BY W. GIFFORD- JONES MD & DIANA GIFFORD-JONES
The immortal Shakespeare wrote in the play Macbeth, “Each new morn new widows howl, new orphans, cry, new sorrows strike heaven on the face.” He was not wrong.
Readers may wonder how I am faring as I near the start of my 99th year. I am glad to report while getting older is rarely much fun, my medical training remains useful!
At a holiday luncheon with long-in-the-tooth friends, one started to cough. It was nothing to attract attention. But the situation suddenly changed. His coughing became intense and breathing more difficult. Food had become stuck in his throat, probably lethally so.
I knew what I had to do.
As a surgeon, I’ve faced many crises: heart attacks, strokes, and other life-or-death situations, but during my long life, I have never had to help someone choking on food. It’s frightening when it happens.
I have practiced what’s known as the Heimlich Manoeuvre on dummy equipment, now it was the real thing. I rushed to start this life-saving procedure on my friend, who was now intensely coughing, struggling to breathe, and unable to speak.
If readers encounter this situation, keep calm and ask someone to call for medical help. From behind the choking person, wrap both your arms around the patient’s abdomen halfway between the navel and the lower ribs. Make a fist with one hand and place your other hand firmly around your fist. Then thrust both hands in quick jerks inwards and upwards into the abdomen five times. Hopefully, this will dislodge the food. But if it does not, repeat the manoeuvre.
Every year, about 5,000 people die in North America from choking on food. More than two-thirds of victims are over the age of seventy-four. Many people choking on food rush to the bathroom where someone later finds they have died.
If you are alone and choking, you can perform the Heimlich on yourself. Place a fist above the navel, grab your fist with the other hand, and use the weight of your body over a chair or table to help thrust your fist inward and upward.
Thanks should go to the late Dr. Henry J Heimlich. He was a Cincinnati chest surgeon who practiced first on beagle dogs to develop the procedure.
Fortunately, my efforts were successful, and my friend survived.
You might think it remarkable that at my age I can perform the move, but I am in good company, as Dr. Heimlich himself also performed the manoeuvre at the age of 96 on an 87-year-old woman, saving her life.
The universal sign for choking is hands clutched to the throat. If you are not sure if someone is choking, and they don’t give the signal, look for the inability to speak, noisy or squeaking sounds in breathing, weak or strong cough, and skin, lips, or nails turning blue.
The best form of prevention is to chew food slowly and well. Avoid common choking hazards for seniors, such as dry food like crackers, rice cakes, popcorn, and bread, especially with peanut butter or other sticky spreads. Older people often use hard candies to generate saliva, but this is very risky.
Prevention of choking among infants and young children requires extreme vigilance. Keep small items out of their reach. On children, too, the Heimlich is possible, but the first step should be to call for emergency assistance and stay calm in providing details so that experts can give optimal instructions until help arrives.
It’s the doctor’s somber work to remind readers to be cautious over the holidays. To all, best wishes for the season.
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Dr. W. Gifford-Jones, MD is a graduate of the University of Toronto and the Harvard Medical School. He trained in general surgery at Strong Memorial Hospital, University of Rochester, Montreal General Hospital, McGill University and in Gynecology at Harvard. His storied medical career began as a general practitioner, ship’s surgeon, and hotel doctor. For more than 40 years, he specialized in gynecology, devoting his practice to the formative issues of women’s health. In 1975, he launched his weekly medical column that has been published by national and local Canadian and U.S. newspapers. Today, the readership remains over seven million. His advice contains a solid dose of common sense and he never sits on the fence with controversial issues. He is the author of nine books including, “The Healthy Barmaid”, his autobiography “You’re Going To Do What?”, “What I Learned as a Medical Journalist”, and “90+ How I Got There!” Many years ago, he was successful in a fight to legalize heroin to help ease the pain of terminal cancer patients. His foundation at that time donated $500,000 to establish the Gifford-Jones Professorship in Pain Control and Palliative Care at the University of Toronto Medical School. At 93 years of age he rappelled from the top of Toronto’s City Hall (30 stories) to raise funds for children with a life-threatening disease through the Make-a-Wish Foundation. Diana Gifford-Jones, the daughter of W. Gifford-Jones, MD, Diana has extensive global experience in health and healthcare policy. Diana is Special Advisor with The Aga Khan University, which operates 2 quaternary care hospitals and numerous secondary hospitals, medical centres, pharmacies, and laboratories in South Asia and Africa. She worked for ten years in the Human Development sectors at the World Bank, including health policy and economics, nutrition, and population health. For over a decade at The Conference Board of Canada, she managed four health-related executive networks, including the Roundtable on Socio-Economic Determinants of Health, the Centre for Chronic Disease Prevention and Management, the Canadian Centre for Environmental Health, and the Centre for Health System Design and Management. Her master’s degree in public policy at Harvard University’s Kennedy School of Government included coursework at Harvard Medical School. She is also a graduate of Wellesley College. She has extensive experience with Canadian universities, including at Carleton University, where she was the Executive Director of the Global Academy. She lived and worked in Japan for four years and speaks Japanese fluently. Diana has the designation as a certified Chartered Director from The Directors College, a joint venture of The Conference Board of Canada and McMaster University. She has recently published a book on the natural health philosophy of W. Gifford-Jones, called No Nonsense Health – Naturally!
