Dental Sedation and being PETRIFIED

On Thursday I am having a tooth removed under sedation . It is a back molar that had previously had a root canal but it has now split in half . The oral surgeon said due to my trigeminal neuralgia he absolutely refuses to do a block and prefers sedation . Now,I am absolutely petrified of being put under. I am terrified that I won't wake up . Apparently though I have the best oral surgeon in the area and he has taken into account my heavy medications . He is the head of oral surgery for two hospitals and also has a doctorate in pharmacology and toxicology . He expects the surgery to last at the most half hour . And the surgery will be done in a local office not hospital. Kind of like the surgery to remove wisdom teeth. The surgical team will include the oral surgeon ,the sedation nurse and the assistant.

99.9% I will probably be OK . My husband and a friend are coming with me . However I am still petrified. I have the express those concerns to the surgeon and the sedation nurse and they have been very kind .

But I am still petrified.

Could you get a second opinion from another oral surgeon? My cousin is an anesthesiologist and generally prefers nerve blocks to sedation, but it sounds like there are extenuating circumstances in this case. At 50 I think you will be fine being put under (if you were 90 it would be different), but it never hurts to know what your options are.

I am so sorry that you have to go through this, Seraphim. First of all, because I imagine you're already in some pain. Second of all, because of the fear.

It is a fear that I realized just a few years ago I have. I have not yet been under. I can't recall specifically why I gained the fear without having gone through it – it wasn't even after I saw a girlfriend (before/ after) go through significant surgery, in fact. But something clicked one day and I realized I'm not going to like it!

And let's face it: there's a good chance most of us in the 'Developed World' will be 'put under' some time in our lives if we don't die first. I have just been lucky so far. So I figure I'm going to be in your position someday and will have to muddle through somehow. Though I admit it's more like abdominal or brain surgery (which one might be conscious for!) that scares me.

This may not be helping! But I hope it shows there are others that have this fear – you are not alone. Also, you seem to be doing what I would be trying to do for myself: recognizing that there is always danger with it, but the odds are very good that you will be ok; and that you will have loved ones there watching out for you, and who will be there before and after. I hope that you have considered some typical recommendations, like calming exercises, meditation, and/ or yoga, if you don't do those things already. And talking about it with your loved ones. Whatever works to help calm you and get you through – including thinking about how much better shape your mouth will be in.

Best wishes for as little anxiety as possible and a successful surgery.

Could you get a second opinion from another oral surgeon? My cousin is an anesthesiologist and generally prefers nerve blocks to sedation, but it sounds like there are extenuating circumstances in this case. At 50 I think you will be fine being put under (if you were 90 it would be different), but it never hurts to know what your options are.

He absolutely won't do the the block because I have trigeminal neuralgia on that side. If the block damages the nerve nerve any further I could have horrible unrepairable pain for the rest of my life . He said he won't do it so if that's the way I want to go get another surgeon. But he said ethically he can't do it .

I am so sorry that you have to go through this, Seraphim. First of all, because I imagine you're already in some pain. Second of all, because of the fear.

 

It is a fear that I realized just a few years ago I have. I have not yet been under. I can't recall specifically why I gained the fear without having gone through it – it wasn't even after I saw a girlfriend (before/ after) go through significant surgery, in fact. But something clicked one day and I realized I'm not going to like it!

 

And let's face it: there's a good chance most of us in the 'Developed World' will be 'put under' some time in our lives if we don't die first. I have just been lucky so far. So I figure I'm going to be in your position someday and will have to muddle through somehow. Though I admit it's more like abdominal or brain surgery (which one might be conscious for!) that scares me.

 

This may not be helping! But I hope it shows there are others that have this fear – you are not alone. Also, you seem to be doing what I would be trying to do for myself: recognizing that there is always danger with it, but the odds are very good that you will be ok; and that you will have loved ones there watching out for you, and who will be there before and after. I hope that you have considered some typical recommendations, like calming exercises, meditation, and/ or yoga, if you don't do those things already. And talking about it with your loved ones. Whatever works to help calm you and get you through – including thinking about how much better shape your mouth will be in.

 

Best wishes for as little anxiety as possible and a successful surgery.

Thank you. I am trying everything to stay calm .

