Wednesday, October 6, 2010

The ENT Specialist's Recommendation

A few weeks ago, I brought the Pumpkin to an appointment with an ENT specialist recommended by our pediatrician. After the multiple ear infections last winter/spring (five total) plus the regularity of liquid build up in her ears when she had any sort of cold, the pediatrician thought it would be a good idea to get her ears checked out by a specialist. Knowing that we tend on the side of less medical intervention, she recommended a specialist she said was generally conservative in his recommendations.

I put off making the appointment, as I tend to do. The Pumpkin's ears weren't bothering her this summer, so I just wasn't thinking about it or worried about it. But then, we started having sleep issues again. And then I read a blog post about tonsils and adenoids that got me thinking: Maybe there is more to the ear infections and even sleep issues. Maybe there is some underlying health reason for both, in addition to my girl's personality making it difficult for her to go to sleep and sleep well.

After just a little bit of research on adenoids and a phone call with the pediatrician, I made the appointment with the ENT. I knew going in that she wasn't having any ear issues, but I was going to see if he said anything about her adenoids. And if he didn't bring it up, I was going to.

The Pumpkin did great for her appointment. The doctor was an older man who was really good with kids, and even had Spiderman cuff links and a Mickey Mouse watch, both of which my daughter loved. He asked some general questions related to her health, ears and sleep.

Here was the conversation as he was checking her out:

ENT Doc: Does she breath through her mouth at night?
caramama: Yes.
ENT Doc: Does she ever snore?
caramama: Yeah. That's actually how we know for sure she's fallen asleep at night. She starts snoring gently.
ENT Doc: Does she come in your room at night?
caramama: Oh yeah.
ENT Doc: Often?
caramama: Oh yeah.

We talked a bit about the ear infections and how the liquid buildup could have been because the adenoids are blocking the normal drainage... or something like that.

Sure enough, her ears looked fine but her adenoids were enlarged. My mother's instinct was right on!

Then, I discussed with the generally conservative doctor whether or not she should have surgery. Here's how that conversation went:

ENT Doc: Well, next time she's asleep, go into her room and check on her. See if she is breathing through her mouth, snoring, and tossing and turning a lot.
caramama: Doctor, I can tell you now. She does all of those things. She sleeps with us enough for me to know for sure.
ENT Doc: So her sleep is regularly disrupted? Does she seem tired during the day?
caramama: She's never slept well, and she does have signs that she is sleep deprived (this was part of what I discussed on the phone with our pediatrician). She has trouble focusing, she gets fussy, and she gets that wildness that kids get when they are over-tired. I mean she gets those things more than I've seen in other kids her age.
ENT Doc: It sounds to me like the enlarged adenoids are affecting her quality of life.
caramama: Probably our whole household's quality of life!
We both chuckled.
ENT Doc: When the quality of life is being affected, especially to this degree, I do recommend surgery.

So, that's where we are. The ENT doctor recommends surgery for my 3.5 year old's enlarged adenoids. Luckily her tonsils are fine, so it would just be to remove the adenoids. Londo and I talked it over, and we think we should have it done. We discussed it again with our pediatrician, and she agrees that we should do it. There doesn't appear to be any negative consequences of having the adenoids removed (aside from dealing with the surgery itself), and it could greatly improve her sleep and quality of life.

Now, I just have to stop sitting on this referral and make the appointment for the surgery. I know I need to, and I should do it sooner rather than later. But I'm finding it really hard to make the call for surgery, aside from my normal procrastination of making appointments. Cause, you know, it's surgery. For my 3.5 year old. My firstborn. My little girl.

This is the part of being a parent that sucks. Having to do the hard stuff when it's probably best for the child. Sigh...


Jan said...

I have a good friend whose little boy never slept well, was still, at 4, refusing to eat any chunky foods to speak of, cranky a lot. He snored and mouth-breathed. They thought he might have sleep apnea. His pediatrician recommended an ENT specialist who told them he needed to have his tonsils out. Apparently there's a score for tonsil size, 1 to 5 where 1 is teeny and 5 is totally occluding the throat. He had a 4 and a 5, poor little guy.

At any rate, they got his tonsils out about 9 months ago and he is a new kid. SO. MUCH. HAPPIER. Everyone is. So for whatever that's worth, it totally changed these folks' lives for the better.

