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Allergic Reaction To Local Anesthetics


Tessa
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Dear friends

I had, what was stated by my the doctors at the ER, as an allergic reaction to an injection of a local anesthetic in 1998. I never thought this could be important, but after I told my dentist last month, she said that knowing my medical history, she had already changed the local anesthetic to a new one, known to provoke less reactions... She seemed to take it as something important and I have been thinking about it for a few days.

I have been surfing the net and found the following:

A patient states "I'm allergic to Novocaine." When questioned further, he describes his experience as "shortness of breath, palpitations, cold perspiration and fainting for a few moments." From this information the dental hygienist should suspect that the patient is

a. a drug addict

b. apprehensive about receiving dental care

c. likely to experience anaphylactic shock if injected with Novocaine

d. suffering from an undiagnosed systemic disturbance and should be referred to a physician for consultation

Also, you need to determine the precise nature of the drug allergy, since "novocaine" is often misused as a generic term for any topical anesthetic.

According to the ER report and from what I remember of my reaction, it seems that it was a kind of anaphylactic shock, which could have been very serious. No wonder that the doctors runned from one side to another while I was taken to the ER in a hurry...

On the report was written that I had to be controlled by my GP and therefore, I should have given a copy to him - but because I felt much better afterwards, I included the document with the rest of my medical reports at home and forgot telling him.

Now I am worried about this, thinking that it could be important in the future. It was not easy to make myself understand at the Dentist when I mentioned that I once had an allergic reaction to a local anestetic... What If I have an accident or need to undergo a surgery. I have no idea if I would stand the anesthetic... What if my reaction is worse? And how can I tell the doctors the kind of anesthetic they can use?

Should I ask my GP to send me to a person specialized in allergies in order to determine the seriousness of my reaction and the anesthetic I am really allergic to, as well as the ones they can use... ? <_< Or do you think he will answer that it happened too long ago to check it now?

BTW, I got the injection in my neck (on the left side) and it was: Novocaine and Celestone.

My reaction was:

Tachycardia (a rapid and irregular heart beat), sensation of warmth, confusion, dizziness, accute chest pain, pain while breathing, difficulty breathing and sudden collapse=Loss of consciousness (could be due to a low blood pressure).

When I recovered:

I was at the ER in bed and wondered how I got there, because my husband and me were at the information desk of the Hospital (at the entrance) when all this started.

On the Medical report:

I have noticed that the pulse has been modified. Another pulse was written first and the figures have been changed on it. Of course, these are not the ones I had when I had the syncope but must be the ones they measured when I regained consciousness.

TA appears as 90-60 and pulse is written as 69 (but as mentioned before, a lower figure seems to be written below).

Possible cause:

I had been suffering from shoulder pain. When I got the injection at the specialist?s room, he did not explain what he was going to inject. It was all done at once, and my husband and me were astonished when he injected it in my neck. He did not explain what it was until later.

Therefore, when I had the reaction later while at the information desk and my husband called him, he rushed to me and took me to the ER in a hurry. (I had already collapsed when I reached me). I was told that he was pale and extremely worried...

I do not want to blame the doctor for it but need an answer to a possible dangerous situation I can have in the future.

Thanks in advance for your answers,

Looking forward to your comments

Please, feel free to ask and express your opinions.

Love,

Tessa

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Tessa,

first, you should be wearing some kind of medical emblem, engraved that you are allergic to medication, either as a necklace or bracelet, so that should you need emergency help, they know to get more information before they do anything that could harm you. Some people engrave their's to say "look in wallet" or "look in purse" for an information card.

Personally, I NEVER leave my home without my MedicAlert bracelet on my left arm, and I keep the MedicAlert company up to date with my allergies. I wear the bracelet on the left arm b/c it's often the left side of your body that's closest to emergency personnel if you're driving a car, or if you're lying in an ambulance. If I'm home alone, the bracelet is ON. If Teri's home, I will sometimes not wear it b/c she knows my entire medical history and has legal medical power of attorney should i be unable to make decisions.

The doctor is unlikely to have done anything wrong, especially if you hadn't ever had a reaction like that before. My first major allergic reaction that sent me into shock was AT THE ALLERGIST's office, just after getting my allergy shots. I had been increased from the lowest possible titer of allergen to the next lowest... and a half hour later, I was disoriented. I was checking out, paying my bill and the nurse looked at me and asked if I was okay because I looked pale. I was insisting I needed to go home and tried to open the office door to leave, but my vision went at that point.

