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I am choking: eMedicineHealth Page Not Found


How to Help an Adult with Severe Choking | Way to Grow

(A person who has entered puberty or is older)


Choking is when food or an object gets stuck in the airway or the throat and stops air from getting to the lungs. Choking can be mild or severe.

Mild choking: The person can make sounds and can cough loudly. You should:

  • Stay close by and let him cough.
  • Call 9-1-1 if you are concerned about his breathing.

Severe choking: The person cannot breathe OR cannot make a sound OR his cough makes no sound OR he uses the choking sign, holding his neck with one or both hands. You should:

  • Act quickly to get the object out of his airway so he can breathe.

Stops responding: The person is not breathing and does nothing when you tap him and ask if he is OK.

How to help an adult with severe choking:

  1. Ask: “Are you choking?” If he nods his head tell him you are going to help.
  2. If he is coughing and can talk, stand by to help as needed.
  3. If he is unable to make a sound or talk, perform abdominal thrusts (the Heimlich Maneuver).
  • Get behind him. Wrap your arms around him with your hands in front.
  • Place one fist slightly above the belly button and below the breastbone with thumb side next to the belly.
  • Grasp your fist with your other hand and give quick upward thrusts into the belly.
  • If the person is very large or pregnant, place your arms under her armpits and your hands on the lower half of the breastbone. Pull straight back to give thrusts.
  • Repeat giving thrusts until the object comes out and the person can breathe, cough or talk OR until he stops responding
  • How to help a choking adult who stops responding:

    1. Lower the person to the ground. Slide his body down your body and use your hands to support his head and neck. 
    2. Tap and shout. If person does not respond, yell for help. 
    3. Call 9-1-1 if help does not arrive. 
    4. Check breathing – No response + no breathing or only gasping = Give CPR.
    5.  Continue giving CPR (push hard and fast on the chest) until the object comes out and the person can breathe, cough or talk, OR until someone with advanced skills arrives. 

    NOTE: If thrusts are needed to relieve choking, the person should be seen by a doctor as soon as possible.

    Disclaimer: This information is not intended to substitute or replace the professional medical advice you receive from your child’s physician. The content provided on this page is for informational purposes only, and was not designed to diagnose or treat a health problem or disease. Please consult your child’s physician with any questions or concerns you may have regarding a medical condition.

    Reviewed: 10/2017

    Swallowed or Inhaled Objects | HealthLink BC

    Have you swallowed or inhaled an object?


    Swallowed or inhaled object


    Swallowed or inhaled object

    How old are you?

    Less than 12 years

    Less than 12 years

    12 years or older

    12 years or older

    Are you male or female?

    Why do we ask this question?

    The medical assessment of symptoms is based on the body parts you have.

    • If you are transgender or non-binary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
    • If your symptoms aren’t related to those organs, you can choose the gender you identify with.
    • If you have some organs of both sexes, you may need to go through this triage tool twice (once as “male” and once as “female”). This will make sure that the tool asks the right questions for you.

    Have you swallowed or inhaled something that might be poisonous?


    Ingested known or suspected poison


    Ingested known or suspected poison

    Did you pass out completely (lose consciousness)?

    If you are answering for someone else: Is the person unconscious now?

    (If you are answering this question for yourself, say no.)

    Are you back to your normal level of alertness?

    After passing out, it’s normal to feel a little confused, weak, or light-headed when you first wake up or come to. But unless something else is wrong, these symptoms should pass pretty quickly and you should soon feel about as awake and alert as you normally do.


    Has returned to normal after loss of consciousness


    Has returned to normal after loss of consciousness

    Did the loss of consciousness occur during the past 24 hours?


    Loss of consciousness in past 24 hours


    Loss of consciousness in past 24 hours

    Are you having trouble breathing (more than a stuffy nose)?


    Difficulty breathing more than a stuffy nose


    Difficulty breathing more than a stuffy nose

    Have you swallowed an object that was sharp (like a toothpick, pin, bone, or needle) or long?

    Long means at least 5 cm (2 in. ) for adults and older children and at least 3 cm (1.25 in.) for babies and young children.


    Swallowed sharp or long object


    Swallowed sharp or long object

    Do you have pain in your throat, chest, or belly after swallowing or inhaling an object?


    Pain in throat, chest or belly since swallowing or inhaling object


    Pain in throat, chest or belly since swallowing or inhaling object

    Have you had mild pain for more than an hour?


    Mild pain for more than 1 hour


    Mild pain for more than 1 hour

    Within the past 2 days, did an object get caught in your throat and cause you to choke?


    Choking episode within past 2 days


    Choking episode within past 2 days

    Are you coughing or wheezing?


    Coughing or wheezing now


    Coughing or wheezing now

    Are you coughing up blood?

    This means blood that is coming up from your chest or throat. Blood that is draining down from your nose into your throat (because of a nosebleed, for example) is not the same thing.

    Were back blows or the Heimlich manoeuvre used to dislodge the food or object from the throat?


    Back blows or Heimlich manoeuvre was used


    Back blows or Heimlich manoeuvre was used

    Are you gagging or having trouble swallowing?


    Gagging or having trouble swallowing


    Gagging or having trouble swallowing

    Are you drooling and not able to swallow?


    Drooling and unable to swallow


    Drooling and unable to swallow

    Do you think an object may be stuck in your throat?


    Feels like object is stuck in throat


    Feels like object is stuck in throat

    Have you vomited blood or what looks like coffee grounds?

    If there is only a streak or two of blood that you are sure came from your nose or mouth, you are not vomiting blood.


    Has vomited blood or what looks like coffee grounds


    Has vomited blood or what looks like coffee grounds

    Have you vomited more than once?


    Vomited 2 or more times


    Vomited less than 2 times

    Has it felt like something has been stuck in your throat for more than 30 minutes?


    Object in throat for more than 30 minutes


    Object in throat for more than 30 minutes

    Have you had any changes in your bowel movements after swallowing an object?


    Changes in bowel movements after swallowing an object


    Changes in bowel movements after swallowing an object

    Have you had:

    At least 1 stool that is mostly black or bloody?

    At least 1 stool mostly black or bloody

    At least 1 stool that is partly black or bloody?

    At least 1 stool partly black or bloody

    Streaks of blood in your stool?

    Streaks of blood in stool

    Have you swallowed a coin?

    Did you swallow the coin more than 24 hours ago?

    Most coins pass through the body without a problem in 24 hours. If you don’t pass the coin in this time frame, it’s best to follow up with your doctor.


    Swallowed coin more than 24 hours ago


    Swallowed coin more than 24 hours ago

    Has the coin passed out of your body in your stool?


    Coin has passed out of body in stool


    Coin has passed out of body in stool

    Do you still have concerns more than a week after swallowing an object?


    Concerns about object swallowed more than 1 week ago


    Concerns about object swallowed more than 1 week ago

    Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

    • Your age. Babies and older adults tend to get sicker quicker.
    • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
    • Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, or natural health products can cause symptoms or make them worse.
    • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
    • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

    Try Home Treatment

    You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

    • Try home treatment to relieve the symptoms.
    • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

    Blood in the stool can come from anywhere in the digestive tract, such as the stomach or intestines. Depending on where the blood is coming from and how fast it is moving, it may be bright red, reddish brown, or black like tar.

    A little bit of bright red blood on the stool or on the toilet paper is often caused by mild irritation of the rectum. For example, this can happen if you have to strain hard to pass a stool or if you have a hemorrhoid.

    A large amount of blood in the stool may mean a more serious problem is present. For example, if there is a lot of blood in the stool, not just on the surface, you may need to call your doctor right away. If there are just a few drops on the stool or in the diaper, you may need to let your doctor know today to discuss your symptoms. Black stools may mean you have blood in the digestive tract that may need treatment right away, or may go away on its own.

    Certain medicines and foods can affect the colour of stool. Diarrhea medicines (such as Pepto-Bismol) and iron tablets can make the stool black. Eating lots of beets may turn the stool red. Eating foods with black or dark blue food colouring can turn the stool black.

    If you take aspirin or some other medicine (called a blood thinner) that prevents blood clots, it can cause some blood in your stools. If you take a blood thinner and have ongoing blood in your stools, call your doctor to discuss your symptoms.

    Pain in adults and older children

    • Severe pain (8 to 10): The pain is so bad that you can’t stand it for more than a few hours, can’t sleep, and can’t do anything else except focus on the pain.
    • Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it’s severe when it’s there.
    • Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

    Pain in children under 3 years

    It can be hard to tell how much pain a baby or toddler is in.

    • Severe pain (8 to 10): The pain is so bad that the baby cannot sleep, cannot get comfortable, and cries constantly no matter what you do. The baby may kick, make fists, or grimace.
    • Moderate pain (5 to 7): The baby is very fussy, clings to you a lot, and may have trouble sleeping but responds when you try to comfort him or her.
    • Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds when you try to comfort him or her.

