Part 5

Physiological and Emotional elements and risks

Premature Ventricular Contractions

When the body gets low on oxygen (for any reason) the heart starts to receive extra “pacemaker” type signals. It is an attempt by the body to kick start the heart into action so that oxygenated blood will reach the brain. These signals are very difficult to pick up on even with a person hooked to medical equipment designed to pick up on them! A very skilled physician may be able to figure out when a person is starting to “throw PVC’s” if they have the proper equipment and background, but even they will have intense difficulty. The extra pacemaker signals will usually effect the heart by making the ventricles contract irregularly. If one of these signals makes the heart contract at the wrong time, it can lead to the heart beating irregularly and ineffectively and finally to ventricular fibrillation (a form of cardiac arrest).

This is a very rare and very deadly phenomenon. If this happens during breath control play, it may be completely undetectable at first. The person throwing PVC’s will most likely be completely unaware of it and may seem well after the play is over. The thing is, the PVC’s may continue for up to 36 hours afterwards and the person may go into cardiac arrest at any time.

This is one of the reasons why working knowledge of CPR is really mandatory for this kind of play. Be aware that even with immediate CPR done exactly properly on a person they only have about 10% chance of coming out of cardiac arrest when it is caused in this way. If they do come out of the cardiac arrest, there is no guarantee that they won’t go into cardiac arrest again.

The best chance of survival in a situation like that is when a defibrillator is available. These are incredibly expensive (the lowest quoted price I’ve seen on one is $4,000) and they still offer no guarantee of survival even when in the hands of a trained physician. They do offer the best chance of survival, however, because they can repolarize the heart the most effectively.

Perspective Now, I would like to offer some perspective on this very scary phenomenon. The body sends out these signals whenever the body is lacking oxygen. Therefore, you are just as likely to experience this if you are straining and holding your breath while going to the bathroom, doing aerobics, moving furniture, snorkeling, having sex, or going to a higher elevation then you are used to. They rarely cause a problem (obviously) because we do a lot of these things all the time. The problem is that if they happen to your partner at the wrong time, it can mean a murder charge for you. If one is using the argument that PVC’s make any attempt at safety in breath control play worthless, I would say that is an incredible misrepresentation of the facts. One could easily use that logic to say that any activity that involves a slight lack of oxygen and extra work on the heart is possibly deadly. Living is dangerous…that is just a fact. The best a person can do is educate themselves about the risks and weigh them against the gains. Then, after making a decision, they should learn as much as they can about how to minimize the dangers. This is a danger that cannot really be minimized very much (outside of learning CPR or attaining a defibrillator), but there are many other factors in this type of play that can be adjusted to provide for more safety.

Respiratory Acidosis
If breathing is restricted, CO2 builds up and ultimately makes the blood more acidic (meaning decreasing its pH). This can cause headache, drowsiness, hyperventilation (as a way to compensate), cardiac dysrhythmias, gastrointestinal distress, nausea, vomiting, diarrhea, blurred vision, and abdominal pain. In the extreme, it can cause death.

The best way to treat it is to restore normal breathing as soon as possible.

It is also important to monitor the person to make sure that Respiratory Acidosis is indeed the cause of the problems. It may be a very good idea to seek medical aid if symptoms do not clear up quickly. An important thing to gather from this is that those who have a build-up of CO2 may experience vomiting which is very dangerous if their airway is being restricted. It would be very easy for them to inhale their own vomit, which is deadly. Therefore, make sure that when you play with someone, they are not in any form of bondage that disallows for quick removal or would be difficult to position them in such a way that they could vomit safely. I think it is a very good idea to make sure that no matter how you are restricting oxygen, you could reverse it within seconds. Have a good pair of heavy bandage scissors. They are slightly curved and have blunt points so they can be worked beneath bondage without harming a person and can cut through materials to hasten the removal. I don’t recommend using things that have a lot of buckles or that are very complicated when dealing in breath control.

Some perspective on this is that we experience this all the time and the body is an expert on how to come back from it. As long as you receive normal air as soon as possible it should never be much of a problem.

Respiratory Alkalosis If the person hyperventilates, CO2 is blown off and it makes the blood more alkaline (meaning increasing its pH). This can cause confusion and stupor, vomiting, hyperactive reflexes, seizure, rapid respiration, numbness, and coma. If the pH of the body increases drastically…it can be deadly.

The best way to treat it is by having someone do rebreathing until the hyperventilation calms down and then have a person breath normally. The classic example is to have them breath into a brown paper bag until they calm down.

Hyperventilation is something that we run into when doing breath control play because the body tries to compensate for the lack of oxygen and may go a bit overboard in doing so. It also is common that at times of fear a person will hyperventilate. The important thing to remember here is to monitor your partner for numbness and to be prepared for possible vomiting (see above) and seizures.

I would like to remind everyone that hyperventilation is extremely common and rarely becomes problematic. As long as an attempt is made to help the person calm down and do some rebreathing they should recover very quickly. This is a very common problem caused all the time by stress or physical exertion. The body is can deal with this easily if you help it along a bit.

Normal pH Range I’ve yet to figure out why people try to inform others of the proper range of pH for the body. I doubt that it will do anyone any good when playing. I suspect it is to be clever. In the interest of being clever, I shall offer that the normal pH of human blood is in the 7.35 to 7.45 range (slightly alkaline). If a person developed a pH falling to 6.9 (or raising to 7.8) they would no longer be in a range that sustains life. Now, don’t you feel informed?

Metabolic Acidosis

If there’s not enough oxygen to properly metabolize the pyruvate in the body, it is converted to lactic acid which changes the PH of the body. Pyruvate becomes a problem because the body attempts to metabolize glucose (sugar) by breaking it down into pyruvate that is supposed to quickly combine with oxygen and produce ATP which the body uses for energy but since the body doesn’t have oxygen, it converts to lactic acid and starts to make the PH plummet.

This can cause headache, drowsiness, hyperventilation (as a way to compensate), cardiac dysrhythmias, gastrointestinal distress, nausea, vomiting, diarrhea, blurred vision, and abdominal pain.

It is treated just like respiratory acidosis. Get them breathing regular air as soon as possible. Please see the explanation of respiratory acidosis for more information.

This is something that can quickly correct itself. It would most likely only become life threatening if breathing was not restored to normal quickly.