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  • First General Anesthetic and muscle issues

    Well went in for my Wisdom tooth extraction today and the hospital surgeon refused to do it.

    Basically said the job is too complicated for local and more likely to cause damage to other nerves if it even takes and numbs the pain to start with. So they want to do a general anesthetic instead and do both at once. Also allows them more ability to do "ouchy" things to do it right rather than have to wonder if I'm in pain and soldiering through it.

    However I currently have a muscle illness and other issues akin to Fibromyalgia (Still no diagnosis as NHS blame it on marital stress). Which seems to be contra-indicated for a GA. I also have anxiety issues and many issues with waking up in strange places beside when the 'wake up reports' come in and red alerts start going off.

    Apparently the person who saw me for assessment should have noted it needed more than a local in the first place. Surgeon was as unhappy as I was.
    I am so SO glad I was not present for this. There would have been an unpleasant duct tape incident. - Joi

  • #2
    I'm that close to saying I won't have them out and take the risk of 25% nerve damage to the jaw nerves plus worsening my possible neuro condtion.

    Once I'm diagnosed or the symptoms of "stress" have gone? Revisit.

    Its not like its a major organ I need an op on.....
    I am so SO glad I was not present for this. There would have been an unpleasant duct tape incident. - Joi

    Comment


    • #3
      As you probably know, I do have fibromyalgia. I recently had a general (they needed to take a look at my upper digestive tract), and noone seemed to think it a contraindication.

      When they took my husband's wisdom teeth out, they damaged the nerve. Apparently, this has caused ongoing dental problems for him. (Well, I know he has ongoing dental problems, he's told it's at least partly because of the damage.)

      My wisdom teeth stayed in for too long, and became 'impacted'. I'm told that this means the upper part of the tooth was pushing against the neighbouring molars, and the 'legs' of the teeth wound up tangling around the various nerves and blood vessels and etc in the area. They had to break part of my jaw (carefully) to get the wisdom teeth out safely.

      Ask your dentist/oral surgeon/whomever. If you are at risk of nasty impaction like mine, I would recommend either getting the wisdom teeth out, or getting the next teeth along removed and the wisdom teeth 'encouraged' (probably with mini-braces) to take their place.
      But ask the professionals. Find out the risks.
      An anaesthetist can probably explain the risks of the general anaesthesia better than your surgeon can; and if you are a potential fibromyalgia patient, a pain specialist (particularly one who went into pain medicine from anaesthetic medicine) can also help with that.

      But I really want to warn you against allowing your wisdom teeth to become impacted. It was Bad Stuff.
      Seshat's self-help guide:
      1. Would you rather be right, or get the result you want?
      2. If you're consistently getting results you don't want, change what you do.
      3. Deal with the situation you have now, however it occurred.
      4. Accept the consequences of your decisions.

      "All I want is a pretty girl, a decent meal, and the right to shoot lightning at fools." - Anders, Dragon Age.

      Comment


      • #4
        All four of my Wisdom teeth were bone impacted. It would have been bad, bad news if I had not gotten them out. They used IV sedation, not a general.

        I'm a bit confused that they would want to use general anesthesia. Normally that entails inhaled gases and intubation. I would think it would be very hard to work in the mouth around an endotracheal tube.

        Gizmo, are you sure they mean inhaled gases, and not IV sedation (moderate or conscious sedation)? If they mean IV sedation, any chance they could use propofol? Nice thing about propofol is when you wake up you wake up. No grogginess. You're just awake and alert.

        In any case, I'm not aware of any contraindications for fibro patients. I would discuss it with the anesthesiologist and ask lots of questions.
        They say that God only gives us what we can handle. Apparently, God thinks I'm a bad ass.

        Comment


        • #5
          I had all 4 of my wisdom teeth out under general anesthetic, rather than the gas it is an IV, but it is a general, not simply sedation. Waking up was not disorientating, and other than sleeping on and off for the next day or there was no effects from the anesthetics. I don't know how it would react with fibromyalgia, but as it was a day surgery I actually woke up back in the patient room with my friend/driver sitting next to me. The nurses had some checks to do before they would let me leave but I was still in hospital less than five hours.

          If they could arrange something like that would it help with the anxiety issues?
          Pain and suffering are inevitable...misery is optional.

          Comment


          • #6
            My sedation (for the gastroscopy(?)) was done with an IV, and my memory of it is the anaesthesia nurse counting down from 10, getting to somewhere around 4, and then waking up in a recovery ward. A different nurse watched me for a time, then took me back to where I could finish recovering while Toth sat with me. A nurse checked my vitals a few times, then decided I was recovered enough for Toth to take me home.

            It was a day surgery, and I went home the same day.


