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Views: 1442 Created: 2011.11.30 Updated: 2011.11.30

Tubemall

Chapter 3

"I don't know how I will react to drowning", Jill said to Doctor Marks, "I've never drowned before". "JIll, it's not really drowning. We will fill your lungs, partially and completely with a liquid you can breathe. You will be closely monitored for your reactions and we can remove the oxygenated florocarbon at any time you have too much difficulty with it", Dr. Marks replied. "And I'll be intubated for a day?" Jill asked excitedly. Dr. Marks said, "Yes, that will be necessary for your own protection. You have been intubated in a few studies here before and never had a problem with it. Are you nervous about anything I've said so far?" "No! I am sorta looking forward to it, actually." Jill reclined upon the examination couch in the respiratory department's prep room. The anesthetist put an oxygen sensor on Jill's finger, and noted 92%. "Nervous? Your oxygen level is a little low". "Yes. A little" Jill said. "Maybe we'll try a little oxygen. Let me get you a mask..." as she leaned over to her anesthesia apparatus and switched on pure oxygen. She held a clear mask with a milky inflatable seal over Jill, "I'm going to put this mask over your face, just breathe normally. There will be a hissing noise". She lowered the mask onto Jill's face slowly, using minimum pressure to make the seal. Jill smiled unabashedly, requiring a firmer pressure to keep the mask sealed. Jill's oxygen level came back up, and the anesthetist removed the mask. "Now we're ready to numb your airway..." A nurse stepped in just then and asked the anesthetist to come to the ED because of a difficult intubation. "I'll be back in a little while, just rest here", and was off. Jill thought, "Just rest! HA! I'll take care of things myself". Jill waited a minute for the staff to be gone out of earshot, then made her preparations. She sat up on the exam table and reviewed the surrounding equipment. Tube, syringe, stylette, gloves, lube, bite block/tube holder, ambu bag, humidified air, suction, everything she'd seen in her other experiences. She swiftly checked the tube's cuff, perfect. She then put on a pair of exam gloves and peeled the endotracheal tube's bag open. Then Jill applied the lube to the bottom end of her tube and slid the thin aluminum wire stylette into the tube. She then bent the ETT into a "J" shape and carefully laid it back onto the sterile tube bag. Now she took a minute to focus her thoughts, knowing how much she would have to stay in control to intubate herself! Carefully she picked the tube back up, inspecting its curves, imagining how to best fit it into her throat. Jill tilted her head back a bit and opened her mouth halfway, jutting her chin slightly. She then passed the tube over her tongue, taking a few deep breaths as the tube hovered just ove her epiglottis. Imagining the tube sliding down her windpipe effortlessly Jill advanced the tube into her larynx until it touched her vocal cords, making her cough repeatedly until she breathed in. Removing the stylette, she pushed the 7.5mm tube down past her vocal cords. "That's the worst of it", she thought as the cuff rudely parted her cords. As the cuff went on past her cords she found the most comfortable spot to secure the tube (comfort being relative in these situations!), and filled her tube's cuff with air until she felt a warm fullness in her throat. Now she breathed easy, returning her focus to room around her, a room with two jaw-dropped medical personnel at the door. Smiling around her tube, Jill held up the tube holder and waved it at the nurses. "I don't believe it! How did you do that?" one asked, oblivious to the fact Jill couldn't talk back even after seeing her intubate herself. Fortunately the nurses had done a respiratory tour and knew what to do, They checked Jill's work, still in disbelief, applying the tube holder and securing it with the wide latex band attachment. They connected the humidifier tubing and sat with her as she tried to answer questions with hand gestures. She was saved by the entrance of Dr. Marks, who was quickly brought up to date by the nurses. Looking her over Marks said, "Jill, that's very dangerous to anyone not trained to intubate. Don't ever do that again". Jill looked pouty and shrugged, but thought "Glad you can't read my mind! And how does one train to intubate themselves?". Dr. Marks examined Jill, sliding an endoscope into her tube for a quick look at her carina. Jill breathed with some difficulty while being scoped. Removing