Caregiver's guide on avoiding life-threatening swallowing problems

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 Dr. 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, 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, Drs. Sayadi and Herskowitz wrote a book to help correct this situation. 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.

Advance praise for the book has come from none other than Dr. Henry Heimlich, originator of the life-saving Heimlich maneuver. He advised: "Don't wait for a swallowing disaster. This book tells you how to keep a swallowing problem from becoming fatal."

Dr. Betty Perkins-Carpenter, a leader in the area of fall prevention among seniors, called the book "a treasure."  

"It's not just the elderly who are at increased risk," Dr. Herskowitz pointed out. "Many persons with Parkinson's disease, multiple sclerosis, Alzheimer's disease, stroke, cancer, or congestive heart failure are also vulnerable." A member of the Boston University medical school faculty, he added that dehydration of any cause and drug side effects can themselves 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. Frequent throat-clearing during meals can be a clue. A change in a person's voice. 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's disease."

The book presents in clear non-technical language a brief overview of normal swallowing, shows how things can go wrong, tells what symptoms to look for, and guides the reader in getting help. A Letter For Your Doctor allows the reader to record observations and concerns. Suggestions for Safe Swallowing give the caregiver concrete guidelines for making mealtimes safer. An entire chapter is devoted to choking, perhaps the most feared of swallowing problems. It guides the reader in knowing when to carry out the Heimlich maneuver, how to do it, and when to hold off. The book is amply illustrated and set in slightly larger-than-standard type to make it reader-friendly.

SWALLOW SAFELY is 180 pages, paper, $14.95, available through Inside/Outside Press, PO Box 661, Natick, MA 01760, and through the website http://www.swallowsafely.com.