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Welcome to our
D/s Medical Advice:
Prevention and Treatment of Injuries
and Adverse Conditions
Author
Unknown
To the best of our knowledge all the below has been
read and approved by an Physician
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I.
Introduction
This
text has been prepared by an M.D. with a
personal and professional interest in D/s.
It covers topics suck as safer sex,
preventing and treating injury, and
psychological safety. It is offered
freely to the D/s community in the hopes
of assisting others to find joy and
fulfillment in a safe and sane
environment.
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II
Sexually Transmitted Disease (STD) Risk
Factors
By
far the most pressing concern in any
sexual encounter is the prevention of STD:
Sexually Transmitted Disease.
These are diseases that can be passed
from one partner to another by different
forms of sexual contact. The risk of
contracting a STD is determined by several
factors:
- The
prevalence of the decease in your
area..... for example..... you are more
likely to contract HIV (the AIDS virus)
in Newark, NJ than in Duluth, Minn.
- The
population your sex partner is part
of..... for example..... the rates of
HIV positivity are higher in
prostitutes and IV drug abusers than
the general population.
- The
type of sexual activity engaged in.....
for example..... anal intercourse
carries a higher risk for HIV
transmission than oral sex.
- The
specific disease..... for example.....
the herpes simplex virus is more easily
contracted by oral - genital contact
than the HIV virus, which requires
contact with body fluids (semen or
blood).
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Partial
List of STDs
The
following is a list of SOME STDs.....
please note this list is not inclusive and
is not intended to substitute for medical
advise. Contact your doctor if you
have ANY concerns or questions about your
own health risks or needs.
AIDS.....
Caused
by the HIV (Human
Immunodeficiency Virus) virus.
It is contracted by exposure to
bodily fluids..... semen and
blood.
Herpes.....
caused
by the herpes simplex virus it
causes a chronic, relapsing illness
characterized by recurrent genital
blisters. It can be passed
from mother to infant during
childbirth as well. It can be
contracted when the virus is
"shedding" (becoming active) and may
occur before the reappearance of
genital lesions.
Gonorrhea.....
caused
by a bacteria (gonococcus),
it can cause sterility, arthritis,
heart problems and disorders of the
central nervous system. In
women, it can cause Pelvic
Inflammatory Disease
(PID). Common symptoms
include: for women..... frequent,
burning urination; pelvic pain; a
green or yellow vaginal discharge;
swollen vulva. For men, a pus
like discharge from the
penis.
CMV.....
Cytomegalovirus.....
can be transmitted sexually as well
as from mother to child during
pregnancy. In the fetus, it
causes deafness and mental
retardation. In adults, it can
cause blindness and mental
disorders. Common symptoms
include..... swollen glands,
fatigue, fever, and general
weakness, nausea and vomiting, loss
of vision. It is spread in
saliva, semen, blood, cervical and
vaginal secretions, urine and breast
milk by: close personal contact,
vaginal, anal and oral intercourse,
blood transfusion and sharing IV
drug equipment, from mother to child
during pregnancy, childbirth or
breast feeding.
Hepatitis
B.....
Contracted
like HIV through exchange of body
fluids or blood, causes inflammation
of the liver with jaundice, fever,
weakness, nausea and vomiting.
Can lead to acute liver failure or
chronic active hepatitis. Follow
precautions for HIV.
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Prevention
The
only absolute protection against sexually
transmitted disease is complete avoidance
of contact with all bodily secretions of
another. All other measures provide
SAFER SEX. The more information you
have, the better able you will be assess
your risk and take appropriate
precautions. By far the most
effective means of REDUCING the risk of
STDs is CONSISTENT, CORRECT and CAREFUL
use of CONDOMS during vaginal, anal and
oral intercourse. Care should be
taken when withdrawing not to spill semen
from the condom. Yes, condoms should
cover the penis during fellatio (giving
"head" to a man). The appropriate
use of condoms is critical when
considering the HIV virus. Since
infection invariably leads to AIDS (97%)
and AIDS invariably results in premature
death. Each sexual encounter must be
evaluated in that light. When toys
are used the result in contact with bodily
secretions, for example, a vibrator used
for vaginal or anal intercourse, it should
only be used with that partner and not
shared between partners.
