FB’s

I suppose my first thought goes back to a trip as a student nurse to one of the London Hospital museums. I remember lots of glass cabinets filled with kidney stones, a massive ball of hair retrieved from a woman’s stomach and an Alka Seltzers bottle, these are other peoples stories…

So in my working time I have removed more beads, buttons and sweets from children’s noses and tips of cotton buds from peoples ears than I would ever want to recall, however occasional something atypical makes you want to stop and think “ooooh, but why?”

Dolphins:
As a student nurse doing paediatrics I remember a girl being admitted for what we jokingly referred to as a Dolphinectomy.  Apparently she had sat on her toy wind up dolphin in the bath and had somehow managed its way past her sphincter – (likely story) Xray showed the metal of the wind up mechanism just inside her descending colon.  Thankfully she managed to save herself from said Dolphinectomy by one rather painful bowel motion. (Whether or not the dolphin swam out to sea or ended up in a museum is unknown to me – hopefully it is not back in her bath!)

 Umbilical Bleeding…

This is quite bizarre, and a little bit legendary in my neck of the woods, so I was slightly reserved against sharing it as it may give away my alter ego identity, (but I’m not too worried).

Are you sitting comfortably?  Then I shall begin…

It was a couple of years ago, when I was a fresh faced NP student. My next patient on  the computer screen was listed with the PC of “bleeding tummy button”.  The patient was an adult female, so my usual guesstimate of what I’m going to see was limited, some kind of grossly ruptured hernia perhaps???

As the patient entered my room, it was apparent that she was more than a few kilos over weight.  She gave a history that she had noticed a small amount of dried blood near her belly button, but was otherwise asymptomatic.

So we took a look, she popped onto the couch and there was a tiny amount of red goo on her skin, nothing gross.  At this point I should have said:

“Oh, probably just a scratch, go home and return if you have any further problems”

But no, not I- this phenomenon needed further investigation, (prompted partially by a slight malodour coming from the deep dark depths of her umbilical region)

So first I try a separate the skin as much as possible, and with the light beaming behind me, have a look. There I see something! I get a cotton bud and delve further into the cavern before me and with a nice scoop action remove the foreign body….

One dead moth….

So my patient is embarrassed, but goes away happy in the knowledge there is no surgical emergency, but from that day to this I have one question…

Surely it didn’t fly in there, so did it go in as a Caterpillar?

The moral of the story –  never forget the importance of good umbilical hygiene.

Other FB’s include:

…Guy comes into A&E having nail gunned his trainer to his foot…

…or the slightly more bizarre –

Guy comes into A&E complaining of dysurea – and due to his slight air of oddness, I have an urge to call records and get his notes down…

A fascinating large file for a 21 year old, with various artifacts the surgical team felt should be cleaned and left in the notes, for curious people like me. Cause of his dysurea turned out to be the Biro he had put up his penis….  Apparently it all started when he was 14 sitting by a river and showed his mates how easy (and fun??) it was to catheterise with fishing wire. As he got bigger so did the foreign bodies….

That’s my back catalogue for FB so tell me yours???

The Blissful Erica  Added her experience and for this we are grateful…

“As for likely stories… the thirtysomething gentleman who showed up in our ER a couple of years ago with a rather impressive rectal FB (a full-sized aerosol hair spray can) told
the triage nurse that he’d awakened to find blood in his stool, and was attempting to examine himself with a hand mirror and said can.  When POOF! the can became a rectal
foreign body.   Riiiiiiight.

Hmmm, thanks Erica, remind me never to borrow any of your hairspray!

 Actually Erica has helped me out with some other things of interest, I followed one of her links to some great FB photo’s on the ER arty site.  I linked to my favorite page, but have a browse.

 Also worth checking out ERNursey list of FB’s

And in the news….a differential diagnosis for shingles…

ImpactED Nurse tells us that it not always the patient with the FB -many a similar story, but none quite so horrible.