Is there a Dr. in the house? 2 yr old needs tonsillectomy.

[somethingshiny]

Any info anyone can provide would be so much appreciated!

Here''s the background. My son (almost 2 1/2) has had 6 cases of tonsilitis since February. Our general dr referred him to an ENT. That ENT put him on Augmentin and said he wanted to wait to do a tonsillectomy to see if he would grow out of it. It was also noted that on a scale of 1-4 (4 the most severe), JT''s tonsils are a 3 when he''s healthy.

Yesterday, day 4 of the Augmentin, JT started running a high fever. It has continued today and the spots in his throat and the roof of his mouth have developed. So, we have an appointment with our general dr this afternoon. We intend on getting a referral to a Children''s Hospital with a Pediatric Otolaryngologist.

This is the 7th case of tonsillitis in less than 5 months. My son has sleep apnea so badly that he stops breathing for between 15-20 seconds every few minutes. According to all the info I have found, he qualifies as a severe case and should have a tonsillectomy as treatment. What do I have to do or say so that he can get the tonsillectomy/adenoidectomy that he needs???


disclaimer: Any medical advice is non-binding and strictly to be used as an opinion.


Thank you for any help you can offer.

 

[brazen_irish_hussy]

I would stress the sleep apnea. Doctors try hard not to operate when there are infections or enlarged tonsils as that tends to improve with age. However, the apnea is a big deal and that should prompt them to act. It is a strange question, but is there a family history of ADHD? Sleep apnea tends to worsen learning problems and ADHD, so indicating your son is already at a higher risk, if he is, might move things along.

 

[somethingshiny]

Thanks, BIH. There isn''t a history of ADHD, but I''ve seen the info regarding sleep apnea causing it. That''s really the last thing I need on top of being sick every 3 weeks.

We just got back from our appt with our general dr. and he immediately gave me a referral to the Children''s Hospital and the pediatric specialist. Don''t know yet when we''ll get in, hopefully soon.

According to our gen dr., the reason most dr''s don''t want to do a tonsillectomy this young is because of possible post-op complications. Does anyone know what those may be??

 

[drk]

You can get postop complications no matter what the age. I think the worst one with tonsils is the risk of bleeding starting up after the kid''s awake and recovering, because the bleeding could possibly be severe, and could interfere with breathing and with intubation for the surgical fix. It''s still a pretty rare complication though, as the surgeons are aware of how serious it could be, and are really careful to make sure they do all they can to prevent it. I don''t think there are too many other big postop complications.

Two-year-olds are pretty hardy, and given the fact that the sleep apnea is so bad, and has these terrible recurrent infections, I''d guess the risks of doing this at age 2 would be greatly outweighted by the benefits of getting rid of the pesky tonsils and adenoids. You may have a little more trouble keeping the IV in a 2-year-old, but they''d probably tape and wrap the heck out of it so that it''s still there in case any emergency were to develop.

I''m no ENT surgeon, but I hope this helps a little.
Kate

 

[somethingshiny]

Kate~ Thank you so much. You don''t know how much you''ve eased my mind. Just "hearing" someone else say it appears the tonsillectomy is necessary really helps. And, the bleeding doesn''t sound like it would be a big deterant for us. The other factor I''ve found is the risk for dehydration, but when the kid is sick all the time, he has a pretty high risk for dehydration anyway.

 

[amy_dub]

This may not be the response you''re looking for, but have you considered going to a chiropractor first? I know, I know, I hear constantly "Chiropractors are quacks." I worked for two years as an assistant to a chiropractor and I must say i''ve seen some pretty amazing transformations.

We had a child come in that had horrible ear infections. He either had tubes in his ears or was getting tubes put in, or maybe he was one his second set, I don''t remember (we had a lot of cases of children was chronic ear, nose and throat conditions). Nonetheless, the child was miserable and nothing seemed to be working. Within a month of beginning chiropractic treatment, the child no longer had ear infections. He no longer needed the tubes in his ears. His ear, nose & throat doctor was shocked that a few minor spinal adjustments could do so much. I would have been skeptical myself if I hadn''t witnesses the change in the child''s condition with my own eyes. It was like a new child was coming through the door.

When I moved to TN, i developed pollen allergies. I couldn''t breath and was constantly battling sinus headaches. Allegra 180 helped me a lot, but i hated the medicine because it made me hungry all the time. I started getting adjusted about every two weeks and i stopped my medicine. I haven''t been on it since and that was 4 years ago.

Just something to consider...

 

[somethingshiny]

Amy~ thanks for the suggestion. I''ve used a chiropractor for migraine management (although it''s been quite awhile) and it didn''t cross my mind for JT. I''ll look into it and see what I think after some investigating. Thanks again.

 

[ladypirate]

Don''t have any advice, but just wanted to send some *hugs* your little boy''s way. I don''t know why it''s so hard to get a tonsillectomy these days--I had my tonsils and my adnoids out when I was a kid and my sisters had their tonsils out as well!

