An adenotonsillectomy is an operation to remove both the adenoids and tonsils.
General & Symptoms
Georgia is currently 3.5 years old, mouth breather;
Snoring sounded like a freight train, spluttering (sounding like choking almost at times whilst asleep);
Visibly enlarged tonsils;
Frequent waking during the night;
Bad dreams, calling out in her sleep & sometime sleep walking;
Tired during the day, bags under her eyes & almost like she was in fight or flight mode;
Only one or two ear infections that we were aware of.
Diagnosis
It started with a visit to our GP who provided a referral to a Paediatrician.
The Paediatrician conducted a sleep study where Georgia and I stayed overnight in a private room. There was approximately 6 rooms in the sleep study centre. I thought we had private health insurance that covered this stay but unfortunately, we did not. The good thing is that you can go as a public patient & Medicare covers a percentage of the stay, which is great!
We then went back to the Paediatrician who advised Georgia has large tonsils and sleep apnoea. Her oxygen levels were dropping 11 times an hour, meaning her sleep apnoea was classified within ‘medium range’.
From there we were referred to ENT (Ear Nose Throat) Specialist, thankfully the local Surgeon carried out a major ENT surgery on me back in 2018 so I had already made an appointment with him for Georgia as I knew how long it could take to get in to see him.
We saw the ENT surgeon, he conducted a hearing test & assessment, advising she also had fluid in the middle ear & may require grommets & recommended surgery. Georgia was booked in within 4 weeks for surgery.
We opted for Private admission as the waiting list for Public admission was 6-12 months. Our private health insurance also covered a portion of the Surgeon’s fee, a portion of the Anaesthetist fee & 100% of the hospital admission (with no excess) as we specifically had ENT conditions listed on our policy for the kids. Being a young family & knowing how common these surgeries are it was important for me to have these included so we had the option of Private admission.
Day of Surgery
Eeep what a day.
Rick woke Georgia up at 6.30am as she needed to fast from that time. She barely ate anything.
She had to cease fluids from 9.30am.
The morning was hard as she ‘realllllllly’ wanted snacks. At one stage she called me ‘a naughty girl’ because I wouldn’t let her have anything to eat.
Admission was 12.15pm so the 4 of us arrived at noon with baby William (7 weeks old) in tow.
As we parked in the carpark, I turned around & witnessed Georgia licking her finger…. It had snot on it. She was desperate for a snack, clearly!
A lovely nurse named Jo took us down to the nurse’s station where Georgia was weighed & we went over her forms. Jo took us to our private room, but on the way, she made a stopover & asked Georgia to choose a handmade knitted teddy from a basket that had been donated to the hospital. Georgia chose a blue & purple one & named him Mr Harriotis (from a song that her brother and her made up about the principal on 'Little Lunch', a Netflix Series).
Georgia was popped up on the bed with her gown. One for Georgia and one for me. I may have made a comment along the lines of “I’ll hop in bed with you & get all snuggly as I’ll be cold too". Dad started laughing, hand over his mouth & eyebrows raised. Did I really think I was going to strip down like Georgia into my own gown? Seriously woman! #mumbrain
Entertainment for Georgia was her choice of book, ‘Peek-a-boo Poo’ of course, so we sat there reading as she was prepped for surgery.
1:00pm pre-med (oral medicine) given to Georgia which relaxed her but also the nurse advised the medicine assists with short term memory loss so they don’t remember the surgery or associate the surgery with any trauma afterwards. She became quite slow, slurring her words but chose to try to fight it in a calm and quiet manner.
2:00pm Georgia and I were wheeled into the Theatre waiting room, anaesthetist discussed with me what will happen, and she said it can be quite confronting. I had heard from mumma friends that it can be too so I was prepared, as prepared as you can be, I guess.
To prepare Georgia for this day, Rick and I had been talking to her about what would likely happen on the day & that the surgeon may put a mask on her face with ‘clouds’ in it that she would breathe in. We told her she would then have a sleep & wake up and mummy & daddy would be there.
2:30pm the Surgeon arrived to discuss the plan with us. I was then advised to carry her into theatre & lay her on the table with Mr Harriotis. She remained so calm & just looked around. The mask went on and I said to her, “this is just the clouds that we have talked about, just breathe them in & relax”. She didn’t budge.
The worst part was probably about here... I held her hand as she started to dose off, as her eyes closed her little body squirmed and wiggled about, her knees raised to her chest & her hands clenched over her face to rub her eyes, then she was asleep. I was told to give her a kiss and tell her that I would see her soon. I leant down kissed her cheek & whispered in her ear that I love her and left the room in tears. Very hard to watch your tiny babe in that situation.
The surgeon was scrubbing in as I left the theatre & he said “I’ll take good care of her”. Ok, now I am sobbing.
Once she was asleep, they inserted an IV cannula in her foot, which was secured to the skin using tape and a bandage to cover.
We waited in her room; and surgery took approx. 45 minutes.