the endoscope, Marks instructed the nurses (part of the test team) to catheterize Jill. Jill was laid back down, her gown was lifted, boxes were rattled in preparation. "Spread your legs, this will keep you from having to run to the bathroom while we do the tests." Jill felt the cath enter her urethra, and urine pouring out into the collection bag. She thought it felt a lot like sitting on a walnut, but that feeling faded with time. "Now let's go to the experiment room". Jill walked. It wasn't unheard of for intubated patients to walk around the halls of the clinic, just uncommon. Jill was a little disappointed at the seeming lack of attention to her and her state. The nurses carried an ambu bag and her urine collection bag. Jill was led to a private-sized room filled with several ventilators, some familiar and others very strange, modified or purpose built for liquid ventilation. She took the recliner offered to her and relaxed for a few minutes as the nurses applied electrodes to her chest and reapplied an oxygen sensor to her finger and a blood pressure cuff. "Jill, we're going to connect you to a ventilator now; it's not the liquid ventilator, just air to get you comfortable with letting a machine help you breathe". Jill was excited, watching the ventilator receive its settings, then she turned her head to meet the clear and blue breathing hose circuit as it neared her tube. She released herself to the vent, letting it fill her lungs then exhale her effortlessly. The chest electrodes were attached to a heart monitor, very quietly registering her pulse. She let the machine pump her for 15 minutes, becoming familiar again with the feel of artificial respiration. "Here's a keyboard for you to communicate with us during the tests. 1 thru 9 for your discomfort, and your opinions according to the criteria in the spaces after", she was told. The experiment was beginning. Jill's pulse raised as the ventilator was disconnected and a large funnel with a lid was attached to her tube via a short clear extension hose. She breathed nervously as a beaker of the florocarbon was brought to the lip of the funnel. "we will add this fluid to your lungs slowly, it may take a few breaths to get it all down. Please try to take it in you, it won't harm you but you will be uncomfortable." Jill nodded, a little hesitant but willing. She laid back in her chair as the first milliliters were added to the funnel. Jill saw the liquid fill the extension tubing, then bubble as her heartbeat puffed out some of her breath, then she slowly inhaled thru her tube. The fluid rushed down into her, splashing into her windpipe! She spastically coughed, sending the fluid back up into the funnel, then grabbed another breath to pull the liquid back into her! "This is much worse than my first cigarette inhale!" she thought as she gurgled the fluid throughout her lungs, shaking with an adrenaline rush. But she was getting used to it!! More fluid was introduced, and she had no choice but to inhale and breathe the fluid thru her. Jill received 1 liter of florocarbon, just enough to fill her lungs during an average exhale. "Hold your breath dear, and we'll hook you to the vent again" Dr. Marks said. Jill breathed with the vent and tried to get as comfortable as possible. She listened to the liquid filling her lungs with every inhale, rushing deep into every small space then rushing to the tube as she exhaled. The staff took note of her monitors as she breathed in and out with the vent for 20 minutes, trying to make critical analysis of her reactions. Jill then filled out the electronic questionnaire: DISCOMFORT- 4 COMMENTS- like having sack of potatoes on chest. feels like never going to get liquid back out, all over inside of chest. some diff exhaling fully. noise strange. "Jill do you want to go on to the next full-liquid test?" Marks asked. Jill gave a thumbs-up and watched as the strange ventilator was wheeled over. Heavy rubber tubes with the last 8 inches clear on the patient's side, much wider than the vent she was currently on. "This vent will breathe in and out for you because the florcarbon is much too thick for you to exhale on you own for very long" Marks explained to Jill. She nodded. The tubes had air in them for now, she noticed as they connected her to them. Jill blew out some of the liquid as they switched her over, but not much; she still had most of the first fluid in her. After checking the connection, the nurse switched on the negative and positive pressure ventilation. Slowly, Jill saw the thick rubber tubing take on the weight of the