Enlarged Adenoids - To wait or not to wait...

Both Haikal's paed and ENT suggested surgery to remove his enlarged adenoids. Though he still snores during his sleeps but his fever alhamdulilah lessened and not as bad as before. Bad - as in every 2 weeks and very high fever. The next check up will be on 28 Jan 09, and we have to decide by then whether we want to proceed with the surgery or not... Arrgghhh... I feel that he is still so small and being a drama king himself, I have doubts... I read this article about adenoids and it freaks me out... Hmm not really.... I am just in doubt....

Enlarged Adenoids

Often, tonsils and adenoids are surgically removed at the same time. Although you can see the tonsils by looking in your child's throat, adenoids aren't directly visible. Your child's doctor has to use a small mirror or a special scope to get a peek at your child's adenoids.

So, what are adenoids anyway? They're a mass of tissue, located in the passage that connects the back of the nasal cavity to the throat. Adenoids — which are also called nasopharyngeal tonsils but are separate from the tonsils in the throat — filter out bacteria and viruses entering through the nose and produce antibodies to help the body fight infections.

Some doctors believe that adenoids may not be important at all after kids reach their third birthday. In fact, adenoids usually shrink after about 5 years of age, and they often practically disappear by the teenage years.

What Are the Symptoms of Enlarged Adenoids?
Because adenoids trap germs that enter a child's body, adenoid tissue sometimes temporarily swells as it tries to fight off an infection. There are several symptoms associated with enlarged adenoids. You may notice that your child:
1. complains of difficulty breathing through the nose (nope)
2. is breathing through the mouth -sometimes
3. talks as if his or her nostrils are pinched - yes
4. breathes noisily - yes
5. snores while sleeping - double yess
stops breathing for a few seconds while sleeping (called sleep apnea) - afraid if he does

If enlarged adenoids are suspected, your child's doctor may:
1. Ask about and then check your child's ears, nose, and throat. Done
2. Listen to your child's breathing through a stethoscope. Done
3. Feel your child's neck near the jaw. Done
4. To get a really close look, the doctor may even want to take one or more X-rays. For a suspected infection, the doctor may prescribe oral antibiotics or maybe an injection of penicillin. Nope but he has been taking antihistamined for the past one year

When Is Surgery Necessary?
If enlarged or infected adenoids keep bothering your child and medicine doesn't stop them from coming back, the doctor may recommend surgically removing them with a procedure called an adenoidectomy. This may be recommended if your child experiences one or more of the following:
1. difficulty breathing
2. sleep apnea
3. recurrent infections

Having your child's adenoids removed is especially important when repeated infections lead to sinus and ear infections. Badly swollen adenoids can interfere with ear pressure and fluid movement, which can sometimes lead to hearing loss. Therefore, kids whose infected adenoids cause frequent earaches and fluid buildup may need to get an adenoidectomy as well as ear tube surgery.

And although adenoids can be taken out without the tonsils, if your child is having tonsil problems, they may need to be removed at the same time. A tonsillectomy with an adenoidectomy is the most common operation for children.

What Happens During the Surgery? Am afraid of this part actually
Surgery, no matter how common or simple the procedure, is often frightening for both the child and parent. You can help prepare your child for surgery by talking about what to expect. During the adenoidectomy and/or tonsillectomy:

1. Your child will receive general anesthesia. This means the surgery will be performed in an operating room so that an anesthesiologist can monitor your child.
2. Your child will be asleep for about 20 minutes.
3. The surgeon can get to the tonsils and/or the adenoids through your child's open mouth — there's no need to cut through skin.
4. The surgeon removes the tonsils and/or the adenoids with a series of incisions and then cauterizes (or seals) the blood vessels.
5. Your child will wake up in the recovery area. In most cases, the total time in the hospital is 5 to 10 hours. 6. However, kids who have trouble breathing or show signs of bleeding will return immediately to the operating room. And kids under 3 years of age and those with chronic disease, such as seizure disorders or cerebral palsy, will usually stay overnight for observation.

