Rye flower lodged in man’s lung removed after month of pain

In early July, Bobby Witkop, 31, was doing yard work and chewing on a rye flower, when he accidentally inhaled it.

“I breathed in, and it shot into the back of my throat,” says Witkop, of Aberdeen. “I tried to cough it up, but it was so light, it wouldn’t come out. I was coughing so hard; I could feel it in my lung. I felt weak and knew something was wrong.”

Witkop went to a nearby urgent care, where he got an X-ray. Nothing showed up on the X-ray, and he was told he didn’t have anything to worry about, and that the flower went into his stomach.

Witkop working on his property with his wife Erin and mom Carrie

Three days later, he woke up in the middle of the night with chest pain and difficulty breathing. His wife Erin drove him to the closest emergency department.

“I wasn’t seen until 10 the next morning,” Witkop shares. “They did an X-ray, said I had pneumonia and put me on antibiotics.”

He started coughing up phlegm and some blood, but these symptoms went away after being on antibiotics for two weeks.

“I have broken my back mountain biking, and this was worse than that,” Witkop adds. “My wife couldn’t sleep in the same room with me for a week and a half because I was coughing all night while my body was trying to get this thing out.”

Symptoms worsen amid misdiagnosis

Airway foreign body aspiration can produce complete or partial airway obstruction, according to MultiCare pulmonologist Venkat Rajasurya, MD. It can lead to a number of complications, including bleeding, respiratory failure and post-obstructive pneumonia, and can be life-threatening if it causes central airway obstruction.

Witkop saw his primary care provider when he started coughing up blood again. His doctor said his symptoms were due to pneumonia and put him on another course of antibiotics.

“He told me he could put in a referral for a lung specialist, but that it would be a month before I’d be seen,” he says. “He said if my symptoms continued after taking the second round of antibiotics, I should go to Tacoma General Hospital and see a pulmonologist.”

His symptoms persisted — he was still coughing up blood. He went to his doctor’s office and spoke to a nurse who said the pneumonia should have cleared up by then.

“I couldn’t wait another month to see a local lung specialist, so I left that appointment and went straight to the Tacoma General ER,” Witkop says. “They did a CT scan and identified something in my lung.”

He was scheduled to see Dr. Rajasurya the next day.

Problem finally addressed

“Due to the urgency of the situation, I told my staff to add Mr. Witkop to my fully booked clinic so I could see him the very next day,” Dr. Rajasurya says. “When I met with him, his pain was so intense he could barely talk. I immediately knew his case required an advanced technique that is performed by Dr. Biswas.”

“Dr. Raj really listened to me and took me seriously,” Witkop says. “I told him how tired I was, and that I’m normally very active and more energetic — I surf, I bike, I hunt. He could tell how tough this was on me and said, ‘I’m going to get Dr. Biswas in here, and we’re going to try to do this procedure as soon as possible.’”

After living with pain and symptoms for a month, the source of his problem was finally being addressed. MultiCare interventional pulmonologist Abhishek Biswas, MD, prioritized Witkop’s case, and an emergency bronchoscopy to remove the rye flower was scheduled for the following day.

In the procedure, Dr. Biswas inserted a thin tube through Witkop’s trachea (windpipe), into his bronchi and down to the bottom of his lung. A large, two-inch stalk was lodged deep in his lung. Dr. Biswas took out the entire flower and stem as a single unit.

Flower extracted using delicate procedure

“Dr. Biswas said it would start to break off every time he tried to pull on it, but he was ultimately able to pull out the whole thing,” Witkop says. “All the seeds had decomposed, but the husk of the plant remained. I still have it.”

Dr. Biswas shared with Witkop it was one of the hardest procedures he’s ever done because it was so far down in the lung.

“This was a technically challenging case and needed real-time improvisation using our slimmest scope,” Dr. Biswas explains. “We injected saline, which acted as a lens so we could see that far into the lung tissue. I’ve removed foreign bodies like pieces of corn and metal objects, but never anything from this deep in the lungs.”

Witkop holds bag with rye flower extracted from his lung

If it hadn’t been removed, Witkop would likely have needed a surgical resection of his lung.

Dr. Rajasurya advises that when a foreign body is aspirated, it is crucial to seek immediate medical care and get a CT scan of the chest for confirmation.

“The longer someone waits, the more likely the foreign body can lodge into a distal small airway, which could be extremely difficult to retrieve, just as in Mr. Witkop’s case,” Dr. Rajasurya adds.

“It could have been really horrible for me had it not been removed,” Witkop says. “I don’t have pain or a cough anymore, and Dr. Raj said I’ll have no long-term impact. It was a life-changing procedure.”