EXPERT
John Bedolla
Emergency Physician
Dr. John Bedolla practices Emergency Medicine in Austin, TX. Dr. Bedolla assesses patients who seek immediate medical attention at any time of day or night. Emergency Medicine Physicians are trained to efficiently work with each patient and situation no matter how acute or life-threatening. Dr. Bedolla examines patients, determines means of testing, diagnoses conditions, and decides the best treatment methods.
John Bedolla
- Austin, TX
- Accepting new patients
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Choking on water?
Your swallowing and breathing tubes are actually connected until you get down into the neck. In the neck, a piece of firm tissue (epiglottis) closes like a door over the entrance READ MORE
Your swallowing and breathing tubes are actually connected until you get down into the neck. In the neck, a piece of firm tissue (epiglottis) closes like a door over the entrance to the trachea (your main breathing tube) when you swallow.
Every now and then, if you swallow too fast or too much, the epiglottis doesn't close perfectly and water in the trachea--even a small amount--will trigger a very strong cough and it can make you feel like you're choking. And it can cause laryngospasm, or tightening of the muscles in the back of the throat, and that can make you feel like your airway is closing.
A one-time event is for us not very worrisome, and we generally think: let your body be your guide.
These are the things that worry us:
1-Not back to normal
2-Still having problems swallowing
3-Pain with swallowing
4-Shortness of breath
5-Continued feeling of airway closing
6-Foreign body sensation
7-Persistent cough, chest pain, fever (sometimes when you swallow water the wrong way, bacteria can get in the lung and cause pneumonia)
8-Multiple episodes of choking on water or food.
A patient who has none of these after a one-time episode is low risk. Staying awake for a couple of extra hours to check yourself a good idea.
Every now and then, if you swallow too fast or too much, the epiglottis doesn't close perfectly and water in the trachea--even a small amount--will trigger a very strong cough and it can make you feel like you're choking. And it can cause laryngospasm, or tightening of the muscles in the back of the throat, and that can make you feel like your airway is closing.
A one-time event is for us not very worrisome, and we generally think: let your body be your guide.
These are the things that worry us:
1-Not back to normal
2-Still having problems swallowing
3-Pain with swallowing
4-Shortness of breath
5-Continued feeling of airway closing
6-Foreign body sensation
7-Persistent cough, chest pain, fever (sometimes when you swallow water the wrong way, bacteria can get in the lung and cause pneumonia)
8-Multiple episodes of choking on water or food.
A patient who has none of these after a one-time episode is low risk. Staying awake for a couple of extra hours to check yourself a good idea.
Can a person develop Co2 narcosis and become unconscious without obvious signs of distress?
Yes. Your body has two receptors that drive breathing. Receptors that tell you there's not enough oxygen and receptors that tell you there's too much carbon dioxide. In people READ MORE
Yes.
Your body has two receptors that drive breathing. Receptors that tell you there's not enough oxygen and receptors that tell you there's too much carbon dioxide.
In people with chronic lung disease, the receptor for carbon dioxide gets reset to where it doesn't alert the breathing centers when the carbon dioxide starts to climb. So, people with chronic lung disease depend only on the oxygen receptors.
If you put someone with chronic lung disease on significantly more oxygen than they're used to, their oxygen receptors think everything is just great and the carbon dioxide receptor is not working at all. The brain is thus not alerted and while the oxygen remains good, carbon dioxide continues to climb.
Eventually, the carbon dioxide will climb so high that it causes the blood to become acidic, and this will make you go unconscious and become unresponsive.
If someone with chronic lung disease develops increasing shortness of breath, it's best to take them to the emergency room. We don't recommend turning up the oxygen to higher than normal.
Your body has two receptors that drive breathing. Receptors that tell you there's not enough oxygen and receptors that tell you there's too much carbon dioxide.
In people with chronic lung disease, the receptor for carbon dioxide gets reset to where it doesn't alert the breathing centers when the carbon dioxide starts to climb. So, people with chronic lung disease depend only on the oxygen receptors.
If you put someone with chronic lung disease on significantly more oxygen than they're used to, their oxygen receptors think everything is just great and the carbon dioxide receptor is not working at all. The brain is thus not alerted and while the oxygen remains good, carbon dioxide continues to climb.
Eventually, the carbon dioxide will climb so high that it causes the blood to become acidic, and this will make you go unconscious and become unresponsive.
If someone with chronic lung disease develops increasing shortness of breath, it's best to take them to the emergency room. We don't recommend turning up the oxygen to higher than normal.
I swallowed plastic?
This may be very serious.
If it were me I would go to the ER immediately.
If it were me I would go to the ER immediately.
Shoulder injury?
Your description sounds like a shoulder fracture or dislocation.
An immediate X-Ray of the shoulder is warranted in any case like this.
An immediate X-Ray of the shoulder is warranted in any case like this.
I took atenolol 5mg twice today 8 hours apart?
Atenolol is a beta-blocker, and taking more than the usual dose can result in a low heart rate and decreased heart function. Heart rate and symptoms are the best guides. We get READ MORE
Atenolol is a beta-blocker, and taking more than the usual dose can result in a low heart rate and decreased heart function.
Heart rate and symptoms are the best guides. We get concerned as emergency physicians when the heart rate goes either a lot lower than usual or anything below 60.
In a patient who is feeling well with a heart rate over sixty and not a lot lower than usual, if it's been 6-8 hours after the accidental extra dose of atenolol, most emergency physicians would consider the risk to be low.
Heart rate and symptoms are the best guides. We get concerned as emergency physicians when the heart rate goes either a lot lower than usual or anything below 60.
In a patient who is feeling well with a heart rate over sixty and not a lot lower than usual, if it's been 6-8 hours after the accidental extra dose of atenolol, most emergency physicians would consider the risk to be low.
When should you go to ER for abdominal pain?
I don't have enough information. One thing I can say is that for age 60+, abdominal pain is very high risk. About half the patients 60+ with abdominal pain have a condition that READ MORE
I don't have enough information.
One thing I can say is that for age 60+, abdominal pain is very high risk. About half the patients 60+ with abdominal pain have a condition that requires hospitalization and about 16% have a surgical emergency.
When I turn 60, If I ever get abdominal pain II will practice what I preach, which is to go to the ED for evaluation.
One thing I can say is that for age 60+, abdominal pain is very high risk. About half the patients 60+ with abdominal pain have a condition that requires hospitalization and about 16% have a surgical emergency.
When I turn 60, If I ever get abdominal pain II will practice what I preach, which is to go to the ED for evaluation.
