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Scheherazade in Blue Jeans
freelance alchemist
I tried! 
27th-Mar-2014 03:48 pm
Unable/Lack of spoons
So today was my first attempt at sedated dentistry. Which didn't work out, but not because I panicked.

Backstory: Dentistry is the one thing that consistently triggers me. It is so bad that researching dentists had me in scared-kid meltdown mode. But I got recommendations... and then the Judah shit happened, and it took til January for me to be able to get back to a point of being even marginally able to handle it. I re-did the research and went to a dentist for an evaluation. (I wrote about that here; yes the rough stuff & misinformation was re: Lynne.) I made my appointment for March 27, because the only other big first-time sedation appointment they had was in February, when I thought I'd be out of town all month.

I had a lot of anxiety last night about today's appointment. Channeled it into knitting and chatting with friends. Got very little sleep. Woke up, took the prescribed Halcion...

And had not much effect. I got a little spacey, but no more so than "day after a very active day" spacey. When I got to the dentist, they said "Huh, yeah, you are like not sedated at all." Gave me another Halcion and left me in a dimly-lit room with soothing music. Still barely anything.

So the dentist came in and gently broke it to me that we were pulling the plug on today's attempt. I tried to push through, but he said no, they really don't want to retraumatize me. He'll research other ways to sedate me and call me back. We'll keep trying. No charge for today, even though I'd already gotten Novocaine.

The assistant is very used to Type A PTSD patients, apparently; she saw that I was frustrated with myself and impressed upon me that this isn't a failure. Me actually doing the research and preparing and coming in and trying my best is a success. We just have to work the rest of it out.

The problem is, basically:

* I'm 105 pounds right now. This leads people to be very cautious about how much medication to give me, because there is just not very much of me to distribute that medication.

* I'm on several medications that interact with sedatives (or, in the case of Lunesta, are sedatives), which also leads to caution in prescribing.

* I have a ridiculously high tolerance for sedatives. I'm on the maximum prescribing dose of Lunesta. At 105 pounds. When also taking prescription painkillers. And there are still times I only get a few hours of sleep per night. I can usually get at least 5 (not last night, I think), and I sleep like the dead when I do sleep, but yeah. Ambien does nothing in me, and it looks like Halcion's the same.

So what the dentist needs to do is find something that he can give me a lot of safely, or that at least works differently in the body so it has a chance of working. And he will call me.

I'm disappointed that we weren't able to get this done today, but.... everyone did everything they could. I'll take that for now.
27th-Mar-2014 09:43 pm (UTC)
You did so well. I'm very glad your dentist cared about your complete well being and not just your teeth.

Here's hoping that they can figure out a good way to sedate you very soon.
27th-Mar-2014 09:58 pm (UTC)
Sorry to hear that the halcyon failed, but it sounds like the right practice.

Do they have nitrous as an option? I've gotten seizures repeatedly from injectables like novacaine, so my dentist has me take soma + trazadoone 1/2 hour before arrival then if that's not enough adds nitrous. He loves me, but hates my mouth because of TMDD and the local fail and my tolerances.
27th-Mar-2014 10:28 pm (UTC)
I wonder if a wee sniff of versed would do it for you. They used that with me (plus ketamine) for my wisdom teeth. Best part of versed is that it causes amnesia.
28th-Mar-2014 03:22 am (UTC)
That was my thought. *nod*
31st-Mar-2014 02:19 am (UTC)
Versed is what they use to do my brain surgeries, so I can't imagine it wouldn't work for dental work. On the other hand, 'song is super-unique. Still worth a try though!
27th-Mar-2014 11:21 pm (UTC)
At the very least, you seem to have found the Right Place to be. Now, if they can find the right drug...
27th-Mar-2014 11:28 pm (UTC)
I am very committed to finding the Right Place to Be this year, medically.
28th-Mar-2014 12:07 am (UTC)
I note that one of the people I read on DW has Ehlers-Danlos and has a LOT of weird medication interaction and I think some of that, at least, is known. Your geneticist/PCP may be able to help with this.
28th-Mar-2014 12:08 am (UTC)
I'll ask next visit!
(Deleted comment)
30th-Mar-2014 11:31 pm (UTC)
Do you know (is it known?) if it's a polymorphism in cytochrome P450 2C19? (aka CYP2C19) That's the first thing I thought of when you said "sedatives and pain meds," since they're metabolized on that pathway.
28th-Mar-2014 07:26 pm (UTC)
28th-Mar-2014 08:08 pm (UTC)
What if they were to work on your dental needs after you've taken your Lunesta?

At any rate, I hope they figure something out for you!
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