Use of sedatives.
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MeanRussian
- Posts: 11
- Joined: Mon Aug 30, 2004 2:51 pm
Use of sedatives.
I have a very strong gagging reflex. It is a real challenge to get through a regular session. Soon my doctor will have to take impressions of my teeth to fit me with the retainer. I do not know how it will be possible. My dentist once prescribed me sedatives. He was able to pull three of my teeth without any discomfort on my part. I was completely awake during the operation. I asked my orthodontist earlier if she can provide my with sedatives that will allow me to relax while she takes impressions. She said that she will not do that, since I have to be fully awake and responsive while impressions are taken. ??? Is that true? If not, should I insist on sedatives?
From one person who gags on impressions to another...
You do need to be coherent and able to follow instructions (i.e. move your head up or down, etc) BUT the process is nowheres as bad as it was when I had braces when I was younger (don't know how old you are so that may or may not be relevant).
For the record, my next comment is NOT PRESCRIBING anything. I am simply providing information with direction to see an MD - but I do not want anyone to think I am trained to prescribe, which I am not (as a clinical social worker, I do have clients on medications, so I am familiar but CANNOT prescribe. )
There are a number of medications that work as sedatives/tranquilizers, the most notable being the benzodiazepines (Valium, Xanax, Ativan), which do a nice job of calming a person down without knocking them out. They are addictive, so if your MD will give you a small dose, just take what you need to "take the edge off." There are other non-addictive medications, like the beta-blockers (tenormin, other blood pressure meds) which are used for calming stage fright and transient anxiety in the short term. The beta-blockers generally are effective because the intercept the anxiety signals in the body (heart racing, heavy breathing) so we don't have the same bodily cues for anxiety. They don't provide the same overall sense of relaxation as do the benzos.
Realistically, the ortho will probably not be willing to prescribe anything, as they just don't have the meds training as do the MDs. If you have a regular physician, I'd recommend explaining the situation to him or her, and asking if they could prescribe a very small dose of [whatever they believe best] that you could take for the impressions, and maybe at one or two later appointments, but that's it. Most MDs, assuming they know you, will do so because they understand that sometimes it is important to have a little help calming down, without being put under. If you go to a brand new doctor, however, asking strictly for benzos, they will probably think you are "drug-seeking" and have a drug addiction problem and will not prescribe them.
Orthos kind of freak out around this topic, so I wouldn't bring it up again, as they may label you "non-compliant" or some other pejorative phrase because of your reflexes. They don't need to know if you get a little Ativan (most commonly prescribed now) because you will be perfectly alert when you go in, just calm. Again, important to talk to the MD but from the ortho's perspective, they just want you in there and cooperative. I don't think orthos do general sedation anyhow, so you'd have to find another alternative.
Here are some recommendations that got me through the impressions (today!)-
1. Breathe through your nose, and let your neck and throat relax. Most often gagging is a panic reaction (don't know your situation though) when we fear we are either choking or not getting enough air. You can get all the air you need through your nose - and by making a conscious effort to relax your throat, you lessen the chance that you make yourself your own worst enemy.
2. They''ll probably put the plastic mold-shaper (or whatever) in your mouth to see what size fits. For me the following has been very important - ask them to start either with the smallest adult size, or for me, I have them start with the pediatric mold-shaper. They tend to overestimate what size to put in, which makes extra plastic in your mouth to fill up and cause panic. If you ask them to start with a small size, and then work up, as opposed to a gag-size big shape and move down, for me it has been much easier to deal with.
3. Ask for a timeframe the mold-shaper will be in with the plastic goop. I do much better when I can predict when the misery will end - you can even ask the assistant to do a countdown to let you know when they will be taking the mold out.
4. Bring a friend, and arrange what the friend should say/talk you through or how they can help you best. This isn't like surgery where no one can come in the operating room - if you want a friend, bring a friend.
5. For me I kept telling myself that if I panicked, I'd have to start all over again, which I really didn't want to do. As long as I closed my eyes, breathed through my nose, let my neck and throat relax, I made it.
6. Perhaps you could bring an iPod or portable CD player to distract yourself.
After all I've said, my general recommendation is to not involve the ortho in asking for any meds, as they just don't go there. An MD is the best trained and can probably find something that will work OK. If you do take something strong (i.e. a high dose of Ativan) please, please have someone drive you home. Most people generally can drive on a low dose, but check with your doctor if they think you should stay off the road. Better safe than sorry.
Good luck and keep us posted.
You do need to be coherent and able to follow instructions (i.e. move your head up or down, etc) BUT the process is nowheres as bad as it was when I had braces when I was younger (don't know how old you are so that may or may not be relevant).