I will say I was semi-conscious--I could hear what was going on, but couldn't respond. The nurse actually caught me before I fell down--and she and the doctor dragged me back to a room and I got several shots of epinepherine and benedryl--a set in each arm since the allergy shots were given one in each arm (different allergen in each arm). Two weeks later it happened again, this time at the lowest titer of ragweed. That was the end of allergy shots--and the start of a strange period of years where my body over-reacted to any medication I swallowed (Mkoven, if you're reading this, I know it will sound like your long lost twin). I now have a list of medications that I can't take that is very long--and leaves me with 2 antibiotics that don't set off a reaction. BTW, I had a 3rd, then 4th anaphylactic reaction -- both in the hospital on IV antibiotics (vantin and vancomycin-say "hello" to the crash cart) for various reasons.

I see an allergist who is simply awesome. Unfortunately, it's very difficult to test for medication allergies; one of the only ones they could test me for was penicillin, but before I could have the test, I had a terrible reaction to Augmentin, in the cillin family, so the allergist said not to bother spending the $ on the test, I now was known to be allergic to it based upon my body covered in hives. If you do a search of previous posts of mine, I list out what he's told me to do; the short version: I keep benedryl in my purse all the time, and at home, I keep a medrol pack and a box of zantac, along with some big bottles of Sarna lotion for the hives.

Nina

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Tessa,

I second Nina's advice (indeed, long lost twin!!!!).

I would get referred to an allergist who can help to determine which agents you are reacting to.

I also keep a supply of benadryl (diphenhydramine, in case it's called something else in Spain?) and 2 epipens in my purse. I've never had to use the epipens, but it gives me peace of mind. My husband justifiably gets mad at me if I forget them.

I'm not good about wearing my medicalert bracelet. I don't have a good excuse...

For some reason (knock on wood), I seem to tolerate local anesthetics. I hope that continues.

But I have allergies and/or other adverse reactions to 30 some drugs. Though I've been told I tend to react to meds that are considered high-allergy potential-- mostly antibiotics and pain meds, with some others thrown in there...

So, I would definitely ask for a referral to an allergist. If they test you, they are fully equipped for any reaction. They may also be able to do blood testing, which is safer, though some dispute if it's as sensitive.

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Hi Tessa,

You've already received some excellent advice. I agree that a consultation with an allergist for allergy testing is in order. One other thought is that the injection that I assume you received as an analgesic treatment for a painful shoulder likely contained a high dose of the two medications, whereas in the dental office, they use a significantly smaller amount for anesthetic purposes. Of course, if you do have a true allergic response, the amount of substance may not matter that much. If you suffered a vasovagal syncope and reaction that is NON-allergic, however, then you may have no problems with dental anesthesia even though you've reacted poorly to the shoulder injection. In any case, an allergy testing for novocaine/lidocaine would differentiate whether you have a true allergy to that anesthetic or a non-allergic reaction. Hope you get answers soon to alleviate your worries. By the way, as you stated, I would not blame your doctor for injecting you with these drugs, but I would expect at least a short discussion about possible side effects from any physician who either gives you a prescription for a new medication or injects medications in the office.

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Hi, Tessa:

I don't have much to add, but I wanted to say "Hi." :)

I've seen people have allergic reactions, and they can be quite serious. My poor cousin used to have horrible allergies to cats that sent him to the emergency room many times. This is probably something that should be addressed as a priority. Also, I wouldn't hesitate to talk to your doctor about it even though it happened a while ago. A good doctor will be glad you brought it up!

Having so many symptoms plus memory difficulties = me always forgetting to tell the doctor about something. <_< You're not alone in that club.

I hope you are doing well!

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An allregist will help determine if you have an "allergic reaction"---------------or your having an adverse reaction for some other reason.

In my case I had systematic circulation of the lidocaine. The doctor inserting the cardic loop recorder used quite a lot--I had several injection points. He had my best interests at heart----he did not want me to have any pain. I requested only local anesthetic without epi, and no sedation drugs. I have such adverse reations to many drugs, and I was afraid to use them.

Considering I only had local anesthetic I was free to go after the procedure. However, as soon as I got to the cafeteria I felt the blood drain out of my face, I got dizzy, couldn't feel my body, and soon after that I was having tremors, tachycardia and nausea. I was so disoriented I sat by the bathroom by the gift shop in the hospital because I thought I was going to throw up any minute. How dumb was that, as this bathroom only had one commode----------what would I do if it was occupied??? <_< I didn't want to go to the ER-----I thought they wouldn't believe I had a reaction to local anesthetic, and they would just make me worse.

