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Nitrious Oxide

Posted: Thu Jul 23, 2009 9:37 am
by guitarguy
I probably will have to go in for a root canal on a lower back tooth, Anyone know if there are problems with Nitrious Oxide and MS?

I am terrified of having a root canal after my last one 8 years ago. My throat was numb because of the novacaine and unable to swallow, also feeling of drowning because of the salaiva build up. Was awful sitting there for 2 hours like that. I have hypertension as well, I need something to calm me.

Posted: Thu Jul 23, 2009 11:55 am
by cheerleader
Wouldn't recommend nitrous oxide...some MSers have problems. It depletes B12 and changes the vasculature, and many dental offices recommend not using it for MS patients. Talk to your dentist about other alternatives...valium? Also make sure they keep that novocaine away from your throat! Should just be localized to the tooth.

I had oral surgery with my ipod on...had a broken molar removed with just novacaine- took over an hour- and the music kept me calm- and I didn't have to hear all the drills and hammers.

good luck!
cheer

Posted: Thu Jul 23, 2009 12:06 pm
by guitarguy
I think I might ask for a little valium. I figured the gas would be bad for MS.
I think my throat got numb because it was a lower tooth in the back. I am worred because this tooth is even further back! The numb throat was horrible! I couldnt swallow. bad enough they had my mouth clamped open, but the salavia and drowning sensation AND unable to swallow has made it so I am terrified to go back. I feel like I want to throw up right now. I don't want to sound all sissy or anything, but I am almost ready to start crying likr a 3 year old. the experience was that traumatic for me.

Posted: Thu Jul 23, 2009 12:14 pm
by LoveActually
Good advice about the ipod. Never thought about listening to music while going through that.

As far as feeling like you're drowning because of the saliva, I would talk to the nurse or doc about this. I've had crappy nurses who don't pay attention and just let it build up until it's pouring out of my mouth. I would just be 100% honest and tell them you have issues with DROWNING and to keep the spit sucker going 24-7 and put it in the right place so it's not just sucking up your cheek.

Does general anesthesia affect MS?

Posted: Thu Jul 23, 2009 2:18 pm
by jimmylegs
LA, if anaesthesia has anything to do with nitrous oxide, then yes it can affect ms.

more particularly it can trigger b12 deficiency and subacute combined degeneration of the spinal cord.

'Anesthesia paresthetica': nitrous oxide-induced cobalamin deficiency.
http://www.ncbi.nlm.nih.gov/pubmed/7644061

Cobalamin deficiency and subacute combined degeneration after nitrous oxide anesthesia: A case report
http://linkinghub.elsevier.com/retrieve ... 9304002680

Subacute combined degeneration of the spinal cord after nitrous oxide anaesthesia...
http://jnnp.bmj.com/cgi/content/extract/64/4/563

no-one with b12 issues should go anywhere near nitrous oxide or general anaesthesia involving nitrous oxide.

this is from wikipedia:
...The duration of action of IV induction agents is generally 5 to 10 minutes, after which time spontaneous recovery of consciousness will occur. In order to prolong anaesthesia for the required duration (usually the duration of surgery), anaesthesia must be maintained. Usually this is achieved by allowing the patient to breathe a carefully controlled mixture of oxygen, nitrous oxide, and a volatile anaesthetic agent or by having a carefully controlled infusion of medication, usually propofol, through an IV. The inhalation agents are transferred to the patient's brain via the lungs and the bloodstream, and the patient remains unconscious. Inhaled agents are frequently supplemented by intravenous anaesthetics, such as opioids (usually fentanyl or a fentanyl derivative) and sedative-hypnotics (usually propofol or midazolam). Though for a propofol-based anaesthetic, supplementation by inhalation agents is not required. At the end of surgery the volatile or intravenous anaesthetic is discontinued. Recovery of consciousness occurs when the concentration of anaesthetic in the brain drops below a certain level (usually within 1 to 30 minutes depending upon the duration of surgery).

Posted: Thu Jul 23, 2009 7:22 pm
by LoveActually
Damn it!!! Well, since I haven't been diagnosed with MS, and probably won't be on the 28th when I see the doc again, then my only worry is the B12.

Once my B12 is up, should I be ok? I will most likely be having surgery at the end of August, which is why I'm so concerned.

Posted: Fri Jul 24, 2009 9:02 am
by jimmylegs
hi LA, if you raise your existing b12 issues with the anaestheticians they might do your anaesthesia without nitrous.

if you can get your b12 levels up to 550-600 nmol/L (whatever we said that was in pg/ml) you can probably avoid nitrous problems, but they'd have to keep an eye on your b12 status.

an important question is, why are you b12 deficient in the first place? whatever the reason is, it needs to be addressed. there may be other deficiencies happening, depending on the reason.

for instance, if you don't get enough calcium, your pancreas might not be able to do its job in terms of processing dietary b12 intake. if you read up on hypocalcemia you will see a very interesting catalogue of ms symptoms that have been experienced by many of us here at TIMS. i haven't paid enough attention to calcium before now.

gg, there have been some good suggestions for managing the stress and discomfort of the upcoming procedure, but it wouldn't hurt to have a look at your b12 status either (and calcium!).