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Adenenotonsillectomy: Pros, Cons Please (sleep apnea)


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My 13yo has moderate to severe sleep apnea. The doctor said he was surprised because she only weighs 84 pounds. He said she had a deviated septum and I'm not surprised. When she was a toddler, she tripped and fell on a low, brick retaining wall right on the bridge of her nose. Thinking back to the bruising and swelling, it's possible she fractured it, causing it to grow crooked. The ENT wants to do a Adenenotonsillectomy, but I'm not convinced it's necessary. He said her adenoids aren't terribly enlarged, so it may help and it may not. Is it worth giving it a shot, or are there some cons I should know about that would outweigh the possible benefits? He said he doesn't do surgery on a deviated septum until the growth plate is completely fused, because you otherwise risk changing the shape of the face. I feel like we need to do *something* because she is injuring herself when she's sleeping. There just isn't anything clear cut about the decision.

 

Any experience or advice?

 

Barb

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Speaking as one who had her tonsils out at 18 - the longer you wait the worse the recovery is. But....I would get a second opinion, if you haven't already. We talked to 3 different doctors before I had mine removed and that was a million years ago.

 

That being said - having my tonsils removed made a huge difference in my overall health. It was definitely worth it!

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I had my tonsils out when I was 6. My sister had hers out at the same time; she was 3. In both of our cases, the reason for the surgery was chronic recurrent tonsillitis. Our ped didn't think we should have them out; she kept telling my parents that the tonsils were an important part of the immune system. (When they keep getting infected? Every several weeks? And how exactly was all of that penicillin--nasty stuff btw :tongue_smilie:--supposed to help our health? :glare:) Anyway, my parents finally took us to an ENT who said that our tonsils were shot and needed to go. I had a raw throat for a week or two, but other than that, no complications. So, even though my surgery was for a different reason, it was overall a positive experience.

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Removing tonsils and adenoids helped my kids here. The oldest age we did it was about 10. If you do it, KEEP UP with the pain meds---meaning give them on schedule AROUND the clock (yes, set the alarm for the middle of the night) as staying ahead of the pain really helps the healing. Less pain means they drink more. The more they drink the faster they heal.

 

Is she a candidate for a c-pap or bi-pap machine?

 

I would get a 2nd opinion but the surgery is not terrible.

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Both of my older kids had their tonsils out for sleep apnea. My son's was severe (he used to sleep with his head cocked all the way back at a 90 degree angle to his back, with his mouth wide open, and he'd make the most horrific sounds when his throat opened and shut. He also suffered with chronic unknown infections, and had been on several extended courses of super strong antibiotics. His surgery was an easy decision.

 

I had them both with me when I took ds to the ENT. The dr asked if dd had problems breathing at night. I told her that she snored, and the ENT took a look at her throat. Then, she recommended that they both have the surgery.

 

Both surgeries were the same morning. Dd was 6, and ds was almost 5. Both recoveries took exactly 14 days. It was a horrible 14 days for both of them, but they had different pain symptoms. Ds could eat anything, even tortilla chips. But, at night, he'd cry in pain. Dd slept fine, but couldn't have anything acidic. I gave her a juice box one day, and she let out this super high pitched squeal that went on and on. She couldn't even cry! It was heart breaking. Neither of them wanted to take the liquid Tylenol w/codeine for pain because it tastes so nasty. So, we just survived through it.

 

Two weeks to the day, though, they were fully recovered. I've never been sorry we did it. Ds's infections didn't come back, and he started sleeping well. He even started eating better and put on a little weight. Dd still has seasonal and cat allergies, but doesn't normally snore anymore. It's been 7 years now. No apnea at all, with either of them.

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It was touch and go there, for a while, when I had mono at 19. I kept getting infections.

 

I have a friend who is certain that removal of his tonsils is what started him on the allergy path. I don't know about that, but I am haunted by the fear that they are actually good for something after all.

 

So when DD's ENT wanted to remove both her tonsils and her adenoids and put tubes through her eardrums when she was 4, I objected. She had started to get clogged ear tubes every time she was congested or caught a cold, but she had not gotten these when she was younger, like many kids do, so her language acquisition was pretty much complete. I thought that if I got the help of a good allergist to control her congestion she might be able to outgrow this with her little throat intact. And that is exactly how it worked out.

 

BTW, the way I control tonsillitus is to suck zinc tablets under my tongue about every 1 1/2 hours when I am coming down with a cold that starts in the throat. This has worked really well, except for when I actually had strep throat.

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Thank you so much for sharing your experiences. I had no idea the recovery period would be so long or so painful. We were thinking 4-5 days should be enough time. This is my only one in school so we'll have to take that into consideration as well.

 

I'll forward this thread to my husband to read through. Thanks again, all. Very helpful.

 

Barb

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Removing tonsils and adenoids helped my kids here. The oldest age we did it was about 10. If you do it, KEEP UP with the pain meds---meaning give them on schedule AROUND the clock (yes, set the alarm for the middle of the night) as staying ahead of the pain really helps the healing. Less pain means they drink more. The more they drink the faster they heal.

 

Is she a candidate for a c-pap or bi-pap machine?

 

I would get a 2nd opinion but the surgery is not terrible.

 

Excellent advice, thank you. I think I would try the surgery before a cpap machine after reading this article: http://www.sleepapnea.org/resources/pubs/children-osa.html

 

I was encouraged to read that size of tonsils and adenoids isn't related to severity of OSA. So that answers my question as to why he would do the procedure if her throat didn't look all that bad. The doc works at the hospital where my husband is CFO. He said his numbers are really good, meaning he isn't the type to do unnecessary procedures to pad his bottom line. So that makes me feel good too.

 

Barb

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Not all recoveries are that bad. My daughter had hers done and wanted real FOOD the same day. I kept up with the pain meds and she only had a minor blip of pain several days later when the scabs came off. She was playing normally, eating, drinking, etc. All kids are different.

 

Thank you so much for sharing your experiences. I had no idea the recovery period would be so long or so painful.
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