Weekend Column: Dysphagia

Are You “Stuck” with a Swallowing Disorder?…..

Dysphagia: Are You “Stuck” with a Swallowing Disorder?
by Brenda Keller, APRN-CNP,
Gastroenterology Associates of Northwest Ohio

Brenda Keller, CNP


Dysphagia is an alarming symptom that requires prompt evaluation to determine the cause and to initiate treatment. It may be due to a structural or motility (movement) abnormality as solids or liquids pass from the mouth to the stomach.

Often, patients confuse dysphagia with odynophagia or a globus sensation. Dysphagia is a subjective sensation of difficulty or abnormality of swallowing. Odynophagia is pain with swallowing. A globus sensation is a nonpainful sensation of a lump, tightness, foreign body or retained food bolus in the neck or upper chest region.
Dysphagia in older adults should NOT be attributed to normal aging. Aging alone causes mild esophageal motility (movement) abnormalities, which are rarely troublesome.

Dysphagia can be classified as acute or nonacute. The acute onset of the inability to swallow solids and/or liquids (including saliva) is likely related to an esophageal foreign body impaction. Food impaction is the most common cause of acute dysphagia in adults. The estimated incidence of esophageal food impaction is 25 per 100,000 persons per year. The incidence is higher in males and increases with age. A food impaction necessitates immediate medical attention. 

Medication can be administered to attempt to relax the lower esophageal sphincter and promote passage of the food bolus. 

The food impaction may require upper endoscopy to either remove the food bolus or gently push the bolus into the stomach with the endoscope.

The first step in evaluating patients with nonacute dysphagia is to determine if the symptoms are due to oropharyngeal dysphagia or esophageal dysphagia based on patient history. In this article, we will focus on esophageal dysphagia.

In esophageal dysphagia, patients commonly report difficulty swallowing several seconds after initiating a swallow and a sensation that foods and/or liquids are not adequately passing from the upper esophagus to the stomach.

An important component of the medical history is determining what types of food (i.e., solids, liquids or both) produce symptoms. Dysphagia to both solids and liquids from the onset of symptoms is likely due to a motility (movement) disorder of the esophagus. Dysphagia to solids only is usually present when the esophageal lumen is narrowed (e.g., by a stricture).

Additional symptoms associated with dysphagia can provide a clue to the possible cause. For example, patients with chronic heartburn who develop dysphagia may have a stricture, erosive esophagitis, or cancer of the esophagus. Patients with esophageal cancer tend to be older males with significant weight loss.

Patients undergoing radiation therapy for chest, head or neck tumors are at risk for developing esophagitis and esophageal strictures. This may result in odynophagia or dysphagia.



Get Tested for COPD: Your Lungs Will Thank You

More than 16 million Americans have been diagnosed with COPD…

(Family Features) If you’re often short of breath during everyday activities, your chest feels tight, or you cough a lot, you may be chalking it up to getting older, having allergies, or being a smoker (now or in the past). Fortunately, there’s a way to know whether something more may be at play

Photo courtesy of Getty Images

Consider getting a lung function test to find out if you have a serious condition called chronic obstructive pulmonary disease, or COPD.1 Knowing the cause of your cough and breathing problems will not only help you manage your symptoms – it’ll help you feel better, too.

COPD includes two main conditions – emphysema and chronic bronchitis.2 It’s usually caused by cigarette smoking or breathing in other irritants, such as dusts or chemical fumes.3 In a small fraction of people, a genetic condition called alpha-1 antitrypsin (AAT) deficiency plays a role in causing COPD.4 More than 16 million Americans have been diagnosed with COPD, and millions more have it but don’t know it,5 according to the National Heart, Lung, and Blood Institute (NHLBI).

COPD doesn’t have a cure at the moment, but if you seek advice from a health care provider and get diagnosed early, you can slow down this progressive disease.6 During your appointment, your provider will talk to you about your symptoms and your medical history then listen to your breathing. He or she also may recommend one or more tests to help diagnose COPD. 7

Spirometry: A Lung Function Test 8

The main test for COPD is called spirometry. During this test, a technician at your health care provider’s office will ask you to sit down and put a clip on your nose, so you can breathe only through your mouth. The technician will then ask you to put your mouth around a mouthpiece, which looks like the mouthpiece on a snorkel. It’s connected to a machine that measures how well you breathe. 9 The technician will ask you to take in a deep breath then blow all of your air out as fast as you can. You’ll repeat that a few times. It’s painless, but it does take some effort.10

Your provider will use the test results to determine how healthy your lungs are, if you have COPD and how serious it is, or if asthma or other conditions are causing your symptoms. 11 Spirometry can also help your provider know if you have COPD before you even have symptoms, so if you’re concerned about your lung health, consider getting a spirometry test.

