Choking

by carlocmd

She was a healthy 40-year old lady who suddenly woke up to find that she could not swallow.  She ended up coughing whenever she drank water or any other liquid.

She goes to the gym regularly, doing light aerobic exercises.  She did not have any vices, no smoking nor drinking.  Her family history was unremarkable.

Upon admission, she was worked up for a stroke.  All imaging tests were normal.  Her chemistries were likewise normal.  She underwent various specialized tests, trying to decipher what happened.  All tests were normal.  There was no hint at all of a significant pathology, except for a persistent inability to swallow.

A nasogastric tube was placed for nutrition.  She was in the hospital three weeks, doing rehabilitation and therapy, until I saw her.  There was a request to install a percutaneous gastrostomy tube.  We inquired if it was possible to temporarily discontinue her blood thinners, to minimize bleeding during the procedure.  We were advised that we should wait a week for the medication to wash out.

She was reasonably easy to speak with, and has gotten used to the idea that there were no straight answers to why she couldn’t swallow.  And I admitted that I could not find a reason either.  We spoke about the risks and benefits of a tube placement.

Then as I was completing my physical exam, I said a silent prayer over her.  A prayer of healing, a prayer of guidance.  The image of Fr. Pio was on a pamphlet beside her bed.

“Fr. Pio,” I prayed, “please intercede for us.”

I told her to keep trying to swallow the food they were giving her.  She was having some success with thick goo, but water still made her cough.

This morning, I saw her smile.

“Doctor,” she began.  “I swallowed this glass of water without choking.”  She pointed to a glass that was 1/3 full.

“I am, perhaps, already eating about 10% of what I used to eat before all this happened,” she continued.

“Then maybe we do not need to place the tube anymore,” I replied.

We spoke about watchfully waiting, delaying the procedure to the last possible date to see how far her recovery goes.

I have no doubt that her healing had begun.

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