    Symptoms of difficulty breathing can range from mild to severe. For example:

    • You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).
    • It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you’re at rest (severe difficulty breathing).

    Severe trouble breathing means:

    • You cannot talk at all.
    • You have to work very hard to breathe.
    • You feel like you can’t get enough air.
    • You do not feel alert or cannot think clearly.

    Moderate trouble breathing means:

    • It’s hard to talk in full sentences.
    • It’s hard to breathe with activity.

    Mild trouble breathing means:

    • You feel a little out of breath but can still talk.
    • It’s becoming hard to breathe with activity.

    Severe trouble breathing means:

    • The child cannot eat or talk because he or she is breathing so hard.
    • The child’s nostrils are flaring and the belly is moving in and out with every breath.
    • The child seems to be tiring out.
    • The child seems very sleepy or confused.

    Moderate trouble breathing means:

    • The child is breathing a lot faster than usual.
    • The child has to take breaks from eating or talking to breathe.
    • The nostrils flare or the belly moves in and out at times when the child breathes.

    Mild trouble breathing means:

    • The child is breathing a little faster than usual.
    • The child seems a little out of breath but can still eat or talk.

    Disc batteries are small, round batteries used in toys, cameras, watches, and other devices. Because of the chemicals they can release, they can cause serious problems if they are swallowed or get stuck in an ear or the nose. Small magnets used in household items and objects that contain lead (such as bullets, buckshot, fishing weights and sinkers, and some toys) also can cause problems if swallowed.

    • If a disc battery is stuck in the ear or nose:
      • The battery needs to be removed right away—within 1 hour if possible.
      • Use tweezers to try to remove the battery. If you can’t remove it, get medical help.
    • If you have swallowed a disc battery, magnet, or lead object:
      • Get medical help right away.
      • Do not try to vomit.
      • Do not eat or drink anything.

    Seek Care Today

    Based on your answers, you may need care soon. The problem probably will not get better without medical care.

    • Call your doctor today to discuss the symptoms and arrange for care.
    • If you cannot reach your doctor or you don’t have one, seek care today.
    • If it is evening, watch the symptoms and seek care in the morning.
    • If the symptoms get worse, seek care sooner.

    Call 911 Now

    Based on your answers, you need emergency care.

    Call 911 or other emergency services now.

    Sometimes people don’t want to call 911. They may think that their symptoms aren’t serious or that they can just get someone else to drive them. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

    Seek Care Now

    Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

    • Call your doctor now to discuss the symptoms and arrange for care.
    • If you cannot reach your doctor or you don’t have one, seek care in the next hour.
    • You do not need to call an ambulance unless:
      • You cannot travel safely either by driving yourself or by having someone else drive you.
      • You are in an area where heavy traffic or other problems may slow you down.


    Do you know how to recognize and help someone who is choking?

    We are living in interesting and challenging times right now, to say the least, more and more people are working from home and self-isolating, which can bring a whole new set of challenges.  

    A simple but common accident that can happen at work in the office or at home is choking, while it’s scary to think about, we have put together some tips to help recognize and act upon in the event of choking. Choking is a common cause of accidental death and often preventable. Objects such as food, candy or small objects can easily become lodged in the airway if they are accidentally ‘breathed in’ rather than swallowed.

    Signs and symptoms of choking

    • Unable to speak or cough
    • Grasping or pointing to the throat
    • Distressed look on the face
    • First aid treatment of choking

    Encourage the patient to cough, If the choking is only mild, this will clear the obstruction and the patient should be able to speak to you.

    If the obstruction is not cleared:

    Give back blows

    Call for help, but don’t leave the patient yet.

    Bend them forward so the head is lower than the chest. For a smaller child, you can place them over your knee to do this.

    Give up to 5 firm blows between the shoulder blades with the palm of your hand. Check between blows and stop if you clear the obstruction.

    If the obstruction is still not cleared:

    Give abdominal thrusts

    • Stand behind the person and wrap your arms around the waist.
    • Place your clenched fist just above the person’s navel. Grab your fist with your other hand.
    • Quickly pull inward and upward as if trying to lift the person up.
    • Perform a total of 5 abdominal thrusts.
    • If the blockage is still not dislodged, continue cycles of 5 back blows and 5 abdominal thrusts until the object is coughed up or the person starts to breathe or cough.
    • Take the object out of his mouth only if you can see it. Never do a finger sweep unless you can see the object in the person’s mouth

    Give CPR, if necessary

    If the obstruction comes out, but the person becomes unconscious, begin CPR.

    Continue CPR until medical personnel arrives.


    What if I am choking and nobody is around to help?

    It’s a scary situation whether you’re in a room full of people or alone at home. But there is a fast and effective solution: the Heimlich Maneuver®.

    The best way to dislodge an obstruction is the Heimlich Maneuver. And if you’re alone, you can perform the Self-Heimlich.

    Even though you won’t be able to speak when you’re choking, call 9-1-1 so help is on the way if you need it. Then take action to dislodge the obstruction.

    Here’s how you can save your life with the Self-Heimlich:

    • Position yourself behind a chair or on the edge of a table.
    • Press your abdomen, the same area you’d place your fist on another person, against a table or chair with quick inward and upward thrusts.
    • Repeat until the object is dislodged.

    You can also watch the Heimlich Heroes Self-Heimlich video for a closer look at how to perform the maneuver on yourself.


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    Why Am I Having Trouble Swallowing?

    Have you ever heard the saying, “it went down the wrong pipe,” after someone has taken a sip or bite of food?

    Eating and drinking are an important part of life, physically and socially. While most of us have definitely had our bouts with something going down the wrong pipe, for some, difficulty swallowing, known as dysphagia, could be a symptom of something more serious and worth getting checked out by a doctor.

    We spoke with Aravind Sugumar, MD, a gastroenterologist with Banner – University Medicine Digestive Institute in Arizona, to help us better understand dysphagia, its causes, symptoms and treatment options.

    What is dysphagia?

    “Dysphagia is a symptom, not a diagnosis,” Dr. Sugumar said. “It’s like saying someone has a fever, but not where it came from or how to treat it. Dysphagia is a starting point for asking more questions.”

    Those with dysphagia have difficulty swallowing, while some may be unable to swallow at all. When this happens, it can be difficult to take in enough calories and fluids, and can lead to additional medical problems.

    What are the causes for dysphagia?

    Although dysphagia can happen to anyone, it is most commonly seen in older adults, babies and those suffering from brain and nervous system disorders. There are many different problems that can prevent the throat and esophagus from working properly, however, generally it falls into the following categories:

    • Esophageal dysphagia: the sensation of food sticking or getting stuck in the base of your throat or in your chest after swallowing. Some of the causes of esophageal dysphagia include:
      • Gastroesophageal reflux disease (GERD): Damage to the esophagus from stomach acid backing up into it and causing spasms, scarring and narrowing.
      • Esophageal ring: scar tissue that builds up and causes narrowing of the lower esophagus.
      • Esophageal tumors: Growths that cause a narrowing of the esophagus.
      • Eosinophilic esophagitis: A unique inflammation caused by an overpopulation of blood cells called eosinophils.
    • Oropharyngeal dysphagia: a weakening of the throat muscles that makes moving food from your mouth into your throat and esophagus difficult when you swallow. Some of the causes of oropharyngeal dysphagia include:
      • Cancer: Certain cancers and some cancer treatments, such as radiation.
      • Neurological disorders: Disorders such as multiple sclerosis and Parkinson’s disease.
      • Neurological damage: Sudden neurological damage from a stroke or head injury may weaken or affect the coordination of swallowing muscles or limit sensation.

    What are the signs and symptoms?

    “Early on symptoms occur intermittently, so people often ignore them,” Dr. Sugumar said. “It often isn’t until the symptoms are persistent and pervasive that they seek medical attention.”

    As dysphagia progresses it will eventually include all food types and then liquids.

    Some symptoms linked to dysphagia include:

    • Choking while eating
    • Coughing or gagging while eating
    • Sensation of food stuck in throat or chest
    • Drooling
    • Heartburn or frequent regurgitation
    • Hoarseness
    • Recurrent pneumonia
    • Difficulty swallowing

    If you are experiencing any of the “red flag” or “alarm” symptoms, such as blood in your stools or a low blood count, along with unexplained weight loss, you’ll want to get immediate medical attention.

    How is dysphagia typically diagnosed?

    Swallowing in and of itself is a complex process that involves more than 50 muscles and many nerves. So, as you can imagine, diagnosing the cause is super complex as well.

    Your doctor will first carefully review your medical history to provide a direction toward its causes, and may advise an endoscopy to rule out other issues.

    “Blood work and an endoscopy are often the first tests we perform to arrive at the diagnosis,” Dr. Sugumar said. “More tests such a barium swallow study can be performed as needed if the underlying cause is elusive.”

    What are the treatment options for dysphagia?

