing necessary medications is underprescribing them.

> 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…

> In the case of opioid-based painkillers, overprescribing leads to unnecessary addiction

So does underprescribing in a world where extremely effective yet more addictive illicit painkillers are easy to come by. I've had to resort to this for a few days after a wisdom tooth removal and would much rather have had access to better regulated options.

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

#272

Post by kurthr »

wolfgke wrote: post #267
kurthr wrote: post #236

Earlier quoted context omitted.

I have had my teeth filled by a dentist that didn't "believe" in novocaine. Luckily, he died before I had any significant issues, and I had a later dentist that did it correctly. If you are doubtful of the usefulness of pain management while receiving a filling, you can try it yourself. I'm perfectly understanding the concern for long term morpohine derivatives for treating post-surgical pain (although there are plen…

> I have had my teeth filled by a dentist that didn't "believe" in novocaine. Luckily, he died before I had any significant issues, and I had a later dentist that did it correctly. If you are doubtful of the usefulness of pain management while receiving a filling, you can try it yourself. I (German) openly prefer it, if the dentist gives the option whether to get a anaesthetic injection or not for dental fillings, no…

You're welcome to have your teeth drilled as you like. However, if you have a younger family member with more sensitive teeth you may understand that it's not for everyone. Imagine if your child jerked away for just and instant that caused the drill to cause more harm than good. The modern novacaine derivative my dentist uses lasts only about 30-60min after the appointment.

Because I was under the age of 18 and he was my parents dentist I didn't really have a choice. I didn't have any cavities as a child so my first negative dental experience was at 17 when he filled 4 molars "preventatively" (because he didn't know that epoxy capping was a thing). It didn't kill me, but it was an excruciating 30 min and an absolutely miserable day. The muscle tension pain from not moving took days to subside. Not a reasonable trade-off for me.

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

#273

Post by refurb »

nosickdays wrote: post #97
HarryHirsch wrote: post #43

Earlier quoted context omitted.

people experiencing legitimate pain are becoming casualties of our crackdown on "inappropriate" prescribing. Perhaps in America they are so easy with the opiates because people have a real or perceived need to get back to work. When I had to have two impacted wisdom teeth removed the pain and swelling was completely under control with ice bags, aspirin and two days off work. A low wage at-will worker in the US can't…

This is a rather salient point. In the Netherlands, if I needed (in consultation with my doctor, of course) to stay out of work for a year to recuperate from illness or injury, I can do that and continue to receive my full salary. The second year would be at 70% salary. My job would await my return - only after 2 years would I be separated from my employer and have access to other long-term disability benefits. In th…

Short and long term disability insurance is common with professionals jobs in the US. After that social security kicks in.

The only think I can think of is the abuse must be rife in the Netherlands? Shit, at full salary I certainly wouldn't be in a rush to get back to work.

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

#274

Post by frostburg »

jjeaff wrote: post #136
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…

I wonder if that doctor has ever had major surgery himself and been told not to use painkillers? Even if that is the case, pain seems to vary greatly in how it affects people. I would be very hesitant to tell someone that they should just let the pain "guide" them, because I have no idea what it is like for them.

Anecdotally, I had a very intricate horizontal impacted wisdom tooth removal surgery done on barely any anesthesia because the thing was dangerously close to a nerve and I needed to be able to inform the dentist when he was getting too close to it (AR people: there is a market here for in-surgery diagnostic image overlays). It wasn't that bad (the healing process was more annoying), I was more focused on the ongoing procedure (but then again I was in med school before I decided to switch to computer science).

Slightly less anecdotally, I have a lot of doctor friends and while they may indulge in overwrought "look at how clever I am" medication schemes for ailments that do not really warrant it, I think that it's mostly because they feel that they don't have the time to rest like the author of the article (and this doesn't involve routine painkiller use either).

Some people argue that in my country (Italy) there is a cultural aversion to painkillers due to the historical influence of the Catholic Church, but it's hard to measure the effect.

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

#275

Post by sannee »

snotrockets wrote: post #262
btian wrote: post #222

Earlier quoted context omitted.

