Dental Anesthetic Adventure
It was 7.00 a.m. I rang the doorbell, after a few moments it was answered by a tall female figure. “Hello, I’m Dr. Hoffman -have you come from the agency?”, “Yes that’s right. My names Colin” , I replied. “Thanks for coming so early-we’ve got a busy day ahead of us, as we are the only dental surgery in town that still has the facility to use gas for extractions , we always appear to be fully booked”. I noticed that she had made the last remark with a crafty grin on her face. “Come in and I’ll show you around. I followed her along a hall and up a flight of stairs, the first area we came to was the reception area with a desk and a couple of telephones . We carried on through a pair of doors and she pointed out a room with a table with magazines and newspapers on it , with chairs arranged all around it. “That’s the waiting area for the normal dental surgery patients”, she said,” “There is another waiting room further on , that’s only in use when we are doing extractions.” As we continued down the corridor she pointed out where the dental surgeries were, I stuck my head around the door of one and saw the large leather covered dental chair with the large lamp above, all around was the usual paraphernalia for dental treatment, drills and mirrors and the mouthwash machine.
The dentist looked round to see what I was doing and said, “Come on I need to show you where you will be working today, we entered an area that had some gas cylinders sitting in a metal cage, “That’s the empties”, the dentist said, “As you can see we use a lot of gas here!”, she said with a smile, “now I asked for you to come in early so I could show what to do, I understand that according to the agency you have only assisted in surgeries where they used injections”, “That’s right Dr. Hoffman I have never assisted with gas before, and was very curious to see what was involved .” “Good the dentist said, I do like to use dental assistants who show an interest in the job, now first of all I need you to change into the surgical clothing that anyone working in the extraction room has to wear, now you will find a small room opposite the waiting room, in there you will find a locker with the clothing in, there are also some red rubber aprons could you please bring them with you as well, I think it likely that we will be needing them!. I found the changing room and sure enough there was the locker, I opened it and looked inside, I could see a dark green gown one of the kind that fastens around the back, just like what the surgeons wear also there was a pair of large white rubber Wellington boots with a large label stuck on one side that said `anti-static`, I had soon changed into the gown and boots ,and remembering what the dentist had asked picked up the red rubber aprons as well, and carried them out to the hall way, I could hear a loud noise coming through from an open door that I had not noticed before, I entered the room and there was Dr. Hoffman. I quickly realized that I was in the extraction room , I could see the large chair , but instead of being covered in leather it looked like it was covered in rubber, it certainly smelled like it! “There you are”, Dr. Hoffman said ” I was wondering where you were. As you can see I have been getting things ready in here ,let me take those rubber aprons and I’ll hang them up until their needed”, she took the aprons from my hands and proceeded to hang them up on a hook on the wall, ” We use the aprons partly to protect us, but also we use one on the patient as a form of restraint, as you have discovered they are quite long and very heavy, not all patients look forward to having their teeth taken out under gas, in fact some even try to struggle and get away!, at that I was suddenly transported back to being a small child of 7 years old and struggling to get away from the nasty dentists wearing rubber who wanted to force me to go to sleep- as you can imagine I wasn’t very keen on the idea!.
I shuddered at the memory of that event and my reaction was noticed by the dentist, she smiled and said ” I see you know what I mean”, I simply nodded in reply. ” I always like my surgery assistants to know firsthand what to expect as regards the gas anesthetic, that way it is easier for you to comfort the patient and put them at ease before the gas anesthetic is started”, I wondered what she meant `first hand`, but I soon found out. The dentist continued “I want you to give permission for me to give you a gas anesthetic!”, I was shocked when I heard this, I hadn’t expected this and at first was very reluctant to agree but after a few minutes , I could see how it would make things easier for the patient if I knew what to expect during a gas anesthesia and so eventually I agreed. “Good”, said Dr. Hoffman with a smile, “We have an hour and half or so , so we can take our time, you haven’t eaten anything since midnight have you?, I did ask the agency to tell you, it’s very important .” I remembered the agency telling me not to eat and had not done so even though I was starving!, ” No Doctor I haven’t eaten. “Good then we can begin, make yourself comfortable in the chair and I will bring through the anesthetic machine from the store room, I tell you what, why don’t I give you one of the rubber aprons to wear that way you will know what it is like for the patient when they have to wear one”, how thoughtful I thought to myself putting me in the position of the patient. The dentist walked over to the hook and picked up one of the red rubber aprons, and with a loud rustling sound, shook the apron and proceeded to put it over me, the apron was indeed long it reached down over my body and down past knees. “Are you comfortable?”, the dentist asked, I nodded yes “Good I’ll go and fetch the gas machine”, the dentist walked out of the room and left me sitting in the chair, covered with a heavy rubber apron waiting for her to return . After a brief delay I could hear the dentist returning, but at the same time could hear a loud metallic clanking sound , all of a sudden the dentist appeared in the open door way pulling behind her a large metallic trolley, that must be the gas machine I thought, I could see a row of cylinders on either side , one side the cylinders were colored light blue and on the other side they were black with a white band around the top, I could vaguely make out some other things but my attention was drawn to the mass of black rubber tubing which came out of the top of the machine and behind, they looked like coiled snakes just before they strike I thought.
