Sedation FOLLOWING Donor Strip Removal ?

[NewB2HT]

Hi, I'm new to all this, so forgive me if this is a stupid question. My HT Surgeon, Dr. Quatela (Rochester, NY) tells me that he doesn't give his patients sedation before the injections or harvesting the donor strip. I told him I was nervous about the procedure and he said "he would give me a little sedation before the injections if I wanted", but wasn't willing to give me his usual 20 mg until after the donor strip was harvested. In his written instructions, it states "You will be given light sedation following the harvest of the donor site". I'm very nervous about having a panic attack during the injections of local anesthetic/donor strip removal. Should I be concerned about his approach?

 

BTW, he recommends 1600 FU grafts. My surgery is coming up and I want to know if I should cancel or go through with it.

 

Thanks!

[NewB2HT]

Hi, I'm new to all this, so forgive me if this is a stupid question. My HT Surgeon, Dr. Quatela (Rochester, NY) tells me that he doesn't give his patients sedation before the injections or harvesting the donor strip. I told him I was nervous about the procedure and he said "he would give me a little sedation before the injections if I wanted", but wasn't willing to give me his usual 20 mg until after the donor strip was harvested. In his written instructions, it states "You will be given light sedation following the harvest of the donor site". I'm very nervous about having a panic attack during the injections of local anesthetic/donor strip removal. Should I be concerned about his approach?

 

BTW, he recommends 1600 FU grafts. My surgery is coming up and I want to know if I should cancel or go through with it.

 

Thanks!

[hairbank]

NewB2--

 

Everyone's different........I think I was given a valium before HT #1 but am not for sure. I'm positive I wasn't given anything of the sort for HT #2. They just numbed the donor area, removed the strip, closed it up. Then went to numbing the recipient site, made the incisions, placed the grafts. If you're real nervous and need a relaxant, I'm not sure what to tell you?

 

As for the 1600 grafts, that's not a huge session by today's standards. I'd need more information to give an opinion as to whether it would be worth it to you. How old are you, where are you on the Norwood scale of loss and where is your loss focused? Any pics you can share would really help.

[NewB2HT]

Hairbank,

 

Thanks for the reply. I'm 46 years old and my hair loss would be classified as a Norwood Class 3V or 4 with mostly frontal and temporal loss with a small crown area loss.

 

Don't most patients receive some type of sedation prior to the injections and strip removal? I can't understand why the surgeon told me he doesn't sedate his patients until after the procedure. Is it just to keep his patients comfortable during the boring part of disection and graft placement?

[the B spot]

A good rule of thumb is multiply your NW stage by 1000 grafts.

 

In your case, this would be 3-4000 grafts.

 

I highly doubt you will be satisfied with 1600 grafts.

 

I would suggest putting your session on hold until you get some information from other Docs.

 

Dr. Quatela is a solid Doc.... If I am not mistaken, he attended the Coalition Workshop hosted by Dr. Ron Shapiro... (I think !!!)

 

Anyway, I am not besmirching his skills, it is just that NW3-4's usually need at LEAST 2000 grafts to achieve a really nice non-balding look (my opinion).

 

I am not sure exactly what your current rate of loss is, or your long term plan, or the state of your donor so some pics would be helpful.

 

I look forward to seeing how your situation plays out.

 

As far as your questioning his methods.... if YOU want to be sedated before your strip removal, then I suggest you find a Dr. that will accomodate you.

 

I am under the impression that some form of Valium and Prednisone is given BEFORE the local is injected into the donor region.

 

At least for chicken's like me!!!!

 

Take Care,

J

[Gorpy]

Uh, no, I did not receive any valium or pain killer before the injections. And yes, they sting a little.

 

I took the valium shortly afterwards.

[Jersey23]

New -

 

For my procedure yesterday I was given a valium before the donor strip removal. I didn't ask for it, but they said they give it to everyone. I'm guessing it's so we don't get too nervous, even if we aren't at the start of the procedure.

 

 

However, the Valium didn't take the edge off the pinches from the injections to numb the donor area. I've read about doctors using topicals first, but for whatever reason, Dr. Feller doesn't use them. I'd have to say that from a pain perspective, that was the worse part of the day, but he moves pretty fast. If your doctor uses any type of numbing agent first, you shouldn't feel much.

 

Bottom line is that you need to speak to your doctor ahead of time about your concerns and see what options he offers. Then report back to the forum and let everyone furthur guide you.

[baldindian]

Hi,

I had my 1st HT just 10days back, here in Shanghai China (around 4500 FUs). My stitches are going to be removed tomorrow.