This will be my 4th time put under. I never relish it for sure. Intelligence tells me I will be perfectly ok. Emotions tell me I am bat crap scared.

I was scared to be put under to have a tooth removed when I was about 20 but I was more scared to stay awake. In the end it was no big deal. I think you've worked yourself up into a frenzy and need to learn to relax. You dont have other options so this is what you need to do. I know it's scary but you seem to have a really good dental team on your side. You have to overcome your fear and get this done!

I was scared to be put under to have a tooth removed when I was about 20 but I was more scared to stay awake. In the end it was no big deal. I think you've worked yourself up into a frenzy and need to learn to relax. You dont have other options so this is what you need to do. I know it's scary but you seem to have a really good dental team on your side. You have to overcome your fear and get this done!

True. It is the only way it can be done . I think I'm scared a lot because I have had some crap recoveries from surgeries ie waking up with tubes in my throat and so on. Although this surgery won't be done with the paralytic .

Ever since my nervous breakdown five years ago I have been a total basket case about thinking that I might die . I've had tons of therapy but this phobia is not budging .

I am also terrified to be put under because I was sexually assaulted while asleep as a kid many times. I did tell the sedation nurse and she absolutely assured me nothing would happen to me while I was out.

Wow – of COURSE you're afraid, then! It would be irrational NOT to be! It scares me, the thought of it, and I've never been out to have unhappy recoveries from it, or to have been assaulted while under. While you were supposed to be looked after before, I hope having your husband and friend nearby (not in the room, presumably, but still) will help calm you in that respect.

Also, knowing nothing about this surgeon, it sounds like he is taking significant care with your health and well-being. I can't say, because I don't know his true motivations, but if he's being genuine, then he cares about your longterm well-being, which is a good sign.

Oh I have never been assaulted while under sedation but while asleep in my bed as a kid. So I am terrified when I am not in control of my consciousness .

Well you know about my fear of hospitals

My fear is more of waking up DURING the operation. >

I had the same fear too when I had to get my wisdom tooth removed a couple years ago. Husband was not allowed to stay in the room with me during the operation, but he had to drive me. I talked to some friends who did it, worked up the courage... was done!

The pain killer drugs are the awesome part. Plus missing work and watch TV/playing video games when you are completely buzzed. The Price is Right is soooooo much fun to watch when you are high on pain killers!!

The worst part is not being sedated... it's the pain killers that make you constipated. You will need laxatives... my biggest mistake was taking one before going to work (was a teacher then.. teachers don't get a lot of bathroom breaks >

You will be fine. This is coming from a giant chicken who has a fear of hospitals

Well you know about my fear of hospitals

 

My fear is more of waking up DURING the operation. >

 

I had the same fear too when I had to get my wisdom tooth removed a couple years ago. Husband was not allowed to stay in the room with me during the operation, but he had to drive me. I talked to some friends who did it, worked up the courage... was done!

 

The pain killer drugs are the awesome part. Plus missing work and watch TV/playing video games when you are completely buzzed. The Price is Right is soooooo much fun to watch when you are high on pain killers!!

 

The worst part is not being sedated... it's the pain killers that make you constipated. You will need laxatives... my biggest mistake was taking one before going to work (was a teacher then.. teachers don't get a lot of bathroom breaks >

 

You will be fine. This is coming from a giant chicken who has a fear of hospitals

I am terrified of hospitals too since my miscarriage 10 years ago.

Not worried about the pain or the pain meds. Had so much pain in my life I don't care much about that. Pain killers don't bother me either. Never get high with them beyond 15 minutes. For me it is definitely being put out.

Oh sweetie im sorry!!

I understand your fears, but at least you have a great oral surgeon who takes the TN into account!! This does not happen al the time!

Try to think of it in the positive light that he does this because of the TN and if he didn't there would be a great chance that that would be so much worse, and for life!

I applaud him because i am in a TN support group and so often exactly that happens what your surgeon wants to prevent.

So it really has to be done this way, hang on to that, the fact that it would be so much worse if he didn't.....

It's very scary, i get that, i dread my surgery too as you know, but this could also maybe give you relief of the TN itself!

It could be what's causing the TN not to go away this time? Has he mentioned that?

