March 30, 2011,
L.M. asks from Littleton, CO on March 29, 2011
Tubes, Adenoidectomy, and Tonsillectomy?
My son is scheduled to have these procedures done next week and I am just wondering if any of you have had positive or negative experiences. A little history on my son. He had a speech evaluation at 2 years 4 months for a delay in his speech. At that time he did not qualify for speech therapy, but we were advised to check his hearing and see an ENT because of his slushy sounding speech. His failed his hearing test and was found to have a double ear infection. We are not sure how long it was there since he had no symptoms. After antibiotics, we rescheduled a hearing test about a month later. It came back with the same results. Poor hearing and another double ear infection. We saw an ENT and were put on a nasal steroid. 3 days later he came down with strep. After another round of antibiotics, we had another hearing test with two audiologists. His hearing test was better but he still had negative pressure in his ears. A week later he had strep again! At our second visit with the ENT, she recommended surgery. We were unable to do surgery until now approximately a month and a half later. SInce then, his speech has improved. I scheduled another hearing test that came back normal. He has not had an ear infection since Nov nor Strep since Jan. I have talked with the nurse and she said the Dr will discuss our concerns on the day of surgery? I'm wondering if I should postpone the surgery and see if he continues to get better on his own. Thanks for you help!
So What Happened?™
Thank you so much for all the advise. For all the comments about seeing a chiropractor, i forgot to mention that he has been seeing a DC once a month since he was born so we had already tried that route. I was able to talk to our Dr. and she said that she saw that his hearing test was better but asked how is breathing and snoring was at night. I slept in the same room with my son and he was still snoring and flipping all over the place. We decided to have the surgery. Before the surgery, his tonsils were so big the anesthesiologist could barely get his breathing tube in! Also, when the dr. tried to remove his adenoids his right nostril was completely blocked by a deviated septum! He may have to have surgery in the future for that. He has done so well since then. It was a rough week. We were in the hopital one night, but couldn't leave without going off the oxycodone. At home all he got was tylenol every 4 hours. He was a trouper though. His hearing is normal and is talkiing up a storm and sleeping wtih his mouth closed. We are definatly glad he had everything done. Thanks again for you answers!
D.G. answers from Houston on March 29, 2011
My daughter had her adenoids out and tubes put in and with hindsight I wish we had done it earlier.
She was slightly speech delayed, and the speech therapist recommended we see an ENT because she was speaking hyponasally.
She had an abnormal hearing test because of fluid in ears. I don't know how long she had congestion there, at least two months but maybe longer since she had a history of ear infections resistant to treatment. Just not quite bad or frequent enough for the pediatrician to recommend tubes.
A mini cat scan revealed her adenoids were huge taking up most of their cavity. The surgeon said if it were her kid she would do an adenoidectomy, since with tubes alone she would probably still have drainage issues.
When we went in for her pre-op appointment she had an ear infection and we didn't even know it. They said it is pretty common for kids like her to not even complain they are so used to ear pain/pressure.
After surgery her hearing was normal, speech took off exponentially, and no ear infections in the two years since. So we are 100% happy with surgery.
Still if you have questions/concerns don't be afraid to set up another appointment with the doctor to discuss.
3 moms found this helpful
K.B. answers from Cincinnati on March 29, 2011
My 5 year old had one set of tubes after a year of chronic ear infections (at age 14 mos) and he hasn't had an ear infection since. My 2 year old had his 2nd set of tubes put in last October (1st set put in at one year, worked great until they fell out about 8 mos later) and he's been great since. My 4 year old had his first set of tubes put in at 13 mos and they worked wonderfully for about a year. He had sporatic ear infections/colds for about two years. His speech was very guttural, he was a very restless sleeper, and his tonsils were nearly "kissing". He had a hearing test and the results came back with some conductive hearing loss due to all of the fluid from the ear infections. After much discussion with our ENT and several appointments, we decided to have his tonsils & adnoids out and another set of tubes put in. For me, concern over his hearing loss and speech was the driving force in going ahead with the surgery. I was afraid that since he was still in such a formative stage as far as his speech was concerned (he was 3.5), that the hearing loss could cause him to spend years in speech therapy. He had his surgery last August and it went very well. His speech has dramatically improved (his preschool teachers think he is on target for his age), he no longer thrashes in his bed and falls out of bed every night, and he hasn't had any ear infections. For us, it was a very positive experience. If you are really uncomfortable with going through with the surgery, I would insist that the doctor see you or at least, take the time to call you to discuss your concerns. Good luck.
