Mom to Mom: Lessons learned from our little one’s tonsillectomy

A simple procedure. They do it every day. It is completely routineThese are my used to be thoughts about having one’s tonsils removed. Even in the weeks leading up to the surgery I never fully grasped the scope, extraction aside, of what this really meant.

Getting Prepared
IMG_8644Honestly, I should’ve known, it’s my own fault. From the day we were told that Charli’s tonsils and adenoids were coming out I was warned. The office nurse not once, but twice, gave me the look of “listen-up mom, you’re in for a wild ride” but it didn’t really phase me; for a few reasons. First of all, because it’s Charlotte. This kid has been through the wringer (black eye, chipped and bruised teeth, stitches, skin glue, IVs, random seizures, oh and that time her sister pushed a TV on top of her leg) she’s had a ride, therefore, so have we. I felt comfortable, more like, I got this, let’s not make a mountain out of it. Second, because it is by reputation, a routine procedure. It’s supposed to be easier on kids than adults and one of the most common outpatient surgeries done daily. I thought, some extra TLC, lots of ice cream and in a week we’ll be through it. HA!

Here’s the nurse’s Pre-Op play-by-play

  • Day 1-2 Expect the typical post-op pain. Lots of love and liquids. Give her anything she wants, no restrictions, just be sure to tackle her pain with round the clock OTC meds. Alternate Tylenol and Ibuprofen every 2-4 hours on top of the daily RX.
  • Days 3-5 Nerve-endings will begin to wake up. Continue the above but expect things to get worse before they get better. Don’t worry about brushing, even though her breath will be horrible. No toothpaste or mouthwash will help this. #truth
  • Days 6-7 At some point she will begin to turn a corner. These few days are bad. If it’s not her throat it will be her ears. Scabs will begin to sloth off. This is painful and these days simply suck (truth) but just keep your eyes on day 8. (Lies)

This was the best information we had going into the process. We trusted our doctors and felt confident we were doing the right thing. A few days prior we headed to the store to stock up on some of her favorite soft foods. We took this time to talk to her, on her terms. We wanted her to understand, as best she could, what was going to happen without scaring her. We used this time to prep her Madz as well. I made homemade flash cards, because theoretically they aren’t supposed to talk, a pain chart to help her communicate with us, although they were really not needed- she found them special though, and some new jammies for the big day. We also let her decide on dinner the night before since she couldn’t eat after midnight.

 IMG_8715 IMG_8714 IMG_8716 (1)

Sibling Tip: We included her big sister through the whole process. Madz helped us shop and prepare Char’s “special stuff.” We briefly explained (in age appropriate terms) what was going on which helped with our little patient. She got a few special treats as well and on the night of the surgery she got her turn to plan family dinner.

The Experience
The procedure came and went before we could finish a cup of coffee, literally. In hindsight, this was a huge parenting lesson for us. We trusted the references and are pleased with the doctor but the surgery center was just that- a surgery center. They scheduled patients by age, youngest goes first, then physicians cycle through the day completing in and out surgeries of all kinds. I was ill-prepared for this. IMO, my pediatric patient should be cared for in a pediatric center with the extra TLC for the patient, their parents and the process. We have some of the best pediatric care centers in the country around us, so personally I feel like I did her an injustice by not getting her in an appropriate facility. All of that being said, the physician was great. Nothing went wrong really. It just wasn’t what we expected. Today, she is healing well and snuggling up with me as I sit here and reflect on our week-long journey through the dark-side of Planet Char.

Not surprising, some of the best recommendations on surviving post-op were from mom-blogs. Which is why I’m writing this now. I hope that my experience and some of the tips I learned will circle back and help someone else. Here’s our week in a snapshot.

Days 1-3: As I said, the procedure was fast and furious. We didn’t know what to expect with anesthesia and had we, I’m not sure it would’ve made a difference. She woke up merely minutes after the procedure. We weren’t even with her yet. So unfortunately she woke up scared, in pain, and screaming a post-op cry (a theme that would continue throughout the week). What is the post-op cry? We are talking one of those middle of the night infant cries. Where they are upset but pissed off as if to say, “I’m wet, I’m angry, and you suck at parenting!!!” Moms you know, the one where their whole face and mouth turn red and their tongue quivers. The cry you think they outgrow. Well, here’s your warning. It’s still in there. Beware. The upside, she was drinking apple juice almost instantly. Which helped. Since she had spent a solid twenty minutes screaming like a banshee, they wanted us out and sent us on our way in record time.

IMG_8733 (1)

These are the “silly-me-steroids.” Don’t be tricked!

