Pneumonia is common in people after a stroke. It ends very badly. Most often, everything happens in the first days after a stroke.
This is usually due to choking on food and stomach contents.
This happens in the elderly or in very severe strokes, or if speech and swallowing is impaired, or if after stroke, the intellect is severely affected, or if it is necessary to suppress the secretion of acid in the stomach (acid protects against microbes).
How to understand that there is a risk of choking
- if a person after a stroke cannot swallow normally;
- if it hurts him to swallow;
- complains of a feeling of food being stuck in the throat or somewhere in the chest;
- coughs and gags while eating;
- saliva leaks from the mouth;
- he has speech problems.
Exercises
More often it is necessary to try to look at the toes while lying on your back. This is how the right muscles in the throat are trained.
There is such a variant of forced swallowing with straining. This helps to improve the mobility of the tongue root during swallowing. So they train without food. The tongue is pressed to the palate and swallowed with effort.
It is also useful to learn to raise the larynx. So they train without food. You need to put your fingers on the Adam's apple, arbitrarily raise the larynx and stay in this position for a few seconds. You can start making a high pitched squeaking sound. This is how the larynx rises. Or make a swallowing motion. So the larynx also rises.
Another exercise without food. You need to stick your tongue forward between your teeth and then make swallowing movements. This is how the muscles of the posterior pharyngeal wall are trained.
Tricks to make swallowing easier
Food should be taken while sitting at 90 degrees.
After eating, it is better to spend a couple of hours half-sitting.
Tilting the head forward sometimes helps to close the larynx and push food down the throat if these muscles are not working well.
If one side of the pharynx does not swallow well, then while eating, turn the head to the weak side and tilt to the strong side. This reduces the volume of the weak side. There will be no unswallowed food left, and there will be less chance of choking on it afterwards.
There is also such a variant of multiple gulps, when repeated purposeful swallowing movements clear the pharynx of food blockages.
If a person after a stroke constantly chokes on liquid food, then they deliberately thicken the food with special additives. Sometimes it's just starch and sometimes it's water-soluble cellulose.
It can be useful to take less food in the mouth at once or alternate liquid and hard throats.
You can try different tools: cups, spoons, straws. Sometimes one way works better than others.
You need to keep an eye on such people while eating.
If swallowing is impaired, then it is better to eat food when the head becomes clear. It is best not to do this when drowsy or lethargic.
While eating, you need to concentrate on chewing and swallowing, without being distracted by extraneous things.
Better to encourage the sick person to eat themselves. You need to try to develop not only the muscles in the mouth, but also the hands and coordination. In general, any physical exercise helps to eat normally, because it improves coordination and strength.
It is sometimes helpful to pull the chin into the neck. So that you get a double chin. The closer the root of the tongue is to the back of the throat, the more pressure the weak muscles of the pharynx can create. This trick does not work in all cases. If choking begins, then the trick did not work, and it is better not to do this.
Another interesting trick. You need to take a breath, hold your breath, swallow food, cough. This sequence of actions helps to drive food past the larynx, and if something gets there, then an arbitrary cough slightly corrects the situation.
It is necessary to conduct oral hygiene before eating, wipe off excess saliva and all that. It helps to distribute saliva and moisturize your mouth before eating. And it also removes excess leftovers and drool that could have remained from the last time. It is easy to choke on these residues.
It is generally helpful to use a chlorhexidine mouthwash twice a day. This way, there will be less infection in the mouth that can cause pneumonia.
All these tricks must be told and shown by a neurologist. So demand from him.