            I don't remember what type of sedation they used for my wisdom teeth, other than that it was a 'fully unconscious' sort.
            Seshat's self-help guide:
            1. Would you rather be right, or get the result you want?
            2. If you're consistently getting results you don't want, change what you do.
            3. Deal with the situation you have now, however it occurred.
            4. Accept the consequences of your decisions.

            "All I want is a pretty girl, a decent meal, and the right to shoot lightning at fools." - Anders, Dragon Age.

            Comment


            • #7
              The teeth are already impacted so no chance of stopping that. Yep, they'll grow. Yep I *could* lose teeth 7 on each side of the bottom of the jaw too. However... 2 teeth rather than all the other issues....

              I have issues with waking up in strange places anyway. And too many people have said they are hazy after GA not to think that I would be. Even the surgeon said I'd wake up "softly". That tends to freak me out. I freak out in a weird place and not only is the IV and catheter coming out damn quickly.... I've freaked during a blood draw and that tells me enough about my 'freak' instincts to get this is a potential bad idea.

              Sedation around here seems to be 2 pills and then an IV. Having never had it I can't confirm which one they use. However I know that sedatives/sleeping pills don't tend to work on me even pre-fibro - my body fights them and I end up in a heightened state of awareness.

              Besides that there is high amounts of stuff out there that suggests extended recovery times (much longer) and potential longer term pain issues due to muscle nerve overloads etc. I already have lots of OTT pain issues as is as well as huge fatigue issues.

              I spent the last 9 months trying to recover my balance, and working with a martial arts trainer to recover the ability to live semi normally. I'm not happy about the chance I could loose that all over again when I'm only months from getting shot of the outgoing husband.

              On top of that NO ONE in the NHS will take my pain and anxiety issues seriously. They were too busy basically looking at the note that says "Depressive Hypochondriac" that I think last years Neuro put on the file.

              Basically its feeling like "do this minor largely cosmetic operation that we've already mucked up on once whilst we ignore the daily agony you are in all the time..."

              With all of this we've taken the decision to cancel and postpone. The pure anxiety issues alone are just too heightening to risk it with a team I just don't trust are listening in the first place.
              I am so SO glad I was not present for this. There would have been an unpleasant duct tape incident. - Joi

              Comment


              • #8
                Quoth NecessaryCatharsis View Post
                I had all 4 of my wisdom teeth out under general anesthetic, rather than the gas it is an IV, but it is a general, not simply sedation.
                General anesthesia is inhaled gases by definition. If you did not get an inhaled gas (I'm not talking about laughing gas) then you didn't get general anesthesia.

                ALL anesthesia involves sedation; that's the point of the exercise.

                Gizmo: you could end up with major dental issues if you don't deal with this problem. I understand that you have major pain issues, and that sedation seems to have long lasting effects. However, I don't think you should postpone until you've talked to the anesthesiologist . . . and bring all the cards to the table; your complete history and that you think you were misdiagnosed. The neurologist should not have diagnosed you with that without your seeing a psychiatrist or a psychologist. An open and frank conversation with the anesthesiologist could make for a better experience this time around.
                They say that God only gives us what we can handle. Apparently, God thinks I'm a bad ass.

                Comment


                • #9
                  Quoth Sapphire Silk View Post
                  General anesthesia is inhaled gases by definition. If you did not get an inhaled gas (I'm not talking about laughing gas) then you didn't get general anesthesia.

                  .
                  Cool. I always thought general anesthesia was whole body, as opposed to local, (like the epidural) and that sedation was drugged but not out.
                  Pain and suffering are inevitable...misery is optional.

                  Comment


                  • #10
                    The issue is that even *with* bringing all of the info to the table they just keep ignoring any issues - including the panic issues. I put forward my issues and say "I'm not comfortable because" and they just motormouth over the top of it. Its like talking to a robot.

                    At least 5 people who know my well and have had GA's have said they would expect me to be freaking out and quite honestly *dangerous* under the conditions laid out in this situation.

                    I don't mean to bash any medical professional here but its like they just want to tick that box saying "assessment carried through to defined expected result" for a damn quota. I'm not a person I'm a number.

                    With that alone if I get near that hospital I expect full level panic, stupidly high BP and everything else that is bad bad stuff.

                    I have reached one conclusion though: I'm going to apply for my full medical records and push for any "non - compliant" or "hypochondriac" marks to be removed. To the top if necessary. Because whenever I try to get action or someone to listen to me they just do the "yeah, whatever" and act like I didn't speak. Not knowing what is on those records doesn't help me look after my best interests.

