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Old 01-11-2006, 10:14 AM   #1
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Hyperthyroid and anaesthesia

I am hyperthyroid which is now in remission - it has corrected itself to the high normal range. I just went for more testing the other day and expect the results back by next week as I am having symtoms again of hyperthyroid - shakiness, chest pain, tiredness and mood swings and weight loss.
I am supposed to get dental surgery done next week which involves anaesthesia and part of it is a minor dose of epinephrine 1/200,000 dose. I am hearing alot about the epinephrine not being safe with hyperthyroid patients but my doctor or dentist does not seemed to be worried about it.
I am scared something will go wrong and I will go into a thyroid storm after or during the anaesthesia. Does anyone have any experience with that? My new tests won't be back in time to verify my thyroid is out of wack again.

 
Old 01-11-2006, 02:47 PM   #2
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Re: Hyperthyroid and anaesthesia

Hi they can use an non adrenaline anesthesia and should always be told you have thyroid problems l believe my 1st attack a few years before been dxn with graves happened at the dentist after the injection l know that now because lve experienced it just before been dxn and after..... can you delay the dental visit till you know whats happening? good luck

 
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Old 01-11-2006, 04:59 PM   #3
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Re: Hyperthyroid and anaesthesia

I think your fears are justified! If you are hyperthyroid a dose of epinephrine could send your heart into overdrive. Dental surgery is usually done in the dentists office, right? Do they have a defibrillator there or other life saving tools should something horrific happen?
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Dx Graves 4/99, tx w/Tapazole & Atenolol - Remission 7/03; Relapse 1/06, back on Tapazole, remission & off meds again 11/06.

 
Old 01-11-2006, 07:03 PM   #4
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Re: Hyperthyroid and anaesthesia

I wouldn't feel totally comfortable with the plan either. Since you don't know your actual levels, IMO it isn't the wisest thing to go ahead without a large degree of preparation. Ask the dentist if he knows how to treat thyroid storm, because even though it isn't a gigantic risk, it is a risk.

Slightly off-subject -- A friend of mine, when we were both in our 20s, went to a pulmonologist's office for a bronchoscopy. She turned out to be extremely sensitive to the anesthetic used to numb her airway. Her throat swelled up, and she suffocated and died right then and there. The MD had not one piece of life-resuscitation equipment in the office. So... my point is not as much that the emergency happened, but that the monstrously idiotic MD had no emergency plan in place to prevent the loss of my friend's life. Stuff happens, and it doesn't always happen to "the other guy".

Here's the URL to the paper I keep in my thyroid file on the subject of anesthesia and thyroid disease, if you want to read it:
http://www.anesthesia.org.cn/asa2002/rcl_source/135_Wall.pdf

 
Old 01-12-2006, 02:51 AM   #5
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Re: Hyperthyroid and anaesthesia

Oh my **** that is scary!!!! I know when l had 'that' dental visit l didnt feel right after recieveing the injection, my heart was going beserk l was shaking hot and sweaty l felt like l was going to die seriously and to make matters worse this 'new lady dentist' started joking with the nurse do we have the right equipement in here? and weve treat patients who have not told us they have other problems and had to revive them! Well you can imagine how that made me feel!! i never went back even to this day!! Can dental procedures trigger graves off? I think ive had it for years and noone tested me l think that day way back in June 1999 was the start of my problems even hubby said since that day l havnt been right, honestly7 speaking if l were you l would wait and make sure everyone knows what there doing ps lm a nervous dental patient to start off with!! Good luck

 
Old 01-12-2006, 06:44 AM   #6
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Re: Hyperthyroid and anaesthesia

Thank you everyone for justifying my concerns. My anxiety about this is through the roof - my fiance is also concerned as I don't take well to any medication - the doctor once gave me propanolol when I was first diagnosed to reduce my heart rate which was at about 100 and it dropped suddently to 60 and I was back at the emergency with it (that was a few years ago). I have also taken a reaction to an anti-migraine med which is supposed to be a common drug - I had 170 heart rate, extreme high blood pressure and lost my proper speech for days and had a 3 hour emergency stay as they would not let me leave til my blood pressure returned to normal.
I have refused to take any other meds since. I had an upper wisdom tooth out a couple years ago with just local and I had a panick attack that evening. I don't think this anaesthesia is a good idea but my doctor keeps telling me to "let them be the drivers" and to relax about it. He said not to worry when I took the propanolol also so his opinion does not relax me. I think they have life saving equipment there although I did not ask as he is an oral/maxillary surgeon. I am going to call today to see if I can just have an anti anxiety drug only with the local anaesthetic as my anxiety is so high I am thinking of cancelling the appt (I have been putting this off for a couple years). The dentist did not give me a choice at the time - either general anaesthesia or lighter anaesthesia. I don't want either.

Last edited by browneyed-babe; 01-12-2006 at 06:46 AM.

 
Old 01-12-2006, 08:37 AM   #7
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Re: Hyperthyroid and anaesthesia

Do ask for the local WITHOUT EPI. Most dentists I have asked are able to give this. The down side of not having epi is that there may be more bleeding, and there may be a need for more injections of local. The purpose of the epi is to constrict the blood vessels, which keeps the anesthetic "where it's needed," and also helps to reduce bleeding.

Unless you put your needs & wishes in writing, there is little guarantee your dentist will comply.

If you are asked to sign a release form prior to the surgery, read it carefully & cross out & initial anything you disagree with. ALSO add something like: Permission NOT GIVEN for epinephrine addition to anesthetic. And then initial it, date it.

If you have already signed some sort of blanket release for the doc or the procedure, you can prepare a revocation at home, in advance of the appointment. The critical points needed: 1) Title (the word "revocation" should be in it.) 2) Specify name of dentist & name of practice 3)
Specify what you are revoking 4) Date it 5) Sign it & have a witness sign it as well.

Please note, I am not a lawyer, however I have done these things with both doctors & dentists. They DO take stuff like this in writing quite seriously. They HAVE TO.

The downside: your dentist/doctor may balk, and say, we can't do this today, or I can't help you at all. Only you can balance your need for health & safety with the urgency of the need for the dental work.

Good luck.

 
Old 01-12-2006, 02:06 PM   #8
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Re: Hyperthyroid and anaesthesia

I made the call to the dental office and spoke to a nurse there - she recommends not having the surgery until I know what my results are. They have postponed the surgery to the end of the month but if my thyroid is up again it will be postponed again until my thyroid is stabalized. She said there is a risk of thyoid storm. They still want to do anaesthesia and won't do just a local so I will have to wait and see how my test results come back. She said they specialize in anaesthesia and deal with people with varying degrees of heatlh problems such as heart, etc.

 
Old 01-13-2006, 02:23 AM   #9
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Re: Hyperthyroid and anaesthesia

Im a chicken where the dentist is concerned l was nervous to go before l had my experience (the experience lasted from mid afternnon when l had that damm needle until near midnight that l can remember. weird but the next day l felt brand new!)l need to go but l wont l know its stupid etc etc but if in doubt do nothing!! Trust gut feelings l say. Hopefully you will get sorted soon with no problems lm havign trouble with my results too after meds of 17 months lm hyper again due to retest in a few weeks to see if things have settled down good luck

 
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