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If you were in poor health and lived alone, what would you do if you were the victim of a debilitating medical problem such as a stroke? How would you contact help if you couldn't speak over the phone?

A reader called with just that question. He is retired and lives alone. "I'm somehwat at risk for a stroke," he said. "How would I contact paramedics if I had a stroke and couldn't talk? What would happen if I dialed 911 and said nothing? Would they be able to trace the call? Would someone come to help?"There are several options. The best one, as far as we can determine, is to contact a local hospital that operates an emergency response service. Holy Cross Hospital, for example, offers a system called Lifeline. You wear a button on a neck chain or wrist strap that if pushed sends a signal to the hospital's emergency room. The emergency room contacts friends or relatives you have designated to help you. If none of the people on the list are available, the emergency room will call 911 and send paramedics to your home. The cost is minimal: a $50 installation fee and a $25 or $30-per-month service charge.

HCA St. Mark's also offers Lifeline.

Another option is to dial 911. A dispatcher who receives an emergency phone call but doesn't hear a voice on the other end will send law enforcement officers out to check on you.

You can contact your local fire department (or whatever agency handles medical emergencies in your area) and ask it to list your medical condition in its computer system. That way if an emergency call comes in from your phone, the dispatcher will be aware of your condition.

If you live in Salt Lake City, for example, you would call 799-4231 and ask for a supervisor who would put that information into the computer system.

The system varies slightly from one jurisdiction in Salt Lake Valley to another so we suggest you contact your local law enforcement agency or fire department for specifics.

Medic Alert Response Service is another possibility. It's available through the non-profit Medic Alert Foundation. You can purchase the equipment for $599 plus a $15-a-month monitoring fee or you can lease it for $35 a month, which includes the monitoring fee.

The equipment includes a monitor that you attach to your phone and a push button bracelet or necklace. If you push the button and speak, the monitor picks up your voice from anywhere in your house and allows you to speak to Medic Alert operators in Massachusetts. They then contact the appropriate emergency agency in your locale.

A number of private companies offer emergency response services. Some of them are very expensive.