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Vitamins may reduce likelihood of ARMD and Dry Eye, or the Patient May Aspirate and Die

... so make sure you read this

Written by Larry J Alexander OD FAAO Friday, 18 January 2013

As a doctor, we recommend nutritional supplements for a number of reasons. Among those are dry eye and macular degeneration. In both cases the patients often have dry mouths as well. When you have a dry mouth, it is harder to swallow things. When you have trouble swallowing the worst thing that you can do is put a large chunk of something in your mouth that is inherently a bit sticky or very dry and try to swallow it. Enter the Omega 3 1000 mg soft gel or any other vitamin supplement or pill. So which one of these in the picture is most likely to get “stuck?”

image3

But…you must also remember that with dry mouth, even the smaller pill can get stuck and/or aspirated. 

I bring you this message because the following story happened to me.  A few months ago, I was lying in bed watching John Stewart and heard this muffled cry from the kitchen where my wife was performing her nightly vitamin ritual.  “Alex, Alex…Help.”  I ran to find her turning blue and choking on something.  I quickly performed the Heimlich maneuver on her and her Omega 3 went flying across the room after a few abdominal thrusts.  After both of us settled down she told me it had happened once before when I was on a trip and she had to perform the maneuver on herself over the sink.  Now, how about that for a scare!  Working hard to stay healthy and risking her life doing so.  As I bring this up in lectures to doctors across the country there are always 2 or 3 in the audience who have personally experienced this.

According to the National Safety Council, choking remained the fourth leading cause of unintentional injury death in the United States as of 2004. In 2006, a total of 4,100 deaths (1.4 deaths per 100,000 population) from unintentional ingestion or inhalation of food or other objects resulting in airway obstruction was reported. 1

One of my favorites from Randy Travis

REVIEW OF THE HEIMLICH MANEUVER

http://emedicine.medscape.com/article/298940-overview

As a review, the universal sign for choking is:

 image4

If you see this or your significant other is calling out, you are to perform the Heimlich maneuver as described in the US National Library of Medicine http://www.nlm.nih.gov/medlineplus/ency/article/000047.htm

The Heimlich maneuver can be used safely on both adults and children, but most experts do not recommend it for infants less than 1 year old. You can also perform the maneuver on yourself.

First Aid

  • For a conscious person who is sitting or standing, position yourself behind the person and reach your arms around his or her waist.
  • Place your fist, thumb side in, just above the person's navel and grab the fist tightly with your other hand.
  • Pull your fist abruptly upward and inward to increase airway pressure behind the obstructing object and force it from the windpipe.
  • If the person is conscious and lying on his or her back, straddle the person facing the head. Push your grasped fist upward and inward in a maneuver similar to the one above.

You may need to repeat the procedure several times before the object is dislodged. If repeated attempts do not free the airway, an emergency cut in the windpipe (tracheostomy or cricothyrotomy) may be necessary.  The Red Cross version involves 5 blows to the back followed by 5 abdominal thrusts and repeated until the object is dislodged.

THE MESSAGE IS:

  1. VITAMIN SUPPLEMENTS MAY BE OF SOME HELP IN A NUMBER OF OCULAR CONDITIONS SUCH AS DRY EYE AND MACULAR DEGENERATION
  2. OFTEN VITAMIN SUPPLEMENTS SUCH AS OMEGA 3 SOFT GELS ARE RATHER LARGE…TRY THEM ON YOURSELF BEFORE YOU RECOMMEND THEM TO PATIENTS
  3. OFTEN THE PATIENT HAS A DRY MOUTH ASSOCIATED WITH AGING OR DRY EYE
  4. WHEN A PATIENT IS TO USE SUPPLEMENTS ADVISE THEM TO:
  5. USE TWO SMALLER “PILLS” RATHER THAN ONE LARGE “PILL”
  6. TAKE WITH FLUIDS
  7. USE A LIQUID FORM
  8. GRANULATE THE VITAMIN AND PUT IT IN LIQUID
  9. COAT THE SUPPLEMENT WITH SOMETHING SLICK LIKE OLIVE OIL
  10. WET YOUR MOUTH PRIOR TO TAKING ANY PILL
  11. PUT YOUR CHIN TO YOUR CHEST AS LIFTING YOUR CHIN OPENS YOUR TRACHEA AND CLOSES YOUR ESOPHAGUS…WHICH IS NOT GOOD
  12. EAT A NICE PIECE OF DARK CHOCOLATE AFTERWARD AS A REWARD

 

wikiHow takes the potential solution to a few more steps.  http://www.wikihow.com/Swallow-a-Pill

 

1. National Safety Council, Research and Statistics Department. Injury Facts 2008 Edition. Itasca, Ill: National Safety Council; 2008:8, 14-15.

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About the Author(s)

Larry J Alexander OD FAAO

Larry J Alexander OD FAAO

Dr. Alexander (1948-2016) was a 1971 graduate of Indiana University School of Optometry. He served in the US Navy then served as a Professor at the University of Alabama Birmingham School of Optometry. Larry contributed to a number of chapters in textbooks and has published three editions of Primary Care of the Posterior Segment, as well as contributed to the professional literature. He also lectured extensively in the area of ocular and systemic disease. His areas of special interest included dysfunctional tear syndrome, glaucoma and macular degeneration.  His lessons are the basis for this site and he will be dearly missed. 

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