Has anyone heard of this?

[Hope12]

The doctor I saw for a consult today said that He wants to use a medication called furcet or something like that?? Has anyone heard of that in an IV sedation? I have heard of fioricet in pills, but I am allergic to it.

Also what is the danger of epinephrine in injection for numbing?
Thanks Hope12

 

[letsconnect]

Hi, the medication you're talking about (Versed) is just a trademark name for midazolam (the drug most commonly used for dental IV sedation).

There is no danger of epinephrine in injection for numbing. Adding it just means that you'll stay number for longer. It would also reduce any bleeding (for example if you had a tooth taken out) because it constricts the blood vessels. Very rarely, some epinephrine (which is exactly the same as adrenaline, a substance produced naturally by your body) can get into the bloodstream if the dentist slightly misses the target (due to bad luck). This may produce a fight-or-flight reaction (increased heartbeat etc. - same as if you're scared). But this is very rare. Many millions of people have dental injections each day, so it will happen to somebody somewhere, and you will find people writing about it on the internet (because unlike an uneventful injection, it's quite memorable). This is not dangerous however - just unpleasant.

A small number of people may be allergic to the preservatives in dental cartridge preparations, but most of the reactions are very mild (like a temporary rash).

Hope this helps

 

[Hope12]

Thank you very much for you speedy reply and you are correct, there is so much information out on the web, reading it can really make someone with a fear to really stay away from any dental care.

Am I being overly fearful of IV sedation? I am so allergic to different meds that I am afraid of being given IV sedation. I really just wanted IM meds and NO, but this oral surgeon didn't even ask me what I felt comfortable with. Do I have a right to ask not to be given IV sedation, and am I over reacting if I do. You know that I have a fear of the dentist but I need to have this work done due to infections, but at the same time I know how my body reacts to drugs. Do I have a right to request IM injection with NO, instead of IV sedation?

Thanks Hope12

 

[freakout]

I believe you have every right to discuss every option that is available to you.  It sounds like you need some communication with this dentist.  You must always remember that "You are in charge"  There could be a reason that he is recommending IV sedation, but you must be given that information.  You should call and ask to discuss the form of sedation options available to you.

Earlier you said the dentist told your daughter you would need sedation, was he communicating with her instead of you? The reason I ask is sometimes people do not react well with things that they do not understand and possibly he thought he needed to communicate with your daughter due to your cerebral palsy. Maybe you need to write down your fears and concerns, so he will understand the need to communicate with you.

 

[Hope12]

Hello Freakout,

Sometimes I feel that is the problem in my case, the dentists and their offic help talk past me due to my Cerebral palsy. There are those who still in this day and age do not realize that CP comes in 30 different types and all who have CP are not retarded. I spend most of my office visits convicing them, I AM NOT RETARDED!

Communication is I agree a big issue in my case. They usually speak with my daughter and over me like I don't exist. Well, I took care of that today.

I called the doctors office and told them I did not feel comfortable with the oral surgeon they gave me, can I have a consult with one of their other oral surgeons. I have an appointment on Jan 13,2007 with a new oral surgeon. After all I am paying $1100. to get one tooth pulled. Why so much? Because if a person has Cerebral Palsy most dental places will not deal with the involuntary movements, so those that do, are very expensive.

Well anyway, if my money is good to take, shouldn't I be good enough for them to talk with me?

Thank all you guys for helping me have the courage to stand up for my rights.

Take care,
Hope12

 

[Gordon]

IV sedation should be safer than IM, if there were to be some kind of problem with the medication, you really need IV access in a hurry and if you've already got an IV line in place, that's a major plus point.
The ability to finely titrate the dose that IV gives you is invaluable too, I have a CP patient who is extremely susceptible to IV meds and I have to watch his dose very very carefully. It would be impossible to do this with IM drugs.

I'm glad you've asserted your rights regarding the communication issue. Well done.

Last thing, I have a couple of CP patients who communicate with me better by e-mail, it seems to work better for us, they're not so rushed and can express themselves better that way. The main upside of it is that one of them uses it to send me a fine selection of filthy jokes.

 

[Hope12]

Hello Gordon,
Now there is something good to hear, the doctor can ascertain the quantity of medication given. Can he also give very low doses at first to see if there is any allergic reations? Also I don't know if I am allergic to the epi in the numbing stuff but I have heard so many stories and read so much negative stuff on the internet about epinephrine that this scares me also. Have you read some of this stuff?

You also stated that Iv sedation is safer then IM medication.

Why do dentists give both? _Have you ever used IM sedation in CP patients? Which do you prefer and why?

Thanks and BTW: Are You anywhere near Florida?
Take care,
Hope12

 

[freakout]

Hi Hope

Congrats for sticking up for yourself You need to find a dentist/oral surgeon that you are comfortable with. Some people just are not cut out to deal with those with disabilities. I would write or type your concerns with communications to the new oral surgeon. Let him read the letter and make sure he addresses all of your concerns. Let them know that you expect to be treated with respect and that you expect them to talk to you and not over you.

My nephew can not talk and therefore people think he is not intellagent, but he is extremely intellagent and when people take the time with him, they figure it out. I am sure that you will find a dentist that will take the time to communicate with you and treat you with comapassion and respect.

 

[Gordon]

Hi Hope, nice "talking" to you.

The way IV drugs are normally given is by "titration" in other words, a little bit of drug is introduced at a time and the effect is checked and then (if required) more given and so on.

You most certainly aren't allergic to epinephrine, if you were you'd already be dead since your body produces large quantities of it
Some people are allergic to the preservatives which are used in local with epi, although it's rare it does happen. If you're really worried about it then you could be tested for it first, but since the allergic reaction is pretty minor the first time it happens then I think you'd be wasting your money, which is a terrible thing to a Scot like me...

I only give drugs IM once in a blue moon, mainly antibiotics. Having said that I can't remember the last time I did do so. I can't honestly think of any reason for doing so nowadays. Never, ever done so for a CP patient.

Sadly I only get near Florida on vacation every couple of years. I have some good friends who are dentists in Orlando if that's a help?

 

[Hope12]

Hello Gordon,
I live about three hours from Orlando. If I can't find someone in my community where I live, will that offer still be open to me? I would travel just to have someone who is understanding of my disability and my fears.

It sounds like the IV sedation is the way to go for me. Now I just have to convince the rest of me to cooperate. I first think I will talk with this new oral surgeon and try to build a of trust. I sure hope I can. I know that I need to tend to these teeth because of the infection. It is so hard and yet my common sense tells me to just do it before it gets worse. I really appreciate your taking the time to talk with me. Somehow you seem to have a very comforting way about you. When you explain the Iv sedation it does not sound so overwhelming as when they just give me papers and tell me to sign them, and when you read all the risks, that dosen't help either. I rally appreciate your kindness and it comforts me to know that you are a professional who has compassion and undersatanding. Most of the dentists and oral surgeons seem to just look at me strange and then talk past me to my daughter. I set that straight this week. I asked for another consult with a different oral surgeon. Hopefully he will talk with me and not past me. Time will tell. I guess that is what separates the real professionals from the others.

I may still take you up on your friends who are dentists in orlando if when I see this surgeon on Saturday, Jan 13th. Sometimes it is better to go the extra length to accomplish what is needed. hank you very much for your help.

Take care,
Hope12

 

[Gordon]

I'll be happy to ask my friends in Orlando if they can recommend somebody, unfortunately neither of them is a specialist oral surgeon, one is a GP and the other an endodontist, however I'm sure they'll know somebody suitable.

IV sedation is most likely the best way to deal with this. PM me if you need Mark and Lizette's address.