It has been about 3 weeks since Abdullah (soon to be 9)’s tonsillectomy. Everything was basically straight forward so I decided to compile a quick list of how to prepare and what to expect. This is my second round of being the mother of a child getting a tonsillectomy and my third for a child having an operation (adenoidectomy) so I can share my experiences but as life likes to keep things interesting this is by no means and ‘ultimate guide’. If your child is about to have a tonsillectomy ask around and listen to other mothers advice as well.
Why a tonsillectomy?
Abdullah has always had difficulty breathing when he sleeps and he has a very obviously deviated septum. When he was 3 the ENT we saw removed his adenoids but said there was no need for a tonsillectomy. A couple of months ago we went to see another ENT as his breathing didn’t really improve that much. He confirmed the deviated septum, suspected there was a bit of adenoid left, and said his tonsils are huge and need to be removed.
His recommendatin for how we would move forward to make sure his breathing gets better:
step one is to remove the tonsils and see if there was any more adenoid to remove.
Step two is waiting 2 months at least and checking out his breathing then.
If it’s not better then we go to step three which is a sleep clinic to see exactly what’s happening when he sleeps.
Step four is fixing his deviated septum. The doctor would rather not have to do that till he’s 16.
What you need to know:
-A tonsillectomy is a day procedure. The actual operation takes about 45 minutes from when they take him in, to when they are finished.
-They will want your child to not have eaten for about 8 hours. So try and have the appointment be the first one early in the morning or the last one so they can have breakfast. We had his appointment at 8 am but he had slept at 8 pm so he had been fasting too long. I was told I should have woken him to eat at some point. I’m not sure I would have tho if I had to do it again. I hate waking kids up in the middle of the night.
-There are two methods used. Removing the tonsils by laser or by cutting them out. My doctor preferred the traditional way as there is less likelyhood of issues from scarring. My daughters doctor all those years ago preffered lased as it causes less pain and bleeding. Both times it made sense to me to go with what the doctor recommended.
Pre operation procedures:
-Blood test (and we all remember how that went). It’s usually done a few days before the operation so they have time to check the results.
-Visit with the anesthesiologist. Make sure to have all your questions ready.
-A great thing to do, which often we forget to do, is to involve the child when they are old enough in the appointments. (I would say around 4 years old and up)
You may think that’s a silly thing to say but often we speak for them, ask for them and talk over them when we take them to the doctors. I ask my children to think of any questions they have for the doctor before we visit. If they voice any concerns to me I make sure they are addressed and they hear and understand the answers to the questions.
-If your child has any expanders, braces or any metal in their mouth visit the dentist first. They broke Abdullah’s expanders during the operation which was painful and annoying for him after and we had to get a whole new one fitted and made (still waiting to put that in).
Also don’t be afraid to advocate for your child. Some doctors or nurses (as again we remember fr0m the blood test experience) just want to get things done and don’t bother with pain management or patience. I made sure that they would do all the IV and needle sticking after he has had the gas in the operating room. Different hospitals have different methods. In this hospital, they let me in the operating room with him! They gave me the gas mask and let me put it on him and hold it so he was looking at me when he went to la la land. That was above and beyond honestly!
When my daughter had her tonsils removed, they gave her something to drink which made her drowsy and then when she was totally relaxed they wheeled her into the operating room.
I was so grateful that the hospitals had these policies. Not sure if this is the common thing that happens.
What to take to the hospital:
-Extra clothing. Sometimes the anaesthesia could make them nauseous. So it’s good to have something extra in case they throw up.
-A pillow (because I hate hospital pillows)
-Some ice cream (yes that’s a real thing for tonsillectomies).
-An I pad if there is no TV in the room.
-A camera to record the post-op gems that come out of your child’s mouth which still out of it.
What to expect in the hour following the procedure:
Stay close to the recovery rooms because generally the operation is a quick one. When your child comes out they may have an oxygen mask, an IV in their hand which will be wrapped in a bandage to keep it in place, heart monitor sticker thingies (more medical terms) and an oxygen monitor on their finger.
They will be very, very high. We assumed, because Abdullah is very proper, that he would not be a happy high. We were in fact very wrong. Abdullah coming out of the daze was the best thing that I have seen this year.
Your child’s voice will be hoarse and their throat will begin to hurt.
They will keep them in the recovery room for about an hour or so to make sure they drink a bit and don’t thrown up. Then they will transfer you to a room.
Past hour 1:
Abdullah’s mood and his high both came down progressively has his pain went up.
The doctor wanted the following to happen:
that he drinks water then has juice then had jello then has ice cream. With 15 or 20 minutes in between.
We just went with him having whatever he wants. Which was water… then the ice cream arrived and it was ice cream.
He nodded on and off, watched TV, was quiet and a little sore. But he was eating ice cream and jello. Slowly at first and only a bite or two. But towards hour 3 he had finished a whole Ice cream and jello and was working on a mohallabeyah.
Around noon we got antsy and wanted to go home. The doctor was not meant to come see us till evening. So I went to the nurses desk and explained to them it would be so much easier for them if we just went home! One less patient to look after.
After visiting a couple of time and being extremely polite and smiley they managed to find the doctor who said he would come by.
At 2.30 he came to see us and said we could go home! Except during the operation, they had broken Abdullah’s expander so we left the room when we were discharged and camped out at the dentist’s clinic to see someone who could deal with the broken metal wire in his mouth.
What to expect the days following the procedure:
-The same Kind of pain your child would have with a throat infection.
-A slight (or noticeable depending) change in voice. My daughter sounded like Mini Mouse when she had hers removed at the age of 3.5. My son’s voice only softened a little. But there was a change.
-Lack of energy.
-There may be some blood form the nose or the mouth. Excessive blood means a visit to the emergency room.
-Make sure to feed your child only soft things for about a week after surgery. My daughter ate something that hurt her throat after surgery then she pointblank refused to eat anything.
-Do not skimp on the painkillers! We were using ibuprofen every 8 hours and paracetamol every 6 hours. I thought he didn’t need the night dose one night and he woke a few hours after crying.
-Try and time the painkiller for 20 minutes before meals. This makes eating easier.
-Do not give your child too much information! I did this, and it didn’t help. I mentioned in front of him about the extra change of clothes Incase he throws up. I didn’t need to add one more thing for him to worry about.
What Abdullah ate:
Breakfast: Eggs, Pancake, Porridge (warm no honey).
Lunch and dinner: Pasta, Eggs, Salmon, White fish, Mozzarella, Warm chicken noodle soup, Soft white bread sandwich with no crust.
Snack: Icelolly,Yogurt, Ice cream, Mozzarella,Jello, Banan.
Be careful not to give them anything too hot or acidic in any way.