    The treatment for dysphagia will be directed at reversing the cause. Thus, the treatment can vary greatly from medication to lifestyle changes to surgical procedures depending on the underlying cause.

    For conditions like GERD, you may find that prescription medications to reduce your stomach acid will do the trick. If you have a narrowing of the esophagus due to scar tissue, your doctor may use an endoscopy balloon to break up the scar tissue and stretch out the esophagus. In other cases, your doctor may recommend swallowing therapy or swallowing techniques to help improve the muscle and how they respond.

    For those who may no longer be able to consume food by mouth (such as patients with advanced esophagus cancer), a feeding system, such as a feeding tube, may help bypass swallowing and ensure they are getting the necessary nutrition.

    Are you having difficulty swallowing?

    If you are noticing a sudden or gradual change in your ability to swallow, schedule an appointment with your physician or a specialist to be evaluated.

    To find a Banner Health specialist near you, visit bannerhealth.com.


    Join the Conversation

    i am choking – Translation into French – examples English

    These examples may contain rude words based on your search.

    These examples may contain colloquial words based on your search.

    I am choking, so you come where I am vulnerable.

    Now I am choking down a cocktail of pills 3 times a day!

    Maintenant, j’avale un cocktail médicamenteux trois fois par jour !

    Suggest an example

    Other results

    I am not choking, which must be counted in one’s favour.

    You know, I am so close to choking you!

    Never hit a choking person on the back.

    Small pieces may pose a choking hazard.

    Choking Hazard This product contains small parts.

    That uncertainty is sapping confidence and choking business growth prospects.

    Cette incertitude mine la confiance et étouffe les perspectives de croissance économique.

    He has documented Trouble swallowing.The choking‘s not new.

    Son dossier nous dit qu’il a déjà eu des dysphagies. Ce n’est pas récent.

    Swallowing of some organic liquids may cause vomiting or choking.

    L’ingestion de certains liquides organiques peut provoquer des vomissements ou l’étouffement.

    Lost consciousness due to choking on food.

    Choking occurs most often in young children.

    The screaming made her start choking.

    Little League game without choking someone out.

    Little League est un jeu sans étouffer quelqu’un.

    Could put Chuck ahead with undecided choking voters.

    Son père pourrait l’emporter avec les électeurs indécis qui s’étouffent.

    Imagine dying after choking on a rice cake.

    That explains the choking And fainting.

    Explication de la suffocation et la perte de connaissance.

    Roosevelt is choking the whole country.

    Die choking on your own blood, please.

    Mourez en vous étouffant dans votre propre sang s’il vous plaît.

    He looked as if he was choking with one of your potatoes.

    C’est comme s’il en avait avalé une toute ronde, de tes patates, et qu’elle lui reste dans le gosier.

    Why Do We “Choke” Under Pressure? · Frontiers for Young Minds


    Why do some people perform worse under pressure, even when using a familiar skill to complete a task? This is called choking under pressure, and it happens to many people and in many different situations. Understanding when and why people choke under pressure can help us perform at our best when it matters the most. In this article, we explain the scientific research on the parts of the brain that cause choking under pressure and how we can prevent this impaired performance from happening.

    What Does It Mean to “Choke” Under Pressure?

    Imagine that you are sitting in class taking a test. You studied really hard, but you suddenly forget an important piece of information that you need to solve a problem. As you try your hardest to remember that one fact, you panic. Your heart races, you start to sweat, and you cannot seem to think clearly anymore. This feeling of panic, often called choking under pressure, is a response of the nervous system to really stressful situations, and it can cause people to perform badly on a task (Figure 1) [1, 2]. Not to be confused with difficulty breathing, “choking” under pressure happens when feelings of stress, worry, and anxiety work together to cause someone to perform worse than they normally would. In the example above, the test can either give you a great reward (getting an A+) or a punishment (getting a bad grade). This kind of stressful, risky situation can play a big role in how much information a student can remember in the moment.

    • Figure 1 – Ways in which our bodies respond to choking under pressure.
    • There are many ways your body can react in high pressure situations like when taking a test. For example, you might feel your hands start shaking or your palms get sweaty. These types of reactions are different from person to person and can affect how well you do on the test.

    While the idea of choking under pressure might seem pretty straightforward, the science behind it is complicated. For example, scientists think that choking under pressure involves memory—specifically, a type of memory called working memory [3]. Not only does choking involve working memory, but it also depends on how different parts of the brain communicate with each other [2, 4].

    In this article, we describe the scientific discoveries that help us understand how brain activity comes together to cause choking under pressure. We focus on how choking affects students, but remember that choking under pressure can affect a variety of people and can happen in many different situations, like in sports or competitions. Because choking under pressure happens so often and to so many people, it is important to understand how it works so that we can try to stop it from happening.

    The Role of Working Memory

    Scientists who study memory have described different processes, or types, of memory [3]. One type is called long-term memory, which lasts basically forever and can store an unlimited amount of information. Long-term memory stores the information we are not currently using, kind of like a library full of books that hold the stories of our lives. Another type of memory, working memory, does not last very long and cannot hold much information. Working memory is the one we use for completing tasks and getting information into and out of long-term memory. For example, we use working memory to do things like mental math or to piece a story together after listening to a sequence of events. Working memory plays a big role in learning and doing well on tests in school [3]. People differ in how much information they can hold in working memory, which is called a person’s individual working memory capacity.

    Stressful situations can affect even the smartest students, by lowering the amount of space in their working memory [1, 2, 4]. Remember that working memory already cannot hold much information. When students are placed in high-pressure situations (like on a test day), worrying about the pressure they are under takes up space in working memory and leaves less space available to use to complete the task. For example, when taking a test, anxious thoughts use up some of the limited space in working memory and lower the amount of working memory space available for solving a math problem or pulling a fact out of long-term memory.

    How Do We Know This?

    Scientists created an experiment to look at how low- or high-pressure situations affected students with different individual working memory capacities. First, the scientists measured the working memory capacities of 93 students. They did this by giving the students two tests: one that involved solving math problems while remembering a list of random words and one in which students were told to read sentences aloud while remembering random letters. Based on their performance on these tests, the students were placed into two groups: students with high-capacity working memory (these students can hold more information in working memory and are represented in blue on Figure 2) and students with low-capacity working memory (represented in red in Figure 2).

    • Figure 2 – Results of the working memory experiment.
    • The high-capacity working memory students (blue) performed better than low-capacity working memory students (red) under low pressure. However, when the stakes were high, the high-capacity working memory students performed equally to the low-capacity working memory students!

    Then, the scientists gave each group a set of math problems in two situations: a low-pressure and a high-pressure situation. They did this to figure out if more space in working memory meant students had enough room to store both the math problem and the stress/high-pressure thoughts, and whether this affected how well they could do on the math problems. To create the high-pressure environment, the scientists gave the students real-world sources of stress, like the possibility of winning money based on how quickly and correctly they could do the math problems. The low-pressure situation was described to the students as practice.

    The results of this experiment (Figure 2) showed that students with higher working memory perform better than students with lower working memory under low-pressure conditions. This means that, when there is no pressure, the high-capacity students can do better on math tests. This makes sense, because these students have more working memory space to conduct mental math or to retrieve information from long-term memory. However, when the pressure was on, the high working memory students performed equally to the students with low working memory! This means that, under pressure, anxious and stressful thoughts consumed the extra working memory capacity of the high-capacity students, and they were not able to use their higher working memory capacity to outperform the students with low working memory capacity. This result might also explain why the students with low-capacity working memory did not do any worse in the high-pressure situation than in the low-pressure situation: they had no available working memory space leftover to process and store the idea that they were under pressure! This research not only shows how important working memory is in the school setting, but also how stressful situations can stop people from doing as well as they potentially can when it matters the most.

    Parts of the Brain Involved in Choking

    Can we point to one part of the brain and say, “that is where choking under pressure happens?” For a long time, scientists thought that the prefrontal cortex, which is really important for a lot of cognitive functions like planning, reasoning, and decision-making, was responsible for holding information in working memory [1, 4]. These scientists came to this conclusion because they noticed high levels of brain activity in the prefrontal cortex when humans used their working memories [5]. Recent studies show that cognitive functions, like attention and motivation, play a key role in determining how much working memory capacity person can have. For example, the more attention a person’s prefrontal cortex can give to a task, the more working memory that person has. Basically, the prefrontal cortex picks and chooses the important information to attend to, and processes that information in a way that affects working memory capacity. So, we know that there is a connection between the prefrontal cortex and working memory. But, there is more!

    Another part of the brain, called the anterior cingulate cortex, is involved in controlling our emotions [4]. In the testing example described above, this emotional center of the brain would have played a role in causing the moment of panic when you realized you forgot something on the test. Together with the anterior cingulate cortex, the amygdala also plays a role in how we perceive fear and anxiety. The amygdala is a small, almond-shaped part of the brain that plays a role in how we respond when we are under pressure [6]. This means that the prefrontal cortex alone is not responsible for choking under pressure. So, we know that the prefrontal cortex helps guide attention and the anterior cingulate cortex and amygdala help control our emotions. But this still is not the whole story, because taking a test does not just involve attention and emotion, performing well on a test involves motivation too.

