A couple of weeks ago I was in the midst of a busy morning. It was one of those days where everything seemed to be going just right and I was making it through the day with relative ease. As I grabbed the next chart, I feared that my luck had run out. My eyes zeroed in on four words that had the potential to sabotage my morning...foreign body in nose. My pulse quickened and my eyes moved slowly to the corner of the chart where the patient's age is listed confirming my worst fears...3 years old. This would certainly be interesting!
One can never be certain about 3 year olds. They can be as pleasant and cooperative as an adult, or the visit can degenerate into a tag team wrestling match, or they can be as charming as an adult as long as you are on the opposite side of the examining table. The minute that you "break the plane of the table" and approach them, they undergo a metamorphosis into something out of a Stephen King novel.
With Kevin, I didn't know exactly what to expect. His blond locks fell on his head in a Beatle-cut, his cheeks were sprinkled with freckles, and he had green eyes that had a sparkle which should have warned me that he probably had a bit of the devil in him. I was not surprised to learn he had put a little plastic propeller from a toy inside his nose. What 3 year olds have about their noses and foreign bodies I'll never know. It seems a law of nature that if an object is smaller than a boulder, a 3 year old can manage to somehow get it into their nose.
Mom was clearly upset with Kevin for depositing the propeller in his proboscis. She had a busy day lined up, and spending a portion of it at the pediatrician's office was not on her list. To top it off, her 18 month old was fussy and pulling on her ears. Mom apologetically asked if I wouldn't mind looking in her ears to see if she had an ear infection...as long as she was here.
My primary concern was in taking care of Kevin who assured me there was no way I was going to remove the propeller from his nose. All efforts to persuade him failed: I tried to discuss the procedure with him in a rational manner, I demonstrated what I was going to do on his sister's teddy bear, mom tried to bribe him...all to no avail.
We moved on to plan B. Amid screaming, kicking, biting and spitting (all by Kevin I might add), and the assistance of two nurses, Kevin was safely restrained and the infamous propeller was removed without incident.
I placed the propeller into an envelope and gave it to mom who was a bit frazzled after the exercise. Putting the envelope on the diaper bag, she warned Kevin that he would have to tell his father what he had done when he got home from work.
We then proceeded to check the 18 month old who it seems was fussy because she was cutting her pre-molars. I assured mom that her ears were clear, and that her throat and lungs were just fine. Mom gave a big sigh of relief. Now she could get back to her busy day.
Kevin by this time had become very quiet. He had the look of GUILT written on his forehead. He was tugging at mom's arm saying, "I want to go home. Now!" His demeanor had changed in a split second. Clearly something was amiss but I wasn't exactly sure what was wrong.
Mom gathered her things and thanked me. She picked up the envelope and squeezed the outside not able to feel the propeller. She opened the envelope, looked inside, and turned it upside down and shook it...still no propeller. "Did you stick it back into your nose?" she scolded Kevin. "No!" he sobbed. He had stuck it in his right ear.