Your Experience With the Donor removal?

[mrkneed]

I just wanted to see if anybody had a similar situation like me when I had my procedure done;

After I recieved a handfull of shots to the donor area my heart started racing for about 15minutes - made me very nervous feeling like my heart was going to pound out of my chest(this happens to me at the dentist etc when I am given the novacaine). Once the doctor started removing the donor area I was fine for about 15 seconds and then I started to feel really light headed, sick and my blood pressure dropped. I communicated this to the doctor and he had me lie on my stomach tilted down which got rid of all of those horrible feelings (note I never took any valium that was offered I just borrowed 2 xanax from a buddy) - has anybody experienced any thing like this?

I am scheduled to go in for a 2nd in Sept and i am really nervous - I do not want to experience those feelings again.

Please let me know your thoughts.

[mrkneed]

I just wanted to see if anybody had a similar situation like me when I had my procedure done;

After I recieved a handfull of shots to the donor area my heart started racing for about 15minutes - made me very nervous feeling like my heart was going to pound out of my chest(this happens to me at the dentist etc when I am given the novacaine). Once the doctor started removing the donor area I was fine for about 15 seconds and then I started to feel really light headed, sick and my blood pressure dropped. I communicated this to the doctor and he had me lie on my stomach tilted down which got rid of all of those horrible feelings (note I never took any valium that was offered I just borrowed 2 xanax from a buddy) - has anybody experienced any thing like this?

I am scheduled to go in for a 2nd in Sept and i am really nervous - I do not want to experience those feelings again.

Please let me know your thoughts.

[Yogi's Dad]

Mrkneed-

 

It was most likley that epinephrine was mixed with your numbing medication.

 

Epinephrine is a form of adrenaline that slows bleeding (a vasoconstrictor) but also increases heart rate, and can invoke a "fight or flight response" in the brain.

 

This response can be similar to anxiety or panic attacks.

 

I've also been told that blood pressure can drop temporarily. Years ago a nurse gave me juice and told me that I was experiencing a drop in blood sugar (not sure if this was true).

 

I've had the exact same sensations with dental surgeries. Surprisingly, I did not get them during my recent FUT.

 

I did tell my surgeon beforehand that I was sensitive to epinephrine and was very concerned about the side effects.

 

I do not know if my surgeon used less with me, but I did not get that reaction during my 6 hour FUT procedure.

 

Besides you and I, I think a lot of other folks also similarly sensitive.

 

Anyhow, tell your surgeon about your concerns before your next surgery.

 

Good luck!

[hairme07]

Upon receiving the adrenline, my heart rate jumped to 230 beats a minute! The doc had to give me somehting that put me too sleep for 30 or so mins!

[Yogi's Dad]

hairme-

 

Wow, that is a very high heart rate. Do you know what medication you were given to slow things down?

 

I've had a sensation of a pounding heart, and anxiety/panic, during various surgeries using epinephrine. Fortunately, my symptoms always waned within a few minutes.

 

Again,I begged Dr. Bernstein to "go easy" on the adrenaline BEFORE my recent FUT. I do not know if he did or not, but I DO know my concerns were heard out.

 

Anyhow, I did not have a hard time during my May 2008 FUT. My guess is that they gave me a little less than normal.

 

I could ask...

[tofueornottofue]

My doc told me prior to the injection, that my heart rate would increase for about 15 minutes and then return to normal...which it did. No worries.

[condoguy]

For some reason, this part of the procedure was not explained to me either, so when my heart rate jumped on the monitor I thought something bad was happening with my heart which made me panic, which increased my heart rate more. I was scared so they decided not to use the epinephrine on the top of my scalp to curb the bleeding. The techs seemed to be able to deal with it though...

 

glad you mentioned this because I went through the same thing.

[Gorpy]

I had the exact same reaction mrkneed.

[MikeN]

mrkneed, another possibility is you may have had an anxiety attack. They have many of the symptoms you described. I used to get them from time to time when I was a kid. Your heart would race, your blood pressure would drop, perspiration would increase. One of the last ones I ever had was when I had my first transplant done at Bosley in 96. They were removing the donor strip and a full blown anxiety attack kicked in. Dr Smith got pissed at me, gave me some medication and then continued the strip removal a few minutes later without incident. My 2nd procedure was with Dr. Wong and although it took him longer to remove the strip, I had no problems. Prior to your next surgery, explain the situation to your Dr. Ask for a valium or similar drug and talk yourself through it mentally. You've done it before. It doesn't last very long and it's not a big deal. Good luck!

[mrkneed]

Thanks for all your responses - good to see I am not alone. I am going with Dr. Keene in Sept and she is sensetive to my concerns. This time I am taking the valium!!

[Gorpy]

This also might help;

 

My first transplant I sat down and was surrounded by 2 or 3 techs, poking me all over my scalp all at once. That's when I had the bad reaction.

 

My second transplant was much better in that there was no hurry. There was one tech taking a lot longer and even taking breaks in between pokes. It was a much better experience.

[Bill - Seemiller]

Mrkneed,

 

It sounds like you are not alone in this. In fact, I experienced a very similar feeling for my third surgery. I felt a bit anxious and my heart rate increased. I started to take deep breaths (in through the nose, out through the mouth) to control my breathing. It helped a lot.

