Beware of UFOs!

This week's guest columnist is Dr. Alex Wolf, a Family Practice resident at the University Hospital and Clinics here in Lafayette. It's Sunday afternoon, you're prepping dinner and keeping an eye on the kids.  You catch a fleeting glimpse of your youngest casually shoving something up his nose.  Did that just happen?  What's he put up there?  You grab his head to look, and see something- let's call it an Unidentified Foreign Object, a pediatric UFO. Besides the obvious question- what the heck did he stick up there- there's others.  Is this dangerous?  Does he need to go to the Emergency Room?  Often, parents decide the answer is yes, I need a professional to remove and identify this thing.  But you don't need the ER with every UFO sighting. Most objects in the nose are benign, and since they irritate, eventually get sneezed out.  If it's close to the nasal opening, you can often grab it with tweezers.  However, if it's big, round, slippery, and far up there, you may need help getting it out.  Also, if it's a disc battery, it needs removal now.  Mucus in the nose sets up a current between the battery's terminals, heating it up and burning the inside of the nose.  UFOs that are far up there pose other risks.  If they clog a sinus passage, mucus and debris can accumulate in the sinus and cause infection.  Also, the back of the nose opens into the throat, and occasionally UFOs can fall back and be breathed into the lungs. Ears are another popular place children hide things.  Dr. Hamilton once had a kid put orange seeds in each ear to block having to listen to his sister. Usually there's less reason kids do this besides, that they can.  Ears are trickier for UFOs- it's harder to get objects out of that skinny, sensitive canal.  Also, there's the ear drum back there.  If you hit that while trying to get a UFO out, it really hurts!  And you might injure the drum and affect hearing.  Ear UFOs that aren't tiny enough to fall out on their own require us, or an ENT specialist, to remove. Back to our toddler from above, casually shoving random objects up his nose.  Let's say he does another common toddler move- putting things in his mouth and swallowing them.  Again you panic, rush over to look, and wonder what was that Unidentified Foreign Object (UFO) he just scarfed?  Is this bad?  You see some coins lying around, was that it?  At this point, many families rush to the Emergency Room. Most ingested objects are benign. They simply pass through the gastrointestinal tract and out the other end.  If the UFO landed somewhere more concerning, like in the airway, or in the esophagus on the way to the stomach, your child lets you know.  UFOs in the upper airway or lungs irritate, causing coughing and obvious distress.  If stuck in the esophagus, kids feel that too, and will gag and squirm and have trouble swallowing.  These kids certainly need the ER. Another emergency situation is if your child swallows toy magnets.  Even though these go down easily and he toddles off to get into more mischief, magnets can cause serious internal injuries.  Two magnets can cling together, trapping intestinal lining between them.  When that lining is compressed, it's blood supply is squeezed out, it perforates, and gut contents can leak out and cause life-threatening abdominal infections. Another stat scenario is disc or button batteries stuck in the esophagus.  Like the battery in the nose from above, the esophageal mucus makes a current between the battery's + and - sides, heating it up, and causing burns.  If the esophagus burns through, it's a risk for another life-threatening internal infection, inside the chest. Understandably, having a UFO in your child's ear, nose, or throat is alarming.  But stay calm.  Becoming upset also upsets your child, and when she's crying, you can't tell if it's because you're crying, or she's in true distress.  No parent wants their child to become the next Area 51, but if he's not coughing and choking, and you're sure the UFO was something inert like a coin or lego, it's cool.  If in doubt, call your doctor for advice.  A UFO is scariest because it's unidentified, but really, they usually come in peace.