Common Questions – ABSSD

Some of the common questions that we have received are posted here for your convenience. Many times the question asked by one member, answers the same question pondered by several other members. Feel free to contact [email protected] if
you have additional questions that are not answered by our current listing.

Common Questions

What is a swallowing disorder?

A swallowing disorder, called dysphagia(dys/pha/juh), is a difficulty or
inability to swallow. There are different phases of the swallow. The
problem can affect any phase of the swallow. What happens in the mouth
is the oral phase. What happens in the throat is the pharyngeal phase.
What happens in the esophagus, called the esophageal phase. A person can
have difficulty in any or all of the phases of the swallow. If the
person can’t eat or drink enough, this will affect their nutrition.

How does normal swallowing occur?

Swallowing is a very complex process that seems to happen so
automatically that we give it little thought. Some 50 pair of muscles
and many nerves work together to coordinate all the movements needed to
transport a bite of food or sip of liquid from the mouth, through the
throat and to the stomach.

What are the different phases of swallowing?

The oral phase of swallow is where the food is chewed and prepared, the
liquid is controlled and collected and moved to the back of the mouth.
It is formed into a bolus. The pharyngeal phase of swallow is where the
food/liquid is transported through the throat as the muscles squeeze and
push the food down. A muscle called the upper esophageal sphincter
separates the upper throat (hypopharynx) from the esophagus (the feeding
tube that leads into the stomach). As part of the swallowing response,
the upper esophageal sphincter relaxes and opens to allow the food to
pass from the throat into the esophagus. In the esophageal phase of
swallow a series of wave- like contractions help carry the bolus
downwards towards the stomach. A muscle called the lower esophageal
sphincter opens and the bolus passes into the stomach.

What is aspiration?

Aspiration occurs whenever secretions, food or liquid goes down “the
wrong pipe” and enters the airway or lungs. This often results in
coughing or choking sensation. However, many individuals who aspirate do
not sense the material going the wrong way. Aspirating material into
the lungs may lead to pulmonary problems such as pneumonia.

What is silent aspiration?

Silent aspiration occurs when food or liquid goes down the wrong pipe
into the lungs and the individual does not feel it so does not cough.

What are some signs and symptoms of a swallowing disorder?

• Coughing or choking while eating or drinking
• A wet or gurgly vocal quality during or after eating or drinking
• A feeling like the food is stuck or won’t go down
• Food that may remain in the mouth or in the checks after the swallow
• Losing food from the front of the mouth
• Weight loss or reduced appetite
• Food or liquid coming out of the nose
• Sensation of a “lump” in the throat

Why can a swallowing disorder be a serious medical problem?

If a person cannot eat enough, they may become under-nourished. If they
don’t drink enough, they may become dehydrated. One of the most serious
complications of dysphagia is aspiration pneumonia. Aspiration pneumonia
can be caused by food or liquid entering the lungs and causing an
infection.

What causes a swallowing disorder?

There are several reasons that may cause and/or contribute to a swallowing disorder. This may include, but is not limited to, neurologic diseases, anatomical differences, autoimmune diseases, oncological diseases, and/or fear of swallowing. Working closely with your team of medical professionals will help you diagnosis your swallowing problem and develop a treatment plan.

How to Protect Yourself from Aspiration Pneumonia

There’s probably been a time when you swallowed some food or drink and it felt like it went down the wrong pipe. That’s when a bit of food or liquid may have headed toward your lungs rather than your stomach. Most of the time when this happens, you’ll cough, and the food or liquid will clear out of your airway. But sometimes, it can reach your lungs and develop into a type of pneumonia called aspiration pneumonia.

You can also develop aspiration pneumonia from breathing in saliva or acid from your stomach that moves up your esophagus due to reflux. Everyone has some level of reflux, where stomach acid regurgitates into the esophagus. But if your reflux is bad enough to wake you up at night, it can cause chronic lung problems that could worsen into pneumonia over time.

And people who lose consciousness and vomit could also develop it. “If you don’t cough it out, you can develop aspiration pneumonia,” said Jason McCarl, MD, a pulmonologist with Banner Health Clinic in Northern Colorado.

What are the symptoms of aspiration pneumonia?

Similar to any pneumonia, symptoms of aspiration pneumonia include fever, shortness of breath/difficulty breathing, chest pain from the inflammation and a cough that’s usually productive.

Who’s at risk for aspiration pneumonia?

You’re at higher risk of developing aspiration pneumonia as you get older, since it can become harder to swallow properly. Swallowing might seem simple—even newborn babies can do it—but it’s not. “Swallowing is a very sophisticated process that requires coordination of several different muscles in your throat. Over time those muscles can deteriorate. That’s why aging puts you at risk,” Dr. McCarl said. If you’ve had a stroke or another neurological condition, this will increase your risk.

“It all comes down to the swallowing mechanisms and protecting your airways,” Dr. McCarl said. “If you can’t protect your airways from secretions going into your lungs, or the muscles that control swallowing don’t work properly, you can end up getting aspiration.”

How can you prevent aspiration pneumonia?

If you’re at risk for aspiration pneumonia, a speech therapist can do swallowing studies to identify ways to lower your odds of developing this medical condition. They can recommend a diet that focuses on foods you’re less likely to aspirate or inhale, based on their consistency. They can also recommend techniques like tucking your chin when you swallow, taking small bites and not drinking from a straw.

If you aspirate at night because of reflux, antacids can help. “We all have reflux—that’s part of how our bodies work. But if you have excessive amounts, antacids can reduce the number of times you experience reflux,” Dr. McCarl said.

Elevating the head of your bed can also help reduce reflux. Dr. McCarl recommends putting blocks under the bedposts, so the mattress stays flat but on an angle. You can also use a pillow or wedge to elevate your head and shoulders.

If you develop pneumonia and you’re elderly, or you have a history of stroke or neuromuscular disease, doctors may recommend a chest X-ray. If the X-ray shows pneumonia in your right lower lung, there’s a good chance it’s aspiration pneumonia. That’s where whatever you aspirated tends to end up, because of the design of your lung anatomy. A speech therapist can also perform a swallowing evaluation to see if you’re coughing when you’re eating or drinking.

Diagnosis and treatment of aspiration pneumonia

Fluoroscopy—a continuous X-ray that can look for signs that food or fluid could enter your lungs—is the most definitive test for aspiration pneumonia.

