Archived from Original Forum -  starflower author



Hi Melissa,
That sounds either like a true allergy or like a reaction to the epinephrine which is often used along with injected numbing agents (lidocaine, novocaine, etc...).  If you ask in advance, it is possible to get the injection without the epinephrine.  If that doesn't solve the problem, you could try one of the less common alternatives like bupivacaine.  Here's a nice little article about it:  http://allergies.about.com/od/medicationallergy/a/localanesthetic.htm


Heather

Archived from Original Forum  -   sandi author

I've had a weird non reaction! Novicane had no effect on me! When I was little I had to go get some teeth pulled and they kept giving me shots and I would wince and they'd give me more, call me a wimp and tell me to sit still there was no way I should be feeling anything. I'd violently throw up afterwards. When I had my first child during the episomoty they were stitching me up and I kept twitching when he'd insert the needle, he'd give me another shot and started getting frustrated with me, and told me no way could I feel it, I told him well I just went through labor without any meds because I was afraid of reacting or my baby reacting so are you calling me a whimp buddy? Then a couple of years later had my Daughter and same thing during epiosimoty new doc starts the drill and I'm trying to be as still as possible, she tells me Oh you are one of those, I've heard of this, some people Novocaine has no effect on, I bet you hate the dentist............... I need moles removed, skin tags and I've reacted to so many medications, I'm afraid to every try anything again unless I really have to! Dreading the epi pen also due to the suflites! I heard that the ER's may have the sulfite free, but not for "public use" do to inablility to remain stable due to temperature/light etc. We will have to stay on top of that! The shots probably have all sorts of things we react to in them! Phenols are another preservative base, that makes me crash bigtime. I've been injected for so many things and literally within minutes ran throwing up in the dr office/ w diahrreah and the area swelling huge, and yep gastro anaphalaxis probably in doctors offices and they had no clue! Makes me crazy now to know that even two benadryls before trying something like that could have helped it not get so bad! Thank God I survived those episodes! Who knows what would happen now!

Archived from Original Forum -   deborahw author



I thought everyone used lidocaine now. They even use that for BMBs. So, anyone needing things done, give that a try. Dr. Akin had told me it wouldn't cause a reaction and we was correct in my case, at least!

Hi. I just had a nice reaction last week when I was getting a cortisone shot. They used lido/depomederol. It was my second time so I thought i was safe. I didnt have time to pack lunch so I bought a tiny 2 meatball sandwich from Wawa- no cheese of course, no extra sauce. Between those two things I had huge red circles all over my neck and a huge stripe down my chest as well as a million spots-I have UP- all over my face and neck. So much for sparing the face right? Thankfully a benedryl helped. Maybe I need to premed for that kind of stuff

I had tremors and a racing heart rate in the dentist's chair a few years ago.  That was one of my first clues to this mast cell problem.  We thought it was the epi, so from then on I then had shots without it, but a year ago I reacted to the lidocaine without epi.  I need some dental work done now and don't want to do it until I see Dr. Castells in April.

Come to think of it, I had surgery on my nose as a teenager & I went into tachycardia from the "twilight sleep" local they were using.  The anesthesiologist didn't know what to do.  Afterwards, no one ever did anything about it.

It seems that our bodies are reacting to these shots as if to poisons, because they really are very toxic to us.  I feel as if my body is in a chronic state of fending off the next toxin.  So odd, when I see people every day who are overweight, smoke & trot off to Wendy's for lunch, yet they don't miss a day of work.

Sorry that happened to you and her!  That does sound scary!  It's hard to know whether it was the lidocaine or a preservative or other additive in it.  It could also have been from stress, as that's a common trigger and one of the worst.  Then again, it could have been a combination of all of those.  I would recommend finding out what all the ingredients were in the lidocaine.  If it was just lidocaine then you know for sure.  If not, you might have a few things she should avoid in the future.  Glad she's okay now!

According to Dr. Escribano and his REMA protocols which we have posted here on the site,
http://mastcelldisorders.wallack.us/yabb/YaBB.pl?num=1293571751/4#4  we do have to be careful with local anesthetics.    And according to his protocols, amide-derivative group of anesthetic is safest.     "4.6. Local anesthetics¶: Exceptional using amide-derivatives "


Now when Dr. Escribano states "Exceptional" he is saying that while using the REMA protocols it has been exceptional when a patient has reacted to amide-derivatives.   In other words, it is extremely unusual that a patient will react to this while using his protocols.


I've spoken with Dr. Ecribano regarding these protocols because I translated them into Portuguese for him.   He explained to me that this use of the word exceptional is in it's classic form, meaning highly unusual.   Also, because I am a rare case and have severe reactions to procedures and such, in trying to find out why I would react when most masto patients would not I found out what he meant by this:

"¶No adverse reactions were recorded in 850 bone marrow biopsies and 1,235 cutaneous biopsies. In these cases, adequate premedication was used (REMA, unpublished data, 1984 – 2006). In 8 cases with previous history of anaphylaxis induced by stress, the bone marrow biopsies were performed in the ICU with premedication, local anaesthesia and sedation (CLMast, unpublished data, September 2010)."



According to Dr. Escribano there is a group of us patients who are extremely sensitive - that our systems are extremely sensitive and we will react to things which stress our systems.   He calls this "Stress Anaphylaxis".   This means that mediators coming from our stress system will trigger us easily.  So, the physical AND/OR emotional stress of going through a BMB or sitting in a Dentists chair is enough to trigger anaphylaxis.   For those of us who have this tendency, we should not do procedures outside of either the OR or the ICU!   We MUST be premedicated prior to the exam, we need to have an anesthesiologist ON HAND overlooking the procedure, ready to jump into action should the patient begin to react.   The patient should be sedated as well as premedicated.   This is what the protocols require for this kind of patient.

This doesn't mean that you are "overly anxious" or "overly emotional" and I just went through an MRI with an anesthesiologist ON HAND, hooked up to the machines and monitored.   I did not have sedation for the anesthesiologist saw that I was calm and doing well and since I don't do well with those meds, we felt it was better.   However, I did react to the contrast about an hour following the exam.  But during it, for the most part, I was fine.   I knew that the doctor was on board and that he was understanding and that everything was going well.   And when he saw that I was having some trouble, later on, after the exam was over, he even stated that the trouble was not emotionally created.   It was created by having to hold my breath repeatedly, that this causes me to faint.  It was a real victory for I finally had a doctor seeing all of this going on, seeing that it was not emotionally caused and that it was having to hold my breath which was the problem here.     But, I was in a perfectly safe situation, in a hospital and with an anesthesiologist ON HAND ready to take action in case I got into trouble.   This is how it should be done for those of us who are this sensitive to exams.  

As to dental work, the last time I had any done, it was in the OR.   When I had my BMB it was in the OR under general anesthesia.  My other procedures are done the same as well.  


I am sorry for your having reacted to the local, but perhaps you are a patient, like me, who goes through Stress Anaphylaxis.


I hope this helps.

Lisa