They will give you a sedative and then you will feel better cause the stress goes away instantly but i know up until that point you will be terrified because of all you had to go through in the past, but think of it, that didn't kill you, in the end it made you stronger and the strong person you are can handle this! you can!

It's not the procedure itself that's the problem, it's our heads! We think too much of the what if's and whatnot's and that is stressing you out....

It's too easy to say try to stay calm because you know i can't either but try to focus on the outcome as someone told me to do as well.......

Oh sweetie im sorry!!

I understand your fears, but at least you have a great oral surgeon who takes the TN into account!! This does not happen al the time!

Try to think of it in the positive light that he does this because of the TN and if he didn't there would be a great chance that that would be so much worse, and for life!

I applaud him because i am in a TN support group and so often exactly that happens what your surgeon wants to prevent.

So it really has to be done this way, hang on to that, the fact that it would be so much worse if he didn't.....

It's very scary, i get that, i dread my surgery too as you know, but this could also maybe give you relief of the TN itself!

It could be what's causing the TN not to go away this time? Has he mentioned that?

 

They will give you a sedative and then you will feel better cause the stress goes away instantly but i know up until that point you will be terrified because of all you had to go through in the past, but think of it, that didn't kill you, in the end it made you stronger and the strong person you are can handle this! you can!

It's not the procedure itself that's the problem, it's our heads! We think too much of the what if's and whatnot's and that is stressing you out....

It's too easy to say try to stay calm because you know i can't either but try to focus on the outcome as someone told me to do as well.......

I will be glad to have this tooth out for sure. It is annoying. Yeah ,he definitely doesn't want to make the disease worse by irritating the nerve. And he does know something about trigeminal neuralgia which most dentists actually don't .

I've had IV sedation for dental work - for my wisdom teeth. All 4 were impacted and needed to come out.

I totally understand why emotionally, you're scared. It's sort of an "out of control" thing, I get that. I would focus on how GOOD it will feel, post healing, to know that you've had this done and it's taken care of. It sounds like you have a great surgeon who takes your other medical issues into account. Kudos to him. If it makes you feel better, I find it likely that he will have another person in the room with him when it is happening. My oral surgeon did the work on my wisdom teeth and I know there was a dental sedation aide (female) who stayed by the whole time and monitored my vitals and made sure I was okay.

First, they will likely give you a benzo (via IV) and then once you are out, the sedation drugs will work. I've had IV sedation a few times and it feels pretty similar each time. You will wake up a bit groggy but you will be with your husband and friend and it will be okay, it really will be.

I've had IV sedation for dental work - for my wisdom teeth. All 4 were impacted and needed to come out.

 

I totally understand why emotionally, you're scared. It's sort of an "out of control" thing, I get that. I would focus on how GOOD it will feel, post healing, to know that you've had this done and it's taken care of. It sounds like you have a great surgeon who takes your other medical issues into account. Kudos to him. If it makes you feel better, I find it likely that he will have another person in the room with him when it is happening. My oral surgeon did the work on my wisdom teeth and I know there was a dental sedation aide (female) who stayed by the whole time and monitored my vitals and made sure I was okay.

 

First, they will likely give you a benzo (via IV) and then once you are out, the sedation drugs will work. I've had IV sedation a few times and it feels pretty similar each time. You will wake up a bit groggy but you will be with your husband and friend and it will be okay, it really will be.

Absolutely there will be 3 people as part of the team. The surgeon ,the sedation nurse and the assistant for the surgeon. The sedation nurse covers respiration cardiac output that kind of stuff . The nurse has assured me absolutely nothing will

happen. I won't even know what happened and then she will be waking me up . My husband can stay in the room until I'm unconscious and then he has to go .

 

As long as I'm not conscious enough to react because if I am I will and it won't be pretty . But I think I probably won't be . R had his wisdom teeth removed probably about five years ago and he said he doesn't remember squat and didn't feel a thing. And the dentist said it will be the same as having that done .