Ask for a lung function test if you: 12

  • Are over age 40
  • Are or were a smoker
  • Feel out of breath often
  • Bring up a lot of mucus when you cough
  • Have already been diagnosed with a lung disease
  • Have AAT deficiency
  • Are concerned about your lung health

Another factor to consider when assessing your lung health is COVID-19, the disease caused by the coronavirus that has spread throughout the world.13 Unlike COPD, COVID-19 causes abrupt coughing and trouble breathing, so your health care provider may want to test you for it.

If you have a chronic lung disease, such as COPD, and get infected with COVID-19, you are at higher risk of getting very sick. COVID-19 can affect your respiratory tract (nose, throat, lungs), and possibly lead to pneumonia and acute respiratory disease. For more information on COVID-19, visit CDC.gov.

NHLBI’s Learn More Breathe BetterSM program provides free educational resources about COPD, videos on spirometry, and more. Find them at copd.nhlbi.nih.gov.


1 https://www.nhlbi.nih.gov/health-topics/copd > Diagnosis
2 https://www.nhlbi.nih.gov/health-topics/copd > What Is >Overview
3 https://www.nhlbi.nih.gov/health-topics/copd > What Is; Diagnosis >video
4 https://www.nhlbi.nih.gov/health-topics/copd > causes
5 https://www.nhlbi.nih.gov/health-topics/copd > What Is >Outlook
6 https://www.nhlbi.nih.gov/health-topics/copd > Treatment
7 https://www.nhlbi.nih.gov/health-topics/copd > Diagnosis
8 https://www.nhlbi.nih.gov/health-topics/copd > Pulmonary Function Tests>SPIROMETRY
9 The COPD testing animation>Pulmonary Function Tests> SPIROMETRY
10 https://www.nhlbi.nih.gov/health-topics/copd
11 https://www.nhlbi.nih.gov/health-topics/copd > Pulmonary Function Tests> SPIROMETRY
12 https://www.nhlbi.nih.gov/health-topics/copd > Diagnosis >video
13 https://www.cdc.gov/coronavirus/2019-ncov/downloads/2019-ncov-factsheet.pdf >Know about COVID-19

National Heart, Lung, and Blood Institute

NBFD 8th Annual Toys for Tots – Photo Gallery of Past Collections

WHEN: Saturday, December 5th, 8:00am-Noon


NBFD 8th Annual Toys for Tots

You can also drop off donations at the North Baltimore Mid-Wood Hardware & Grain & Tire Shop.

When: Sat. December 5
8 am-Noon

Where: North Baltimore Fire Department
(corner of N. Main & Broadway for Drop-Off)

Bring a new and unwrapped toy for a boy or girl up to 12 years old. Monetary donations will also be will be accepted. The toys and donations are for families in this area only.

PAST TOYS for TOTS Collections by North Baltimore Volunteer Firefighters

NB Local Schools Update COVID Plan

To the North Baltimore Community, Staff, and Students;

To the North Baltimore Community, Staff, and Students;

As the State of Ohio continues to experience a record number of Coronavirus cases, the North Baltimore Local School District’s highest priority remains to ensure staff and student safety, as well as providing the critical education our students need.

As we are heading into the Thanksgiving Break weekend, I want to take a moment and give some updates to the staff and our community:

First, I want to let everyone know how proud I am of the staff, students, and parents for how they have handled this year so far, we know it has not been easy for anyone.

With that being said, community spread in Wood County and in the State of Ohio is at an all-time high right now. The purpose of this letter is to ensure parents and staff members have plans in place in the event we have to make a change in our current mode of instruction.