 

Bill

[HairTodayGoneTmrw]

Yeah i think this kinda reaction is fairly common amongst patients regardless of the number of HT's they have.

 

I went in for my first one and my heart was racing a little bit, but i didnt have a panic attack. I just let the valium or whatever they gave me, kick in and i was golden. I slept thru 90% of the procedure.

[Dr. Michael Beehner]

Mrkneed,

If your pulse truly did reach 230 that is not directly from the epinephrine, but almost certainly has to be a brief supra-ventricular arthythmia. There's a good chance that the presence of some epinephrine in the numbing solution was a stimulus to help it occur though. I would recommend that you check with your personal physician, who in all likelihood may arrange for a Holter monitor (24 hour tracing of your heart rhythm) and/or a cardiac stress test. I wouldn't just go into another hair surgery until you checked this out from a cardiology standpoint.

Panic attacks and reactions to epinephrine can make the pulse go up to the 130-150 range, but do not directly cause a pulse that fast. The reason that these types of tachycardias occur frequently in the dentist's office is that the mouth area is rich in blood vessels and it is very easy for the dentist to have the tip of the injecting needle within the lumen of a vessel, but I find this is extremely rare in hair transplant surgery in my experience. Perhaps this is partly due to the fact that we inject our Lidocaine and Marcaine with an extremely small needle (30 or 27g), which makes that possibility much smaller.

Mike Beehner, M.D.

[Dr. Timothy Carman]

Dr Beehner brings up an excellent point; a heartrate of 230/minute IS consistent with supraventricular tachycardia, and I "second" his recommendation that you follow up with a cardiologist/primary care physician PRIOR to your next procedure.

[mrkneed]

Dr. Carman and Dr. Beehner Thanks for your response. Actually it was another poster who said they had a similar experience to the point where thier rate went to 230 - All I know is that I was not monitored for the heart rate and my heart raced after the shots for roughly 10-15 mins then went to normal. Once the doctor started the donor removal was when I started to feel sick, extremely light headed, sweating and could feel my heart rate slowing down which scared me. However once the doctor flipped me on to my stomach tilted downward I felt ok.

[bUZZED]

Could someone tell me if this drug (epinephrine) is used during FUE surgery or only used in strip?

 

Thanks

[Dr. Timothy Carman]

Buzzed-

Epinephrine is a potent vasoconstrictor which can be added in variable amounts to the medication used to "numb" the surgical field, usually lidocaine. The blood supply to the scalp is very rich, and, as such, lidocaine injected into the scalp can "wear off" by two mechanisms. One is direct metabolism- this varies from individual to individual, but is fairly constant in each patient. Some people metabolize drugs faster than other people and vice versa.The second mechanism is clearance from the surgical area by the brisk blood supply. This second mechanism we can control, unlike the first. We can keep the lidocaine in the area of the scalp for a longer period of time by adding epinephrine, as it constricts the local vessels, thus decreasing the rate of perfusion of blood, and keeping the area "numb" for a longer period of time.

The "hatband" anaesthesia (a ring block of lidocaine all around your head) is still the technique used in general whether employing the FUE or strip technique.

Good question.

[bUZZED]

Dr.Carman,

 

Thanks for that explanation. If I am understanding it correctly then epinephrine is a drug that restricts bleeding and lidocaine is like an anesthetic i.e the drug that numbs the area.

 

I'm fairly certain I've had a dose of lidocaine before or similar, before getting some deep cuts stitched up in A&E. But my concern would be my reaction to the epinephrine. Rapid heartbeat etc... Or am I to understand patients are given the option to take valium or similar to offset this reation?

 

Many thanks.

[Dr. Timothy Carman]

Your reaction (rapid heart rate) is a fairly common response to epinephrine, exaggerated in some individuals relative to others. The concern for you, specifically, that Dr Beehner brought up was the extent (HR = 230) of your reaction (although I understand from your post that maybe that was not the actual number).

Simple tachycardia (fast heart rate) is quite different from PSVT (Paroxysmal Supraventricular Tachycardia) (Very fast heart rate); in PSVT the actual conduction paths of the heart change- a change that could in your case be "triggered" by exposure to epinephrine.

[Dewayne]

I guess I'm a lucky one here as well, as I didn't have any issues with the donor area. In fact, I had a 17 year old scar that was still tender and risen in some places. It feels and looks better at the 3 month mark now than it has in the last 17 years.

[Hairtechnician]

Originally posted by mrkneed:

Dr. Carman and Dr. Beehner Thanks for your response. Actually it was another poster who said they had a similar experience to the point where thier rate went to 230 - All I know is that I was not monitored for the heart rate and my heart raced after the shots for roughly 10-15 mins then went to normal. Once the doctor started the donor removal was when I started to feel sick, extremely light headed, sweating and could feel my heart rate slowing down which scared me. However once the doctor flipped me on to my stomach tilted downward I felt ok.

 

I realize this is a post from some time ago, but I just want to clarify that Mrkneed's first surgery was not with Dr. Keene. Dr. Keene's office does constantly monitor heart rate. I believe Mrkneed did much better during the anesthetizing process at Dr. Keene's office.

[mrkneed]

Yes!! This is from my first procedure. Dr. Keene and her staff were amazing!!!