# Fat people and sedation



## loopytheone (May 6, 2019)

I'm not really sure what the purpose of me making this thread is, other than wanting to get something off my chest here.

I have a pretty severe phobia of dentists and I need to be sedated to have dental work done. Last time this happened was about 5 years ago and they used IV sedation and it worked great. 

I talked to a dentist and he wont give me IV sedation at the health centre because of my weight and insists that I would have to go to the hospital and have an anaethetist present incase of breathing problems. They are willing to give me gas and air at the health centre though.

It's scary being told I have to change my routine regarding something I'm already super anxious about. I either have to chose to go to the hospital or chose a sedation method I've never had before. I chose to try the gas and air. 

...this is the first time I've ever had somebody tell me they have to make special adjustments because of my weight. And honestly, it stings more than I thought it would. I don't really understand why it bothers me (I was expecting them to say that) but somehow it does.


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## agouderia (May 6, 2019)

To me, it seems more that this dentist is not qualified to do regular anaethesia.

I had general anaesthesia for having my wisdom teeth removed (necessary because they had grown in such complicated angles). My size was no issue at all - and weight wise we're not that far apart. But - it was done by a fully qualified anaesthesiologist, not by the dentist himself. No problems whatsoever,

More generally speaking - we had the opposite problem with my grandmother, who suffered from botched anaesthesia because she was so tiny (app. 85 lbs.) Our family doctor then told us that the overwhelming amount of experience with anaesthesia is for the weight range 60-100 kgs/130-220 lbs. If a patient is clearly below or above that, that's when complications can seit in.

As unnerving as it may sound - I would try to find a different dentist.


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## LarryTheNoodleGuy (May 6, 2019)

You might want to consider "taking it" - facing the phobia with the express purpose of deflating it and not letting it claim power over you.

Understanding that they will numb your gum, then stick a needle in, it will sting, then in 10 minutes you'll feel nothing except pressure, the uncomfortability of stretching your mouth far further than you normally would, then your sweet little choppers will be all better and you will go out in the world knowing you've conquered a demon.

Once you let 'em numb you, it's nothing, really, just one of those uncomfortable but necessary aspects of life everyone has to do now and then - a bother.

Wouldn't that be better than stressing about general anesthesia, which is like rebuilding the whole house when the toilet is stopped up?


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## Tracyarts (May 6, 2019)

I'm nervous about sedation. I'm having some medical tests done under sedation in a few weeks to check for signs of cardiovascular and pulmonary issues. A TEE (trans esophageal ultrasound), heart catheterization, and some kind of lung scope procedure. All in one go. So they're going to load me up with propofol, knock me out, and go into my esophagus, heart, and lungs. I am scared shitless. I had previously been told that the tests were not an option because my age and BMI restricted me from any kind of sedation (I am 48 years old, 5'10", and 380 pounds). But my cardiologist says nope, based on my current health status and all the tests he's done so far, he's confident that I'm a safe candidate for the procedures. Still doesn't make me feel any better about it.


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## loopytheone (May 7, 2019)

Thanks for the replies, all.

Something to mention though; sedation isn't the same thing as a general anesthetic, at least not over here. Sedation makes you relaxed and calm, but it doesn't put you to sleep and as such can usually be done by a dentist in a dentist clinic rather than at a hospital.

The issue is, they aren't willing to do it outside a hospital with me anymore because of my weight. At least not the usual IV sedation. I'm about 95kg, but I'm short and they decide these things based on BMI (well, in my case they just basically looked at me, hah). I'm not complaining at all that they want to be safe and have extra people looking after me whilst I'm sedated, I'm just... eh. My autistic little brain finds the change hard to cope with. 

Larry, I understand that you are trying to be helpful and I appreciate that, but giving people with severe anxiety the advice to basically 'get over it' is almost never helpful. I actually have a genetic condition that in addition to giving me crappy teeth, also means I'm resistant to local anesthetic. Which means that my teeth un-freeze during dental work, so I've actually never had dental work done without them hurting me. The sedation relaxes me enough to be able to tell them when they are hurting me; otherwise I go into something called a shut down, where I can't really move or communicate. The last time that happened they pulled a tooth out when it wasn't frozen and the pain nearly made me pass out.

