Tuesday, April 16, 2013

Beauty Sleep: Tonsils, Adenoids, and Ear Tubes-obstructive sleep apnea and chronic sinusitis

There is something so precious about a sleeping child.   Her face goes slack.  Her beautiful eyelashes brush against her cheeks.   So peaceful.  Tricking one into thinking that she is an angel and not a wild child.



So beautiful and peaceful until Ellie started to sleep in some rather worrisome positions.  Positions that can suggest obstructive sleep apnea.

Sitting up.  Upper body raised half on the bed.  Head thrown back.   All ways a child naturally attempts to make it easier to breath while sleeping if they has apnea.  Of course, my daughter is a wind-up toy.  She essentially is go-go-go until she literally collapses so this could also be the case--collapsing mid-play.  



We did not do a sleep study.  While it seems that a sleep study is the gold star for diagnosing and determining the severity of sleep apnea, Ellie did not undergo one.

Ellie's lateral neck Xray to rule-out possible AAI showed moderate obstruction by the adenoids.  Ellie's head/neck CT scan from her extremely scary fall in February showed the same as well as a wicked case of sinusitis.

Photo: www.kids-ent.net


You cannot see the adenoid. It is a lymphatic tissue located behind the nose-where the nose meets the throat.  Similar to the tonsils it is a part of the immune system in that it can help fight infections.  An enlarged adenoid can make breathing from the nose rather difficult.

An enlarge adenoid can also contribute to sinus infections in children in that it blocks drainage from the sinuses.  This fluid accumulates in the sinuses and makes the perfect breeding ground for bacteria and viruses.  This is Ellie's problem.  Her MAIN problem.

My little Ellie has had a sinus infection since January.  Yes, January.  As in several months.  She has a low grade fever every 7-14 days that lasts anywhere from 24-72 hours.  Then the snot appears.  Thick, very thick snot.  Copious amounts of snot.  I don't rush to the pedi every time The Bear has a fever or snot.  Remember, former pedi health care provider over here.  I wait and do a lot of nasal saline.  When the snot wasn't going away and the fevers were hitting nearly every 1-2 weeks, I would finally take her in.  Sinuses.  Always the sinuses. We would try antibiotics and things would improve for a bit, but it was never completely eradicated.  About 1 week after antibiotics, BAM! it would be rear its ugly head.  We even tried nasal antibiotic spray that required me to go to a special pharmacy to compound it.  We do intensive allergy treatment as well. Her sinuses just wouldn't/won't clear.

Fortunately, my little girl is a trooper. Nothing stops her.  Febrile or not, she would still be climbing onto the kitchen island or running around our backyard attempting to play fetch with Sophie dog.  However, she was missing school and she was in pain at night.  That sinus pressure while laying down was too intense and this mama bear couldn't ease her nighttime suffering.

Therefore, we are removing the adenoid!

Where do the ear tubes come in?  That pesky honking large adenoid is also blocking the eustachian tubes.  Again, as with the sinuses, when the eustachian tubes are obstructed, fluid can accumulate in the ears.  This can lead to hearing loss as well as infections.  Ear tubes allow any fluid in the middle ear to drain.  This will be Ellie's 4th set of ear tubes!

Why are you taking my tonsils and adenoid?


In a few hours, I will hand my baby over to the surgeon for her 5th surgery--the ENT trifecta of tonsillectomy (oh, did I not mention her large tonsils?!), adenoidectomy, and ear tube placement.  As with any surgery, I panic and worry.  There is anesthesia involved!  We have to spend the night in the hospital! So what does a mama bear do when she is up at 2:30am and cannot sleep due to anxiety?  She blogs of course!  Now my husband, he is up because he is more worried about her attempting to climb out of the hospital bed and cracking her head open--I think his worry is more appropriate as that is more likely to happen.

Prayers and happy thoughts would be appreciated today as my baby, my little darling girl has surgery.




References:

Obstructive Sleep Apnea.  Lucile Packard Children's Hospital. http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/respire/apnea.html

Children's Sleep Apnea.  American Sleep Apnea Associtiation.
http://www.sleepapnea.org/diagnosis-and-treatment/childrens-sleep-apnea.html

Tuncer UAydogan BSoylu LSimsek MAkcali CKucukcan AChronic Rhinosinusitis and Adenoid Hypertrophy in Children. (Jan-Feb. 2004). American Journal of Otorhinolaryngology. http://www.ncbi.nlm.nih.gov/pubmed/15011200

Adenoidectomy. Children's ENT and Facial Plastic Surgery: Children's Hospital and Clinics of Minnesota http://www.pedsent.com/surgery/adenoidectomy.htm



The Hailey Herald is a delightful blog about a little girl who rocks something extra.  Her mom is a fabulous writer and Hailey is gorgeous.  She also likes to conk out in the funniest places/positions.


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10 comments:

  1. Praying for her. I hope all goes well and she gets to feeling better.

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  2. Praying that everything goes well for Miss Ellie!!❤❤

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  3. I hope everything goes well and I hope this helps with all the sinus issues too.

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  4. Poor, mama...SO scary, but I feel certain your baby girl will feel so much better in the long run. I know I did when I was a young girl and had my adenoid removed and tubes placed.

    Keep us posted!

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  5. Oh man. Poor Ellie! And poor you guys too. I thought it was weird that the ENT never told us how sore the recovery can be for some children. But even though Cora had an unusually rough time after hers, I am so glad we did it. She doesn't sleep in nearly as unusual positions any more. Hoping that this will help her poor sinuses. How hard on her poor little body. Sending good thoughts and prayers to you all and hoping that she has a smooth recovery.

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    1. I remember Miss Cora's rough recovery. I couldn't believe how young she was when she had it done :( I am relieved to hear that she is doing better since her surgery. I also cannot believe how much your munchkin has grown!

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  6. Praying that everything goes well for Ellie.

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  7. Thank you, ladies for all of your thoughts and prayers. They are much appreciated!

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  8. Anna, how did everything go with the surgery?

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