Most Important Fact to Remember:
You are the one who has final responsibility for your own health, whether you are submissive or dominant, top or bottom.

This has three aspects:

• You need to keep yourself as well informed as possible about your medical condition, both in general and as it relates to BDSM.
• You need to make sure your play partners (and anyone else relevant) know everything they need to know in order to play with you safely.
• You need to put your knowledge into action – don’t do anything you know or suspect to be unsafe for you, or let others coerce or persuade you into doing so. You only get issued with one body, so make it last!

Some General Advice

• If you carry any medication ‘for emergencies’, consider showing your play partner(s) how and when to use it.
• If you simply must not ever miss taking your medication, consider taking some with you when you go out to play if there is even a remote chance that you may not get back to wherever you left it in time for the next dose. If you are going to carry medication around with you, make sure that it is properly labelled and kept safe.
• If your medical condition is unstable, make sure that there is always someone with you who knows what to do if you take a turn for the worse, or at least wear a Medic-Alert item somewhere where it will be noticed. Try to avoid playing in places where there is no means of calling for qualified help should this be required. Nowadays, this is quite easy – with the advent of mobile phones, you can call an ambulance from the middle of a field. Provided you have a mobile phone, some credit, a battery that isn’t flat, and reception, of course. Make sure you have all of these if there is no land-line. Make sure you know where you are: ‘London’ is not specific enough for the Ambulance Service to be able to find you.
• If you are at risk of suddenly becoming unconscious, make sure that your play partners know. This will affect whether, and how, you do bondage, particularly – whether you are top or bottom. If you enjoy being put in bondage, a sudden descent into unconsciousness could put strain on all the wrong places. If you are in upright bondage and suddenly become unconscious, your top then has the task of lowering you down without damaging either of you, and this can be harder than it looks. Consider using an arrangement of pulleys so that you can be lowered in a controlled manner. If you are the top and at risk of sudden unconsciousness, ensure that your bottom always has a way to rescue themselves from bondage – even if it’s only having a phone within reach. If you need any of these arrangements, test them. The point at which you are trussed up like a turkey and your top is lying on the floor is not the time to discover that while you can touch the mobile phone on the little table, you can’t actually pick it up and dial.
• If your medical condition limits your day-to-day activities in any way, think about how this relates to your BDSM play. Are there any similarities? If so, apply the same restrictions.
• If there are circumstances which you know make your medical condition worse, avoid creating them. Even as part of BDSM play.
• If your medical condition affects your perception of, and/or ability to react to, the world around you, your partner(s) need to know. Ideally, if you go to clubs alone, someone on the club management team should know. You will need to keep your limitations in mind constantly, and so will your partners.
• If you have reduced feeling in any part of your body, it would be best to avoid play involving that part – whether it’s impact play of any kind, or bondage. With impact play you need to be able to tell when you are taking too much damage, and with bondage you need to be able to tell when your circulation is restricted.
• If you have any difficulties of perception or communication, make sure that you have a way to communicate with your top/bottom that you want the scene to stop.
• If your hand/eye co-ordination is affected, be careful with impact play. Consider using some kind of shield so that if you miss your target you won’t hit anything you’d rather not.
• If your medical condition affects your breathing, breath control play is probably best avoided. If you are desperate to do it reading this website is probably not going to stop you (I know of asthmatics who like breath play because it gives them some control back), so the advice is to be very, very careful. Always play with someone who knows you and your condition very well indeed, have emergency medication to hand, always have a way to get you out of whatever restriction has been applied very quickly, and never, ever play whilst even slightly drunk. Alcohol affects judgement, so adding alcohol to the breathing problems/breath play combination is a recipe for disaster.
• If you wear a Medic-Alert, make sure that it can still be seen and read/opened even when you are in the middle of a scene. It will be no good to you if it is hidden below a layer of skin-tight latex and lots of rope.

This list is not, of course, exhaustive. But hopefully it will have got you thinking along the right sort of lines. The key is to think ‘Under what set of circumstances, however bizarre, could this go wrong?’ – and then plan to stop it happening.

Bibliography
The Toybag Guide to Dungeon Emergencies and Supplies. Jay Wiseman, Greenery Press 2004. (This is an excellent little book; I recommend that you read it – its ISBN number is 1-890159-54-9)