Adenoid and tonsil removal today. Help me control pain.

[Loz1975]

My DS 6 had the above op today. I thought he's doing great all day. Home by 6 I clk . At 8 the anaesthetic must have worn off as he became so distressed with pain. He's been on calpol and nurofen all day at hospital. I'm following their guidelines with regular doses but he's so upset. Waking every half hour in distress and then when asleep he's whimpering in pain. I thought regular nurofen and calpol would control this but doesn't seem to be touching it.

I thought Id seen him in his worst pain with his constant tonsilitis every few weeks but this is something else and I'm so upset seeing him in this pain.
Every time he coughs it wakes him and sets him off again for 10 or so minutes. Don't understand why meds aren't helping. Anyone to re assure me that tomorrow will be better.

He's crying again so got to go.

[Badmumof3]

Oh you poor things. My son had the same op in December and I found that the best thing was to keep on top of the pain relief. You can stagger ibuprofen and calpol so they don't wear off at the same time. (I actually set the alarm through the night so it didn't wear off!) Also check the dose the hospital recommend as its based on weight. Mt son was given 3 spoonfuls of 3month plus every 4 hours, whereas the advice on the bottle is based on age, so I'd have otherwise given him 1 and a half to 2 spoonfuls. The hospital probably gave you advice to call them if you have any worries and if the pain control really isn't helping I'd do that. Rest assured he will start to feel a whole load better in a few days time and will be a lot better in the long term.

[Loz1975]

Thank you very much. Had a very bad night, it's the battle to get him to take it that's hard. I wasn't prepared for that as he's had tonsilitis so much and always been great with taking meds. I called Doctors and she called me back, requested to see him this morn as he'd been refusing fluids but all good , no dehydration and she told me yes to up dose as I was being cautious and going by hospital dose but there was scope for more because of weight etc. . Thank you . I was in bits last night after the long day and then sudden change in pain after anesthetic wore off. I thought I was so prepared with all my re search before the op but didn't quite grasp just how much pain he'd be in. Cried most of last night in his sleep. Today much better, he's listened to the doctor, taken his med, antibiotic, slowly but surely sipping water and things are calmer. Just got to get through it. Thanks for your reply, much appreciated.

[Pobblewhohasnotoes]

It's very normal for it to get worse before it gets better once you get home, OP. I always tell my patients that!

Keep up with the pain relief regularly and encourage the food and drink. Little and often is fine, maybe lay some stuff out around the room he can just pick at.

Just remember, any fresh bleeding go to your local A&E. It's normal for his breath to smell, normal for white spots to appear at the back of the throat and normal to get ear pain, a warm towel can help with that.

[girliefriend]

Hi my dd had this op aged 4yo and was in severe pain afterwards, I am surprised they sent him home the same day as dd stayed in over night and required liquid morphine to settle!

She stayed on 2 hourly pain meds for the best part of a week!! I also found it difficult to get her to eat or drink anything and she actually seemed quite depressed afterwards for a while

What helped was letting her eat and drink whatever she wanted (ice cream for breakfast ) keeping life very simple for the first week - lots of telly. She also had a temp problem that everytime she had a drink some of it came back out her nose it looked very odd but the drs said it shouldn't cause any probs. That lasted a good few weeks.

In all the op was a lot more traumatic than I had anticipated but now nearly 4 yrs on it was worth it as not had any more tonsillitis, chest infections or problems with sleep apnea.

Hope your ds feels better soon. We were advised to keep dd away from school for 2 weeks to minimise chance of getting an infection.

[Loz1975]

Thank you very much for all replies. Last night so much better, slept so soundly(he was probably exhausted from night before). He started vomiting around 5 am though so not at all interested in eating. Pain meds only stayed down once today so far. Hasn't been sick for over two hours now so going to encourage something to eat.

I've been giving small but regular amounts of diarolite and sips of water. Yes I'm very surprised they don't keep them in for the first night, I definetly felt that he could have done with some stronger pain relief that first night. He does seem depressed, flitting between telly and reading him stories. Yes harder than I expected even though I'd re searched so much beforehand and thought i was prepared but had to be done, he couldn't go on being so sick all the time with tonsilitis and sleep apnea.

