After a couple of months experiencing sporadic pain from one of my hindmost molars, it was clear that a visit to the dentist was called for. Unfortunately, he diagnosed a cracked tooth and advised that a crown would be the best solution.
When he explained the procedure that was required – the sculpting of the tooth to accommodate the gold crown and adhesive – I realised that this may involve a need for local anaesthetic – a daunting prospect for someone who relies on a healthy team of hookworms to remain free from a multitude of very unpleasant symptoms.
While they don’t kill hookworms, local anaesthetics (lidocaine, novocaine, etc.), like antibiotics, can cause a loss of efficacy for up to eight weeks, so I discussed this with my dentist and he said that we might be able to manage without using anaesthetic, at least until he got near to the gum line. At this point, he suggested, it might get a little “sore”, but he thought that anaesthetic dribbled onto the gum might be adequate and that there would probably be no need to inject beneath the tooth.
Had my dentist been conversant with the use of the gumEase device, I would have opted to try this, but, like most dentists, he hasn’t explored this idea yet.
In the event, I took 1,000 mg of paracetamol (acetaminophen) and 30 mg dihydrocodeine two hours before my appointment and experienced only brief moments of mild, dull pain which were quite manageable, so I needed no anaesthetic at all.
Benzodiazepine hypnotics (Versed, etc.), as used routinely during procedures such as colonoscopy, do not adversely affect hookworms, nor do narcotic analgesics and opioid pain killers (Fentanyl, etc.), so, taken at high strength, the latter may be a suitable substitute for local anaesthetics in some situations.
If the use of a local anaesthetic is unavoidable, the period of time that hookworms will be adversely affected can be shortened – perhaps to as little as two weeks – by obtaining a small additional dose of worms after undergoing the procedure.
If there is a need for a general anaesthetic, propofol, which is by far the most commonly used general anaesthetic these days, will not harm hookworm or whipworm (although it may be fatal to the laboratory worm C. elegans) and propofol can be used alone, without the addition of nitrous oxide which, even in very small amounts, will kill hookworms stone dead. (More on this here).
Any helminth host facing surgery should discuss this issue with their anaesthetist well in advance of their procedure, and be sure to request that no nitrous oxide be used at all, under any circumstance – not even as an adjunct to propofol.
Nitrous oxide can also be encountered in the home, in the form of whipped toppings and other “foods” contained in aerosol cans. These use the gas as a propellant, and just one whiff of this will wipe out an entire colony of hookworms!
Another unlikely source of an anaesthetic-like substance is kava tea, whose active ingredient is kavalactones. These can create mild sedation without disrupting cognitive function, and act as a muscle relaxant, with higher doses having an effect similar to that of a local anaesthetic, according to this report, so this tea may be best avoided by helminth hosts.
Disclaimer: This post is not intended to provide medical advice, diagnosis or treatment.