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III
Injuries - Prevention and
Treatment
A.
The most important factors in the
prevention of injury during D/s activity
are picking the right partner and using
common sense.
For
a sub, picking the right Dominant is
crucial. In order to avoid injuring
a sub, a Dominant must have control of
Him/Herself, and a deep sense of
responsibility to protect the well being
of those in His/Her care. Kiss and
knowledge of techniques employed ain't bad
either.
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B.
Safety tips for Subs:
First
meeting are particularly risky.
There are many sources of information on
safety tips. I recommend a chat
room, safe for new subs, on aol, dal.net
or bondage.com as a place to ask questions
and get helpful advise from knowledgeable
people. Also, safety tips can be
found at the following website:
http://www.mouse-works.com/subnation/main.html
Submissives should always know how and
feel free to use a safeword or gesture to
stop D/s activity at any time. A
safeword is a word that when uttered,
signals the Dominant partner to STOP
immediately. If unable to speak, (as
when gagged), a safe gesture is
employed.
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C.
The use of alcohol and/or drugs is to be
avoided during D/s play as it clouds
judgment
The
Dominant partner may not be able to
exercise the necessary control when
intoxicated, and the submissive partner
might not be able to accurately assess her
limits. This can lead to
injury.
DRINKING/DRUGGING AND D/s DO NOT
MIX.
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IV Specific
Injuries - Prevention and
Treatment
- Poor
Circulation
In
using restraints, care must be taken
not to compromise the circulation of
the restrained limb. Restraints
must NOT be so tight as to cause the
following: numbness and tingling (pins
and needles), cold sensation (can also
be checked by the Dominant by touching
hands or feet); blue color of
hands/feet, diminished sensation,
burning sensation. Serious injury
can result in these signs and symptoms
of compromised circulation
persist. The restraint must be
released at the first sign.
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- Choking
While
I have no idea how common this practice
is in the D/s community, it is so
potentially dangerous I have to speak
to it. Choking (compressing the
nick) is sometimes done as part of sex
play. (erotic asphyxia).
In which case the choking is used to
heighten orgasm. Any
miscalculation can result in death by
strangulation. Choking in any
other context, as part of power
exchange, not only carries the risk of
miscalculation resulting in serious
injury or death. Some people are
especially sensitive to carotid
pressure and develop a slowed heart
rate in response. This can result
in simple fainting, or more sever heart
rhythm disturbances. For this
reason, choking is not a recommended
activity
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- Bruises
In
the context of D/s play, not all
bruises can be prevented. Those
who engage in activities leaving
frequent bruises do well to consider
the following. On a daily basis,
taking 1000 mg. of vitamin C, which
helps with tissue repair. Avoid
the frequent use of aspirin, ibuprofen
(Motrin), naprosyn (Naproxen,
aleve) and other drugs of the
nonsteroidal anti-inflammatory
class. Activities leaving bruises
are to be completely avoided if a
person is taking COUMADIN, a drug to
prevent clotting. Bruises can be
treated simply with ice for the first
24 hours followed by application of
heat.
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- Lacerations
This
is the medical word for a cut.
Welts that bleed are forms of
lacerations, as are those inflicted by
knives or razors. The two main
considerations with lacerations are
first, blood is a body fluid that can
transmit disease, and disposable gloves
should be worn when treating a
partner's lacerations. Secondly,
the prevention of infection.
Lacerations should be washed with warm,
soapy water and if significantly open,
dressed with an antiseptic ointment
(bacitracin is good) and covered
with a Band-Aid or sterile
dressing. Minor bleeding can be
stopped with direct pressure over the
wound. If bleeding persists,
consult a physician or go to the
emergency room at your local
hospital.
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- Abrasions
These
are rubbing injuries, typically
sustained from restraints. Also
from carpets, the so called rug
burns. These should be washed
with warm, soapy water, and if
significant, dressed with bacitracin
and covered with a sterile dressing and
gauze.
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- Burns
First
degree burns result in reddened and
painful skin. Second degree burns
blister. Third degree burns
destroy tissue. Extensive second
degree and any third degree burns
require medical attention. Minor
burns should be treated immediately
with immersion in cold water.
