DRHOOK- Breathe easy: Lungs no place for foreign objects

the handsome doctor John Hong of Charlottesville

Choke? I used to choke in golf– 100% of the time. When I competed, when I tried out for the high school golf team, when I had an amazing score going into the 18th hole. 

"Wow, I'm doing great! I might break par." 

Flash forward: sand trap, water hazard, out of bounds, lightning strike.

What happens if you end up with something in your lungs?

Aspiration means inhaling something into the windpipes/lungs. We cough and gag to bring up food, dust, and objects and keep them from going into our trachea and down into the lungs. However, most adults who aspirate a foreign body don't recall ever choking, gagging, or coughing when something goes down the wrong pipe. 

Ron Sveden, the pea man, is a senior citizen with Chronic Obstructive Pulmonary Disease, COPD. He's also a Jolly Green Giant because a surgeon found a pea plant growing in his lungs. (Is this like the Princess who couldn't sleep because of the pea 20 mattresses below?) 

I suspect because of his COPD, he couldn't cough hard enough to keep a pea from going down his windpipe (must have had butter on it).

Though foreign bodies down the windpipe occur mostly in kids (80 percent of cases), adults are most likely to inhale veggies, bones, and watermelon seeds. After all, who eats watermelon that isn't seedless? You end up spitting the seeds out more than enjoying the watermelon (the greatest fruit in the world, in my opinion).

When something is stuck in the airways, a chest x-ray will often show a hyperinflated lung because the object kind of acts as a ball-valve letting air in but not out. In the case of Sveden, his lung collapsed because– well, the pea plant sprouted and totally blocked any  air from coming in. Hold the Miracle Grow, Batman!

I don't know about this one, but in 2009 in Russia, a person reportedly had a tiny sprout of a fir tree growing in his lungs. I know fungus can grow in the lungs, but a pine tree to spruce things up?

Things that have been pulled up from the trachea (windpipe before it splints in two to the right and the left lung) include seeds, small particles from weeds and plants, tacks, screws, nails, pills, dental debris and prosthetics. One woman claimed she swallowed her night guard, but I think she just lost it under her bed because those are pretty darn big. 

Kids put peas up their nose, and toys, and pens– well, you get the point. In an emergency for objects lodged in their breathing pipes, a rigid bronchoscope can locate and sometimes remove the object. In fact, the bronchoscope was "invented" in 1987 in Germany when Gustav Killian pulled a pork bone out of a farmer's trachea using an esophagoscope. 

Getting the foreign body out should be done faster than answering an RVSP to an Oprah Winfrey dinner party. A foreign body can kill someone, although it's interesting many adults don't have breathing problems. 

More common symptoms of the uninvited lung guest include coughing, chest pains, and fever. Coughing up blood to wheezing can occur.

I don't know if the surgeon extracted the pea plant from Sveden during flexible bronchoscopy. I assume he did, because Sveden isn't having the same breathing problems he did for the past two months. 

So choking can be a good thing– as long as you get the sucker out. You never want to be like a pea in a pod– if the pod is your lung.


Dr. Hook cracks a joke or two, but he's a renowned physician with an interesting website, drjohnhong.com. Email him with your questions.