Tuesday, January 23, 2018

Recovery Journal & Tips: Tonsillectomy, Adenoidectomy, Nose Cautery

My son Caleb is 11 years old and recently had all three procedures done in a out patient hospital this month. He is currently on day 15 of post operation healing. I have had a few people ask me about this surgery and if I would recommend it and any tips I can share. I figured what better place to share this wealth of information then here on my blog! It makes for a wonderful topic of discussion and insight.

Saying "Yes" to the surgery was scary in itself for me, I had known for years that my son was having trouble with sleeping at night. Not getting a full nights rest. Due to pausing in his breathing {sleep apnea} and due to snoring loudly (like a grown man). This is something that started at a very young age around 3 years of age I noticed. He had tubes put in at 1 year old, but was never suggested at that time to have his adenoids and tonsils removed. Caleb is always sick, more then a normal kid. This year alone we have missed so many days of school due to sickness. Common colds, flu and upper lung virus's.  Luckily he had never got tonsillitis and kept a pretty good record of no throat infections. It was everything else he experienced.

It's scary as a mom laying next to your young one and physically being able to see paused breathing during sleep, it's frightening. Countless times I would wake him up because the pause was a little to long. It was finally time, I took him in to a Ear Nose and Throat Dr. and in that appointment the Dr. looked him fully over and told me we should get the surgery done to remove his tonsils, adenoids and have his nose cauterized. Caleb was also getting a lot of nose bleeds over the years, so many that a few landed us in the ER because we couldn't get the bleed to stop.

I said yes, right there in the clinic. It was scheduled, so many times during that wait period I questioned my decision. I knew it would be hard for him and making that decision was a hard one. However one that I knew would benefit him in the long run, waiting till he was older to make his own decision was not a option. The older they get, the harder the recovery is. Only if I had done this years ago.

I kept track of Caleb's recovery day to day and made journal entries on Facebook for anyone else who maybe thinking of doing it for their child. You should know there are risks and be prepared for them before hand. I did a lot of research before going in and asked the Dr. the risks and benefits and went from there.

Day of Surgery:
Caleb fasted from 10 pm the prior night, so a empty tummy is required so patients don't throw up after anesthesia. The bring you into a room and have your child dress in their gown, change clothes and start a IV. Our nurse missed a vein or inserted it wrong and it was very painful for Caleb. It bruised over awful later on. I had to ask for a another nurse, one who knew what they were doing. Don't be afraid to ask right away for a nurse who is skilled in IV's. There was a lot of waiting...Hours of sitting there in the room, which makes it hard on the kid who is anxious already to get it done. They gave him a medicine through the IV to help relax him, which made him really goofy and loopy. Be prepared for that. When the time came, they wheeled him away down the hall in the hospital bed. I was not allowed to go back with him, when the child gets older they do not let you in the room when they go to sleep. Before in his previous surgeries I was always back there. It was all done in 40 minutes. Dr came out and told me that Caleb's tonsils were larger then he thought, which was confirmation for me that it was good we were getting them out.

After Surgery/Day 1:
Caleb did not have any negative reactions to the anesthesia, he did however kept saying he wanted to "Wake up" and that was repeated many times. He was out of it, slept some on the way home. He looked like a deer in headlights, very White and pasty. I honestly think day one was the hardest for us, coming out of the druggy feeling and feeling pain. The Dr. prescribed pain meds through the IV while there and then instructions to give Tylenol every 4 hours and Motrin every 6.
One of the biggest tips I can give you: Stay on top of the pain meds. Don't skip a dose. I administered around the clock and set alarms on my cell phone. This includes waking up at night 3-4 times to give him the meds. Second biggest tip I can give you, keep them hydrated. Have them take sips, don't take no for a answer remind them what happens if they don't. You have to keep the scabs and area moist and it will allow for correct healing. Caleb loved crushed blended fine ice and pedilite drinks.
We went through so much ice and liquids but its so worth it. Caleb did not eat this day.
Day 2:
Prayers that Caleb may find rest and sleep tonight. He is not sleeping well, not because of pain but because he says he is nervous. He did not sleep at all today, though he should have. Last night he only grabbed 2-3 hours here and there.
Caleb had his nose cauterized and day 2 I started to notice Bright Green globs of boogers all over his bedding/pillows when he woke up, lots of leaking through the nose. We went through 6 boxes of tissues in 3 days. My gut told me he had a infection, his pediatrician called in some antibiotics and it cleared it up. Trust your instinct.

Day 3:
Antibiotic's are helping with the Green drainage, he had a infection. Talking more today, still very plugged up and talking funny. No fever, eating a tad more today. Sleeping good at night, yet still snoring loudly.

It took him a few days to even want food, this is normal. Long as you keep up with fluids it's ok. Caleb's favorite thing to eat and something we went through three large packages was scrambled eggs. It was really easy to go down for him, so we ate a lot of that. Also bananas mushed up to go with it. Then a Pedisure Chocolate drink, the picture shows Ensure. I wouldn't do that, those are made for adults and the elderly {I found that out later}. Pedisure's are made for kids and they can drink two a day to keep up on calories. This was a favorite of his. It added 700 calories a day, if you drink two and you need all you can get! I already have a small child and the thought of loosing more weight was not a good one. Every day because of his nose being cauterized, I was spraying saline in each nose 3-4 times a day. This helps keep things moist and easier to dislodge. We did avoid blowing the nose for 7 days. Also avoid clearing he throat to much. You know making the "Ahm" noise.