If you’re diagnosed with aspiration pneumonia, your doctor will probably prescribe antibiotics to treat it. And you can take the prevention steps outlined above to make sure it doesn’t happen again.

The bottom line

If you breathe in or aspirate food or fluids, you could be at risk for aspiration pneumonia. If you have swallowing problems or reflux, your odds of developing it are higher, but you can take steps to reduce the risk of aspiration pneumonia. If you’d like to connect with a pulmonologist to learn more about your risk, reach out to Banner Health.

Other useful articles

• Should I Be Worried about Pneumonia?
• Why Am I Having Trouble Swallowing?
• Heartburn Drugs: Do the Benefits Outweigh the Risks?

Infectious Disease
Pulmonology and Asthma
Senior Health

“I didn’t think that bread could be beautiful” Many Ukrainians had to face real famine in the 21st century because of the war.

Read our material to understand what it is like

Despite the fact that many Ukrainians were waiting for the Russian invasion and preparing for it (for example, they joined the ranks of the territorial defense), few could have imagined that the hostilities would lead to the siege of several cities at once, and hence to a humanitarian crisis. At the very beginning of the war, problems with food began in the Kyiv region and Mariupol, as well as in many settlements that were in the way of the Russian army. At the request of Meduza, Kiev-based journalist Irina recorded the stories of Ukrainians who nearly died of hunger and thirst in 2022. Still lifes with food for this material were photographed by Soi.

Valentina, 70 years old, pensioner from Bucha

What she ate and drank:

ri spoons of buckwheat porridge a day, water from a rotten well, boiled potatoes, fried lard and onion soup

Na for three years at Valentina from Bucha progressed necrosis of the hip joint. On February 10, 2022, the day of her 70th birthday, she finally underwent surgery. In the hospital, Valentina contracted the coronavirus, and she was discharged without having time to remove the stitches. Valentina’s children, who lived in another part of the city, could not get to her due to hostilities from the very beginning of the Russian invasion. They later evacuated. So Valentina was left alone: ​​without food and without the opportunity to go for them.

The gas was turned off in stages. There was less and less of it in the burner. The buckwheat porridge that I had left since my daughter’s last visit, I divided into several days. She was in a small saucepan, I’ll eat two or three tablespoons, and that’s it.

The question of water bothered me the most. The water in my well is very bad, rotten. The well is very old and has not been cleaned for a long time, it is full of slugs and grebes. There is no running water in the house. I had three or four liters of clean water left from the one that the children brought. I was ready to drink water even from a well, but I couldn’t get it on my own. Then both the Internet and the connection disappeared. And my children have completely disappeared. I’m lying and don’t know what to do. I lie down and pray, but the prayer is in vain. Where does everything go? And I realized that since there is a war going on and there are no children, then my children must have died. It was just a nightmare…

Within just one night, the last heat vanished from the house through the old frames and cracks. I threw all the blankets that I had on myself, covered myself as best I could. And there was no internal warmth, no boiling water to somehow warm myself. I tried to get up, but it was very painful, I had no strength. I spent one night like this. Then she poured water into a smaller bottle and lay down on it with her body in order to warm it up with her warmth – because the water was already freezing. I drank it sip by sip, but it began to run out. It lasted me about four days. True, my daughter brought me Borjomi [before the war], I put it on the table and almost prayed for it. Left it in case I die.

On the third such cold night, I felt that I was completely freezing, it was hard even to make a sound, although I always pray out loud. I realized that I would definitely freeze that night, and read a prayer for the Lord to accept me. And then my brother Slavik comes ( the names of Valentina’s relatives have been changed at her request, – note by Meduza ). He stayed alone with his son in their house. They live nearby, but we were in a quarrel for more than ten years and did not communicate. And then, you see, the Lord put the thought into his head to come. Slavik says: “There is a potbelly stove, I will put it in the kitchen for you, I will heat it there, and it will be warm in your room. And I’ll cook for everyone there.”

I dreamed of boiling water. Slavik put on a potbelly stove and boiled water for me. And I became warm. I came to life. Slavik walked, cooked food, but he didn’t have much of it either. I had my first lunch – two boiled potatoes.

[In the beginning of March] the bombing began in black, the house shook day and night. I began to get used to it, but I lay there and constantly thought: “Probably this is my last hour, day.” And so every day and hour. I prayed and was afraid that I would die without repentance. But when there were explosions around, during all this time not a single glass flew out.

They ate once a day, at noon. My brother would come and cook soup on fried bacon with onions, dilute it with water. And this bowl of soup saved me.

They drank boiling water: the tea was over, I brewed the last bag for three days. They boiled that water from the well. You can even get used to rotten water with wood lice. I had a thermos, I poured boiling water into it and drank it throughout the day. And I slowly ate a pack of cookies that my daughter-in-law brought me before the war. We also had some vermicelli. One time my brother was frying fish. He boiled beets and carrots several times, rubbed them and gave them to me.

God forbid you find out what it is when you have no strength. I could not hold the prayer book in my hands. But I kept praying that God would work a miracle and the occupiers would leave. And in the breaks between prayers, she lay and counted the branches on the tree, which she saw through the window.

Valentina’s food during the worst days of the war: two or three tablespoons of porridge and a minimum of water

At the end of March, Russian troops retreated from the Kyiv region. In early April, volunteers and doctors began to visit Valentina.

The traumatologist arrived first, she brought me a doctor’s sausage and some kind of fortified energy drink, she told me to drink. She also [diagnosed] me with anemia and literally catastrophic dehydration. A day later, volunteers came and brought me a sea of ​​products: vermicelli, stew, and some effervescent vitamins. It was such a joy!

I don’t even know how and when my coronavirus ended. She just recovered, and that’s it, really a miracle. Due to hunger, my rehabilitation is delayed, because the necessary muscles that should support the new joint do not grow. Prolonged hunger gave complications to the gall [bladder], it became gangrenous, it had to be removed, so I recently underwent another operation.

My daughter returned from Rivne and immediately took me away, it was April 19th. All this time we have been living in Kyiv. I’m afraid to return home to Bucha, to see that bed again, to remember it all again… Before the war, I weighed 92 kilograms, and now I weigh 70.