Speaking as someone who works in healthcare INCLUDING with those who are sedated/out of it, trust me, no funny business will happen - especially when there are multiple people there. Just not gonna happen. These people are paid well for their jobs and spent good money on school - they will not just toss that way. Occasionally, people who are out of it/on drugs say funny things and we just smirk/laugh sometimes make small talk with them and carry on. Before I got sterilized, I had some IV drugs to help put me out and I apparently started laughing out loud and kept laughing the whole time and saying funny things like "I feel so DRUNK!!!!!!" but there was a doctor, the midlevel, and 1-2 nurses in there. The midlevel later told me that I had them giggling until I was sedated further.

You're in good hands, promise.

I just cry in response to the sedation . Any kind of sedation makes me cry like a baby .

Speaking as someone who works in healthcare INCLUDING with those who are sedated/out of it, trust me, no funny business will happen - especially when there are multiple people there. Just not gonna happen. These people are paid well for their jobs and spent good money on school - they will not just toss that way. Occasionally, people who are out of it/on drugs say funny things and we just smirk/laugh sometimes make small talk with them and carry on. Before I got sterilized, I had some IV drugs to help put me out and I apparently started laughing out loud and kept laughing the whole time and saying funny things like "I feel so DRUNK!!!!!!" but there was a doctor, the midlevel, and 1-2 nurses in there. The midlevel later told me that I had them giggling until I was sedated further.

 

You're in good hands, promise.

And I'm sure he has probably calculated for the fact that I take a lot of anti-seizure meds .

Sedation (benzos) makes me deliriously happy and giggly. People have told me that I start talking about alcohol (probably because it feels that way to me) and mortality and how "it feels like I'm dying" but I keep laughing about it.

Isn't it funny how the same neurological reaction can lead to different feelings/actions in different people? benzos work by binding to areas on chloride channels in your neurons and they delay the closing of these channels so that more chloride ions flow into the cell and this leads to sedation - very, very, VERY difficult to OD on benzos alone, btw!

And I'm sure he has probably calculated for the fact that I take a lot of anti-seizure meds .

Oh my goodness, yes, and I know some sedation nurses too. Sedation is all they do - and they are damn good at it. You will be watched like a hawk and they will take into account EVERYTHING - your meds, your tolerances, your allergies, your body weight - everything. And they will adjust accordingly based on how you respond.

So while your doctor is focusing on you and getting your teeth done, the sedation nurse will only be watching you and monitoring/adjusting the meds.

They go to specialized schools JUST to learn how to do this. Remarkable, really. As I said, you're in excellent hands. And I can promise you, you are not the hardest patient that they have taken care of, not by far.

Sedation (benzos) makes me deliriously happy and giggly. People have told me that I start talking about alcohol (probably because it feels that way to me) and mortality and how "it feels like I'm dying" but I keep laughing about it.

 

Isn't it funny how the same neurological reaction can lead to different feelings/actions in different people? benzos work by binding to areas on chloride channels in your neurons and they delay the closing of these channels so that more chloride ions flow into the cell and this leads to sedation - very, very, VERY difficult to OD on benzos alone, btw!

And I read they usually use a benzo to put you out. I think it starts with an M?

Whatever it is I saw on the surgery paper he has ordered four units of sedation .

And I read they usually use a benzo to put you out. I think it starts with an M?

Yup, what they do is usually use a benzo to put you out first, and then the further sedation will come later (fentanyl, propofol, etc) but you will be out when that stuff is introduced.

Midazolam (Versed) is commonly used. I think that may be the "M" drug you're thinking of.

I just can't wait for this to be over. Approximately how long does it take to wake up ?

Depends on how much they use and your tolerance and such but generally speaking, not very long at all. It's kind of a slow wake-up for most people, you're pretty groggy but you usually know what's going on and where you are and such. I think I was awake-ish within 15-30 min of my stomach surgery and sterilization procedures, but of course, they monitored for me longer than that afterwards. I was inpatient after stomach, but I went home after sterilization - I couldn't drive (obviously) but I was okay.

My dad got a LOT of versed during his colonoscopy and I was with him when he was waking up. He woke up within 15-30 min. I was there right when he got out.

Same thing with wisdom teeth - I think they let me sit in the chair for about 20 min after procedure, and then they helped me to a cot to lie down for a little bit longer while my mom came by to get me to take me home. I was SO groggy but I was with it and I remember all of that.

The only time I didn't remember anything was when I got home and I took Vicodin. THAT caused me issues. But sedation, after waking up? Nah.