My neighbor wants me to cut his throat. Or give him a hug.

Miscellaneous and Personal Stuff I Must Share
1

Or reach down into his gullet with a clamp. Just do something!!

Got home from work today during a moderately heavy snow, and right on my heels is my neighbor, from an eighth mile down the road, hot in pursuit. The guy, staying alone at his place, swallowed a hunk of meat, and it got stuck, blocking his esophagus. Can’t swallow, can’t spit it back up. Panicking. Still breathing, thankfully, but in a panic that he will lose that ability. Gets in his car to DRIVE HIMSELF TO THE HOSPITAL 13 miles away, sees me pull in, pulls in behind me. Wants me to do an emergency trach, or maybe a Heimlich or meat extraction!

Well, I don’t do that, but I do settle him down by talking to him, get the Mrs. to call 911, and get him relaxed enough to sit still until the EMTs got there, explaining that it was better to have the obstruction removed in the ER under the care of well-equipped professionals, over me doing it right on my foyer. which is composed of slab rock. Heated slab rock, but still.

He initially wasn’t buying it, but I explained patiently that since he was still breathing, and showed no signs of stopping, all his desired interventions were contra-indicated. Trachs gone awry are more often deadly; Heimlichs when not needed crack ribs and lacerate livers; and blind probes with my trusty Kelly forceps (of course I have Kelly forceps at home, and NOT to smoke a joint, either!!) could tear tender nerve, artery, or vein tissue.

He was still dubious, but when I promised I’d consider doing all those things if they became necessary, he found acceptance.

So, I droned on in my sonorous dulcet tones, lulling him into a state of relative quiet, as I observed just how much saliva a guy who can’t swallow will produce in a few minutes. Got a bucket out for that. Impressive amount, really!

The ambulance hauled him off. We mopped up drool. Rinsed the bucket. His car is still in my driveway, not sure how he’ll get back to it, but we’ll deal with that later.

Really, the only thing atypical about this day was that this happened at home, and not work. Work was even more action-packed, but that’s expected. That’s why it’s called work.

Seriously the neighbor should have called 911, rather than drive himself, but that’s not uncommon for people in a panic to do that. I’m just glad he stopped by my place, because he’d been a menace on the road. I’m also glad I only had to clean up saliva. That’s easy. :wink:

2

Did he swallow the whole steak in one bite, or what? :eek:

You’d expect that kind of excitement at work, but not at home! Hope your neighbor’s OK.

3

Oh yes. I get the occasional esophageal spasm that shuts off access to my stomach (consequence of a hiatus hernis and scarring) with a bolus of masticated food in transit.

It doesn’t take much time and you are at risk of drowning in your own saliva.
Buckets are certainly needed, and some self-control to not panic. I certainly would not drive anywhere, though - mostly I am rushing into the kitchen for a glass of water. A good solid swallow should flush the bolus, and if not, I’m already spitting stuff out and a glass of water won’t make anything worse. Of course, that probably won’t work for a big chunk of steak.

4

Yep, I recently heard a truly appalling story from an area ED (not mine) wherein someone attempted a trach (well actually a cric) and missed badly. Pt had massive bleeding from a lacerated large vessel.

This is usually my biggest tell when determining whether someone truly has an obstructing food bolus. If they’re handling their secretions but still complaining of that lump that feels stuck in their throat/chest I give them a GI cocktail to numb the esophageal irritation and they’re all better. GI clinic f/u instead of emergent GI consult with a sedation that I’ll have to find time to perform.

5

I often have difficulty swallowing after a particularly nasty thyroidectomy. Living on my own, I often worry about that one time when I won’t be able to cough something back up.

StG

6

I was just thinking about this today (kinda)? I can probably look it up online, but, is it still called ‘choking’ when it’s in your esophagus/throat and not your windpipe? That is, it’s stuck, for reals, but you can breath. It’s painful, not just uncomfortable, but you can breath.

I had this happen a lot before I got my esophagus dilated (took three times). I learned not to panic, but to just excuse myself to the bathroom (if I wasn’t at home) or to a sink, calmly take of my glasses, get some paper towel, make sure there wasn’t anything nearby that I didn’t want to messy and, well…puke. I knew the feeling, I’d be eating and everything was fine, then suddenly a bite of food just got lodged. Maybe 1 in 20 times, it would make it’s way down after about 30 seconds (sometimes jumping a few times would move it, but not usually). When it happened, I knew the routine, it had to come up, it wasn’t going down. I got pretty good at puking just enough to pop it out.

