Tonsillectomy preop teaching for kids

LydiaGreen · Dec 19, 2003

Great question. I will be watching for the responses that you get. I too have a six year old with chronic obstructive sleep apnea due to enlarged adenoids.

My family physician has been advising against surgery for four years, saying that it should be a last resort even though I have letters from two teachers (one is a reading recovery teacher - special education) saying that she has trouble concentrating, is tired and distracted, can sometimes be overly sensitive, etc. She needs twelve hours of sleep to have a good day that lasts until she's home and then she's exhausted.

Had to take her to a different doc in the same clinic in September for tonsilitis/adenoiditis/strep throat. This doc went off on me about how terrible it is for a child to be tired all of the time. I told her what my doc has been telling me for years but she still made me feel like I beat my daughter. Saw the family physician when he returned and told him what the other doc said. THEN he tells me that he's against it because he had a T&A when he was kid and developed a post-op hemorrhage after d/c - he had to be readmitted and received two bags of blood. (Let's remember that this was forty years ago.) So his experience is prejudicing the decision that I make for my child? I don't think so. I got him to refer us to the EENT who will be here at the end of January (only comes once or twice a year). I'll present him with the evidence of the teachers, myself, my husband, my daughter, the opinions of the two GP's who have seen her and then ask for HIS advice before I make a decision. At this point though, I am thinking that it would be in her best interest to have the surgery.

Sarah, RNBScN · Dec 19, 2003

Post this in the OR forum, I am sure some can advise you re: procedural stand point. Peds forum for health teaching.

From what I saw in the OR, you don't have to say "cut" think of it as peeling tonisl away from the side. Sometimes too much info...the child might conjure different thoughts from what you are explaining.

Hope this helps.

sunnybrook83 · Dec 26, 2003

Thanks for the suggestion for posting in op area. I know the procedure, I'm just not used to explaining things using words that won't scare a kid to death. He has his ENT appt next Friday, so if I don't get any input here, I'll ask for some at the office. Thanks all.

GR8RN2B · Dec 30, 2003

When my son was almost 6 we had his T & A done.

Best thing we ever did. The poor kid couldnt sleep and snored like a freight train. My only regret was that we hadnt done it sooner.

When his ENT told him he was going to take them out, my son asked how...the doc said he was going to go scoop them out.

He looked at the doc for a sec...then said ok.

Of course this was after he was told he could have lots of pop sicles (non red of course).

24 hours after he snuck outside and was racing up and down the street on his bike..gave me heart failure...

:eek:

sunnybrook83 · Dec 31, 2003

Kids, gotta love em. If that had been an adult, they wouldn't have ridden a bike for weeks (myself included).

Rhon1991 · Feb 9, 2004

Just curious... my 3yo was having sleep apnea d/t enlarged tonsils so she had the T&A 12 days ago.

Those of you who had children like this, did they have low O2 sats post op? Also, prior to surgery and even still she complains alot of always being cold, no matter how much clothing we have on her! Does your child c/o of being cold all the time?

Im just wondering about the long term effects of sleep apnea and how long that will resolve itself.

She still c/o's of her throat hurting and she required the Lortab the full 10 days because anytime I tried to give Tylenol day 3-6 she would be crying an hour later for 2 hours straight and not take anything in! So for the last 2 days Ive been giving the Tylenol just once in the am and once pm and she seems better. But now shes constipated! so now its that we are working on.

Just curious about the 'cold' thing and low O2 sats post op... BTW, when they would drop 83-86% she was still having the apnea but although she would pick back up, her RR never compensated for the low O2. She was breathing her regular, comfortable-looking rate! So does that mean she has probably been having low sats at home for a while?