Not A lot Been Posted About Tooth Extraction.... TIPS? Thanks so much!

[rsacdoolittle]

Dad is 78, probably Stage 4-ish with Parkinson's. His family and his neurologist are still working on relieving the psychosis symptoms which began after an unplanned-for, emergency surgery on his broken ankle (fell while gardening). We now have printed handouts to give every doctor, nurse, or surgeon who sees our father... before we allow him to be treated by them . It's important for medical workers to understand the complexities of using anesthesias and pain meds and of making sure the PWP receives their PD medications on time, every time while in the doctor's office or operating room.

That being reiterated, our daddy needs to have a tooth extracted, so today I am looking for a local oral surgeon to do the job.....AND FOR PERSONAL EXPERIENCE. IF YOU OR YOUR LOVED ONE HAS HAD A TOOTH PULLED, DO YOU HAVE ANY GOOD IDEAS TO SHARE WITH ME?

Being he is a later stage Parkie we are worried about his ability to sit still, of needle going in wrong place due to his mouth tremors, of his being able or not to hold open his mouth... And his anxiety. (He does have a prescription for Lorazepam he can take if he needs it, and he does have "marijuana gummies" he could take.). Please understand if I seem to be overreacting about getting a tooth pulled. The hallucinations and delusions immediately following ankle surgery are very real to us each and every day! One encouraging word on this: neurologist took him FULLY off Pramipexole 2 days ago and is working him into an appt months early 🙂 just in case the stopping of that med doesn't do the trick at least for a while. He plans to try Dad on the controversial Nuplazid... Since it can't get any worse from here. THE HAPPY NEWS IS HE HAS BEEN MENTALLY MUCH MORE HIS SWEET, FUNNY SELF OFF THE REMAINDER OF THE PRAMIPEXOLE! 🤓🙏🤗🙌👏

Of course, I'll meet with the oral surgeon beforehand and make sure he reads all the pre-op, op, and post-op information for people with Parkinson's. Make sure he knows there are SAFER alternatives for anesthesia and pain.

Thankful too it's not a broken bone! 🤗

Blessings,

rsacdoolittle

[chartist]

The following systematic review and meta analysis may be of interest to you :

frontiersin.org/articles/10...

A relevant quote :

' Melatonin at dosages of 5 and 3 mg considerably decreased the risk of delirium in adults who underwent cardiac surgery, according to our results. '

Art

[rsacdoolittle in reply to chartist]

Thank you for posting the study, Art.

[Kat343]

I can't help you much with the drug issue for surgery, but I can suggest that you get a HIGH quality colloid silver spray and use it to prevent infection after surgery - several times a day is safe and effective. Also, please look into ozonated oil for that same thing. Look at Pur O3 - and do the research on their website - I am ordering the ozone suppositories for HwP to see if that improves him. Blessings and good luck!

[OLS3010]

Our loved one had to have 2 teeth pulled about 6 months apart. He did great with it. Only needed local anestnesia type shots in gum at the site to deaden it. We did none of the other options because we didn’t want to add to confusion. We did have some Seroquel just in case, but never used it. I also stayed in the room and talked to him regularly during the procedure but it went well and no issues afterwards. Good luck.

[Normanjean]

hi

Apparently most Anaesthetic's contain Adrenalin which for me makes tremor really bad tell the dentist to use an alternative

[gomelgo in reply to Normanjean]

You can ask for novacaine without epinephrine. I always got very jittery with it and years before my diagnosis asked to not have the epinephrine.

[kaypeeoh in reply to gomelgo]

Epinephrine keeps the novacaine on the nerve roots, where you want it. Without epinephrine the novacaine disperses before the dentist is done. Meditation can train you to not focus on nerve pain. It might still be there but if your mind is on something else, it doesn't register the nerve pain. Meditation is focusing on your breath and nothing else. With practice it gets easier. I went to a dentist and put myself into a 'meditative state' as he started poking and prodding with his sharp steel tools. My 'meditative state' was strong enough that it affected the dentist and his nurse. All through the procedure they were chatting constantly about her kids. Occasionally as he was prodding he'd say , "Oooh, sorry, that should hurt." I said no and he continued. It really does seem to work. The pain is not gone, but seriously "obtunded" which is just as good.

[gomelgo in reply to kaypeeoh]

Unfortunately not everyone is so disciplined as you when it comes to meditatioon. Some of us have a lot of dental trauma since childhood. Epinephrine is the ingredient that creates the adrenaline issue, and could make the procedure take even longer if one cannot control tremor. And then it's pure torture for all involved. I'm not advocating for anything here, just sharing information.

[Ripraniya]

Since your father is 78 yrs old, I don't think there'll be any problem removing a toothMy mother in law got all her teeth removed at 75 in order to fix a denture. She experienced no issues at all during the whole removal process b'cos at that age the roots are not strong and the dentist can handle the anesthetic injection aswell as the tooth extraction quite easily

So don't worry

You have mentioned that the neuro has taken off all the Pramipexole tabs. Was he taking only pram.... tabs for his p.d

[rsacdoolittle in reply to Ripraniya]

No, he is taking other meds and supplements, but Neuro removed any meds that might possibly be affecting him psychologically. Pramipexole does include this as a side affect.