Once we got home and got settled things were okay. Of course Charlotte isn’t textbook so the whole soft foods thing…no bueno. My child’s preferred medicinal cocktail included Cheetos, Tylenol and juice. In fact, we had to convince her that ice cream would be relieving. Who’s child is this? The prescription was helpful but also a bit conniving. Our doc prescribed a steroid to promote eating and healing. But again, it was a steroid. What steroids don’t do is promote sleep and relaxful healing. They make little children hyper. So days 1-3, not THAT bad in hindsight. She was actually kind of funny and as long as we managed her pain with round-the-clock OTC meds, she was seemingly okay.

Days 4-6: She woke up on day four in horrible pain. We anticipated this. So we took it in stride. Her eating habits and screeching were certainly not helping things but we slowly started to see improvement. With her little liver in mind I had begun to pull back on the OTC meds. MISTAKE! BIG MISTAKE! DON’T BE FOOLED. These are the days where the nerve endings will fully wake up and the pain will increase but you don’t know that yet. Save yourself, and your patient, by keeping on top of the meds. Her fluids must still be pushed another easy miss when they seem to be acting okay.

Leading into our final days and “keeping our eye on day 8” our hopes led us straight to hell. She regressed because we had pulled back on the meds too soon and let her activity go back to normal. #meaculpa She still wasn’t sleeping well and neither were we. She was fighting, wrestling, running and screaming against meds more and more because she hurt all over and everything (EVERYTHING) was a struggle. Finally on Day 7 I called the on-call and I was reassured of how normal it is and that it’s really more of a 10 day process not 7-8. ::::insertevileyetothefirstnurse::: After shedding a few teatrs of hopelessness, I pulled it together and lent on my team. We had to get back on managing her pain in the same method we used the first few days and then (maybe) we will begin to see the light.

The Lessons
As we head into what is hopefully the final days, I don’t know if I see the light yet but in my few parenting years I have learned one thing that runs true, this too shall pass. Ultimately the process is just that, a process, for every patient and parent. Little ones may not remember this but parents will; and even though they may heal faster and arguably easier than adults, they will still be in pain (as will you). Their breath will be HORRENDOUS, words cannot describe it. Sleeping will be that of taking care of an infant all over again; and if you must look in their throat, and curiosity will probably tempt you, be prepared for the ultimate gross-out.

Here are some helpful tips we learned:

  • Turn off the house fans and set-up a humidifier near where they are sleeping. This may be your only effort to keeping the throat moist which is extra-hard at night.
  • If you can, accept screen time. Some of Charli’s favorite shows helped distract her from the pain even if only for a moment. It was also a really helpful bargaining tool. My cousin brought over her Wii, we hooked up Netflix and watched Barbie for days.
  • Stay away from acidity. This seems like a no brainer but when you’re desperate to give them something, anything, it can easily slip. Try to avoid juices with orange, lemon, grapefruit, etc.
  • Get straws. I hadn’t even thought of how much easier it would be for her to drink if it were through a straw. Stock up!
  • Honey helps, if you can get them to take it. Char would have none of it but research shows it does help with healing.
  • Worse case scenario, and probably the meanest mommy-moment for me, was when we reached rock bottom with the pain. I read that diluted chloraseptic spray will numb the throat and it does but it is a mean tactic to get it in there. 😦
  • Go hot and cold. The obvious food sources are ice cream, yogurt, pudding, etc. but we found chicken soup to be just as helpful and she wanted it.
  • Let them pick out their OTC flavors. We don’t use these meds very often so I didn’t give much thought to it. Mistake! I had no idea the child would have such a strong preference for orange and white meds over purple or red. Let me tell you, the right color can make a bit of a difference in medicine wars.

Oh and speaking of, when it comes to medicine wars. Set your pride aside. Do what you have to do. Toddler/preschool age is hard. We bartered. We begged. We threatened. We got mean. We sweet talked. We played good cop/bad cop. There were hugs and kisses, Facetime and phone calls, Disney Junior at 4:30am and at our lowest, we tuned into our college-days, positively chanting 1.2.3. go.go.go and she loved it- for a few days and then it (thankfully) got old. Leading me to Brent’s tip: do what you gotta do. It will pass but stay strong and do what you have to. 

IMG_8721In the end, Charlotte was a trooper. It could have been worse. Much worse. Sure, the bad moments sucked. Truth. But it needed to happen and she will be better in the long-run. For us, copious amounts of wine and chocolate were consumed. I think I ate more ice cream than her. Endless cups of coffee and cans of Redbull consumed. It is only a week or so but it is a long one. I wish I had realized the amount of sleep that would be loss or the heartbreak that would happen. I’m a tough momma but I’m still a momma and these moments are hard. Soak up the luvin’ and snuggles. Your little patient, and you, will heal the best with some extra TLC. -ox-

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