Wednesday, 15 December 2010

Cough, splutter, choke

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I assessed swallowing for a living for about 10 years. I was a speech pathologist who worked in the hospital system and my specialty was dysphagia (swallowing problems).

When it comes to eating problems, I have seen it all. Chewing problems. Food that comes out the nose. Food that sits in the back of the mouth, unable to be cleared. Food that falls out the front of the mouth. Choking. Coughing. Swallows that are initiated so late that the food has already fallen into the lungs before the swallow is triggered.

I have palpated swallows, 'listened' to swallows through a stethoscope, x-rayed swallows and done endoscopic evaluations of swallows.

I have treated people who have tracheostomies, those who have had their larynxes removed, babies learning to breastfeed, dying patients and people with no tongues (glossectomies from cancer, usually).

I have fed people pureed food, minced food, soft food, hard foods, and chewy foods.

I have prescribed thickened fluids, water only or no fluids, depending on the needs of the patient.

I have withheld food because the person's swallow was not present and the only 'safe' way to feed them was through a tube.

One man died whilst I was present in his room before I even got to assess him. I always wondered about the person who referred this man to me. What were they thinking? But I was happy to be with the man when he died. The alternative was he die alone.

One woman choked when one of my rogue student's did not follow procedure and we had to perform the heimlich maneouvre.

All of this experience has meant that feeding my children has never raised a sweat for me. I don't mean the nutritional side of things (that has always been difficult), but the actual teaching them to eat bit. I have never feared when my toddler's have coughed or spluttered a bit whilst tackling their first lumps. I have never panicked when my children have gagged on their meat.

Last night whilst Dew Drop was munching on a corn chip (nachos) he managed to lodge the chip in the back of his throat. He went silent and then tried to cough it out but it was stuck. The Geege freaked out a bit but I crossed the room and calmly poked my finger to the back of his mouth in a sweeping action, dislodged the chip and gently bend Dew Drop forward so he could cough it out. No drama. No worries.

It is times like this that I am thankful for all those dysphagics I have treated, for they taught me a lot about the human swallow mechanism. There are few situations that would make me panic when it comes to choking. Experience breeds quick, sensible reactions that might just save a little person's life.

I am sure grateful for that.

Have you experienced any choking incidents with your kids? How did you manage?

13 comments:

Lucy said...

You.are.so.cool.

I relaxed with each subsequent child, but will have to admit to being a tad scared of the chocking possibility.

(Can I admit to still cutting grapes in half?)

Katie said...

I'm with Lucy. WHEN (not often) I let my SEVEN year old have grapes, they are cut in half. Somtimes thirds. This was one of my biggest fears as a new mother. I am in awe of your calm in handling this situation. GO YOU!!

Rachel said...

I had to dislodge a screw from Bops throat once ... why she put it in her mouth I do not know ...she puts everything in her mouth even now... I have to say I was a bit scared but I got it out and she is still alive and kicking...

life in a pink fibro said...

I wish you lived at my house. There's general freaking out and flapping when the coughing begins. We could do with some cool.

DancingInTheRain said...

Yes, I wish I had you on hand at my place at the moment. JJ is finding every small object on the ground and there are many fishing expeditions with my fingers in her tiny mounth!

CSaM said...

My little guy is only 5 and a half months old so we haven't had any choking yet. He has gagged a few times but I just say something like 'oops' so he knows not to freak out about it.

I hope that being a nurse will help me out when/if the little guy chokes on anything. Fingers crossed I can remain calm in the situation like you did with your little Dew Drop :)

Maxabella said...

Seriously cool, Coo. Thank god!

Max had that choking incident about 2 years ago (he was 4). I stood like a statue in utter fear, got myself together, fly across the room, belted him on the back swiftly 3 times and out popped a piece of apple. Fark. Just remembering it and I've broken out in a cold sweat. x

Rebecca said...

I used to be a "back slapper," but then a PA friend of mine told me that could actually make it worse. Now I simply sit across the table and yell my advice to whichever Crazy has shoved enough food into his/her mouth with wild abandon. Eventually, they'll learn their lesson, right?

Disclaimer: If one of my kids were really choking, I would totally do something. I learned the "finger swoop" technique while student teaching in a 5th grade classroom...silly boy bet his friend he could eat a whole donut...he couldn't!

Me 'N My Monkeys said...

thanks for stopping by!

I'm one of 'those ones' that could be sitting next to a child choking, (with my partner in the next room,) and instead of helping the poor child i freak out and scream out to hubby..
good thing im not in the childcare industry lol

Soo wish i could be as calm as you!

Bubby Makes Three said...

my scariest incident was when Fern was <1 and we were in Coles. She ate my shopping list b4 I could stop her, and I totally panicked! For some reason, I grabbed a woman near me and squeaked my concern. She calmly forced Ferns mouth open, stuck her hand down her throat and pulled out the shopping list!!! A total stranger!

Tracy said...

Oh, I wish I had you here in our home.... I just started Jadon with a speech pathologist because he won't eat more than a few foods and it's a problem. After his assessment, she doesn't think it's a tone issue but that he is just picky and has some sensory issues. I'm hoping she can help. It's soooo hard to get him to therapy with 3 other babies to take care of.

Interesting that just the other night Jadon got a tortilla chip stuck in his throat at a restaurant. It wasn't blocking his air, but scared us all.... Can't say I was as calm as you....

Jodie at Mummy Mayhem said...

That was so interesting to read.

I think I've always been pretty relaxed with the kids when they've struggled to swallow something. There was one time, when I was at the chemist, the 8yo (then less than 2) was munching on some cracker biscuits and got one stuck. It didn't come out as quickly, so I started to panic a bit there, but it soon found its way out.

However, the 6yo started choking on a lolly that was given to him at an ice rink, and he really struggled to get that out, and I was freaking out that time. I honestly thought something awful was about to happen. Fortunately, it eventually found its way down his throat! I wrote about it here: http://mummy-mayhem.blogspot.com/2010/04/why-i-am-so-thankful-today.html

My 3yo has a problem with fruit & vegies or anything gooey. From a baby, he would just start to dry reach, or throw up (esp if it was banana). He still gets funny with that stuff - we still have to give him pureed fruit! Agh!

Suzie G said...

We freaked in the hospital on the night Miss A was born and half way through the night she woke up gagging from all the left-over gunk inside her - we knew better with Mr C that they are learning the gag reflex and was totally normal... apparently?!

Everyone else freaks around me when one of the kids starting choking (which isn't too often), but I just calmly stick a finger in and hoick it out :) No use making the kids frantic also, if I am getting upset about it!

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