[amykp]

There are places you can go to be sedated/anesthetized for dental procedures—my DH is an anesthesiologist and works at one. Most of his patients are children but he does get adults with disabilities.

Ask the dentist!

[gomelgo in reply to amykp]

People have gotten pd from being sedated. At least I have read about that.

[amykp in reply to gomelgo]

This is anesthesia with an anesthesiologist. But I've never heard of anyone "getting" PD by being sedated. With what? There are some specific drugs that can cause PD symptoms to worsen, but any decent anesthesiologist should know about those and avoid them.

My husband says: Knowing that? That's my JOB!

PS--You're right in that there may be some risk (not specifically PD) to people who work with anesthetic gases and are exposed, day in and day out. There might be risks to small children who need multiple long surgeries, whose brains are not fully grown. But doubtfully anything long-term for any normal exposure.

[gomelgo in reply to amykp]

I believe I have seen comments even on HU from someone who got pd after a surgery. Try searching for it. I believe it was a veteran and it happened at a VA hospital if I remember correctly.

[amykp in reply to gomelgo]

That could be, but there are over 300 million random surgeries each year, and over 600 million random people diagnosed with PD each year. If it happened once (or even twice) IMO it seems most likely a coincidence.

Either way, your husband is probably pretty safe (and maybe more comfortable?) if he chooses to go that route...as long as he has a qualified practitioner! And that assumes you could find a center. I don't know how common they are.

[rsacdoolittle in reply to amykp]

Nervous about anesthesia, because last time with a broken ankle when he fell gardening, it was after surgery all the nightmare of the cognitive issues/psychosis/hallucinations and delusions in which he often doesn't know Mom, his main caregiver and he even gets angry. THIS IS NOT HIM AT ALL.

[amykp in reply to rsacdoolittle]

Yes. That happened to my elderly mom (she doesn’t have PD). I think staying in the hospital makes it worse.

[amykp in reply to rsacdoolittle]

Also a longer procedure. Or, with PD, using the wrong drugs…which should never happen

[rsacdoolittle in reply to amykp]

Amykp trying to get it pulled with something safe for him. Getting info from ankle surgery surgeon on what exactly all was used

[ryzlot]

Has anyone got any experience with nitrous oxide?

[kaypeeoh in reply to ryzlot]

Nitrous was used on me once. It caused an incredible headache.

[gomelgo]

your dad is fortunate to have you

[tacato]

I second gomelgo’s comment. You are indeed a blessing to him. Would you consider sharing the “pre-op, op, and post-op information for people with Parkinson's” that you refer to? I am also looking at a procedure soon.

[rsacdoolittle in reply to tacato]

Tacato, yes of course! I ORDERED THE BOOKLETS AND PACKET FROM "THE PARKINSON'S FOUNDATION". Here are a couple links I ordered from (mostly free!):

parkinson.org/resources-sup...

parkinson.org/resources-sup...

Hmmm...Appears the physical kit you receive in mailbox is not available now, HOWEVER all except a couple extra doo-dads and a zipper bag ARE included... in the sheets you print out at home or at a print store. I purchased a few folders to store these in and keep them in a backpack, ready to grab whenever we are taking Dad to any kind of doctor or procedure. First thing we do now, is to hand them the information.

Yes, it appears the website and book cover(s) have been updated since I ordered a few months ago, but I am pretty certain this is it. I ORDERED THE PHYSICAL SAFETY KIT THAT ARRIVED IN THE MAIL. AND THE PHYSICAL BOOKLETS THAT ARE REALLY NICE AND INFORMATIVE, EASY TO UNDERSTAND AND IN LAY TERMS. For example, we ordered the booklets on Psychosis, Cognitive _______?, Mood etc etc. Ones more applicable to us currently. I also downloaded everything so I'd have it stored on my computer.

Some of the nice things included are cards to carry in wallet, magnet and lists to stick to anything metal beside a hospital bed for nurses and doctors who come into the room, print-outs to hand every doctor, nurse, surgeon etc., so that they have some quick information on PD. Things like the importance of receiving their meds on time, medications someone with PD should never be given, anesthetics and pain meds more PD friendly, a form to list of all your meds and personal information, so that you can have them packed and ready to grab inside a backpack....I'd recommend keeping one set of all your used prescription bottles and supplements bottles and take those with you in the backpack as well.

WE TRULY BELIEVE IF WE HAD KNOWN AND BEEN PREPARED, MY DADDY WOULD NOT BE IN THIS TERRIBLE MENTAL STATE POST-SURGERY. But he is being well-cared for and is still at home and sometimes he is "mentally here". We cherish these times!

Let me know if this info helps. Like I said the website has changed a bit last few months, so if need be I can take pics of what I ordered to compare and to show you what we did to "package" ours, ready to grab. REALLY LIKE THE THINGS WE ORDERED. THEY WERE ALL FREE from the Parkinson Foundation, except I believe there was a small fee for the physical kit (not papers to print off).

Blessings to all!

[tacato in reply to rsacdoolittle]

Thank you so much!!!

[rsacdoolittle in reply to tacato]

You're welcome! 🤗