    There is a highway in the brain called the meso-limbic-cortical pathway that plays a role in how rewarding a situation feels to us [4]. This part of the brain would be partly responsible for the pressure we feel to get an A+ on tests—because we want the reward of doing well in school and we see the risk in doing poorly on the test.

    Let us return to the question above, can we point to one part of the brain and say that is where choking under pressure happens? The answer is no. Many tasks the brain accomplishes are spread across many areas of the brain, meaning we cannot just point to one part of the brain and say, “that is where choking under pressure happens.” But we can describe how several regions of the brain are involved, including the prefrontal cortex, anterior cingulate cortex, amygdala, and the meso-limbic-cortical pathway (Figure 3).

    • Figure 3 – Parts of the brain involved in choking under pressure.
    • The meso-limbic-cortical pathway, which controls how we perceive reward, is shown in red; it starts in a part of the brain called the ventral tegmental area and moves up through the prefrontal cortex. The anterior cingulate cortex, which is involved in controlling our emotions, is shown by the dashed white line. The amygdala, which also plays a role in how we perceive fear and anxiety, is also pictured.

    How Can We Avoid Choking Under Pressure?

    Luckily, there are some steps we can take to prevent choking under pressure. Recent studies have shown that writing about your thoughts before taking a test is very helpful in preventing choking, probably because it frees up the working memory space that any negative or overwhelming thoughts were using, by getting those thoughts down on paper instead. Also, practicing under pressure (like studying in a way that is similar to the actual test) gives you a chance to practice pausing and breathing during hard problems [1].


    At some point in our lives, most of us will experience a moment when we choke under pressure. Our stressful emotional state may cause us to seemingly forget an important piece of information, and this can result in worse performance on the task than we expected. Scientists have shown that choking under pressure interrupts the functioning of working memory. If you interrupt the ability of working memory to stay focused on a task, performance can suffer because of changes to attention that occur in the prefrontal cortex, emotions that occur in the anterior cingulate cortex and amygdala, and motivation that happens in the meso-limbic-cortical pathway. Luckily, practicing staying calm and jotting your feelings down on paper to get them out of your working memory are strategies that can reduce choking under pressure.

    Although we know which brain areas are involved in choking under pressure, more research is needed to learn how the mechanisms and pathways in these areas interact with each other, so we can understand how to perform at our best when there is a lot on the line.


    Working Memory: A limited storage space for memories that we are currently thinking about or using.

    Long-term Memory: An unlimited storage of memories that we are not currently using.

    Individual Working Memory Capacity: The amount of information (or capacity) people can hold in working memory differs slightly across people, meaning that each individual (or person) has their own working memory capacity.

    Prefrontal Cortex: A part of the brain located in the frontal lobe that is involved in complex behaviors.

    Cognitive: Relating to the process of thinking.

    Anterior Cingulate Cortex: A part of the brain that is involved in impulse control, emotion, and decision-making.

    Amygdala: An almond-shaped area of the brain that is involved in in emotion and behavior.

    Meso-limbic-cortical Pathway: A reward pathway in the brain that plays a role in processing reward information.

    Conflict of Interest

    The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


    [1] Beilock, S. 2010. Choke: What the Secrets of the Brain Reveal About Getting It Right When You Have To. 1st Edn. New York, NY: Atria Paperback.

    [2] 2. Beilock, S. L., and Carr, T. H. 2005. When high-powered people fail: working memory and “choking under pressure” in math. Psychol. Sci. 16:101–5. doi: 10.1111/j.09567976.2005.00789

    [3] Cowan, N. 2014. Working memory underpins cognitive development, learning, and education. Educ. Psychol. Rev. 26:197–223. doi: 10.1007/s10648-013-9246-y

    [4] Yu, R. 2015. Choking under pressure: the neuropsychological mechanisms of incentive induced performance decrements. Front. Behav. 9:19. doi: 10.3389/fnbeh.2015.00019

    [5] Curtis, C. E., and D’Esposito, M. 2003. Persistent activity in the prefrontal cortex during working memory. Trends Cogn. Sci. 7:415–23. doi: 10.1016/S1364-6613(03)00197-9

    [6] Ressler, K. J. 2010. Amygdala activity, fear, and anxiety: modulation by stress. Biol. Psychiatry 67:1117–9. doi: 10.1016/j.biopsych.2010.04.027

    A Case Report and Review of the Literature

    Shanghai Arch Psychiatry. 2016 Dec 25; 28(6): 349–352.

    Language: English | Chinese

    Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India

    * Dr. Swapnajeet Sahoo. Mailing address: Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India. Postcode: Pin -160012. [email protected] © Shanghai Municipal Bureau of Publishing


    Choking phobia is a relatively uncommon phobic disorder which is often encountered by otorhinolaryngologists and referred to psychiatrists as a cause of psychogenic dysphagia. If not diagnosed early and treated appropriately, it can have severe detrimental effects on the physical and psychological health of an individual. We present a case of a 20 year old female who presented with choking phobia and was treated with behavior therapy. Additionally, we discuss the differential diagnosis and treatment strategies of this rare anxiety disorder.

    Keywords: Choking, Phobia, Psychogenic dysphagia, Behavior therapy, India


    窒息恐怖症是一种较少见的恐怖症,是心理性 吞咽困难的病因之一。患者往往在耳鼻喉科就诊,之 后被转诊到精神科。如果诊断不及时、治疗不恰当, 那么它会严重影响患者的身心健康。我们报告一个20 岁的女性患者,表现为窒息恐怖症,接受行为治疗。 此外,我们还讨论了这种罕见的焦虑障碍的鉴别诊断 和治疗策略。

    1. Introduction

    Choking phobia is a rare condition characterized by intense fear of choking accompanied by avoidance of swallowing solid food, liquids and taking pills/ tablets in the absence of anatomical or physiological abnormalities.[1,2] Patients usually present with a history of intense fear to swallow food or drinks after a traumatic event of being choked but it may also be seen without such an event.[3] Existing diagnostic systems have classified it under “Other (300.29/F40.298)” category in Specific phobia disorder of Anxiety disorders in DSM IV and the same has been retained in DSM 5. [4,5]

    Existing literature on this rare phobic disorder is limited to a handful of case reports/series and review articles.[6-8] Indian data on choking phobia is almost not available, though it is not uncommonly encountered in routine clinical practice by otorhinolaryngologists and psychiatrists. Several treatment strategies have been used, but there is no common consensus over an appropriate approach. Most of the case reports/series support use of behavior therapy. We report a case of choking phobia in a 20 year old female who underwent successful treatment with behavior therapy.

    2. Case history

    Miss X, a 20 year old girl, 2nd in birth order, an engineering student living in a hostel, and hailing from a urban background was referred to our Psychiatry Outpatient department from the Otorhinolaryngology department for detailed assessment and management. Exploration of history revealed that she had developed a constant fear of swallowing solid/semi- solid foods and pills for the past 5 months after a choking incident which occurred while she was having her dinner consisting of “chappatis (bread) with black gram curry” which are some of the more commonly prepared food items in our country. Prior to the incident, she was stressed due to exams and some family issues. She reported during the choking incident, she suddenly felt as if some food particles had stuck to her throat. She started to feel an abnormal sensation which did not go away by drinking water. Following which she started to have negative automatic thoughts like she would be choked to death and no one would help her. She had a panic attack characterized by severe anxiety with palpitations, sweating, difficulty in breathing, and restlessness along with a sense of impending doom.

    Her fellow classmates rushed her to the emergency department of a nearby private hospital within 15-20 minutes. However, by the time she arrived her anxiety had decreased significantly and after a noneventful detailed examination of her throat by the otorhinolaryngology resident she was discharged. However, after reaching the hostel again she had the same feeling of something being stuck in her throat and started having the same degree of anxiety. Being unable to sleep and having the same choking feeling again, she was readmitted to the same hospital but no physiological or organic cause was detected. Despite being counseled again and again by the treating doctors regarding her unreasonable fear she continued to harbor anxiety. Within a week, she started to have fear whenever she would be given food to eat and would have thoughts that she would be choked by the food item, thereby leading to severe anxiety and refusal to eat. Her parents visited several otorhinolaryngologists but no organic cause could be found. Gradually her condition further worsened. She started to refuse solid/ semisolid food items and completely shifted her diet to liquid based food items like fruit juices and soups. Later on, she even began to have doubts that fruit juices may contain some fine residues (e.g. seeds etc.) which may choke her and started to avoid them as well. She would scrutinize each food item before eating, at times would even use a sieve to check for any fine residue or grind up the food items. Due to such behavior, there were repeated altercations at home leading to significant family disruption. She refused to go back to her college or to continue her studies and would be preoccupied with the fear of having an anxiety attack if she stayed alone at the hostel and of being choked. She lost around 7-8 kg of weight within a span of two months. She was completely preoccupied with her fear related to swallowing and she did not bother about her exams and family issues during this period. By this time, she also started to have depressive symptoms such as persistent pervasive sadness, anhedonia, feeling helpless, ideas of worthlessness, low self-esteem and decreased sleep. For these reasons, they initially visited to the Otorhinolaryngology department of our centre and after ruling out all organicity (both clinical examination and barium swallow did not reveal any obstructive pathology) she was referred to us. There was no history of any suicidal ideations, delusions or hallucinations or any history of fear of any other specific object or situation. No history of constant preoccupation with body image or weight related issues or any previous mood episode could be elicited. Family history revealed a dysfunctional family in which her father used to be an alcoholic since the patient’s childhood who would physically abuse her mother under intoxication. Her mother appeared to have chronic depressive illness along with a generalized anxiety disorder but she never received counseling for this. However, no history of any physical/sexual abuse to the patient was reported.

