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45 or Die
By Dallas Hall
“Please, put my head up!” her mind
desperately cried out as she choked and gasped for air.
She couldn’t speak because a stroke had taken her voice
a few months earlier, so she pleaded with her eyes, wide
with fear, to anyone who cared to help.
Nobody did, not even when her body rocked violently as
she continued to strangle.
“Why is this happening to me?” But she already knew.
Her body hadn’t been positioned in a 45-degree angle and
her lungs were filling with fluid.
“Please!” she mouthed again and reached out a shaky hand
for someone to give her assistance. Luckily, my mother
and I walked in, just as a CNA rushed past us down the
hall to attend another patient. We stared in disbelief
as she laid there, wheezing and clutching her throat as
mucus oozed from her mouth. Horrified, I immediately
called 911, but pneumonia soon set in, then six weeks
Nannie, as she preferred to be called, was my beloved
grandmother and she had dysphagia, a medical condition
where the muscles of her throat were weak and caused her
to aspirate (inhale) food, water, or saliva into her
lungs. Because of the stroke, she had difficulty
swallowing, so solid foods were pureed (blended or
grounded into small pieces) and her water was thickened
to a honey-like consistency. Whenever she ate or drank,
her head had to be at a 90-degree angle and 45-degrees
the reminder of the time. When we entered her room that
morning, she was flat on her back.
This all began when my grandmother was sent to a
rehabilitation center for abdominal feeding tube
therapy. From the start, her head wasn’t properly
elevated while the feeding machine was on, and
incredulously, it wasn’t put on hold or turned off when
she was repositioned or changed. Only her second day at
the facility, Nannie aspirated.
How did we know? She had vomit on her nightgown.
Other symptoms of dysphagia include: difficulty
breathing, a gurgly or weak voice, coughing; discharge
from the nose, drooling, weight loss, or burping. In
some cases, there are no obvious signs: what is referred
to as silent aspiration. In my situation, Nannie
When we reached the ER, the attending physician said
she’d definitely aspirated because the X-rays showed a
significant amount of fluid inside her lungs.
Unfortunately, it came as no surprise, for we’d stressed
the importance of keeping her in an upright position at
all times only to be ignored. As a reminder, a nurse
even posted a sign on the wall directly behind Nannie’s