Should we let ’em cut the kid?

August 25th, 2010  |  by  |  Published in Uncategorized  |  8 Comments

800px-Surgery_c1922_LOC_npcc_23063I think they call it cold feet. A month after setting a date—to have our 2-year-old son’s adenoids operated on and to have tubes placed in his eardrums—we are wondering if it isn’t somehow elective surgery. The procedure is a week away and we’re thinking of cancelling, at least the adenoidal part.

I had the same dual procedure done in the early ’80s—a time so benighted and backwards that people were driving Pintos and Gremlins—and I survived. I even got a He-Man action figure from my toy-stingy parents for my trouble.

There are reasons, of course, for having the procedures done to Nico. The tubes are most important, because he spent all of last winter with one long ear-infection, and he’s as stubbornly antibiotic-resistant as a veal-calf on a factory farm, so there was really not much treatment available. The ear infections don’t just hurt, they gave him a bit of hearing loss (at least, we think that’s what did it). Not that he’s about to get all Marlee Matlin on us, but still: I spent a lot of time as a half-deaf kid, before my operation, and had to go through speech therapy after I got my hearing back, yadda yadda. It sucks.

The adenoids are a different story. As far as I understand it, having oversize adenoids (a gland in the nasal cavity) basically makes you a snotty mouthbreather, which he is from time to time. But he doesn’t snore heavily, have sleep apnea or other breathing distresses. And the adenoid operation is a slightly more intense procedure. They don’t actually cut (misleading headline, right?), but they snake a cable through the mouth, reach up and cauterize (i.e., burn the crap out of) the adenoids. It swells up for a few weeks, but then it shrinks as it heals, and he can breathe easier.

The thing that gives my wife pause—and she should know, since she’s a tube jockey—is that he would have to be intubated for the adenoids, with an IV in his arm and the whole deal. For the tubes, it’s just some happy juice and a gas mask. Intubating is not a big deal, but there is a risk—however minute—that they won’t be able to ventilate him. Death is always a risk with anesthesia, and you just want to feel like you needed to do it.

So: any advice? Encouragement? Scorn for being such cowards—either too scared of anesthesia or too scared of mouthbreathing?


  1. Jack says:

    August 25th, 2010at 1:42 pm(#)

    I have three nephews and a niece who all had their adenoids removed. It is a little disconcerting and somewhat nerve wracking- but there were no complications with any of them.

  2. Ellen M says:

    August 25th, 2010at 2:12 pm(#)

    Is it any easier to do the two procedures at once? If not, you could wait and see if he grows into his adenoids, since he’s not having those problems yet. A friend at work is going through this. Her kid had tubes at 2, and now at 4.5 is looking at the adenoid surgery (for sleep apnea), but they are trying the less-aggressive massive anti-biotic treatment first. No results one way or the other so far, though.

  3. Nathan says:

    August 25th, 2010at 4:40 pm(#)

    I think there’s something to be said for doing them together–the lead-up to the surgery that’s probably tough and weird for little kids, so if we’re going to do the adenoids, it seems worth doing together. But we are definitely feeling wait-and-see at this point. On the other hand, like Jack said, it’s pretty routine. And I wouldn’t want to short the kid just because we can handle stressing out about the procedure!

  4. Jaida says:

    August 26th, 2010at 10:03 am(#)

    My three-year-old son just had his adenoids (and tonsils) removed. His was a different case, he had severe sleep apnea and low oxygen levels. It was very nerve-racking, but at the end of the day I knew it HAD to be done and that made the difference for me.

    My two cents: why not see if the tubes make a difference before doing anything else? There are other potential “risks” (more annoyances) we are experiencing with the loss of the adenoids, like having food come out his nose on a regular basis. Not a huge deal, but uncomfortable for him. I think doctors tend to hop on the “get it all done at once” bandwagon, but it doesn’t sound like the adenoids are medically necessary in the way that the tubes are. Good luck making your decision…I know from experience that it’s heart-rending to have to send your tiny boy off and place your trust in several strangers to keep him safe.

  5. David says:

    August 26th, 2010at 1:07 pm(#)

    Do some research on over-consumption of milk, sugar (including high fructose corn syrup), and processed grains.

    Our son was getting one ear infection after another, and we went to an ENT who recommended both procedures. We did this research, cut out milk entirely and reduced sugar and processed foods (switched to whole grains). Within weeks, the congestion went away.

    Granted, we didn’t see an alergist. When asked, our pediatrician said there was no link between diet and ear infections. He said it could be that our son grew and the eustation tubes elongated, or just changes in weather.

    However you can find plenty of anectdotal stories about how diet (especially milk over-consumption) is closely related to ear infections.

    We wound up not having any procedures, and our son – who used to be a mouth breathing, lawn-mower sounding snorer – is now breathing and hearing just fine.

  6. Nathan says:

    August 26th, 2010at 2:53 pm(#)

    @Jaida I love your two cents, thank you. Food out of the nose sounds awful, and it kind o makes me feel what I’ve already been feeling–like maybe we should wait at elast on the adenoid part. Because as you point out, it’s different knowing you HAD to get it done versus thinking it would be a help.

    @David, I hadn’t heard about any of that. I suppose it’s a good goal regardless to cut down on those things, especially milk, since the boy has been known to have some intestinal distress. I do believe, though, that there’s a physical link–particularly since this is exactly the problem I had as a child, and they say that just as his earlobes look like mine, so to could his inner ear. But I am hesitant to to the cauterizing and I know surgeons have their own special view of the world. So congratulations on having gotten him out of it without surgery.

  7. David says:

    August 26th, 2010at 3:47 pm(#)

    @Nathan: Thanks. I had my tonsils and adenoids out as a toddler, but I wasn’t consulted on the decision or the alternative options!

    With our son, it was a tough decision after going through many painful nights and useless overdoses of anti-biotics. Yet we agreed as parents to put off the surgery and wait out an “unproven” dietary solution.

    Could your child have a physical cause? Sure. But don’t rule out exploring diet as a cause as well.

    I had some more time, and here is one of the milk-specific articles:

    This seems like a balanced article. I’m not some anti-milk guy, but I just didn’t feel confident about our doctor’s responses to diet-based questions.

    Also do a search on “ear infection diet”. Here is another article:

    In Childhood Ear Infections, Dr. Michael A. Schmidt presents over 16 scientific studies that show that many cases of chronic ear infections are due to food or airborne allergies or hypersensitivity reactions. Allergies can cause significant pressure changes within the middle ear, as well as obstruction of the eustachian tube. The most common allergens implicated in ear infection are cow’s milk and dairy products, wheat, eggs, chocolate, citrus, corn, soy, peanuts or other nuts, shellfish, sugar, and yeast. Dairy is the number one contributor to childhood ear problems. Proper allergy management, such as elimination and rotation diets, can produce dramatic recovery in allergic children with chronic ear infections.

    Research over the last 8 years has shown that antibiotics actually make very little difference in the recovery from an ear infection. Yet, antibiotics are usually prescribed in children with ear infections. A reasonable approach in treating a child with an ear infection, who is otherwise healthy, is to wait four days and see if the body will recover without antibiotics. If after four days, the infection has not gone away, antibiotics may make a difference. Keep in mind that if an allergic child continues to be exposed to an allergen, or if the main cause is not resolved, recurrent infections are likely.


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