    On the mental status examination, the patient was alert and oriented, with constant preoccupation with excessive fear of being choked if she ate food. Insight was preserved i.e. she assumed that her fear was irrational, illogical and mostly psychological and agreed for treatment. A diagnosis of specific phobia “choking phobia” along with comorbid moderate depressive episode was considered. She was started on Escitalopram 10 mg and benzodiazepines (Clonazepam 0.25 mg BD). Personality assessment using International Personality Disorder Examination (IPDE) revealed cluster B traits of emotionally unstable borderline type. After 2 weeks, her symptoms suggestive of depression improved by nearly 60% but her phobia regarding eating or swallowing food remained the same as she would even grind all tablets and then take them with water. She was then taken up for behavior therapy with her consent. Hierarchy of food items which cause anxiety were charted down with subjective unit of distress (SUD). Along with progressive muscular relaxation exercises and proper psycho-education regarding behavior therapy, biweekly sessions were started with the food item with the least SUD. She would be asked to eat the food item in presence of the therapist and to face her anxiety. After initial resistance due to excess anxiety, she started to carry out sessions as described. After 10 sessions, she developed confidence and started to carry out daily similar sessions at home. Clonazepam was stopped within one week of starting of behavior therapy. A total of 25 sessions were taken and by the end of 3 months, she reported very minimal or no anxiety while eating. In the subsequent sessions, family issues were discussed. Her father was brought into the treatment network and family therapy was planned. In spite of continuing family issues at home, there had been no recurrence of symptoms of choking phobia at 12 months follow up and subsequently Escitalopram had been stopped.

    3. Discussion

    Phagophobia and swallowing phobia are other commonly used synonyms of choking phobia.[8] It is of the utmost importance to differentiate it from organic dysphagia before labeling it to be of psychogenic origin. Very commonly it has been misdiagnosed with eating disorders and conversion disorder. However, it should be kept in mind that phenomenologically it is completely distinct from eating disorders, it is characterized by the phobic stimulus of swallowing that results in the avoidance of food or drinks, and ultimately to weight loss, social withdrawal, anxiety and depression states whereas in eating disorders the main psychopathology is the constant preoccupation with losing weight or fear of becoming fat.[2] Similarly, it can be differentiated from conversion disorder (Globus Pharyngeus) as in Globus pharyngeus, patients often have the ‘perception’ of an abnormal sensation and a feeling of globus which is usually unrelated to actual swallowing. Conversion disorder was ruled out as our patient had the sensation of being choked and the fear that food would become lodged in the throat was experienced only during meal time.[9] Two types of choking phobia (i.e. post-traumatic type and malingering type) have been described. In the ‘post traumatic’ type, the psychic trauma is caused after an experience of gagging or choking whereas in the ‘malingering’ type, the malingering maintains the symptoms and conversion symptoms allow the patient to avoid conflicts.[10] The index case belonged to the former type of choking phobia and organicity was ruled out by clinical examination and detail investigations by several otorhinolaryngologists.

    It has been proposed that choking phobia occurs most commonly secondary to a conditioning experience of being choked by food.[7] In the index case, swallowing food became conditioned with the fear of being choked after a choking incident leading to an avoidance or restriction of foods, panic attacks and weight loss. Panic attacks in the index case acted as a fear conditioning factor and maintained the vicious cycle of anxiety leading to avoidance. Existing literature reflects that choking phobia has been most commonly seen in females but in a very wide range of age groups (i.e.as low as 5 years to as high as 78 years).[7] Comorbidity with other psychiatric disorders like social anxiety, panic disorder, personality disorders, depression etc. has been reported.[8] The index case was also in line with these facts.

    In the index case, medication was continued during the course of behavior therapy for management of depressive symptoms and for the anxiety related to the choking phobia. Currently, no controlled trials or guidelines are available for the treatment of choking phobia. However, existing case studies describe a variety of treatment approaches ranging from hypnotherapy[11], Eye Movement Desensitization and Reprocessing (EMDR)[12] and cognitive behavior therapy.[6] Although pharmacotherapy like low dose selective serotonin reuptake inhibitors had been used for treatment,[13] behavioral approaches have been more commonly used.[1,14] Treatment protocol consisting of psychoeducation, cognitive restructuring, aversion /distraction and in-vivo exposure had resulted in remission of symptoms in patients with choking phobia.[15] Given the severity and level of dysfunction in the index case, both modalities of treatment (i.e. pharmacotherapy and behavior therapy) were combined. Though Clonazepam has a half life of ~16-24 hours, however in anxiety disorders a low dose Clonazepam (0.25-0.5 mg) BD or TDS dosing is recommended [16] which was later tapered off following improvement with behaviour therapy. Treatment followed in the index case was holistic and complete (i.e. psycho-education, cognitive rechallenging and in-vivo exposure in front of therapist) which ultimately led to complete and sustained remission.

    The index case highlights that otolaryngologists should be aware of this disorder along with the fact that psychogenic dysphagia needs to be evaluated in detail. Further, if appropriate treatment strategies are followed then such conditions can have a very good outcome.


    Dr. Swapnajeet Sahoo obtained his bachelor’s degree from VSS Medical College, Burla, Odisha, India in 2011 and his MD in Psychiatry from the prestigious Post Graduate Institute of Medical Education and Research, Chandigarh, India in 2015. He is currently working as a senior resident in the Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India. His main research interests include psychopharmacology, psychotherapy, cognitive neurosciences and Schizophrenia.



    No funding support was obtained for preparing this case report

    Conflict of interest statement

    The authors declare that they have no conflict of interest related to this manuscript.

    Informed consent

    The patient signed an informed consent form and agreed to the publication of this case report.

    Authors’ contributions:

    SS drafted the manuscript and NH critically reviewed the manuscript.

    SS, NH and SKP jointly made the clinical diagnosis and the psychiatric evaluation.

    SS carried out the behavior therapy sessions. All authors read and approved the final manuscript.


    3. de Lucas-Taracena MT, Montañés-Rada F. [Swallowing phobia: symptoms, diagnosis and treatment]. Actas Esp Psiquiatr. 2006; 34(5):309–316. Spanish [PubMed] [Google Scholar]4. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders : DSM -IV. Fourth Edition
    Washington, DC: American Psychiatric Association; 1994 [Google Scholar]5. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders : DSM -5. Fifth Edition
    Washington, DC: American Psychiatric Association; 2013 [Google Scholar]8. Shapiro J, Franko DL, Gagne A.
    Phagophobia: a form of psychogenic dysphagia. A new entity. Ann Otol Rhinol Laryngol. 1997; 106(4): 286-290 [PubMed] [Google Scholar]10. Okada A, Tsukamoto C, Hosogi M, Yamanaka E, Watanabe K, Ootyou K, et al.
    A study of psycho-pathology and treatment of children with Phagophobia. Acta Med Okayama. 2007; 61(5): 261-269 [PubMed] [Google Scholar]13. Banerjee SP, Bhandari RP, Rosenberg DR.
    Use of low-dose selective serotonin reuptake inhibitors for severe, refractory choking phobia in childhood. J Dev Behav Pediatr. 2005; 26(2): 123-127 [PubMed] [Google Scholar]15. Ball SG, Otto MW.
    Cognitive-behavioral treatment of choking phobia: 3 case studies. Psychother Psychosom. 1994; 62(3-4): 207-211 [PubMed] [Google Scholar]16. National Institute for Clinical Excellence. Anxiety Disorders. London: NICE; 2014 [Google Scholar]

    I am suffocating – Arkady Babchenko’s Journal – LiveJournal

    I am suffocating. Professionally, as a journalist, I absolutely suffocate. I have no work. There is no oxygen. There is no politics, state, strategy, development, vision of the future, mistakes, disputes, discussions.
    I turned out to be absolutely unnecessary for this time, I have no place in this circus, like an ocean marlin thrown out on the sand of the arena. I didn’t have my element left in which I could swim – an adult politician who made the Revolution of Dignity of the country, building its sovereignty and entering the international arena, as an equal, and in some issues and leading, a member of this international community.There are no speeds I need. There is no space required. There are no adequate challenges and tasks.
    In just two years, this sea dried up. Fully. And on the muddy bottom, consisting of a kindergarten of absolute clowning, there were left to gulp the remnants of at least some, even a small-town, politician, in small puddles there are all kinds of journalists, bloggers, opinion leaders.
    We are trying to gasp for this air – but it is no longer possible to fully breathe it.
    And, most importantly, there is nothing for now. Nobody needs it anymore.
    And so everything is already clear to everyone.