As the dentist pushed the gas machine nearer said,” I will position the gas machine in front of you that, way you can see what I will be doing when I give you the gas anesthetic , also it will allow you to familiarize yourself with the relevant components of the apparatus.”. She started to point out the main parts of the gas machine- the cylinders contained two different gases, the oxygen was stored in the black and white collared cylinders and the nitrous oxide which was the gas I will be given to put me to sleep were stored in the light blue cylinders .The dentist also pointed out the flow meters, there were 3 of them arranged in 3 vertical metallic gauges and as she showed me, as the gas flow was increased a black thin rod would appear in the gauge to show the percentage of gas flow. I was shown the glass bottle which contained a powerful liquid anesthetic called ether, this was used to keep the patient asleep for longer duration procedures , but Dr. Hoffman said that I wouldn’t be getting any . I was relieved to hear that as having heard about ether from relatives who had been given it to put them to sleep for surgical operations in hospital ,they told me how it’s strong , overpowering smell caused them to panic and struggle.
Dr. Hoffman continued to show me the gas machine ,she showed me the flat rubber bag what was called a reservoir bag and told me that when a patient breathed in or out ,the bag would mirror the action that way the doctor giving the anesthetic could see if there were any problems with the patients breathing. Finally she showed me the breathing circuit, she pulled out the two black rubber tubes from behind the machine, at the end where the ends of the two rubber tubes met I could see that they fitted onto a metallic Y shaped adaptor at one end was a rotary valve, which when turned would allow the flow of gas to the mask, underneath the adaptor I could see a plain piece of circular metal, ” That’s where the mask fits on, here let me show you,”, she leant over to the back of the machine to a small tray on top, she picked up a black rubber facemask and with a slight squeak fitted it onto the adaptor, ” I’ll be using this full face mask to give you the anesthetic, it’s designed to fit over both your nose and mouth, but usually I would use a nasal mask”, she leant over again to the tray and picked up a smaller mask, I could see that there were two thin rubber tubes one either side, leading away from the mask for approx 2 feet into a circular metallic adaptor which could be fitted onto the larger mask fitting as well.
Having told me all that I should know about the gas machine, Dr. Hoffman asked “Are you ready for me to begin your gas anesthetic?”, “Yes doctor”, I replied “OK then here we go, now because it’s just you and me after I have placed the mask on your face and made sure that it’s comfortable I will be using a head harness to keep it in position, that way it will be easier for me to keep an eye on the machine adjustments as I give you the gas”, she leant over the machine and came back holding a large odd shaped piece of black rubber, it was triangular shaped but had a strip of rubber coming out at each point, each strip was about 10 inches long and had a number of holes along it’s length. She asked me to lean my head forward so that she could place the harness in position, I did so and could feel the harness being placed behind my head. “Right I think every things ready here”, she remarked.
Now I’m going to begin with just the oxygen, that way it will you a chance to get used to the mask over your face, she turned to the machine and picked up the black rubber face mask, as she brought the mask closer to my face I could see the two rubber tubes going from the mask to the gas machine, sway with the movement, all of a sudden the mask was there in front of my face, I could look into it’s deep confines and just make out the hole from where the gas would come through , also I could smell the rubber of the mask, strong but at the same time strangely pleasant. “Ready?”, asked the dentist and so I replied that I was as ready as I would ever be!, the black rubber mask came ever closer until it was actually touching my face, “Is it comfortable ?”,she asked and I nodded that it was OK, she smiled and said “Right now you are going to feel some pressure on your face as I connect the head harness ,just try to relax and breathe normally, as I breathed in and out I could hear my breaths echoing in the mask and the tubes leading back to the gas machine, I could also see the rubber reservoir bag responding to my breathing.. in out, in and out, the pressure on my face suddenly increased as the harness was fixed to the mask, first of all, I could feel as one of the rubber straps was brought one side of my head, then the other side and finally I felt it as the remaining strap was brought up over my head and fixed to the top of the mask. “Is it too tight?”, she asked, no I responded it wasn’t too bad. “Now for the gas!!” she remarked.
