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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

#331

Post by kuschku »

majormajor wrote: post #158

There's something deeply concerning to me about claiming overall universal insights in pain management based on laparoscopic surgery. Good for her that she was fine, but I've had the opposite experience with more serious stuff. Moaning in bed unable to sleep due to the pain being worse than anticipated is no fun, and that was in a hospital with the nurses aware but waiting on the proper overnight staff to have time t…

The 1-10 scale is very clearly defined:

0 Pain free

1 Very minor annoyance-occasional minor twinges

2 Minor annoyance-occasional

3 Annoying enough to be distracting

4 Can be ignored if you are really involved in your work, but still distracting,

5 Can’t be ignored for more than 30 minutes.

6 Can’t be ignored for any length of time, but you can still go to work and participate in social activities.

7 Make it difficult to concentrate, interferes with sleep, you can still function with effort

8 Physical activity severely limited. You can read and converse with effort. Nausea and dizziness may occur.

9 Unable to speak, crying out or moaning uncontrollable- pain makes you pass out

10 Unconscious. Pain makes you pass out.

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

#332

Post by ubernostrum »

sundvor wrote: post #223
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…

The US mind programming of painkillers / drugs as an answer to everything is killing you by the thousands. I'm glad Australia is taking steps to avoid falling into the same pit. Sometimes, and at least on scale, a dose of HTFU can be much, much better.

I've read a few coherent accounts of what happened here in the US, and several of them blame changing Medicare/Medicaid quality-of-care guidelines. Specifically, that at one point one of the guidelines -- which factor into how much various entities in the system get paid -- changed from measuring whether pain was appropriately managed, to measuring whether pain was being eliminated. Which in turn led to an explosion of prescriptions of high-strength pain medications in order to hit the measure.

Having some experience with Medicare's version of the guidelines, most of them are sensible and do directly relate to whether someone's being treated in a way that will lead them to be healthy and happy in the long term. But it appears that one was a major mistake.

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

#333

Post by kuschku »

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.

No. You can leave the public insurance system at any time, and get a private insurance.

But if you have ever done so, you can never return into the public system.

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

#334

Post by sologoub »

Just spent two weeks on the other side of the border from Munich, in Austria. The article is very accurate on over the counter meds - you can’t get what you are used to in US.

I caught a really nasty flu the first few days there and by end of the week was searching for something to ease the cough. The cough syrup I was able to buy tasted like rubber and did not contain the active ingredients you normally find in US. It sort of worked - better then nothing, but certainly did not really help the situation. Cough drops I was given plain did nothing for me. All was purchased in a local Apotheke and dispensed by a pharmacist.

Upon return to the US, I continued to struggle with the cough and finally gave up and when to a doctor. Sinus infection and antibiotics... so much for the non-drug way of healing.

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

#335

Post by oxide »

underwater wrote: post #297
jjcm wrote: post #293

Earlier quoted context omitted.

On the flip side, Australia prescribes antibiotics like they're candy. I'm always amazed at how easy it is to get a flight of them here.

Compared to where? I found US doctors much more likely to prescribe them than Australian doctors.

The undertreatment of pain in the US is affecting my grandparents in a huge way. My poor grandfather spends a week or more a month suffering from the rapid taper the doc is putting him through. We are trying to get him into pain management, apparently every doc in CA is scared of prosecution.

The irony is he would be just fine if they never rescheduled hydrocodone. When they did thst he had to be put on fentanyl and dilaudid, forcing us to seek out a pain specalist to get my grandfather the quality of life he needs to keep going.

The guy fell twice in two years and they just keep cutting him back, while abusers switch to heroin.

Genius tactic IMO. Deny those who need it, deny those who seek to abuse it, and force everyone to switch to heroin. Kidding of course- but thats where the abusers will go.

The legit QoL patients suffer with zero alternative. They cant take ibuprofen without shitting blood for a week.

Its like drm. The legit consumer is punished by those who abused the system.

Its more nuanced than that, but thats how it affects my life directly. Watching my grandparents in extreme pain because of crackdowns in all the wrong places. It makes me hurt and sick.

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

#336

Post by MindTooth »

After surgery in December I used some mix of antibiotics and anti-inflammatory for five days. Occasionally some painkillers if needed.

As a Norwegian though, I expect to get well, and only take painkillers when needed. I never pop painkillers when I have a headache, minor pains, etc.

I am a also a firm believer that when the time comes, I have a lesser tolerance and the painkillers will work better.

Regarding pain, if you feel it, you can work to resolve it. If you do not, how can you?

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

#337

Post by kuschku »

ams6110 wrote: post #309
lispm wrote: post #250

Earlier quoted context omitted.

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?

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

You could opt out of the public system, and get a private insurance company. But once you have done so you can never re-enter the public system. And private insurances are cheaper for young people, but significantly more expensive later in life, so much that you’ll end up paying several times more over your lifetime.

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

#338

Post by photonios »

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…

Funny.

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

I am not sure you'd say the same after 3-4 hours of treatment. I've done some root canal treatments here and there, which can take a long time. I'll take a numb jaw for a couple of hours afterwards over being in pain for 3 hours.

But I guess you're right, for 5-10 minutes of pain, it isn't worth it.

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

#339

Post by cunningfatalist »

Vendan wrote: post #17
maxxxxx wrote: post #11

"I took two ibuprofens that first day. In hindsight, I didn’t need them, but I felt like I should take something" I have noticed the need to "take something" with a lot of American friends when they have problem. It's almost like a reflex.

My wife fusses at me when I mention I've had a headache for the past X hours and I haven't taken anything for it...

I don't use pain killers at all, but headaches are sometimes the exception. I rarely get a headache (maybe once a month?) but when I do, I know that it won't go away before a good night's sleep. So I either go to sleep in the evening or take an Aspirin or something when I'm at the office. I just can't work or even properly think with a pounding headache.

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

#340

Post by myhf »

jjcm wrote: post #293
sundvor wrote: post #223

Earlier quoted context omitted.

The US mind programming of painkillers / drugs as an answer to everything is killing you by the thousands. I'm glad Australia is taking steps to avoid falling into the same pit. Sometimes, and at least on scale, a dose of HTFU can be much, much better.

On the flip side, Australia prescribes antibiotics like they're candy. I'm always amazed at how easy it is to get a flight of them here.

That's not how I would describe the situation.

In America you can buy topical antibiotics at convenience stores, but you get a lecture if you ask for something stronger. Painkillers are prescription only and there's very little stigma for something like Tylenol 3.

In Australia you can buy codeine over the counter, but you get a lecture if you ask for something stronger. Antibiotics are prescription only but have no stigma.

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