Anna, 36 years old, a housewife from Mariupol and her family

What they ate and drank: marinated vegetables, a kilogram of potatoes, cereals, crackers from one loaf of bread, dried dates

Before the war, Anna (the name was changed at the request of the heroine) with her husband, three-year-old son, mother and younger sister lived in their house on the Left Bank of Mariupol. But in the very first days of the war, due to shelling, they moved to an empty apartment of friends in the city center, having managed to buy some cereals and sugar. The main food supplies remained in the old apartment on the Left Bank, where it was no longer possible to return due to shelling.

We managed to buy two bottles of water at the last open water point in the city. And then the husband, like the rest of the townspeople, went to the spring under shelling for water.

The owners of the apartment found some cereals, pickles, flour. But we couldn’t bake anything out of it – there was no light. The flour went to dumplings with cottage cheese, which we bought in the last days before the war. Everyone got five dumplings … And then they caught a few more in the pan. There was so much joy!

As soon as all the supermarkets were looted, people began to look for warehouses and any opportunity to buy groceries. The potatoes in the city ran out very quickly. In one of the stores, we were lucky to get a kilogram of scattered potatoes from the bottom of a truck trailer for free. We ate it for a long time: one potato a day for soup with cereals and carrots for four adults and a child of two and a half years. We also managed to buy cabbage and carrots, and the neighbors gave us some semolina. From this we made vegetable cutlets. They ate mostly cereals: Artek, rice, a little bit of millet. Macaroni ran out first because my son loves them.

The food was distributed as follows: they put five plates on the table, [put] a spoon on each, and so on in a circle until the porridge was over – so that everyone was equally divided. More baby. We saved a lot of small supplies of the owners of the apartment – cereals ended at lightning speed.

Every day I thought that there was three days of food left, but somehow it still remained. For the last week [before the evacuation from Mariupol], the feeling of hunger did not leave, it simply did not go away. Then I ate some trifle – a dry date that was lying around somewhere in the apartment, a piece of carrot … I had to throw something into my stomach so that it would not ache, and it worked. Usually I wanted to eat in the evening, at night and in the morning, while nothing was cooked on the fire [in the yard].

Meal for a family of four adults and a child during the worst days of the war: two potato soup, half a glass of rice, an onion and half a carrot; porridge from an incomplete glass of cereal; tea — a cup a day

Literally a couple of days before my departure, for some reason I again climbed into the owner’s refrigerator, which had been closed for a long time (after all, we got everything from there), and found two cans of sauerkraut there. And also a jar of pickled tomatoes and a jar of mushrooms. Since everything was pickled, it did not spoil [without electricity]. How did we eat it! All the food before that was absolutely insipid, even vegetable and absolutely lean soup, which we once cooked on a fire – this soup had cabbage, onions, carrots and tomato paste that friends found, and that’s it. We also saved and stretched these three jars of delicacies. But then I read stories about the hunger of other people and realized that we were completely chic.

Once we were told that a humanitarian aid [humanitarian aid] had come to a neighboring yard — we exchanged such news and rumors with our neighbors. We went there, where the Ukrainian military brought bread by car, and this bread was distributed among the shelter sectors of a particular house. I remember when I saw this bread from a distance of three meters, I caught myself thinking that it was very beautiful. I never thought bread could be so beautiful. But other people from our house did not get bread, and they left. We said that we had a small child, and that military man gave us two loaves. We gave the second loaf to a family with a little daughter, also from our house.

We stretched this loaf of bread for a week or more. The bread didn’t taste amazing, it wasn’t that different. There were obvious impurities in it – oatmeal lumps, sunflower seeds, but we were tasty and satisfying. I cut this bread into small pieces [and dried], they were enough for us [for the road] all the way to Berdyansk, where we soon left. The journey lasted more than ten hours, we had nothing to take on the road, except for these pieces of bread, and they helped us out a lot.

My great-grandmother Niusya, whose childhood was spent in Mariupol, survived the siege of Leningrad. Her great-grandfather took her out of the city in the first train, and in this way [eating dried pieces of bread on the way] she was able to escape. But until the end of her days, she dried black bread crackers and treated them very carefully. When the blockade of Mariupol happened, the first thing I remembered was my grandmother Nyusya. These pieces, into which I cut the bread… I did it like she did.

Pavel, 71 years old, pensioner from Mariupol

What he ate and drank: buckwheat, soup from uncooked peas, one egg a day, dry oatmeal with water

Pavel learned about the beginning of the Russian invasion from radio news. He expected war, but did not think that Mariupol would be under siege. Pavel himself can hardly walk. The money ran out in the first days of hostilities – he simply could not withdraw his next pension from the card (relatives usually did this). Until mid-March, Pavel’s niece Maria brought food. P after the shelling of the Drama Theater , her family evacuated, they did not have time to take Pavel with them.

On February 24, I went to the store for the rest of the money, but there was nothing there – everything was sold out. With the last money I bought very expensive cheeses. I joked at the checkout: when would I eat them if not during the war? There was simply nothing else, and they were the last ones on the shelf.

When I had already eaten everything I had, I went out into the yard, to the people. Everyone lit fires to cook. At first, my neighbor Luda fed me, she cooked soups. Then it got really bad, because I didn’t really have any food, but now no one had it. I took a little bit from my neighbors so as not to tear them away from them, and I was starving. Twice I fell into a hungry faint.

In March-April, hostilities were very intense, shells fell right into courtyards. But people were still preparing – there was nowhere to go. We learned to distinguish by sound which particular projectile is flying. And if anything, they ran into the doorways, each to his own house. And when it calmed down a bit, they went out and continued to cook.

The shelling began – I covered myself with a warm blanket with my head, and splinters were flying around. And I waited. Stopped – crawled out. Then there was a direct hit on the house. But my bed is in a good location – not near the windows. A piece of plaster just fell on me, I was slightly dizzy. And the next room was gone. It’s good that it wasn’t something large-caliber, otherwise I would have been killed.

Mainly buckwheat, I don’t remember any other. Potatoes were in short supply, we ate them occasionally. Pea soup was cooked from dried peas. Firewood was saved, so the peas were not particularly boiled. The peas [in the soup] were like pebbles. Most often I ate like this: one egg a day. I drank oatmeal with water. Sometimes it could turn out to eat two eggs. This was the case from mid-March to mid-April.

Paul’s meal during the worst days of the war: one egg; oatmeal soaked in water

It also happened that a neighbor would give a few chocolates for a snack – she had supplies from somewhere. At first, I had a little coffee left, I myself brewed it in a Turk over a fire. It quickly ended, and I drank the tea that was offered to me. Everyone had plenty of tea.