Scary anyway, I'm sure, but I hope your outcome is as amazing as theirs was.

moink said...

I had my adenoids removed when I was 3. I'm 32 now. I remember going under the anaesthetic and that they had me count. I remember I slept in a crib in the hospital (they called it a six-year-old crib, and I'm told I figured out how to get the side down and climb out). I don't have any traumatic memories.

mom2boy said...

Tate had ear tubes put in and his enlarged adenoids removed at a year old. Cured the ear chronic ear infections but he's still a mouth breathing, snoring, restless sleeper. The surgery went really well, watching him come out of the anesthesia was tough, recovery was a breeze. It is a tough decision. Good luck!!

Cloud said...

This stuff is hard, isn't it? Do what you think is right, and allow yourself an adult beverage (or two) of your choice when it is all over.

Personally, I am really looking forward to when I know Petunia is healthy. Then I'll feel like I can crack open a beer and sit back and try to get over the events of the last couple of days!

Anonymous said...

sweetie, make the friggin' call.

I had surgery at her age for tonsil removal. i can still remember a couple key moments before surgery (hanging out with fun nurses while in a 'cage crib' awaiting anesthesia.. counting down from 10 with the gas mask on) and after (waking up in the ward with nurse krachett telling me to hush, realising that the "no more sore throats" pre-surgery promise was a lie, as my throat freaking HURT!.. the green lifesaver lollipop and daily prizes i got the first week home (and the ice cream and jello!)
... anyway, point is, it's totally liveable and can actually be partially good memories, some of it.

and not to mention, potentially REVOLUTIONIZING THE QUALITY OF LIFE IN YOUR HOUSE!!!!

Me? I'd be running for the hospital her on my back.

SO glad you have a probable answer to long standing concerns, in any case. Aunts are on hand to assist with all duties.

Melba said...

This is how I felt taking Rosie to get her cavity filled. Except that fretting over a filling at the dentist seems pretty silly compared to surgery complete with general anesthesia. I'd be procrastinating like nobody's business. Its tough. But you'll do it. :) Good luck Pumpkin.

Zenmoo said...

I had my adenoids out (and grommets for ear drainage) when I was about 7. I don't know if I had sleep issues but I do recall lots and lots of painful ear infections. I remember seeing the adenoids in a jar afterwards... And being served a boiled egg without an egg cup. I was a bit worried my food had come from the hawker stalls in the car park. (i had the surgery in Malaysia)

A couple of days ago I was playing with my cousins kids at my parents and found my earache Teddy. Yes, I had a special Teddy to hold to the side of my head when I had earaches... Surgery was all good in my book.

Good luck Pumpkin!

Karen said...

I had my adenoids removed when I was a kid. I remember having the mask and counting for the anesthesia. I remember having sherbet afterward. There were no lasting (negative) consequences; everything was fine. It has not been, say, a lifelong trauma that my parents sent me for surgery when I was a wee kid.

Good luck. I predict that it'll be harder on you than on her.

Lisa F. said...

Good for you getting it checked out! my son had tubes in his ears at 15 months & it was scary, but went fast & what a relief to not stress every time he touched his ear. I had ear tubes, tonsils & adenoids removed as a child. The adenoid surgery does leave a sore throat, that I clearly remember.

I now have to make an appt for DS to have an MRI for unexplained pulses of vertigo that occurred for a bit 2 yrs ago, and this last spring. I have a feeling it's not going to show anything conclusive, and it's really just to rule out some unlikely scenarios. and I really don't want to go through w/the intensity of it all, but I need to make the appt. ugh. good luck & keep us posted.

- Dana said...

That's great you discovered that! I really hope it improves everything. Surgery is hard...Aria had eye surgery at 2.5 and it was so was scary. The hardest part was her coming off the anesthesia. It made her pretty sick. but 8 hours later she was running around and being her old self! They are resilient, those little ones.

Best of luck! And a quick and easy recovery for your little girl!

Jacquie | After Words said...

Sorry that I didn't see this post until now...

As you know, we did the surgery (both tonsils and adenoids), and after a pretty horrendous recovery due mostly to the fact that my daughter refused her pain meds, we've seen no real improvement from the surgery. She doesn't snore anymore, but she still tosses, turns, and wakes up several times a night.

Hate to be the dissenting opinion, but if I had it to do over again, I would have done the sleep study before we did the surgery.

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