Ok so here's the kinda crazy part. I'm a sideshow and fire performer. I've suffered large burns, I can drill into my sinus cavity, I had my tongue surgically split, I staple myself with an upholstery stapler all the time.
I do it with icepicks, nails, and even power drills. I can also mental floss, in which a tube goes in the nose and out the mouth, though I'm still new to that one. Power drills are very uncomfortable and have caused the most nosebleeds.