If still vomiting this evening the ward has recommended GP. I am however very confident in not letting him get dehydrated as I'm so used to him constantly vomiting when he had his tonsilitis attacks. It just stops us moving forward as can't keep pain relief in because of empty stomach and if no pain relief kept down then he won't eat. Catch22. Just got to wish next two weeks away quick, hate seeing him so sad.

Really appreciate helpful advice girliefriend, Pobblewhohasnotoes andBadmumof3. Thank you.

[Elibean]

Hi Loz, so sorry your ds is going through the same sort of pain levels my dd2 did - by the sound of it - but also glad he had a better night. It can be a very painful op, throats have a lot of nerve endings!

I found the best tip I got was to give pain meds before they were due, by about 5-10 minutes, so she was never without some level of cover. Tricky if he's throwing up though. My dd was only just 2 when she had the op (along with a few extra snips and stitches to relax a floppy larynx) so I wasn't able to reason with her over meds - she wouldn't swallow after the first day, and we had to resort to suppositories. They were a godsend - Voltarol and Paracetamol, alternated including at night (I set my alarm clock).

My guess is your ds might be distressed at 6 by the idea of suppositories, but if he isn't - do ask your GP to issue a prescription asap, as they are far easier to tolerate if his tummy is fragile or if he doesn't want to swallow. They are tiny, and melt fast, totally painless.

Ice lollies by the bucketload also helped not dehydrate. Don't worry about food, he'll catch up again soon

Also, keep up pain relief for at least a week to ten days - there is a second 'peak' of pain around the 5-7 day mark, as the scabs shrivel and fall off. Then it all gets better very fast.

Wishing him, and you, well and happy again soon!

[Elibean]

ps dd was kept in for a night, because of her tricky airway with the larynx issue - but tbh the pain only kicked in the following evening as I guess the anaesthesia takes a while to wear off properly.

[girliefriend]

Yes suppositories might be a good plan, he will need the pain relief.

Why is he vomiting? Could he have some anti sickness meds as well? I am thinking that vomiting will not be doing his throat any good at all and I would have thought an infection risk, plus it must bloody hurt!!

[Loz1975]

Hi, vomiting stopped around 1 o clk. I'm certain it was the antibiotic on an empty stomach making him sick. I called the ward and antibiotics are not always prescribed so the nurse told me not to worry too much if not keeping it down. So I decided is stop antibiotic until his stomach settles and he eats and he's been much better. Has kept pain relief down since 1 o clk and has just asked for some wotsits so have sent DH out to the supermarket as I was so pleased he asked for something.

He's a lot happier and asked for a dvd to watch so pain relief at last is helping. I was begging the doctor for suppositories for pain relief and she said they won't prescribe them for children as they come in too high a dose for his age. I thought this was strange as I thought children can have them, after asking 3/4 times she said she'd check with colleagues. She rang me later on and said no but left a prescription for a throat spray to numb it, I think that helped last night as he slept beautifully for 12 hours but refused to let me spray today.

He just looks brighter now and is smiling. Once he's eating and stomach not so fragile I will seek some advice regarding antibiotic again and whether I should resume.
Thanks Eilbean , yes I've given him his calpol etc a few minutes before due to keep on top of pain , now that he's tolerating it again he's not so sad.
It was the antibiotic coming up and flem only as nothing there to bring up, he didn't complain when being sick of any worse pain as I thought it would hurt also. He's so used to having tonsilitis and vomiting he takes it in his stride. Poor love. He's a very brave little boy so that first night freaked me somewhat as I knew he must be suffering so much.
Glad that first night is over. Had been told about pain peaking again around day 5-7 so will be ready.

Looking forward to a healthy, happy boy on the other side of all this.
Thanks again everyone.

[Loz1975]

On a positive though, it's weird but his eczema has disappeared since his operation. When he came round from anesthetic I noticed it had gone a v light pink then to nothing yesterday. I usually have to epiderm 3/4 times a day and use cortisone on bad days(behind knees and inside of elbows mostly, not covered all over thank goodness) but haven't creamed him at all today and not a sign of it. It was always at it's worst when his tonsils were infected. Coincidence perhaps it's calmed so quickly but I'll be watching it with interest.