Myasthenia Gravis Support Group

Hi all, lots going on so havent been around. Eyes are worsening. Hard to see well enough to be online. But need your help today.

I am to have surgery to remove 3 teeth due to my sjogrens. The oral surgeon is going to give me IV sedation so I need to fast for 6 hours before the surgery. I didnt realize this at the appointment tho I dont see him as having the answer. I dont want him to not do the sedation. I personally cant take mestinon on an emty stomach. That alone would make me vomit.

Have any of you had surgery with IV sedation and how have you and your docs handled your mestinon or generic version of.

Annie the Treelover

Greetings Treelover Annie,

As a MG patient and also a non MG related illness patient, I have recently spent approx. 30 days out of about 90 in the hospital. Most has been for a non related MG illness but because of my MG have been treated medication wise in two different ways.

Upon going in the hospital I made it very clear to the staff about my MG and how no matter what I take my Mestinon at regular intervals. As a matter of fact when I'm home I even set my alarm to get up and take it in the middle of the night. And it's usually taken at that time on and empty stomach. Mestinon does not have the sick feeling for me that it does for some. But also being a diabetic I usually take a couple crackers in the middle of the night also with it.

When I have been in a poorer medical condition while in the hospital, they have given me the Mestinon in my IV drips so that took care of that.

As far as fasting, (and I'm not any kind of expert at all) I've had to have blood work done alot over the past 6 months where fasting was required. But me also being as stubborn as I am about making sure I still continue to take the Mestinon at the regular times I have still sneaked a cracker or so right at the time I have taken the Mestinon even if it is just a few hours before having any work done.

I'm not sure how much or what you would need to do but from my own past experiences I would suggest taking or have a couple small crackers to maybe help with getting sick from taking Mestinon on the empty stomach.

Also, I'm not sure about your situation in regards to any kind of sedation and having MG, I do know there are simple sedations, anesthesia, medications that can have a very strong effect on your MG and some can even set a MG patient into a full blown crises. I have no idea if any sedation that you might be going to receive for this upcoming surgery would have any effect on that, but I would suggest you make absolutely sure that this doctor is aware of this before administering any sedative.

Hope this may be of help in some small way.

Best Wishes & Good Luck

Stay Well

Hoz

Hello Annie and Hoz,

Hoz said, "... but I would suggest you make absolutely sure that this doctor is aware of this before administering any sedative..."

"ABSOLUTELY!"

As to the fast, it is vital that your stomach is empty, if that's what they've requested. They'll usually allow only a tiny sip of water, if you have medications that MUST be taken. If you vomit, as some people will when anesthetized, it could aspirate into the lungs, leading to pneumonia. You must discuss this with your doctor, and I would advise, if it is safe to do so, that you not take anything without discussing this, prior to your surgery.

I did not take mestinon prior to any procedures (even in my very difficult times) as it just seemed to, and continues to, work better for me without it. This was nothing more than instinct, and it works.

I have as yet, not had any difficulties with any anesthetic. My personal favourite is propofol. Ring any bells?

Hoz, if I catch you nibbling on crackers, without a go-ahead, I'm telling...'cuz now I know where you live!

McCanada, But what about my breathing? It isnt my arms and legs I am as concerned about it is my breathing. I need the mestinon for my breathing. I assume but am not sure of course that if you do it this way with no mestinon your breathing is not as involved yet in your MG.

Certainly tho I am on the heavy side and dont want to fall like I did last time after surgery taking my daughter with me cause I was so weak and unsteady. I had surgery in January. By luck it ended up that way and by January I am better somewhat from the months of cold winter. But I get worse in summer and am worse this yesr anyway. If I didnt have to do this now I'd wait but I need to get these 3 teeth removed. It has waited already too long.

Annie the treelover

annie, mgcanada is right you don't need to have ANYTHING in your stomach prior to surgery. i recently had a colonoscopy and received iv sedation. i am not on mestinon but am on imuran and did not take my medication that morning, they did suggest to bring it with me and as soon as i woke up and if i COULD take it as soon as i could. upon waking up they did have to remind me to take deep breaths cause the o2 monitor was reading low cause i wasn't taking deep enough breaths. once i woke up good there was no problem. yes mgcanada propofol is great had it when i had my knee replacement.

hope all goes well for you annie.

quilter

LOL Quilter, It IS good stuff!

Hello Annie,

It's my understanding that you've been without mestinon on occasion. You'll need to rest for a full 24 hours, prior to your procedure. Talk to your doctor about possibly putting a 1/4 tablet or 1/2 a tablet, under your tongue, about 15 minutes before your procedure. Anyway, Annie, this particular issue is your doctor's call. Don't take any risks.

As well, don't let them send you home until you feel safe in walking to the car.

At this point any activity requires mestinon. My life is so so depressingly limited. If I had had my usual internist and not her student the last 9 months this situation might be alot better. The minute I showed her the letter from the Wolfe Clinic here in Iowa confirming MG in my eyes she went to work to make sure I get better treatment than have been getting.

I plan to talk to my pulmo before the surgery. I just found out today that my daughter cant make it for the Tuesday appointment.

Annie the treelover