Recovery from a toddler tonsillectomy in the UK

My son, 2 on the verge of turning 3, was scheduled in for a tonsillectomy and adenoidectomy - an 'adenotonsillectomy', if you will. In the desperation of the previous year of him being unable to breathe, choking both on his food and on his own tonsils in his sleep, and his voice sounding unlike the voice of any other toddler I had previously heard (so deep and rasping), we greeted this news with joy. Having entered the ENT clinic prepared for a fight, to be greeted so easily with this news, after the doctor merely glanced at his throat, and listened to his laboured breathing, we were on cloud nine. Hurrah, our poor boy will no longer struggle to breathe, i will no longer have to sleep with one ear open, listening for him choking, leaping out of bed to check he's OK.

It was only once this news had sunk in, that i began to think about the reality of it. What could we expect from this operation? Would our son be in pain? How do we cope with the pain? What would happen at the hospital?

Having had the operation myself, aged around 8, i can honestly say i really have no memory of it - except for crying at a family barbecue because my throat was too sore to manage sausages. However, my son is just a toddler, he can't fully explain how he's feeling, and it is a BIG deal, and a BIG operation for such a small person. So Google became my friend.

Google is great - there is a wealth of information out there on tonsillectomies, for both adults and children. But not much for toddlers. What little there was was USA based, so i didn't understand the jargon, the medicines given were all alien, and the procedures for hospital admission completely unlike that of the UK.

I went into the situation feeling daunted, through the process feeling overwhelmed, and out the other side feeling relieved. What we went through was two weeks of solid pain management, emotional trauma (both me and him!) and a rollercoaster of physical symptoms.

I can't really predict what each individuals experience is going to be... and i can't claim to give any medical advice. What i want to do is write down what WE went through, from a perspective of a UK mum in a UK hospital, and hope that it makes another mum feel a bit more prepared.

We were admitted on the morning of the hospital and told we would be staying one night. The thing about staying in hospital is there is a LOT of waiting about. A good book for you, and some trusted toys and books for your child are a must. Our ward had free TV for the children, and films on demand (this is an NHS hospital by the way, not private), thank goodness for CBeebies!

When we were given our 5 minute warning my son changed into his pj's, and was wheeled to theatre with his cuddly toy. He was very calm and happy, and the porters, nurses and doctors were great with him. In the anaesthetic room, he was given a heart rate monitor on his finger, and an I.V. was put into his hand, with no fuss thanks to the provided numbing cream. He drifted off to sleep (with the obligatory tears from me) and i was promptly dispatched to the nearest cafe to wait.

I was called after just over an hour. I was expecting about 30 minutes so i felt a bit anxious, but all had gone fine. (He was also having gromits put in, which i would imagine would add to the time). I walked (ok, ran) to the recovery room, where i was greeted by my son. He was very tearful, having woken up in a strange place surrounded by strange people, and felt sick i think as he kept retching (this is a common side effect of the op, kidney trays at the ready!). He also had dried blood all round his nostrils, from the adenoids coming out. I sat on the bed with him and we cuddled. I really don't think at this point he was in much pain. He was talking to me, and he wasn't sleepy at all, which i was surprised about. We were wheeled back to the ward, this was about 4pm, and he kept asking when dinner was coming, because it came on a Thomas train!

About half an hour after we got back to the ward, he asked to go to the toilet, and he was very sick. It was all liquid (as he had been nil by mouth all day), and red in colour, from the blood that was swallowed. It didn't seem to hurt him, and he felt better afterwards.

Dinner arrived, it was chicken curry and rice, with bread rolls and jelly for pudding. He picked at most things, but didn't want to drink. It seemed the drink hurt him more than the food. Pain-wise, he still seemed ok, he wasn't complaining, and was fairly bright. He had a bath and changed for bed and fell asleep at his normal time.

We were offered paracetamol and ibuprofen for him at about 8pm, but as he was asleep i didn't want to wake him. This was my first mistake. Stay on top of the pain. Wake them for medicine. He woke at 11pm, absolutely beside himself with pain, it broke my heart. He was given the paracetamol and ibuprofen, and we tried to get him to drink but he would barely sip it. All i could really do was hold him until he fell asleep again.

When he woke early the next morning, it was the same situation as the night before. To be honest it was the same situation every morning for the next 10 days. A night of no pain relief and (mainly) no fluids, made his throat dry, and the pain relief wore off before we could top it up.

After we were discharged with little fuss, the work began! Really the main lesson i've come out of this with is that toddlers, when they are not in pain, are fine - they act normal, run around, chat, misbehave - there's no time to sit about and feel sorry for yourself! However, like the flip of a switch they can turn. We would one minute be playing happily, the next inconsolable, seemingly in agony. Never let your guard down, you need to be on constant watch and alert. Sip water or juice regularly. Ice pops were a hit with us, as was ice cream (obviously!). I've read that smoothies could be a hit, for us i think they were a bit acidic and stung, as did juice so it was mainly water in our house.

We were advised to give Calpol every 4 hours, ibuprofen every 6, which we did, round the clock. Sometimes, when it was really bad (days 7 - 10 are the worst, the scabs come off) we would go more regularly than that with the medicine. At night i would set an alarm for every 2 hours, to either get up and make him have a drink (yes, i really had to make him have it, at night the pain was so much worse), or give him his medicine. Unfortunately being tired is going to be your world for a couple of weeks, it's like having a newborn again, only louder!

After two weeks my son went back to nursery. He was still absolutely shattered, this op took it out of him so much more than i thought it ever would. However nursery were well equipped with what they needed to know, and it took his mind off being poorly. I can honestly say that although after a couple of weeks the pain was gone, it took a couple of months for him to return to his normal self... no longer being so easily tired and run down.

The other lasting effects were that as a toddler, he took advantage of playing up at night... he'd never been one for shouting out and slept through and well from a pretty early age. Now we had to break the habit of him shouting for us every couple of hours, just because he could. A sticker and reward chart worked pretty well... we still have the odd night. He also suffers from bad dreams, although he can't tell me what about - i think it's more related to being more disturbed at night than the operation itself, time will tell.

I really hope that someone gets something useful from this blog. I hope it doesn't scare anyone. It has honestly been the best thing we could have done, and the change has been phenomenal - i can only hope it makes someone feel more prepared. If it does help you, please comment and let me know!