Prescription tranquiliser addict with some queries please

[overcame_1t]

Hello

I hope you dont mind but I have put my questions in bold type so that you can see them easily.

I was prescribed tranquilisers by my doctor, and inadvertently became addicted. I only found out I was addicted when I went on a benzo support forum, and my doctor has been great about it.
My doctor and me have now put me on a slow taper program to wean me off them.

In the meantime I have been told that I am not allowed to have local anaesthetic with adrenalin in.
I am due to have a filling by local anaesthetic.
I use the community dental service in the UK, an NHS service, and they do not have local anaesthetics without adrenalin.
I want to know what will happen if I have a local anaesthetic with adrenalin in, will it bring on a panic atack?

Also, I am due to have two very broken molars and one wisdom tooth out by general anaesthetic, at the hospital which is a fair distance away.
I do not have anyone to escort me as I live alone.
What are the options for people who do not have an escort but need an operation like this?

I find that my tranquiliser withdrawal symptoms, panic, is brought on by hunger, and low blood sugar as I understand the brain goes into fight or flight when starved of glucose.
I have a dilemma, I believe you are not allowed to eat food for a certain amount of time before the procedure. How long do you have to starve before the procedure?
Also, what if there are delays, and I am made to wait longer and get lower blood sugar?
Two of the molars were abscessed, but there is no pain in them now, as I have been using salt water swills every day. There has been no pain for ages.
Can I put off this procedure until after my taper is over?
The whole taper could take upto a year.

What foods I can eat after the procedure as I will have to travel quite a distance home from the hospital?

I am also not allowed to have a benzo premed as this will mess up my tapering schedule, which has to be very strict, as I am being slowly weantd off them.

What can I say to the surgeon in my upcomong consultation, and will he be understanding?

ps If I can have the filling and the extractions done without any anaesthetic, how painful will it be, and is there any techniques to get me though the procedure as comfortabley as possible?

I would be very grateful if you could answer these questions as I am getting very nervous and petrified.



thank you

 

[Stress Doc]

Hello:

I will do my best to answer some of your questions which are in my area of expertise.

Benzo recovery can take up to 2 years depending upon the drug, dose and duration. But full recovery is possible. I live in the USA and do not know all the alternatives for LA. LA contains epinephrine. Pregnant women should not have this drug so most dentist have an eppie free LA. This should be common.

If you suffer from low blood sugar (hypoglycemia) there are medications you can take to keep blood sugar balanced. Also increasing the protein intake can help the blood sugar swings as protein take longer to digest than carbs. Family doctor should be able to help.

It is a good idea to discuss options with the surgeon if you elect to use GA. I would be upfront and explain the entire situation. They are accustomed to dealing with issues of this type, so do not worry.

There are non-medication techniques that can be used for dental work. Dr. Gow from Scotland has an excellent success record using hypnosis for dental work. You can PM him and i am sure he would be happy to speak with you.

I hope this helps.

 

[overcame_1t]

I am due to have fillings with a community dentist in SW england. One on 22nd september, and one on 29th september.

I am also due to see the oral surgeon on 11th September, re getting one wisdom tooth out and two broken molars one of which has no surface material above the gum.

I have not been able to contact them by telephone, so am wondering if I could write them a letter, before my appointments, basically saying what I stated in the post above.

Will they be sympathetic or will they respond to my letters?

I know protein foods were advised but if I am not able to eat then I will not be able to eat protein.

Also, if I have general anaesthetic, I know I will not be able to eat for some time prior to the procedure, please can you telll me how long I have to starve before the procedure.

thank you, I am very scared.

 

[brit]

Gordon would be best qualified to answer your queries as he works in CDS and in hospital in Scotland.
I would say yes you should try to raise these questions in advance - why are they not contactable..a letter is entirely in order. Do they have email? Can you go to the CDS clinic to hand deliver it so you know the dentist at least gets it?
You have to be completely honest with them about the addiction problem as it could impact appropriate care...no one is going to treat you without anaesthetic(your other post)..so don't let that be a concern about being honest. Fillings can sometimes be done with minimal pain without LA but not extractions...best just forget that option.

In my experience of GA how long they want you to starve depends on what time of day the procedure is....for instance when I had an early afternoon slot for wisdom teeth, I was allowed a very early breakfast of toast and tea. Not being able to have the pre-med doesn't matter..it never worked on me anyway. I'm sure there will be ways round this in your case..a sugar drip or something- you can't be the only one with this problem which is why you do need to raise it in advance otherwise you risk the slot being wasted when you turn up, they ask for all the lowdown and then decide they need to do sth slightly different maybe and its too late for that day.

Thinking about it, your situation probably means you'd benefit from an early morning slot.

Your CDS dentist should have the no-epi LA though so maybe you can leave it till that appt and he can contact the surgeon for you. The main downside of no-epi is that you may need more and it may need to be topped up since the anaesthetic effect doesn't last as long.

 

[Gordon]

Came late to this. I'll try to answer questions that haven't been covered.

CDS clinic better have the non-epi local or somebody should be fired We're more likely to need it than anyone else!
Having said that the quantity of epi in local isn't likely to cause a panic attack.

Unescorted patients are usually kept in overnight. You need to let the hospital know this ASAP so that arrangements can be made to get a bed for you.

Starved for 4-6 hrs is the norm, but you can have a glucose drip if there's a problem with blood sugar, it's just swallowing food that's the problem, or actually the regurgitating of it during the anaesthetic that's the big problem!

I don't see any advantage to you in putting it off. Better to handle things in a planned fashion just now than to have to deal with an emergency half way through the next year.

You need to be as upfront as possible about your medical history to the people treating you, trust me, nothing you can say or do will surprise or shock us. I've been doing this job for over 20 years now, I can safely say, I've seen it all

 

[overcame_1t]

Thank you for your reassurance that CDS clinic better have the non-epi local or somebody should be fired

Having said that the quantity of epi in local isn't likely to cause a panic attack.

I would rather not go the GA option as the hospital is miles to travel to, and I already have panic attacks two hours after eating.
I was with my friend yesterday and he saw me go into one, and agreed that things would probs go pear shaped if I starved for 4-6hours.

I am quite happy to get the teeth out by non epi local, even though one is broken down to the gum surface.
I accept I may need top up injections, and jabs are not popular, but they dont scare me. GA does, however.

I could see me panicking and eating, and having to have the whiole thing postponed.

I wrote those letters, and shortened the surgeons one, and they are now winging thier way to them. I rang up the hospital and they said they wont force me into haveing a GA, thank god.

Thank you very much for your reply, and sorry for the further questions.