What to Expect: Your Toddler’s Tonsillectomy

What to Expect: Your Toddler's Tonsillectomy | Twin Cities Moms Blog

My son recently had his tonsils and adenoids removed. While this a routine surgery, his young age -under three- made me anxious. You hear a lot more about preschool aged kids having this type of surgery so it was hard to know what to expect with a younger child. Here’s our experience in hopes it will be helpful to other families.

The Back Story

I used to think that having your tonsils removed was a result of too many rounds of strep throat. That wasn’t our case. My son has had strep once before. However, he has never been a good sleeper. He was waking up frequently and was very restless during his nighttime sleep. It was common for him to wake up sweating. If he crawled into bed with us we would feel him tossing and turning most of the night. Many times we would be woken up by a kick to the face. We noticed he was snoring more and breathing out of his mouth during sleep. At first we just shook it off. He was our first child so who knew? Maybe his behavior was normal. My husband and I both figured he would grow out of it and start sleeping better.

We soon realized his sleep wasn’t improving, in fact it was getting worse. Coupled with a newborn baby, no one in the family was getting any sleep. We were starting to get desperate. We had tried so many things (salt lamp, fan, adhering to a bed time routine, essential oils, no screen time, etc) to help improve his sleep. In my gut I knew there was an underlying issue. I called my pediatrician and received a referral to a children’s sleep clinic. Our initial consult at the sleep clinic was very thorough and detailed. The nurse practitioner mentioned his tonsils were enlarged but she identified other problem areas to work on first. We went home with a sleep log and instructions on how to get him to sleep better. It took a great amount of effort but his sleep did improve. However, he was still waking up a few times at night and snoring. We sensed the nurse practitioner was going to recommend a sleep study. The week before we were scheduled to follow up with the sleep clinic, he came down with tonsillitis.

His pediatrician took one look at his tonsils (they were almost touching) and referred us to an ENT. Fast forward one month later to our consult with the ENT and she said what we knew was coming. He needed to have his tonsils (and adenoids) removed. Yes his tonsils were impressively large, but more importantly he was having sleep and breathing issues. Did he tilt his head far back when sleeping? Yes. Did he snore? Yes. Did he ever gasp for breath during sleep? Yes. Was he a restless and active sleeper? Yes. Was he a poor eater? Yes. 

His surgery was scheduled for just two weeks later. Gulp.

Preparing for Surgery

The week of the surgery we received a call from Children’s Hospital to let us know what to expect. His surgery was scheduled for 9:15 am, but we would need to arrive at 7:45 am. He needed to have his hair and body washed the night before. He could eat anything he wanted until 11:45 pm, white milk and clear liquids until 1:45 am and then only water until 5:45 am. We knew he would have to stay overnight since he was under three.

The day before the surgery I went to Target to stock up on popsicles, ice cream, applesauce, yogurt, diced peaches and a few treat items. I knew he would enjoy opening a present at the hospital so I stopped at the dollar spot to buy a few goodies. Target is the best! I also bought a book for myself to help pass the time. (Spoiler alert- I didn’t get a chance to read much).

That evening we went out for pizza (our son’s favorite) and then had some extra snuggles before bed. I barely slept.

The morning of the surgery I was pretty anxious. My son asked for milk when he woke up. I explained to him that he couldn’t have any milk until after the surgery. He somewhat understood this but kept asking throughout the morning. It worked best for us to distract him. On our way to the hospital we dropped the baby off with grandma and grandpa. I am so grateful we were able to have our family’s help. This allowed us to give 100 percent of our attention to our son.

What to Expect: Your Toddler's Tonsillectomy | Twin Cities Moms Blog

At the hospital, we went to the surgery center and waited to be called back. They had so many fun toys in the waiting area. Next we were led to the pre-op room where we changed him into hospital pajamas and the nurse took his vitals. The room had been set up with Paw Patrol toys and books. He was so excited to have new toys to play with! The toys were able to distract him while we discussed the procedure and answered questions from his nurse. Throughout the next hour we met with all of his care team: the surgeon, the anesthesiologist and a child life specialist. They were all so wonderful and allowed us to ask any questions. I felt much more at ease as the morning went by. The child life specialist was amazing! She showed our son pictures of what the operating room looked like. She told him about the special “bubble lights” and he was so excited to go see them. She also had a mask with her and demonstrated how it would be used for the anesthesia. She had bubbles, stickers and yummy smelling chapstick to entice him. He was having a great time. Honestly the hardest part was waiting for the surgery nurse to come take us back to the operating room. I kept glancing at the clock and counting down the minutes. Finally the team arrived.

