The Other Side Of Gas.
Most people in this group over the age of 30 will have had General Anaesthesia at some point in their lives.
For a lot of us it was at the dentist, for some it was in a hospital.
If you have had a mask induction with a black rubber mask and hoses complete with a rubber re-breathing bag, it is something you will probably never forget.
My Dental Practice would hold regular “gas days” sometimes up to three a week, where children and adults both came in for treatment under general anaesthesia.
Our practice had it's own anaesthesia machine and I have never seen one quite like it since.
It was floor mounted with two sets of two cylinders on each side and in the middle of the machine at nearly floor lever it had what looked like a radiator from a car that the low pressure gasses passed through.
I assume this was to warm the gas up slightly before it was passed to the simple Magil type breathing circuit.
This was a corrugated rubber hose leading from the outlet of the machine that had an angled exhaust valve / mask fitting at the end.
Your visit would always start at the reception desk where a dental nurse would book you in and the patient would be asked to sign the consent form for general anaesthesia.
If you were under age you would be accompanied by a parent who would sign the form.
You were always asked when the last time you ate or drunk anything and sometimes if you have had gas before and were there any problems.
After this you were asked to take a seat in the waiting room.
If you had an early appointment you might be the only one in the waiting room, but others would soon join you.
Most of the kids were quiet and looking quite nervous, quite a lot of the adults were looking rather apprehensive too.
If you were first on the list, A nurse would come through and call your name and take you through the door back into the main hall.
If you were second or later you could watch others leave the waiting room and be taken through the standard procedure.
The nurse would stop at a door half-way down the hall open a door and ask you to try to use the toilet inside.
I'm sure that many patients were too wound up or frightened to actually manage a pee.
When you had finished the nurse would escort you the rest of the way to the dental surgery.
When you got to the door there was always a strange chemical smell lingering in the air, this became stronger as the door was opened.
You were then ushered through the open doorway by the nurse and the door closed behind you.
I always tried to have a good look around that room but usually got thwarted by a bloke in a white coat saying something like “Hi John, come and take a seat”
The seat in question was like the chair in our barbers shop but this one had extras.
You would mount the footplate and get into the big leather chair.
“Have you had gas before?” The guy in the white coat asked.
I shook my head to mean no.
“Right John, I'll explain how it works, I will give you some nice sweet gas to breathe from this mask” Holding the mask in his hand. “ I want you to take a few nice deep breaths for me, from the mask and you will gently slip off to sleep and when you wake up it will all be finished, OK?”
Another Nurse appeared and slipped a wide leather belt around me and got busy fastening it around me snugly at the back behind the big chair. “ That's so you don't slip off the chair” She said smiling.
Another nurse came over holding a big blue rubber apron that had a hole in it at one end.
“right John, I'm just going to slip this over you head, can you clasp your hands for me, that's it just keep them like that for me”
I got big blue apron over my head and noticed it had a strong rubbery smell that wafted from it as she moved it around. I also noticed that it was very heavy as the arranged it over my legs and tucked it underneath me on both sides.
“there now, that will keep you nice and snug and keep your clothes clean” she said smiling at me.
I was beginning to wonder where the mess was going to come from to make my clothes dirty, when I noticed the guy in the white coat was fetching a black rubber hose over my left shoulder, he made a half loop on my front and brought the end up towards me., I noticed that it had a mask fitted to it and it had a rubber seal all around the bottom.
All was quiet in the room except for a gently soft hiss, I realised it was coming from the mask as it was brought nearer to me.
“Now, I want you to breathe normally for now for me John”
I watched the mask being lifted toward my face the gentle hissing growing a little louder.
The mask stopped close to my face, but not touching it, I could see the gas tumbling out of the mask
It made the air shimmer like a heat haze.
As the mask approached I noticed it had a large hole in the middle that lead to the black rubber pipe from the gas machine.
There was a very strong odour of rubber, rising up from the apron as it warmed.
I was now concentrating on the mask, what was this going to smell like? I was frightened that it was going to be awful, anyway what kind of smell could put you to sleep?
I had not noticed but I was holding my breath.
“It's OK John, you can take a breath, it's not unpleasant, just a little sweet and cool” The voice from beside me said.
Hesitantly I took a ragged nervous breath.
The gas was rubber flavoured, I guess from the bag, hose and the mask, there was a very slight chemical tinge in there too but nothing really horrible.
I let the breath go and took another ragged breath, as I did so I noticed the swirling gas stopped shimmering as I drew it in, only to go crazy when I blew out towards the mask.
