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Please educate me on sedation


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My children have MRIs scheduled for the end of this month. They are both young, so they will only do the MRIs with sedation. When I initially asked about information about the sedation, I was told that a nurse would call me two days before the procedure to go over questions I may have. While looking for information on their website, I see the information provided is as helpful as "they will breath through a mask that will make them feel silly and giggly inside." I plan to call back on Monday and ask to schedule something sooner to go over details, but I'm having trouble preparing myself. Does anyone have any experience in this area? My daughter especially reacts to absolutely everything. Are there types of sedation and something I should be pushing for, or something I should be bringing to their attention? This gas that is not named, would they be using nitrous oxide? Low B12 is an issue. I did bring my concerns up to the neurologist who ordered the MRIs, but she brushed them off and said that MOST of the time, everything is fine. I have already seen that we have different ideas of what fine is, so I want to make sure I do this right, or don't do it at all if there's no safe way.

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Without looking it up, I think laughing gas is nitrous oxide (NO). I have a rather vague recollection that people with particular genetic polymorphisms (probably MTHFR, among others) have difficulty clearing medicines and toxins, but I don't remember what it is about NO specifically that is a problem with MTHFR. It is well worth googling.

 

Two of my kids, including my PANDAS kid, are known to be compound heterozygous for MTHFR but I'm not sure if they've ever had NO. PANDAS kid has had a number of medical procedures and it's possible he had some NO prior to the IV being placed for his cardiac catheterization - it was a few years before onset of PANDAS though.

 

I am homozygous for MTHFR A1298C and I know I've had a bit of laughing gas on a few rare occasions earlier in my life, no issues.

 

In the big picture, the percent of people with MTHFR polymorphisms is not small, and yet commonly there aren't a lot of problems with NO, with even pediatric dentists offering it. My concern would probably be along the lines of pandas exacerbation and if the NO can't be avoided, instinctively I'd load up on liver detox (NAC or milk thistle if the child tolerates those).

 

Maybe there are other genes involved. Have a google and if it's a problem, maybe IV-conscious sedation is the way to go, without the NO.

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If she has low B12 you don't want to use nitrous oxide (aka laughing gas)! Additionally, you don't want you to use nitrous oxide if you have:

low glutathione levels

MTHFR 677 homozygous or heterozygous

MTHFR 1298 homozygous

MTHFR 677 / 1298

Methylfolate deficiency

Chronic condition/disease, such as Lyme, autism,

PANDAS, IBD, etc.

 

https://www.ncbi.nlm.nih.gov/m/pubmed/18580170/

http://anesthesiology.pubs.asahq.org/article.aspx?articleid=1922603

http://mthfr.net/nitrous-oxide-mthfr-trouble/2015/02/06/

Edited by nancyd
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