Monday, May 26, 2008

Caregiving: dysphagia and choking

Dysphagia (dis-fey-juh, -jee-uh) derives from the Greek root dys meaning disordered, and phagia meaning "to eat". 


As I finished mowing my lawn Sunday afternoon I noticed my cell phone had a voice message from Patti’s care facility.


Checking in I learned that Patti had a near disastrous choking episode during lunch.


Patti’s level of MS progression changes the formula for the signs of choking, her physical and cognitive impairments from Multiple Sclerosis confound communication between brain and body to signal – HELP!


Cyanosis (turning blue) should be a warning sign you do not even want to see. Lack of oxygen in the blood is why the face is turning blue. Even MS cannot confound this biological last call for help.


Fortunately Patti was in the right place surrounded by professional medical help. A Heimlich maneuver was successful and she instantly began breathing on her own.


If anything she was probably over monitored for everything the next couple hours and continues to be monitored for aspiration pneumonia which can result if food or gastric particles were inhaled into the respitory tract.


In assisted dinning the ratio of staff to residents is at minimum 2 staff to 4 residents at every table. Additionally Patti’s food is literally ground up into tiny pieces.


Patti’s MS related dysphagia short circuits the brain’s communication to all the muscles involved in the physiology of swallowing. Because it is all about short circuiting she may eat just fine one moment and be choking the next.


Whether in a care facility or with family eating may be the most dangerous aspect of caregiving in Patti’s case. All the more challenging since meal time tends to be highly social and distractions compete with monitoring.


Picking Patti up later for an outing she was in fine spirits. MS memory loss and mental confusion I guess can have a silver lining when they serve to erase trauma.


Patti’s version … “My memory sucks, I just want a cigarette.”  


Caregivingly Yours, J Patrick Leer 





(also available in Blogger edition, Caregiver Blog: "Caregivingly Yours")


  1. gotta love Patti's attitude; is she able to smoke at the care facility?

    I hope you guys enjoyed your outing and I hope you enjoy your day today Patrick


  2. .i love the way Patti cuts to the chase!

  3. That was scary... thank goodness the staff know how to deal with this kind of thing. I've never seen anyone turn blue. I learned the Heimlich maneuver back when my son was in the Cub Scouts, and I was a Cub Scout Pack Leader... I wanted to know how to handle the more common medical emergencies since I'd be around kids in outdoor situations. I took First Responder Training, and Red Cross CPR training. I've never had to use any of the training over the years, but at least I was prepared. I'm glad Patti is well, and even that she doesn't remember the event. Have a good week. bea

  4. (((((((((((((((((((((((HUGSTOYOU))))))))))))))))))))I think Patti is a very strong and brave person to go through all She has been through.Patti,is very lucky to have you.I have trouble eating all the time,maybe,not like patti,but.everytime,when I eat,it always gets stuck right in the middle of my throat and I have to stick my finger down to get it out.No,I am not a belimic or the other word.I love to eat.I do need to get that checked out.HAve a good week.

  5. Gosh! a frightening episode, even with people around that know what to do.  Am glad Patti is ok.  I like how you spell the word out, some of these terms differ with accents and become another word.

    I like your art :) sounds a wonderful day, one to be savoured. Rache

  6.  I am glad it turned out ok.  Choking is so frightening.  I love the way she handled it , My memory sucks and I want a cigarette, LOL.  Such is life.


  7. Glad Patti's ok... Maybe it's just as well her memory sucks... and only wants a cigarette!! It's a great thing she was in thte care facility. She might be 'over-monitered', but that's ok.



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