Tonsils and breathing difficulties

[shouldwestayorshouldwego]

Dd is nearly 11. She has always had large tonsils but over the past two years they are really affecting her daily life. One side touches the epiglotis the other side approaches it. She hasn't had many bacterial infections - about 1-2 per year. She is in daily pain though and it frequently keeps her awake. Has Difflam spray on repeat prescription but says it isn't as effective now.

She has been a fairly active child but now it is impacting on her stamina. A brisk 15 min walk to school if we are running late will leave her breathless. She can only run 100m before she has to stop. Swimming is affected too. The breathlessness doesn't sound like a wheeze, it is a rasping throaty sound. She hasn't got asthma. She is normal weight.

We have tried piriton in case it was an allergy but it made no difference. Currently waiting for blood test results for glandular fever and full blood count. Any ideas what else can ask GP to do?

I would ask the GP for an ent referral with a view to tonsil removal. Ask her to keep a diary of the problems she is having so you can show them

You could ask for a referral to Ear, Nose and Throat. I think that as her breathing is affected, they should assess her suitability for a tonsillectomy.

How is her sleep? I know you said it keeps her awake, but did you mean pain, or are her tonsils causing an obstruction? DS1 has his tonsils (and adenoids) out when he had just turned 4. He fit the criteria as he had so many infections, but what they were really concerned about was the fact that they were causing sleep apnea. ENT strongly recommended removing them as they considered it a serious problem. DS2 has an ENT appointment next week - he's 2, but seems to be developing breathing difficulties too.

I hope something can be done for your DD - it's awful that she has to struggle when she should be able to run around like the other children.

Definitely ask for an ent referral. I'm surprised you haven't had this already. Having her tonsils out can make a massive difference.

So far they have said that because she doesn't have enough bacterial infections she won't meet the criteria for removing them so won't refer. It just seems to have a big effect on her life. She misses 2-3 weeks of school a year as even if it isn't bacterial she will have a high temp and pain which nurofen and calpol doesn't touch. Even with viral infections she can only swallow soft food immediately after pain relief. She has at least 4-5 viral infections per year which lead to time off school. This is on top of the constant daily pain and the breathing difficulties. Sleeping seems ok once asleep but she is usually still awake when I go to sleep. I will ask again for a referral once we have blood test results. Beginning to wonder if we might need to pay.

That sounds really poor on the GP's part. Why aren't they referring due to the breathing difficulties? Tonsillitis isn't the only thing to refer for. Does she have obstructive sleep apnoea?

Have you seen the same GP or someone different? You really should get a referral as its affecting her life so massively.

You can pay for a private ent consultation, if you live in London I can recommend who to see. You can get referred on the NHS afterwards. Your GP sounds useless.

She needs an ENT assessment.

Frequent bacterial infection are one indication for tonsillectomy - of course there are others too. You need an ENT surgeon explain to you (and her) why having her tonsils out would or would not help her particular problem.

This is a new GP who to be fair has done more than the previous one. The last one would either just give antibiotics or say it was a virus and send us away. She also thought ds might grow out of an ingrinal hernia. The new dr has given piriton to see if it is an allergy but it made no difference and has ordered blood tests and given pain relief. I think that it is becoming more of an issue partly because the expectation is increasing that children of her age can swim further and run further but dd is just not able to. She doesn't snore so that isn't an issue. Will see what the blood tests show and then look into ent referral. Thanks for all the advice.