Anethesia/sedation

Trigger warning - mention of drugging , medical/dentist talk

So I have an abscess on one of my teeth and need a root canal to save the tooth. We often have a hard time keeping still at the dentist due to our anxiety and ptsd so our mom thinks we should be sedated . I’m worried because my alters have talked about being drugged and waking up in the “bad place” , we’re very good at masking that we’re a system under most circumstances but we worry that waking up not remembering what just happened will be triggering or someone other then me might wake up and act like a kid or something , or worse act aggressively . I’ve tried to bring up my concerns to my mom but she’s minimizing them / not listening . I was wondering if you’ve been under sedation or anethesia for a medical procedure what was your reaction upon waking up? I’m trying to figure out if my fears are rational here. Also if anything helped you . I’m planning on talking to the kids in my system to make sure they understand what might happen , as well as at least trying to give the people doing it some sort of heads up about my past (not sure how much is nessacarry , should I try to explain what a dissociative disorder is to people that may not know?)

I have had every type of anesthesia over the years with no issue. Also, I am sure that dentists see all types of reactions, so even if you acted different, they'd just think it was that.

I would never choose to tell them I have DID, just anxiety and depending on the situation that I can dissociate. I only had to explain that at the dentist during my first cavity being filled when they numbed me, and I started freaking out internally. But I think they gave me too much numbing, so it felt like I couldn't swallow (but I could).

The most interesting thing I had was when I was out fully for surgery, and it was actually a nice warm place for a bit. I had similar worries of things going bad with each type of anesthesia, but nothing weird or bad happened.

I'd just explain the procedure to the young ones and reassure them that things will be okay. If by chance something does happen, maybe try to come up with a plan beforehand or if you can, get the young ones to go inside somewhere safe.

I had a full anesthesia for my top surgery. When I woke up I had a few reflex movements with my arms, but that's normal for me when I wake up or fall asleep.

Before the surgery I made sure everybody knew we were at the hospital for a procedure that would make us feel better on the long run. Made sure that everybody knew we would wake up in a hospital but that things will be ok and the nurses will be here to help us stay calm and stay safe when we wake up. I made sure that everybody knew the nurses could try to keep us in bed for our own good in case we try to get up too early for the body. That things could be fuzzy and confusing for a few hours after we wake up, time for the body to completely wash out the anesthesia. The most vulnerable/anxious parts stayed inside deep in a safe place waiting for things to settle down. I did not even have to suggest it to them, they just went "Okay I'll stay inside you call me when things are settled outside."

Inside, it was an adult part who woke up first. Then he made an inside full check-up and everybody was calm and relaxed. The parts who stayed inside deep were just "Oh you woke up? Cool, cool." I was afraid at first that I would be rapid-switching but it turns out I was too confused and in too much of a haze to panic or switch. I just got an earworm for days of the song on the radio when I woke up.

I had the exact same fear. I had to get my wisdom tooth removed a few days ago, and it had to be done under general anesthesia. We worked around it with our resources and our T, and everything went totally fine. I wrote about it, what we did etc. on another forum, I can copy/past here.


For context

So, as I said, we were afraid of waking up after the anesthesia. Usually, when we suddenly awake from a normal sleep, it's our physical protector who wakes up first. One important thing to note is : he holds the "flight/fight" responses, he will fight anything that prevent him to run away when triggered.

During those past years, he calmed down a lot, and now it takes a very serious situation to trigger him - which, at this point, is considered normal - or an intense EMDR session. But he's a sub-system, a group of an ANP and multiple EP, and we didn't know if they are integrated enough now to stay together even with the effect of the anesthesia.

Aside of that, my mom is a nurse, and I've already seen a friend and animals waking up from anesthesia. I know the consciousness of the environment doesn't always "wake up" at the same time as the brain. Sometime, patients are so confused they try to get up, can't be talked out of it, and need to be forced to stay on their bed, so they don't fall and hurt themselves. It's for their own safety, and they really try to avoid it and talk to the person to calm them down. But being hold against his will is a part of our physical protector's trauma, and I doubted he could be calmed down by talking if it reached that point.

So yep, we were afraid our physical protector would be the first one to wake up, react badly and end up with more medical trauma because of that.



What we did before

Since the moment we knew we had to do the surgery, we made sure everyone knew what will happen. We worked hard to share all the information that were appropriate for anyone to hear, using every communication tools we know works for us (meeting in our head, talking out loud, writing).

The goal was to make sure that anyone waking up will have a chance to understand quickly where we are and what's going on. As I said, we have already seen what's "waking up" can look like, so we shared this information too. One thing we insisted on, because we didn't know if a young alter would wake up, was : maybe the brain will not be awake right from the start, so maybe some alters, like the adults, might not be available right from the start. It will be normal, they'll just have to wait. It's like a very old computer turning on, it can take time for all component to be ready. It might be scary, but it's very normal, they will wake up, and they will come back.

We also worked to build a safe image for visualization, that was our safe mental place for the surgery. We used an image that we already visualize for falling asleep when under stress or anxiety, but the goal was to have one totally disconnected from anything we have done before, to not have "parasite stress" raising from weird associations made on the moment. So we took the "falling asleep" image and changed the POV for one we never used before, and it was enough for us.

I warned the medical team that I have PTSD and can have a very bad time waking up. They are used to having bad wakes up, and the anesthetist I met pre-surgery already knew the link between bad wake up and PTSD, so they wrote a warning about a "potential bad wake up due to psychological condition" in my file. The team took it seriously and made sure to take care of everything to prevent the risk of having to hold me in my bed.

Also, we had an appointment with our T just the day before, to make sure we thought about everything. It helped a lot to ease the anxiety.



The Big Day

We weren't anxious at all, to our big surprise, and the grounding technics were used mainly in the waiting room to reassure the young ones, like a stuffed animal would have.

Those who didn't want to be involved at all went into their room, after we shared all the info one last time. At the end, we were only three remaining conscious : me, the main protector and the physical protector. We decided it was best if our physical protector stayed conscious of the outside. He was stressed, but not too much, so being aware of what was going on until we fall asleep seemed a good decision, to try to make sure he'll understand what was going on if he was the first to wake up.

We went into our safe mental image as soon as possible, to have enough time to be correctly focused inside of it, to feel every aspect of it (temperature, sounds, textures, etc.).

Just before the anesthetist came, we remember our talk with ArbreMonde about it, and how it was the part who fell asleep who wakes up, so we decided to put our main protector to the front. He's really calm and not violent at all + he's our gatekeeper, so the others can't be co-present with him like that.

Just a side note : luckily, we were warned of what the anesthesia might feel like just before you fall asleep. For us, it felt like an acute derealization crisis, it was really weird - but we understood what it was and didn't freaked out.



Results

From what my mom (she works here, so they let her be in the recovery room) and the other nurses said, it was our main protector who wakes up first. He talked to them a bit. From what I saw inside when I woke up, the kids were the second ones and he stayed with them, then I was the next one.

At the end of the day, the anesthesia had a very strong effect on our brain, and all the anxious alters were still asleep when everyone else woke up - which include our physical protector. We were really awake and okay around 10am, but they woke up only around 3pm.

So, everything went just fine.



Also...

Anesthesia ins't exactly like normally falling asleep. It's more of a "on/off" thing. People usually remember well everything just before the injection. We remember what the team was talking about, what the room looked like, etc. My mom often talk about how patients can continue a talk they were having while the injection was made right after they properly wake up.

I wanted to address the fear of having a young alter waking up first and acting like a child : medical teams see people regress because of anesthesia all the time. It will not be weird at all for them. They are used to much weirder reaction than that!