I wasn't given any kind of sedation before the start of my procedure. First I was given a local anesthesia at the donor area & my strip (about 23cms long & 1cm wide) was removed & stitched up. Then my doc gave multiple injections of local anesthesia over my receiving area & started punching the holes. As he didn't gave much anesthesia on my forehead, it started to pain when the holes are getting puched over my frontal area, then I asked him to give more injections and after that my surgery lasted for 7 hrs (no music or videos during the process)

After 3 days post-op, my whole face was swollen like hell for 4 days(I looked like a Martian). Swelling went away completely just yesterday. Now I am almost normal, except the numbness on top of my head & little pain in my donar area. But overall , even though I suffered with pain, I beared it like a Rambo & now I am on my way of recovery...I am completely satisfied with my surgery when I compare it with my money I spent. I am going to travel back to U.S in couple of days !

[HK500]

Originally posted by baldindian:

Hi,

I had my 1st HT just 10days back, here in Shanghai China (around 4500 FUs). My stitches are going to be removed tomorrow.

I wasn't given any kind of sedation before the start of my procedure. First I was given a local anesthesia at the donor area & my strip (about 23cms long & 1cm wide) was removed & stitched up. Then my doc gave multiple injections of local anesthesia over my receiving area & started punching the holes. As he didn't gave much anesthesia on my forehead, it started to pain when the holes are getting puched over my frontal area, then I asked him to give more injections and after that my surgery lasted for 7 hrs (no music or videos during the process)

After 3 days post-op, my whole face was swollen like hell for 4 days(I looked like a Martian). Swelling went away completely just yesterday. Now I am almost normal, except the numbness on top of my head & little pain in my donar area. But overall , even though I suffered with pain, I beared it like a Rambo & now I am on my way of recovery...I am completely satisfied with my surgery when I compare it with my money I spent. I am going to travel back to U.S in couple of days !

 

Welcome to the forum, it would be great to know more about pour details, Dr. name, your Norwood level, before, after pictures, cost of surgery and such.

[George8211]

I've had panic attacks in the past... I was concerned that the procedure might bring one on. I spoke with my surgen about this. He prescrided 10mg valuim. For me... It did the trick.

 

I was nervous while the strip was being cut.. the Doc told me "Take some deep breathes and relax as much a possible. The cuts didn't really hurt. Kinda felt like a light burning feeling.

 

The next thing I remember was asking how am I doing? Doc replies, "We have the first 2,000 slits cut.

 

Appearantly, I fell asleep from the time of the donor area cuts, till 2,000 slits prepared.

 

I was happy about that.

[Bill - Seemiller]

George,

 

Glad to hear things went well for you, especially since you were nervous about it. Some doctors do give Valium as a mild form of sedation before the strip is cut and some don't. I turned it down the first surgery when it was offered to me, however accepted it the second. The valium made me feel a little silly, therefore relaxed, but not tired...everyone responds differently. i was given a second one later and it had no effect on me. Strange.

 

Any details about the surgery you are wiling to share with us? Any before/after pictures?

 

Bill

[George8211]

Later on down the road I'll post some pics... I ended up with 2,950 graphs... Doc said I had lots of 3 or 4's, so the crown should be good.

 

I guess my last post covers some of the high lights. Scabs were gone by 3 weeks (I'm a slow healer on all my cuts and scrapes), at 1 month still holding all the graphs, numbness, redness, tight scalp feeling are all gone.

[justme051]

i was actually put to sleep for the whole experience by dr waldman in lexington ky. never felt any pain.

[NewB2HT]

Well, I had my HT three days ago and it went well (1600 FU). Dr. Quatela was very understanding of my anxiety and gave me sedation (valium) before the procedure started. The injections did hurt a bit at the beginging and when they started to wear off during placement of grafts, they gave me more. For some reason, the sedation (several pills of valium) and injections of demerol during the day did very little to ease my anxiety. I couldn't relax and kept jumping at every little sound. I brought in a DVD and even that didn't help. I guess I'm such a high strung individual that drugs don't do much for me. Anyway, I got through the day (10 hours) and the HT looks great. Dr. Quatela and his staff were very professional and did a great job. I'll post pics in a separate post tomorrow.

 

Thanks for all the encouragement and insights I have gained on this site!

[George8211]

Congrats.... glad to hear it went well.

 

I'm abit jumpy too. As the V wore off, I could tell it did a good job while it was working.

 

I kept a MP3 player going with the volume way up... so I couldn't hear a sound from the outside world. I didn't think the DVD would be enough distraction for my brain.