PROPOSAL FOR THE CSSG APHASIA CAFÉ MEETING, 14 JANUARY 2022
By Martin Kay, Member of the Cork Stroke Support Group
Introduction
This ‘proposal’ was prompted by an unpleasant experience on the morning of 24 December 2021. Its purpose is to make the subject available to the next Aphasia Café meeting where the Chairperson, a Speech & Language specialist, might wish to discuss it further, decide upon its relevance and even make separate recommendations for the training of stroke victims if not also of others.
Limitation
The author was reminded at the last Aphasia Café meeting that aphasia is not dependent upon prior stroke – which he had not understood. But it is difficult for him to determine whether the subject is actually relevant when he has no meaningful diagnosis of his own condition. ‘Broken voice box’, ‘compromised esophagus’, ‘problem in your throat’, ‘ we’ll decide in 6 months’ time’. Those, with erratic speech patterns, are all he has to go by.
The ‘unpleasant experience’
The author was eating a Christmas ‘short’ pastry of some sort when a part broke off and lodged in his airway. Using a version of the Heimlich Manoeuvre, he managed to clear the obstruction but wonders whether a person who was unaware of the Manoeuvre would have managed the same. Certainly, nothing had been mentioned by Speech & Language therapists at in-patient or out-patient appointments.
The lessons learned
Before the incident, the author had given no thought to how he might respond in such a situation – which is one of his key recommendations (below). The lessons learned, therefore, were all spontaneous and on the spur of the moment:
1. The victim could have as much as 1 minute to decide what to do. I might have had longer but resolved what to do in about 1 minute.
2. The Heimlich Manoeuvre assumes that a second person is present who will apply force to the underside of the rib-cage working from behind. There was no-one with me and I had very quickly to find an alternative. I chose the metal corner of the foot-board of my old hospital bed which was at just the right height for the underside of my ribs.
3. It takes courage pulling yourself sharply on to such an object but the alternative is worse. It also hurts but the pain is brief and passes quickly.
4. It is true, you can see the offending obstruction shoot out of the mouth. This gives a sense of relief (the worst is over) but not relief itself.
5. It took about a minute and a half to recover control of my breathing and by then all had returned to normal.
Recommendations
For stroke victims, it seems sensible to describe how to deal with such a crumb or obstacle. We cannot leave it to chance that all will turn out well. My first recommendation, therefore, is to formally include the topic into pre-release training for them. The extent to which aphasia victims might benefit from such explanations is not clear to me, hence the ‘Limitations’ above. My second recommendation is for vulnerable patients to think about such an eventuality in advance: do not leave it to chance
Forwarded to The Secretary of the CSSG on 31 December 2021
HAS ANYONE ELSE AN EXPERIENCE TO SHARE ?