Tracy, that does sound scary, its a lot of things to have done, especially when you've been told before that you couldn't have them done. Hopefully everything will go well, and all the tests will come back fine.


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## LarryTheNoodleGuy (May 8, 2019)

(((hugs))) please forgive my ignorance, you seem like a nice lady...wishing you the best! (bows out)


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## agouderia (May 8, 2019)

That still sounds odd, Loopy.
As mentioned, I had full anaesthesia for surgery in a regular dental practice at roughly that weight - no issue whatsoever. And if it's only the milder sedation, their fuss does sound overblown. Are they able to produce any medical guidelines to underpin their approach? Or are they just trying to get out of working with a patient they deem "difficult"?


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## loopytheone (May 9, 2019)

Well, the guidelines over here say that if a patient has a BMI over or near 40 (mines around 38, I think?) then there are increased risks for IV sedation and the dentist is allowed to refuse to give it unless the patient is in a hospital. They are a specialist clinic for sedating dental patients and I don't need much work doing to my teeth so I can't imagine that I'm a difficult patient for them (basically, I need 1-3 small fillings doing). 

It's really interesting that they gave you general anaesthetic at a dental clinic, I'm sure that isn't done over here. Like, as far as I know, if you need general anaesthetic for any reason, you have to be in a hospital over here. 

I guess I just don't get why at 180 lbs, my weight wasn't an issue at all and nobody even mentioned it, but at 210 lbs I apparently can't have the sedation outside of a hospital and they wont budge on that. It's, like, 30 lbs difference, not 100.


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## Tad (May 9, 2019)

Dental surgeons here do general anaesthetic too. I had that for getting wisdom teeth taken out.


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## Tracyarts (May 9, 2019)

Sometimes the criteria are strictly adhered to. And they're kind of arbitrary. One hospital classes me as a bariatric patient because I'm over 350 pounds, and another hospital doesn't because I'm under 400. My town's EMT department will transport me no problem, but one town over called a bariatric transport unit for me. It sometimes makes no sense. 



loopytheone said:


> Well, the guidelines over here say that if a patient has a BMI over or near 40 (mines around 38, I think?) then there are increased risks for IV sedation and the dentist is allowed to refuse to give it unless the patient is in a hospital. They are a specialist clinic for sedating dental patients and I don't need much work doing to my teeth so I can't imagine that I'm a difficult patient for them (basically, I need 1-3 small fillings doing).
> 
> It's really interesting that they gave you general anaesthetic at a dental clinic, I'm sure that isn't done over here. Like, as far as I know, if you need general anaesthetic for any reason, you have to be in a hospital over here.
> 
> I guess I just don't get why at 180 lbs, my weight wasn't an issue at all and nobody even mentioned it, but at 210 lbs I apparently can't have the sedation outside of a hospital and they wont budge on that. It's, like, 30 lbs difference, not 100.


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## DragonFly (May 9, 2019)

Tracyarts said:


> I'm nervous about sedation. I'm having some medical tests done under sedation in a few weeks to check for signs of cardiovascular and pulmonary issues. A TEE (trans esophageal ultrasound), heart catheterization, and some kind of lung scope procedure. All in one go. So they're going to load me up with propofol, knock me out, and go into my esophagus, heart, and lungs. I am scared shitless. I had previously been told that the tests were not an option because my age and BMI restricted me from any kind of sedation (I am 48 years old, 5'10", and 380 pounds). But my cardiologist says nope, based on my current health status and all the tests he's done so far, he's confident that I'm a safe candidate for the procedures. Still doesn't make me feel any better about it.



I’m older and bigger than you, and I have been successfully put under the way you are being done multiple times. No side effects like other kinds of sedation. Make sure they know if you use a Cpap. When they put me under that way they put on a cpap mask to make sure they keep a good airway. I would choose this type of sedation over any other!!


