A book by Atul Gawande, Being Mortal, has been read and discussed by many people here since it is the Oak Park Public Library’s “One Book, One Oak Park” selection for the summer.
This was a very well written book that describes the problems of medical care, aging and death with sensitivity and empathy and suggests how to approach difficult health issues with the patient and relatives. I enjoyed reading it and thought it was very informative. However, I found the way he described one ailment to be very misleading.
On page 51, the author describes a scene in a nursing home where an elderly couple is dining and both are described as “chewing slowly.” The wife begins to choke on her omelet and is in distress until her husband gives her a drink of water and explains, “As you get older, the lordosis of your spine tips your head forward. So when you look straight ahead it’s like looking up at the ceiling for anyone else. Try to swallow while looking up: you’ll choke once in a while. The problem is common in the elderly. You have to eat looking down.” The husband tells the author to “listen” and coughing and choking is heard throughout the dining room. The author then observes the husband who gave the advice experiencing a choking attack of his own. “He began coughing. He turned red. Finally he was able to cough up the bite. It took a moment for him to catch his breath.”
I had been having trouble swallowing food for the past year. A piece of meat or a lump of bread would become stuck in my throat and could not be digested; it had to be coughed up again. This happened several times at friend’s homes or at a restaurant and I excused myself saying I had the hiccups and retreated to the bathroom until I could “unswallow” the offending morsel. It happened when I was alone as well and it was very scary not to be able to breath.
I had discussed my problem with my doctor and I had in my possession a prescription referring me for an upper gastrointestinal endoscopy, which consists of a gastro scope being passed through the mouth to view the esophagus, stomach and duodenum. When I read this book I had the referral in hand, but I hadn’t made an appointment.
After I read this, I realized that I had the same experience and I thought that perhaps all I had to do was keep my head down while eating and I would not need medical attention. After thinking about how ridiculous this sounded I made an appointment for the evaluation.
I had the esophagogastroduodenoscopy (ERD) and they inserted a thin tube with a little camera through the mouth to view the stomach, esophagus, and the small intestine to determine blockage, inflammation or growths. They dilated or stretched the sphincter between the esophagus and the stomach since acid reflux had narrowed that region. The treatment itself took about 15 minutes and I had no discomfort. I was given an anesthetic and there was recovery time so the whole process took over two hours.
I understand this is a very common ailment and sometimes has to be repeated. To prevent its recurrence, I was told to elevate my head while sleeping when most acid reflux happens and also to avoid aspirin, ibuprofen or any of its trade names such as Advil and Motrin.
Choking is a frightening experience and its cause should be determined. I encourage anyone who has endured this distress to seek medical treatment. I am glad I did.
Elizabeth Mull is a resident of Oak Park.
