Posted by: Ticktock | February 3, 2009

Tonsils!

My four year old, Sasha, went to the E.N.T. today to have her throat examined.  The doctor exclaimed that her tonsils were “as big as they get”.   She’ll be better off once they’re gone, even though their removal will diminish her immune system.  Here’s a blurry photo…

picture-038

I was a little surprised that the nurse gave her a prescription for antibiotics to be started three days before the surgery.  I asked her about this policy because it seemed odd to me.  Should I expect a problem with infections and bacteria?  No, that’s never a problem, according to the nurse.  The only reason it’s prescribed is because a study showed that antibiotics lessened the pain after the surgery.   I have no idea why this would be, but I’m planning to look this up and make sure it was a blinded study that controlled for placebo.  Or is that the point, I wonder?  [update:  I questioned another nurse on the phone about the prescription, and she claimed that the antibiotics were a preventative measure in case my daughter contracted strep in the days before surgery.]

On our way back home from the hospital, I explained to Sasha that she had flaps in the back of her throat near where she swallows, and that they are blocking her air tube.  I told her that the doctor would put her to sleep with a mask and cut it out, so that she can be better.  Amazingly, she seemed totally cool with this procedure (as long as there are no needles).

In other news…

I wanted to update a previous post about my 1.5 year old daughter, Juliet.  The doctors sent her through a series of tests to see why she was “failing to thrive”, and just as I had predicted, they have yet to find anything wrong with her.

So, why did I proceed with all the testing if I was so sure she was healthy?  Because I trust my doctors.  They were absolutely correct that she could have had cystic fibrosis or celiac disease, for which she ultimately tested negative.

Our pediatrician has given us a break from the testing – we will wait until her two year appointment and check her progress then.   She may very well have some kind of problem, but as long as she is prancing around the house being cute, we’ll chill on the tests.  That’s what I thought we should’ve done in the first place!

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Responses

  1. Poor Sasha! Tonsilitis is some of the worst pain there is. My understanding regarding the antibiotics prior to surgery is that if there is any inflammation at the time of surgery, there will be more bleeding and recovery time will be longer/more painful. So the antibiotics are to ensure that nothing is growing in there causing inflammation.

  2. Thanks for your reply. That’s really helpful to know.

  3. Hmm. Those antibiotics seem interesting. I found a cochrane review regarding the subject. Their opinion on the subject was

    “The present review suggests that there is little or no evidence that antibiotics reduce themain morbid outcomes following tonsillectomy(i.e. pain, the need for analgesia or secondary haemorrhage rates). They do however appear to reduce fever. Some important methodological shortcomings exist in the included trials which are likely to have produced bias favouring antibiotics. We therefore advocate
    caution when prescribing antibiotics routinely to all patients undergoing tonsillectomy. Whether a subgroup of patients who mightbenefit from selective administration of antibiotics exists is unknown and needs to be explored in future trials.”

    Link to the PDF:
    http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD005607/pdf_fs.html

    The only thing would be that if you decide not to use them, make sure they still give IV perioperative antibiotics on the day of surgery- I don’t see why they wouldn’t but if they assumed she already had an Rx for abx then they might not give them IV that day.

  4. We experienced the same thing with our daughter. All tests came back negative – that is, until she was tested for growth hormone deficiency. Because early identification and treatment give the best results, I’d advise scheduling a consult with a pediatric endocrinologist, regardless of what your general pediatrician says. It’s been my experience that very few general pediatricians have the time or inclination to keep up with the emerging science on endocrine issues. With GHD, it also can be a very long battle with an insurance company, so that’s one more reason to begin early. My daughter, although previously diagnosed and treated, went for months w/o her medication because my husband’s employer changed providers. magicfoundation.org is a good start for information. Good Luck.

  5. […] Tour for My Toddler & Post-Op Pain My daughter Sasha finally had her enourmous tonsils removed yesterday, and she handled it like a champ.  She is the type of girl that will have a […]


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