'Tis the Season To Be....Careful

“We’re talking about eating – specifically swallowing,” said Dr. Joel Herskowitz. “Choking is a hazard at any age – not just for young children,” said Dr. Herskowitz, a pediatric neurologist on the Boston University Medical School faculty.

“Choking on food accounts for three to four thousand deaths every year in the United States,” he said. “Most of those are adults.” The elderly, age 65 and older, appear to be particularly vulnerable.

“It’s not about being old,” said his wife, Dr. Roya Sayadi, a speech-language pathologist with the Visiting Nurse Association based in their hometown of Natick, Massachusetts. “But as people age, they often pick up medical and neurologic disorders that set them up for swallowing problems.” The kinds of problems she sees in her practice include Parkinson’s disease, multiple sclerosis, stroke, Alzheimer’s disease, cancer, congestive heart failure, and COPD (chronic obstructive pulmonary disease).

The choking that is of greatest concern results from blockage of the airway. This can occur at the level of the throat or the trachea (windpipe). With complete or near complete obstruction, the person will not be able to breathe, talk, or cough. She may clutch her throat in a sign of distress. She may leave the room in panic out of embarrassment.

“When that happens,” Dr. Sayadi stressed, “you must follow that person. To the bedroom, to the bathroom, wherever” and, if necessary, carry out the Heimlich maneuver, as recommended by the American Heart Association.

What kinds of foods should people be careful with? “Food and liquid in general,” said Dr. Sayadi. She noted that with the excitement of the holidays, talking, laughing, and drinking alcohol may add up to a dangerous situation. Meat (especially steak), hard candy, peanut butter, marshmallows, and hot dogs are on the list of foods that require special attention.

Weak muscles of the face, mouth, and tongue, poorly-fitting or painful dentures, or dry mouth due to medication side effects, radiotherapy, or simply dehydration can interfere with safe swallowing and lead to fatal choking.

Dr. Sayadi pointed out that a life-threatening choking problem may be preceded by more subtle swallowing problems. “If you’ve ever had the sensation that food or drink ‘went down the wrong pipe’,” she said, “you’re probably right. This may be signified by a fit of coughing, runny nose, teary eyes, a change in voice (becoming “gurgly”), or one or more bouts of pneumonia.

“If you suspect something’s not right with your swallowing,” Dr. Sayadi said, “write down your concerns and bring them to your doctor. He may request a swallowing evaluation by a specialist in this area such as a certified speech-language pathologist.

And, as Dr. Sayadi emphasized, you should take care in swallowing all year round, not just during the holidays. The usual recommendations apply, she said. Take small bites. Chew thoroughly. Finish swallowing before talking.

Drs. Sayadi and Herskowitz are authors of the recently-published book, "SWALLOW SAFELY: How Swallowing Problems Threaten the Elderly and Others. A Caregiver's Guide to Recognition, Treatment, and Prevention" published this year by Inside/Outside Press (www.SwallowSafely.com).

The book presents a brief overview of normal swallowing, shows how things can go wrong, tells what symptoms to look for, and guides the reader in getting help. A Letter For Your Doctor allows the reader to record observations and concerns.

SWALLOW SAFELY (ISBN 978-0-9819601-2-8) is 180 pages, paper, $14.95, available through the publisher, Inside/Outside Press, 11 Wilson Street, Natick, MA 01760, the website www.SwallowSafely.com, and Amazon.com (including Kindle version).

For additional information contact Joel Herskowitz at (508) 740-5578 or herskowitzjoel@aol.com

Inside/Outside Press is a publishing company in the Greater Boston, Massachusetts, area devoted to health, especially as it pertains to caregivers of elderly persons. Its principals are Joel Herskowitz, M.D., a pediatric neurologist on the Boston University Medical School faculty, and Roya Sayadi, Ph.D., CCC-SLP, a speech-language pathologist with the Natick (Massachusetts) Visiting Nurse Association.

Joel Herskowitz, M.D.
Inside/Outside Press
11 Wilson Street
Natick, Massachusetts 01760
USA

This release was published on openPR.