                    And yeah, the Neurologist was "oh, just remove your stress factors and it will all go away and you can stop wasting my time...."
                    I am so SO glad I was not present for this. There would have been an unpleasant duct tape incident. - Joi

                    Comment


                    • #11
                      Hypochondria is a genuine and serious illness. If you're hypochondriac, you need a family doctor who is so familiar with you that she can notice that something's physically wrong just by observing changes in your mannerisms and unconscious/subconscious behaviours. Hypochondriacs get physical illnesses too!
                      Toth has a friend who is hypochondriac; his family doctor and his psychiatrist work together to try to ensure a physical illness isn't missed, while managing his hypochondria to minimise its negative effects on his life.

                      You can use that as an argument to get 'hypochondria' removed from your medical records. If your self-reported symptoms can't be trusted, then they will need to use observation and testing to determine whether or not you have a physical problem...


                      I do understand how frustrating it is to be misdiagnosed. Did you know I have Narcissistic Personality Disorder?
                      Seshat's self-help guide:
                      1. Would you rather be right, or get the result you want?
                      2. If you're consistently getting results you don't want, change what you do.
                      3. Deal with the situation you have now, however it occurred.
                      4. Accept the consequences of your decisions.

                      "All I want is a pretty girl, a decent meal, and the right to shoot lightning at fools." - Anders, Dragon Age.

                      Comment


                      • #12
                        Quoth Gizmo View Post
                        The issue is that even *with* bringing all of the info to the table they just keep ignoring any issues - including the panic issues. I put forward my issues and say "I'm not comfortable because" and they just motormouth over the top of it. Its like talking to a robot.

                        And yeah, the Neurologist was "oh, just remove your stress factors and it will all go away and you can stop wasting my time...."
                        From my viewpoint, it appears that one of your biggest stress factors is that doctors ignore your concerns - how does the neurologist expect you to remove that?
                        Any fool can piss on the floor. It takes a talented SC to shit on the ceiling.

                        Comment


                        • #13
                          Quoth NecessaryCatharsis View Post
                          Cool. I always thought general anesthesia was whole body, as opposed to local, (like the epidural) and that sedation was drugged but not out.
                          We used to use the term "conscious sedation" for IV sedation on the theory the patient would be semi conscious and able to comply with instructions. But that really isn't true. So the term has been changed to "moderate sedation," because the patients are generally completely out.

                          Inhaled gases do produce a much deeper sedation which is required for major surgery. You don't want someone waking up on the table when you're taking their gall bladder out, or doing a coronary bypass graft.

                          Moderate sedation is useful for procedures that don't involve cutting into the body, but are either painful or potentially painful. Examples include major dental work, scoping various parts of the body (bronchoscopy, endoscopy, colonoscopy), or setting broken or dislocated bones. You typically can't get people deeply enough asleep with IVs to do major surgery.

                          Locals involve temporarily anesthetizing a nerve to eliminate pain in a very small area. Examples include the mouth (cranial nerve VII to be specific), small tissue areas for suturing/stapling, and childbirth.

                          My dentist once gave me too much novocaine when he was fixing a broken tooth. The whole right side of my face sagged as if I'd had a stroke, and remained numb for hours after. It was actually kind of scary for awhile.

                          Quoth Gizmo View Post
                          I have reached one conclusion though: I'm going to apply for my full medical records and push for any "non - compliant" or "hypochondriac" marks to be removed. To the top if necessary. Because whenever I try to get action or someone to listen to me they just do the "yeah, whatever" and act like I didn't speak. Not knowing what is on those records doesn't help me look after my best interests.
                          I would encourage you to do this. In the US you have a right to correct your medical record (not sure about the UK). Keep trying to find a provider who will listen; take someone who knows you well to the appointment to help explain the issues. You probably get emotional when you try to explain it because of all the stress; a friend won't. Go up to the provider's bosses if you have to. Does the UK have an omsbudsman system of a neutral party to help patients work with administration/providers? Find out, and use them.

                          I know this seems like a terrible choice right now. But putting off this dental issue is just going to make things so much worse when you're finally forced to deal with it. Better to deal with it now when it's still a minor problem than wait too long and have more pain, more issues because fixing got so much more complicated.
                          They say that God only gives us what we can handle. Apparently, God thinks I'm a bad ass.

                          Comment


                          • #14
                            Problem is that we have the NHS, no "providers" to be monitored as such. and I have the "appearance of competency" - as in I can talk about it non-emotionally and that makes them think its not as bad as I state. If I was a wreck they'd listen more.
                            I am so SO glad I was not present for this. There would have been an unpleasant duct tape incident. - Joi

                            Comment


                            • #15
                              Not to go off topic but talking to a friend who is very much in fairy land.... "oh if you do suffer effects from the GA just sue the hospital....."

                              Umm, that won't get me back the time I'll lose rebuilding myself all over again thanks.
                              I am so SO glad I was not present for this. There would have been an unpleasant duct tape incident. - Joi

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