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Swallowing safely is no choke

That's the message of Drs. Roya Sayadi and Joel Herskowitz. They are a wife-husband team from Natick, Massachusetts, who are spreading the word that swallowing problems are everywhere and they can be deadly.

"Many people these days know about the dangers of falling in the elderly," said Sayadi, a speech-language pathologist with the Natick Visiting Nurse Association. "Caregivers are on the alert and do many things to prevent falls. But not many people realize that swallowing problems, too, account for tens of thousands of deaths every year in the United States."

These deaths result from choking, pneumonia from breathing in food, liquid, or saliva that's chock full of germs and malnutrition, Dr. Sayadi explained. "Many of these deaths can be prevented," she emphasized, if only people know what to look out for and what to do when they encounter a problem.

Recognizing a knowledge gap in the patients and families she treats, Dr. Sayadi and her husband wrote a book to help close this knowledge gap. It's entitled Swallow Safely: How Swallowing Problems Threaten the Elderly and Others. A Caregiver's Guide to Recognition, Treatment, and Prevention published this week by Inside/Outside Press.

"It's not just the elderly who are at high risk," said Herskowitz, a pediatric neurologist at Boston Medical Center and an assistant professor of pediatrics and neurology at Boston University School of Medicine. "Many persons with Parkinson disease, multiple sclerosis, Alzheimer disease, stroke, cancer, or congestive heart failure are also vulnerable." A 1967 Princeton graduate, he added that dehydration of any cause and drug side effects themselves can cause a life-threatening swallowing problem.

"Part of the difficulty," Dr Sayadi said, "is that it can be hard to pick up a swallowing problem unless you know what symptoms to watch for. Frequent throat-clearing during meals can be a clue. A change in a person's voice can be, too. Even having a runny nose while eating. Sometimes it's just "taking forever to get through a meal," a common complaint in persons with Parkinson disease, Dr. Sayadi said, "or "having repeated bouts of pneumonia.


Contact: Gina DiGravio
Boston University Medical Center

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