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  • sedation during oral surgery while using duragesic

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    Old 04-22-2009, 06:01 PM   #1
    bullymom
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    Red face sedation during oral surgery while using duragesic

    Let me start by saying I have had a relationship with my oral surgeon for over 20 years. I have had tons of procedures on my teeth/ mouth. Numerous root canals that only failed and the tooth had to be extracted anyway. More crowns that I can count, and to make a long story short, have lost all of my upper teeth. I am currently trying to save the bottom ones. I am having two implants placed this coming monday. The surgeon tried to put the implants in on the same day he had to extract 3 teeth. I have a very tiny jaw bone and there was not enough bone to place the implants. He put bone growth stimulator materials in my jaw and now wants to do the surgery. My question is, how do your doctors deal with the fact that you have the duragesic patch on and he is going to give you more versed and demerol to sedate you while this work is being done. My oral surgeon is intimidated by the patch I wear. The last time he did work on me, he told me not to wear my patch the day of the procedure. I asked my pain doctor about this and he could not believe the oral surg. would want me to take the patch off. My pain doc has always said that patients who are on long acting pain meds usually need more medication to get a good sedation. My doc tried lowering the amount of med he gave me for sedation during a procedure, and I was MUCH too aware of things going on around me and It was not fun. Just curious if any of you have had to be sedated for a procedure, colonoscopy, dental work or whatever and what your pain doctors recomendations were? The last procedure I had, my doctor assured me he would not let that happen again and would be sure to give me more sedation. I am holding him to it. If any of you have had experience in this area, I'd love to hear form you. Thanks so much
    Bullymom

     
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    Old 04-22-2009, 07:22 PM   #2
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    Re: sedation during oral surgery while using duragesic

    Quote:
    Originally Posted by bullymom View Post

    Just curious if any of you have had to be sedated for a procedure, colonoscopy, dental work or whatever and what your pain doctors recomendations were?
    I had a root canal recently and followed up with a crown...No fun, that's for sure.

    I had similar concerns and the PM Doc told me to tell the dentist doing the work that I may need extra sedation / oral numbing. I took my LA meds (morphine) as usual, as well as BT meds as needed....Didn't change a thing.

    When I first sat in the chair, the dentist gave me an extra shot or two (than normal) in the gum & mouth area just to be safe. He also gave it extra time to kick in, which I appreciated. He used gas over my nose, and it worked very well. They said that most patients who are gassed, nod off to sleep or are very sedated. However, I just got "dopey" feeling and was very relaxed....I'm sure that was due to my tolerance. My regular dentist had even prescribed valium for me to take ahead of time, but I elected not to take it because I wasn't all that worked up....Just wanted it over with.

    They kept the gas on for most of the procedure and I have to say that it worked well. They also recommended me bring an iPod, which I did, and I just relaxed in the chair listening to music with the gas over my nose. I was very relaxed and for about an hour afterwards, I could tell a big difference as it took a bit for the gassing to go subside. I was very pleased how it all went. The hardest part by far was just keeping my mouth open. They did give me breaks when needed, so it wasn't that bad.

    My only issue was that afterwards, the dentist didn't want to prescribe me any pain meds and said that what I normally took would suffice. I could tell he was apprehensive about prescribing me meds since I was a CP patient.

    However, I objected and told him that my pain Doc said to get what I needed from him because if I had additional pain, that it needed to be treated accordingly because I couldn't get any early refills on my regular meds and I wouldn't be able to use my regular pain meds more than usual. He agreed and gave me a script for hydrocodone. This is a good example of having to be one's own best advocate.

    Hope this helps. Best of luck to you.

    Regards,

    Ex

     
    Old 04-23-2009, 01:19 AM   #3
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    Re: sedation during oral surgery while using duragesic

    I have not had oral surgery since having my patch, only fillings a few weeks ago. I did have an endoscopy last year. The dr knew and was reminded by the nurse that I was on it and asked if he wanted to add benadryl. He declined but I woke up during the procedure grabbing for everything. The normal regimen for the procedure is versed and fentanly. I guess they shot me with something as I went back out. I was much more looped after this one as previous ones I had over last few years.
    All you can do I think is be adamant that he give you what is needed for sedation. Seems you have addressed it but a good reminder wont hurt at all.
    Best wishes and let us know how it goes.
    S

     
    Old 04-23-2009, 04:25 AM   #4
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    Re: sedation during oral surgery while using duragesic

    Hi there, I have nothing more to add because my experience has been much the same as Ex - except my experience was with wisdom teeth.