3:15pm I was escorted into recovery where she was still sleeping (thank god), as I was nervous that she would wake & freak out that I was not there & wonder where I was. I laid beside her and cuddled in. In her sleep she was calling out ‘mummy’ and as she started to wake, she was frustrated, arms swinging around, trying to stick her fingers down her throat (as it was numb from the local). She was drooling a lot, a small amount of blood was coming out in her drool and fluid depositing from her ears.
We spent just over one hour in recovery where the nurses monitored her breathing. Once she was settled, she was offered a lemonade ice-block which perked her up quite a bit.
Back in her room she was hungry and had some afternoon tea consisting of jelly, ice-cream, custard, a jam sandwich and some apricot bites. She managed to eat well and did not complain at all.
When the surgeon came to check in on her again, around 7pm that night he said everything went well but she had a lot of scar tissue on her tonsils and adenoids, which is a sign of recurring infection. Her tonsils were huge, and he was pleased that they were removed.
Rick stayed the night with Georgia in hospital. I asked whether I could stay but as I am still breastfeeding William they wouldn’t allow both William & I to stay so daddy to the rescue!
The next morning, she was still quite calm and ate all her breakfast.
When we were discharged around 9.30am we were provided with post operation instructions for her care. Georgia got quite upset when the nurse was removing the bandage, fluid line and cannula which was on her right foot. The worst part was removing the tape around the cannula.
Post Operation
Day 1: Hospital discharge day. False hope that the recovery was going to be easy.
She was amazing (as we now understand, she was still dosed up on medication). She was playing with her dad, bossing him around, eating as normal, running about the house but by 6pm she started to crash, was extremely hot and ready for sleep.
The night was frequent waking in pain, constant drooling everywhere, crying & refusing water.
The post operation information sheet advised that bad breath is common but the first day & night were completely on another level.
Day 2: More rested day.
She woke up in bad pain. Perked up a little mid-morning & rode her bike on the driveway for 20 minutes.
Skipped dinner, couldn’t get anything down.
The night was hard, her body was extremely hot by 6pm so she had a bath then fell asleep on my bed in her towel, crying in pain. She woke a few times wanting to cuddle but refused medication. Once she finally gave into the medication she slept better, although remained extremely hot all night.
Temperature was not recording a high reading. Requested lots of water.
Day 3: Very slow day on the couch.
Didn’t wake until 8am then went back to sleep until 9am after some medicine. Slow day on the couch with a blanket, snuggled in & seemed quite well in herself until the afternoon. Ventured out for a short walk in the pram and she was happy eating, giving anything a go. By the afternoon she was very pale in the face.
Skipped dinner again. Attempted some plain pasta around 9pm when she woke but cried out in pain that it hurt.
The night was frequent waking, avoiding pain relief & just wanting cuddles.
Day 4: Another very slow day.
Lots of green snot from her nose, asking for medication during the day. Very pale in the face. Starting to pick at her ears.
Night-time, refusing medicine and up a lot crying out in pain.
Day 5: Seemed well in herself all day.
Day 6: Worst day yet.
Whining a lot, pale, hot but no temperature.
By 5pm she was fast asleep and woke really upset an hour or so later. Grabbed McDonalds for dinner as an easy fix, she ate the chips (cooled down) which went down well, accompanied by apple juice. She eventually took medicine, and we noticed a spike almost instantly. Fell asleep around 8pm for the night.
Frequent waking at night but no medicine.
Day 7: Complained of sore throat once or twice. Managed to eat though. Took medicine first thing in the morning thank goodness.
Day 8 – 10: Snoring has ceased!!!! Scabs seem to have fallen off.
Panadol once at midday, nothing overnight. Breath not as bad.
Day 11: Our girl seems to be back in fine form!
Tips:
Allow the full two weeks for healing. Child dependant, they will be very clingy.
I found a bath in the morning helped brighten Georgia a little for the day ahead & another at night to clear any additional build up before bed, and to help soothe.
Lots of fluids (water) and hydrolyte iceblocks!!!
Set an alarm for regular medication to avoid too much pain returning.
Offer the child a choice of medicine ie liquid Panadol or the prescribed panamax (or equivalent from the Surgeon) so they feel in control of their decisions. The Surgeon may prescribe a very low dose of Oxy, which we only used three times when she was far worse.
Encourage eating anything the child wants, whether hard or soft.
Some surgeons advise to drink coca cola as a throat disinfectant however Georgia’s did not (thankfully, as she is 3)!
There was a lot of drool & discharge on the first 3-5 nights. Make sure you use pillow protectors under pillowcases as it tends to be rather smelly. I laid towels over the pillows too.
Take it slow for the first week, they will want lots of extra cuddles.
Around days 5-7 it really ramped up for us, be prepared around this time as the scabs start to harden & fall off.
Burn some essential oils in a diffuser, try frankincense and lavender, 3 drops each to create a calming environment & to promote healing. If you don’t have any oils speak to Brittany at ‘Sparkle in the Nude’ on Instagram, she will be able to source for you.
They won’t be allowed back at school for the full two weeks as per Health NSW guidelines.
You are required to remain within 25 minutes of the hospital for any post op emergency ie bleeding etc
Be aware that their voice may change. Georgia’s seems to be quite high pitched (not sure if it remains this way).
Be patient & calm. Enjoy those extra cuddles.
S x