The Surgery and Post Surgery

I assume each hospital has it’s own procedure but ours allowed us the choice to stay back in the room or have one us go to the OR with him while they administered the anesthesia. This is a deeply personal choice and there is no right or wrong choice. Each parent has to do what is best for their child and situation. We knew that he needed mama with him. So even though it would be difficult, I put on the the surgery gown, hair net and mask. Our son thought it was funny that I was “doctor mama.” We walked towards the OR hand in hand. He was excited to go see the “bubble lights.” Once in the OR, he sat on the bed and found the lights. Next, it was time for the face mask. I didn’t know what to expect but prepared for him to be upset. He protested a little bit but started counting with the anesthesiologist while I held his hands. He was giggling. She warned me that his eyes could get a little a wild but that it was a good sign! I just held him while he fell asleep (it took less than 30 seconds) and then kissed his cheek and told him I loved him. At this point I had a big knot in my throat and I could feel the tears coming. A nurse escorted me back to the waiting area and told me I did great. I just nodded. When I saw my husband I could barely look or talk to him. I knew I was going to lose it. I let the tears fall for a few minutes, said a big prayer, texted family and then we waited.

The surgery itself took about 20 minutes. It was quick and the surgeon came out right away to tell us everything went smoothly. After another 10 minutes, they came to get us and bring us to the recovery room. Our sweet boy was waking up and asking for mama and daddy. Thankfully he came out of anesthesia pretty well. He was most upset about having an IV in his hand but his cries were soft and he didn’t have any adverse effects. We were able to get him to take a dose of Tylenol and Motrin, and a few licks of a popsicle.

What to Expect: Your Toddler's Tonsillectomy | Twin Cities Moms Blog

Once he was stable, we moved up to the floor where we would be staying for the night. He continued to do well but was still drowsy and unhappy about the IV. Throughout the next few hours we were able to get him to drink small sips of water, milk and vanilla ice cream. He even felt well enough to leave his room and walk around the hospital (with the IV). Right outside our unit there was a toy room and on the floor below us they had a big center full of more toys and activities for older kids. It was really cool. I can only imagine what a fantastic place this is for the kids who have to spend several days, weeks and months in the hospital.

What to Expect: Your Toddler's Tonsillectomy | Twin Cities Moms Blog

The rest of the time at the hospital was uneventful. He did pretty well for the majority of time but you could tell when he was ready for the next dose of medication. I would say our biggest challenges were the IV in his hand and him not wanting to stay in the room. We were grateful he was drinking fluids, eating ice cream and didn’t seem to be in too much pain. We were able to be discharged the following morning and very happy to be heading home. Overall, our very short experience at Children’s Hospital was amazing. We are so lucky to live in an area with incredible children’s hospitals.

Recovery 

At home, our son was pretty much back to normal 90 percent of the time. He was more low key than usual but had no problem playing with his toys and moving around. We spent the weekend laying low, watching movies and playing at home. By the third day we went to the park for some fresh air. He continued to drink water and milk without issue, but he wasn’t interested in eating anything for a few days. We knew it was ok as long as he was drinking and staying hydrated. He was on a strict regimen of Tylenol every four hours and Ibuprofen every eight hours. We did go home with a stronger pain medicine but thankfully did not need it. On day four, we were instructed to give him one dose of a steroid to help with inflammation. By day four, we were able to start weaning him from medication.

We had been told that at his age, recovery would be 4-5 days. We went into the experience expecting it to be a rough four days. I am incredibly grateful to have had a better experience than I was expecting. Every child is different but I think that being proactive about pain and making sure we stayed on top of medication made a big difference.

It has now been one week since he had the surgery. He is almost back to his normal self. He’s needed a dose of Tylenol or Ibuprofen here or there- we can tell because his behavior starts going downhill- but otherwise he is happy. His sleep has improved greatly. He isn’t snoring anymore and is already sleeping through the night. His eating has been slow, but in full disclosure he has never been a good eater. We can’t even bribe him with ice cream! The important part, however, is that he is staying hydrated. I know his eating will improve as he continues to recover and heal.

What to Expect: Your Toddler's Tonsillectomy | Twin Cities Moms Blog

Tips 

  1. Talk to your child about the surgery. In the week leading up to his surgery, we started telling him that he was going to the hospital to have this tonsils taken out and we would stay overnight. Although they may not fully understand what is happening, toddlers are smart! For us it was important that our son knew what was coming.
  2. Let your child help you pack his suitcase. We let him choose pajamas, a change of clothes, stuffed animals and books to pack. If your child has a security item, make sure to bring it.
  3. If possible, arrange childcare for your other children. It was great to be able to focus our full attention on our son and know that the baby was in great hands.
  4. Have some new toys and movies for your child to enjoy while they are recovering. Our son loves puzzles so I ordered a few new ones from Amazon. I also ordered a TV tray for him to have easy access to water and foods.
  5. Your child will need to be on a soft foods diet for two weeks. Anything hard or crunchy can irritate the tissue and cause bleeding. Stock up on soft foods (eggs, pancakes, pasta, canned fruits/veggies, peanut butter sandwiches) and cold foods (popsicles, ice cream, applesauce, yogurt and jello) as well as plenty of fluids.

For those who have gone through this before, what other tips do you have?

2 Responses to What to Expect: Your Toddler’s Tonsillectomy

  1. Clare July 29, 2016 at 2:33 AM #

    Thanks for this, it’s helped put my mind at rest with our 2 year old going in for surgery next week,

  2. Angie jenson February 14, 2017 at 2:16 PM #

    I’m glad you wrote this article. I have a 2 1/2 yr old that has this surgery in a few weeks.

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