Neighbors called me to feed me. And I went out and ate. They didn’t drive me away, but I left myself. It was uncomfortable for me to callous my eyes – that I, they say, need to be fed. We ate once a day, mostly in the morning. Then I went to sleep so that I didn’t want to eat. There were no forces. Sometimes I sat in the front garden and read. From the house of a neighbor who had left, books were carried out into the street by a blast wave, I found among them the “History of Ukraine” by Orest Subtelny. And so I sat under fire and read. I didn’t expect anything good anymore – I thought that my relatives were killed, and no one would save me.

At the end of April, communication was restored in Mariupol, and Pavel’s niece Maria, who had been evacuated by that time, was able, with the help of her friends (or for money – with people who made money in this way) to send him food: eggs, chicken. Pavel shared food with neighbors. Spontaneous markets appeared in the city, food began to be brought from Russia and the self-proclaimed DPR. Even so, it took Pavel several days to get groceries (someone has to cash out – find groceries – get to Pavel) . There was also humanitarian aid from the Russian Federation. Pavel got it only once, among the food was a can of stew. Pavel opened it on the way from Mariupol to Vilnius, where he was later able to evacuate through Russia. The stew was inedible.

Alexander, 44, teacher of computer science and robotics from Bucha, his wife and son

What they ate and drank: dry pasta, canned food and cereals, fried (but slightly rotten) fish

Alexander together with lived with his wife and son on Yablonskaya Street in Bucha – where, after the retreat of Russian troops at the end of March, they found most of the bodies of the dead residents of the city. In winter, Alexander saw photos of military equipment on the Russian-Ukrainian border on the Internet – and he had no doubt that there would be a war. Before the invasion, Alexander’s son broke his leg and moved on crutches. Alexander himself is a disabled person of the first group, he can only walk with a cane.

On February 25, my wife went to the supermarket [located] between Bucha and Irpen, and she was able to buy some food — a few sausages. There were no special supplies at home. Like everyone else: potatoes, eggs, some cereals, butter, sugar – nothing special, at least. In this regard, we were absolutely not ready for war.

Early in the morning of February 27, we began to be heavily shelled. We sat at home, closed ourselves in the bathroom, because everything was shaking. We were afraid – if only our house wouldn’t get hit … After that day, the gas disappeared: the pipe was broken. My wife began to cook in a slow cooker. In those days, there were still all communications: water, light, and heat.

Serious problems started when there was a second entry of the orcs [Russian military] on March 3rd. Around that day, electricity and water went out. We sat on home stocks, ate everything that was in the freezer and cereals, ate everything that was in canned food. It was dull, I always wanted to eat. There was very little food for three adults: one piece of dry food.

The house manager brought us a herring and a loaf of bread from somewhere. And there was an Orc dry ration [leftover from the Russian military]. Our men [acquaintances] found rations with the inscription “Army of Russia” in the wrecked infantry fighting vehicles, brought us another one on the 28th [February]. There was dry alcohol: we made tea and coffee on it when the gas disappeared. We tried canned meat. It’s not very good. There were also biscuits, some concentrates, but we did not eat it. Unpleasant. It was the last food left at our house.

One evening, around March 5, the orcs started shooting at the apartment doors, breaking down on the doors on the first floor, and kicking. We were sitting on the second floor, hiding in the bathroom. After that, we were called to our neighbors from the fourth floor, a large family. They invited us and another family, there were a lot of people in the apartment. They have three rooms, and we lived with them until we left for Kyiv. They had a small gas burner, also pulled out of wrecked enemy vehicles. But it is not suitable for cooking, we used it to heat water in a mug. There were a lot of us, so you won’t get much tea.

Cooking [by this time] was already very tight, and all the neighbors began to cook on a fire near the house. Shared with each other. They took out what they had. We ate what they gave us. Whoever gives, they took food from him. The war taught everyone to share.

The neighbors were making some soup on the fire: they found vermicelli and potatoes, carrots. The fish was fried – it seems to have been pollock, already a little rotten, because it was stored without light [without electricity]. Once someone cooked dumplings – they were somehow preserved without a freezer, maybe because it was very cold. “Mivina” [instant noodles] was even eaten like children – dry food. They ate once, in the morning, and in the afternoon they drank some kind of tea, maybe that’s all. A bowl of soup and a cup of tea is the average daily ration. For health reasons, I can’t really eat carbohydrates, but I had to eat everything – I wanted to eat something.

On March 8, when all drinking water ran out, my wife went to a closed store, went down to the warehouse, into a dark basement, and found a couple of small bottles of water, juices, and corn sticks there. Neighbors also went, found frozen crab sticks, shared.

On one of the days of the bombing, no one ate anything at all: they sat in the basement all the time. When there was heavy shooting around, there was no time for food.

Alexander’s family food during the worst days of the war: a bowl of lean soup and a cup of tea (no food at all on the hardest day)

On March 10, we evacuated. The neighbor with whom we lived said: “The food is over, the water is also over, there is nothing to wait, we have to leave Bucha.” We packed our things into backpacks and, under bullets, went through this apocalypse, through broken wires, past the corpses that lay on the street. We went at our own peril and risk towards Kyiv. The family of neighbors, my wife, me with a cane and my son on crutches… Such a picture.

When we reached our checkpoint, I rushed to hug our soldiers – I was so glad to see them! Our soldier carried me in his arms across the destroyed bridge in Irpin. My wife’s friends drove us to Kyiv from there. Now we live with friends in Obolon ( area in the north of Kyiv, – approx. Meduza ). The wife still cannot return to Bucha: she is afraid. Psychologically, the state after the experience is very difficult.

The most delicious thing I ate during that entire period was instant coffee in the refugee tent at the entrance to Kyiv. I don’t know what it was – “Jacobs” or what. But I was very happy.

Vladimir, Tatyana and Evgenia, pensioners from Rubizhne, Luhansk region

What they ate and drank: e

teaspoons of grated raw potatoes with jam a day, pear and plum compotes from the cellar, three walnuts

73-year-old Vladimir, 71-year-old Tatiana and her mother, 94-year-old Evgeniya, lived in Rubizhne, Luhansk region, in their house. At the beginning of the invasion, Evgenia’s legs failed, she could no longer walk. The front line in Rubizhne passed through the area where the house of Vladimir, Tatyana and Evgenia was located, so they were cut off from other parts of the city. It was unsafe to go out into the street, shells flew into the yard. As a result of one of these hits, Vladimir was shell-shocked, he partially lost his hearing.