Huh? You don't need a prescription to get paracetamol, acetaminophen, and ibuprofen

Both of them (Acetaminophen is the US name for Paracetamol) are highly dangerous, even in small dosages. Paracetamol poisoning can kill within a day, and the lethal dosage is equivalent to about 20 pills. Ibuprofen is proven to cause heart attacks & stroke. Your suggestion is the perfect example of why over the counter drugs as so dangerous: a Dr or a pharmacist is aware of the dangers, that we (being the public) may…

> the lethal dosage is equivalent to about 20 pills.

It's really hard to accidentally eat 20 pills, especially when the usual does is about 4 per day...

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

#276

Post by arbie »

wolfgke wrote: post #267
kurthr wrote: post #236

Earlier quoted context omitted.

I have had my teeth filled by a dentist that didn't "believe" in novocaine. Luckily, he died before I had any significant issues, and I had a later dentist that did it correctly. If you are doubtful of the usefulness of pain management while receiving a filling, you can try it yourself. I'm perfectly understanding the concern for long term morpohine derivatives for treating post-surgical pain (although there are plen…

> I have had my teeth filled by a dentist that didn't "believe" in novocaine. Luckily, he died before I had any significant issues, and I had a later dentist that did it correctly. If you are doubtful of the usefulness of pain management while receiving a filling, you can try it yourself. I (German) openly prefer it, if the dentist gives the option whether to get a anaesthetic injection or not for dental fillings, no…

> I strongly prefer 5 to 10 somewhat inconvenient minutes over having a numb jaw for a whole day.

Is it possible only a minority would consider the pain of a drill into the core of their tooth an inconvenience?

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

#277

Post by BLKNSLVR »

The article abruptly ended without its appropriate summation commentary on the cultural dependence on drugs inherent, normalised, and seemingly encouraged, in the US.

Admitting taking ibuprofen like candy? Even as a joke, it would only be funny where such behaviour isn't too far from normal. No wonder your pain threshold is low.

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

#278

Post by frostburg »

dpark wrote: post #179
Terretta wrote: post #159

Earlier quoted context omitted.

On the contrary, since nobody in the US is willing to prescribe opioids any more, hospitals are doing Tylenol IV drips, and pharma is now charging 10x for acetaminophen. They’re just fine with the hysteria and the studies, they still get paid.

> since nobody in the US is willing to prescribe opioids any more Since when? I was given opioids when my wisdom teeth were pulled a year ago, far more than I needed. From what I understand, opiate prescriptions are down, but only by 10-20% or so.

Opioids for wisdom teeth removal is insane to me (and 100% of the medical doctors that I know, and it's a lot of them). This is utterly disfunctional.

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

#279

Post by dmarlow »

wolfgke wrote: post #267
kurthr wrote: post #236

Earlier quoted context omitted.

I have had my teeth filled by a dentist that didn't "believe" in novocaine. Luckily, he died before I had any significant issues, and I had a later dentist that did it correctly. If you are doubtful of the usefulness of pain management while receiving a filling, you can try it yourself. I'm perfectly understanding the concern for long term morpohine derivatives for treating post-surgical pain (although there are plen…

> I have had my teeth filled by a dentist that didn't "believe" in novocaine. Luckily, he died before I had any significant issues, and I had a later dentist that did it correctly. If you are doubtful of the usefulness of pain management while receiving a filling, you can try it yourself. I (German) openly prefer it, if the dentist gives the option whether to get a anaesthetic injection or not for dental fillings, no…

That's interesting. My dad (half German) is the same way. After having gone to the dentist and seeing that, I though to myself, if he can do it, so can I. I now prefer it over having a numb mouth the whole day.

I've never had to to anything beyond simple fillings so I'd like to think that's the limit for me.

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

#280

Post by dxw92297 »

brandonmenc wrote: post #230

Cue the anti-drug (really, anti-medicine) comments from all the people who have never encountered chronic debilitating pain, either personally or in a loved one.

Absolutely. Pain needs to be evaluated on a case-by-case basis. I have experienced cluster headaches for decades. Then, a few years ago I had a small stroke which left me with central pain syndrome. After working with my local pain clinic, and based on my types of pain and inability to take some alternative medications, opiates were my best bet. With small, regular doses, I can function and work with minimal pain. I am not pain-free but these medications allow me to go about my daily activities with relatively few problems. So, in my case, the key was finding the right opiate mix and dose, ongoing medical monitoring, and long-term physical therapy. Opiates have a place in modern medicine and their use is not black and white. Lumping all types of pain, plus chronic vs temporary pain, is bad medicine.
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