Just wondering if anybody has experience of taking a small dose of lorazepam before a surgical procedure done under a local anaesthetic. I am having a MOHs procedure for skin cancer (bcc) on my nose in two weeks and quite frankly I am terrified.
the procedure involves taking layers and examining them until no cancer cells remain. Long waits in between and may take all day. Skin graft afterwards on same day usually.
Local anaesthetic makes me feel wobbly anyway for a short time, but they don’t use adrenaline free due to the nature of the surgery.
My cardiologist has suggested this med the night before and on the morning if the dermatologist is agreeable.
I'm taking flecainide ,bisoprolol, warfarin and levothyroxine.
I totally understand you can’t advise me yes or no, but I’m just asking for experience of using it to help me stay calm. Did it work for you?
I was in quite a state after the biopsy and it was nothing like this procedure will be. I guess it’s because it’s right under my eyes. On my face and the whole thing about somebody doing this to your face.
I'm already so anxious my heart is lurching about all over after a very long period of no issues at all.
I know it’s got to be done. There’s no alternative to local anaesthetic.
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Gilli54
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Sympathies on that. I had a BCC removed from above my right eye a few years ago. Looked a bit like Harry Potter for a few months but not noticable now, Never took anything so can't answer you question.
Yes. I think it’s the fact that the size of the BCC that is visible bears no relation to the wound site you end up with. I’m glad you have healed so well. 😊
Basal cell carcinomas are one of the least dangerous skin cancers to have.
My daughter had a BCC removed from her nose and a skin graft (think it was from her neck). that was quite a few years ago and looking at her now it's not what we notice.
Me - well I've had loads removed after biopsies .My latest one which I'm just just hoping will heal quickly is around from my leg shin and is like a crater (exaggeration) that needed a skin graft and is about the size and depth of half an apricot. I must admit on seeing it for the first time I was shocked. I've had about 15+ BCC's removed plus one that was squamous. Fortunately the two scars on my forehead are hidden by my fringe.
I've never ever thought about having any form of sedation beforehand, but I'm quite unusual in the way I think - I don't worry about what I can't change. I'm probably a bit too 'couldn't care less'. Have never ever been a worrier. I do understand though that some people suffer with anxiety and cannot help feeling that way.
I can't for the life of me see how it could possibly take all day to do your nose op, but different places sometimes have different procedures. The consultant who did my last procedure a few months ago had something a bit like binoculars strapped on. I didn't feel anything at all as she did it, in fact I've never felt any of the procedures, not even any soreness afterwards either.
I was once being driven home by a friend after having one removed and was wallowing in self pity. Then at the side of the road sat on a bench I saw a young man who had lost both legs from the knee down and he wore what I think are called running blades. My goodness I can't tell you how ashamed I felt of myself.
Sending you a big hug and I'm here for you if you want to 'private message' me at any time. I can also ask my daughter who had the same procedure questions about it.
Chin up, you will be looking back on this procedure one day. Plastic surgery these days is really quite amazing. a friend has had two little skin cancers removed from an eye lid. You would never know looking at her.
Take those tablets if you feel they will help you.
Aw thanks Jean. Really appreciate your reassurance. They’ve said that each layer removed requires a wait of 1.5 hours for results. So it can take several passes to get all the cells I am guessing. Then they need to do the graft.
Yours sound really extensive. The one on your leg especially. I hope that helps up quickly for you.
But the outcomes for your daughter and friend on the face seem very hopeful
I do feel like a wimp over this stuff and totally manage procedures and operations where a little bit of sedation is used it’s the cold, stone sober aspect of it that gets to me.
I think I would be ok if it wasn’t my face. It’s quite disconnected if it’s a part a bit further away from you. And it’s the worry of whether you’ll look the same afterwards if they need to remove cartilage.
But you are quite right. In the grand scheme of things it’s absolutely nothing. I need to give myself a good talking to and get hold of myself. I am very glad that it can be dealt with now and not left to become a problem in years to come.
Thank you for your sensible and sympathetic response.
Many years ago my mum had the same although back then they didn't test on the day; shed have to go back weeks later to have it done again to catch cells they'd missed. Much better that they now check it on the day. How did she look once it al healed up? Exactly the same as before. You couldn't tell she'd had anything done. It was on the top of her nose just to one side. All that was left was a faint silvery mark that you didn't notice.
Hi Gilli54 l have taken lorazipam for anxiety they just take the edge off and make you feel a little more relaxed nothing major like your in another world but it did help with my panic attack.
I had three prostate biopsies during the years. They were done with local anestethics. The procedure is quite scary for me (8 needle samples around your crotch). Each time I took 1 mg Lorazepam a couple of hours before the procedure. It really helped to keep me relaxed and feel the pain as tolerable. Always ask your doctor because what helped me is not what is good for you.
I believe that lorazepam is similar (in terms of being fast acting and quickly metabolised) to alprazolam, which isn't available in the UK but which many Americans take for anxiety episodes. It seems to be effective for helping some kinds of AF episodes, too, judging from responses on a US based AF Facebook site.