The view across the room to the window with the blinds on it was all wavy and distorted by the gas.
“ Can you relax and just breathe regularly and deeply for me?” The voice asked.
I felt the mask gently touch down on my face and the hand holding it moved till his fingers were under my chin, gently but firmly pressing the soft rubber sealing cuff of the mask against my face.
The shimmering effect stopped immediately, and I could feel the gas pressing against my lips and nose.
“John, take nice deep long breaths for me now and start counting to ten for me, nice and slowly” the voice instructed.
I drew another smoother breath from the mask, it was rubbery and cool, but had a definite sweetness that I could feel at the back of my throat, rather than taste.
“That's great, all the way in, nice long deep breath, One.” The voice said.
One. I repeated and exhaled again. I noticed that I had to push my breath out against the gas coming in.
Two, I said taking in another big deep breath, The sweetness was rather stronger, but nothing alarming, it was quite pleasant mingled with the rubber.
“Your doing great John, Nice big deep breaths all the way in...... and all the way out.”
Three, I said taking another big inhalation, The sweetness was fairly strong and the gas pushed it's way into my lungs filling them right up.
I pushed quite hard to empty my lungs into the mask. I felt a distant tingling feeling in my hands and feet, It was a strange sensation, It was slowly creeping upwards and inwards towards me.
Four, I said as I started another breath.
I started to feel as though I was slowly sinking into the chair, I looked down and tried to study the armrests, the were at the same height as before, so I must be imagining it.
My lungs are again full of the sweet rubbery gas, The tingles are now advancing strongly upwards and inwards in my limbs.
I pushed the gas back into the mask, The first couple of breaths were fairly normal, just like normal air, but this was starting to get sickly sweet and a bit thick.
Five, I said, letting the gas rush into my lungs till they were once again full.
This caused a slight buzz in my head as I took the breath in.
I built up the required effort to start pushing the gas back out again.
“Now I'm going to add something to the sweetness, it has a funny smell, but it's nothing to get alarmed over, just try and blow it away if it gets too strong.” The voice said.
Six I said, letting the gas flood my lungs again, it had a different smell now, it was a musty chemical smell, a bit like the glue on new shoes. This new smell had a very immediate effect on the buzz in my head, it grew to a steady low tone and a nice warm feeling spread outwards from my chest.
As I pushed the musty smell out I noticed something move on the other side from the arm holding the mask, I noticed I was feeling quite dizzy as I struggled to focus.
What I'd seen was the Anaesthetist's other hand holding the black rubber bag with a corrugated hose trailing from it, That's strange that was on the machine before.
I took another breath in, I remember that I had not said a number, what number was it? How far had I counted? These thought were interrupted by the black rubber bag being squeezed until it was nearly empty.
The gas roared as it went though the mask, it seemed to scream Innnnnnnn............. as it filled my lungs.
In my head all hell was breaking out, the buzz that grew into the low tone started howling loudly, I could no longer see what was happening in the room, I was having flashes of different coloured stars all twinkling and growing.
I pushed the heavy musty gas back into the mask, it responded with a long slow Ouuuuuuuttttttt!
I suddenly felt myself tip forwards, I felt I had fallen into the mask and everything had become black.
I heard a couple of long slow breaths that got quieter as I floated downwards in the blackness.
It was warm and quiet in the darkness, I seemed to be there for a long time, no dreams or feelings
just deep warm darkness.
After what seemed a long time, I noticed the black gradually turning grey and getting lighter until
it had almost reached white.
I noticed I could hear noise in the room, I could hear at least two people talking to each other and the occasional metallic noise of surgical instruments on stainless steel trays.
“John, It all over now, Can you open your eyes now?”
I could taste the musty anaesthetic on my breath as I breathed, I felt totally disorientated and for some strange reason I could of happily had the mast back on my face and breathe some more of the
sweet musty gas and return to the quiet dark.
“ John, Can you open your eyes please?”
I forced my eyes open and was quite surprised by the brightness of the room.
When I last was in the room it was just the Anaesthetist and myself, now the dentist and two assistants were all in the room.
I suddenly realised that I had two wads of gauze packing, one on each side of my face and they were in spaces where up until very recently I had teeth.
My mouth tasted salty and had blood oozing from the holes where the teeth had been.
A young dental assistant who was watching me offered a stainless tray to spit the blood into.
As I put my head forward it just sort of ran through my front teeth and dribbled down my chin and into the tray.
Giving me a warm sympathetic smile she wiped my face with a warm cloth.