3 moms found this helpful
D.B. answers from Charlotte on March 29, 2011
It is NOT too early to get help for speech. Intervention is never a mistake. Once he gets his hearing issue handled, it probably wouldn't take much help to get him back on track. Knowing what he SHOULD be able to say at his age is what speech therapists can tell you, so that you will know if your son is behind or not, or how far behind he is. Speech therapists are professionals who can tell you where your child stands. I would NOT just make assumptions that he will not need a little help after all this time lost to infected ears.
What concerns do you want to talk to the doctor about? Don't be mad at the doctor for this jerk of a nurse. She doesn't have any business keeping you from the doctor. Schedule a pre-op appointment, writing down all of your questions. You should feel better walking out of that appointment, and not worse.
My own son had all these problems at this same age, minus the strep. We had his tonsils removed, his adenoids reduced (not removed) and ear tubes put in. It was a godsend - he stopped getting so sick. His speech therapy stood a fighting chance of starting to work once his hearing improved. Having negative pressure and fluid in the ears makes it sound like he is underwater, and it's impossible for them to learn to talk when they are dealing with chronic on and off problems like this.
In addition to seeing the ENT before surgery, what does your ped say about these recurrent strep infections? The ped and the ENT should actually be speaking to each other about this issue before surgery.
I do not think that you should ignore this issue with his ears - he needs those tubes. I would think that the tonsils coming out may help with the strep issue, according to how badly those tonsils look. Sometimes they are so corroded with infection, that they no longer help the body, but hurt it. You need to know if his tonsils fit this category. I would ask the doctor to ve careful of removing too much of the adenoids - if your child has ANY nasal sound in his voice, it would be better to not remove too much, or the nasality could become a lot worse. (I know about this because of my own son.)
I wish you lots of luck,
2 moms found this helpful
A.S. answers from Philadelphia on March 29, 2011
i know the idea of surgery is scary.. but i have to say esp with his hearing being impacted... it is worth it.
My son had ear tubes twice, and speech and balance improved. This last time he also had the adnoids and the recovery was so much better than we expected
1 mom found this helpful
B.B. answers from San Antonio on March 29, 2011
Our experince is a bit different than yours, so I can only speak to our outcome. My daughter got tubes put in her ears on March 9th. (constant ear infections from Sept of 10 to March of 11). They discussed the adenoids at that time, but we chose the conservative approach of tubes to see what would happen. She is like a different child. Her speech has improved tremendously - she has added approx 15-20 words to her vocabulary (she is 18 months old - but only said a few words before the tubes), her balance is much better, she is def hearing more than ever before. She has been in twice to have them checked and there has been no fluid in her ears. It is the first month in the last 6 months that she has been on no anti-biotics. It honestly has been the most amazing change, and I only wish I had pushed for it sooner.
I would call the dr or see if they have an e-mail concern line (our ENT does - she responded the same day I contacted her) and talk to them about your thoughts. If your son is moving forward you may want to delay things, or possibly see about just the tubes to limit the infections, but hold off on the tonsils and adenoids? I would also ask the risks associated with delay.
1 mom found this helpful
M.W. answers from Fort Collins on March 30, 2011
I don't have any advice to give you as of yet, But I'm glad you asked this question because the answers you've received have been helpful for me as well. My 23mo daughter is scheduled to have this procedure done tomorrow morning! She has had chronic ear infections for the last 6 mos. Has had trouble breathing since 3 weeks old! Her tonsils are abnormally large and are almost "kissing" as one other mom described. And her adenoids are large as well. After tons of mis-diagnoses from allergies to asthma, we finally took her to an ENT and he has assured us she will be a completely different child after recovery. She does have some minor speech delay but we were unable to get an accurate hearing test due to the amount of fluid behind her ear drums. She doesn't eat very well either I am wondering if it's because it's just to uncomfortable for her since she has so much tissue in the back of her throat.
