If you are like me, the thought of your child going through any sort of medical procedure outside of normal well-checks may have you scared. That is how I felt when we found out our two-year-old daughter needed to have her adenoids and tonsils out. Even though I realize how routine and common this is, truth be told, I was a wreck. I was nervous about leaving our daughter and her going under anesthesia. I am writing this to hopefully ease your mind a bit and let you know all of this is manageable. We learned some tricks to manage care, which I know I would have benefited from had I known pre-surgery.
What are the symptoms?
How exactly do you know? After talking to other parents who have gone through this, the overwhelming response was that their child had frequent bouts of strep throat and/or ear infections. Their pediatrician gave them a referral to an ear, nose, and throat doctor. That was not our case. Our daughter has always been a loud sleeper. You have always been able to hear her breathing while sleeping. More recently, that turned into snoring. We never thought much of it. We had also realized that she was an audible breather. You could hear her breathing. She never had problems breathing, it was just audible. We always assumed that was just her. It wasn’t until our neighbor, who is a nurse, pointed it out to us and said that she could be having adenoid issues. She recommended having her seen by an ENT (ear, nose, and throat doctor).
After getting the referral from our pediatrician, we made an appointment with an ENT. Prior to her going in, I took a video of what she sounded like when she was sleeping so they could hear her snoring. When we went to the doctor, he listened to the video and commented that it sounded more like her tonsils than her adenoids. Upon looking in her mouth, he noticed that her tonsils were very large. He immediately recommended surgery to remove them and her adenoids.
How does the surgery work?
When discussing his recommendation for needing surgery, our ENT doctor informed us that the surgery is an outpatient procedure. The fact that it was outpatient eased our minds a bit right there. Of course with any outpatient procedure, that time could be increased if things do not go as planned. That is very rare, but could happen. With a tonsillectomy and/or adenoidectomy, the patient is put under general anesthesia. Because of the anesthesia, the patient is not allowed to eat or drink 12 hours before the procedure. In our case, our daughter’s surgery was at 8 a.m., so she was not allowed to eat or drink after 8 p.m. the night before surgery. They require you to be at the hospital a little over an hour early to prep the patient and to allow time for parents to meet with the ENT doctor and anesthesiologist.
With kids, they try to make it fun to go back to the OR. They wheeled our daughter back in a little car. We appreciated this because it did not seem scary for her and with her smiles, it made it easier on us.
After they take the patient back, they use a mask to put them to sleep. Then they start an iv of fluids. The patient is also given pain medication. After the patient is ready, the doctor will go in and remove the tonsils and or adenoids. Once they are removed, they cauterize the incision spots to stop the bleeding. The actual procedure is actually quite fast. The surgery itself does not last more than about 20 minutes or half an hour.
What to expect after surgery
This is the part that we were not prepared for. They say everyone comes out of anesthesia differently. A lot of times with little kids, there will be crying after coming out of anesthesia. Our daughter was groggy, confused, and disoriented. When they brought her back to us, she was crying like I had never seen her cry before. It was not because she was in pain, it was because she was having the aforementioned reactions. They brought her to us and had me sit in the chair as they laid her in my lap. We sent our two year old back happy and she came out sad and disoriented. Talk about breaking your heart. We know this was a symptom of the anesthesia, but it was heart-wrenching for us. We just did what we could to console and soothe her.
Eventually she fell asleep and that seemed to help things. She did wake up a few times with the tears again, but quickly fell back asleep. Once she was awake for good, she was much more herself. (Thank God!) She was given pain medicine and offered popsicles. After the pain medicine kicked in, she was our little girl that we know and love. The rest of the time in the hospital was spent finishing up receiving her iv bag of fluids. Once she had her fluids, we were able to go home with specific instructions for recovery.
In addition to pain management and crying, we also noticed our daughter’s voice changed. It was more high pitched. We learned that is normal and that is expected to go back to normal after a week or two
Recovery at Home
We were sent home with very specific instructions as to what she could eat, drink, take for pain, etc. We were told she would probably do a lot of sleeping like kids do when they are sick. The important thing they stress is to push fluids. This is important to prevent dehydration and to keep the mouth and throat wet to prevent the scabs from coming off pre-maturely. They also recommend around the clock pain management for at least the first 48 hours.
You are sent home with an oral antibiotic for the incision site. They also recommend pain medicine to stay ahead of the pain. The pain medicines they recommend are Motrin (Ibuprofen) and Tylenol (Acetaminophen). Some doctors do not prescribe or recommend Ibuprofen because it thins the blood. However, it is also an anti-inflammatory which helps with pain. Obviously use whichever method your doctor recommends. It helps to chart when you give pain meds and so you know which medicine is coming up next .
For the first 48 hours they recommend around the clock pain management, which means getting up during the night to administer meds. Honestly, it feels like you have a newborn again with getting up every three hours.
Food and Drink
For the first week, only soft foods are allowed. Here are some essentials that we found very helpful in our process.
Canned peaches and pears
Macaroni and cheese
Apple juice or clear fruit juice- (avoid citrus juices as that can cause pain in the back of the throat).
The important thing we learned is that hydration is the most important concept here. For the first few days, eating was hard. The key was to keep our daughter hydrated to help with healing and to avoid having to go to the hospital for fluids. Sucking is not recommended, from a straw or otherwise. Our daughter did not want to drink from a cup so we found that using a syringe from medicine gave her the best results. We were able to measure the amount of liquid she was getting that way as well.
To aid with hydration, it is also a good idea to keep a cool mist humidifier by the child’s bedside. This will aide in keeping the throat moist, especially if they are breathing through their mouth.
As I read over this, it sounds very daunting. What I can tell you is that everyone I have talked to said their child was so much better off after having this done. It is extremely hard to see your child in pain no matter what the procedure is. However, like anything else time heals and your child will be better off because of this procedure.