Wednesday, August 19, 2009

What NOT to Feed Your Kids...A Nickle: Choking and Coins

Last Thursday, my son stood up in the middle of watching TV and told me "Mommy, I swallowed a penny." His voice was meek and teary and I could tell he was scared. I am good at many things but I am horrible when there is a crisis. I got angry. "Why did you swallow a penny?" I asked desperately while calling the pediatrician. The pediatrician told me to take him to the ER when I described that he could talk and was breathing okay. I hung up and called 911 who immediately sent some paramedics and an ambulance over. We were in Vermont and everyone was amazing--no one even rolled their eyes at all the supplements my son takes. Although my son was breathing, he was also throwing up a little foamy spit, which seemed strange. The paramedics, nurses and doctors were all reassuring me that kids swallow pennies all the time, they land in their stomachs and they eliminate them in a couple of days. But as a precaution, they need to x-ray them to make sure it isn't in their esophagus, because then it can turn and cut off their airway.

Although I am pretty negative about mainstream medicine, in the event of an emergency, there is nothing better than mainstream physicians. Our "death and disease" model of medicine is great if you have a crisis or an emergency.

Here is what I learned:
• If your child swallows a penny call 911.
• Don't give the child anything to eat or drink until you are sure the penny is not in their throat.
• Don't bang on their back as this may make the situation worse. On Feb 5, 2009 Henry Heimlich wrote in a letter to the New York Times: "Backslaps are proved to cause death by driving a choking object tighter into the airway."
• Go to the ER to get an x-ray to determine the location of the penny.
• In rare cases, for a very young child, the only sign they have swallowed a penny is that they stop eating and start losing weight and have breathing problems. The hospital told me a story like this one about how doctors overlooked a penny in one child.

Anyway, for my son was truly like life imitating art. They checked my son into the hospital, gave him a bracelet and a gown and x-rayed him and it was just like Curious George Goes to the Hospital. When he went to get x-rayed, I stood behind the radiologist as the x-ray image of my son came up on the computer. There was a perfectly round white circle at the top of his throat--no where near his stomach. I could feel the situation change from a casual "these things happen" to a true medical emergency as they rushed us back to meet with the attending physician who informed us he was calling the ENT and GI doctor to remove the penny.

They put my son to sleep using propofol--the same drug that was implicated in Michael Jackson's death. They told me it was actually called the "presidential treatment" because one former president had it when he needed anesthesia. The formulation of this product is actually 1% propofol, 10% soybean oil and 1.2% purified egg phospholipid (emulsifier) and 2/25% of glycerol and sodium hydroxide. Interestingly, it also contains EDTA as an antimicrobial agent. The good news is my son did fine with it.

I was with him when they put him to sleep and although I was scared, I was actually more terrified of the penny in his throat. As they wheeled us into the surgery (they let me lie with him on the stretcher) the doctors were taking bets on what kind of coin it was because it looked bigger than a penny on the x-ray. A half an hour later the GI doctor came in with a silver nickel in a little cup and I went to my son in recovery while he woke up.

I was most freaked out that it happened while he was watching TV and seemingly safe. He had been playing for two weeks in the garage with his cousin where there were so many more dangerous items around. There was a mother's helper three feet in front of him watching his cousin and I was ten feet behind him in the kitchen. I also wondered if I had conjured the whole episode to happen, like in the secret, because I had been overly focused on my 8 month old niece putting everything in her mouth.

Luckily, our emergency had a happy ending. The paramedics gave him a bear and asked him to give it a name. He named the bear "coin." Now I am determined not to let my son put ANYTHING in his mouth ever again. Any non food item that gets put in his mouth gets removed immediately. There are no warnings or second chances. Big or little, nothing goes in his mouth but food. Well that is the plan...but as every parent knows, theory is one thing, reality is another. I have a few toys on the mantle that I found him chewing on.

According to Choking Episodes Among Children by the CDC, coins involve 18% of all choking related emergency room visits. Hard candy accounts for 19% of all choking related visits.

The New York Times has an article on Choking: Infant Under 1 Year and another article Choking: Unconscious Adult or Child Over 1 Year. According to these NYT articles "A partial blockage can quickly become life threatening if the person cannot properly breathe." I am glad our emergency is over and everyone is safe and sound asleep and I am baking for my trip tomorrow to California.

Never a dull moment. Enjoy every crazy moment, I say. And when you are done, bake some cookies.


gfcfcanadianstyle said...

Yikes! So glad to hear everyone is ok. My son was an everything in the mouth kid, I'm still amazed he never swallowed anything dangerous.

Good tip on the ER visit too - I probably would have just figured a coin would pass "in a few days"

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~beautyandjoy~ said...


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Betsy said...

Wow, that is truly scary. I am so happy to hear that everything turned out okay.

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