Would you go for tonsillectomy and adenoidectomy in a "borderline" case?

[UmmingAndErring]

Hi. Just looking for opinions about the above.

DD(6)'s sleep has been quite disturbed on and off through snoring and (I think) apnoea for years. She has big tonsils. She does seem tired in the day, and has some attention problems, but I don't really know how much - if at all - this relates to poor sleep. And even if it does relate to poor sleep, I don't know how much this relates to snoring/possible apnoea.

She doesn't get infected tonsils very often, and doesn't miss any school.

I can't decide whether to push for tonsillectomy. Does anyone have any advice?

Many thanks in advance.

If your DD is losing sleep it is not a borderline case. Go for it.

Possible apnea? Should you not make sure she has it before considering the operation?

I was told by the doctor to sit by DC's side as they sleep and count for how many seconds they stay in apnea. Iirc they won't consider the operation if it's less than 10 seconds.

Thank you both for replying.

I shared a bed with DD the other night, and there were several pauses of 10 seconds plus. One was almost 20 seconds. Can this be diagnosed for definite without a formal sleep study?

Incidentally, I don't know whether this happens when she doesn't have a cold. But she gets a LOT of colds.

Definitely mention to the doctor that she has 10+ seconds of apnea. I don't know if a sleep test would be required.

Having tonsils and adenoids out can make a massive difference to tiredness, concentration and poor sleep. So yes go for it.

Yes I would push for it. We're currently waiting on an appt for 3 year old ds1. Ent requested a sleep study but that did show mild sleep apnoea and they gave us the choice of seeing if he grows out of it or going for the op. I chose the op now.

DS (3) had his removed due to recurrent tonsillitis last year, age 2 - much earlier than they usually do it, but our GP was really supportive. I asked them to look at the adenoids whilst they were in there, and both his tonsils and adenoids were significantly enlarged, so whilst that wasn't the reason for their extraction, his sleep improved MASSIVELY and IMMEDIATELY. We hadn't really actually noticed how poor his sleep had been until he suddenly wasn't shattered all the time! Good luck!

You need to get a referral to Ent first. Ours then did a sleep study which will show what is happening. I think when you have the facts it will be easier to make a decision.

Thank you all for your input - it's been really helpful.

My suspicion is that she has apnoea some nights but not others. She does show signs of being perpetually tired, and her sleep is always loud and unsettled.
But I would have liked to have a sleep study for her before going ahead with this.
However, it's now been rather taken out of my hands, because we've seen an ENT consultant and he said she needs them out fairly urgently because one is quite a lot bigger than the other and when this happens there's an outside chance of lymphoma. They've always been uneven, so I think this is extremely unlikely. But I'm assuming it would be foolish of me to not get them taken out now, right? Just on the offchance?

My daughter had exactly the same issue. Started when she was 1 and eventually there was no choice but to take both out. The youngest they would do it is 2. It scared the life out of me (bit of a wuss when it comes to my babies) but since she has had them out she has thrived. Slept better, better behaviour, ate better.

She is 6 now. Just had the adenoids shaved again and gromits in. She is coming on leaps and bounds.

Operations both times went well. No complications.

That's great, financial. Glad your DD's doing well.

As someone who had a really poor quality of life in childhood owing to issues with my tonsils I would encourage you to do it. I was old enough to be able to remember the before and after... I wish my parents had pushed

Just a personal perspective. I remember having tonsils/adenoids/grommets done aged 6. Nobody was even talking about sleep apnoea back then (Dark Ages), but I can so clearly remember waking up after the operation and feeling completely different. The realisation that I could breathe through my nose was a transformative experience in itself. It made such a huge difference to me, I'm very very glad that I had it done.

Clobbered that sounds great. Same age as my DD, too!

Otto, thanks for the encouragement. How old were you when you had them out, if you don't mind my asking?

Sorry for the late reply! I was 15, I missed cumulatively 2 years of secondary school because of it!

Blimey, Otto, that's a lot of school to miss.

Thanks for the reply.

We have same issue, DS(4) has one of them significant large , blocking totally the airway on one side. Seeing an ENT next week, but wanted to ask if anyone knows, does taking them out mean that they will be more ill more often? They say tonsils are good for immune, so does this mean we ll be getting all the bugs when they are out?

My DS had his out when he was 2, but he had severe apnoea with his (airway totally being cut off...waking up and gasping for breath, that kind of thing). I don't regret doing it because he was cured instantly and even wanted to eat crisps the next day so he wasn't even in much pain! 7 years+ on and I don't notice he's more ill than any of the other kids. He gets a cold every now again, the usual stuff.

Saga very helpful thanks

I had a tonsillectomy when I was 20. I was going to say no don't do it. But I can see I don't know what I'm talking about in this instance. All I can say is that I wish I hadn't because once the tonsillitis were removed, the problem just went deeper. Since becoming chronically ill, I have been told tonsils are there for a reason and are a fundamental part of your immune system. I have chronic fatigue syndrome (ME) btw. I'm not saying it caused the illness but apparently ME is caused by low grade infection, which cannot be treated with antibiotics and not having this first line defense will have made me more susceptible. If I could do it all again, I would address the underlying issue as the tonsils were inflamed constantly because there was something wrong inside my body and inflamed tonsils was a symptom. Removing them was not a cure. The medical profession can disagree with me if it wants but the medical profession has offered me zero treatment when I have made massive strides with non allopathic medicine. As I said I'm not qualified to comment further than that. Good luck whatever you decide.

Hi Janec, I'm really sorry to hear of your suffering. Have you been told the tonsil removal might have made things worse? Do you know where I might research this before going ahead? Many thanks for the reply.

Having your tonsils out for tonsillitis and having them out for sleep apnoea is completely different.

Another tip for apnoea, if you can record your DC on your phone so the consultant/GP/whoever can hear their snores/struggles for breath, it sped up the diagnosis/appt for surgery quite quickly for us.

Yes recording it is a really good idea.

OP, I'm a nurse and regularly look after children having had their tonsils out for sleep apnoea, it makes a huge difference to their lives. Yes it's scary thinking your child has to undergo an operation but it's only an overnight stay, possibly a day case depending on the severity of the sleep apnoea but can make a big difference long term.