Another setback...

[pauln2719]

So first the good news. I have been seeing the dentist with some regularity, starting to do some work on my teeth, thanks to the anti-anxiety meds (Xanax) that I was prescribed earlier this month. My new dentist is pretty good about making sure that I'm relaxed, informed, and comfortable with the procedures. So far so good right?

Well, not so fast. I still need to have the one tooth extracted. And that's proving to be a HUGE problem.

Apparently, you can not have general anesthesia while taking Xanax or any other prescription anti-anxiety medication b/c there is a risk of not coming out of the anesthesia. (And there is NO WAY that I'm doing it w/o being under general anesthesia, the thought of being awake is even MORE terrifying!!!!!!!!!). OK, I understand that. But quite honestly, I can't even BEGIN to imagine going to the oral surgeon to have this taken care of WITHOUT having some anti-anxiety meds first. At this point, I am so completely paralyzed by fear that I almost can't function when I think about enduring this w/o anti-anxiety meds. I can't imagine any alternative but to be put into physical restraints (think straight jacket) and taken there in a padded ambulance and wrestled into the chair by four burly attendants. And I seriously doubt that would be good for me either. I really am not even sure that I could get into the car to be taken TO the oral surgeon without taking something beforehand...I am that scared!

I really don't know what to do. I know this needs to be taken care of but there seems to be no way for me to be able to endure this...either I go in so completely terrorized by fear that I need to be physically restrained or I don't do it at all which is really not an option long-term. I have talked to THREE oral surgeons and they have all told me the same thing, no Xanax (or anything else) beforehand...how do I face this without it?? I really don't think that I can!

 

[tabatha7]

Are you talking about general in the hospital or iv sedation? I know you can have anti anxiety meds with iv sedation. Which tooth are you needing pulled? You know you will be numbed up right? Trust me, I understand your fear.

 

[pauln2719]

As I understand it, this is general anesthesia in the oral surgeon's office. He is also trained as an MD so I guess that is why they can do it there and not in the hospital (and btw, with no insurance and being unemployed, the hospital is absolutely out of the question, no way I could afford that; even with help from my parents, we can barely afford this as it is).

The tooth in question is #18, both bottom wisdom teeth are long gone (12/30/94, yeah it was a bad experience and the date is etched on my mind). #35 came out last year at the same oral surgeon and although I was "numbed up", my pain tolerance is so unbelievably low that when I came to I was in agony...then it was two hours until I got the prescription, took it, and started to get some relief...but it was Vicodin so then I got physically ill.

Again, there's absolutely NO POSSIBLE WAY that I would have this done while awake, even if on some seriously strong meds (you'd probably have to give me something that could take down a charging bull elephant for me to do that). I can't even begin to imagine what that would feel like, sound like, the sensation of feeling the yanking and then the blood running into my mouth, the taste of that, and in my case (due to my remarkably low pain tolerance) the instantaneous pain of unbelievable proportions...no, no, no! I can't even go there in my imagination w/o breaking into a panic attack!

 

[tabatha7]

HHmmmm I'm wondering if it is iv sedation. Its my understanding that with general it has to be in a hospital because you have to have the tube to help you breath because you are not doing it on your own with general. Maybe it means deep sedation which is what I will be having. Anyway, I hope everything goes well for you. I'm sure it will. Even with iv sedation you won't even know it happened. From your perspective it will like you just took a nap. Take some pain meds before your local wears off.

 

[pauln2719]

Well, I thought about it all weekend and in the end I can't go through with it...the procedure was scheduled for December 18 but I called this morning and cancelled it. I just can't go through with this extraction!!!!! Given that what happened when I had one a year ago (my worst nightmares were all confirmed, it was the worst thing ever!), should I expect things to go any better this year? NO!


Perhaps the solution is to be put into a medically induced coma before the procedure and then brought out of it seven days later when the pain is finally over?

 

[tabatha7]

Awe... I'm sorry you had to cancel. I totally totally understand exactly how you feel. I don't want to go through with it either but I have to. I'm not even sure when the time comes that I will be able to do it but I have to find a way to make myself do it. My oral surgeon is also an m.d. and they told me to check general on the permit but it is my understanding that he is prescribing me valium to take the night before and morning of the extractions. I don't know if general means deep sedation or what because it's my understanding that I will still be breathing on my own. I will have to ask the os about all this before my appt. Paul, may I ask if your extraction is a difficult one or just a normal extraction?