    I wasn't told to lower my meds and I'd be too scared to anyway - if you have any sort of wd it makes it very difficult to sit still and you may hurt yourself by jumping. It will also make you hypersensitive. As you probably know. Unfortunately Dentists or Dental surgeons don't seem to understand much about cp, mine just gaped at me when I told him the meds I'm taking (which are not high).

    My dentist is ok with rxing pain meds or valium for me but just for safety I get it from my gp - this is his preference. My dr prescribed some more bt meds and some valium.

    Just a note - when I had a problem a while ago the dr wouldn't account for the meds I was on and only gave me the usual doses for someone not on meds. I woke up in terrible pain and ended up in ER.

    Good luck, I'm terrified of the Dentist. I hope it all goes well for you.

     
    Old 04-23-2009, 08:50 AM   #5
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    Re: sedation during oral surgery while using duragesic

    Quote:
    Originally Posted by Juliet31 View Post

    I wasn't told to lower my meds and I'd be too scared to anyway - if you have any sort of wd it makes it very difficult to sit still and you may hurt yourself by jumping. It will also make you hypersensitive. As you probably know. Unfortunately Dentists or Dental surgeons don't seem to understand much about cp, mine just gaped at me when I told him the meds I'm taking (which are not high).
    This is a very good point made by Juliet. Reducing one's meds would put one into some type of WD, unless it were done over a long period of time at very small increments. Any benefit would be negligible. In fact, I think Juliet is right in that it would probably make one even more sensitive, so it would net out negative, IMO.

    Regards,

    Ex

     
    Old 04-23-2009, 01:48 PM   #6
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    Re: sedation during oral surgery while using duragesic

    Thanks so much to everyone who posted. I am one of those people who would rather sleep with a snake than have to go to the dentist. I am grateful that my oral surgeon has always been very good at giving me extra pain meds after all my procedures. I usually only need them for the first 24 hours, but it's nice to know you don't have to risk running short on your regular meds. I think this man felt so bad about the level of sedation I got during my last procedure, he responded when I was leaving, " next time we WILL give you more sedation if you need it!!" And reminded me that he would not be charging me for a general anesthetic the next appointment when he would be seating the implants. Sounded good to me. They charge you about $400 for a little versed. Granted, they put a blood pressure cuff on your arm and start an IV, but that's a bit steep. I am just too much of a chicken to try it without any sedation, and they always use nitrous as well. I think your right Juliet, dentist and doctors of other specializations do not have a very good understanding of the best way to treat CP patients. I am very fortunate to have a great internist who sees me monthly and prescribes my meds. He is very informed when it comes to treating CP patients, but still insist that I see a certified PM doc once a year or if I have a need for surgery or anything out of the ordinary. I will keep everyone posted on my progress, and again Thanks so much to all
    Bullymom

     
    Old 04-27-2009, 06:39 PM   #7
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    Re: sedation during oral surgery while using duragesic

    Update:
    Implants are in and hopefully will heal Sedation was perfect, I don't remember a thing until it was time to walk out the door. Pain has been minimal, I declined to get a rx for anymore pain med. I take percocet every day anyway and I am hoping that will cover this nicely. I found a couple of hydrocodone that he prescribed for me a year ago when I had some work done, I will use them if I need to. Hope a year isn't too long?? Thanks everyone for posting.
    Bullymom

     
    Old 04-28-2009, 01:57 PM   #8
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    Re: sedation during oral surgery while using duragesic

    That is great to hear bullymom. I am having the nerve block done this friday and will go with the sedation so hopefully I won't feel or remember too much. take care

    brian

     
    Old 04-28-2009, 02:16 PM   #9
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    Re: sedation during oral surgery while using duragesic

