Saturday, February 23, 2008
Button, button. Who's got the button?
There are certainly a lot of expressions and stories about buttons, and now we have a story of our own. Last week, while we were in Hawaii, I promised to share how we came to have a Kona Bear, and it goes like this:
Maria loves the song "Frosty the Snowman." Even this long after Christmas, she talks about the animated version and she asks me to sing her the song. Remember? "With a corncob pipe and a button nose, and two eyes made out of coal"? Maria found a small white button to balance on the end of her nose and we giggled together at her inventiveness. She had a button nose. So clever. So cute.
Ruth and I were sitting together, sharing a long cry, hugging, and Maria walked in with her button. She put it on my nose and we laughed. She put it on her own nose and we laughed some more and we talked about Frosty and his button nose. And then I made a miscalculation. You see, sometimes good parenting is as much about what we don't do, as what we do. And as Maria left the room, in a moment of misguided good intention, I said, with sincere caution: "Don't put the button in your nose," and in a classic case of foreshadowing, I said to Ruth, "She'll think that was a recommendation." Maria was gone for 1 minute and returned with a suspicious grin.
"Maria," I asked, not wanting to suspect what I already suspected, "Where is your button?"
Her grin deepened and she pointed to the opening of her right nostril.
No. I looked and saw nothing. I sighed and asked her again, this time in a serious Mommy's not kidding tone: "Maria give Mommy the button."
Again with the finger to her nose.
I followed her to the room with better light. I tipped her back so I could get a good look up her tiny, dark nostril, and there it was. White, small, and wedged on its side. Too committed to be pried out. Perhaps a sneeze. Maria was calm. Breathing fine. I was calm. Breathing fine. Max was curious and he looked and saw the button too. We agreed a good sneeze was in order and we blew pepper around her nose. This produced a small, delayed sneeze and no button.
At this same time Geoff was with William and Alex in Waipio Valley. In deference to Madame Pele, they were returning some rocks Ruth and Corm had borrowed from the river. He was well out of cell phone range and I really did not want him taking any panicked driving risks, so I thought it was just as well that I couldn't call and tell him we were on our way to the clinic in town, so they could extract a teeny-tiny white button from Maria's nose. I was still calm, but dreading the usual patronizing criticism I am accustomed to enduring from our doctors, and I was sad for Maria who might suffer some temporary discomfort. This will be over soon, I consoled myself.
Shall we skip the business end? There were forms to fill and file, and questions to answer. Insurance cards to photocopy. Everyone was nice. Everyone was competent, but I kept thinking "It could be out by now people. I'll pay. Trust me. Just pop that little booger out now."
By this time Geoff had reached me and he and the boys met us at the clinic, which was helpful, because the doctor's first idea was to send Geoff down the street to the drugstore for some over the counter nasal decongestant. I was to administer the spray and the hope was that it would cause the membranes to release the button. Easy peasy. Small town. Nice people. I heard several Stuff in Nose stories from nurses and staff. All with happy endings, and not one recriminating, finger wagging, bad mother remark from anyone. This was very refreshing and nothing like So Cal. But the decongestant was not working. The nurse, Sharon, had a vacuum in her car. Yup a home vacuum that had the distinction of sucking something out of a little kid's nose before. The doctor assured me that he tried it on his own nose to be sure it wasn't too sucky.
By this time Maria was far less calm, and so was I. She endured the probing light in the nose and the bad tasting nasal spray. She was tired, hungry and more out of sorts than ever. It had been a hard enough week as it was and now this? I had to hold her tightly, trying to assure her, while also covering her ears, and she had to endure a vacuum attachment directed at her face. It didn't work.
While Maria slept, the clinic doctor tried to find an ENT on the Island. He wanted an expert's help. He was concerned about Maria's septum, and the risk of her aspirating the button. He was especially sympathetic and concerned because he was Corm's physician. He wanted us to get the best care possible, which was to be found an hour and a half away in Kona. He said we were lucky there was an ear, nose and throat specialist available, otherwise they would be sending us to Oahu. So, the specialist was waiting for us at Kona Hospital. Anxiety is escalating. By this time I was feeling very distressed and frustrated and tired and hungry and anxious and worried and I know it doesn't show in the picture, but the picture was taken 1 minute before they said we had to drive half way around the Island to see a specialist who was waiting for us in the OR.
Shall we skip the business end? There were forms to fill and file, and questions to answer. Insurance cards to photocopy. There was incompetence on this end that might be funny in 10-12 years. I was glad we stopped to get Maria fries and milk, at least she was only missing her brothers and not tired and hungry. The first doctor to stick his head in the room said, "I'd like to save you a lot of money, so I wonder if you would try this: Pinch her nostril that does not have the button and then covering her mouth with your own, forcefully exhale. This will force (something) to close and should expel the object from her nose." I think this would have worked, if we had tried it 4 hours earlier. Maria looked stunned after I gave her a "special big kiss" and she said "Wow, Mommy. That was too much kiss."
The specialist, fresh from school in Minnesota, wanted to sedate Maria and do the procedure with her out, so she would not be traumatized. This prospect was very traumatizing to her father. And Maria cried all through the discussion with the anesthetist, because she did not like him, "I want a real doctor. I not like him." Geoff's reservations were founded and the drama heightened when we realized that her happy snack would delay the safe administration of the anesthesia by 4 to 5 hours.
By now Maria is crying and inhaling hard and increasing everyone's fear that she will aspirate the button, and so they decide to sedate her with pain killer. She will be awake during the procedure, but not in pain. I had to hold her while they put in an IV. That was hard. Her tiny hand and that big needle and the bright lights, the smell of rubbing alcohol, the mounting tension.
They wrapped everything, so she wouldn't be distressed by the stuff. They put a monitor on her toe, then they hooked her up to the drip and we waited for the medicine to take effect. It didn't take long for her to look limp, a little detached, and then they came in with a board and velcro wraps to hold her head, arms and legs. She did not resist or protest. The nurses and the doctor were kind and gentle, they took great pains to reassure her, to comfort her.
And then someone came in with this bear. They asked if she would like him to sit with her. Her eyes locked on him. I stepped away and the doctor began to look for that button. He had long, very long tools and even I could not take pictures. This whole thing had gone too far, too long. I was certain that she would be coming home, but the journey was scary and sad. And... no button. It could not be found. Somewhere, some time between 2 p.m. and 9:30 p.m. she must have swallowed the button. It was highly doubtful that it went to her lungs, since she was not choking or in distress. They listed all the signs and indications we should watch for, like bad smells and/or gagging. I might find it in her pull-ups, which would be reassuring.
We waited for her vital signs to look good, for the medicine to lose its effect.
Long story, and I suppose I could have just said, "Maria stuck a button in her nose and after two different doctors tried to get it out, I found it in her diaper the next day," but you would have missed all the gory details and drama.
All the way home Maria talked to her bear. She showed him her bandage and told him about her brown bear at home. She has reenacted the entire show from vacuum to band-aid, from button to toe-monitor, a dozen or more times. She is the doctor, and she wraps me or Alex or Geoff, and pantomiming, she tries to vacuum the button, she even tries the too much kiss! The only game we haven't played is Frosty the Snowman with the Button Nose.