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Anxiety and panic disorder and oral surgery


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#1 Angeni Mai

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Posted 01 February 2013 - 01:10 AM

I have been putting off having my tooth extracted for months because I am scared shitless by the prospect of having any type of surgery, even a minor one such as an extraction. Now I am in a position of I either have it done within the next thirty days or get kicked out of my dentist's practice.

They don't offer nitrous oxide at the surgeon's office I was referred to so I am going to have to be put under general anesthesia. I'm afraid that I'm going to end up waking up and flipping out because I'm confused or have something go wrong during the extraction and end up having to have a subsequent surgery because of an error that was made during the procedure. Anybody else have any tips on managing anxiety and panic the day/ night before the procedure? Any reassurance would be appreciated.


Dxs ~ Mood Disorder NOS, Panic Disorder with Agoraphobia, Borderline Personality Disorder, Personality Disorder NOS, Dissociative Disorder NOS, Unspecified Depressive Disorder

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#2 melissaw72

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Posted 01 February 2013 - 01:43 AM

I had 4 wisdom teeth removed under general anesthesia.  I did wake up groggy but was "with it" enough to know what was going on.  It didn't hurt much until the anesthesia wore off, but I'd been given pain killers.  A word of advice if you get them ... eat something with them, whatever you can.  I passed out because I had nothing in my stomach when taking them (at least that was the only reason at the time).  Can you take a little klonopin if needed the day or night before?  I wasn't anxious leaving the office because I was still groggy.  After that though I was ok because it was over with.


Current Psychiatric Dxs ... Schizoaffective, bipolar type; Anxiety disorder, PTSD, agoraphobia

Also recovered Anorexic/Bulimic finally after 20 years.

Current meds: Provigil, Klonopin, Xanax, Naltrexone, Wellbutrin, Abilify, Lamictal, Prozac, Lansoprazole, Linzess, QVAR inhaler, Xopenex inhaler, Flonase, Flexeril, Zofran,propranolol.

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#3 Angeni Mai

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Posted 01 February 2013 - 02:16 AM

I had 4 wisdom teeth removed under general anesthesia.  I did wake up groggy but was "with it" enough to know what was going on.  It didn't hurt much until the anesthesia wore off, but I'd been given pain killers.  A word of advice if you get them ... eat something with them, whatever you can.  I passed out because I had nothing in my stomach when taking them (at least that was the only reason at the time).  Can you take a little klonopin if needed the day or night before?  I wasn't anxious leaving the office because I was still groggy.  After that though I was ok because it was over with.


I'm not sure if I can or not. I won't be given that critical piece of information until I go to have my physical and the results get to the oral surgeon's office.


Dxs ~ Mood Disorder NOS, Panic Disorder with Agoraphobia, Borderline Personality Disorder, Personality Disorder NOS, Dissociative Disorder NOS, Unspecified Depressive Disorder

Rxs ~ None

"A brave man may not live forever, but a cautious man does not live at all." ~ Unknown

“I’m pretty, but I’m not beautiful.
I sin but I’m not the devil.
I’m good, but I’m not an angel.” ~ Marilyn Monroe


#4 melissaw72

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Posted 01 February 2013 - 03:50 AM

Can you call ahead of time and ask if it is generally ok to take?  Or ask your pdoc?  My GUESS would be that a little would be ok ... when I go under general anesthesia for surgeries, they say to definitely take it the morning of the surgery (probably to relax me a little), and I  have had no problems with it.  But that is what my DRs have said.  You might want to ask yours ahead of time too. 


Current Psychiatric Dxs ... Schizoaffective, bipolar type; Anxiety disorder, PTSD, agoraphobia

Also recovered Anorexic/Bulimic finally after 20 years.

Current meds: Provigil, Klonopin, Xanax, Naltrexone, Wellbutrin, Abilify, Lamictal, Prozac, Lansoprazole, Linzess, QVAR inhaler, Xopenex inhaler, Flonase, Flexeril, Zofran,propranolol.

Any questions just ask :)

 

"I'm still kind of mad they never actually told us how to get to Sesame Street."


#5 crtclms

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Posted 01 February 2013 - 04:18 PM

When I had surgery last, the only morning med they let me take was the xanax. I guess it is easy for an anesthesiologist to work with benzos in your system, as they use them themselves, anyway. So you should definitely call your dentist's office to ask if it is okay, there is a solid chance it will be.

 

This is lame, but when I have to face an ordeal, I always say to myself over and over: "Only x hours until this is all over."  If I can remember that something is finite, I can deal.