The plan is to return on Monday, November 30th, and continue with our current 5 days per week in-person learning. However, if the District reaches absences of 15 percent or 107 students and staff for isolation, quarantine, or general illness, this will meet our threshold for going to a full remote learning environment for two weeks. This means all NBLS students will be learning remotely from home for two weeks to curb the spread of illness and then return to 5 days a week of in-person learning. The District is trying to be as transparent as possible with what decisions might be forthcoming.

In the event the District reaches the above threshold of 15 percent or 107 students and staff during the week of November 30th, NBLS will not return to 5 days per week of in-person learning until January 4th, 2021. The reason being, that a two-week remote learning environment will coincide with our Christmas break.

NBLS will continue to use this 15% threshold for the foreseeable future.
In conclusion, please start to make plans for your child/children if the District has to switch our current mode of instruction. The better preparation parents make now, the easier the transition will be if we have to switch to a remote learning environment.

Stay safe and stay healthy,

Ryan Delaney, Supt. NB Local Schools

Gov. DeWine, Lt. Gov. Husted Declare Thanksgiving Day as a Day of Prayer, Gratitude, & Remembrance

Recognizing Ohioans who are taking necessary steps to emerge from this crisis, care for their fellow citizens, and support Ohio’s healthcare workers….

(COLUMBUS, Ohio)—Ohio Governor Mike DeWine and Lt. Governor Jon Husted issued a proclamation today that declares Thanksgiving Day 2020 as a Day of Prayer, Gratitude, and Remembrance. 

The proclamation recognizes the resilience and determination of Ohioans who are taking necessary steps to emerge from this crisis, care for their fellow citizens, and support Ohio’s healthcare workers. The proclamation also encourages Ohioans to pause and acknowledge those currently suffering from COVID-19 and those who are grieving the deaths of loved ones who have died because of the virus.


COVID-19 testing available Saturday in Perrysburg

Pre-registration slots available starting Friday for testing event at Perrysburg High School….

PERRYSBURG — A COVID-19 pop-up testing site will be available from 11 a.m.-4 p.m. on Saturday, Nov. 28 at Perrysburg High School, 13385 Roachton Road.


Anyone can get a no-cost test at this event, which is a partnership between Wood County Health Department, Perrysburg Schools, the Ohio National Guard and the State of Ohio.


A health care provider’s referral is not needed. Testing quantities may be limited.


Although no appointment is needed, some testing slots will be reserved for people who pre-register in advance. Time slots will become available to select starting Friday. Those who are interested can pre-register using the ArmorVax app. Links to download the app via Apple and Google will be available on the Health Department’s social media channels Friday.


Anyone who plans to attend the testing event is encouraged to save time by filling out and printing required paperwork in advance, available at https://sites.google.com/view/wchdohio-coronavirus/home/Testing/pop-up-testing-event  


Test results are expected within 4 days but may take longer. Stay home until test results are returned if you have had COVID-19 symptoms or suspected or known exposure to the virus. You should also monitor your health and talk to your doctor or health care provider.


Anyone who tests positive will be contacted by their local health department and should stay home and away from others for at least 10 days. Public health officials will check in on your health, help you identify resources needed to safely isolate, ask where you have spent time with others and discuss who you have interacted with.


For more information about COVID-19 testing, go to Coronavirus.WoodCountyHealth.org and https://coronavirus.ohio.gov/wps/portal/gov/covid-19/testing-ch-centers/  


The mission of Wood County Health Department is to prevent disease, promote healthy lifestyles and protect the health of everyone in Wood County. Our Community Health Center provides comprehensive medical services for men, women and children. We welcome all patients, including uninsured or underinsured clients, regardless of their ability to pay, and we accept most third-party insurance. For more information, visit www.WoodCountyHealth.org 

How To Avoid Common Winter Health Problems

Winter can wreak havoc on the body. Here are tips on how to avoid common winter health problems and discover a few specific concerns….

As the winter season officially begins, many people are eager for the first snowfall and, of course, for the holidays. However, this time of year also comes with its own set of hazards to be on the lookout for—mainly those having to do with your health. If you want to better protect yourself as the temperatures drop, learn what the risks are and how to avoid these common winter health problems.


Whether it’s the cold or the flu, the likelihood of getting sick greatly increases with the arrival of colder temperatures. For this reason, it’s crucial that you wash your hands regularly, get enough sleep, and take immune boosters when necessary. All these things will work together to keep your immune system strong and make it more efficient at fighting off infections.

