Surprise Surgery

Technically, I was expecting this bit of surgery. What I wasn't expecting was the person doing the scheduling at the dental school going: "How about next week". Now I have a week to prepare for a round of pre-dental-implant bone grafting, and the joys of whatever they decide to sedate me with.

I have let the grad student who will be cutting my gums open know that I am a CPAP user, and I intend to bring my machine with me for the trip. Anything else, beyond don't panic?

tetragon wrote:Technically, I was expecting this bit of surgery. What I wasn't expecting was the person doing the scheduling at the dental school going: "How about next week". Now I have a week to prepare for a round of pre-dental-implant bone grafting, and the joys of whatever they decide to sedate me with.

I have let the grad student who will be cutting my gums open know that I am a CPAP user, and I intend to bring my machine with me for the trip. Anything else, beyond don't panic?

Hi tetragon!

If it were me I would try to put it together to get a consultation between a very Obstructive Sleep Apnea aware Anesthesiologist and whoever will be using the chemicals to take away the pain or put you out. It seems to me that there is way to much chance for ignorance to put you at risk!!

Have a great week!

Todzo

I had the sinus lift with bone added before the three implants. Since this was three years ago, I did not know I had severe sleep apnea with desats to 65. Only during the first sinus lift was I sedated with IV meds. From what I recall, I had an EKG and B/P cuff, not sure about the oximeter. This dental surgeon did the procedure with me more upright in reclining dental chair. No problems during the procedure. I was given the option of no meds other than the local, but since my referring dentist thought that since I was having surgery on both sinuses, he would opt for the sedation. In retrospect, I could have tolerated the procedure without this sedation, but I was lucky in that the sinus lifted up easily and quickly. Still he had to supplement the bone with "everything in the kitchen sink". For the second procedure, inserting the implants after the gums heals,I only took Valium 5mg prior to the apt. Tetragon, feel free to PM me with any questions, pre or post-op. I'm very pleased that I had this procedure.

A responsible oral surgeon will monitor you carefully for BP, O2 sat, & pulse, and should have a crash cart with defibrillator nearby. When you do the pre-op visit, you should definitely tell them about the apnea and check with your own eyes for this equipment.

You can't wear your CPAP during the procedure, obviously, but ask if you should bring it for the post op period before you go home. I doubt it, though. My daughters both had their wisdom teeth removed recently and they shuttled them out of the office ASAP, so you probably won't be there long after they are done working on you. You might still want to have it in the car, so if anything goes horribly wrong and you're admitted to the hospital, your designated driver will see that you have it.

No separate pre-op appointment has been arranged at this point, so I expect what I'll get is a variant of the cursory "healthy young person getting sedation" minute that I had prior to my colonoscopy. From what I overheard in the decision for when it will be is the availability of one of the anaesthesia profs and bringing in a nurse. No time to ask, so just bring.

The only instructions I have been given so far are the usual ones for sedation: no food after midnight, no water three hours before my scheduled time. It's possible that my student would have given me my instructions in the second consultation appointment that he decided was unnecessary when the patient after me didn't show (he kept going forward, to make the most of his clinic time (she was an hour late)). I'm hoping that I'll be handed an instruction sheet on the day itself.

Even though I'm getting my graft on the lower jaw, I do wonder a bit what effect (if any) CPAP would have on a sinus lift.

And now, to make things even more fun, I have been told separately by a nurse and one doctor (not my usual one) that I cannot come in contact with tape anymore. All thanks to the itchy, blotchy rectangle my leg gained when I used paper tape to hold on some gauze when a small chunk of skin got scraped off.

I'm now supposed to tell them that I'm allergic to tape when I arrive for the graft, but I'm not entirely convinced that I'm allergic to the stuff, instead of just having sensitive skin that gets irritated by it. Anyway, I don't expect to have this "no tape" thing to have much of an effect on anything involved with this procedure beyond what they do to keep the IV securely connected to me.

As Janowitz posted, be sure you have the close monitoring set-up. I told all the nurses and doctors during my knee surgery about my OSA and reminded them to monitor the oxygen sats. They had a CPAP machine in the outpatient surgery clinic, but make arrangements to have your own machine ready, should you need it during the post-op care. The swelling and eating post-op is challenging for a few weeks. From the first procedure to the actual implants, was slower than expected, taking 11 months. Bottom line, I'm so pleased that I had these implants which have stabilized my entire mouth.

It's now less than three hours until my arrival time, and I'm starving. I don't know what it is about being instructed to have no food or water that does it, as I normally wouldn't have had breakfast yet, but both this time and last time I got the "we don't want you to misplace your stomach contents in your lungs" instructions, I've been hungry at times when I'm not normally hungry.

Still no specific pre-op appointment, but I did get quite the phone call at work a couple days ago. It was my student asking all sorts of questions, like what is my weight, what happened last time I was sedated, and when was my sleep study. No mention of bringing my machine, or even the space maintainer that I'll still need to wear that won't fit after the graft. I'm still planning on bringing both.

And the time frame that I was led to expect from first procedure to done is closer to 18 months (could be longer). Some of the profs are very conservative when it comes to healing (and bone making) time. I was told that the next stage will be in six to nine months, if nothing goes wrong.

Wishing you the very best in your surgery and and a smooth recovery. This will be behind you before you know it.
Take care and treat yourself with the gentleness you deserve while you deal with this surprise surgery.

Karen

More surprises to this surgery. They decided to place the implant today instead of grafting first. I still had enough bone, which had been suspected earlier, but confirmed after they got a direct view of my jaw.

I had the fun of being turned into a pincushion first by my student, then by the anesthesiologist (who almost called everything off on account of all the failed IV attempts). And of being used as an educational tool that shows what happens when the IV isn't actually in the vein. Wandering profs would pop in, occasionally replacing my student to stop or prevent any problems.

I just wish the anesthetic was still working. The area is kind of sore and stingy right now.

tetragon wrote:More surprises to this surgery. They decided to place the implant today instead of grafting first. I still had enough bone, which had been suspected earlier, but confirmed after they got a direct view of my jaw.

I had the fun of being turned into a pincushion first by my student, then by the anesthesiologist (who almost called everything off on account of all the failed IV attempts). And of being used as an educational tool that shows what happens when the IV isn't actually in the vein. Wandering profs would pop in, occasionally replacing my student to stop or prevent any problems.

I just wish the anesthetic was still working. The area is kind of sore and stingy right now.

Congrats on making it through.
The thing with the IV - I would have been freaking leaping off the table! Though I have gotten much better about needles since I have been giving Mom her insulin, the last time the dentist forgot to give me the little pill, I threw up on his shoes.

Teragon, that is great news that you have enough bone to immediately have the implants. For me, the bone graft was much worse than the implants and delayed the implants by almost a year. Best wishes for a quick recovery.

Hope your healing goes well with as much comfort as possible!

Now that it is day later, there is no pain or discomfort, just so long as I don't fully stretch out my tongue. The bigger annoyance is the full post-op routine. Antibiotics, vitamin C, soft food, and tonight I get to start using a special mouthwash.

In the phone call I just got from my student, amongst the usual post-surgery questions, I was also asked if I used my machine. What I wasn't expecting going into this was how it was with all the instructors, their query to my student (that they seemed to assume the answer to which was "Yes") of "Healthy?" would end up with a reply of "Yes, but…", and the resulting questions about what CPAP is like. I also wasn't expecting to be put on oxygen during the surgery. The oxygen didn't stop the oximeter from occasionally yelping in surprise and displaying a saturation in the low eighties, but repositioning its sensor did.