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26 November 2010 @ 02:28 pm
On safewords and not using them  
Disclaimer one: Not BDSM related, but does mention it.

Disclaimer two: This is all about dental stuff.

If either of those bothers you, please skip this post.

So, okay, I had dental surgery on Monday to deal with “deep pockets” around my teeth (basically, cutting my gums down to reduce the space around my teeth and, in some spots, trimming down the bone as well).

I was more afraid of the nitrous oxide than I was of the surgery itself. I’d never had it, didn’t know how I was going to react, and was terrified that I’d be out of control and say or do something deeply embarrassing to me or offensive to the dentist. Given that all knowledge is contained in LiveJournal, I posted there to ask my friends about it, and the consensus was basically, “It’s like being drunk” (with one “I remember the really nifty geometric patterns”). Okay, fine, cool, I’ve been drunk and I can deal with that.

It wasn’t, for me, like being drunk: my progress through alcohol starts with feeling relaxed, proceeds on to giggling (big surprise there, right?), and then to falling asleep. My progress through nitrous started with my fingers and toes getting fuzzy, then to crying (not sobbing, but tears dripping and my throat all tight and rigid), then to a kind of drifty sensation. I did not feel out of control, and as far as I know I didn’t say or do anything incredibly stupid until the very end.

However, this was supposed to be about safewords and not using them.

I don’t normally use encoded safewords in play; I tend to communicate in plain English. I have used them occasionally, though; one of my favorite anecdotes is about the time I got an unscheduled break in a scene by announcing “chartreuse” (which is, you see, more yellow than green, but more green than yellow) and causing my playpartners to fall over laughing. So I knew that it’s possible for me to use encoded safewords under stress.

Because I didn’t know how I was going to react or what I might say, I told the assistant before anything got started (while she was prepping me), “If I say anything that sounds like ‘yellow’ or ‘red’, it means there’s a significant problem and you need to check in with me.” She didn’t sound taken-aback or amused, she just said okay.

So, anyway, the surgery part. This dentist is all about not causing more pain than absolutely necessary; he used a topical anesthetic before injecting the local anesthetic, and he waited to make sure that the local had taken effect before he started cutting and trimming. I was conscious but I think I was drifting in and out, because I don’t have really clear memories of what was on my iPod, but rather of suddenly realizing that I was hearing music again. I know that I was responding to verbal check-ins and to instructions (“turn toward me a bit”, “close your mouth halfway”, that sort of thing).

After a while I realized that my toes weren’t fuzzy anymore; apparently I’d stopped breathing through my nose and wasn’t getting the nitrous. Did I mention that I basically don’t breathe through my nose unless I’m concentrating on it? I have a hard time getting a really deep breath through my nose. Anyway, I started thinking, “Hey, this isn’t so bad, maybe I’ll ask if next time we can forgo the nitrous and just use the local”.

But after a while something – I don’t know if it was the bone nipper or the suturing – started to feel unpleasant. Did I think to say, “Wait, I need more nitrous”? Did I even think to say, “Yellow”?

No, I did not. What did I do? I thought, “I want more nitrous”. I remember trying to breathe faster to get more nitrous into my system. I probably started hyperventilating, because I started to feel dizzy and nauseated, and the next thing I remember clearly was him pulling all the instruments out of my mouth and telling me he was switching me back to pure oxygen, and telling me to move my arms and legs and to stretch. [This is not what I initially remembered, but it’s clearer now.]

He was pretty concerned. Apparently my blood pressure had spiked to an unacceptable number, and he decided that it would be best to just finish suturing the current section and reschedule the remainder of my upper teeth.

As things started wearing off, I started crying again (which he said is not unusual), and asking for Dale, that I wanted Dale to come hold my hand (okay, *that* was kind of embarrassing). And when the dentist okayed trying to stand up, the giggles hit (that was definitely embarrassing; I shut it down right-quick because I realized that I was about to say, “It’s okay, this is normal for me”). When he was explaining to Dale that if I started to feel faint, Dale should not try to hold me up, but just support me carefully to the floor, I seemed to think it was relevant to say, “He knows that, he has epilepsy.” At the time it made sense, but in retrospect it sure doesn’t.

