Each week we comb through science journals to explore a baffling medical issue.
It’s never a good thing when your New Year’s Eve activities are described by doctors as a cautionary tale — something a 41-year-old Australian would learn the hard way one fateful night in 2014.
As she prepared for another night of revelry in the glorious pre-pandemic days, the asthmatic woman felt a tightness in her chest that prompted her to reach into her handbag for her inhaler. She heard on odd rattling sound as she picked it up, according to LiveScience, but assumed it was merely a loose connection in the device. She pressed the button, inhaled deeply and immediately felt a sharp pain at the back of her throat. She began wheezing and coughing up blood as she was rushed by friends to the nearest emergency room.
She would soon learn the error of her ways, according to Lucinda Blake, a core medical trainee at St. Vincent’s Hospital in Sydney and the lead author of the woman’s case study. “Unfortunately, she was not taught to replace the cap on the inhaler after she has used it,” Blake said. “While her inhaler was uncapped in her bag, an earring that was also loose in her bag found its way into the inhaler and became lodged in it.”
While her perplexed patient assumed a small piece of tin foil from her bag might be the culprit, a chest X-ray revealed that a heart-shaped stud earring was currently accessorizing her right bronchus — one of two main airways leading from the windpipe into the lungs. Doctors used antibiotics to combat any infection before removing the buried treasure via a bronchoscopy — a procedure that employs a thin, flexible tool with a camera to remove unwanted objects.
Large amounts of mucus had already begun to surround the earring, likely evidence of the body’s efforts to repel the attractive intruder. Had they waited any longer, Blake said the jewelry may have become a permanent resident of the woman’s body. With the misbehaving bling safely extracted, the patient made a swift recovery and has learned the importance of keeping a lid on her medication.
It’s a lesson that bears repeating, Blake said. “I think that teaching should include explaining to patients the importance of replacing inhaler caps, teaching them how to inspect their inhalers thoroughly to ensure that there are no unwanted objects concealed and educating them on the potential damage inhaled objects can cause,” she said.
Asthma is a chronic inflammatory disease of the airways that affects more than 3.8 million Canadians — 850,000 of which are under the age of 14, according to Asthma.ca. The symptoms, which include shortness of breath, coughing, wheezing, tightness of the chest and difficulty sleeping, can be relieved in the short-term through the use of an inhaler. These devices offer fast but temporary relief to restricted breathing but do not address the underlying airway inflammation. Doctors treat this inflammation through the use of controllers that reduce the swelling and inflammation and provide long-term relief.
If you have asthma or other issues breathing, it is important to discuss the best treatment options with a doctor and ensure you are using your inhaler properly. Newer devices have attached caps to help decrease the likelihood of getting more than you bargained for when you take a puff.
Ultimately, such cases are rare, according to Brahim Ardolic, the chairman of emergency medicine at Staten Island University Hospital. “To be honest, if your inhaler is not covered, just don’t use it,” he said.
Dave Yasvinski is a writer with Healthing.ca