Just a few weeks after the outbreak of a full-scale war, from mid-March, the family began to have problems with food. In the first days, Vladimir bought a bag of potatoes. According to their granddaughter Victoria, who told Meduza this story, this purchase saved them. In addition to potatoes, the pensioners had jam, flour and pasta, but the main part of the preparations remained in the summer kitchen and sheds, which burned down as a result of shelling. Water, electricity and heating were gone. Until the beginning of April, there was gas: they fried potatoes on it. Then he disappeared too. Vladimir kept a diary from the beginning of the war until mid-April. With his permission, Meduza (with minor editing) publishes those parts of the diary that describe the famine in the family of residents of Rubizhne.

March 19, One bottle of five or six liters of water is left. You can’t leave the house – either explosions or machine gunners.

March 22, Food is running out, water even more so.

March 23, The house shook like a house of cards. They just shoot at houses. We sit in the corridor, tremble, pray. There is no time to cook food. There is no water. We just fry potatoes. We do not wash dishes. Today, constant shelling does not give peeling potatoes.

Grandmother [Evgenia] ate very little today, she is weak. As bread, mother ( so Vladimir calls his wife Tatyana, – approx. “Meduzy” ) bakes pancakes. Today I strained, today I didn’t bake. Drinking water is running out. Leaving the yard is dangerous. We eat leftover fried potatoes with one pancake from yesterday’s baking. I ate boiled oatmeal with potatoes, and Tanya and grandma ate potatoes. We opened a three-liter jar of Lemonka pears (2016), we give juice to our grandmother. She asks for a drink, but there is almost no water.

March 25, There is one three-liter jar of Epiphany water left. When we peel potatoes, we do not wash them as thoroughly as before. Now we won’t wash at all. I don’t know what will happen today, but the water has run out. And without water, nothing.

March 26, We ate fried potatoes with pancakes and ate two pears from a jar. There is nothing to water indoor flowers, they wither.

March 27, I want peace and quiet, water and electricity.

March 28, There is only water left for today. Where to go to bring at least five or six liters of water? We eat pears from a can and some juice, which is mainly for grandma. The next morning there were almost no pears left, and even less juice. There are 0.5-0.6 liters of water left in the jar.

March 29, No light or water. We are all waiting for something. Today is 21 days [as] there is no water, Tanya said. I don’t know, I didn’t count. They ate potatoes and washed down with drops of pear juice. Grandma is sleeping, but you need to wake her up so that she can eat. It’s 9:40 now. We sit and think what to do. You can’t go out in search of water: they shoot without warning.

March 30, We ate potatoes and washed down with plum compote. Got the last can. There is nothing else to drink besides this liquid.

31 March Our faith in light and water is slowly drying up. We don’t seem to be looking forward to it. The thread of some reserves is getting thinner and thinner. No drinking water

April 1 There is nothing to fry potatoes on. We will eat it raw, little by little. There were very few potatoes left out of the 20 kilograms that I bought.

April 2, I went to the barn and cellar for compotes, since there was not a drop of water in the house. Nothing to cook for. What to give grandma?

3 April Ate grated raw potatoes with plum jam with mum. Washed down with compote brought yesterday.

5 April In the morning we counted the available potatoes: 12 pieces. Divided into three piles of four. I cleaned one and rubbed it on a grater. We eat several tablespoons of thick jam. We pray, trusting only in the Lord. Today Tanya and I ate two small grated raw potatoes. Grandma has a separate meal. She sleeps more.

April 6, Breakfast and lunch were reduced yesterday. Up to two potatoes – for me, and apple jam for mom and grandmother. I ate grated potatoes with plum marmalade and three pieces of walnut. “Washed it down” with compote cherries. There are two small potatoes left for tomorrow. You can’t go out to the cellar. What we will do, I do not know.

April 8, We drink compote from cans that I brought from the cellar. They are running out.

April 10, Zhenya lies yesterday and today. Eats a little. We finish our last grubs: a liter jar of “assorted” ( from fruits and berries, – note “Medusa” ) and semolina soaked in cold water. A little bit for each. We need to go to the city, perhaps there is a humanitarian aid. No food for tomorrow!

April 11, We ran out of food today. There were a couple of jars of jam left. Without humanitarian aid – blockage.

April 12, The food is over. We soak small pasta in water for five to six hours and eat with plum jam. Little by little, drinking water is running out, which I brought from the cellar before the fire. Volunteers don’t visit us.

April 14, Ate pasta soaked yesterday. Topped up with new water. We pray to the Lord!

In recent weeks, Tatyana, Vladimir and Evgenia have been eating grated raw potatoes, mixing them with plum marmalade — two or three teaspoons each for lunch and dinner. Soaked pasta turned into a dough, which they also mixed with plum marmalade and ate in the same way – two or three teaspoons at a time.

Food of Vladimir’s family during the worst days of the war: a small grated raw potato with plum marmalade – two or three teaspoons per person

According to granddaughter Victoria, the family stayed in Rubizhne as long as they could. Great-grandmother Evgenia did not want to eat apple jam because it was too sweet, she asked for water, prayed and asked God why he did not take her away. It was not possible to evacuate Evgenia, who stopped walking. Once, a neighbor agreed to help Vladimir and Tatyana: he drove the car, and together with Vladimir on sheets carried Yevgeny out into the yard, but at that moment the shelling began, and the trip had to be abandoned.

In mid-April, Tatyana and Vladimir were evacuated. According to Victoria, they ran for several kilometers under shelling to a school in the LPR, from where the authorities of the self-proclaimed republic organized evacuation to Russia – there their relatives were already waiting for them. Vladimir and Tatyana asked that Evgenia be taken away from home – but this was impossible due to hostilities.

On April 30, familiar families managed to get into the house of Vladimir and Tatyana and found the body of Evgenia. A few days later, Evgenia, like many other dead, was buried in a mass grave. It is located near Rubizhny.

