While it might make an amusing anecdote well after the fact (and it keeps the advice nurse job from being far from boring) it can be quite the ordeal when you find out that your child has stuck some little object into an orifice.
By far and away the hole that gets the most inappropriate things passing through is the mouth; that got its own post several weeks ago. This week I am going to focus on all of those other interesting places that need to be explored. I refer to noses, ears, butts, if there is a hole...things get stuck in there.
One of my favorite stories is told by a friend who had a child who simply smelled horrible. No amount of baths could mask a mysterious foul odor. The child was taken to the doctor who asked the all important question.
"Honey, do you ever stick anything in your nose?"
The child shrugged and then answered matter of factly, "just cheese..."
My dear friend Brittany, who was the therapist at my recent start-up, told me that she was also guilty of sticking cheese in her nose when she was younger. One day she also put a little red hot candy up there. This brought that habit to an abrupt end.
When I worked at Noe Valley pediatrics I would get calls on a fairly regular basis that a child has stuck something somewhere. The nose came in second to the mouth as the most popular. It seems that it is just so hard to resist.
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Dr. Ted told me that one of his more memorable extractions was a pink fluffy flower. As he pulled it out by the stem, it spread right out into a full bloom.
I remember one call about a little fellow who had stuck a bright yellow lego piece in his nose. Mom was trying to figure out how big it was, it was really wedged in there. Her helpful child went over to the lego catalog and was able to point out the exact piece that he had stuck up there.
One of my Noe colleagues, Nurse Jen, recounted the time that her daughter Isa stuck something in her nose in order to find out if the nose was connected to the throat. While a little proud of this attempt at an early science experiment, Jen recalls that a straight jacket was needed in the ER to get it removed. Isa was absolutely right - the nose is connected to the throat, but there are all sorts of sinus cavities where something could get waylaid.
Gianna Frazee, a pediatrician who I worked with years ago, shared with me the story of a memorable five year old patient who felt the need to stick her tongue inside a Barbie doll head. The tongue swelled up and got stuck.
You may want to tell your children stories about other little children who have done these things and then had to go to the doctor and it was yucky getting it fixed. Perhaps a little teaching and mild scare tactics in advance might be preventative but the urge is strong. In my immediate family we told the tale of my niece Lena who stuck a raisin in her nose, and perhaps the power of the tale kept my own kids and the other nieces and nephews "raisin free." On the other hand, for some kids you might not want to give them any ‘ideas’.
If prevention hasn't done the trick and there is something stuck up the nose you have several options. If your child is old enough, have them try to gently blow it out. If that doesn't work, or your child is too young to have mastered the concept of nose blowing, you can try to suck it out. Whereas, years ago, I did have a patient’s mom who successfully sucked a pea out of her toddlers nose with her mouth (good for her but...ugh), I would suggest trying the suction with a Nose Frida or snot sucker. Don’t use a bulb suction or anything that actually goes into the nose. You don’t want to risk pushing it further in.
If that doesn't work, I have another method for you. Assuming the something is in the right nostril, push the left nostril closed with your finger and do a firm rescue breath into the mouth. If it doesn't blow the object out, reposition and try again. This works more than 50% of the time. I have seen all sorts of interesting things go into noses....peas, beads, little wads of paper, raisins, a starburst candy. Kids are creative!
It is fully possible that whatever was stuck in there got sucked up and subsequently swallowed, but nevertheless, if you are pretty certain that something went up in the nose and you weren't able to get it out, an appointment is probably warranted.
This is especially true if you are dealing with a constant drainage from one nostril, foul odor, or signs of irritation in or around the nose.
Keep in mind that kids are often not the best historians when it comes to finding out the truth. If you ask them if they put something in their nose and they think that answering yes will either get mommy or daddy mad, or land them at the doctors the answer may well be an emphatic "Me? Something in my nose? I don't remember!"
Many pediatricians are willing to try to get something out, but they might not be your best choice. If there is a way to get into the schedule of an ENT that can be a better option, They have better tools for getting the job done right the first time.
Although, clearly you want to remove whatever is in there, there are some things that may have been in there for days or weeks. Unless it is something that can cause harm, such as a button battery, it is rarely an emergency situation.
The ears are another favorite landing spot for odds and ends. One of the more memorable for me was the little boy whose brothers had convinced him to do a little experiment by seeing how many unpopped popcorn kernels could fit in his ears. Of course this was 4:30 on a Friday...right? As he came into the office I could hear him crying "I don't want them to have to cut off my ears." Those same brothers of course were behind that as well. Ah siblings. Although we may be able to remove something simple from the ear, that little fellow also ended up at the ENT.
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Parents shouldn’t be sticking things in their kids' ears either. Q-tips are the biggest offenders. Between 1990 and 2010 there were more than 260,000 children treated in the emergency room for ear injuries related to cotton tipped applicators.
Yes, I have seen the occasional thing stuck in the butt (in fact it was a tube of mascara most recently); those are fairly rare thank goodness.
It would be nice to think that there is a magic age when folks grow out of this. Any ER doc or nurse could likely regale you with stories that probably not suitable for sharing in this post.
Thank you to my model, EJ for showing us what NOT to do.
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