Day 4/5:
Prayers for Caleb, he is on day 5 of his surgical recovery. Today is the hardest for him, pain wise. Considering giving the narcotics as the other two may not be enough. He's not eating as much, drinking has slowed way down. Having to push fluids and he's not taking in much, hoping dehydration doesn't set in. Hard emotionally to watch my son go through this...I had a break down this morning, trying to keep it together.

We were given the stronger stuff if needed for his pain and we never used it. We wanted to but using that can also make them more loopy and constipated. Do note for the first 3-4 days his bowels were very very stinky. It's normal things are changing in the gut. Also know around this time you will start to smell something awful coming from their mouth. This is normal as well, its the scabs that stink. It stinks so bad that over a week it would fill a entire room with the smell, for me the smell was making me sick as well. When we were in the car I would have to drive with my window cracked. Also every day I would look in his mouth to see how he was healing. Don't be alarmed for the first few days the inside looks terrible. Raw, Red and choppy looking. It all goes down. Seeing White goo everywhere is also normal, we also had Black mixed in. It's all scabs and they will all slowly fall off.

Day 6:
Last night was another rough night, I slept on the couch to monitor Caleb. He did a lot of coughing and was so worried he was going to pop a incision site and cause bleeding. Wonder if the ice cream at night I'm giving him is coating the throat and not in a good way...

Something I learned. Don't give dairy. It just coats the throat. I would stay away from ice cream. Caleb did a lot of coughing and it was worse when he had dairy.

Day 7:
Today has been just a tad easier on him, he actually sat on the ground and played for a few minutes before retreating back to his chair. It's a very slow healing for us and won't be going back to school as planned this week. Starting a slow wean off the meds starting today.

The white scabs are getting less and less. We were going to go back to school on day 8. This did not happen for us. He was still on pain meds around the clock on day 8, however day 8 was the day I started to wean him off and lower his pain med dosages. I kept a log on paper and checked off every dosage,  to  make sure nothing is over lapping.

Day 8/9:
Caleb's first day back into the public, since his surgery. He had his cub scout weekly meeting, that he truly enjoys. He got to build his very own tool box out of wood today, the den leaders even burned the Boy Scout logo on the lid for each kid. And then a grandfather of one of the boys donated each kid tons of new tools to fill their boxes. We are grateful and blessed and love being part of the Cub Scouts.
This event, kinda took it out of him. I avoided taking him anywhere the first week. I don't have a hubby to sit with me, so my mother helped sit with him when I had to run errands. Try to avoid them going into public so they don't get sick. I did have to take him once and had him wear a mask. Sickness at this point is not your friend.

Day 10:
Progress! Day 10 of post operation recovery for Caleb, the last 48 hours {night sleeping} there is ZERO snoring. So silent I have to lean my ear down to him to make sure he's breathing. This is HUGE, this boy has been snoring like a grown man since the start. I was waiting to see when he was healed enough to notice a difference and it finally has happened. The swelling has gone down enough for the snoring to stop, praise Jesus! This means better quality sleep for him

This was a turning point for us, it's around day 10 I seen improvements all around. Just hang in there, it get's easier! There is light at the end of the tunnel.

Day 13
He is now sleeping soundlessly through the night. No more snoring! He is off all medications, including pain and antibiotics. His scabs are still in place, however slowly chiseling away. He is still talking with a muffled/stuffy sounding voice. He starts back school first time since Christmas break tomorrow! Caleb is eating solid foods {including pizza}, still avoiding chips/crackers and popcorn. Didn't realize so many kids snacks are hard. No restrictions for him going back to school, recess and PE as normal. So happy he is finally moving forward, we were very lucky to only have 1-2 days of light ear pain. I hear that soon as the scabs really start falling off, it can cause residual pain. Let's hope not.

Day: 14
Caleb's Uvula is displaced to side of his tonsil bed...The thing in the middle is not in the middle...It's attached to the side... Took a peek to see how it was healing this evening. It's not coming loose with food/water or light coughing...Called the Dr. and he said it should detach once the swelling is all gone. Caleb still has some inflammation on the right side of his tonsil bed, still has White scabs and goo. However the scabs are around 70% all fallen off. Two weeks in, hoping by next week we have another huge turn around in healing.

I hope that everything I shared, helps someone in some way. The surgery was not a easy one, it takes time. I am lucky that I have a child that did not complain one single time. He simply told me one time "I'm ready for this to be over". Caleb still is primarily breathing through his mouth and is still stuff in the nose. His voice is still high pitched and not back to normal. Scabs are going away slowly but still there. He is back in school and no longer needing any pain meds. I will come back here and write another update in a week to see what progress has been made.

Did you child have their tonsils out?
Thinking of doing the surgery?
Would love to know.

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