Asthma Attacks

Cold-weather asthma is also a possibility for people who already have sensitive respiratory systems. The dry winter air can irritate the esophagus and trigger inflammation that makes it more difficult to breathe. To avoid this common winter health problem, it’s recommended that you limit the time you spend outdoors and refrain from strenuous activities while exposed to cold outside air. If you suffer from frequent asthma attacks, you should also keep your prescribed medication nearby at all times.

Dry Skin
Make sure you pay attention to your skin during the winter season. As we mentioned, the outdoor air becomes significantly drier as the temperatures drop. Therefore, in addition to drying out your throat, the air can also sap the moisture out of your exposed skin. In severe cases, your skin can become so dry that it flakes and becomes painful to the touch. For this reason, it’s vital that you keep your skin healthy and hydrated.

Seasonal Depression

As excited as we always are when winter first starts, there always comes a point later in the season when we begin to feel isolated from the outside world. This leads to lethargy and an overall decrease in happiness as the frigid months seem to drag on—also known as seasonal affective disorder or seasonal depression. Remember to look out for your mental health this season and to find time to do things you enjoy. This will make the days go by more quickly and put you in a better frame of mind.

Huffin For The Stuffin 5k

Thanksgiving morning 9 am Registration and 10 am Starts!

Come on out to North Baltimore Nutrition’s “Huffin’ For The Stuffin’” 5k Turkey Trot!

Thanksgiving morning 9 am – Registration and 10 am Starts!

All proceeds will be donated to the Ohio Treatment Center – North Baltimore!

Let’s come together with social distancing to help those that need a helping hand!

Call Laura Vitt, 419-619-1498, if you have any questions.

OHSAA Confirms Parents Can Attend Athletic Contests

Schools will determine the process for how parents will attend athletic contests, such as how many are permitted and where they will be placed to watch the contest.

OHSAA Confirms Parents Can Attend Athletic Contests

Ohio Governor Mike DeWine asks that no other fans be permitted to attend games through December 31

COLUMBUS, Ohio – Following Governor Mike DeWine’s remarks during his news conference on Tuesday (Nov. 24), the OHSAA, in conjunction with the Governor’s Office, recommends that schools restrict attendance to only the parents of the participants, or eliminate all spectators, for their winter sports competitions through December 31, 2020, due to the recent spike in COVID-19 cases.

“We want to follow this recommendation so that our kids can continue to compete,” said OHSAA Executive Director Doug Ute. “We believe it is crucial that parents be permitted to attend the contests of their children, but large crowds at our indoor athletic contests are not a good idea at this time. We all need to work together to give our kids and schools the best chance at having a full winter season.”

Schools will determine the process for how parents will attend athletic contests, such as how many are permitted and where they will be placed to watch the contest.

Regarding media coverage, the OHSAA asks schools to still permit media coverage of their contests, but the number of media attending should be restricted to those who regularly cover the teams involved. Schools are encouraged to provide live video streaming of their athletic contests for those who cannot attend.

The OHSAA provided the following recommendations for member schools:

  • For those schools that decide to admit parents, list the names of the parents on a roster sheet that is located at your ticket window/admission table. This will help clarify who should/should not be admitted and will hopefully eliminate non-parents from attending.
  • Limit media to those who normally cover your school and consider utilizing a streaming service in order for fans to view your contest(s).
  • There is no prohibition on cheerleaders and pep bands, but schools should make their own decisions on these students’ participation and should strongly consider not sending cheerleaders to away contests.

As administrators were notified last week, the OHSAA winter sports seasons are moving forward as planned. That decision was made after the Executive Director’s Office had discussions with the Governor’s Office, the OHSAA Board of Directors and numerous administrators combined with the results of the membership survey in which 56 percent of the 1,464 respondents recommended that the OHSAA begin all winter sports contests as they are currently planned and scheduled.

The decision for schools to move forward with sports is a local decision. Schools may certainly choose not to participate in a contest or to pause their season(s) for a period and should do what is in their best interest. The OHSAA believes that our member schools provide student-athletes with the safest possible environment to continue participating, and we all recognize the educational, physical and mental health benefits of participation.

