This article was guest written by Dr. RP Lindeman, who received a BA from Yale and an MD-PhD from Columbia. He was trained in general pediatrics and pediatric pulmonary medicine at Boston Children’s Hospital. He practiced pediatrics in Massachusetts for over 20 years.
Funny things happen in a pediatrician’s office all the time. Kids are naturally funny humans. Most of the time, they don’t even realize they’re being funny. It takes a pediatrician years to develop the ability to maintain professional composure when a child does something hilarious—although I nearly burst out laughing several times. As you’ll see, parents who bring in their children for objects lodged in the nose are generally not in the mood for a laugh.
I’ve altered the details of some of these stories to protect the privacy of those involved. As funny as these stories seem in retrospect, I assure you that the parents were not amused at the time, and the children involved (now adults) need not be embarrassed publicly!
A Nosebleed Gone Sour
Nosebleeds are extremely common in children (My own children’s noses bled with remarkable frequency!) Sometimes, the aftermath of a nosebleed can have unexpected effects, like when you put a tissue up the nose and forget it’s there.
One day, a mother brought in her 5-year-old (let’s call him Jake). The boy had developed terrible sour breath. Extra brushing of his teeth did no good. She even resorted to giving him lollipops, but nothing could get rid of the foul odor.
I confess that I was stumped at first. I asked a bunch of questions that I hoped would help me figure it out, and then I did my routine physical examination. I focused on the little boy’s head, suspecting (correctly as it would turn out) that the problem would be found somewhere from the neck up.
Jake’s mouth, teeth, and throat looked perfectly normal. But sure enough, his breath was awful. That’s not normal for a 5-year-old. Then I looked in his nose and immediately spotted the problem. There was a grayish-yellow thing inside one of his nostrils. His mother and I distracted him with jokes while I performed my ‘remove a foreign body from the nose’ trick (which requires a post of its own). Out popped a very old, very stinky piece of toilet paper.
It turns out that Jake had a nosebleed the week before. His mother had placed some rolled-up tissue paper up there to stanch the flow, which worked. Unbeknownst to them, a small piece of tissue had been left behind.
I dimly remembered from medical school that the list of things that can give you bad breath includes ‘foreign body in the nose’, although I confess that until Jake came in that day, I had never seen it myself!
The Tale of the Tic Tac
A three-year-old boy, let’s call him Nat, mysteriously developed a persistent stuffy nose. When blood started dripping from one nostril, Nat’s mother brought him in. Upon examination, it didn't take long to uncover the truth. Nestled comfortably within the nasal cavity, we discovered a colorful Tic Tac. With a sense of relief, we safely removed the tiny mint, leaving Nat with a newfound respect for his nasal anatomy. I guess that the minty freshness of the candy spared Nat the embarrassment of developing a case of bad breath.
The Crayon Wrapper Chronicles
I’ve told this story before, but it bears repeating. Children have the most fascinating imaginations. To a small child, the most mundane objects can transform into extraordinary artifacts. A four-year-old girl (we’ll call her Lily) presented a unique case when she complained of her nose itching. After gentle exploration, I unraveled the mystery—using my otoscope (a fancy name for a magnifying glass with an in-line light source), I unexpectedly encountered the words ‘burnt sienna’, which I recognized as a shade of brown from a box of Crayola crayons. It appears that an artistic adventure had led to the insertion of the crayon wrapper into her delicate nasal passage. With gentle guidance, we retrieved the culprit, teaching Lily that her nose was meant for breathing, not storing art supplies.
The Misadventures of the Mother's Earring
Adults are not the only humans with ‘shiny object syndrome’. Children possess an innate fascination with shiny objects. I had a substantial collection of shiny objects as a child. Today, I collect books (not so shiny).
Young Ethan, a curious toddler, saw his mother place a stud in her nose and thought this would be a fabulous idea to try himself, so he sneaked into her jewelry box and found a pretty pearl stud (as opposed to a hoop? Forgive me, I’m a man with no piercings, so my terminology might be off). Mom’s earring fit perfectly… in Ethan’s nose, and there it stayed all morning.
Ethan's mother called me right away. Ethan was an adorable kid, and it was hard to be angry with him. We carefully removed the earring and ensured that Ethan's future fashion endeavors focused on more appropriate choices. I would very much like to know how Ethan (now an adult) feels about earrings today.
Pity the pea! How does a small vegetable have such a terrible reputation and cause discomfort when inserted where it doesn’t belong? Little Oliver, an adventurous eater, lodged a small pea deep within his nasal passage during dinner. With Oliver's anxious parents looking on, we deftly extricated the tiny green intruder, emphasizing the importance of enjoying peas on the plate rather than through the nose.
While these incidents may cause initial panic for parents and discomfort for the child, they serve as gentle reminders of the endless surprises that come with the journey of parenthood.
So, let's embrace the wonders and occasional mischief that come with childhood, recognizing that sometimes the most unforgettable stories can arise from the smallest places—like a child's nose.
Finally, some doctorly advice: Never stick anything smaller than your elbow in your child’s nose (I heard that as a child but didn’t understand it was a joke until I had already graduated from medical school). Don’t use tweezers or your nails, no matter how long they are. Call your care provider before trying to get it out yourself. I’ll reveal my secret hands-free trick in a future post.