could you describe what the process would be for a misbehaving patient (it/its, tm, afraid of needles) who was taken in to be stitched up… down there… and left in your care?
This one got a little away from me, I'm afraid it's become its own short story, I hope it was worth the wait!
1,700 words, gyno surgery, awake but numbed surgery, dubcon(owner consented on behalf of patient,) crying.
I had a similar case not too long ago, the patient was brought in by it’s owner who explained it’s inability to keep it’s hands out of its pants, after trying and failing several less extreme chastity methods under medical supervision they resorted to the extreme of having it stitched closed. This was a patient I had interacted with quite a few times before while trying to resolve this overuse issue and had been known to be a trouble maker. Generally it was muzzled upon arrival to ensure everyone’s safety. With permission from it’s owner, here are my notes on the procedure which should give you a good idea what to expect when it’s your turn on my operating table.Patient 404 was brought in by its owner at 9am, an hour before the scheduled procedure, as discussed. The patient had frequented the clinic for the past few months so while it was unaware of today’s specific procedure it was relatively at ease, familiar with the routine. It had it’s muzzle secured first thing upon arrival before being changed into a gown and having its vitals taken. An IV was inserted by the nurse on staff. The patient does not fare well with needles so it was restrained to the table and it’s owner attempted distraction during insertion. The patient still attempted to bite despite the muzzle. Once the patient has calmed down from the needle exposure he was allowed to sit unrestrained in the table. The owner stayed with the patient in the exam room.
I arrive and greet the owner and patient. Owner and I discuss how the three weeks since it’s last appointment have been. 404 has circumvented yet another chastity method and remains undeterred by the usual punishment at home. The owner and I had discussed this all over the phone last week when we decided it was time to stitch it up. Hearing the word surgery patient 404 started to panic but was able to be calmed down by it’s owner. I administered 4mg Ativan intravenously at 9:25. The patient looked a little slack-jawed but remained awake and alert. I explained to it what was going to happen. It’s owner reminded the patient that he had already signed the consent forms on it’s behalf and that he was doing this in it’s best interest. It was at this point that patient 404 tried to make a break for it, but did not make it out of the exam room before being caught by it’s owner and myself. I called for a gurney to be brought in and we swiftly had the patient secured by it’s wrists and ankles on the gurney. The patient resorted to switching between profanities and pleading. Neither of which proved effective.
Once we reached the restricted area, it’s owner had to say goodbye to the patient. Patient’s fierce facade broke and it let loose some tears which it’s owner wiped away before kissing it on the forehead and walking back to the waiting room. My patient’s pleading had ceased without an owner to hear such pleas of distress. My Nurse and OR assistant transfer and secure patient 404 on the operating table with his legs in the stirrups, removing it’s gown, while I scrub. When I enter the OR the patient is fully nude, attached to the necessary monitors and terrified. The compromising position has the patient agitated again, attempting to bite, and thrashing in it’s many restraints. I am displeased to see such behavior in my OR.
My assistant helps me into my gown and gloves, I walk to the head of the bed to greet my patient yet again. I lean in to block the bright surgical lights from it’s view, forcing it to look at me despite the mask obscuring my face. I ask if anyone had fully explained what was going to happen? It shakes it’s head to the negative. I explain in vivid detail what I will do and how it will feel. When I see the horror in it’s eyes I instruct the nurse to deliver the muscle relaxer to prevent it’s struggles from interfering with my work. I take my place between it’s spread legs. The head of the table is slightly raised so the patient can see me and enough of what I’m doing to add to the anticipation and anxiety. His owner wanted this to be a corrective experience aka scare it into behaving. 404 does not realize how lucky it is that it’s owner agreed to let me use local anesthetic. Not all disobedient patients are that fortunate.