I ended up hanging around the hospital until I felt safe to go home. I had the symptoms for atleast 8 hours-------the worst of it being the first 4 hours. My mother in law came to the hospital and sat with me because my son had to go to work. One of my POTS friends talked to me to help me keep my sanity until my Dad and husband got there. I ended up having a pretty bad set back with my POTS.

I fractured a molar recently, and now it has to be pulled. I'm very scared because I have bad instability in my neck/cranium area along with an unstable jaw-------and of course my reactions to local anesthetic.

Did you know that if you use lidocaine without EPI that the dentist or physician should use less lidocaine? The EPI is a vaso constrictor, and it prevents inadvertant systematic circulation. If EPI is not used they have to be very careful not to overdose and cause any adverse or toxic reactions.

My EDS doctor said I'm likely having systematic circulation of the lidocaine due to the EDS--(I'm not holding the lidocaine in the tissues, and it circulates into my vascular system too quickly because I also have vascular involvement from the EDS)---------------giving symptoms of overdose/toxic reactions.

The oral surgeon I consulted with is having my see an allergist first to rule in or out any allergies.

Maxine :0)

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Hi Nina, :)

Thanks for answering to my "toc toc". I know that you are always prepared to help. And I appreciate it.

I just tried to get some attention on my previous questions :blink:

(..) Mkoven, I thought that these kind of tests used a small amount. What if the amount is too small to cause a reaction? Do they increase the amount? Do they only check the drug you suspect to have an allergic reaction to or do they try others too?

What about the drugs I am taking for POTS, is it possible for them to avoid a reaction at the allergic test?

...

I hope you do not mind me asking... So many doubts...

Thank you for caring about me,

I am going to ask for an app with my GP next week. I need a blood tests done and I will ask for an allergist too.

Regarding the blood test, my husband and me suspect that I might have hypovolemia, because of all the reactions to blood tests and symptoms... Therefore, I wonder if I could ask something to feel better after the blood test... What do you do after a blood extraction? Even though it is supposed to be a low amount of blood, I always feel sick for the rest of the day, dizzy, chest pain, nauseas, headache, etc.

Is there a special test to determine if I have hypovolemia? Is this test accurated?

Thank you for your support and help

Love,

Tessa

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OOps, I changed the previous post instead copying it and adding a reply ;) (It seems I was more lightheaded than I thought)... :lol:

Hi Nina, :)

Thanks for answering to my "toc toc". I know that you are always prepared to help. And I appreciate it.

I just tried to get some attention on my previous questions :)

(..) Mkoven, I thought that these kind of tests used a small amount. What if the amount is too small to cause a reaction? Do they increase the amount? Do they only check the drug you suspect to have an allergic reaction to or do they try others too?

What about the drugs I am taking for POTS, is it possible for them to avoid a reaction at the allergic test?

...

I hope you do not mind me asking... So many doubts...

Thank you for caring about me,

I am going to ask for an app with my GP next week. I need a blood tests done and I will ask for an allergist too.

Regarding the blood test, my husband and me suspect that I might have hypovolemia, because of all the reactions to blood tests and symptoms... Therefore, I wonder if I could ask something to feel better after the blood test... What do you do after a blood extraction? Even though it is supposed to be a low amount of blood, I always feel sick for the rest of the day, dizzy, chest pain, nauseas, headache, etc.

Is there a special test to determine if I have hypovolemia? Is this test accurated?

Thank you for your support and help

Love,

Tessa

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Thank you, Michelle :)

I am sorry, I think I am feeling a little down these days, because I am feeling extremely tired very often and my bp is stuck at 80-40 for 3 consecutive weeks. :lol:

Furthermore, I am with the period & having many blood clots coming out.

Added to our suspicions of having hypovolemia, the period is not helping too much...

I would say that the Licorice Root treatment has stopped my bp from going down and keeps it at 80-40 but it is not going up and we are starting to be a little worried. I do not think that it is healthy to have it so low all the time.

At 80-40 as a baseline it easily goes down only by cooking, with higher temperatures, etc.

;)

I am missing words to express how frustrating I feel.

I do not know what to do. I am afraid that I run out of ideas.

:)

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