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Thread: Ear tubes, adenoidectomy for a toddler

  1. #1
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    Default Ear tubes, adenoidectomy for a toddler

    Hi- We took our 20-month old son to a ENT today and he advised us to have ear tubes and surgery to remove the adenoids of our son who has had problems with sinusitis symptoms for about 1 year. He has either had a runny nose, along with ear infections and coughing while sleeping, or he's been on antibiotics and doing ok. The ENT feels that he needs this surgery now, rather than later, because Steven also has asthma, and so the constant blockage of his sinuses means just that much less air getting into his lungs.

    I know that getting tubes put in is a fairly common thing. Has anyone been through this? Is there anything special I should be prepared for? I hate the idea of him being under general anesthesia, but I know it's necessary

    The surgery will be Apr 11. We are hopeful that he'll be feeling much better before we move across the country in August! Thank goodness kids are so resilient. I know if I had to have this stuff done I'd probably be moaning and groaning for 3 or 4 months, at least!

    Any words of advise?

    (By the way, please excuse my spelling! I don't know how to spell 15% of the words I type, and I am far too lazy to look them up!!!)

    Peggy
    Peggy

    Dh will finish training (like they ever finish) June 30 2014!

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    Peggy-

    Several of the kids attached to my staff have had tubes put in their ears and everyone has said that it's an amazing recovery. One little girl suddenly started talking like a champion- her parents realized that her ears were so clogged all the time that she wasn't hearing the conversations! My receptionists grandson has also had an amazing turnaround- going from always feeling sick to hardly having a day out of day care!

    Jenn

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    Wanted to say that I have been ther and done this 3 times. When my oldest son was 18 months we had the tubes put in. After 5 different episodes of ruptured eardrums and possible hearing loss it was a miracle. He never had another infection. We did not have the adnoids out as he has a cleft uvula and would have affected his speech.

    Fast forward 10 years and my oldest daughter has the same problems. One round of tubes-great for 14 months til they fell out. The proceedure lasted 15 min and she slept through it. Second set of tubes w/ adnoidectomy and she was kinda hard to deal with for a couple of days. She still has her tubes, she is 5. Tonsils out last summer were worse than all my previous experiences with my children's surgeries, but we were back to normal in about 10 days.

    Long story short. Do it while they are still little. The older they get, the more they whine

    Best of luck,
    Trisha

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    Thanks- I have heard in passing that getting the tubes in is no big deal. But, of course, everything is a biggie when it comes to one's own child, isn't it?

    Has anybody's child had any problems/bad side effects with anesthesia?

    Thanks again for the encouragement- I do think that it's much better to get this done sooner rather than later. Plus I don't like having Steven on antibiotics for so long! I think he's devastated his gut flora...

    Peggy
    Peggy

    Dh will finish training (like they ever finish) June 30 2014!

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    Both of my twins had ear tubes placed (in both ears for each!) around 10 months of age. Their surgeries went smoothly and we did not experience any longterm complications from the surgeries. (One aside, one of the reasons we had the tubes placed so early is that one of our twins daughters had been on antibiotics for months on end. She developed an allergy to sulfa drugs subsequently).

    None of my children have experienced complications with anesthesia , so I can't help you there! Good luck!
    "I'm not funny. What I am is brave."~~~~Lucille Ball
    "Every gun that is made, every warship launched, every rocket fired, signifies in the final sense a theft from those who hunger and are not fed, those who are cold and are not clothed."~~~~
    Dwight D. Eisenhower
    "Extremism in the defense of liberty is no vice. And moderation in the pursuit of justice is no virtue." ~~~~Barry Goldwater

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    Thanks Rapunzel for the input. Today I was at Twins Group and one lady there talked about how some children thrash around a lot while coming out of anesthesia. Have you ever heard of that? Did your girls come out of it calmly? Did they even let you back there to be with them when they woke up?

    I'm sure the docs and nurses will go over this stuff in detail. But it still freaks me out a bit to think of my baby going through surgery. His Dad hasn't even ever had a surgery! Chances are, he'll PERFORM a surgery before he needs to go through one... He's so healthy.
    Peggy

    Dh will finish training (like they ever finish) June 30 2014!

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    Quote Originally Posted by peggyfromwastate
    Thanks Rapunzel for the input. Today I was at Twins Group and one lady there talked about how some children thrash around a lot while coming out of anesthesia. Have you ever heard of that? Did your girls come out of it calmly? Did they even let you back there to be with them when they woke up?

    I'm sure the docs and nurses will go over this stuff in detail. But it still freaks me out a bit to think of my baby going through surgery. His Dad hasn't even ever had a surgery! Chances are, he'll PERFORM a surgery before he needs to go through one... He's so healthy.
    You have some very valid concerns, Peggy. My children have had a total of five surgeries combined and so I can relate what our experiences were with general anesthesia and recovery from it.

    Some children come out of it quite calmly, my experience is that most do NOT. This is the pattern I've witnessed in my own children: you might notice a gray palor to their skin while they are still under full anesthesia, after this they will gradually wake up and will be VERY disoriented. They will probably not recognize you for a few moments - if that happens don't worry, they'll know who Mommy is soon enough. One of my children (my son whose been under general anesthesia for three surgeries and countless MRIs) has a TERRIBLE time coming out of it. He does thrash around, pulling out iv's, kicking nurses (and me), screaming, etc. It was scary the first couple of times. What helps him considerably is that he is given a bolus of saline solution immediately when he starts waking up. It helps "clear his system" of the drug somewhat and hastens his recovery from the anesthetic effects.