    Hello Everyone, I thought I should share my story. About 3 summers ago when I was 23 years old, my GI doctor wanted to do a colonoscopy on me. At the time I was on the fentanyl patch 75mcg and the doctor knew this. Well the prep made me horribly sick, non stop vomiting, and the drive to the dr's office/hospital was a 2 and half hour drive, and we where almost an hour late cause my aunt kept having to pull over so I could vomit. Well when we finally arrived to the hospital, the gave me a thing to vomit into and took me straight back to the prep surgery area and got me ready with the IV and all asked me a million questions, one of them being what meds I was on, and I reminded them about the patch, and they didnt say anything. So when I get back tot he procedure room the doctor just started, NO meds, NO sedation , just plain IV saline. I screamed the WHOLE time begging them to stop and they wouldnt. It was complete torture, I could feel every twist and turn in my intestines. This traumatized me so bad, it took me 3 months to recover from the pain and depression it caused and I still would throw up and have diarhea daily. And when I asked afterwards why I didnt receive any sedation, they said what I was already taking had enough sedation with my patch, and when I asked for a shot of phenergan for the ride home, the nurse got mad at me. She waited forever to ask for the shot and when she finally got it, I asked her what it was because I cant use Reglan or Compazine for nausea because it causes severe side effects and she yelled at me "it's phenergan, that's all your getting!!!". Since this experience, I have been scared to death of having any future procedures or surgeries. And I'm suppose to have upper GI scope every 2 years cause I have genetic stomach issues that cause severe pain (certain parts of my stomach, not intestines, where not formed all the way). Also I should tell you, after the colonoscopy, when hte dr comes in to tell you what they found, he wouldnt talk to me cause I wouldnt look at him, I was vomiting.....

    The moral of my story is to always ask about sedation when your taking narcotics daily cause some doctors just dont understand that because you take meds daily for pain means you need more sedation then normal. I should of sued the dr but I was so sick, I didnt even think about it, I actually thought that it was normal, til everyone told me how they didnt remember anything, or was so drugged up that they didnt feel a thing...so I knew something about what happened to me wasnt normal.

    -lovemydegus

     
    Old 04-28-2009, 02:17 PM   #10
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    Re: sedation during oral surgery while using duragesic

    Brian,
    Thanks for the good cheers. I will be praying for you this Friday, I just know everything is going to go well. Let us hear from you when you wake up. Many hugs being sent to you.
    Bullymom

     
    Old 04-28-2009, 02:29 PM   #11
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    Lovemydeugs,
    I can't imagine having to go through anything so horrible!! I have NEVER heard of anyone being tortured like that in my life. I can assure you, this is certainly not the acceptable way to do a colonoscopy. I don't know what to say. I hope you wont let it interfere with your having them in the future if you need them, but you can bet your sweet arse, I would not be going back to that doctor! I would tell everyone I know what he did to me and report him to the medical board. It is a true example of the injustice that CP patients endure on a regular basis. I am so sorry. I hope you are feeling better. I had a colonoscopy done at age 50, and it was a wonderful experience. The worst part was the prep, and that wasn't even bad. Take care
    Bullymom

     
    Old 04-28-2009, 02:32 PM   #12
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    Re: sedation during oral surgery while using duragesic

    Bully, I'm glad it went well!

    Brian, I hope it all goes well!

    Lovemydegus, I had a very similiar situation with an endoscope. I had been throwing up blood from all the anti-inflammatory's they had been giving me and when I was referred to a GI, the nurse came out to the waiting room and told me when to come for the procedure and handed me a pamphlet that was it. I never met the doc nothing. When I got there, they put me in the room, I saw the doc come into the room but he went right to the sink so I never saw his face, I heard the nurse ask if he wanted sedation, he said no, I began to panic. I kept telling myself it will be OK, it wasn't, I started fighting like crazy. It was horrible, the gaging and coughing. They must have given me something because I did finally black out. This was years ago and good thing because if that happened to me today, I'd have his licence, jerk. I still have no idea what he looks like. Never had a follow up with him, he just sent the results to my gp.

    Melissa

     
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