I take occasional diazepam (5mg), which is very similar (slower but longer acting) for muscle spasm in my neck and back. It does help a little. All of these are from a family called benzodiazepine drugs. They are generally not willingly prescribed as up to a third of people who take them regularly can become dependent on the drug.
I feel sure you will be fine with it. I think in the UK, lorazepam is only used in hospitals (or initiated by a hospital specialist). You might ask your doctor if you might try one before the day, taking it at night, in that case. That will reassure you.
I’ve taken alprazolam (similar drug, I believe) many times before procedures, with dr and/or nurse approval. Most recently with a very recalcitrant tooth being “jackhammered” out of my jaw. Certainly helped me stay relaxed and out of tachycardia. Good luck with the procedure!
I haven't had this procedure but I know of others who have. Try to focus on gratitude for this advance in medicine.
Your situation is quite different from mine in that it's a much longer procedure, but here is my experience with Ativan (same thing). I took it recently to help me through an MRI (I'm very claustrophobic). My doctor had prescribed it and I went to my trusted pharmacist for details and assurance a few days before. He suggested taking one two hours before and another about a half hour before. I had other ideas: letting staff know, and a plan to keep myself mentally focused. I think the Ativan helped, the staff had ideas, and with all of it I managed. We feel like whimps but they've seen it before. One doctor suggested I try one tablet a few days ahead of time, and maybe a second and see how it worked for me. I didn't do that but I don't know why you couldn't. It takes one unknown off the table.
You might also inquire as to whether you could take any more later in the procedure.
I will certainly ask about this option. Thank you. I can understand how stressful an MRI would have been for you. I am very grateful I can get this bcc removed now before it becomes a problem. 😊
I keep a few 2mg Diazepam around, mostly for dental work which I'm a total wuss about. Diazepam & Lorazepam are very similar, the main difference I believe being that Lorazepam leaves your system quicker that Diazepam.
Personally I find it very helpful to have something to take the edge off my terror! If your Dr is happy to prescribe it then you are free to use it.
Agreed. I just about manage the dentist by having my earphones in and listening to something distracting. But it’s a shorter period and I know much more what to expect. Also I know my dentist very well and have complete confidence in him. But it’s borderline coping!! If it takes the edge off it’s the way to go. Thank you for your reply and information. 😊
My husband had a Mohs procedure last year for a melanoma on his cheek, he was clueless as to what was going on, this spot was small and it was just something he mentioned to the dermatologist and she wasn't convinced it was anything, but it was! Anyway, he had the procedure, and had no idea what they were doing - it lasted six hours and he had 42 stitches in the Harry Potter zig zag style. Three months later you wouldn't have known. The surgeon was so skilled, there is a very tiny thin line across his cheek and I forget he had it done. He said it didn't hurt at all but he didn't know what they were doing, he was oblivious but a bit shocked when he looked in the mirror! I had offered to go with him but he told me not to as they were just taking a mole off!!
Lorazepam - my daughter takes it for blood tests and anything involving a needle. It works well at the right dose, otherwise she passes out, it is a huge problem for her and so I feel for you as I know what it is like to have anxiety around these procedures. It makes her feel sleepy though, however she takes quite a large dose to stop her panicking and she is not a big girl. She also takes propranolol for anxiety and finds that works well. I can't remember if she takes them together for needle things. You may want to experiment with dosing a few days before you go if you have enough to try. I don't know if you live in the US (easy to get here) or the UK (my mum has a hard time getting enough- she's dependent on them and has been for 60 years and if she drops one she is in trouble). Anyway, good luck, it should heal very nicely...
A one time use of Lorazepam will help relax you and help calm you and even make you feel a little sleepy. Your docs have guessed that you tend to be anxious and so the drug is so you won't react while undergoing the procedure. Any opioid taken as a one off should be quite safe; it's only when prolonged use over many months when it's addictive. Your procedure has been done on millions of patients worldwide. You will be fine.
Sleepy I can do. 😊 I think I’m going to go for it and be kind to myself in this occasion. And you are right. It is the gold standard treatment for bcc. It’s been used countless times and I’m hearing with excellent outcomes for the majority. Thank you for your reply. 😊
~Indeed I use 1mg Loraz. prior to minor procedures and did so when I had MOH's for a bcc temple area close to eye.
About to have more bcc's removed - again I will take the edge off with the Loraz. despite me not liking drugs very much. Would prefer to breathe my way through but not as good as I once was in achieving that result.
I would not hesitate for one moment - if it just gets you through a difficult time especially with ticker batting along at rapid pace, I would take it
Sending good wishes for a smooth yet gentle recovery ~
Thank you. An update is that my GP has prescribed 2mg of diazepam instead as she feels that 2mg of lorazepam is too high as a starter. So I guess that’s Valium by another name. The dermatologist has agreed for me to use it. So looks like I’ll be going with diazepam instead. 🤷♀️
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