    I am atrophying.

    Like there at Conan Doyle. The Mighty Mind of Sherlock Holmes. In the days of green politics, the “mighty mind” of Sherolk Holmes had absolutely nothing to do. He suddenly, to his greatest surprise, found himself in a situation where, instead of confronting the equally powerful mind of Moriarty, he had to look for which of the crumpled kids had stolen a typewriter in kindergarten.
    Well, it’s impossible, in fact, to build journalism on this incredible, fantastic, booth with Chaus, Milovanov’s black eye, slippers in the Capitol, and another ripped out context of Arakhamia with Arestovich.
    Indeed, the next Maidan will be under the extinguishment “Stop the bullshit!”

    Despite the fact that Moriarty has not gone anywhere.
    He is standing nearby, abroad, preparing his army and everything is in order.
    And I’m messing around with some shit, damn it.
    Feuilletons, frogs on the judge, pictures of food …
    But, it must be admitted, Vladimir Alexandrovich is perhaps the only president who fully met the expectations of his voters.
    Were abused to the point of vomiting. Green.
    What’s true is true.

    If I had a passport and a work permit now, I would go to a construction site as a laborer. Feuilletons are, of course, great, but you have to feed your family, and to write about all this nonsense from day to day is no longer any strength, no desire, no inspiration.

    By the way, about the Maidan. What is happening now is called the “desacralization of power.” Power can be anything you want – stupid, cruel, idiotic, unreasonable – but it cannot be funny. Judge Chaus can be anything – a thief, scum, shit – but he cannot be like a clown in his underwear, being kidnapped by state structures from each other, like … Damn, I can’t even find allegories.
    This weekend, highlighted by NABU chasing a judge in panties in an SBU minivan stolen from the police, showed that the state in Ukraine – as a set of working public institutions – does not exist. Instead, a set of still somehow functioning traveling circus troupes. Speakers in the same square, but separately.
    Would you like Du-Solei?
    Special offer from the chef. Acrobats-pi *** s and a drunken elephant on a trapeze.

    Where the authorities turn themselves into clowning, they themselves sign their own absence.Yes, there are still separate undestructed islands of the state, such as the army, but in general …
    And when I see, as under the post of the mayor of Dnipro, that in response to the blocking of the road by indignant residents, he cut off the water for them with the words “I will not allow blackmailing the authorities with positions of power! ”, thousands and thousands of likes are collected – I see that in this clownery the request is – even if not for a strong hand, but for at least someone who will put at least some order in this mess, even with gopnic raider methods a serious kid – this request has already, in general, been formed.At least voters of one mayor of one city.
    You are a hired worker, people are your employers, if they go out on the highway, it means that you do not work well and, therefore, leave your place of work – that you will not allow there, who you will block what there …

    I must admit, colleagues, that as journalists, we are complete shit. As a public institution, as the fourth estate, our journalism proved to be completely incapable of resisting this wave of crap about the Svinarchuks, the Lipetsk factory and the brother killed in Moldova.Yes, then everything became clear – the Svinarchuks turned out to be a blessing, the Lipetsk factory was a project of a media war and information throwing, and my brother in Molodov wasn’t hungry. But that didn’t matter anymore. Truth is unable to withstand post-truth in the era of hybrid war.
    The most annoying thing is that all these tools are absolutely primitive. And we can use them with much greater efficiency. Against this fucking circus. And loosen it once or twice.
    But only all these tools can only destroy.
    And they cannot create.

    But most of all the melancholy is not the present. Most of all, the future is catching up with melancholy. In which it is already obvious that Zelensky will be pulled against Boyko. Well, they just don’t have any other options.
    This means Zelensky again. Well, because if they come up to the second round with this pair, we won’t have any other options. Who would have told me that I would campaign for Vladimir Alexandrovich.
    Which means eight more years of this swamp and fucking circus.
    Damn …

    Yes, Ukrainian politics is unpredictable and anything can happen – but so far there is no one on the horizon who could provide the country with the necessary acceleration. Well, yes, Klitschko can shoot. God knows him. Like the apostle Muntian.
    But Klitschko – to whom I have a generally positive attitude – is the station superintendent. Solid, sturdy, but – station superintendent.
    And this train needs a locomotive.
    And the locomotive was thrown down a slope.
    Ukrainians have no equal in this.

    Moreover, the locomotive itself is in perfect order, turns the wheels, the power one works, there is more than enough fuel in the flasks of fuel oil – it beats with its hooves, it wants and can. It would seem that. Just put it back on the rails. But no. They won’t let you do this. By common efforts. They will stand up with their chests, but the locomotive will not be allowed.
    And I’m not talking about Poroshenko right now. More precisely, not only about him.

    And that means there is only one thing left for now. Eight more years to sweep this station, repair it where it collapses, prevent the clowns from crawling all over the floor, drive them back into their holes, try to keep it in the form to which they managed to repair it, until a sign was nailed over the main entrance ” Circus “- and wait until a new locomotive appears on the horizon.
    And they hope that he will not be derailed again.
    Good morning.

    Within the framework of the project “Journalism without intermediaries”.
    Subscribe to me on Patreon:

    Unfortunately, every time I have to remind you that for a text with two or three thousand likes and half a thousand shares, only a few translations come. Perhaps everyone thinks that they have already been translated quite well without him. But no. Hungry children cry, folder, give me some macaroni.
    If you think that I do not live my writing life in vain, that my texts made me think, reconsider some decisions, make them, look at the world in a new way, laugh, cry, empathize, improve my skills in critical perception of information, or otherwise useful, then everything is as always.
    Thank you.

    Privat-bank card number: 5363 5423 0856 3718

    “I’m suffocating”: a British woman who has been ill with COVID about endless consequences


    “I’m choking “: a British woman who has had COVID about endless consequences

    ” I am suffocating “: a British woman who has had a COVID about endless consequences – Radio Sputnik, 10/23/2020

    ” I am choking “: a British woman who has had COVID about endless consequences

    A resident of Great Britain who suffered from COVID back in April, it still suffers from the consequences, according to RIA Novosti, citing The Mirror.Radio Sputnik, 23.10.2020

    2020-10-23T11: 01

    2020-10-23T11: 01

    2020-10-23T11: 01



    health – society

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    MOSCOW, October 23 / Radio Sputnik. A resident of Great Britain, who suffered from COVID-19 back in April, is still suffering from the consequences, RIA Novosti reports, citing The Mirror.32-year-old Tony Frank suffered a severe illness and spent seven weeks in intensive care, but still needs hospitalization. It is known that the woman continues to smell strange odors, suffers from lung damage, heart problems, chronic fatigue and asthma. As the newspaper explains, Frank belongs to a group of patients suffering from the so-called “long COVID-19”. This term is officially recognized by the UK National Health Service and is used to refer to the long-term, severe consequences of an illness.Earlier, Sputnik radio reported that Japanese doctors have identified unknown consequences of COVID-19. Briefly and to the point. Only selected quotes in our Telegram channel.


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    in the world, great britain, health – society

    “I’m suffocating.”Protests erupted in the United States after the death of a man who was strangled by a knee by a police officer

    Photo author, Getty Images

    Photo caption,

    Despite the pandemic, hundreds of Minneapolis residents took to the streets

    Brutal detention of 46-year-old George Floyd, a black resident of Minneapolis, was killed by a policeman choking a detainee with his knee. The FBI opened a police investigation, four police officers were fired, but hundreds of protesters took to the streets.

    In response to the news, hundreds of people have protested in Minneapolis against police violence and racial inequality. They marched towards the police station. Some demonstrators painted graffiti on police cars and threw stones at the police station.

    Police used flash grenades and tear gas to disperse the crowd.

    How did George Floyd die?

    Photo by Darnella Frazier


    Video of the incident in Minneapolis was posted on social networks

    On Monday, the police stopped Floyd’s car.In a statement, law enforcement officials say that he resisted the arrest and was handcuffed. There is no evidence of this yet. The officers had body cameras working, but their recordings were withdrawn for investigation.

    The video published on the Internet starts from the moment in which a white policeman uses a strangulation technique, kneeing on the detainee’s neck.

    Passers-by gathered around the stage, urging the policeman to stop choking Floyd and take his pulse.

    A recording made by one of the observers shows that lying on the ground Floyd was repeating “I’m choking! I’m choking!” and asked: “Do not kill me.”

