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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

#401

Post by frostburg »

dpark wrote: post #310
frostburg wrote: post #278

Earlier quoted context omitted.

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.

I had this done two time (jawbone cut, tooth extracted in fragments, stitches thereafter) and while the healing process was annoying, it wasn't painful unless I tried eating solid foods with the wrong side of the mouth or something like that (which was a good indication of the fact that it was too early to do so, which helped healing faster, which is why - even discounting addiction issues - taking painkillers for avoidable pain is dangerous).

The "quite a few bone fragments migrated out" part sounds pretty bad, on the other hand; that's not really supposed to happen as far as I know.

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

#402

Post by criddell »

rscho wrote: post #46
criddell wrote: post #20

Earlier quoted context omitted.

Aren't they worried about the patient vomiting and choking? I had a dental implant done at the end of last year and I wasn't supposed to eat anything before surgery.

Clear liquids such as sugared water can be safely ingested until 2 hours before surgery.

That's interesting. I was told to eat and drink nothing except enough water to swallow the pills I needed to take beforehand (pain killers and an antibiotic).

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

#403

Post by dpark »

frostburg wrote: post #401
dpark wrote: post #310

Earlier quoted context omitted.

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.

I had this done two time (jawbone cut, tooth extracted in fragments, stitches thereafter) and while the healing process was annoying, it wasn't painful unless I tried eating solid foods with the wrong side of the mouth or something like that (which was a good indication of the fact that it was too early to do so, which helped healing faster, which is why - even discounting addiction issues - taking painkillers for av…

I agree that the opiates probably weren't needed. I took the recommended dosage at first and just completely passed out for hours, so I have no idea how much pain I would have been in. After that, I cut the dose in half for the next day, until I got really sick of feeling foggy and just stopped entirely. (I found the whole "high" to be really annoying and not particularly pleasant, aside from the pain dulling properties. All I wanted to do was read and I couldn't do that.) I suspect ibuprofen would have been sufficient but I don't really know, either, since I took the surgeon's advice and took the opiates at first.

I do still have one wisdom tooth left. If I ever get that one out, I'll see how it goes without the opiates.

Bone fragments migrating out are apparently not that uncommon. Any bone piece that breaks off but doesn't get completely removed will eventually migrate out of the gums.

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

#404

Post by snotrockets »

DrScump wrote: post #366
snotrockets wrote: post #266

Earlier quoted context omitted.

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.

the deal isn't the price, but the quantity: if you need 1,000 pills of any medication, you should be under medical supervision/follow-ups, not buying them like they were groceries.

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

#405

Post by snotrockets »

pkaye wrote: post #327
snotrockets wrote: post #289

Earlier quoted context omitted.

Recommended dosage, which most people take more of – take two every couple of hours, and you're going to need a new liver. And when you're in pain, it's easy to loose count. Which is why in some countries, the maximum amount allowed over the counter is 16ct or so (sometimes a bit more when bought from a pharmacist who can make sure the buyer is aware of the dangers). It is irresponsible to sell a 1,000 ct bottle of p…

What if they buy the 16ct packs over multiple days and overdose on them?

the idea is to reduce risk, not eliminate it. thinking is, if you need 1000ct of any drug, you should probably see a health professional first; if you're going through the effort (and extra cost) of buying 63 packs of it, then there's probably nothing that could be done to stop you from whatever you are trying to do.

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

#406

Post by snotrockets »

Lordarminius wrote: post #318
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…

I am a practicing doctor and I don't know where this is coming from. Paracetamol and Ibuprofen while they have potentially lethal side effects are incredibly safe and effective in daily practice and consequently are very widely used. Every known drug has side effects and if you ever read a drug insert you would never pop a pill again. In the case of ibuprofen/paracetamol we are careful to avoid use in patients with u…

would you recommend a patient take any drugs regularly without regular follow ups? that's the danger of 1000ct over-the-counter. taking a couple of ibuprofens when you have a headache is one thing. taking enough to need 100s of them, without a professional recommendation is another.

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

#407

Post by aeriklawson »

linuxhansl wrote: post #234

I am German living the US, and I can absolutely second this. Neither view-point in inherently better or worse, just different. Note that Germany does have two class system now. The public class, and the private class. When you're in the public system you often sit in different waiting rooms for hours while those with private insurance get priority treatment, choice of Dr., better rooms in hospitals, etc. Many Germans…

As for the cost part, do German hospitals behave like American ones? i.e. overcharging for everything on the expectation that insurance will cover it?

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

#408

Post by dangerbird2 »

arbie wrote: post #276
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…

> 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?

It depends on the procedure. I had a minor cavity filled when I was younger, and it really wasn't all that horrible. Something like a root canal would be unimaginable.

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

#409

Post by dang »

znpy wrote: post #256
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 think I have found an american.

Nationalistic swipes, which this crosses into, are not allowed on HN. They create flamewars and a nasty environment. I realize you may have meant it in good humor, but the communication channel here is much too poor for that to mitigate anything.

https://news.ycombinator.com/newsguidelines.html

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

#410

Post by DrScump »

snotrockets wrote: post #404
DrScump wrote: post #366

Earlier quoted context omitted.

That link is for ibuprofen, not aspirin. Aspirin is dirt cheap in the U.S.

the deal isn't the price, but the quantity: if you need 1,000 pills of any medication, you should be under medical supervision/follow-ups, not buying them like they were groceries.

Generally, sure. As for aspirin, though, if you're a couple on a common low-dose daily regimen, that's 730 pills in just 1 year without a single head or body ache.
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