fluid and apprehensively waited for it to appear in the clear sections before it was pushed into her lungs. Then it was there, one more breath and it met her endotracheal tube, pushing a bubble of air ahead of it! Seconds later the bubbles came back out of her lungs thru her tube and into the exhalation tubing; she was breathing fluid full time now! A few rattling gurgles as the last air made it out, and she closed her eyes to feel what it was like to breathe like a fish. "We want you to breathe without aid from the ventilator for a few minutes so we can get your comments on how hard it is to breathe that way, honey", of course Jill agreed and the vent was hesitated for a few minutes. Jill felt very scared. The liquid didn't move freely through her like air, but had to be dragged in and blown out. She began feeling faint and tired of breathing, the liquid pressing against her chest. Jill began to falter! "I really don't think I can breathe like this!!" she thought. After 2 minutes she waved for the vent to be put back on, and was relieved to have the machine do all the work for the next 30 minutes. DISCOMFORT- 8 COMMENTS- really scared couldn't breathe on own. feels heavy full of fluid, very uncomfortable. would like to get off vent soon. "Okay, you did better than our other subjects actually! We will get that fluid out of you in a few minutes." Jill waited as the nurses reset the ventilator to respire air. Soon she saw the tubes lose their sagging as air moved closer to her with every breath. She breathed in the last of the liquid with a little air, then breathed out all the machine would let her. The next breath was all air, causing her to gag with the sensation! Jill blew out all she could but still had quite a lot in her lungs. Dr. Marks disconnected Jill from the vent and a nurse bagged her, urging her to breathe on her own. The ability to move air on her own, Jill began coughing against the tube in her windpipe and the liquid in her lungs, liquid dripping out the bag's exhale valve. The tube holder did it's job well, thick rubber straps holding Jill's tube in place against her efforts. It's not that Jill didn't like endotracheal tubes, but this situation was extreme. Marks passed a suction tube into her ETT, pulling out small amounts of liquid repeatedly, then letting JIll recover for a few minutes. Jill bagged herself, knowing best when to squeeze for a breath. After a few more suctioning, Jill was lifted onto a gurney and taken to the respiratory ward for overnight observation, tube in place. Later that evening, Jill succumbed to her situation and started masturbating furiously! Intubated, breathing fluid that panicked her badly, on assisted breathing now!!! She stopped with a jump as Dr. Marks entered her room. "Sorry to give you a start JIll. I'm doing my final rounds and just wanted to check on you. Is there anything bothering you? Is your tube alright? I'm very curious about that intubation job you did, but I'll ask you more in the morning." JIll nodded no, and Marks turned to leave. Jill spontaneously tapped her bedrail loudly, making Dr. Marks turn. Jill held out her hand, Marks reached unconsciously, Jill grabbed it gently. Jill lifted her gown and pulled her thigh over to show her wet and swollen vagina. Marks went wide eyed as she pulled his hand to her vulva and rubbed it all around. Jill explored her tube, showing with her eyes and hands the pleasure she was getting from her experience. Marks thoughts ran like never before! He had been dismissing his feelings for performing intubations on attractive women under the guise of professionalism. But here was a woman of great looks getting turned on by ventilation, and she DID intubate herself! He fumbled with his clothes for a few seconds, then stripped himself. He had a condom and made use of it, Jill stroking his hard rubbered erection as he mounted the bed. Jill's knees drew up, giving him full access to her very warm and ready vagina. Marks looked at Jill's face; endotracheal tube firmly in her mouth, tube holder strapped securely, ventilator tubing pulsing with life-giving air, pushing it down her tube and into her lungs! He thrust himself deep inside her, pulling most of the way out morning being added to by Marks' well sized penis shaking her insides to orgasm uncontrollably! Marks watched Jill's mouth open wide in orgasmic pleasure, the tube hanging from the holder, hearing the big draws of air with each of her spasms that went on for a minute. Marks came in her, all the emotions of his years of denial forcing him to not miss another chance like this!