Balloons in Medicine

Over the last few years, I have blogged about ballooning health care costs, or discussed health-related scares that popped my proverbial balloon. Some of my nearly 300 blogs posts have been popular; some went down like a lead balloon. In these trying economic times, we hear about balloon payments. There are pop-up balloons on many Web sites, and we read about released Mylar balloons causing major power outages. A few years ago, many people were injured at the Macy's Thanksgiving Day Parade by one of those huge renegade helium balloons. The Mars Lander used balloons for a safe, albeit bouncy, landing.

Photo Credit: a4gpa

Balloons are a part of every birthday celebration. In my office, the staff usually decorates my office with dozens of balloons; a nice gesture, but a bit annoying on a busy day. As kids (and college students), we threw water balloons, often making catapults out of surgical tubing and a plastic dog bowl.

When I turned fifty, my older brother surprised me with a hot air balloon ride over Sedona, Arizona. I chickened out, remembering those shocking videos of hot air balloons landing on power lines, and of course, the Hindenburg. My brother was disappointed. I am not a big fan of heights, so I don't regret not giving it a try. I threatened to give him scuba time in a shark cage on his birthday, so he understood (I think).

Photo Credit: Denise Chan

The medical profession has been using balloons of some sort for decades, heralding new and safer, non-surgical approaches to common human afflictions. Many people are familiar with balloon angioplasties for opening clogged blood vessels, intragastric balloons for weight management, balloon urethroplasties for those enlarged prostates (Ouch), balloons to repair a broken back (balloon kyphoplasty), balloon ablations for menstrual disorders, balloon endoscopies for treating small bowel cancers or ulcers, and even balloon dilatation for naso-lacrimal duct obstructions (clogged tear ducts). Balloons are surgically-inserted under the skin to expand tissue before certain surgical procedures where "extra skin" is needed. In many surgical procedures, a Foley catheter is inserted into the urinary bladder; a small balloon is inflated to keep it from coming out. Basically, if there is a natural (or surgically-created) hole in the body, some medical professional will think about inserting a balloon in it.

In the ENT world, there is a new procedure called balloon sinuplasty to open up those blocked sinus passages, and, for years; medical providers have used a rhino-balloon to control epistaxis (severe nose bleeds). One simple home remedy for ETD - Eustachian tube dysfunction is to try and equalize middle ear pressure. By blowing up a balloon (a difficult-to-blow up one), you can force a little air up the Eustachian tubes into the middle ear. Of course, you can do this without a balloon, too.

A condom is a balloon of sorts, too. "Get outta my room unless you brought a balloon!"

Photo Credit: Ed Luschei

Balloons can save lives, but they can also be health hazards, even cause death. Kids insert balloons (deflated, of course) in their noses and ears. I have taken out many of them, but not any of the ones that I gave them. It is also very common for children to swallow deflated balloons - something nature will dispose of naturally in most cases. Sadly, some children have died by aspirating a deflated balloon into their airway. In the United States, at least 121 children have died in a similar manner in the 15 years between 1973 and 1988 according to a report by the US Consumer Product Safety Commission. The highest mortality occurred among infants, 30 (25%) of the 121 deaths occurred in children 6 years of age or older. Balloons account for 43% of the approximately 15 childhood deaths related to children's products that are documented each year by the Consumer Product Safety Commission. Children frequently choke on tiny toys, peanuts, a Tic-Tac, pieces of apple or meat, and other foods - just about anything that fits in their curious mouths.

One of the first, practical things you learn in pediatrics is how to use a latex glove to make a balloon animal of sorts, usually a lame-looking rabbit, and for the less-creative, a big hand, a cow udder, or five-armed octopus (pentapus?). Assuming no one is allergic to latex, this can be a useful skill. Balloons can carry your germs if you blow them up yourself, so unless you have an inexpensive inflation pump, you may be passing on your pathogens to others. I have never left a latex glove inside a person after surgery, but you sure read about them.

Photo Credit: Katy Warner

Many years ago, my wife gave me an interesting birthday gift - a class to learn how to make real balloon animals. For many years, I have thrilled some of my little patients with a balloon dog, giraffe, swan, sword, or hat. I make pirate swords and scabbards, occasionally challenging them to a duel. While on a medical mission in Jamaica, I made balloon animals for the kids who came to the clinic. They were so popular that some of the women in the village asked me to make them some elaborate balloon hats for a political rally. In some of the news footage, my hats could be prominently viewed.

Last year at a medical conference, selected participants were asked to present a pearl. We were all given two minutes and could only use two slides. I won (a book store gift certificate) for showing the audience of 800 how to make a wiener dog - an "anatomically correct, male wiener dog" to be more accurate. This was one of my own, naughty creations. I have adult patients, too.

Bosco the Clown, my balloon animal mentor, claims he has handed out over a million balloons in his career and hasn't killed or harmed one child to his knowledge. He is sure that if he did, an attorney would be contacting him. Nevertheless, balloons should not be given to children under the age of three (some warning labels state age eight), developmentally-disabled children, or any child who may have irresponsible parents. Common sense is often not age-related.

Not all children are thrilled by a balloon. A heavily-inflated balloon that bursts can scare the crap out of anyone. I wonder how many parents have swerved off of the road when one of the kid's balloons exploded in the back seat, or dove for cover in the inner-city. Frightened parents may be able to experience another life-saving balloon - the automobile airbag.

Balloons do save lives, and tragically, take some away. We should always be careful with young children and balloons. I still give out occasional balloon animals to selected kids with responsible parents. Do I worry? Not really. I do worry about that prostate balloon, though.

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