finland is notoriously "conservative" (read: medieaval) about pain medication.

[cimorene]

Dear Finnish doctors:

There's nothing cool about pain. It doesn't build character. It doesn't bring you closer to any higher powers. It doesn't lead to philosophical epiphanies. At best, it increases your tolerance. More likely, it interferes with your eating and sleeping habits. All it has to do is keep you awake a few nights to convert you to a semi-useless and extremely unhappy lump of seething resentment. So, you know, if someone comes to you in agonising pain because of some kind of medical problem, and they can't even sleep, then I think that fucking ibuprofen is not really the answer. A good clue would be if they've already been taking ibuprofen and it didn't help. The beautiful thing about your medical degree is that all kinds of options for pain relief for your patients are available to you with the use of something called a prescription book, and many of these are ones they couldn't buy at the drug store without your help! If you want to earn acclaim and admiration from your colleagues and patients, you could even try using something strong enough to actually fight the pain!

An extra-special note to Finnish dentists: Try anaesthetic when performing root canals, oral surgeries, and even just your average cavity fillings! Your patients will like it and they won't become a) weaklings or b) hardened drug addicts, honest! Fuck sisu.

No love,
Cim

P.S. You guys aren't nearly as cool as the Finnish cops.

Comments

[vass]

At best, it increases your tolerance.

Actually, I read somewhere that the reverse is the case, that the longer and more often you're in pain, the worse your tolerance gets. It wears you down.

[brownbetty]

That's what I read too, and it's not out of line with my experiences. :(

[cimness.livejournal.com]

In that case, there really is no best.

[emmuzka.livejournal.com]

I agree with your view on Finnish pain meds policy. Guess what my mother was offered after a hip prosthetic surgery? Ibuprofen. Yeah, right. (Thankfully she got better meds after she threw a fit) Toothache is especially what it seems like the doctors are *instructed* to deny prescription medication. Maybe it's their way to try stop people for jonesing drugs, as toothache is one of the pains that is extremely subjective experience and difficult to "prove".

On the other hand, after my wisdom teeth were pulled out and my request of prescription pain meds were laughed at, I found out that I actually didn't need anything, not even Burana. If they would have given me the recipe, I would have taken the drugs without listening my body if they were really needed.

But yeah, I feel sorry for Finnish chronic pain patients who are expected to survive with like, taking up yoga or something. On a larger picture, I feel like the pain meds policy follows Finland's general drug policies. When drugs can't be advertised straight to the consumers, drug companies have to advertise straight to the doctors. It's not financially profitable to advertise pain meds because they are cheaper than drugs for blood pressure and diabetes and such and their patents are so old that the meds are interchangeable. So no point advertising. So there is no force lobbying the use of pain meds. So the situation doesn't change from what it was decades ago.

Personally, I'm one of those annoying "You can't pop a pill for every illness and sorrow"-people who have never even experienced excruciating pain in my life, so. I wouldn't want to see the medication policy to change to what it is in the States.

[cimness.livejournal.com]

Okayyyyy, ibuprofen for hip replacement is up there with the top "surgery and/or medicine" anecdotes I've ever heard. Srsly, WHAT? It's kind of funny in spite of the horrifying aspect when you try to imagine if it happened to you.

But as for the attitude to pain medication in the US, I've never experienced exruciating pain either, because I was medicated adequately when I had oral surgery. I suppose there might be people who get addicted to medication when it could have been stopped, but I don't see any downside to all people who were given, for example, total anaesthesia for a wisdom tooth extraction (as I was, because I had all 8 out at once), or strong pain meds - even if they are drowsy - for intense pain, at least for short periods of time. I see my father struggling with chronic nerve pain and physical pain, and the doctors doing their best to adjust his prescriptions to handle that. I can readily imagine what would happen if they were stingy with those medications. I remember the weak moans and occasional screams I heard from him and that was with medication. The worst of the policy to me seems to be the chronic pain sufferers - who are screwed even with medication, but maybe equally screwed in America if they don't have health insurance (not able to AFFORD any medication) as here (where they just can't get any unless their limbs are actually falling off).

[emmuzka.livejournal.com]

Yeah, my mother was like, " I have eaten Panacod FOR BREAKFAST for the last two years because of this damn hip and now you offer me Burana?! GIVE ME THE REAL DRUGS!"

