When the doctors recommended that my 2.5 year old son have his tonsils and adenoids removed and grommets put in, I was relieved that his speech delay and hearing issues would be resolved but equally apprehensive about surgery for my sweet, little boy.
At 18 months of age, we become worried by our son’s speech delay. The tone and quality of his voice was concerning. He sounded like he had a mouthful of marbles and was very difficult to understand. He was an enthusiastic snorer, a restless sleeper and a very picky eater who would frequently gag on food. I wasn’t concerned about his hearing at all as he was able to follow instructions. He’d had no more than two or three episodes of tonsillitis and ear infections in his life. At GP appointments, our doctor would comment on the size of his tonsils but we assumed that was because he was sick – which is why you take a kid to the doctor in the first place!
My son and his twin sister were part of a medical study which included a physical and developmental review at the age of 2. At this assessment, the doctors noted his language delay and suggested a referral to a speech therapist and pediatrician. They also referred us for a hearing test which to our surprise, showed that my son had moderate hearing loss caused by fluid in his middle ear.
Fast forward a few months through speech therapy, pediatrician and ENT appointments and we had a diagnosis of “kissing” tonsils (when the tonsils are enlarged and touch at back of the throat), obstructive sleep apnoea (from enlarged adenoids which causes snoring and restless sleeping) and fluid build-up in the inner ear causing hearing loss.
In late August, the day of our surgery arrived and despite a few requests that “we go home now” my son was fairly calm during all the pre-surgery exams and the different waiting rooms. We spent a few days beforehand preparing him – talking about the doctors with their stethoscopes who would fix his sore throat and practicing breathing into a mask just like Luke Skywalker does when he flies space ships.
The actual surgery only took 45 minutes and I was able to go into recovery while he was waking up. Coming out of the anesthetic was distressing due to emergence delirium – a not uncommon reaction to anesthetic in little kids where they get very upset, do not recognize familiar people and thrash around. This lasted for around 45 minutes until we were back on the ward where he lay down in the bed with me and promptly fell into a deep sleep for 3 hours.
We stayed overnight in hospital and he was able to eat and drink normally almost straight away. We were sent home on a cocktail of pain medication and antibiotics that had to be administered every 4 hours for a week and then only paracetomol 4 hourly for the second week.
I’m not going to lie; the first week was really tough. It was like having a large, newborn that was in terrible pain. During the day my son was quiet with moments of being his usual self. Often he just wanted me to sit with him or hold him. Overnight, he would wake every 2 to 3 hours in terrible pain so we took turns co-sleeping to give whichever pain medication was due and sips of water and then try to soothe him back to sleep. The pain got worse around day 5 until day 7 when he was refusing most food and we had to convince him to drink and swallow his medication. By day 10 he was back to sleeping through the night and eating most things with only a few complaints of being sore. Overall, the tonsil part of the procedure caused the most pain and discomfort.
A month later, the improvement in his hearing, speech and sleeping has been astounding. He now hears “birdies and planes” and is genuinely delighted by all these new sounds. We are often told we are being too loud! His words are much clearer but it will take a little longer for his brain to convert all the new sounds to correct sounding words. We will follow up with our speech therapy in a month or two. Previously, I had a very picky eater who would eat very little and then only foods that were easy to chew and swallow. Now he eats anything and everything. When he sleeps, he is so quiet and still that I often check he is still breathing. He no longer has obstructive sleep apnoea, and doesn’t need as much sleep as before – the only down side has been the end of my favourite time of the day – naptime!
My hot tips for any parents or carers are to plan to be homebound and sleep deprived for 7 to 10 days following the surgery. If you have other children, try and get as much help from family and friends as possible. Make sure you follow the pain management plan to the letter and schedule pain relief 30 minutes before a meal or snack so that eating isn’t too painful. Using a small treat every time they take their medication worked well for us – over the 14 days that equated to dozens and dozens of chocolate drops but was worth it for a cooperative patient. Prepare your child so that having doctors examine them or having an anesthetic gas mask cover their face isn’t too distressing.
At the end of all this, I’m glad my son had this surgery, especially at a relatively young age. Although it was challenging at the time, those rough times only last for a week or so and the benefits will last his entire life.