Regarding the saliva, yeah, lots and lots of it. That’s why I’d get the paper towel out. Also, because my eyes would get really watery and my nose would run quite a bit.

So many people would tell me either that it’s ‘all in your head’ or ‘just have a sip of water or a bite of bread’. That would make things so much worse. Trying to drink anything, was painful, the water wouldn’t actually go anywhere. Having your throat go through the motions of swallowing and not being able to push the liquid down isn’t fun.

I’m guessing it was just a one off thing for him but I’m glad getting my esophagus dilated cleared my problem up. It wasn’t pretty.

So, TL;DR, is there a word for choking when the obstruction isn’t in your windpipe?

Also, ignoring nerve issues messing with where things feel like they are, this is food caught right at the top of my esophagus, not at the bottom of it.

7

Even more exciting than poisoning my spouse with heavy-metal laden toxins while I napped in a recliner at the infusion center. Actually, chemotherapy is pretty boring. But I’m not sure I want Qadgop’s sort of excitement.

8

Aphagia. Inability to swallow. Dysphagia. Difficulty swallowing.

Of course, “to choke” also means “to have difficulty breathing” and if the esophagus is obstructed and/or spasming, it certainly gives the sensation of having difficulty breathing in that moment.

9

I haven’t heard of aphagia. Most docs I see (even having nothing to do with this), will put down dysphagia if I bring it up…cept for one that seemed to refuse to believe me and put me firmly in the ‘it’s all in your head’ category, then when I finally got him to believe me, just told me to chew more carefully. That seemed like a good reason to stop going to that ENT.

But even still, you wouldn’t tell someone that you’re having --phagia, the way you’d tell someone that you’re choking*. ISTM, there’d be an acute term for when there’s actually something lodged in there.
For example, when the person in the OP comes back from the ER, what will the report say? If the item were in his windpipe, it would probably use the word ‘choking’ in there somewhere, even if it were mixed in with medical terminology.

FTR, when it happens/happened, I just tell people that “I had something stuck in my throat”.
*Yes, I know, you can’t talk when you’re choking.

10

I really love the title of this thread!

11

Joey P thank you for the tangent. My son has this and now I know the correct terms to use to describe it to his doctor.

Apologies Qadgop for the detour. Very helpful information!

12

The rest of that steak was still waiting in his dining room. Just saying.

13

I’ve seen dozens of those in the ER as you can imagine. I’ve had IV glucagon work two or three times, but usually the GI doctor gets called in for a scope.

14

Glucagon doesn’t work well. Ativan doesn’t work well. A Foley catheter sometimes works, I like to scope or, if I have to, CT them. It always seems to be steak. Though I’ve had a few fish and goat bones.

Globus is the anxious sensation of a foreign body, which is what I’d call steak in the throat. Difficulty swallowing is also often caused by esophageal spasm (DES), reflux or achalasia. Sometimes by a bad hiatus hernia, stricture, stenosis or fistula.

15

Years ago I was house sitting and began choking on a piece of pot roast. As in, entirely unable to take a breath.

Figuring I had maybe a minute to save my own life, I looked around, and finding a kitchen chair, I bent over it from behind and forcefully yanked it up into my abdomen. Out popped the piece of meat, only a bit smaller than the cow from which it came.

Later on I was told that I’d done exactly what you’re supposed to do in those circumstances; although now, when I google “DIY Heimlich,” there are plenty of recommendations, and there’s even a DIY Heimlich Maneuver Tool, available in a single decorator color for hanging in your dining room:

https://www.thisiswhyimbroke.com/diy-heimlich-manuever-tool/

16

I once ‘Heimliched’ a friend choking on a piece of donut. (I know. They’re made for you to shove the whole thing in.)

The entire incident surprised me.

Firstly because I thought she was joking.
Secondly, because I didn’t even know I knew how to do that.
Thirdly, the velocity with which it exited.
And fourthly, how victimised a dog can look when woken by a flying wad of pastry in the head.

17

(snerk!)
and now i have to clean juice off my keyboard, thanks!

mc

18

…blame the dog :smiley:

19

I can only assume the dog rectified the situation by eating the offending pastry?

20

I once had an intern at work who managed to bite off and half-swallow part of a plastic fork while eating lunch. Found him in the men’s room hunched over the sink having puked up everything he had been eating, but still hadn’t dislodged the fork-part. He was otherwise holding his neck very still and talking just enough to try to dissuade us from calling the paramedics.

We called the paramedics anyway.