The patient's reactions are significantly slowed by the medication, indicating we are ready to begin. I begin with the first prefilled syringe injecting lidocaine in 12 spots along the labia majora. Mild complaints and hisses of pain from the patient, “fuck, that shit burns!” Being one phrase of note. While we wait for the numbing to take effect I apply a small amount of sterile lubricant to the patient’s urethra and the tip of the Foley catheter. When I line up the catheter for insertion my patient panics, resumes pleading. I take my time inserting the catheter ensuring it feels every second of the violation. Once the balloon is inflated and the catheter is secured I drain it’s bladder and clamp the catheter using a pair of forceps. The nurse was kind enough to dry it’s tears before we begin the main part of the procedure. My assistant readies #0 sutures and hands them over in the needle graspers for me. I pinch the skin of the left labia majora tightly between my surgical gloved thumb and forefinger and watch for a response. There is a mild pain response to the increased pressure, it is numbed just to the level I intended. The needle piercing it’s delicate flesh should not hurt much if at all, but it will feel the uncomfortable tugging and pulling as I suture it’s favorite hole closed. I warn the patient to take a deep breath as I grasp the skin on the left side between forceps and feed the needle through, I repeat the same action on the right side with relatively little response from the patient. As I pull the suture suture closed I hear a gasp from my patient. The lidocaine numbs the pain but it can definitely feel the tug and new pressure. I repeat this process a few more times as my patient begins to get antsy.
When I reach the catheter I loosely wrap the suture around the catheter and secure it in place with another couple of stitches, hopefully enough to discourage this maladaptor from attempting to remove it itself and doing more damage. As I suture lower and reach it’s vaginal opening, I can’t help but insert two gloved fingers in the iodine soaked cavity, causing the boy to gasp and moan. I feel it squeeze my fingers briefly before I remove them just as quickly as I inserted them. The whole OR heard it’s audible whine of protest as it’s hole is left empty again, as it will remain for the foreseeable future. I resume suturing leaving the patient to sob quietly about the lack of stimulation and penetration it will miss so dearly. But it does not fight, it does not beg. It has resigned to it’s fate. Sometimes all you need to successfully break a patient is a trip to the OR. I finish my tidy row of sutures leaving a small gap at the bottom to allow necessary discharge to escape but not even one of it’s fingers will be able to enter.
The clank of me setting down my tools startles the patient’s attention back to me. I inform it that we are finished with it’s operation, and it’s days of vaginal penetration are equally finished. I clean up and bandage the patient before stripping my soiled surgical gear and leaving the nurse to move the patient into the recovery room. I scrub out and update the owner.
Now here’s where your experience will differ: this misbehaving patient was lucky enough to get to go home with it’s owner the same day of it’s surgery. It spent a couple hours in recovery letting the muscle relaxers wear off then left with an owner who will ice it’s sore pubic area and drain it’s catheter with far more love and affection than I would. Who knows, it might have even gotten ice cream on the way home as a post surgical treat. Many owners give in to such pleasantries often feeling guilty for having subjected their charge to the painful procedure.
You, however, get to stay with me. You will be moved to your new inpatient room where you will spend the remainder of the morning and afternoon restrained to your bed to recover. If you are unable to settle and rest I will not hesitate to provide a sedative but most patients are so tired from the stress of the event that they either sleep or cry quietly to themselves. I’ll be in and out to check on you, your catheter will be fixed to a collection bag, I’m afraid your days of using the toilet independently are gone with your days of vaginal penetration. You’ll certainly experience some soreness and pain as the numbing wears off, you will be given Tylenol and ice for the swelling which might take the edge off the pain mildly. You’ll have your arms unrestrained to feed yourself at dinner time if you can remain cooperative, however if you misbehave there’s other ways your feeding can be done. Although I’d like to remind you that your cooperation goes a long way in making your time in my care less restrictive and more comfortable. The next day you will begin to experience regular life inside the clinic and learn what to expect for your time inpatient. Every six weeks we will need to repeat the process and change your catheter tubing, clean you up, as well as examine your opening and ensure all is healthy before we stitch you back up.
Did that put your mind at ease?