    Photo author, Twitter / Ruth Richardson


    Floyd worked as a security guard in a restaurant

    At the end of the video, Floyd, who no longer moves, is put on a stretcher and taken away in an ambulance.

    Minnesota Police said he died in a “medical accident” while interacting with the police.

    The four police officers who took part in the arrest were dismissed. The Mayor of Minneapolis supported this decision and apologized to the Floyd family and all black residents of the city.

    But the case for the police may not end with just dismissal. The FBI has opened an investigation into the actions of the police during the arrest.

    Photo author, Getty Images

    Photo caption,

    George Floyd’s death reminded of other incidents of police violence against blacks

    This incident recalled the case of African American Eric Garner, who also died in arrest in 2014.A choke hold was applied to Garner, and he also repeated many times that he was suffocating.

    The phrase “I’m choking” has become the slogan of activists who protest against police violence against black people in the United States.

    Minneapolis Mayor Jacob Frey tweeted that firing employees is the right decision. Earlier, during a press conference, he called the incident a complete and utter disgrace.

    “It was wrong on all counts,” said Frey.“Being black in America shouldn’t be a death sentence.”

    This is not the first time police brutality against African Americans has been reported.

    An incident in Maryland recently drew widespread attention when an officer shot and killed a man while in a police car.

    Knee strangulation is one of the legal methods of arresting Minneapolis police, whose chief Medaria Arradondo said on Tuesday that “restraint methods” would be overhauled.The FBI has so far declined to comment.

    Photo author, Reuters

    Photo caption,

    The words “I suffocate” have become one of the symbols of the fight against police violence. This demonstration in New York last summer

    Amy Klobuchar, Senator from Minnesota, called for a comprehensive and thorough independent investigation.

    “Justice in relation to this person and his family, justice in the name of our society and our country must prevail,” the senator said in a statement.

    The phrase “I suffocate” has become a national watchword in the fight against police brutality since the death of Eric Garner in 2014.

    He was not armed and repeated this phrase 11 times when the police detained him on suspicion of illegal sale of cigarettes. And these were the last words that Garner spoke, already in the police stranglehold.

    The city pathologist later ruled that this seizure was one of the causes of Garner’s death.

    The NYPD officer involved in Garner’s arrest, which ended in the death of the suspect, was fired from service more than five years later, in August 2019.

    Alexandra Dialfova – I’m choking … read online for free

    Chapter 1. Morning.

    So I start to write. Morning. Sunday. 4 a.m. I did not sleep all night and do not want to sleep, perhaps a person can still get enough sleep sometime so that later he will not sleep. But people are accustomed to living according to the regime and therefore they cannot do that, or their brain is so programmed. But why hasn’t anyone tried to rewrite it? Although, then, probably, the world would have changed. I’m only interested in one thing: for the worse or for the better? On the one hand, life would become easier, but on the other hand, it is necessary to redo all systems, all schedules, especially work.Just imagine, you urgently need to buy bread, and the store has not yet opened, because the seller is asleep, but according to his working schedule, it should be open. That is, there would be chaos. Perhaps other people have guessed about this possibility, but having found a bunch of arguments against, they did not develop this idea. What am I talking about? Oh yes, I am standing on the balcony and enjoying this beautiful morning. Perhaps it’s like this every morning, I just do not see it every morning at 4 in the morning, when everyone is asleep, but cars drive and birds sing, although they sing all night.But in the morning it is especially beautiful. The sky is reddish on the left, and blue-blue on the right. There are almost no clouds. You are standing on the balcony and from time to time you can hear a train in the distance. You can hear him, since everything is asleep, during the day it would not be heard, because the railway is far away. I love staying up at night and watching the dawn. You stand on the balcony and feel the morning coolness, but the coffee warms you up, although it does not burn, it is just warm and pleasant. I would like to stand like this forever and enjoy this beautiful morning. I like the fact that it is Sunday at 4 am and no one needs anywhere, but cars are starting to drive, why can’t they stand? It’s still so early, isn’t it? At this time, probably only cars and I, and my mother, who sleeps very lightly, can stay awake with me all night, because she wakes up from the slightest rustle.The coffee has already finished. Only the mug, which has absorbed the warmth of the coffee, warms, but it is already getting cold. So there is a lack of someone who would warm me. Where is he? Where is my prince on a white horse? Although if he came now it would be at least strange. At 4 in the morning, a prince rides up to one balcony on a white horse, in a city in the 21st century. Strange, but this is just, in my opinion, perhaps someone thinks differently. Probably it’s romance. I am far from being a romantic and I do not like tenderness and affectionate nicknames. I have to do some exercises, then there will be a run, then I will cook breakfast for my family, But what should I cook? Well, I think like a housewife.What to cook, which wallpaper is better to glue, which saucepan is better to buy – all these are their typical thoughts. I should be a goddess, everyone should admire me, both male and female. I do not understand the stereotype that there is no female friendship, that ladies are friends for the time being. There are good people. It’s true? Are they still there? Eh, I would like to find them. Knocking on the keys can wake Mom up, you have to finish, and the battery is already running out.

    Chapter 2. The first depression.

    I took the book “War and Peace”, I wanted to read it for a long time, but everyone said that it was not interesting, but the beginning struck me.Just the way I love, I myself would like to write like Lev Nikolaevich Tolstoy. The depression began with this book. I realized that I made a mistake, choosing for myself the role of an exemplary daughter who does not lie to her parents and is a good student. I was left without friends. One friend throws me up all the time, it’s my second birthday, and we only walk with her in the presence of the first, but the third, the best for me, went to my grandmother in Kazakhstan. I never understood those people who communicate very closely with their grandmothers, ask them for money, stay overnight, live with them.I would also not mind living with my grandmother, but I’m not used to it, I’m used to being independent. The fact is that when I was in primary school, my mother was in the hospital for several years with her younger sister, and therefore very little attention was paid to me. I can safely say that I raised myself. At 16, I understand my parents’ feelings, but do they understand me and my feelings? Unlikely. Probably, because of this, I cannot ask someone for money, as my peers do. I can be truly open only with friends, only with those whom I trust.My first friend, she is also my former classmate. Fatter than me, but prettier. Though I am slender, I don’t really like my face terribly, once I liked it, I even considered myself beautiful, but then my mother began to say that I had a “dibble face” and I began to be ashamed of my face. Guys don’t pay much attention to me, probably because of my character. I am open, straightforward and go. And because of my mistake, I am not interested in anything.

    In my opinion, I am losing my reputation, I present myself in public as a fighter, an iron lady, a kid, I tell everyone that I never cry, but it is in such depressions that I hide from everyone.I need to be alone for at least one day and feel free, a person to whom no one and nothing indicates.

    I started to sleep naked, but because of the birthdays and guests, I could not do it. Finally, I sleep today without guests. I’m so happy about that. During depression, I want to be alone, sing the songs that I hear on my headphones, no matter what language they are in, drink coffee and eat chocolate. I love chocolate, and they also say that it helps to cope with depression. Let’s see how true this statement is, I ate two chocolate wedges with orange peel.I was not particularly impressed with the taste, I like chocolate with sea salt more. I so want to take a bath and take a dip, not in a bath, but in a bath. With sea salt, feel this heady aroma of wealth and luxury. I want to go shopping, buy myself something. But walking the way we walk with mom. And just like that, walk around the mall for a few hours and see beautiful things, try them on, then go to a cafe and drink coffee or go to some shop on the way and buy ice cream. Mmmm yummy, I especially like the green almond.

    And why did I get this condition? Due to the fact that the first friend threw, her beloved sister is in another city and she is not up to me, the guy I like is also busy. He seems to like me too, but so far he does not take the first step. But I will not do it either, because I am convinced that the guy should seek the girl, not she. During the depression, I bought myself a chocolate bar, straightened my hair, sprayed with perfume, put on makeup, dressed up, just forgot to swing. Eh, that would be the one who I like, told me what I want to hear from him for a decent time.“I like you, because of you I don’t want to leave” – that’s what I need. Every girl has a moment when she wants to find her beloved, so I have such a moment, I never thought that it would come. Maybe. For some, it insists early, for others it is late, but it insists. I wrote about my depression, and it subsided. Or maybe this is due to the fact that he wrote to me and offered to meet tomorrow morning? Do not know. I don’t know anything anymore. Now I’m going to cry again. So, don’t cry. You may have washed, but you didn’t wash off the mascara.

