HangingByAThread

Local Anesthesia and being Hyper

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I'd like to hear back from folks who have had the sjogren's lip biopsy.............were you able to tolerate the local anesthesia?  I was seen at Johns Hopkins and was told to come back for the lip biopsy.  Only problem is that I haven't had local in ages.  About 8 years ago (before all my issues started) I had a very bad time at the dentist having a filling (my heart was beating out of my chest and I got very panicky).  Since then, I've had my next two fillings without any medication whatsoever (the pain wasn't a problem at all for me).  The doctor wants to use lidocaine and epinephrine.  I'm thinking the epinephrine is a no-no (I can't even tolerate caffeine) but am not sure about the lidocaine.  I know I'm being a baby about this because I've been through a million other tests without any issues but I'm absolutely terrified about having the shot and totally losing it.  An ENT will perform the biopsy and they don't put people on heart monitors or really monitor your vitals.

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You are correct about the epinephrine, my neuro told me absolutely to never have that.  I have used topical lidocaine with no problems but don't know about injectable.  Sorry.

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I'd be really hesitant about the epinephrine, especially since they're not monitoring your vitals.  I've never had a lip biopsy, but I was under local anesthesia when I had my port put in a few years ago. They used topical lidocaine which was ok because it didn't go directly into the bloodstream. They told me the epi was mixed in with the lidocaine. I also avoid the anesthesia with epi in it at the dentist. Maybe you can talk with the ENT to see if they have an alternative anesthesia without the epi? I'm sure they've had others who can't tolerate it so hopefully they'll have something else on hand. 

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Are you me?? Literally have the same story as yours. You can always get the injectable lidocaine WITHOUT epi IF you warn the techs beforehand! (Topical lido without epi is also an option, but takes awhile to kick in and may not be as effective as the injectable)

Keep in mind, though, that you may experience prolonged bleeding from the site of the biopsy. I just had a skin biopsy yesterday, requested lido without epi, and my neuro warned me that I might bleed for a little longer than most patients. Apparently the epi helps speed up the clotting process, which is why it's used a lot in dental work. Who knew! 

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I have had this experience with both a skin biopsy for skin cancers and at the dentist office. I always tell them no epi, the plain lidocaine works fine. My dermatologist is very understanding of this, and it is no problem. The dentist, well, he gave me the epi after I told him I could not tolerate it and I thought my heart was going to beat out of my chest! His partner I saw the next time, and he had actually heard of pots and knew about the symptoms, and only used lidocaine. My PCP said just always remind them to only use lidocaine. Oh, and by the way, yes, it does not help control the bleeding as well, but still seems quite ok, and for sure preferable:)

My daughter suggested I list epi as an allergy!

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