She turned to the machine and with a loud hiss she turned on the valve of one of the oxygen cylinders, she then turned her attention to the flow meter and set a flow , I could see the black rod inside start to indicate that there was a flow of gas going through, at the same time I noticed that the rubber reservoir bag seemed to jump to life and quickly started to inflate to the size of a large football, at the same time it suddenly became a lot easier for me to breathe in the thick confines of the rubber mask now strapped firmly over my face, “That’s the oxygen”, she said “I’ll leave you like that for a few minutes before I start the anesthetic gas. I just sat there in the dental chair, wearing a heavy red rubber apron, with a black rubber facemask strapped to my face connected to an anesthetic machine breathing oxygen, I looked at the two lengths of black rubber tubing going from the mask adaptor to the gas machine, I wondered if I were to move my head would the rubber hoses do their swaying ?, I moved my head to one side towards the gas machine and the rubber tubing started to sway as I did so- how funny I thought.
My train of thought was interrupted by the dentist Dr. Hoffman saying “Ok now that you are used to the mask and breathing from the gas machine I’m going to start the nitrous oxide, keep on breathing normally”. She turned to the anesthetic machine and turned the valve on top of one of the light blue cylinders, there was a loud hiss as the nitrous oxide started to run through the system, she then went to one of the vertical flowmeters and turned the rotary control on top, I could see the black rod showing a percentage of flow of nitrous oxide. Almost immediately I detected a change in the smell inside of the rubber facemask strapped over my face, I could still smell the rubber of the mask but at the same time there was a new smell, slightly sweet and sickly but nothing to worry me, certainly not enough to cause me to try to struggle and escape from the chair as I did as a child.
I was just sitting there concentrating on breathing the nitrous oxide through the rubber mask when after a few minutes the smell increased and the dentist said “You will have noticed that I have increased the concentration of anesthetic gas , time is getting on and so I’m getting close to putting you to sleep, I will be increasing the concentration after every few breaths and then I have a surprise for you, true to her word after a few more breaths from the rubber mask the smell inside increased, I could see the rubber bag inflating and deflating with my breathing, at the same time the sound of my breathing through the mask and hoses seemed to be getting very loud almost like water running downing a waterfall, I could feel my head beginning to spin and I had this urge to close my eyes because they were beginning to feel sooo heavy, I noticed that Dr. Hoffman was leaning very close to me and then with a smile, she turned back to the anesthetic machine and reached out her hand to the control on the glass bottle that contained the ether!!, ‘NO I thought you said no ether!, but before I had time to react, the dentists hand turned the control and as she did so I immediately detected the strong , overpowering smell of the ether-it was very sickly and it was causing me to gag and cough, it was so strong that it obliterated the smell of the anesthetic gas and rubber mask, but after only a few breaths of ether I could feel the darkness coming on of the approaching anesthetic sleep and with a roar of sound I was under!!
—” I awoke to the voice of Dr. Hoffman “wake up ,wake up now Colin”, at the same time she was patting the side of my face, I slowly regained my senses and as I did so I could feel that the rubber mask was still strapped over my face but instead of the strong smell of ether , or the sweet smell of the nitrous oxide there was just the smell of the rubber mask, “Your only breathing oxygen it will help you to regain full consciousness and at the same time clear your head of the anesthetic gas and ether, just remain seated in the chair for a 10 more minutes then you should be recovered enough to get up”, she said and so I stayed in the chair for the 10 minutes and then it was time for me to get out of the chair. Dr. Hoffman leant over me and undid the straps of the mask harness and removed the rubber facemask from my face, she lifted the mask off and as she did I could hear the hiss of the oxygen coming into the mask from the anesthetic machine, she draped the mask and twin hoses over the long cylinder bracket and as she did so they swayed until they had settled, she then turned to the oxygen flow meter and turned the control knob to turn the flow of oxygen off, as that happened the hiss of the gas coming through the mask and at the same time I looked down to the rubber reservoir bag as it started to deflate until it was completely flat.
Dr. Hoffman leant over me and removed the red rubber apron ,and then carried it back over to the hook and hung it up. “Well Colin how did you find your gas anesthetic, was it as you remember as a child?” “No Dr. Hoffman it was nothing like having gas when I was a child, then I felt smothered and as if I was being suffocated when the mask went over my face, but today was much better so much so that if I had to have a tooth extracted I would come to see you, but, I do have a question, why did I get the ether even though you said that I wouldn’t?” “Yes I’m sorry about that, it was taking so long for the anesthetic gas to have any effect on you that I had no choice ,but to move things along a bit quicker than I would have liked, anyway it’s all over and now we have only half an hour until the patients start to arrive.
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