Tonsillectomy in Egypt

[IndieTara]

Hi all looking for experience or opinions from health professionals if possible

DD is 10 and has had recurrent tonsillitis since January, classed as 6 different bouts with 6 different types of antibiotics. She was hospitalised in April due to very high temp causing hallucinations and confusion and since then saw a consultant and is 8 weeks into a 12 week antibiotic course. Her yltonsils are still swollen and sore but no temp.

Consultant seems reluctant to take them out and try all other avenues first, understandably but did mention as a future possibility.

This has affected DD so much, she has no energy and constantly talks about her tonsils and feeling ill. It's taken over her life despite me trying everything to be positive and showing her ways to cope and help

She is going to Egypt on holiday on Saturday with her dad for 3 weeks. His uncle is a surgeon at a private hospital there.

He wants DD to have her tonsils out while there. I'm dubious. I used to live there and it's so hot and know how dirty it is as a country in general . NHS advice also says you shouldn't fly for 3 weeks after a tonsillectomy.

It's a ridiculous idea, she's supposed to be on holiday, she'll be miserable and probably scared without you there. Plus, if the NHS suggest avoiding flying for 3 weeks afterwards, I'd not go against that.

Had mine done privately we do have medical insurance so a lot of the cost was covered but it was the best money I’ve ever spent if you can afford it do that in the UK, just go without a holiday next year, you won’t regret it it was seriously the best decision for my children’s health. . The amount of antibiotics and emergency appointments they had plus holidays ruined made the money we spent totally worth it. They are much happier healthier and enjoy their holidays with outfitting in foreign hospitals

@GruciusMalfoy yes all of that is a worry. But potentially it would make a huge difference to her going forward.

I absolutely hate the idea of it being done while I'm not there but also know it could take months and months longer here to be sorted.

In the meantime she's feeling miserable and ill a lot with no end In sight, it's had a huge impact on her schoolwork this year, in total she's had about a month off school in the last 6 months. Which means I've also had to take loads of time off work.

Luckily I have a very understanding boss, but I was off last year for 6 weeks with a hip replacement and 6 weeks the year before with a spinal op.

I feel as if I'd be saying no to something that could really help DD for selfish reasons. I've told XH I will think about it

@madeyemoodysmum I don't have health cover and couldn't afford to go private in the UK. I do have a holiday every other year in Spain because my parents live there and often pay for mine and DD's flights

Egypt is her dads home country

I still feel it would be worth finding out the cost they might not be as much as you expect we paid £800 for two children obviously health cover cover some of this but a lot of money but we had to spend was for nursing care the actual operation wasn’t very expensive and the health insurance didn’t cover the nursing care

What sort of doctor is her uncle? Is he an ENT? Has he done a tonsillectomy recently? Or will someone else do it for him?

I’d also ask what other surgeries they do there, Are they equipped for an emergency? What do they do if there is one, or do they have to transfer out. If so how do they transfer and how far away? I don’t mean to add stress to you. But it’s important to think about these things.

I’m theiry it sounds like a good idea, but I’m not convinced I’d do it if it was my DD

@madeyemoodysmum I think having part of it covered by insurance must make a big difference prices I have seen for tonsillectomy are around the£2500 mark with extras for after care. Blood tests and follow ups are also expensive.

I'm a single parent and just don't have access to that sort of money

@Starstruck2020 I'm with you completely and have asked those questions today.

I wouldn't even consider this, sorry OP. Get back to your GP and ask for a referral for a tonsillectomy. Ask to see the treatment access policy and this will confirm how many times your DD has to have the infection and antibiotics, push the NHS to perform this if DD meets the criteria which it sounds as though she does.

@itbemay1 I've already done that when she saw the consultant in may. Apparently she needs to have had at least 7 confirmed instances of tonsillitis over a 12 month period. And even after that its up to the consultant.
He also said they don't like to operate on tonsils that are infected at that time as it makes the op more difficult and higher chance of complications

Can you get an appointment with the consultant again to explain the effect this is having? Or even get your GP to write a letter?

I had mine out age 38 because I was having time off work etc, I had to almost plead the consultant but they do listen.

Awful situation for you, I was the same as your DD and had suffered up until their removal, it's an horrific operation with a lot of possible complications which is why I would rule out Egypt. Hope you get sorted.

Thanks @itbemay1 the consultant said he wouldn't consider seeing her again until the current 12 week course of antibiotics was up and there's still 4 weeks to go.

Her throat got worse over the weekend so took her to GP today ( as she goes to Egypt Saturday ) and he just gave penicillin again.
He also wouldn't do anything until the 12 weeks is up

Clearly none of us can tell you what you should do, but these are some things I’d think carefully about/ask before contemplating this surgery abroad....

Who would be doing the surgery? I may have misinterpreted this but your post suggests that your partner’s uncle would be involved... In the UK it would not be considered acceptable to operate on your own relative under these circumstances.

How many paediatric tonsillectomy’s do that unit do each year? What is their incidence of complications (in particular post-tonsillectomy haemorrhage).

If the surgeon you’ve seen here wouldn’t operate while she has an acute infection because of the increased risk, and she’s just started more antibiotics for another infection, what are they going to do differently in Egypt to make it lower risk than the surgeon who’s seen her here thinks?

How will having elective surgery affect her travel insurance? (They’ll need to know she’s on antibiotics & whatnot anyway, but what you’re proposing will likely cost a good deal more to cover).

How soon after the surgery would she be flying home? She may well still be within the window in which post-tonsillectomy haemorrhage can occur when she’s flying back - it’s a scary enough scenario in a hospital at sea level but could be disastrous at altitude.

@Greybeardy thank you very much for those thoughts it's really helpful.

For clarity it's my ex husbands uncle who is the surgeon. He apparently has 3 PhD's and specialises in ENT. He has done more than 16000 ops ( not all tonsillectomies )

The hospital there would do all the blood tests etc and examine her before agreeing to do the surgery. It's not a given. I did wonder here about operating on infected tonsils too.
Surely it must actually happen, my DD can't be the only child or adult who antibiotics haven't worked for but whose tonsils have been taken out anyway. If the antibiotics don't work what's the next step in the UK?

Very good point about insurance

It would be an absolute no from me.
Is her health insurance happy for her to be travelling with an ongoing condition requiring medication?
As above, operating on a relative would not be considered appropriate in the UK.
This could get me flamed, but as Egypt is a country that practices FGM, are you confident she isn't at risk? Especially considering your exh is suggesting she is taken into a medical environment for another reason.
This could get me flamed, but I

@Her0utdoors that's quite a jump from tonsils to FGM don't you think.

And she doesn't have health insurance, if she did I'd be getting this done in the uk

I ment travel insurance, apologies. Glad you are confident she is safe.

Do you think he would get it done even if you said no?

@SoupDragon I suppose it's always possible but In that instance I couldn't stop him

@Her0utdoors it's the first issue I brought up when he started taking her to Egypt

Would be a no from me, not in Egypt, not without me there, not with a current infection, not somewhere I hadn't fully and carefully researched even if it was private in the UK.

How much is it going to cost in Egypt compared to private in UK? Even if the surgery is free will the medicine, nursing care, additional insurance also be free? Is the difference really worth the risk and her not having you there?

I think the uncle would cover the costs from what I gather.
The whole point of me not being there is that I feel a bit selfish because I want to be there. DD would have one of her parents with her, it just wouldn't be me