What the hell is wrong with me, anyway? I know that I’m perfectly capable of safewording when I’m bottoming; I’d even set myself up to do so at the dentist’s. So why didn’t I? I kind of remember the dentist telling Dale, “She hangs in there, she doesn’t let go, this is more likely to happen with people who don’t let go.” But I don’t hang in there when I’m playing; if something hurts in a way that I don’t like, I speak the hell up. And from the inside, it didn’t feel like hanging in there; it felt like panicking and over-reacting. Can I legitimately blame the fact that I was in an altered state that I’m not familiar with for the incorrect response?
 
 
 
Ayeshabrowngirl on November 26th, 2010 07:51 pm (UTC)
Can I legitimately blame the fact that I was in an altered state that I’m not familiar with for the incorrect response?

I'd say so.

I'd also say you're being WAY too hard on yourself... in exactly the ways I would be on myself, so I'm a hypocrite. *laugh at myself* But I'm speaking from experience: I think you did much better than you're crediting yourself for, and if we were in the same room I would totally hug you.
madshutterbug: RN Self Hard at Workmadshutterbug on November 26th, 2010 07:56 pm (UTC)
First of all, yeeesss nitrous is 'like' being drunk, and no it isn't. Different substance, different reactions. Most probably same lowering of inhibitions, which is part of why some of your reactions took place.

Second of all, very different causes and sources of pain. We've talked about that before; in a scene it is both the purpose and under control. In a surgical/theraputic intervention it is a by-produce, and there is significantly less control even with a use of safe-words.

Also, any anesthetic agent is going to affect vital signs; reading this I'm inclined (from experience) to go with your BP spiked when the pain set in, probably about the same point or a bit before you started thinking you wanted more nitrous. Difference with nitrous is, being an inhalational it also affects how much oxygen may be transported/transferred simply because it (nitrous) is occupying some of the same space as the oxygen. You may not of been hyperventilating despite the situation, you may of been getting hypoxic from insufficient oxygen due to the nitrous.

So, I"m not at all sure there's anything wrong with you. I see this as one of the potential paths going into the procedure/anesthetic.
Barbrahirah on November 26th, 2010 09:23 pm (UTC)
Nothing's wrong with you. Anesthetics put you in a weird mental state - for me it's very like dreaming. It feels like I'm in control and everything's normal, but it really isn't. I'd be more surprised if you HAD been able to use your safeword.
une idee fixeideealisme on November 26th, 2010 09:31 pm (UTC)
That sounds like a difficult procedure. The only time I ever had dental surgery that invasive was a wisdom tooth extraction at the age of 15. And that was under general anaesthetic. To have it under local is incredibly tough! I would not worry if you reacted to the gas with difficulty, it is not a contest and you are there for better dental health.

I hope you have a swift recovery from this procedure, it sounds tough.
Johnjohnpalmer on November 27th, 2010 12:55 am (UTC)
Well, first, oxygen dep hits *hard* and *fast*, and so does the panic for it. And it's primal - it's not a reasoning thing. Not feeling comfortable with oxygen, and the sudden (probably OD) of nitrous was probably part of the problem.

The other side of it... well, darlin', there's a lot of experiences where people have to do things for the first time to learn how they respond. Until then, they can't really prep for it. And this sounds like it was a first-time experience.

Herm. And I'd like to give you permission to not be perfect-in-your-own-mind your responses to every new thing, but it seems a bit late for that. But darlin'... you really don't need to be perfect. You're allowed to be human, *especially* the first time.
The Evil Twingrey_evil_twin on November 27th, 2010 01:43 am (UTC)
the dentist is not a scene. Two entirely different contexts.