“Just keep pressure on the packing gauze and the bleeding will soon stop” She said softly.
There was no sign of the mask or the machine it was attached too, just everyone bustling around clearing up instruments and trays with blood soaked gauze in.
“ You done really well, John, you will soon feel a lot better, are you dizzy?” The young assistant asked.
I slowly nodded my head.
The assistant offered the tray again but I indicated that I didn't need it.
She smiled and said. “ I shall get that apron off and we will take you next door to come round a bit”
As she gently pulled the apron from under both sides I noticed it was very warm and sweaty under the apron, the room air felt cold as it seeped in under the apron.
The strong rubber odour was wafted around as she moved the apron around.
She pulled the apron over my head then held it up and checked it over before moving behind me with it.
I heard the older assistant say “I'll give that a wipe and hang it up”
The assistant returned to me and gently untangled my fingers from each other, I noticed she deliberately looked at the front of my trousers and one point I thought she was going to feel them.
I looked at her questionably.
“Your fine, some people wet themselves under gas” she said.
Both assistants arranged themselves at ether side of me. “Right lets get you out of the chair and through next door.”
With that they both lifted me from the chair and carefully stood me up on the footplate of the chair.
I felt rather dizzy and swayed slightly as the supported me.
“There we go, just let us support you, Are you still dizzy?”
I nodded.
They both manoeuvred me off the footplate and slowly set off towards the other door.
I was trying to get a last look at the gas machine behind the chair, but my view was blocked by the older assistant at my side.
We entered a small room with a large padded adjustable chair, I was guided towards it and gently lowered into it.
The older assistant said “I'll just get back for the next patient.”
“OK, Ellen, see you shortly” the other replied.
Looking around the room there was a large rack in the corner with gas cylinders mounted in it, Blue Nitrous oxide on the left and Black and White Oxygen on the right.
I was quite surprised by just how many cylinders this place held in stock.
“How are you feeling now?” the young assistant asked.
“A bit woozy and dizzy still” I answered.
“That will soon pass, I want to change those gauze pads for some fresh ones” she said.
She went to a drawer and brought two sealed packages also a stainless tray, after opening the two packages she said “ Carefully and one at a time gently remove those gauze packs and spit them into here.
I complied and as soon as the packs were out I instinctively started probing the space where one of my teeth had been with my tongue.
“Try to resist doing that, you will dislodge the blood clots and give yourself dry sockets and that will be painful and rather unpleasant.”
I nodded my head.
I was still scanning around the room, I looked at the far end and there was a long couch and set up beside it there was an oxygen cylinder with a mask attached.
Further over was a drying rack that had garments hanging on it, after looking for a few seconds I realised that these garments were actually rubber covered training pants, the were far bigger than normal toddler size.
“What are those for?” I mumbled through the new packing.
“What?.... Oh those, They are for people who don't use the toilet before we go into the surgery”
I nodded. Noticing for the first time that she was wearing a badge that read Hazel White, Dental Nurse.
“What was that smelly stuff they gave me next door to make me sleep?” I said.
“It was Nitrous Oxide, with Oxygen to start with, then some Halothane added to take you under.” Hazel said.
“It was a funny smell, a bit like shoe glue, that keeps getting stronger all the time.” I said.
“I get to smell that every gas day and think it has quite a pleasant smell” Hazel said.
“Not when it's being held over your face it's not.” I argued.
“It is far better than the stuff they used to use and besides it's not as if you have to breathe it for a long time, it puts you to sleep very quickly.
“It takes ages I said I counted up to six and was still awake”
“It just seems like a long time, I've timed it and from the mask first going on your face till your eyes close it usually around a minute, It just feels a lot longer” Hazel said.
“Are you feeling better now?” Hazel asked.
“Yes, I'm fine now.” I replied.
“Right lets get you back to your Mum.” Hazel said.
Hazel watched me stand up and was ready to catch me if I wobbled or fell, but I was fine.
We walked back to the reception desk and Hazel called my Mum from the waiting room.
My Mum looked a bit concerned and asked “how are you?”
“I'm fine Mum” I answered.
“He was really good, no trouble at all.” Hazel said.
“That's good.” Mum said.
Hazel explain that if I felt any pain later I could have some junior paracetamol and I was to keep the gauze in for about an hour, then I should have salty mouthwashes and eat something soft later when I felt hungry.
As we were about to leave Hazel said “ Now if you need gas again you know what to expect and will not be frightened.”
I nodded “ It was quite weird , but quite fun too” I said.
Hazel winked at me as we left the surgery.
jbz2079 2012.