    I have had most of my experiences with Alex (the above son 8) )at a hospital that allowed parents into surgery recovery - in fact encouraged it to the extent that the nurses paged the parents from the surgery waiting room to be there when the children were just about to wake up. This was at my husband's med school hospital (Children's in Dallas) and they took their practice from a recent study showing that emergency care for children actually benefited from having the parents present during acute procedures (especially during the worst parts for the kids).

    The hospital my daughters had their ear tubes placed had the opposite policy and it was terrible. I was called back to recovery but they wouldn't "allow" me near my screaming, scared babies for quite a while - I could hear them but I wasn't allowed to see them or touch them because of some archaic rules. After I complained and said if they didn't bring them to me I was going to get them, they brought the girls out. I made sure I immediately reported the incident and the corroborating study on emergency room visits to the patient feed-back department. The archaic policy was changed shortly thereafter and we received a note of apology. It probably helped that the top administrator at the hospital is a close family friend of my husband's.

    In summary: Expect your daughters to react poorly to recovery from general anesthesia. If they react well then you can be pleasantly surprised, if they react badly you will be prepared emotionally. Definitely confirm with the nurses before your children are given any anesthetic that a saline bolus will be administered via iv immediately after the surgery (ie when the anesthesia is no longer needed) to flush the drug out and hasten recovery from the anesthetic. And finally, CAREFULLY check and question the hospital's policy towards parents being present post-surgery. In my experience it is VERY important for the children, the parents, AND the nursing staff if the parents are present during the traumatic time period immediately post-op. That's my experience. I hope it helps!

    Oh, I just remembered one more thing: pay VERY close attention to your children's iv's post-op ESPECIALLY if they are thrashing around. It is very possible your child will "blow a vein" and the saline solution will get pumped into the tissue rather than the vein. This is soooooo painful and if it isn't caught immediately can cause some serious problems. In my experience this is yet another reason to have parents close at hand post-op because the nurses (who usually have several patients a piece) don't notice these things as fast as a concerned parent sitting over their child constantly. What you will notice is your child screaming histerically (especially if the iv location is touched or moved), attempts to pull out the iv (although that can be normal for anesth recovery so it doesn't necessarily indicate an infiltration), and a noticeable, rapid swelling in the area immediately around the iv (ie if your child's extremity looks "puffy" that means possible infiltration and the iv needs to be removed immediately). Also, some goofy nurses forget to anesthetize the skin area prior to inserting the iv needle. Make sure whoever places the iv FIRST uses an anesthetic on the area. Also, a good nurse only takes about ten seconds to get an iv needle into a thrashing, screaming, non-cooperative, scared small child. If your nurse takes any longer than that or starts "digging around" with the needle IMMEDIATELY tell them to STOP and demand another nurse do the procedure. (This I speak from experience as well). You must be very proactive - even with minor surgeries.
    "I'm not funny. What I am is brave."~~~~Lucille Ball
    "Every gun that is made, every warship launched, every rocket fired, signifies in the final sense a theft from those who hunger and are not fed, those who are cold and are not clothed."~~~~
    Dwight D. Eisenhower
    "Extremism in the defense of liberty is no vice. And moderation in the pursuit of justice is no virtue." ~~~~Barry Goldwater

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    As a nurse practitioner working in pediatric emergency medicine, I just need to interject about what GOOD nurses do and dont do.....

    While I start IV lines on children approximately 10 times per day three times per week, I can tell you that A) it often takes more than ten seconds to start, B) searching for the vein is often necessary in a child with rolling or miniscule veins. Young children who are ill and/or dehydrated will consequently have veins that are difficult to find. Parents who insist that the provider stop in the middle of the cannulation automatically guarantee that their child receives another needlestick as well as a delay of treatment. While I encourage parental involvement at evey level of treatment, it is important that the parent recognize their role as parent rather than healthcare provider.

    Similary, a nurse is not "goofy" because they do not place topical anesthetic prior to placing the intravenous line. Rather that nurse may be "following the policy and procedures of the hospital". Topical anesthetics may be the standard of care at some hospitals, but certainly not all. If the nurse does not place it, perhaps instead of labeling him or her as 'goofy', you might complain to the hospital administrator who refuses to purchase the anesthetic due to its high cost, or even to the insurance executives who refuse to reimburse the hospital for the use of it.
    Mom to three wild women.

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    I have to interject here too. As an ER nurse I have to "stick" kids almost every time I go to work. I have been doing this for over 10 years and I have NEVER put an IV in a baby in less than 10 seconds. Last weekend I had to start an IV, draw, blood and insert a urinary cather into a "thrashing" 2 month old. If I had done that in just a few minutes I doubt I would have been being very careful!!! It usually takes more than 10 seconds to just find a decent vein.

    As to anesthesia, my daughter has had it twice and she did thrash about and kick. This isn't that unusual.
    Luanne
    Luanne
    wife, mother, nurse practitioner

    "You have not converted a man because you have silenced him." (John, Viscount Morely, On Compromise, 1874)

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    Apparently after one of my many oral surgeries, I 'thrashed' to the point that I kicked the surgeon in the 'family jewels'. My mom said all of a sudden she heard this yelp of pain and then the radio got really loud in the waiting room.

    I always felt like poo after my oral surgeries- often like I had the flu. It took me a few days to get better.

    Jenn

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