Choking and Aspirations with COPD

Dysphagia is a word you may hear more and more often. It means that someone is having difficulty swallowing. You might find that you have dysphagia if you have COPD.

Aspiration differs from choking

Drooling or choking on food indicates that you have an increased risk for aspiration pneumonia. Yet, aspiration differs from choking. When the airway is blocked by food, drink, or foreign objects, choking happens. Aspiration happens when food, drink, or even mucus enters the lungs.

Aspiration happens to me at times

I can aspirate when swallowing air. That might sound a bit goofy, but that’s the only way that I explain it. Sometimes when I breathe in and swallow, the mucus goes down the wrong pipe. Then I choke, have trouble getting air. My husband tells me it’s because I’m always talking, so I swallow wrong. That's a possibility. Then it's breathed into the lungs. No wonder why it’s so easy to get aspiration pneumonia. I have also hiccupped a couple of times and can aspirate from that as well. This can be very scary. I picture myself with a deer in the headlights look. Thankfully, I haven’t had aspiration pneumonia.

I always have my inhaler around

Because eating or drinking sometimes causes aspiration, I always make sure that I have my Pro-Air inhaler. My Pro-Air is an albuterol rescue inhaler. You may have a different or name on the inhaler that your doctor prescribes for you. Sometimes I find it hard to recover my “air” and ability to breathe normally. The inhaler helps very much.

Struggles while eating

Years ago, I worked in a nursing home. Actually, two different ones, during different times in my life. One of the most important things was knowing what to do when feeding the residents as they ate and after they ate. Some people may struggle with what they eat, be it from a special wheelchair in the nursing home to a regular dinner table in their home or a restaurant. Make sure that you or the person who might aspirate is in the proper sitting position. If the doctor has orders, follow them.

Feeding tips

One of the most important things when feeding patients in a nursing home was knowing what to do during the meal and afterward. Eating in a very low (almost laying down) reclined position, such as a person in a nursing home or even a baby can hinder the person’s ability to swallow correctly and they can aspirate. It might be safer for their head to be raised a notch or two higher. For some, sitting upright when eating, might cause the food or drink to go down a wrong chamber. Adjust the thickness of the food, which is frequently pureed. Don't eat or drink anything in bed. Sit upright for 30 minutes after eating.

Where does COPD fit in?

On Medpage Today, it was cited that “poor coordination between swallowing and breathing, in chronic obstructive pulmonary disease (COPD) may increase risk of aspiration pneumonia and exacerbations, researchers warned.”¹

Other causes of aspiration can be:

• Coughing
• Mucus (Dentures affect this too)
• Liquids - maybe you will have to add something to thicken the soup or drink
• Poor hygiene
• Dental problems which include missing teeth, novacaine, and dentures
• Anesthesia, even the "forgetting type"
• Tongue piercing
• Vocal Chord Dysfunction. I have this as well.
• Eating
• Chewing or swallowing gum
• Talking (Oh yes! Guilty!)

Aspiration pneumonia is lung damage or infection after breathing in a foreign substance.
The person might develop a cough that brings up mucus, tiredness or even brings on a fever.

Other things that are so very important

If you take care of someone who is known to aspirate, I personally recommend that you take a class or two. This includes caring for a person with COPD or any chronic illness. People who do child care, daycare, or are a student or work in a school. Some scouts can earn a certificate and badge too. It may be needed in the workplace. You never know when you will need CPR or First Aid. Here are a few last things to keep in mind:

• Know what to look for. Is the person still breathing? Did the person stop breathing? Lose consciousness? Turn blue? I asked “Does the person have a heartbeat? Are the persons' eyes reactive to light?” It’s good to know for sure. If you are going to do CPR, be sure to move the person to the floor or solid ground, where you can give compressions. Not everyone will know how to test reactivity to light. Some places may have an AED: Automated External Defibrillator. Follow directions on AED and as trained.
• Call 911
• Begin CPR when needed