Grease, butter, petroleum jelly, etc.
should NOT be used. Burns
blisters, when opened, should be
treated as abrasions and covered with
bacitracin and dressed with a sterile
dressing.
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- Vaginal
Injuries
To
prevent injury to vaginal tissues, care
should be taken not to introduce
anything into an unlubricated
vagina. If sufficient vaginal
secretions are not generated, a water
based lubricant such as KY jelly should
be employed. Care should be taken
introduction large objects at the
introitus (the entrance to the vagina),
as the tissues there can be torn if
excessive force is employed.
Douching, unless prescribed by a
physician is NOT recommended. The
vagina is self cleaning. (Much better
even than an oven). Should there
be soreness, redness, swelling, etc.,,
these should be checked by a physician
as some STDs present that way and
distinguishing injury from infection
can sometimes be difficult.
Objects that are breakable (such as
light bulbs) must never be inserted
into the vagina.
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- Anal
Injuries
See
above. Liberal use of KY jelly is
critical, as is slow penetration of the
anus, allowing tissues to stretch and
the muscles to relax. Enemas
should NOT be used to "clean" the
rectum following any vigorous anal
penetration because there are always
microtears in the rectal wall.
Introducing an enema under those
conditions could cause serious
infection and illness. Enemas
given recreationally should not contain
chemicals, should be around skin
temperature, and should not be given
too fast.
CONDOMS MUST BE WORN FOR ANAL
INTERCOURSE TO PROTECT AGAINST
STDs.
Any
object, finger, dildo, or penis, used
in anal play must be thoroughly cleaned
in warm soapy water before being put
into the vagina or mouth in order to
prevent infection. Condoms should
be changed when switching from anal to
vaginal or oral intercourse.
Glass objects do not belong in
rectums. Be careful not to lose
anything inserted into the rectum,
unlike the vagina, which is a closed
space, the rectum is a large vault and
items can be difficult to
retrieve. Please leave mice,
gerbils and guinea pigs in their
cages.
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- Penile
Injuries
Use
common sense . If catheters are
used, they should be sterile and used
ONLY for that sub once. Rubber
cannot be resterilized. Do not force
anything into the urethra (the opening
into the penis). If compression
of the penis is practiced with any kind
of device, pain is a good barometer of
when to stop. Any deep
lacerations sustained to the penis must
be evaluated medically.
Lacerations in this area should be
avoided.
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- Animals
If
an animal is used in erotic play, a
muzzle should be used to prevent animal
bites which are serious, especially to
the face. The animal's toenails
should be clipped as well.
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- Beating
There
are some areas of the body that should
be avoided when administering a
beating. The kidneys area, which
is located on the back where the ribs
join the spine, is one such area to
avoid. The area of the spleen is
also vulnerable to excessive
force. This area is on the left
side of the abdomen just under the
ribs. Head injuries can be
serious and heavy blows to the face and
head are not wise. Stick to the
tush, the upper back, shoulders, and
legs.
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- Frostbite
Sometimes
ice is used in D/s play. If there
is prolonged contact to the skin,
frostbite can result. The first
response to cold is blueness to the
area, then redness and burning or
diminished sensation, followed by
tissue injury. The area must be
rewarmed
IMMEDIATELY
in
WARM,
not
HOT
water.
Serious, extensive frostbite needs to
be seen by a physician. The
extremities, the fingers and toes, are
most likely to get serious
frostbite.
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- Wax
Use
only paraffin candles for wax
play. The height that the wax is
dropped from determines how hot it will
be when it hits the skin. Less
than 6 inches dripping
height
CAUSES BURNS,
avoid
this.
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- Bite
Wounds
Bite
wounds on the face should be avoided
and if serious, should be seen by a
doctor. All bites should be
thoroughly cleaned with warm soapy
water, covered with bacitracin and a
dry sterile dressing. Infection
is the major complication of
bites. Signs of infection
include: redness extending from the
wound, swelling around the bit, pain at
the site, heat at the site and
fever. An infected bite is very
serious and should be treated by a
doctor.