Boost Your Spirits Through the Holidays and Beyond

Practice self-care and nurturing your mental health, especially if you’re tackling this season single…….

(Family Features) Stress and anxiety are all too familiar to many Americans, this year especially, and the added pressure of the holiday season may provide a new set of challenges. Practicing self-care and nurturing your mental health can help you navigate these potentially isolating times, especially if you’re tackling this season single.

Photos courtesy of Getty Images

With so many other demands in life, taking care of yourself, including your emotional and mental well-being, may not always be at the top of your list. However, putting more emphasis on yourself and your needs can be achieved in small, measurable ways and may not only help boost your spirits but can affect your approach to dating, too.

“We believe happy and healthy relationships start with happy and healthy individuals,” said Stefan Harvalias, head of global marketing for Plenty of Fish, one of the largest global online dating companies.

Harvalias points out there are a number of ways you can alleviate stress and anxiety. While there’s no one magic formula that fits all, many people find coping easier with activities like these.

Listen to music. Numerous studies have demonstrated the benefits of music in managing mental health. Slow, mellow music can help the mind shift into a lower gear and has even been shown to influence the body’s physical state such as reducing blood pressure, pulse and heart rates. For someone with anxiety, music can be a welcome distraction from the troublesome thoughts occupying the mind. For others, music is simply a way to escape from reality and focus on something enjoyable.

Talk with friends and family. Although COVID-19 may be creating physical distance, there’s one way it can bring people together: by acknowledging your shared stress to one another. While the impacts of the pandemic vary greatly, everyone has been navigating uncertainty and change that comes with such a widespread event. A weekly check-in call or video chat with friends and family members can help you feel less alone with your feelings and experiences. Topics like mental health and mindfulness have risen to the surface of everyday discussions, removing a lot of the stigma they once had.

Seek out tools to help you unwind. If you’ve never given much thought to managing your mental health, you may not know where to begin practicing better self-care, and that’s OK. That’s where you can benefit from resources like those available through Plenty of Fish. Knowing the toll the pandemic is taking on singles, the dating app partnered with Shine, a leading self-care app, to create two free dating-related meditations developed to help singles better manage anxiety and improve mental health and wellness.

Navigating dating, work and your personal life can feel like an intense juggling act. To help find balance and feel less pressure, consider listening to the “Balance Dating While Busy” guided meditation and reflect on your energy and priorities so you can make space for dating in your life.

Although dating may look and feel different right now, it’s still doable. Shift your mindset and reflect on ways to adapt with an option like the “Navigate Dating During COVID” guided meditation.

Recognize the role of physical wellness. The mind and body are intrinsically connected, and how you take care of your body can have an impact on your mental state. This includes eating well to ensure you’re getting proper nutrition, which can positively impact your mood. Additionally, exercise releases feel-good hormones, so a quick walk around the block or a 10-minute exercise video can benefit you both physically and mentally.

Give yourself permission to disconnect. When life feels uncertain, being closely tied to an information source like your smartphone can give you a sense of security, but it can also add to your everyday stress. If you’re working from home, you may find you never fully shift out of work mode. However, it’s easy to become addicted to refreshing your newsfeed, allowing your devices to cut into time you could spend more productively. Limit your screen time to force yourself to focus on the present and activities that bring you pleasure while allowing your brain to rest, like spending time with loved ones or enjoying a good book or movie.

Find more resources to support your mental health and dating experiences this holiday season at blog.pof.com.

Keep COVID from Crushing Your Dating Game

As if single life and dating didn’t bring enough uncertainty on their own, a global health crisis has only heightened the anxiety many singles feel. Dating pressures and anxiety tied to COVID-19 were the subjects of a study by Plenty of Fish, which showed just how challenging dating has been for singles this year.

According to the survey of singles:

  • 60% have experienced feelings of anxiety before going on a date
  • 29% have canceled a date due to anxiety
  • 44% are anxious about their date not wearing a mask

When it comes to the benefits of self-care, a majority of surveyed singles reported:

  • 66% practice self-care regularly
  • 87% said self-care activities reduce stress
  • 78% said they feel less stressed after a self-care routine
  • 50% meditate
  • Alone time, exercise and pampering were listed as the top self-care activities

“Prioritizing your mental health matters more than ever,” Harvalias said. “Self-care and wellness mean something different to everyone – all that matters is that you find an outlet to disconnect and do what makes you happy.”