Meduza

Photo editor: Ekaterina Balaban

Stories from the finalists of the second season of the competition

Dudko Maria. Keys

So… Tick… So…

The voice of the old grandfather clock from the hallway already met me, but I could not open the door. Well, where are these keys?… Really lost? Only this was not enough, and so the day didn’t work out!.. Ah, no, here it is…

The clock struck eight when I stepped on the creaky parquet of the hallway. How I missed the quietness of my apartment! I just wanted to fall apart on a shabby sofa, and lie there until the morning … But instead, I trudged to the computer. While the old unit, inherited from the dinosaurs, turned on, I made myself coffee. Today you will need more than one mug. Article for the night, and inspiration from gulkin’s nose. They also threaten to make layoffs at work. You can not delay, otherwise the dismissal cannot be avoided. And it would not be bad to update the blog, otherwise the last subscribers will soon scatter. Eh…

I worked in the editorial office of a magazine that was in demand in our district, and in the city in general. The editor – Fedot Stepanovich – always put only the best into print.

The best. Yes. It means not me. For some reason, lately my writing has not been impressive at all. Even myself. Honestly, not surprised. It looks like I’ve lost the spark, like there was nothing to write about. It’s funny somehow: I live in a metropolis, where something happens every day, but I look as if into a void. Other people’s problems ceased to excite, everyone here is a drop in the ocean. So my news is gray, alien, distant and unnecessary, in general, to no one.

What did I write about? As I then still thought, about the important. About eternal, to some extent. I noticed that the people around were so closed that they seemed to stop seeing each other, let alone feel and understand. Everyone at some point withdraws into himself and loses the key to the door he entered. Locks up the heart. Puts on a mask. Indifferent. And silently walks along the gray stones of the pavement…

I just wanted to be heard… I thought I would become the key to the world on this side of the mask. I will help those in need with my word, I will teach people to listen and hear, I will save the world… But it seems that something went wrong. And now… Now I don’t even know how to save myself. So in response I get the cry of tearing paper and the famous last warning from the lips of Fedot Stepanych. Last chance. Tomorrow I will not come with a sensation – that’s it. Well… It looks like it’s time to forget about your reasoning for a while and plunge into the world of human intrigues. Write what will be read. What is expected of me. No not like this. What do you expect from an article in our magazine.

What are the stone jungles talking about these days? What is the wind of change carrying along their paved paths? The most discussed topic was a series of strange deaths, however, as is usually the case. For a long time now, criminals taken into custody have been dying one after another. The most different: from simple pickpockets to almost murderers, adults and still teenagers of fourteen years. Most of them haven’t even been sentenced yet. And they all have the same diagnosis – poisoning. What is still a mystery. This happened with some frequency in different parts of the city, but most often in our police department. And, by pure chance, none other than my older brother, officer Yuri Diskarin, worked there.

How I could use his help now… But no. My brother and I don’t get along. And they never got along. It just so happened … Probably, we are just too different. Yurik is secretive, distrustful. He never told me anything, he preferred to do everything himself, and I felt that he did not need me at all. I must have been a little jealous of my brother. He is successful, just the pride of the family, and I grab the last chance to stay at work.

…Grasping for the last chance to stay at work. Although … You can try to find out about the high-profile case first hand, so to speak. This, for sure, would interest Fedot Stepanych, but he would have to turn to his brother for help. Yeah … And once again become a loser in the eyes of a whole family. Hell no! Even for the sake of work, I will not ask for the help of this person!

Well, nothing. I prepared, collected materials, now I will write and saved! I manage myself. If only I could make it in the morning…

GO!!!

The sound took me by surprise. It was a signal that the factory was over, from the old watch in the corridor. The matter is fixable. I got up, went to the clock, opened the lid and reached for the key with a familiar gesture. Only the key was missing. What’s the strange thing? In my house, I valued order, but such incidents simply unsettled … What should I do now, look for this lost key? Looks like I’ll have to…

Casting a sad glance at the computer, I began to remember where I could put this old piece of iron. So I have already climbed several shelves, looked into the boxes and …

What is this? There was an envelope in the dresser. And, if I was ready to see the key to the winding mechanism among the socks, with my absent-mindedness, then there’s no strange message at all. Although, maybe I’m too naive? Oh, I don’t like it all…

Naturally, I opened the envelope and immediately recognized Yurik’s handwriting.

“I’m not sure I wasn’t followed. Check your mail. I never forgot your birthday!
Yu.»

What jokes? I knew that it was necessary to take away the keys from him when he moved in! Wait, there’s something on the back…

“KeyHole4u…”

I scanned the hastily written lines again. The text seemed devoid of meaning and meant nothing to me.

What is he? For henbane, it seems, it’s not the season … Just in case, I checked the calendar and made sure that my birthday is not today and not even in the coming days. The only thing that made sense was to check your email.

What am I doing with my time? Before my hand could close the text editor, a window popped up asking if I really wanted to do it. Here, even it mocks…

One letter actually arrived in my mail. So, why is Yurik doing this: invading my house with a strange note and tweeting on the Internet at the same time? After all, isn’t it easier to call? Of course, I would not jump with delight when something would make our little star descend to mere mortals, but why reinvent the wheel?

So I thought as I sipped my cold coffee while waiting for the text to load. Finally, the following lines loomed before my eyes:

“Hello, Egor.

I know you will be surprised by my letter, but I wouldn’t bother you if it wasn’t really serious. I wanted to call, but my new phone didn’t have your number. My number hasn’t changed, if you’re interested…

Let’s get down to business. We need to talk. But the conversation must be face to face. Come today at nine at the intersection of Pskovskaya and Myasnaya, there, in the courtyard of house 26, I will be waiting for you.

It’s about a series of prisoner deaths. Correction, about a series of murders… I thought it might interest you, I’ll explain everything when we meet, if, of course, you show up… your guilt. But I ask you to believe me one single time. You are my last key to hope. I expect you to read this letter and come.

Your brother Yuri Diskarin

Hmm…

Everything is more and more wonderful, as the heroine of a famous fairy tale used to say…

I re-read the message several times to make sure that I had really ceased to understand anything. Except, perhaps, for the fact that some kind of mystery lies in this whole affair, and Yurka for me now is the key to all answers. Besides, since he himself calls me to talk, I will not fail to interview the lead investigator . .. Unless, of course, this is a stupid attempt at a joke … But it is unlikely that he would write to me for fun.

And what, now it’s raining again, right?.. But he came home! Okay, I’ll figure it out quickly, and I’ll have another six hours for the article … I glanced at the clock, belatedly remembering that this was pointless. Another advertising message comes to the phone, helpfully suggesting that I need to go out if I want to be in time for a meeting. Having extinguished the monitor that had just woken up and abruptly grabbed my raincoat, which had not yet dried out after a day’s walk, I jumped out into the entrance.

