T&A and my 3yo

[Rhon1991]

My 20mo and 3yo had T & A's on the same day. It was either that or have them done 2weeks apart. Anyway, my 3yo took 2 HOURs to recover whereas my 20mo took the usual 30min. What are the usual reasons for the 2 hour recovery? It really bothers me being the family member as I feel we dont get the 100% truth, whereas we would if we were the nurse recovering the pt.

Then, during the night and the next day her 02 sats would drop to 83-86% while asleep. When awake, 93-95%. Her pre-op sat was 99. Come to find out by cxr, she had LLL airway disease-collapse vs pneumonia. She had a cold preop. Im not trying to assign blame, just trying to understand what happened, but could a most likely reason be that she had R bronchus intubation during the 30min procedure that caused that? When I see the surgeon on their follow-up appt I am going to jokingly tell him she should have had a CRNA do her anesthesia... (its been my pet peeve here in Columbus, it seems 'very MDA' land here and CRNAs are not acknowledged as there were in Virginia, IMO.)

They are fine now. In fact, I didnt even know the cxr results until we were home and I called the resident to check it and he put her on a stronger abx. She seemed to really turn around after I had her in the shower with me, some chest PT, ect.

Ironically, she could have done this out pt surgery. 20 mo old needed the hosp stay over 1 night, so we did both that way. I have a feeling she would have done better had she done it out pt surgery as my 8yo did in Oct. Just a feeling. But Im just glad they are fine now.

Any opinions why she needed 2hr recovery and got the LLL airway dz? (Ive never heard it called 'airway disease'-is it the same as infiltrate?) Just trying to understand here....

[kae rn]

Hope both of your children are doing well. I was an Ent nurse for many years. Age and recovery time just don't always seem to match up. My guess is the cold preop could have affected the recovery time. Any child with pneumonia within the last 6 weeks we would always recommend that they come back later. Also every child's airway is a little different. Even though the parents are the same, the airways can be different. Did the older child also have sleep apnea? If I were you, I wouldn't worry about what might have gone wrong. Just count your blessing that you have healthy children. Give them lots of fluids, and pain control. Also beware that around 7-10 days those scabs are going to fall off and you will see an increase in pain. After that you are hopefully cured of strept, ear infections, sleep apnea....

[Rhon1991]

Originally posted by kae rn

Did the older child also have sleep apnea?

yes, they both did. when her o2 sats dropped her RR didnt increase, she was breathing just as she did at home...

Originally posted by kae rn

Also beware that around 7-10 days those scabs are going to fall off and you will see an increase in pain.

Yesterday was POD 10 and she was still requiring the Lortab for pain and there was never really a slump time for the pain as it was for my 8yo. (Day 3-6) Isnt 10 days too long to be taking Lortab almost q 4-6 hours? If I gave Tylenol, 2 hours later she would just cry and cry and not take in any fluids... she seems better this morning though, but dont know if husband gave her med during the night yet. I will be calling dr Mon if she is still having alot of pain.

Thanks, kae.

[imenid37]

My 11 yr. old goes in on Thurs. 2/12 to have her T&A. I am a little nervous too. She was supposed to go in November, but had a fever and "mild" cold which turned out to be pneumonia, so the surgery was cancelled. Thanks so much for the info. I don't remember much from when I had mine out. (It was 1972.) She is going to a surgi-centre and having it done outpt.

[kyti]

I work in PACU and recover lots of children after t&a. Recovery times very alot based on Dr and pain level and cooperation of child. Some children are awake when they arrive, require little pain med and take fluids willingly. Other are still asleep when they arrive and require time to wake up first and I alway keep for a min 20 after the last dose of pain med given ( which is titrated q 5-10 min) so if they require lots of pain med this takes a lot longer. Maybe the cold affected her sats never had this problem and I have recover lots of kids. By the way, were you allowed in the recovery room? I alway let parents come in one at a time and comfort their child.

[Rhon1991]

Originally posted by kyti

I By the way, were you allowed in the recovery room? I alway let parents come in one at a time and comfort their child.

Not at children's hosp- I was told to wait in her room... when my 8yo had it done out pt surg, of course I was able to come in once she was more awake. Maybe at children's it was because I had two children and had to be upstairs in his room for when he got back and it was just easier for everyone if I waited there for her as well?

I certainly can see where Surgery Centers are becoming more popular. It seems more efficient in every way. I will always go that route, given the choice. Plus I think the teams are used to working with each other thus increases quality of care and efficiency. I just had many minor issues with the whole hosp experience. Now I know what its like being on the parent side. I would always rather be on the nurse side!