Failed transplant twice due to inability to sufficiently anesthetize locally

[marchtop]

 

First I’d like to say thanks to this forum and all the help it provided. 

 

I received my first successful transplant in 2016, but the surgeon (in Chennai India) said that he had to use the maximum dose of local anesthetic. 

 

In 2022 I went back for my 2nd transplant, and the surgery was canceled as he was at maximum use of local anesthetic, but I still had feeling in my head. He said He had never had this issue before but that he often has to use a lot of anesthetic with alcoholics (I don’t drink, but I do have a history of use of opiates from several injuries and surgeries).

 

I flew back to the USA, and found Dr. Nader in Mexico, I went to him for a try in May 2023, and it was also not successful. Dr. Nader said he was getting too close to toxic levels of lidocaine, marcaine, epi and bicarb. 

 

I saw an endocrinologist and anesthesiologist, and it seems likely that I have accrued some type of tolerance through adaptation on the surface of the receptor, which metabolizes the lidocaine too quickly. They asked if I ever had trouble at the dentist, and I have, I always feel way too much, even after multiple injections of lidocaine. 

 

To be clear, I was willing to continue both surgeries in India and Mexico through the pain, but both surgeons refused to continue (Hippocratic oath or something).

 

This scientific paper seems to shed some light on the issue: “CONCLUSION

 

The findings of this study suggest a longer time to onset of anesthesia and higher lidocaine dose required in opium abusers, particularly chronic abusers, compared with similar patients not abusing opium.”

 

I’m trying to brainstorm how to successfully transplant. I have a few ideas.

 

1. Find a surgeon who will put me down under general anesthesia.

2. Try to lower my drug metabolism through fasting, abstinence from all drugs and medicine

3. It was suggested by a hair surgeon to maybe do 10 transplants of approximately 300 grafts each.

 

Do you have any ideas or suggestions or input?

 

Thanks in advance.

 

[JoeD]

Find a clinic that can do it under sedation?

[Turkhair]

Depending on the drug, the receptors are permanently changed and there’s no way to reverse it. There’s a reason why drugs are bad and illegal. 

Good luck trying to find a hair transplant doctor that can put you under. Unlike in movies, knocking someone out isn’t so easy and requires trained anaesthesiologist who charge ridiculous, I doubt any clinic will hire them just for you and I would be wary of any clinic that does it for you too because it would be some very low quality clinic.

I also believe it is illegal as the drugs required to knock someone out are highly controlled substances and can’t be used outside hospital by some random even doctors can’t use it. 

We all live with consequences of our actions, and sometimes there are no second chances. You’re not in easy situation and it maybe impossible, at least with a reputable surgeon.

[shadowcast]

15 hours ago, marchtop said:

To be clear, I was willing to continue both surgeries in India and Mexico through the pain, but both surgeons refused to continue (Hippocratic oath or something).

If you feel pain then your heart rate will increase and so will the bleeding, this is a basic reason why the surgery can't be performed without anesthetic.

As for solutions to your problem, I can't think of any. I've heard of clinics putting people under, but that seems like an unnecessary risk for cosmetic surgery.

[Al - Moderator]

As one Dr said, you could try doing a series of very small transplants. I would space them 2 to 3 months apart to allow for some healing before going through the next one, but you can adjust the time between sessions if you feel OK with it. The donor area can start at one side of your head and stay in a small section and then work around a bit more on each session. I don't know what the area to be covered looks like, but I wouldn't do the very front hairline first. I'd start further towards the mid scalp and work your way forward a few rows each session. If you do it that way you may be able to hide it better as it will slowly be coming forward and you don't want to start on the front and then take the chance that you can't tolerate that halfway through either. It's better to have a few grafts in the top center as a first test where it won't be noticeable if you have to stop. If the first session goes well then you know that's the way to go and you can work forward from there.

If you do that, both the donor area and recipient area will be very small in each session, so you shouldn't need much anesthesia and it should be over fairly quickly. It may take you 2 years to get it all done, but that would probably work.

 

Edited June 19, 2023 by BeHappy