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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

#301

Post by ianai »

clwk wrote: post #294
jjeaff wrote: post #136

Earlier quoted context omitted.

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.

I have a very relevant anecdote: My grandfather was an open-heart surgeon. In the days following surgery, he would always insist that his patients get up and take a short walk. They would not want to, but he insisted that this was an important and valuable part of recovery (in several dimension) and that they needed to push past resistance and force themselves to do it. Later in life, he underwent a surgery requiring…

Makes sense. They make nurses sit with a wet diaper in bed in medschool.

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

#302

Post by ianai »

vanderZwan wrote: post #167
jjeaff wrote: post #136

Earlier quoted context omitted.

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.

> I wonder if that doctor has ever had major surgery himself and been told not to use painkillers? Since when is that a requirement for knowing what is best for your patients? The doctor is basing their judgement on current consensus within their field, which hopefully involves careful studies.

Having surgery may not be required. But an appropriate knowledge of what’s going on certainly is.

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

#303

Post by secabeen »

sannee wrote: post #275
snotrockets wrote: post #262

Earlier quoted context omitted.

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...

Lots of people take 2 Extra Strength Tylenol at at time. If you do that every 4 hours (instead of 6), you're looking at 12 pills a day. Add to that a few doses of Nyquil or some other multi-medicine that has Tylenol in it, and it's possible to get up to a toxic dose.

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

#304

Post by hn_throwaway_99 »

refurb wrote: post #290

"Time is a flat circle. Everything we have done or will do we will do over and over and over again- forever." For those of you who were around in the late 80's early 90's. Today's moral panic about opioids will give you a chuckle. Back in the 1980's opioids were the devil and many patients, even in hospice, had undertreated pain due to fear of addiction. In the 1990's it dawned on doctors that maybe they should be a…

I think calling current thoughts around opioids a "moral panic" is ridiculous.

Much of today's response to opioids is an actual panic given that there is a real, ongoing epidemic of opioid abuse that is killing tens of thousands of people. The number of deaths by opioids more than doubled in 2016 compared to 2015.

I was around in the 80s, and this isn't just some "cyclical response". Take a look at any of graphs of opioid deaths or overdoses - there is no cycle, just something that is shooting up and up and up.

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

#305

Post by bluntfang »

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.

>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.

You should be hesitant, unless you're a doctor.

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

#306

Post by justonepost »

cal5k wrote: post #7

I had jaw surgery recently... while I wouldn't describe it as incredibly "painful", particularly since everything was numb (they have to slice through nerves for this procedure), it was really uncomfortable and stressful for a couple of days afterwards. I wasn't at all ashamed to take percocet after the surgery. Could I have lived without them? Sure. Did they turn me into an instant addict? Of course not. This story…

You are projecting anecdotally your own situation and extrapolating in a somewhat irresponsible manner. Statistically it is shown that these prescriptions do lead to addiction in a frightfully large number of people. Being "uncomfortable" and "stressed" is a part of pain and it's an important signal that you need to take it easy. If pain is to the point where you can't sleep and heal appropriately, than I can see where it might be used. Even then it's important not to confuse general insomnia with pain induced waking.

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

#307

Post by ridgeguy »

kurthr wrote: post #272
wolfgke wrote: post #267

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 (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 wa…

I had your experience at ages 6-9 in Alaska. The only available dentist had moral qualms about using novocaine.

The resulting aversion conditioning kept me away from dentists until I was 36, when my then-girlfriend coerced me to see a dentist. I needed lots of work, all of which was done using novocaine.

Pain control is part of good professional medical practice. If a practitioner puts you through gratuitous pain, find somebody else.

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

#308

Post by refurb »

hn_throwaway_99 wrote: post #304
refurb wrote: post #290

"Time is a flat circle. Everything we have done or will do we will do over and over and over again- forever." For those of you who were around in the late 80's early 90's. Today's moral panic about opioids will give you a chuckle. Back in the 1980's opioids were the devil and many patients, even in hospice, had undertreated pain due to fear of addiction. In the 1990's it dawned on doctors that maybe they should be a…

I think calling current thoughts around opioids a "moral panic" is ridiculous. Much of today's response to opioids is an actual panic given that there is a real, ongoing epidemic of opioid abuse that is killing tens of thousands of people. The number of deaths by opioids more than doubled in 2016 compared to 2015. I was around in the 80s, and this isn't just some "cyclical response". Take a look at any of graphs of o…

Sorry, it's a moral panic.

When I read comments like "just one Vicodin and you're addicted for life!", "nobody should take opioids" and "opioids are destroying our country" it's moral panic.

As for the number of overdose deaths, take a look at other countries that never saw the massive overprescribing of opioids like Canada. The deaths are due to synthetic opioids mostly coming from China.

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

#309

Post by ams6110 »

lispm wrote: post #250
germanier wrote: post #226

Earlier quoted context omitted.

While it certainly makes sense to discuss the difference, for a US-based audience it doesn't make much sense to pedantically point out that these aren't taxes. Social insurance contributions are mandatory, based on income, and to a state entity (though independent from the government) enforced through exactly the same channels as regular taxation (as opposed to private debt). The important difference is that they are…

That's simply not the case. It is exactly for an US audience important, because the German system is vastly different: universal health care, regulated by the government, 99.9% coverage, run by a system of 100+ insurers and various health care providers. > Social insurance contributions are mandatory Mandatory is to be insured. > based on income in a range, or if one is privately insured one pays based on risk/age Fa…

> Mandatory is to be insured.

While I will admit there are varying interpretation, for me, living in the USA, if I am mandated to pay for something, it's a tax.

I take it that as a German, working in Germany, I could not "opt out" of all of this and just take my chances?

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

#310

Post by dpark »

frostburg wrote: post #278
dpark wrote: post #179

Earlier quoted context omitted.

> 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.

In fairness my wisdom teeth removal wasn’t exactly textbook. I had to go to an oral surgeon and he had to dig into the lower jawbone to remove one of them, breaking it into pieces to get it off the nerve. I had a lot of damage to the gums and quite a few bone fragments migrated out over the next few weeks.

I was however even offered opioids for a root canal once (different dentist). I didn’t fill that prescription.

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