New here - Severe needle phobia, and major surgery coming up Aug 30

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Bluelightning_03

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Hello to all,
First off I want to thank the person who approves members on here for approving me, I hope my concerns and questions help people looking for advice in the future. First off I want to start by admitting my negligence in caring for my teeth though the years, now I' am paying for it, I have a top denture for the last 16 years, now my bottom teeth look like the New York skyline when I smile, and August 30 is D-Day. I have a very large Mandibular Tori, for those that don't know what that is, it means the whole bottom of my mouth has filled in with bone growing outward from the jaw, I can post a pic if you request, here in Calgary the OMF Surgeons remove them with a chisel and hammer, then all the teeth are coming out.

I have a very very severe needle phobia, the Surgeon and OR Booking staff have said I' am the worst patient they have ever seen, I have a fight or fight mechanism that works very well. In order to do this surgery they are using Propofol and Sevoflurane as an anesthetic, the trick is getting an IV in me, I have the history of being one of these people were everything is in excess, usually I need double to what everyone else needs historically speaking, I was told that I will be getting laughing gas at IV insertion time, I know when I feel them wipe that alcoholic swap to do the job I will react very violently, my question is; Will laughing gas kill skin sensation so I don't feel the IV? When I talked with the anesthetist about some anxiety medicine ( 6 adavan and 2 lorazopram didn't even make a dent in me last time ) he said he would rather not as waking up from the anesthetic would be a long time and require an overnight stay. Anyways see what you can come up with to relieve my frustration, I really would appreciate it.

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Paige2018

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There is Actually a way of placing an IV without pain. Talk to your doctors about a numbing cream that they can put at the injection site that will help you not even feel it.
 
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Bluelightning_03

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There is Actually a way of placing an IV without pain. Talk to your doctors about a numbing cream that they can put at the injection site that will help you not even feel it.

That's Emula Cream, It was tried already and it doesn't work on me. The Doctor said it works great on kids as their skin is thinner than an adult, the downside to Emula Cream is it shrinks the vein making it harder to tap I was told.
 
Dg6300

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You are facing a difficult situation indeed.

What is your plan?
 
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geos

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Did you ever try laughing gas before? At least if their is an anesthesiologist they have better training on how to use it and should be able to make sure you are properly relax and calm before inserting IV.

When I was a kid, I had one non-dental operation where I was supposed to be put under. I was so nervous before going in that I never went under. However they still did the operation and I went through it with no problem. Later on, I’ve had a few dental work where I was put under and had no difficulties from it. You might be able to get through it this time even if previous experience wasn’t great.

Do you have any cases where you had success getting IV?
 
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Bluelightning_03

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Did you ever try laughing gas before? At least if their is an anesthesiologist they have better training on how to use it and should be able to make sure you are properly relax and calm before inserting IV.

When I was a kid, I had one non-dental operation where I was supposed to be put under. I was so nervous before going in that I never went under. However they still did the operation and I went through it with no problem. Later on, I’ve had a few dental work where I was put under and had no difficulties from it. You might be able to get through it this time even if previous experience wasn’t great.

Do you have any cases where you had success getting IV?

yes, 19 years ago I had an absess i ignored, I dropped over in our shop, I was taken by ambulance to the hospital, when my lights were out the got an IV in me, i didn't mind that. They cut holes in my face and a big cut along my cheek inside my mouth, I wad on Clindamician for 2 weeks, endocarditis set in and i had a heart attack, the infection was so bad all my top teeth were pulled in emerg, I was 29 then I' am 43 now.
 
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comfortdentist

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They might consider using sevoflurane as a sole induction agent then after you are out they place an IV. This is a nice technique for some people. It depends on your overall risk assessment by the treating doctors. You are young so if possible consider having 2 or more implants placed in your mandible at the time of extraction. It makes a world of difference in comfort.
 