For the record, my next comment is NOT PRESCRIBING anything. I am simply providing information with direction to see an MD - but I do not want anyone to think I am trained to prescribe, which I am not (as a clinical social worker, I do have clients on medications, so I am familiar but CANNOT prescribe. )
There are a number of medications that work as sedatives/tranquilizers, the most notable being the benzodiazepines (Valium, Xanax, Ativan), which do a nice job of calming a person down without knocking them out. They are addictive, so if your MD will give you a small dose, just take what you need to "take the edge off." There are other non-addictive medications, like the beta-blockers (tenormin, other blood pressure meds) which are used for calming stage fright and transient anxiety in the short term. The beta-blockers generally are effective because the intercept the anxiety signals in the body (heart racing, heavy breathing) so we don't have the same bodily cues for anxiety. They don't provide the same overall sense of relaxation as do the benzos.
Realistically, the ortho will probably not be willing to prescribe anything, as they just don't have the meds training as do the MDs. If you have a regular physician, I'd recommend explaining the situation to him or her, and asking if they could prescribe a very small dose of [whatever they believe best] that you could take for the impressions, and maybe at one or two later appointments, but that's it. Most MDs, assuming they know you, will do so because they understand that sometimes it is important to have a little help calming down, without being put under. If you go to a brand new doctor, however, asking strictly for benzos, they will probably think you are "drug-seeking" and have a drug addiction problem and will not prescribe them.
Orthos kind of freak out around this topic, so I wouldn't bring it up again, as they may label you "non-compliant" or some other pejorative phrase because of your reflexes. They don't need to know if you get a little Ativan (most commonly prescribed now) because you will be perfectly alert when you go in, just calm. Again, important to talk to the MD but from the ortho's perspective, they just want you in there and cooperative. I don't think orthos do general sedation anyhow, so you'd have to find another alternative.
Here are some recommendations that got me through the impressions (today!)-
1. Breathe through your nose, and let your neck and throat relax. Most often gagging is a panic reaction (don't know your situation though) when we fear we are either choking or not getting enough air. You can get all the air you need through your nose - and by making a conscious effort to relax your throat, you lessen the chance that you make yourself your own worst enemy.
2. They''ll probably put the plastic mold-shaper (or whatever) in your mouth to see what size fits. For me the following has been very important - ask them to start either with the smallest adult size, or for me, I have them start with the pediatric mold-shaper. They tend to overestimate what size to put in, which makes extra plastic in your mouth to fill up and cause panic. If you ask them to start with a small size, and then work up, as opposed to a gag-size big shape and move down, for me it has been much easier to deal with.
3. Ask for a timeframe the mold-shaper will be in with the plastic goop. I do much better when I can predict when the misery will end - you can even ask the assistant to do a countdown to let you know when they will be taking the mold out.
4. Bring a friend, and arrange what the friend should say/talk you through or how they can help you best. This isn't like surgery where no one can come in the operating room - if you want a friend, bring a friend.
5. For me I kept telling myself that if I panicked, I'd have to start all over again, which I really didn't want to do. As long as I closed my eyes, breathed through my nose, let my neck and throat relax, I made it.
6. Perhaps you could bring an iPod or portable CD player to distract yourself.
After all I've said, my general recommendation is to not involve the ortho in asking for any meds, as they just don't go there. An MD is the best trained and can probably find something that will work OK. If you do take something strong (i.e. a high dose of Ativan) please, please have someone drive you home. Most people generally can drive on a low dose, but check with your doctor if they think you should stay off the road. Better safe than sorry.
Good luck and keep us posted.
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jennielee81
- Posts: 2144
- Joined: Tue Mar 22, 2005 2:31 pm
- Location: The Old Line State
I gag as well. I just told my assistant about it and she had 3 steps to prevent it.
1. Once the mold was in, I tilted my head slightly forward.
2. I played a little "game" with my feet, holding one up and then the other. It is impossible to vomit when you're straining your stomach muscles!!
3. realize that it only takes 5 minutes per mold.
REALLY!! Tell the person who is doing the molds...they've seen it before. They know what to do.
Above all, realize that it is only going to take a few minutes and that you will be fine. RELAX!! It was uncomfortable, but I didn't even have the slightest gag reflex!
1. Once the mold was in, I tilted my head slightly forward.
2. I played a little "game" with my feet, holding one up and then the other. It is impossible to vomit when you're straining your stomach muscles!!
3. realize that it only takes 5 minutes per mold.
REALLY!! Tell the person who is doing the molds...they've seen it before. They know what to do.
Above all, realize that it is only going to take a few minutes and that you will be fine. RELAX!! It was uncomfortable, but I didn't even have the slightest gag reflex!
"Life is an occasion; RISE TO IT!" --Mr. Magorium
I wore Damon 3's and Opals for 20 months at age 42. Braces off January 2007
http://www.archwired.com/phpbb2/viewtopic.php?t=3535 a little more about me here: http://www.businessweek.com/magazine/co ... 961130.htm
I wore Damon 3's and Opals for 20 months at age 42. Braces off January 2007
http://www.archwired.com/phpbb2/viewtopic.php?t=3535 a little more about me here: http://www.businessweek.com/magazine/co ... 961130.htm
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MeanRussian
- Posts: 11
- Joined: Mon Aug 30, 2004 2:51 pm