What's a maggot when it's NOT a maggot??

Well, it COULD be tiny balled up pieces of paper that SOMEONE shoved (or had help shoving) into their ear.
Now why would someone do that?  Oh yes.  Because they are a not quite 18 month old and clearly LOVES paper.  Now let's start this story a few months back (around 3) with me walking into the Bercario (nursery) to find Chelsia and Augustinho looking very mischievous.  These two are just days apart and get into a lot of things together, encouraging each other to do bad things, and learning, and feeding off one another.  Basically, they are cute messes!  Real Cute!  I half ignored the mischievous look on their faces, as I was honestly too busy to find out what they were up to, but something told me I should look into it.  So I came a bit closer and noticed that Augustinho seemed to have something in his mouth.  So I asked him to open up his mouth and inside I found balled up paper.  I gently explained that paper was for the trash and not food for his mouth and that we do NOT eat paper.  Then I took it out of his mouth and threw it in the trash, thus punctuating my point.  I then got back to what I was doing....a few minutes later, I notice that he has MORE paper in his mouth.  Perhaps I did not speak portuguese clearly enough to him.  So I squat down and remove the paper and start to give a toddler version of a lecture on not eating paper when I notice that Chelsia has something in her hands.....it is THEN that I realize what was really going on.  Chelsia had a small square of cardboard paper (like from a box of cereal or such) and had been tearing it into tiny pieces and literally hand feeding it into Augustinho's mouth, who was thus eating it.  I burst into laughter, took away the paper from Chelsia and the paper out of Augustinho's mouth and then explain (again) why we DON'T EAT PAPER! Chelsia immediately burst into tears, threw herself into the floor and Augustinho stamped around screaming at me.  Apparently, I had ruined all their fun.  But I was hoping that the paper is for lixo (trash) had sunk in....
Fast forward to last week.  The tias bring dear Chelsia to me because her ears look dirty and she's pulling at them.  I look and sure enough they look as though perhaps they have an infection in them.  I go grab my otoscope from the Baby House and have a little look.  One looks super dirty and I can't see much, so I pour some normal saline into her ear to loosen up the dirt and have a better look.....she immediately starts screaming and grabbing her ear and wiggling out of my hands....that's weird it shouldn't hurt that much.  I man handle her a bit and let the water do it's job....I then flip her over to have a look at the other ear.  This one looks a bit red and pussy and I clean it out with some water.  No reaction.  Hmmm....why did her other one hurt so much, I think to myself.  Back to the first ear.  I look in and now there's a giant round, very white and oddly looking thing in her ear.  In fact, it looks just like a maggot.  Not what I think a maggot looks like.  No, it looks just like a maggot cause I've seen and extracted them from children and missionaries in my time here.  Disgusting.  Hmmm.  Why does Chelsia have a maggot in her ear?  Well that would explain the fit she just through.  Maggot's need air to breathe and I successfully cut of his supply off and tried to drown the sucker...he was probably moving all over the place and hurting her.  Now I think....in all my time in nursing school and working in the hospital as a neonatal nurse, and all those hours watching medical shows, not once do I recall what to do if you find a maggot shoved into a 1 year old's ear.  So I think.  And decide, perhaps if I attempt to drown him again, he'll come even closer to the top and I can just grab him out with tweezers.  Right.  I pour in some more normal saline and Chelsia throws another grand fit.  I look again, even closer to the top.  I knew it.  I'm going to DROWN him out.  stupid worm.  I continue.  After several more minutes, I decide I might need a little more backup as my brilliant plan isn't exactly working out like I had hoped.  Clearly not my fault.  So I call in Meghann.  I hand her the otoscope and the bottle of normal saline and say....chelsia, right ear, have fun.  let me know what you think.  She takes one look in her ear and says....she totally has a maggot in there!  Yup, that's what I thought.  Thanks for the confirmation.  So then, the 2 of us try to drown out the maggot.  Without success.  Though at one point I could see it very clearly at the top of her ear canal with just the light and was attempting to extract it, when the fact that one little wrong move (from her of course) could result in me busting her ear drum.  So I give up and decide we'll flush it out with a syringe.  No.  We do NOT have those cool ear syringes.  But what we do have, are normal syringes.  So I filled a 60 ml syringe with normal saline, plunked Chelsia into a baby bath tub, meghann held her and I **attempted** to force that sucker out of it's cave.  Chelsia did not like my idea.  And now the darn maggot had curled itself up around the opening to her ear canal and was too far in for me to pull it out.  Darn thing.  So we conceded and decided we'd let the Mozambican doctor that afternoon have a go.
That afternoon, I bring her into the the doc and say....so I have a little problem for you.....there's a maggot in Chelsia's right ear, could you please remove it?  Well he takes a look and says....did you look with one of these (motioning to his otoscope)?  Why yes of course I did.  I responded with the same.  He looks at me funny and says, there's no maggot in there.  I say....ummm.....well there's something in there and it's big and it's white and it moves and it hurts her.  To which he responded...there's no worm or maggot in there.  I said, did you see the big white thing.....he says, what, this?  I say yes, that giant squirmy white thing.....he replies....THAT is normal.  Um.  Now, I know I'm NOT a doctor.  Believe me.  I respect that fact, but I know what a normal and a not so normal ear looks like and I especially know that giant white squishy round tubular things are NOT normal for anyone's ear.  The End.  So I say....well what is it then.  He replies- I don't know.  To which, I respond....what would you like to do about this normal giant white thing in her ear that was never there before.  and he says oh let's just give her ear drops and put her on antibiotics.  I take a breath and the prescription and walk out.  after mumbling thanks, I'm sure.  I take Chelsia back to the Bercario and call in back up # 3.  Jannie.  I say, please look in Chelsia's ear and tell me what you think that giant white thing is in her ear, cause I've been told it's normal.  She conferred with myself and Meghann.  So jointly, we decide on an extraction plan.  We haul her back up to the air-conditioned clinic and put her on the one stretcher we got. Then the 3 of us go to it....I hold Chelsia, Meghann's got the light, and Jannie's got the tweezers ready to do some damage.  By now, I'm pretty convinced that I've killed the maggot cause it's been in the same position and location for the whole afternoon and Chelsia doesn't scream anymore when you put in the water.  Probably drowned the little stinker....So Jannie tries to scoop it out and gets a piece of it.  Hooray!  I grab a piece of tissue and she puts it on there and starts to go back for the rest of it.....When I notice.....it's NOT a maggot after all....but it is CERTAINLY NOT normal to have in your ear.....it's paper.  Tiny pieces of wad up paper.  We spend 5 minutes extracting lots and lots of paper from her ear.  She still has some in there too.  Then I started her on antibiotics, gave her a big hug and explained that paper does NOT go in your ear EITHER!  Perhaps I should have been more specific last time.

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