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Monday, June 21, 2010

A Family Doctor's Tale - FOREIGN BODIES And OTHERS


Children have a tendency to experiment with their hands. 
Small objects like small marbles, parts of a toy,small coins etc may inevitably found their way into the inside of nose, ears or mouth and may not come out. 
I have removed at least 100 of these small objects from the nose, ears or throats of many crying children thanks to my training in the Ear Nose Throat  Department.

The most important part of the removals is for the anxious mother or father to grip the child tightly in order for the instrument to enter the nose or ear or throat to remove it without the child moving otherwise the instrument may injure the child. 

Rarely a child may swallow a coin and usually you have to send the child to the hospital for an x-ray. 
If present in the stomach or intestine, the only thing you can do is to wait for the child to pass it out through his faeces or poo.
Then another x-ray may be done to confirm the coin is out and that there is no other coin still stuck in the intestine.

Foreign bodies ( A Simple Guide to Ear Infections)like cotton buds may get stuck in the ear canal.
They can be easily removed by using a crocodile forceps or by sucking it out using a suction machine. 
Sometimes syringing of the ear with warm water can also flushed out the cotton buds or other foreign bodies. 

Wax in the ears is also commonly seen in the ear canals of young and old adults. 
One of the best ways to remove the wax is to flush them out by syringing of the ears with warm water. 
After the wax comes out and is shown to the patient , they are shocked by the amount of wax that can be found in their ear canals. 
Prevention is by giving the patient olive oil ear drops or Waxsol ear drops to apply to their ear daily and advising them not to dig their ears with cotton buds which will inevitably pushed the wax further into the ear.

Foreign bodies can also be found in the eyes like dust, small particles, drill bits, some iron bits from construction sites.
Small dust particles and metal bits can be removed easily if not stuck to the cornea. 
Any particles that is stuck on the cornea need to be examined by an eye specialist who may need to check for any metal particles passing into the cavity of the eyeball. 
Iron particles are especially dangerous because the iron can cause damage to the eye.

Fish bones and chicken bones are also common foreign objects found in the throat. 
Usually if they can be seen these can be removed easily especially if you have Ear Nose and Throat experience. 
In some cases if the fish bone or chicken bone cannot be seen, the patients may need to have an X-ray of the throat. 
If present or too far down the throat, removal may be required to be done by endoscopy by an ENT specialist. 

Splinters of wood, glass or metal ( A Simple Guide to Lacerations)which are stuck in the fingers or other parts of the body can be removed easily with special tweezers with or without local anesthetic. 

Bee stings ( A Simple Guide to Bee Stings)are also some of the foreign bodies which family doctors are asked to remove.

One of the worst case of bee stings was a Filipino maid who had almost a hundred bee stings stuck to her scalp. She had disturbed a nest of bees and was attacked by them. Luckily she did not have any bad allergic reactions to the bees' venom and did not go into shock. I had to patiently remove the stings one by one until all the stings are out.

One of the  work of a family doctor is the removal of foreign bodies in children and adults. Ear Nose Throat experience is useful where removals are concerned because of the  frequency of occurrence in children.
Parents should not allow children not to play with coins, small toys or parts of a toy.
People should be careful when eating fish and chicken with bones.
Construction workers must wear goggles when using drills with metal bits.
Avoid disturbing bees or other insect nests

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