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## squeezablysoft (May 10, 2019)

I had to have 5 teeth pulled plus fillings in most of the ones they were leaving in (fun fact: medical/dental self-neglect is one of the lesser known depression symptoms) a few years ago and they also we're initially recommending I go under sedation to make it easier to do everything at once, especially since I at this point hadn't been to a dentist since I was like 12 and was kinda freaked out about it. So I filled out the paperwork and had the initial consultation with the oral surgeon and after that he said he wasn't comfortable with sedating me in the office so we could either do sedation at the hospital or do it in the office with gas. He didn't say exactly why and being the idiot I am I didn't ask, but I researched possible contraindications for dental sedation and the only thing that matched my medical history was hypothyroidism and even that it said shouldn't be a problem if it's well regulated with medicine, which I was taking although my doctor was still adjusting the dosage every few months. My bmi was just like 33 at the time but now I'm wondering if it could have been a factor in the oral surgeon's decision. Anyway we decided to go with gas in the office but when it actually happened he apparently made the decision on his own to try it without gas first and was basically already in my mouth before I even processed anything. It ended up being ok, truly the worst part was the needles with the numby stuff going in and I was so proud of myself for getting all those teeth out (we decided to do the fillings separately) with just the numby stuff I walked out of there with a mouthful of gauze and an "I'm such a [email protected]$$" swagger lol. I've got a wisdom tooth removal coming up soon though that's gonna be a real pain I'm afraid cause it's so broken off they will have to cut into the gums to get it all out, plus it's in the top row which means it's hard to get to (felt like my jaw would break when they were prying it open to get back to fill the tooth beside the wisdom tooth). But for you, Loops, idk it might be worth going ahead and having the sedation in the hospital if you can, it is really annoying when such a slight change makes the medical ppl decide to change course and complicates things.


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## Emmy (May 21, 2019)

loopytheone said:


> Thanks for the replies, all.
> 
> Something to mention though; sedation isn't the same thing as a general anesthetic, at least not over here. Sedation makes you relaxed and calm, but it doesn't put you to sleep and as such can usually be done by a dentist in a dentist clinic rather than at a hospital.
> 
> ...


... It's totally normal to feel whatever you are feeling! Being comfortable isn't something you should have to compromise because of weight, when it comes to pain.


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## loopytheone (Jul 3, 2019)

Well, tomorrow is the big day for this, I'm having my teeth done. I'm so terrified, hopefully it will go well.


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## sarahe543 (Jul 3, 2019)

Hoping it all goes well


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## Tad (Jul 3, 2019)

Best of luck, Loops. (with the procedure and your nerves)


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## squeezablysoft (Jul 3, 2019)

Good luck, Loops!


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## loopytheone (Jul 4, 2019)

Thanks for the well wishes everyone!

Everything today went fine. The gas and air was a very weird feeling, but certainly relaxed me. I was able to have the right hand tooth filled and the dentist was very good and patient. They will do the left hand side next month but now I know how it works, I wont be as scared. 

I'm honestly super proud of myself for facing up to my fears like that.


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## sarahe543 (Jul 4, 2019)

Excellent news!


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## DragonFly (Jul 6, 2019)

loopytheone said:


> Thanks for the well wishes everyone!
> 
> Everything today went fine. The gas and air was a very weird feeling, but certainly relaxed me. I was able to have the right hand tooth filled and the dentist was very good and patient. They will do the left hand side next month but now I know how it works, I wont be as scared.
> 
> I'm honestly super proud of myself for facing up to my fears like that.


Great job Loopy! I’m proud, I know anxiety and you did great.


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## loopytheone (Jul 6, 2019)

Thank you! I've been taking these last few days really slowly to recover from the stress.


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## Tracyarts (Aug 1, 2019)

I'm supposed to be having a crooked wisdom tooth removed soon. I'm having it done by an oral surgeon because I take blood thinners and he uses IV sedation. I have had a wisdom tooth extracted with only local anesthetic before, and am kind of anxious about this. But my medical doctors all cleared me for it so it's happening. 

I also need a root canal, and am really not happy about that.


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## loopytheone (Aug 3, 2019)

Best of luck, Tracy. Hopefully everything goes well for you and you are much more comfortable without the crooked tooth.


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