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Bluelightning_03

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The did just Sevoflorine the one time and I was happy as heck about that, I' am trying to talk them in to doing that this time but they seem reluctant, I should mention I' am a steady 92 for blood oxygen and I have a CPAP machine, to help anyone reading this I'am 43 5'10 and 182 Lbs. Thanks for that feed back Comfortdentist, I will make an appointment with OR booking and see if I can chat with an anasteieologist about that.
With laughing gas if they use it, does it take away the touch sensation? last time when they tried Emula Cream I felt the jab and yanked my hand back causing bad bleeding, I really wish they would just put me out directly and do the job, my last appointment the doctor said they want to put the IV right in the fold of my arm, I told a friend of mine about that, he had that done to him once and it was a disaster as your arm folds there, I have deep veins I guess, last time it was just up from my wrist and I would rather they put it there.


Sorry hor being a drama king everyone, no one knows the anxiety I' am going through.
 
letsconnect

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Is Ametop cream available in Canada? It’s supposed to be more effective than EMLA.
 
Sol

Sol

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Just wanted to say you have my empathy. I have the needle phobia as well and flinched when they put the swab on my arm prior to setting up the IV. However, they were able to talk me through and the experience wasn't as bad as I had been visualizing. Hope they agree to a plan with you to handle your reflex prior to the appointment.
 
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Bluelightning_03

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Just wanted to say you have my empathy. I have the needle phobia as well and flinched when they put the swab on my arm prior to setting up the IV. However, they were able to talk me through and the experience wasn't as bad as I had been visualizing. Hope they agree to a plan with you to handle your reflex prior to the appointment.

I thought i' am the only one in the world with this phobia this bad. My problem is every time someone makes a suggestion I just refer back to the time they gave me gas and that's it I was out, why is that so difficult for everyone in the medical community to understand.
 
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MountainMama

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When I had my last extraction and bone grafting, I had nitrous (laughing gas). During the procedure, the oral surgeon had a nurse come in and draw blood from my arm to use for the grafting. I didn't know that was going to happen, but I barely felt anything. I was aware of the nurse touching my arm and the rubber tourniquet, but I don't even remember the needle prick. I do remember hearing him ask for the nurse to draw blood, and panicking a bit. He told me to slow my breathing and take deep breaths, and close my eyes. That helped a lot.
 
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Bluelightning_03

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When I had my last extraction and bone grafting, I had nitrous (laughing gas). During the procedure, the oral surgeon had a nurse come in and draw blood from my arm to use for the grafting. I didn't know that was going to happen, but I barely felt anything. I was aware of the nurse touching my arm and the rubber tourniquet, but I don't even remember the needle prick. I do remember hearing him ask for the nurse to draw blood, and panicking a bit. He told me to slow my breathing and take deep breaths, and close my eyes. That helped a lot.
That right there would set me off
 
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Bluelightning_03

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I forgot about that dam tourniquet
 
Gordon

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The nitrous will dull sensations a bit, but not to the amount you're looking for. The cream you need is Ametop 4% gel, it needs to be applied about an hour before hand to get good skin numbness.

Sevofluorane induction as Comfortdentist suggests would be easier for you, but you're a higher risk patient, not all anaesthetists will be happy to do it that way.

Going into the vein at the "bend" of the arm is easier for the patient, the veins are bigger and sensation is much less there, there are less nerve endings than on the back of your hand. Try pinching the skin on your elbow, you'll hardly feel it :)

Good luck with it all.
 
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comfortdentist

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Yeah, I hate that part, but mostly because I know what is coming next. You shouldn't have the tourniquet with an IV, though.
While I have placed an IV without a tourniquet it is a most rare exception. The band allows the blood vessel to fill with blood and greatly increases the success rate.
 
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MountainMama

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While I have placed an IV without a tourniquet it is a most rare exception. The band allows the blood vessel to fill with blood and greatly increases the success rate.

Really? I hadn't realized. The few times I had an IV, it was in the hospital though, and they didn't use a tourniquet. I can see where it would be very helpful. One of the times I had it done, it took the nurse several tries.
 
Gordon

Gordon

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Most anaesthetists I've worked with used a nurse as a "tourniquet", just holding the patient's wrist tightly.

I always used one myself for placing IV, we get nice disposable ones now that for some peculiar reason smell like vanilla ice cream!
 
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