Only at the car I hesitated a little. Isn’t it too easy for me to fit in? Just a couple of minutes ago, I was sure that for the sake of my brother I would not lift an eyebrow, and for my own sake I would not mess with him. What did this message do to me?

It filled me with a sense of self-importance. Finally, something depended on me, on me alone! Probably, I was driven by the desire to prove that I was worth something . .. But I didn’t want to admit such motives. From this, an incomprehensible annoyance settled in my head, but I stubbornly explained it only by the spent time taken away from writing the article.

Stopping at the appointed place, I looked at my watch. Another full five minutes … It was possible to leave later, although … as if it would give me something. Around no one like Yuri.

An unpleasant, vile fog reigned in the street. I hid from him in the car.

The sun has long since set behind the clouds, and the city has lit its fires. Lanterns, not stars. I sometimes thought about how this noisy world lacked stars. Each of them is unique, even though there are billions of them in the darkness of the sky. It’s the same with people, isn’t it? But we almost purposely forget about that, therefore we hide from condemning burning looks from the depths of the immense.

And just now the thought flashed through my head: how often do I myself think about others? It would seem that constantly . ..

I digressed from philosophical reflections to look at the time. Five minutes. There was no one even humanoid in sight, the yard was empty.

Ten… I’m checking my phone, mail. Not a line about being late.

Twenty! No, it’s not serious anymore! I shouldn’t have come… Nervously dialing a number, preparing a scathing speech. In response, only long beeps are heard. Okay… Let’s wait… You never know. He’s got a job too… Trying to calm down seems to be working until I remember that damned article never started! Where the hell are these fools?!

“I’m waiting another fifteen minutes and I’m leaving” – I angrily type a message and press “Send” furiously.

Time is running out and the message hasn’t even been read! Twenty-five minutes… thirty… Still silence. There is no point in waiting any longer.

To clear my conscience, I call again. A melodious female voice is heard from the handset:

– The device of the called subscriber is turned off or is out of coverage area . .. – the lady says, slowly repeating the phrase in English.

– Damn you!.. – irritably hissing, I throw the phone on the next seat. – So… Okay… I warned you, I waited… waited longer than promised. Now you can go home with a clear conscience.

As I looked down the road, I was surprised to find that I was not so much angry as nervous. It pissed me off even more…

***

There was less and less time left for work, and I continued to pace the apartment. Usually such a calm creak of the floorboards now mocked my poor hearing with all its might. It was by no means the article that occupied my thoughts, despite the fact that they would not forgive me if I screwed up such material…

Minutes passed slowly. I felt them even without the usual ticking of the clock. OK. I will be frank with myself, because my strength is no more, and then to work! All this is strange! What exactly? That I couldn’t get through. Yura does not turn off the phone and diligently monitors its charge, he should always be in touch, should I, as a brother, know about this. Also this line from that note, it is no coincidence that it is the very first …

So… don’t panic. What the hell is this blockhead in general so businesslike settled in my head?! Anything happens. All! Article. Only an article.

By an effort of will, I managed to sit down in front of the monitor and even write a couple of lines before I again plunged into thought. And yet… what could have happened?..

***

The days raced by like clockwork, but not mine. I never found the key, and I haven’t tried, to be honest, since that evening. They froze, showing half past nine, as if that day had not yet passed. I didn’t show up for work the next morning. I don’t believe it myself… how could I put everything on the altar for the sake of a person whom I was mortally envious of, whose disappearance I dreamed of… the one whom I had known all my life and with whom I was still connected invisibly?!..

And the apartment! Oh… if the old me had seen what my temple of comfort had turned into. .. however, he would have shot himself right away, leaving behind only the gloomy aesthetics of a broken creator… All the tables were cluttered with dirty mugs and fast food packages. The entire floor is full of shoe marks. Here and there were meticulously compiled lists of those with whom my brother could communicate, where he could go, who could wish him harm…

But none of that mattered anymore…

“- Yegor Diskarin? – I heard a calm male voice from my phone this morning.

– Yes. I answered nervously.

– The police are bothering you – my heart threatened to break my chest. It must be from stress and lack of sleep … And in the meantime, in my head: “If only they could find …”.

– Your brother was found today at noon, – a short pause, as if to realize what was said, – He is dead. The circumstances of death are being investigated. – just as calmly, as if nothing had happened, the man on the other end of the wire continues. – We offer our condolences. Today you should come to the department … ”

Followed by instructions and occasional questions to which I answered things like “yes”, “no” and “understood”. Be afraid of your desires. Found…

I spent the next half day in the same department. Some papers, some formalities, a funeral… And a conversation.

From that conversation I learned something that struck me. Yura was suspect. They said that he killed the prisoners by slipping poison into their food or something like that. There was not much evidence, so they only planned to arrest him, but now the main version of my brother’s death is suicide during an attempt to escape from justice. What heresy… But at that moment I could not object anything. Exactly like believing even a single word.

And now I’m back in my home again. Devastated, with only one thought in his head: “he is no more”…

What are words? A set of letters, a set of sounds, nothing more. .. But some become keys. This key with three heavy teeth will open one of the most terrible doors: the door of despair and pain. Maybe I should have phrased it a little more bluntly? But as? What would it change? There is only one key, no matter how you decorate it, and there is only one door, and you are standing on the threshold. You can’t go back. And the castle succumbed. Started…

I look around the apartment with a detached look, slowly falling into a rage.

– Damn! – comes out of the chest. How long have I not uttered this word, – Damn! – I repeat louder, clasping my hands sharply. My whole army of mugs is flying down to the sound of glass. A blanket of scribbled sheets covers them from above.

– Dunce! Brat! Freak! I scream, not remembering myself.

– Look… Look what you’ve done, you bastard! I lost everything because of you! Inspiration! Work! Dreams! How can I pay my bills now? I’ve wasted so much time on you, damn it, even the key to the clock. .. – the silence hurt my ears, so I continued to throw empty phrases, trying to throw out everything that had accumulated inside me. My voice broke, growled and wheezed, turned into hysterical laughter, and I didn’t even understand why I was so angry … At myself?

