Give me ideas please. DD7 still not swallowing (day 5 after op) for Tonsils, Adenoids, Grommets and Tooth Removal

[Maymay07]

It's Fri now, the op was Tue, (Tonsils, Adenoids, Grommets and Tooth Removal).
DD aged 7 was discharged this am, after 4 days in hospital, as the surgeon says a change of environment may encourage her to start swallowing.
Surgeon says she has a low pain threshold with a lot of referred pain in the ear from the throat. The visual checks show all is as it should be at this stage.
DD has not eaten since Mon and is only swallowing less than 50ml of fluids most of which she holds in her mouth and then spits out. Not taken her medicine since this am as she is scarred of the pain. She is holding her ear and occasionally thrashing around with pain. Loves to hold water in her hamster cheeks and then spits it out (minutes later). Not dehydrated (yet).
The nurses and I have tried most tricks but nothing gets her to swallow past the pain.
All tips, tips and humour taken on board. X x

Assuming surgeon's hypothesis is right and she is able to swallow but scared to do so because of pain... Is she swallowing her saliva? (I.e. She does not need to spit it out?) if she is she is old enough for you to try and explain if she can manage that she will manage some fluid... Start with a small amount, then move on to yoghurt and then try solids. Hope it helps.

Thanks. Not swallowed saliva for days now....pain in ear. Scared.
So she holds liquid in mouth for an hour or so and then spits it out and starts again.
Has anyone come across this?

Has anyone come across this?

I was similar the first time I'd had to be tubed after going into anaphylactic shock. I was critical and the trauma team only just managed to secure my airway in the normal way, in the process I took a fair bit of trauma to my throat. The pain when they were able to extubate was beyond description, any attempt to swallow felt like I was swallowing broken glass after someone had taken a sandblaster to my throat - so I refused to swallow.

I was already in ICU so they refused to move me until I would take fluids; it took 5 days, a brilliant nurse and the use of a local anaesthetic sprayed into my throat before I would attempt it again. From there I could be given enough pain relief to swallow fairly comfortably, pain relief was then stepped down over a few days.

Depending how much pain she is in, she may well feel as though she doesn't have enough room to swallow so she could be worried she will choke or cough - thus causing even more pain. There was no explanation which worked (or would have worked!) to get me to try and swallow past the pain I was in because it was just too severe, only the knowledge that the spray would have killed the majority of it worked.

As for 'low pain threshold' after:

Tonsils, Adenoids, Grommets and Tooth Removal

I'm not surprised she's scared, how much pain relief did they give her before asking her to swallow the first time post op? Quite honestly, if she wasn't up to her eyeball on painkillers it must have been hell!

I wouldn´t be happy about this at all op.

What form of medication is she on? Liquid or tablet based?

How is she today?

If a child is in that much pain post op with no improvement then there are things that the hospital can do to help her.

If you are worried and Mothers instinct is telling you she is in a lot of pain then please go back to the hospital. A different paediatric doctor may view thing differently or be able to suggest alternative causes of action etc.

A child not able to swallow their own saliva or drink etc needs medical attention no matter what the cause

Thanks for all.
Pleased to report that it's day 7 today and Miss is now eating and drinking - last 48 hours. She refuses to take medicine (normal for her) and has found ways of coping, i.e, holding water in her hamster pouches all day. This has led to some amazing sign language with plenty of laughter and results in her spraying us with water as she laughs/spits it out.
Just need to sort the constipation out now.... Oh well...
Thanks for all your words.
X