    Read more

    90,000 I’m gasping for breath, guitar chords

     Play bar on the 7th fret
    -5-8-7-8 ---- 7-8-7-10-8-8-7-7 --- 10-8-8-7-7-8-7-- 5-8-
    -7-8-7-8 --- 7-8-7-10-8-8-7-7-7-8-75-10-8-8-7-7- --7-8-7-5-5-
      Em   Bm 
    Quietly, quietly my heart beats so
      Am   B 
    Quiet, quiet, something says
      Em   Bm 
    Quiet, quiet, letting go of the pain
      Am   B 
    So that the blood runs stronger and faster in him
      Em   Am 
    I'm choking on my love
      B   Em 
    I choke, there is no love more tender
      Em   Am 
    Kisses make me crazy
      B   Em 
    I didn't love how I love you
      Em   Am 
    I'm choking on my love
      B   Em 
    I choke, there is no love more tender
      Em   Am 
    I won't be able to forget your eyes
      B   Em 
    And I understand - this is forever
    Solo. Em   Bm 
    Gently, gently, say hello to me
      Am   B 
    Gently, tenderly, I will smile back
      Em   Bm 
    Gently, tenderly, you will embrace again
      Am   B 
    I fly to pieces from your love
      Em   Am 
    I'm choking on my love
      B   Em 
    I choke, there is no love more tender
      Em   Am 
    Kisses make me crazy
      B   Em 
    I didn't love how I love you
      Em   Am 
    I'm choking on my love
      B   Em 
    I choke, there is no love more tender
      Em   Am 
    I won't be able to forget your eyes
    And I understand...
      Em   Am 
    I'm choking on my love
      B   Em 
    I choke, there is no love more tender
      Em   Am 
    Kisses make me crazy
      B   Em 
    I didn't love how I love you
      Em   Am 
    I'm choking on my love
      B   Em 
    I choke, there is no love more tender
      Em   Am 
    I won't be able to forget your eyes
      B   Em 
    And I understand - this is forever 

    90,000 a resident of Novosibirsk spoke about the death of her 26-year-old son from coronavirus due to broken equipment

    © zdrav.nso.ru

    24 Jun 2021, 11:39

    In Novosibirsk, 26-year-old Artyom Shishkov died of coronavirus. The doctors told his mother that they had installed a breathing support machine that did not supply oxygen to his son. For 12 days, Shishkov’s kidneys, lungs and heart failed. However, according to the woman, under pressure from the regional authorities, the doctors retracted their words. She filed a statement with the police.

    Artyom Shishkov, a 26-year-old tattoo artist and musician from Novosibirsk, was taken to the city infectious diseases hospital No. 1 in an ambulance on June 2 with a positive PCR test for coronavirus. Artyom had a history of moderate asthma and stage II hypertension. But the diseases never worsened, his mother Elena Shishkova told Taiga.info. Before that, the man had been waiting for the results of the examination at home for four days.

    During hospitalization, Shishkova warned the doctors of the eighth department about the danger of suffocation in her son due to asthma, but, according to the woman, the doctors ignored her.On June 5, Artyom was injected with the drug Fragmin (an anticoagulant used for thrombosis and for its prevention. The instructions for the drug indicate that patients with hypertensive retinopathy should use it with caution). After the injection, which thinns the blood, the man began to choke and cough up blood.

    “I came to the hospital, the doctor on duty said that this drug had already been canceled. Artyom was getting worse and worse, the doctors for the four days that he spent there did not take any anti-allergic measures, ” Shishkova told Taiga.info. – On June 5, at night, my son wrote to me: “Mom, nobody wants to fuck here, I feel bad, I suffocate, I cough up blood.” I answered him: “Bring the nurses on, save yourself.” They, he said, do not care about everything here. At four in the morning he was transferred to the intensive care unit and connected to a ventilator. The doctors kept repeating the same thing: low oxygen saturation, chronic diseases, serious condition. The nurse said that he was given an antibiotic and paracetomol. ”

    Two days later, Artyom’s kidneys failed and he was put into a coma. The doctors contacted the officials and decided to take the man to the Meshalkin clinic.There he was connected to an ECMO apparatus (used to oxygenate the blood of critically ill patients with pneumonia).

    “For 10 days I heard the same thing: low blood saturation, excess weight interferes, organs continue to fail,” the mother of the deceased clarified.

    On June 18, Elena came to visit her son, the head of the cardiology department came to her and, with tears in her eyes, said that the reason for the sharply deteriorating condition of the man was “an ECMO installation with incorrect functionality.” They began to reinstall the device for Artyom.

    “The supervisor told me in a half-whisper: ‘There is a chance that the blood will be saturated with oxygen, and they will start letting you in to it.’ It was Friday, on Saturday I was not allowed to visit Artyom, the doctor on duty said that he looked very bad, was swollen all over and was bleeding from his mouth, ”Elena recalls.

    On Monday, June 21, Shishkova appealed to the regional government. According to the woman, she stood in front of the governor’s office and shouted: “Help.” Andrei Travnikov sent her with his assistant to the Deputy Minister of Health Elena Aksenova, who began to “reprimand” her.

    “She asked where I got the information about the incorrectly installed apparatus. Then she began to shout that she would call the department head into corporate etiquette, because she had no right to give out such information, ‘added Shishkova. “Then the deputy minister began to threaten me:“ Do you know what you are doing? You can write a statement to the police, but your son is in their hands, and either the doctors will treat him or deal with the checks. This is his only chance, pray. ” On the same day, I called the head of the department, she answered that her son had good saturation for the first time in two weeks, but his condition was serious.Artyom’s organs were simply denied, they kept him without oxygen for 12 days. After that, the physician retracted her words, said that I misunderstood her, and went on sick leave. ”

    On June 22, the woman was again forbidden to see her son because of the “worsening epidemiological situation.” Doctors also told Shishkova that “if you turn off the equipment, he is finished.” On the night of June 23-24, Artyom felt even worse, soon the man died.

    “Artyom’s heart, kidneys and all organs were healthy.They just killed him for 12 days. This is negligence, I want other people not to die like that. In infectious diseases hospital No. 1, there is not even a CT machine, when the procedure was carried out in Meshalkin’s clinic, there was already 100% damage to the lungs, “said the musician’s mother.

    Shishkova filed a statement with the police.

    On June 24, the regional operational headquarters did not report the death of a 26-year-old man from the coronavirus.

    UPD (17:54) The Ministry of Health in the Novosibirsk region Taiga.info said that the city infectious diseases hospital No. 1 and Meshalkin’s clinic will conduct internal checks of quality control of medical care.

    90,000 “I choke on your love …” | Life Science

    Let’s talk today about redundancy in the expression of feelings. It would seem, well, what’s wrong with that? After all, it’s nice when they show you signs of attention, talk about their feelings, show tenderness. But, the reverse side of the “test of love”, it turns out, is sometimes unbearable. And people who find themselves in such a situation not only experience discomfort and irritation, but also try to break off such relations.

    And how it all started well …

    At the very beginning of a relationship, emotions are seething, feelings are overwhelming, you want to see a person every day. During this period, all impulses and manifestations of feelings seem to us very sweet and desirable. But later, when you encounter a person in the everyday life of coexistence, many of these seemingly pleasant manifestations lose their initial attractiveness.

    You need to understand very well that people:

    • Very different in temperament;
    • Have their own interests and hobbies, which sometimes go beyond the relationship;
    • React differently to actions in their own direction, from a loved one;
    • They have different concepts and views on the manifestation of love and relationships.

    Please don’t judge another person by yourself. Do not strive to give him what you want and do not have enough for you, especially in the same quantities. Remember, if from the outside you receive, as it seems to you, less emotions and manifestations of feelings, this does not mean that the person does not love you. All people are different.

    So what to do?

    Love – does not tolerate compulsion

    Love – does not tolerate compulsion

    Well, firstly , the guarantee of a good relationship is when it is good not only for you, but also for your loved one.Therefore, it is advisable to check whether the person is really comfortable or whether he is simply afraid of offending or offending you.

    Secondly , you don’t need to say “I love you” 1500 times a day to your soulmate. Believe me, if these are sincere feelings, the person you have chosen will feel it himself. After all, feelings are manifested not only in words, but also in actions, eyes, emotions.

    Thirdly , not everyone likes constant tactile contacts. Someone, perhaps, is very shy, another is less emotional, the third generally considers this a lack of upbringing.

    Fourthly , do not force your loved one to endure or put up with something, just so as not to offend you! Agree at the very beginning of the relationship that you will immediately notify each other about the actions of the other that are not comfortable for yourself. And if you see that it is becoming more difficult for your soul mate to “breathe”, immediately draw a conclusion and correct your actions. Sometimes the consequences are irreversible.

    The measure is good in everything

    sometimes even in a drop there is a whole world…

    sometimes there is a whole world in a drop …

    For example, you are very fond of ice cream, but what will happen if you start absorbing it in kilograms, and even in winter? Or, do you like to spin on a carousel, and do not get off it for many hours in a row? I don’t think the consequences will be very pleasant.

    In relationships, it is also great when everything is dosed. Thus, you will avoid getting used to constant manifestations of feelings, indifference and coldness. After all, a person who “suffocates” from your love for a long period will simply find a “safe haven” where it will be easy and comfortable for him to “breathe”! Would you like that?

    Photos used from https: // yandex.