Yes… I was jealous of my brother in black! The pride of the family, a great future, office authority, lofty goals, a dream job – everything I wanted to hear about myself, I heard about Yurashi! I remained his little brother, always second, always underestimated. It was an axiom that everything was easy for him. But for some reason it did not occur to me that we were actually brothers. Our conditions were the same. And I seemed to be blind, I did not see what he had to go through. And what did I do when I got tired of being a shadow? Exactly. He erected that very wall, the wall of indifference. I didn’t care. And there is one more drop in the ocean. It was not Yura who closed himself off from me, but I from him. And what did it lead to? “He is no more,” and I can’t even say with certainty that I’m not the brother of the killer! And all because I don’t know! I don’t know how he lived all these years, I don’t know what was going on in his soul, I don’t know if he called me to stop the rumors in the bud, or to repent of what he had done even a little to his own creature, albeit such a vile one, how I . .. And I will probably never know, my key to this secret is forever lost … What a blockhead I am … What are all my arguments about feelings, words, stars, but all about the same keys worth now! How could I have changed the world when I myself could not find those vices for which I reproached mankind?! That’s why my articles weren’t being read. When changing the world, start with yourself, otherwise everything is empty words. Gray, alien, distant and unnecessary, in general, no one … Such words will not become keys … Keys … I return to them over and over again. Oh, this world is really crazy about them! We have the keys to everything, they are even where we don’t think to find them, because they have entered our lives so deeply that everything now rests on them alone, and we don’t even notice. Yes, and life itself is like a constant picking of locks! But even that is not important. The important thing is that there is no key leading from There. This is what gives meaning to all other keys. No matter how hard I try, I won’t start Yurik’s time again like the old clock. But who knows from what doors, I would have taken him away, if only I was there … It’s a pity, I realized it too late …

– I’ll never sit down to write again… – I said to myself, almost delirious, barely recognizing my own hoarse voice. After that, I fell asleep and didn’t think about anything anymore.

***

I spent the next day almost without getting up. Only in the evening I somehow tried to eliminate the consequences of my yesterday’s insanity … But the attempt was nipped in the bud, as soon as the very note that I found among the socks caught my eye … Surprisingly, all the time while I was busy looking for my brother, I almost did not remember her, as a thing that does not carry any meaning in itself. But there were so many questions connected with it! I re-read it. As expected, nothing new appeared … And yet … Why was she needed?

I immersed myself in the memory of the day when I lost the key to the clock, which was so silent for the last week… It seems that since that time I have not turned on the computer… How is it, my old man?

The heritage of the ancestors, as expected, grumbled and buzzed at my long absence, but in the end they had mercy and opened my e-mail page for me. Yurik’s letter has not disappeared anywhere. I didn’t reread it. One thing is a note with unclear text, and another is an invitation to a meeting that was not destined to take place …

“Check your mail…” echoed in my ears. The sudden realization made me jump. What if… This strange text on the back is nothing but a login? But my hands are unstoppable…

Hastily logging out of my account, I entered the characters into the appropriate box. But you need a password… Password… Another stupid thought… “I never forgot your birthday!” I enter.

Only one digit changed on the monitor, but I didn’t believe it. This eternity could not last for one miserable minute.

– It worked… – I said, looking into this luminous box in a frenzy. Another account. And only one letter.

The entire apartment fell into absolute silence as I read what was written here.

“Egor, I knew that you would solve my message! Help out, brother! I need you, we all need you!

For several months now I have been busy with the death of several criminals in custody. These are not just deaths, Yegor, these are murders. I’m sure I got very close to the solution. I have two prime suspects. But there is a problem. Both of them are my work colleagues. And I don’t know if any of them acted alone or in concert. In other words, I don’t know who in the police force I can trust with regards to this case.

Also, I notice that I am being watched. Apparently, the attacker feels that I got too close, and will soon try to eliminate me. Well, that’s what I use to pinpoint the culprit. How? I told one of us about our upcoming meeting. If I guessed right, and he’s not a criminal, then you don’t have to read this, I’ll tell you everything myself. But, if I made a mistake, and you are still reading this, then most likely I am already dead …

Brother, now only you can solve this case. And only you can I trust him. To this letter I will attach documents in which my evidence is collected, there you will find the details of the plan, all the names, all the evidence. Publish them in your journal, let everyone know, and then the villains will have nowhere to go! I hope for you. I know you won’t let me down…”0012

For some reason, my heart skipped a beat. Brother… I won’t let you down!

***

Never say never. For the next few days, I did not let go of the keyboard. I know, I promised myself, for writing, no, no, but the last, last time! For Yurik! This will be my best article…

And it really became the best. Where did I get it from? Just my blog would not be enough for such an important mission. So I had to visit Fedot Stepanovich. I almost begged him on my knees to read my work. But he still read it. Read it and put it on the first page!

A few days later I had to go to our police station again. There, of course, there are again formalities, thanks, apologies … But they did not interest me. He was arrested. I wanted to talk to him. With a killer. I wanted to look into his eyes. For help in solving the case, I was even allowed to do so.

I was taken to a special room. He sat opposite me and froze with his cold gaze. But there was nothing in the eyes… He was… Empty. However, the first one spoke.

– Because I saw how souls died, – he answered my question before I could ask it, – Every criminal who was brought here did not set foot on this path from a good life. The world has treated them cruelly. It’s wild, but for some, crime is still a way to survive. Not for everyone… But I didn’t talk to everyone. Do you know why? Because they don’t listen, you know? And when I talked to them in this very room, they just wanted to be heard … And I listened to them, watching how the eyes on the contrary go out, and how hopelessness penetrates into the very heart. They had not yet been sentenced, but they no longer believed that something could be changed. Outcasts of humanity. They could only hide in themselves and wait for the end. Then I gave them the key to freedom. An ampoule with poison, as the end of all torment. You won’t understand, must be…

– And now, being in their place, would you like the same? I asked quietly. My interlocutor was silent. And I continued, – Do you know why? Because there is no key from there. As long as you’re alive, you can still fix it…

We talked with him for a while, and then I went out into the street. It was already getting dark and the lights were on. The downpour threw fragments of stars right under my feet, and they flared for a moment with earthly human light, breaking on the wet asphalt. I silently walked along the gray stones of the pavement, finally throwing off my indifferent mask. Raindrops on my cheeks from something became salty. His image stood before my eyes. Indifference. The way I saw him once on Bolotnaya Square – not seeing, not hearing, impregnable. The source of human vices. I wanted to run away from him, and I even ran, as if it could help. God! Who would have known that it hurts so much to open your heart to the world! The dialogue with the murderer still sounded in his thoughts, and his brother’s voice echoed in his soul.