I can imagine that in the States peoples pains are managed better because they can always change the doctor (if they can afford the doctor in the first place) but in finland it's the same institution everywhere so there is pretty much nothing else. Also, the policies for giving people sick leave is totally unjust; Company's own doctors will probably not give you sick leave even if your head would be falling off, public health care give you two days after you have queued to the doctor for ten hours, and someone else can get a week off from work by calling every other day and *sounding sick*.

On the other hand, if one gets cancer or needs a heart transplant or brain surgery, Finland is pretty good place to live since then getting a treatment is not a matter of money anymore.

[wildestranger.livejournal.com]

My friends in Finland have had similar problems with their dentists, but they found that private doctors are much more happy to provide drugs during and after treatments. Perhaps you might consider getting a private dentist? I understand they are not much more expensive.

[emmuzka.livejournal.com]

Actually, private dentists in Finland are so much more expensive. The common healthcare-provided dental care is practically free, something like 10-20 euros per visit. A visit to a private clinic will cost so much more. Fixing one tooth costs about 100 euros, minus the portion that the State will pay you back that is about 30% of the price, --> 60 euros. That's reasonable, but still a lot more costly than in public healthcare.

[wildestranger.livejournal.com]

That surprises me - I had really got the impression that they were a lot cheaper than that. Isn't there a thing where you get half the money back from the government, though, or is that only for special cases?

[anglepoiselamp.livejournal.com]

Trying to get money back from the state here is worse than dentistry without drugs. -___-

[emmuzka.livejournal.com]

*checks*

Okay, these are prices for correcting a hole in a tooth, in a dental office situated in the bumfuck, nowhere, Finland. So, if you are lucky and you only have a small simple hole, that costs you as little as 37 euros, of which you will pay 20,20 euros and the state will pay rest. Cheap! If the hole needs more care, the price goes steeply up, one crown on a tooth will cost 122 euros, of which you will pay 74 euros. Of course you will have to peddle up the whole sum first, and then ask your money back within the next six months. I for example, was an idiot who lost the receipts' for my eye doctor and then was just lazy and therefore lost lost my chance to get money back for my 90 eur appointment.

price, EUR patient will pay, EUR
SFA00 Pieni täyte 37 20,20
SFA10 Yhden pinnan täyte 50 30,20
SFA20 Kahden pinnan täyte 78 45,00
SFA30 Kolmen tai useamman pinnan täyte 91 53,20
SFA40 Terä tai kruunu 122 74,00

[cimness.livejournal.com]

Oh, Wax is already at a private dentist, but he wasn't giving out medication stronger than extra-strength ibuprofen - she's got an infected root, which I guess to him is a toothache. He wouldn't even write her an excuse from work.

[anglepoiselamp.livejournal.com]

Yup. Basically you have to specifically ask for the anaesthetic every time at the dentist.

And recently I went to the doctor to get something stronger for my joint pains (they get pretty severe at times and I can't sleep or, say, hold a pen) and told them I've tried all sorts of pain medication, of which only one has helped (Orudis, a prescription-strength anti-inflammatory). Their solution? Telling me to buy over-the-counter paracetamol. Which hasn't ever been effective for me, for anything.

[cimness.livejournal.com]

The WHAT THE HELL? They SERIOUSLY suggested PARACETAMOL when you can't move your joints and have, you know, tried all kinds of medication already? What, like maybe you'd been put on multiple prescriptions before but paracetamol just never OCCURRED to you? o_O

[brownbetty]

Ugh, pain is terrible! My sympathy!

The only pain that's difficult to get treatment for here is menstrual pain. They're always like "Have you tried B vitamins? What about hot pads?"

But when I got my wisdom teeth out I got a bunch of codeine without so much as asking for it, so I saved it for my menstrual cramps.

[cimness.livejournal.com]

I'm very fortunate in that 400-600mg ibuprofen every six hours will pretty much kill my menstrual cramps. They seem to be getting worse with age, though. I see myself in ten years being practically bedridden one or two days a month. >.@

[fingelverse.livejournal.com]

Ibuprofen's anti-inflammatory properties start at 200mg per 25kg weight of the patient. The pain relief starts at 100mg per 25kg. So it can be dosed twice as high for injuries with swelling as for injuries that just hurt. The side effects are more likely to occur at higher doses, though.