 

[somethingshiny]

Thanks, LP.

JT''s finally feeling better this round, and we have a backup RX just in case it comes right back. Poor little guy finally ate something today. Everytime he gets it, he loses weight. He weighed 28 lbs at 1 yr old. ( I know, he was a chunk! lol!) And, today, he only weighs 31 pounds. Recently, he was down to 25 lbs. He''s not skinny for his age, but it''s still a lot of weight for a little guy to lose.

Our appt with the pediatric specialist is in mid-August. I wish it was sooner, but there''s not much I can do about it, so why stress?

 

[LaraOnline]

My friend had a little girl that had enlarged tonsils (not recurrent infections)
Apparently enlarged tonsils are somehow related to hearing problems (!!!???)

Anyway, she also had chronic sleep apnea from the breathing difficulties related to the enlarged tonsils, it took an absolute age for them to diagnose the problem. Her mother''s concerns were discounted for an absolute age.
Eventually, someone picked up the problem.

The little girl''s lack of sleep led to some term growth / weight gain problems (not to mention the sleep deprivation to her mother!), and her hearing problems led to speech problems / delayed speech.

The doctors would not operate on her until she reached 15kg in weight (in Australia), basically because they were worried about blood loss below that weight. Her mother was frantic, as you can imagine, but the story has a happy ending.

This beautiful little girl finally had her tonsils removed, and immediately began rapid improvements. She is fine weight wise and is catching up with her classmates in speech.

Anyway, keep your strength up (hugs)

 

[Dandi]

We do quite a few tonsillectomies on kids under age 3 at work. With kids they are typically distressed on waking, but that''s usually the case regardless of the surgery they''ve had, it''s the fact that they''re in a strange place with strange people. We usually keep kids in recovery for half an hour to an hour depending if they are complaining of a sore throat or not (some tonsillectomy kids are used to a sore throat anyway!). Quite often all they need is mum and dad''s hugs and a cold drink or some icecream to soothe their little throats. Blood loss is rarely a problem for us in recovery because the surgeons will sit and watch the child''s throats and post-nasal space for signs of bleeding whilst still in the theatre, so it is nipped in the bud quickly. I agree with you that the little tyke would be much better with the little suckers out!

I feel for you and your little fella, please keep us updated as to how this all pans out!

 

[somethingshiny]

Thanks, Lara. JT does have some speech delay that the dr has attributed to a rash of ear infections following tonsillitis. It''s not that bad, but we don''t want him to become more delayed over the next months or years. I''m glad to hear your story of the little and that she''s doing well.

DA, Thanks for the added info on the surgery and post-op. I''m glad so many of you agree with me that the tonsils need to come out. This ENT that we were seeing was beginning to make me feel like a twit.

 

[~*Snow*~]

somethingshiny:

Just from personal experience i''ll throw in my 2 cents.

I used to get tonsilitis about every month, it got to a point where the meds they prescribed would stop working. So i can relate, and understand your frustration.

- When your son does get a flare up have lots of gatoraide, or pediasure equvalent on hand, atleast he''ll still get the nutriants and vitamins.

- The rule of thumb ( atleast here in Canada) was that more then 5 times in a year qualified you to have the tonsils removed. After that you got refferend to a ENT specialist.

- Keep bringing the little guy to the doc, eventually they''ll get the hint that this is on going and not going away ( they told me the same thing, took them till i was 22 to have them removed, cronic infections since about 16)

They also might not want to do the surgery because it is really unconfortable afterwards... you are suppose to drink 2-3L of water a day, to keep your throat hydrated but it hurts to swallow, but if you don''t keep it hydraded you''ll get scabs and that hurts even more. It''s lose lose.

Also about 1 1/2- 2 weeks after surgery you tend to get a really upset stomac, since all the blood is leaking down into your stomac ( it''s normal) Then what happens is you throw us causing more pain and irritation to the area.. it really is a horrible cycle.

Over all the Surgery and Recovery was hard, and it sucked, and was the most unconfortable i''ve ever been, BUT I have been infection free for over 2 years now, it has been the best 2 years in a while.

So all that to say, Weight the nessesity of surgery, and if its really what you think he needs, make sure you push for it. The worst the doc can say is No.

~*S*~

 

[somethingshiny]

Thanks, Snow.

The rule of thumb here is 5 for 2 (meaning 5 sore throats each year for two consecutive years) or the 7/1 (meaning 7 sore throats in one year). Also, severe sleep apnea qualifies for removal. So, yes he qualifies, we just can''t seem to get someone to do it yet. His regular dr used to do tonsillectomies, but has given up his surgical license because he''s getting older. Hopefully this pediatric specialist will help us out.

I keep Gatorade/Pediasure/Pedialyte on hand, but JT just won''t drink it. Everytime he gets tonsillitis, he gets dehydrated. He probably should have gone to the hospital a couple times for it.

I am going to take him to the doc everytime he gets it. At least if it''s documented, I may have a better chance for getting someone to listen.

Thanks again!!