The Ice Chip

It’s five thirty A.M., and cold and dark. Even the cats are all curled up and asleep.

The telephone connection is amazingly clear. The tension in the hospital room seems as substantial as the phone against my ear.

“She’s gurgling, and sounds wet,” the speech therapist said. “I’m going to see what she can swallow.”

Her voice becomes louder as she speaks to the elderly patient. “I’m concerned about your ability to swallow. Can you lick you lips? Can you lick your lips?”

Holding the phone, I lick my lips in response to the orders on the other end and urge the patient to do the same.

“No? You can’t lick them? No saliva?”

Damn.

“Okay. I’d like to give you an ice chip to see how you swallow. Would you like an ice chip?”

“Yes,” the patient says in a low, weak gravel.

“Yes, I bet you would,” the speech therapist says. “You’re probably pretty thirsty because you haven’t been able to swallow anything for a couple days.

“Can you stick your tongue out for me? Can you put it out a little further? There we go. Good, that’s good. Now, I’m going to put the ice chip on your tongue, okay? There we are. Good. Now take it in your mouth and let it melt. Feels good, doesn’t it? Yes, I bet it does. Don’t let it run out of your mouth okay? Keep it in your mouth.

“Okay, are you ready to swallow? Swallow it for me. Let me see you swallow. Okay, that’s good.”

I hear an odd sound and listen, trying to understand what it is. I imagine the process it takes to let ice melt, and the muscles and passages used to swallow.

The speech therapist’s volume drops to a normal conversational level. “She couldn’t swallow, and I can hear wet gurgling.”

That was probably the odd sound that I heard.

The speech therapist says, “The fluid is going down into her airways. Normally, when that happens, we violently cough. That’s a normal reaction. But she lacks the strength and energy to cough.”

My sister-in-law speaks. “She’s in advanced stages of Parkinson’s, and hasn’t had her meds for several days, because she’s had the flu and pneumonia, and hasn’t been able to swallow. They’re going to insert an NG tube and begin her meds again.”

“Yes, we’d expect to see an improvement in a Parkinson’s patient with their meds, so we’ll try the test again after the NG tube is inserted and her meds are given.”

Thanks are given, and comments about things that will be done later are made. I listen and absorb it, but I remain thinking about the importance of a melting ice chip and swallowing.

 

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