Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

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

nytimes.com

Post reply on HN
Print view View original

361–370 of 421 posts

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

#361

Post by kelnos »

eropple wrote: post #44
problems wrote: post #26

Earlier quoted context omitted.

Yeah, I question the idea that it's beneficial to experience pain - why should I? Especially if it's going to cost me days of my life that I could do something with. Maybe not go out, but at least be able to catch up on some of the more passive content... seems like a needless waste of life.

The experience of pain (and I'm separating this from the dopamine-release thing for people who groove on that sort of thing) is, for my money, a useful training facility for willpower and restraint. Separate from the pain-as-warning-signs noted by 'lukeschlather, few things hurt that much and the fact that you are not the master of even yourself is a valuable reminder. The experience of being uncomfortable is not a b…

I don't buy the "it's good and normal for you; suck it up" perspective. Pain is a useful signal that you're doing something wrong with your body, or that you need to rest to recover and heal. But if you're lying still on your bed recovering from a surgery and are still in pain, what purpose does that serve? It "builds character"? If that makes you happy, go for it, but don't impose that view on the rest of us.

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

#363

Post by burgerdev »

mschuetz wrote: post #344
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…

"And please be careful with ibuprofen" Ibuprofen is what allows me to get out of the bed for the past 3 months. I'm not sure that doctor knows how bad pain can be without medication.

They are probably right advising careful use of Ibuprofen, not because of kidney problems but because of heart conditions. There have been a couple of threads in HN recently, e.g. http://time.com/4568552/ibuprofen-naproxen-inflammation-safe... and http://time.com/3952889/painkillers-safety/?iid=sr-link1.

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

#364

Post by germanier »

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…

> Krankenkassen and Krankenversicherungen are not generally state entities

They are state entities established by law (Körperschaften öffentlichen Rechts mit Selbstverwaltung) and have to follow the strict regulations of the public sector. They regularly issue Verwaltungsakte.

> Would you call something like the Audi BKK a state entity?

Yes, absolutely. It's a state entity that provides care for Audi employees, since 2010 for everybody (and they can't legally refuse members). Audi has absolutely no input on their inner workings, it's really just the name and the fact that they have many members working there (and thus provide special services for them). It's basically a historical quirk of how the German insurance system came to be.

> No, health care contributions are paid directly to the Krankenkasse/Krankenversicherung where one is a member, not the tax administration (Finanzamt).

The Krankenkasse (to be exact their Einzugstelle) is really just a Finanzamt for social insurance contributions. If you don't pay they have the whole range to force you that's just available to state entities. See e.g. https://www.bundesversicherungsamt.de/fileadmin/redaktion/Kr... A private entity does not have these options and would need to go through general courts.

> Obviously not. In the health care domain, the Social Insurance systems and tax-based health care systems are different models.

They are different models (and should be contrasted) but both are financed through taxes (just different kinds). Yes, we don't call these "Steuern" in German but that doesn't translate 1-to-1 to other countries. "Abgaben" would be a much better translation for taxes.

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

#365

Post by coldtea »

toomanybeersies wrote: post #285
coldtea wrote: post #140

Earlier quoted context omitted.

It's a belief of some advocacy groups, like AA and such. In real life, there are lots of drug addicts and alcoholics that managed to recover for the rest of their life just fine, including drinking in moderation for social reasons without relapsing (as opposed the teetotallism stance advocated by said groups).

Not to say it's a bad thing to drink after recovering from alcoholism, but wouldn't that just be managed addiction? My uncle is an alcoholic, but has managed to drink at a reasonable level (not healthy, but doesn't socially harm him, e.g. drink driving, losing a job) for the past few decades. He'll crack his first beer at 10 AM, but manages to keep a good level of control.

>Not to say it's a bad thing to drink after recovering from alcoholism, but wouldn't that just be managed addiction?

Not any more so than drinking before alcoholism is "managed addiction".

If you can manage it and drink whenever you want after being an alcoholic (e.g. not drink for weeks, then drink at a party and then again not for weeks, and have no withdrawal effects when you don't drink) then you're not addicted anymore.

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

#366

Post by DrScump »

snotrockets wrote: post #266
ggregoire wrote: post #39

Earlier quoted context omitted.

I'm not sure it's a valid point since I can just enter in one of the 3 pharmacies near me and buy a box of aspirins for 2€. We don't have medications in supermarket but we have a LOT of pharmacies here (France).

But can you buy a box of 1000 aspirin tablets? That would be $23 in the US: https://www.cvs.com/shop/cvs-health-ibuprofen-tablets-200mg-...

That link is for ibuprofen, not aspirin.

Aspirin is dirt cheap in the U.S.

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

#367

Post by pseingatl »

Would you rather live in a country where medication is freely available over the counter, or one in which you need a prescription for everything? Having lived in both, I'd choose the former. What is a problem in the latter is trivial in the former. Does requiring medical intervention lessen drug abuse? Not entirely. But the vast majority of medications purchased are not drugs of abuse. When was the last time you heard of patients abusing blood pressure medication? Or heart medication? Sure, there are idiots who will eat Tide pods. An adult can purchase a semi-automatic rifle in my country, but .375 milligram aspirin? God forbid.

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

#368

Post by DrScump »

sologoub wrote: post #334

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.…

Flu can certainly impair one's immune system and pave the way for an opportunistic bacterial infection, but in the general case, antibiotics do nothing for viral infection.

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

#369

Post by kuschku »

germanier wrote: post #354
kuschku wrote: post #333

Earlier quoted context omitted.

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.

You cannot leave at "any time". To qualify, you need to have an income of over 59k € or be a freelancer. For most others (which is most of the population) private insurance is not possible. You can however purchase additional insurance on top of the public one.

Well, this is HN, a forum for mostly software engineers, so an income of over 59k€ should be expected.

You are right, though, if one considers the average citizen.

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

#370

Post by jagermo »

andrewksl wrote: post #315
woodpanel wrote: post #232

Two words: German Romanticism. Although the article‘s premise seems reasonable (given the author‘s origin, the USA, being renown as prone to prescribe pain killers and psychotropics for the most menial things[1]) - a similar bias must be outlined when trying to understand the German perspective: That we are still romanticists. Many German doctors will send you off with „some rest“ and „tea“. Some will prescribe homeo…

Whoa, seriously? Actual medical doctors will prescribe government-paid homeopathy?

Not really. Some insurances offer to take the cost of homeopathy, but no doctor will prescribe "crystals" or other new age stuff. Are there black sheeps? Yes, like in every profession.

How a doctor reacts depends highly depends on the illness. If you have a cold, your doctor will recommend some tea and rest, but if you have a tonsillitis, you will get anti-biotics. And there is no such thing as a pain index.

Post reply on HN