So all I can really say is if you like I can get back in touch with you in a few days to let you know her recovery and answer any questions you may have based on my personal experience!
I am very scared for her because she is so young and really has no idea what is coming to her. And can't really understand when I try to talk to her about it. All I can do is just know that I'm making the best decision for her now, and hope that her future is better because of my choices.
We will be staying overnight in the hospital which I actually prefer just because it will be nice to know that I have assistance in case something is of concern. I just hope I can keep her comfortable there and have her pain under-control.
Anyway, good luck! And if you'd like to keep in touch with me my email is ____@____.com
N.G. answers from Dallas on March 29, 2011
From my experience (and I'm very experienced in this department- I've had chronic ear infections my whole life, had tonsils/adenoids out at age 7, tubes put in my ears at age 11, saw my little brother go through the same thing, oldest daughter had tubes/tonsils/adenoids out at age 3, and now my four-year-old is scheduled for her surgery), it takes until at LEAST age 3 to see how a child's speech is going to really pan out. Kids develop their speech mostly between age 2 and 3, so interventing at age 2 is really too early, IMO. If your child is having chronic problems well into their fourth year, I think it's time to intervene. Kids can grow out of those things, but why suffer when the procedure is really so minor, and benefits are so great?
My older daughter, now 7, had tubes/adenoids/tonsils at age 3. The results were immediate and phenomenal. She slept better, breathed better, talked better, heard better, and was overall healthier. However, four years later, we are still having problems from the procedure. When the inital tube fell out in her left ear, it left a small hole in her eardrum that still hasn't closed. The ENT may have to go in and repair her ear drum, which basically consists of placing a tiny flap of skin over the hole. When the right ear tube fell out, she immediately started having ear infections again. In addition to that, a portion of her adenoids and tonsils actually grew back (rare but yes, it does happen) and had to be removed again, so she had to endure a 2nd surgery at age 5 to remove those again and place a 2nd tube in her right ear. We are still dealing with the hole in her left ear drum, which has led to a reduction in hearing but the doctor is still watching it to see if it will close on its own.
With my younger daughter, as you can imagine, I was much more hesitant to go ahead with the surgery because of all of the drama associated with my older daughter's procedure. I have to keep an open mind though, because the complications she had are rare and not so severe. In fact, the benefits that she got from it far, FAR outweigh the issues we had subsequent to the surgery. My younger daughter has pretty severe speech delays so I do need to go ahead with the surgery but I have been waiting, hoping, PRAYING, that she grows out of the ENT problems. So far, she has not, and her surgery is scheduled for April 26.
If I were you, since your son is so young, I would get a 2nd opinion from another ENT to see if surgery is the best course of treatment. It is possible that they could treat him for allergies/inflammation to buy him some time to grow/develop those little eustacian tubes more and maybe prevent surgery. I really think that ENTs nowaday do this surgery so readily that they forget that parents have very real concerns, whether emotional or financial (my daughter's procedure next month is costing us $2100!).
S.S. answers from Cheyenne on March 30, 2011
If you are concerned he doesn't need the surgery, I would insist on either a phone call from the doctor today or an appt today or tomorrow! If you can wait until he is older (5-7), they say it is easier on the kids and they bounce back faster after surgery!
If you end up going through with the surgery, here's some suggestions...my son had a T and A when he was the same age as your son (as a "cure" for PFAPA-weird, rare fever disease) and you should know that even though they say your kiddo should be feeling better in 3-5 days, he will not be-keep on the codeine pain meds around the clock (set alarm to get up at night) for at least 5-7 day or longer (my poor son...I stopped the meds on day 4 and went to ibuprofen and just thought he was milking it...finally took him back in to MD cuz he stopped wanting to eat and drink and also did research online to find out that kids in the 2-5 range have a much harder recovery time-so I had to start up the pain meds big time again). Also, know that the pain meds sting going down so if you give them a bite/drink of something cold right before the dose, it helps! Also be prepared for TONS of drooling for a few days (I put double layered towels on the couch to catch it all) and for lots of screaming and crying when they come out of surgery (nurses say they want them to scream and cry-gets anesthesia out faster-but if you are like me, hard not to console your child) and you have to get your kiddo to drink before they can leave (ours is an outpatient proceedure so we didn't stay overnight). Also, you will do nothing but hold you kiddo the first day and then spend the next 2 trying to keep your bored kiddo on the couch-so be prepared with lots of movies, toys, books, puzzles! Also, have lots of popsicles, applesauce, jello, suckers, mashed potatoes on hand (though, after all that, my son only seemed to want Pediasure and Oreos-both not recommended foods, but at least he was eating!) I'd have to say the worst day is about day 5-6 when the scabs fall off and it suddenly gets very painful for them again!