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- Electricity
- Related Injuries
If
toys are used that involve electricity,
the major injury is an accidental
burn. These should be evaluated
and treated as outlined in the burn
section above. Please keep all
electric toys away from water, and
check all wires before play to make
sure they are intact, and not
frayed. Should electric shock
occur, the possibility exists that the
person's heart will stop and CPR will
be required. Before touching the
person, make sure that the electric
source is off, interrupt it using an
insulated item or at the source
(circuit breaker). If the person
is not breathing, and you know CPR,
follow the protocol. Otherwise,
call 911 and tilt the person's head
back (person is positioned on back) to
open the airway. Taking a CPR
basic course is the best way to save a
life.
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- Strains
and Sprains
These
are injuries sustained to ligaments and
tendons around joints. They may
be complications of restraint and
suspension. If pain is so severe
that the joint cannot be moved, a
doctor consultation is advisable.
For minor injuries, remember
RICE: Rest, Ice, Compression and
Elevation. Rest the affected
joint. Use ice for 24 hours, then
heat. Ace bandages can provide
compression and reduce swelling.
Elevate the effected joint.
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- Branding,
Cutting and Piercing
These
activities by their very nature cause
injury. Any activity that breaks
the skin must be done under sterile
conditions. This means the skin
must be cleaned first with warm soapy
water. Then, the area should be
washed with betadine. Allow the
betadine to dry, then wipe off with an
alcohol wipe. The person doing
the activity should be wearing sterile
gloves, both to protect Him/Herself
from blood contamination, as well as
protecting their partner from
infection. Any of these
instruments should only be used if they
are sterile. Either purchase them
in a sterile fashion and discard, as
with needles, or sterilize. An
item can be considered sterile if it is
brought to a rolling boil and kept
there for 20 minutes. It must be
completely immersed in the boiling
water. These activities may
result in infection, please see above
for sign of infection and
treatment. Any infection
accompanied by fever should be
evaluated IMMEDIATELY by a
doctor. These activities will
result in bleeding. Minor
bleeding can be stopped by continuous,
direct pressure over the wound.
Remember to wear gloves. If
bleeding is spurting out, and artery
may have been opened and this requires
emergency medical treatment.
Apply direct pressure and get to a
hospital. Another complication of
these acts may be shock, due to
excessive blood loss. Follow
guidelines for treatment of active
bleeding, keep the person warm, and
raise the legs higher than the
head. Get emergency medical
attention. Shock can be
recognized by pallor, sweating,
tremulousness, faintness, rapid,
thready pulse and loss of
consciousness.
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- Psychological
Risks
The
D/s power exchange can be a deeply
fulfilling, joyous, and thrilling way
of life in the right context.
Some "mental health awareness" unique
to our community seems in order.
There is a pattern for submissives
particularly, to be aware of. In pain
play, for example, the central nervous
system responds with an outpouring of
endorphins, the natural painkiller,
whose chemical structure is similar to
morphine. This may indeed be the
physiologic basis of subspace. As
this wears off, there is a "let down"
and should not be confused with
depression. Depression that is
clinically significant lasts 2 weeks or
more, and is characterized by
persistent low mood, decreased energy,
disturbed sleep and appetite, feelings
of helplessness and hopelessness, and
sometimes suicidal thoughts, delusions
and hallucinations. These
symptoms should lead one to consult a
physician. Other hazards include
those associated with the use of sleep
deprivation (one should not drive sleep
deprived!). Psychological
consequences of sleep deprivation
include altered perceptions
*hallucinations), unstable mood,
irritability, decreased fine motor
performances and impaired
judgment. Much the same picture
as produced by prolonged sensory
deprivation.
Psychological health between Dominants
and submissives is fostered by clear,
open communication, respect, trust and
communication, communication,
communication. If you can't talk
to each other, you shouldn't play!
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I hope this
document has been useful to you.
Please consult a doctor for any questions
or concerns you may have. Better to
be safe than sorry. Better to be
informed than not. What you don't
know, in this area CAN hurt you.
Long life, good health, play safe.
~~~~~Yaldahtvah (a D/s Physician)
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V.
Medical Advise links for submissives and
Dominants
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