The typical recuperation after a tonsillectomy and/or an adenoidectomy often involves a week or more of pain and discomfort due to the exposure of the throat muscles. Because of throat pain, your child will probably prefer eating a lot of soft foods, like ice cream, pudding, and soups.

About a week after surgery, everything should return to normal. The cut area will be left to heal naturally, which means there are no stitches to worry about. There's a small chance any tissue that's left behind can swell, but it rarely causes new problems.

After surgery, a child's symptoms typically disappear immediately, unless there's a lot of swelling that could lead to some temporary symptoms.

Understanding Enlarged Adenoids
Even though some kids may need surgery, it's important to remember that enlarged adenoids are normal in others. If your child's adenoids aren't infected, the doctor may choose to wait to operate because the adenoids may eventually shrink on their own as adolescence approaches.

Tonsils and Tonsillitis
Tonsils are clumps of tissue on both sides of the throat that trap bacteria and viruses entering through the throat and produce antibodies to help fight infections.

Tonsillitis occurs when tonsils become infected and swell. If you look down your child's throat with a flashlight, the tonsils may be red and swollen or have a white or yellow coating on them. Other symptoms of tonsillitis may include:
1. sore throat
2. pain or discomfort when swallowing
3. fever
4. swollen glands (lymph nodes) in the neck

But enlarged or swollen tonsils are a common finding for many kids. Left alone, your child's enlarged tonsils may eventually shrink on their own over the course of several years. Don't rely on your own guesses, though — you might not be able to judge whether your child's tonsils are infected. If you suspect tonsillitis, contact your doctor. Recurrent sore throats and infections should also be evaluated by the doctor, who may order a throat culture to check for strep throat.

About Tonsillectomies
The surgical procedure to remove tonsils is called a tonsillectomy. The doctor may suggest tonsillectomy if your child has one or more of the following:
1. persistent or recurrent tonsillitis or strep infections
2. swollen tonsils that make it hard to breathe
3. difficulty eating meat or chewy foods
4. snoring that might be affecting the child's daily activities
5. obstructive sleep apnea (a condition in which your child may stop breathing for a few seconds at a time during sleep because enlarged tonsils are partially blocking the airway)

Surgery, no matter how common or simple the procedure, is often frightening for both child and parent. You can help prepare your child for surgery by talking about what to expect.

During the tonsillectomy:
1. Your child will receive general anesthesia. This means the surgery will be performed in an operating room so that an anesthesiologist can monitor your child.
2. Your child will be asleep for about 20 minutes.
3. The surgeon can get to the tonsils through your child's open mouth — there's no need to cut through skin.
4. The surgeon removes the tonsils with a series of incisions and then stops any bleeding.
5. Your child will wake up in the recovery area. In most cases, the total time in the hospital is 5 to 10 hours.

However, kids who have trouble breathing or show signs of bleeding will return immediately to the operating room. And kids under 3 years of age and kids with chronic disease, such as seizure disorders or cerebral palsy, will usually stay overnight for observation.

The typical recuperation after a tonsillectomy often involves a week or more of pain and discomfort due to the exposure of the throat muscles after the tonsils are removed. This can affect your child's ability to eat and drink and return to normal activities.

Intracapsular tonsillectomy, a variation on traditional tonsillectomy techniques, is surgery in which all involved tonsil tissue is removed; however, a small layer of tonsil tissue is left in place to protect the underlying throat muscles. As a result, the recovery is much faster because most kids experience less pain, don't need as much strong pain medication, and are more willing to eat and drink. Additionally, the risk of bleeding after surgery is significantly less than with a traditional tonsillectomy. Since residual tonsil tissue remains, there is a very slight chance that it can re-enlarge or become infected and require more tonsil surgery, but this occurs in less than 1% of children undergoing intracapsular tonsillectomy.

How? To do or not to so?