 

Which is weird, because that is kind of the opposite of mindfulness, isn't it? Or is it?


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#6 lysergia

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Posted 01 February 2013 - 04:55 PM

hi Angeni,

 

oral surgery sucks, doesn't it?  i feel for you.

 

oral surgeons and anesthesiologists are VERY accustomed to patients who are terrified.  many people who otherwise have no irrational fears will run far and fast from this kind of procedure!  not because it's that terrible, or dangerous... it's just scary.  so they encounter this all the time.  if they are skilled, they should be able to help you feel a bit better before the surgery.

 

in advance, be sure they know you have an anxiety/panic disorder and will require benzos just to get there in the morning, and also the night before.  the anesthesiologist HAS to know this (and what your other meds are).  s/he calculates the amount of anesthesia based on several factors, including medications (especially sedatives).  don't let them tell you that you cannot take your anxiety meds - you can, but you have to do it per their instructions beforehand (such as what doses and times are acceptable).  sometimes medical professionals don't take your need for anxiety meds seriously (because they see so many scared people), and need to be reminded of your dx.  if you insist (such as i did, heh), i am sure they'll work with you to find a good compromise.

 

you'll have to have someone with you to take you home afterwards, since you won't be able to drive.  bringing someone who understands your fears and can hold your hand (i mean literally!) really makes a difference.  as others have said, you'll be really groggy afterwards so anxiety isn't likely to be a problem.

 

i was so terrified of the dentist for twenty years that i didn't go, at ALL.  eventually i developed TMJ problems and was in a lot of pain, so i was kind of forced to go.  i ended up having all of my teeth pulled at once so i could replace them with dentures.  i was SO scared, between the anxiety and the PTSD triggers and just general "this is awful"... i thought i would run out the door at the last minute in a panic.  but i consulted with the anesthesiologist who allowed me to take my clonazepam (but only as planned beforehand, no extra PRNs).  that helped, and so did having my sister with me to comfort and distract me from my fear.  and much to my surprise, everything went just fine!  she stayed with me for the first few days of fogginess and nausea from the pain meds, and that helped a lot too.  i don't function well on opiates.

 

as for how to manage your anxiety up until that day, maybe others could chime in and let you know what has helped them.  my way of managing that level of fear usually involves dissociation, which i don't really recommend heh.

 

best of luck!  you can do it :)


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bupropion XL 300 mg, clonazepam 3 mg, zopiclone 7.5 mg, synthroid 0.15 mg (supplements: D3, B12, Omega 3)

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#7 Energizerhoney

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Posted 03 February 2013 - 03:39 AM

Oh boy can I relate.
I've been under general anesthesia before for a surgery and that was far better for me.

Another thing someone mentioned to me is if it's surgery related to take my benzo, get the gas, bring your iPod and turn it up full blast. There are dentists who specialize in sedation dentistry because your fear is not at ALL uncommon. Have you checked anything like that out?

Edited by Energizerhoney, 12 April 2013 - 01:18 PM.

Bipolar 1, Panic disorder.

Lamictal 400mg
Seroquel 200mg
Klonopin 1mg prn

#8 Angeni Mai

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Posted 03 February 2013 - 08:30 PM

Well I don't really have much of a choice in who I go to for it because my dentist had to refer me to the person who he wants to extract my tooth (according to the rules of my dad's insurance plan), so it's really out of my hands. All I know is that I have to get a physical done before the "surgery" and have my GP send the results to the oral surgeon and that I cannot eat or drink anything between midnight and the time I have it done.


Dxs ~ Mood Disorder NOS, Panic Disorder with Agoraphobia, Borderline Personality Disorder, Personality Disorder NOS, Dissociative Disorder NOS, Unspecified Depressive Disorder

Rxs ~ None

"A brave man may not live forever, but a cautious man does not live at all." ~ Unknown

“I’m pretty, but I’m not beautiful.
I sin but I’m not the devil.
I’m good, but I’m not an angel.” ~ Marilyn Monroe


#9 Energizerhoney

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Posted 03 February 2013 - 10:03 PM

Angeni: Is there anyway you can show your dentist your official diagnoses from your pdoc? That way the dentist will clearly understand your problem and can work from there? Yes, they say no food or water before surgery except a small amount to take ur daily meds, a lot of ppl take some type of daily meds, ur not unusual in that regard...that's usually ok and what I've done and what they have told me.
Bipolar 1, Panic disorder.

Lamictal 400mg
Seroquel 200mg
Klonopin 1mg prn





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