There is a mom with a really good blog about this: typeamama.blogspot.com/2008/05/recovery-for-toddler-tonsillectomy.html so check that out!
So whatever you guys choose, good luck and just so you know, even with all the trouble we had with pain control and how miserable my child was, if I had to do it again, I would in a heartbeat! My son has been fever free for over a year now!!!
S.W. answers from Pocatello on March 30, 2011
Given his age and all the problems he has had with upper resp infections I would say do the surgery. The eustation tube does not elongate until around 6 years old. If he has had silent ear infections (without symptom) this will not improve until the eustation tubes change position. As for the tonisils/adnoids, if he has had strep that many times already and slushy speech, chances of him having to have the surgery when he's older is vastly higher. Surgery in a 2-3 year old is alot better than surgery in a 9-12 year old. My son had his out in October at 12 and it was the worst recovery ever. My other son had his out when he was 3 and asked for crackers when he came out of recovery. A week later you wouldn't know he had had surgery. I say do it... You will be so much better off to get it done now instead of waiting.
J.P. answers from Denver on March 30, 2011
I wonder if the reason the ear infections seems so bad is because they are fungal infections. The only times my boys have had ear infections it was yeast in their ears---giving them anti-biotics would only make the problem worse. Also, strep will hit more often if yeast is weakening the whole system--which would make a lot of sense with all the anti-biotics your son has been on. We have always treated our children with alternative methods with great success. I can recommend an alternative doctor (chiropractor by training) if you're interested. He is the one that, after our pediatrician prescribed anti-biotics, found the yeast and was able to treat it more effectively. I would also go get your son a full-spectrum pro-biotic and start him on it right away. I do think you can avoid surgery, and I'm happy to discuss this with you further if you feel compelled to do so. Good luck!!
M.W. answers from St. Cloud on March 29, 2011
If he has made improvements, I personally would hold off. (But we prefer the natural method when possible.....) Have you tried chiropractic care for his ear infections and strep??? They have helped our family multiple times!
I would be a little frustrated that the doctor doesn't want to discuss things with you PRIOR to the surgery date...... They will have their schedule to follow and want to keep things going. So I would be worried that they will continue to recommend the surgery whether necessary or not just to keep THEIR agenda........
J.H. answers from Colorado Springs on March 30, 2011
My son had all three surgeries done at the same time last June (he had just turned 5). It has turned out to be such a good decision. He could not sleep due to his snoring, he had seen a speech therapist for "muddling his words", and we were in to the Dr. with an ear infection every other month. Since the surgeries, his behavior has improved, I guess because he can finally sleep all night, his speech has improved so much because his hearing is better, and he has not had an ear infection since the surgeries. Which is truly unbelieveable. His Dad and I are so glad we decided to go ahead with it. It was scary, I was nervous for the general anesthesia, but he had no problems and has literally been a much more enjoyable child since June. One other note, he suffered some hearing loss due to the repetitive ear infections, it may never come back, so I really wish we would have been offered the chance to do the surgeries sooner rather than later, it may have prevented some of the hearing loss. I hope this helps. I wish you and your son the best of luck.
D.S. answers from Houston on March 29, 2011
i am border line on this. tubes helped my oldest immensly. my youngest tubes arent helping. now your sons hearing is improving and so is his speech. wether he needs it is questionable. but strept and earinfections are probably going back and forth and if that is the case I would do the tubes. I am thinking you should post pone the surgery. depending on how much progress his speech is making. if its alot i would postpone. If its a litte I would do the tubes. if he is saying certain combinations wrong in his speech I would do it. like the sp, st, th,ch combinations. I hvae been through this with 2 kids and my suggestion is trust your gut you are the only one who knows the answer. jmo