Probably most dialysis patients don’t even tell their Neph they’re going to the dentist…do you?
I tell my Neph about what’s going on and he does give some tips…things like use very little heparin, or use saline flushes…also, says that we have to take antibiotic or bacterial medicine one hour before dental work…espcially, if patients are vulnerable to infections and have artificial limb implants…
This is news to me too but I will certainly mention it to my neph. The only restrictions ect. I have is that with a leaky aortic valve I must remember to take my antibiotic prior to dental visits. Too much lidocaine will also cause my heart rhythm to act up. Lin.
Gus wrote:
Probably most dialysis patients don’t even tell their Neph they’re going to the dentist…do you?
I tell my Neph about what’s going on and he does give some tips…things like use very little heparin, or use saline flushes…also, says that we have to take antibiotic or bacterial medicine one hour before dental work…espcially, if patients are vulnerable to infections and have artificial limb implants…
We have always consulted with the nephs before putting any drug into body or any medical/dental procedures. Have no idea what other patients do. Maybe most patients don’t even go to the dentist? Nevertheless, nephs should guide patients on concerns should they go to other doctors who may not be familiar with special needs of kidney patients.
Nephs have told us that heparin is completely out of the system in a couple hours so any dental work on off day shouldn’t have any effect. We had one dentist who refused to extract a tooth as he was afraid of bleeding due to heparin. He wanted a signed release from our neph. Our neph laughed insisting heparin is gone long before the next day. So, our neph never said to cut down on heparin or use saline flushes before dentist apointments. Nephs did say to take antibiotic one hour prior to apointment.
Probably less than 10% of what we know about my husband’s kidney disorder and treatment, dialysis access and treatment, we learned from his Neph. :evil:
More than half of each appointment is spent discussing what we have learned elsewhere. Generally he confirms that what we have learned is accepted as true, has been proven accurate by medical studies, or has anecdotally been demonstrated to be true/effective. If we waited for my husband’s Neph to “guide” us, my husband would be in serious trouble.
Internet access appears to be the only way to get the information we all need. The differences in the medical care my husband has received in the past year because of Internet access, would already fill a small book. We are so thankful for those who were unfortunately the guinea pigs, who learned by trial and error, and are kind enough to unselfishly pass along their knowledge. Of course, it goes w/o saying that those who manage the boards are our heroes as well, and far more valuable as a “guide” than his Neph.
I’m not sure how this heparin thing came up, but the half life of heparin is pretty short in the context of dialysis. On conventional hemo and on nocturnal hemo, at the relatively small doses used, it’s pretty much all gone after an hour (and by this, we’re talking about the anti-clotting effect). This is why we stop the heparin pump one hour or a bit more before the end of treatment. This is plenty of time for the anti-clotting effect to be gone so that you don’t bleed after holding your sites for 10 minutes. If heparin lasted much longer, you would just continue bleeding.
A practical example from my own experience is that one night a couple of hours into nocturnal, I woke up with a nose bleed. I managed to continue my treatment by stuffing a gauze in there after stopping the heparin flow for one hour. After the hour, my nose wasn’t bleeding anymore, and I restarted the heparin and I finished my 8 hour treatment that night without any further incident.
Pierre
Lorelle wrote:
Probably less than 10% of what we know about my husband’s kidney disorder and treatment, dialysis access and treatment, we learned from his Neph.
Lorelle, we hear ya! Would be interested to hear how supportive others’ nephs are. We have had numerous nephs to this point and they have all been about the same. They are never forthcoming with information/education unless we ask. And even then, they don’t really expand on what we’ve brought to them. None have been confident educators. They go over labs so quickly they miss things, don’t check reports sent to them from our other doctors, don’t know the latest info on home programs, we’ve had to remind them where we left off with our issues- it gives one a really bad feeling that they are not really looking out for our welfare. A nurse told us that with one of our nephs his desk was so piled up that his secretary would tell him what order to handle things :evil: :roll:
Personally, if someone does have a great neph who educates, we’d love to hear about it. We have no idea if our nephs are knowledgeable and up to date since they don’t share what they know. But we get the feeling they are neither, and like you Lorelle, we owe everything we know to the net patients and moderators and a few staff who educate online from time to time. It is good that if our nephs aren’t forthcoming, somone else’s neph across the country or the world may of educated them and they are on the net to share what they found out. But of course, this is a strenuous way to get info. How great it would be if there was a hotline where we could get solid answers to our questions…
http://www.nocturnaldialysis.org/
Prof John Agar is my idea of a great Neph, as I have already mentioned on other posts! Even though he lives the other end of Australia to me, I have had the pleasure of emailing him and hearing him talk at conferences and he is has been a total inspiration to many. I believe he should be in the states around now.
I have had 3 very good Nephs (had to change each only because the of the tyranny of distance ) It takes a lot of work on both sides to build up an empathy and get your Doc to really work for you. But it can be done, keep asking lots of questions, keep them on their toes. I find now I am on dialysis, my home training nurse also is working for me and keeping the neph on their game and if the nurse isn’t I would make sure I remind him/her that I am still out there! 
Reading over this thread, has anyone else had any wisdom teeth out? Wondering what method you used?
Gus,
We called an oral surgeon’s office and spoke to the nurse to see if they used the local anesthetic procedure without needles that you spoke of in your previous posts. The nurse said they use a topical anesthetic for the top layer, but then they give a needle to block the nerve along the jaw. She said they do not have a needleless procedure in this city that she’s ever heard of. Would it be possible for you to ask your dentist/oral surgeon what the name of the procedure is? The nurse said they would be interested to know what it is as they might be able to look into it.
If I get a chance I will ask…while there I should have asked…ugh…
gus,
If you are busy if you could provide the tel# I could call myself.
Sorry, but for privacy matter I can’t…just be patient while I get a chance will you? :roll: …somehow the procedure in faded sense is Needleless something…
EDIT: They used a needle like tool that looked like a needle, most likely it was a jet stream and no needle at end…here’s a page.
The American Kidney Fund used to have a booklet for dialysis patients with advice about the dentist, but apparently this booklet is no longer available – or at least it’s not on the AKF website. I found this information from a Nebraska dental provider about things to consider in providing dental care to dialysis patients.
http://www.dentalgentlecare.com/renal_-oral_health.htm
This is a really interesting device. Is this the exact device you experienced or something like this? Is it anything like a lazer?
My goodness, Beth- do you have magical powers? You are like a magician who can pull a rabbit out of a hat lol! I’ve never seen any info like this before on dialysis and dental. Will certainly read it first chance I get tomorrow, thanks
I had my wisdom teeth removed. They tryed with gas and local and could not get them out. I blacked out and when I came to my mouth hurt so bad I thought they had got them out. they had to put me under general to get mine out. One was impacted( I still have a hole there) the other two were normal. the problem with mine was the roots went out all over the place. When they pulled them they broke up all in my gums. It was annoying cause I would feel something in my gums that felt like I had been eating popcorn. I would work around it with my tongue till it came out. Shards of tooth!!!@?!@$@!!! I hate dental work, I hate needles and hospitals. Why am on dialysis anyways?? O’ my kidneys don’t work- DARN IT!!!
LSB
There is loads of dental info for renal patients in Beth’s linc and I went to Google and found that there is loads more under “oral health and renal patients”.
Exact device, I really don’t recall…but it must have worked the smae manner and its not like a laser…it merely shoots a high pressure stream of medicine into the gum area…