Plenty of Fish

THANKSGIVING 2020 Click it or Ticket

The overall seat belt use rate in 2019 for Wood County was 98.4% percent, which is fantastic and we proudly lead the state in overall seat belt usage….

The annual Click it or Ticket mobilization is being held over the Thanksgiving holiday this year from November 16-29. State and local law enforcement agencies across the nation are stepping up their enforcement efforts for motorists who aren’t wearing seat belts in an effort to save lives.

The overall seat belt use rate in 2019 for Wood County was 98.4% percent, which is fantastic and we proudly lead the state in overall seat belt usage. However, there is always room for improvement and crash injury statistics explain why. Among young adults injured in crashes in 2019, 35% were unrestrained. Among mature drivers injured in crashes in 2019, 33% were unrestrained. 

Make it a point to buckle up each and every time you get behind the wheel, and enforce wearing seat belts by all of your passengers as well.

From all of us at Wood County Safe Communities have a safe and healthy Thanksgiving. 

For More Information:

  • Lt. Angel Burgos, Ohio State Highway Patrol: 419-352-2481
  • Sandy Wiechman, Safe Communities Coordinator: 419-372-9353 or swiechm@bgsu.edu

Monday, Nov. 23 is Public Health Thank You Day

Observed annually on the Monday before Thanksgiving…..

BOWLING GREEN — Wood County Health Department is celebrating the community’s overwhelming contributions during Public Health Thank You Day, observed annually on the Monday before Thanksgiving.


In the face of unprecedented challenges that the COVID-19 pandemic has created throughout 2020, it’s important to remain grateful and highlight the ways Wood County has come together.


“While we must acknowledge the hardship, struggles and loss that many people are fighting through due to COVID-19, we also truly have a great deal to be thankful for,” said Benjamin Robison, Wood County Health Commissioner.


“We appreciate the sacrifices everyone continues to make to lessen the impact that the pandemic is having on our community, schools and businesses, and the activities we all want to enjoy.”


Posts, photos and video on the Health Department’s social media channels will give thanks to:

  • Everyone who lives and works in Wood County, both for adapting so well to the constant change this year has brought, and for the voters who supported Wood County’s health levy renewal earlier this month. Wood County residents have recognized since the 1990s the need to fund quality public health services. This levy provides a stable base of funding and has been essential support for Wood County’s local COVID-19 response.

“We’re thankful not just for the support we received at the ballot box, but for the investment that our community makes in public health every day,” Robison said.

  • Wood County Health Department staff for their hard work responding to this pandemic, and their commitment to maintaining WCHD services during this time. This also includes the contractors and volunteers who have come on board to assist with our response. Teams have stayed flexible and found opportunities to help reduce the spread of COVID-19 while also continuing to provide as many services to the public as possible. This has required everyone to stay adaptive and resilient, and Health Department staff are no exception.

  • The families, spouses, partners and children of WCHD employees, for supporting them during such a challenging time for public health workers.

  • To community partners, both individuals and agencies, for their support. Such willingness to assist in responding to COVID-19 and help in any way you can, including sharing our most important messages, is greatly appreciated.

Thanksgiving is a good time to focus on practicing gratitude in your daily life. Taking time to notice and appreciate the positive things in your life, like the food on your plate or the roof over your head, can increase your optimism and help manage stress, anxiety and depression.

Some ways to show gratitude include writing a thank-you note, thanking someone mentally, counting your blessings, praying and meditating.

Your mental health is just as important as your physical health. If you’re struggling during these challenging times, the Ohio CareLine is a toll-free emotional support call service created by the Ohio Department of Mental Health and Addiction Services and administered in community settings. Call 24 hours a day, 7 days a week: 1-800-720-9616.

The mission of Wood County Health Department is to prevent disease, promote healthy lifestyles and protect the health of everyone in Wood County. Our Community Health Center provides comprehensive medical services for men, women and children. We welcome all patients, including uninsured or underinsured clients, regardless of their ability to pay, and we accept most third-party insurance. For more information, visit www.WoodCountyHealth.org.