 

[sharon]

Pauln, sounds like you have a lot of fear in you and you are probably feeling a big relief now that you have cancelled the appointment. I would feel the same way if I were in your situation. I think this will give you a little breathing room and time to take a second look at this.

I'm confused as to why you can't take xanax or something else beforehand. I had general anesthesia in the hospital several years ago (with a tube down my throat and all that) and they gave me valium a couple hours before the surgery because I was so anxious. And they even let me take it with a sip of water which is a big no-no.

I agree with what Tabatha said, it is kind of unusual to have general in an out of the hospital setting. Would you be able to get through this if you had iv sedation? As far as what you will feel during the procedure it won't be any different than general and you will wake up and be back to normal a lot faster.

 

[tabatha7]

Sharon, They told me to check the option of general too when I was at my consultation but it's my understand it will be in the oral surgeons office. I think this is deep sedation. You are still breathing on your own but it's a deeper sedation. I'm going to find out for sure before my appointment and whether or not the valium is ok before it.

 

[pauln2719]

I'm not sure if the extraction I should have is easy or not. The tooth at one time was above the gumline, but now it is almost completely sunk back under the gum (you can really only see the top of the tooth and not even all of that) so I imagine it will be a rather more involved procedure (ie more pain/bleeding/etc). I have consulted with three oral surgeons in my area and they all say the same thing, no anti-anxiety meds before being put under. And without the anti-anxiety meds I'm honestly doubting I could even be gotten out of bed the morning of the procedure! WIthout them I'm quite likely to make such an embarrassing scene in the office that I doubt seriously they'd consider working on me...

Since the tooth is so far beneath the gum and likely to continue to be "reclaimed" by the gums, that's a big part of why I say, "Why do I have to do this? Why not just let nature take its' course? When it's completely submerged, is it likely to get infected or anything like that? I dunno but I doubt it."

The problem remains that I had an extraction last year, it went horribly, every thing I feared would happen did and then some (with the possible exception of waking up during the procedure which I didn't). I woke up in pain (nowhere near enough novocaine). It was two hours before I could take pain meds to start working, and then they made me nauseous, which was even worse. I couldn't eat for a week and starving for a week is not fun (I choose to take recovery slowly). I couldn't have my daily coffee so I got a "caffeine headache" every day for a week. The extraction site bled for AT LEAST nine hours afterword (we stopped applying gauze after nine hours b/c it was still bleeding and we were out of gauze). B/c it was still bleeding we went back to the surgeon's office, the assistant looked into my mouth, said everything was "just fine", and jammed a wad of gauze into the wound so hard it's a wonder I survived it. And the warm saltwater rinses make me want to puke. It's such a horrific ordeal, I just honestly can't force myself to go through this again!!

 

[sharon]

Pauln - please read chickenlegs's post on her update with 8 extractions. Does this look like something you would be willing to try? She had a very positive experience with halcion (and valium).

 

[pauln2719]

Thanks for the information, but it sounds like she went through the experience sedated but awake, and there is NO WAY that I would even remotely consider doing it awake without being strapped to the chair (and probably in the company of a minister). The thought of being awake is even more terrifying.

 

[tabatha7]

Paul, I think you and I are in the same boat. I'm just as terrified as you are. I will be finding out when i set the appointment for my extractions exactly which type of sedation I will be having. They told me to check general and the paper they printed out for me says deep sedation. I like you am going to have to have a valium or something to even be able to get myself in there. I hope I will still be able to have the valiums with this type of sedation. I hope we can over come our fear enough to be able to get the dental help we need. I know you have already seen some oral surgeons but my advice would be to keep looking. There is someone out there who can help you. The only reason I'm even considering going through it is because i found an os who is incredibly nice and reassuring. I'm still scared and have many fears including not waking up. However, i still have these cursed wisdom teeth that are trapped and need to come out. I am trying to find a way to MAKE myself do it.

 

[coolin]

I agree with Tabatha - I think you need to keep looking for the oral surgeon who will allow you to have a diazepam or something before the sedation. I am in the UK and I know there are people on this forum who have oral sedation before iv sedation - just to get them into the dentist's office.
Just a small thought - some people have success with things like hypnosis....but you have to want it and believe it will help....
The root that is left will likely cause a problem at some point. I had two roots in my mouth for a few years and I had chronic infections in them. Once I finally did get myself to the dentist - they were quite low down on the list of work to be done. When they were finally removed - they were removed by my dentist quite easily with no gum cutting or stitches. The dentists who answer questions on here all say that roots are easier to remove than whole teeth - the crown part gets in the way apparently.

By the way - well done on getting to a dentist and getting work done - big pat on the back