The Pregnant Tourist

It was a beautiful Saturday morning, and I was in the mood to do some gourmet cooking. Somehow, it makes me relax and feel like I am in the kitchen with my Mom who cooks delicious meals. Alas, she never taught me how to cook, always telling me to go study instead. After marriage, I had to make some quick adjustments, and started collecting cook books. Fortunately, my husband has been very supportive although he did once call my pancake a “Frisbee” – something I have never forgiven him for. Over time, I have amassed quite a few books, and they appear pretty stunning sitting on the shelves. But there was one recipe that caught my interest described as chicken rolls filled with crushed dates, lemon juice, and chili peppers. So here I was cutting and preparing, when I got called to the Emergency room for a nose bleed. Oh well, I thought, shouldn’t take too long before I return and continue my cooking project. I was so very wrong!!

I walked in to find a sweet young pregnant lady holding a big basin filled with blood. It continued to pour out of her nose without any intention of stopping.

Her supportive husband stood by her side, and appeared bewildered and scared. I saw fear in her eyes as I tried my best to reassure her, while my mind was racing in order to work out a swift plan of action. We had to work fast to save the baby. The mother was in her third trimester, and the couple was visiting from Australia. Suffice to say, it took considerable measures to control and stop the bleeding. Fortunately, no harm came to the baby. They returned to Australia two weeks later with no further problems. About two months later, I got a thank you card and picture of their healthy beautiful baby boy!

More about Nose Bleeds

Both patients and doctors dislike nosebleeds, also known as Epistaxis. Fortunately, most of them are minor and arise from the very front part of the nose along the septum also called “Little’s” area. It can often be cauterized in the office followed by application of ointment within the nose for about a couple of weeks to lubricate the mucosa, and prevent secondary drying and crusting. If bleeding continues, then more definitive surgical measures can be taken under general anesthesia. Posterior bleeds are those arising from the back of the nose. They can be much more severe and are often seen in elderly patients or those with hypertension. Use of Aspirin, Aleve®, Motrin®, PLAVIX® (clopidogrel bisulfate), and especially Coumadin® can make the bleeding much more severe. Nasal packs are usually the first line of approach in trying to control Epistaxis. If not successful, nasal endoscopy and cauterization of bleeding sites under general anesthesia is done. Finally, embolization of intranasal bleeding vessels by the radiologist can be considered for persistent severe bleeders, and is usually very effective.

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About the Authors

Kari Kingsley, MSN, CRNP

Kari works as an otolaryngology nurse practitioner in collaboration with Dr. Neeta Kohli-Dang. Together they share nearly forty years of ENT experience. They treat dizziness, ear infections, hearing loss, nasal congestion, sinus infections, thyroid nodules, tonsillitis, neck masses, hoarseness, trouble swallowing, and a multitude of other ear nose and throat conditions.

Neeta Kohli-Dang, M.D., F.R.C.S. (C)

Dr. Neeta Dang has had a successful and busy practice since 1987 with vast experience in the treatment of ear, nose and throat disorders, both pediatric and adult.

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