We're wrapping up 2 grueling weeks of surgery and post-op for our littlest guy. Here's what we learned and wish we'd known.
If your kid talks like he's hearing impaired, he probably is. Ours was. We would comment to each other that when he was sick, it was worse. His words sounded throaty, or mumbled or something else despite being attuned to both of us, communicative, holding eye contact, using his hands and body language. He would stare at our lips or seem like he didn't hear us — but it was inconsistent. His speech and language were not progressing at pace with his development and he had seen speech therapists from years 1.5-2.5. He passed his 1 year and 2 year hearing tests but failed the 3rd at his 3 year old check-up. At that point, his 3rd winter with us, we had also noticed a pattern with chronic ear infections and strep for half the year (fall/winter). This fluctuation in hearing due to fluid build-up in his ears and ongoing illnesses has been a critical barrier in his speech and language development. It wasn't until he failed his hearing test, in combination with polling the internet and talking with friends, that we realized there were connections to be made between speech, language and chronic ear infections and strep. This was when we pushed for a consult with a pediatric Ear, Nose and Throat specialist.
It's no secret we've struggled with sleep in our house. We were in crisis in this area at the onset of fall 2017 and saw positive impact after making significant changes to our diet, but with mild change for our littlest guy. Since his arrival in our home at the age of 6 weeks, he has slept largely in 3 hour cycles. Down by 7p, up by 10p. Up by 1am. Up by 4am. This cycle continues, though he's usually just looking for one of us by 10p and needs his diaper changed by 2a, otherwise he'll soak his bed. Another mystery to us.
As part of trying to arrange the best sleeping plans for all of us, at some point in the last year and a half we swapped out sound machines for fans in each room. The power went out in the middle of the night not long ago, and for the first time, we could really hear how loudly Tiny snored and how frequently uncomfortable he was. We carried this information forward and along with his frequent ear infections and strep, we opted directly for what was recommended - tonsillectomy, adenoidectomy and ear tubes.
Tonsillectomy, Adenoidectomy & Ear Tubes
I'm just going to drop this thread here because this was the most helpful information we got and it came from followers and readers who had lived experience with these surgeries. If you're wondering if your kid (or you!) is working through the mystery of sleep and sickness and speech and the like, these shared stories were HUGE for us and may be useful to you. There's more here and here as well.
The Surgeries - What You Should Know
Once we decided a tonsillectomy, adenoidectomy and ear tubes were the way to go, we waited for the call. Our options were right away (while we were prepping our house for listing) or at the end of summer. We didn't want to delay any improvements to his health, hearing and speech so we opted for immediately.
He went in early (7am) on a Tuesday morning, with no food or liquids after midnight the night before (we were told small sips of apple juice or water were ok). He was with us until they needed to anesthetize him, at which point the separation from us to them was traumatizing for him. We learned later that he was so upset he vomited and had to have his stomach suctioned empty before safely moving forward with the procedures. There was also concern he may have asphyxiated and we needed to watch for pneumonia symptoms the following week. We've learned since that a better plan for him would have included sitting with him until he fell asleep. Obviously.
He was under for 45 minutes and coming out of anesthesia and transitioning from morphine during the surgery to regiments of acetaminophen (tylenol) to ibuprofen (advil or motrin) every 3 hours ate up the rest of the day. He also slept almost the entire day after leaving the hospital. While in the hospital, he needed to be observed for a couple hours, where they gave him popsicles and juice. Little man only wanted his clothes back on and his mama. So we sat there, the three of us, fully clothed and sipping as much as we could. He went to the bathroom and once all vitals were normal, discharged from the hospital about 3 hours after the start of the surgery. In and out. And then hell at home.
Post-Op, Days 2-6
After sleeping all day on surgery day, Tiny was up for big chunks of the night thereafter. He slept with us (as in — our bed— for most of the week). We did tylenol/advil every 3 hours for the following 9 days. Clockwork. Even he knew when it was coming and would ask for it 15 minutes before it was due. Days 2-6 were a roller coaster. Some moments he seemed fine and full of life and energy, but not eating much. He was clearly in a good amount of pain and that energy didn't last long. We alternated popsicles with pudding, ice chips, apple sauce, yogurt and water, water, water. Juice, juice, juice. He also slept with a humidifier. The goal was to keep his throat moist and to keep fluids coming. He had a low-grade fever early on, which nurses attributed to mild dehydration. I disagreed with that over-the-phone assessment because I knew he was peeing hourly or every other hour and he was pooping without trouble. Had it gone over 101.5 we would have had to take him back in and we wanted to avoid that at all costs. So we hydrated non-stop. Everything liquid counts.
We administered 3 ear drops (antibiotics) into each ear 3 times a day for 3 days and he hated this. We tried to time it 30 minutes after giving him advil, to curb the sting. The first 2 days this looked a lot like one of us holding him down while the other got the job done followed by cheering, snuggles and another popsicle. Cold stuff.
We avoided anything acidic or sharp (would burn or cut) and anything red, just in case there was bleeding. We were told to get back to the hospital or to the ER right away if there was any bleeding. He also wasn't allowed to run around — or get his heart rate too high. Keeping a 3 year old still is a lot like nailing jello to the wall so we snuggled while watching movies, had activity books and honestly, feeding him was so hands-on and laborious, he had to slow down for that. We would sit him on the counter to attend fully during moments when he really needed to slow down. See also showers and baths. We don't have a bath tub but showers were awesome — steam, multi-tasking, and water is just a great sensory experience for him. We kept water off his face.
Dragon Breath, Days 7-10
Hell. These are the days you prepare for. For us, they were only 3 days but at a time that came at a high cost. We were exhausted and injured with the marathon of getting the house ready, the commute into/out of the city for Sweet's school, and our daughter had a very high temp during this time as well. Suffice it to say we were all on "E" at the part of the song when the key changes. The part of the race where you either gear up or give up. Since the latter wasn't an option we just pushed through the best we could. Early bedtimes, simple dinners, mismatched outfits. Late for everything and underperforming across the board but showing up none-the-less.
When Tiny's breath took a noticeable downturn, we understood we were entering what was probably the most painful period for him. Scabs on his tonsils were going to be coming off, exposing raw skin at the back of his throat. His drool got thicker, his cries changed from typical to just sad and helpless moaning and whining. He even kept saying, "I'm so sad. I need my mama. I need my mom-mom." We felt largely helpless but what did help was recognizing that the cold stuff wasn't as more painful than helpful at this point. Luke-warm for 2 days was the way to go. We shifted from ice-chips etc. to lukewarm, pureed, organic chicken soup delivered via syringe. Over and over and very slowly. He stayed hydrated, semi-full and was getting plenty of liquids. A total champ in this department but wants NOTHING to do with the smell of chicken soup right now.
Other things we did for comfort — chewing gum in the car. Sugarfree, light and minty, he LOVED it and it gave him some agency over managing his own discomfort. Also driving in the car for naps. Nothing puts my kid to sleep like a long drive on the highway with the hum of a little wind or air from the vent. We managed to sneak in a 4 hour nap on day 9 and I think it was really well timed because he woke up after that seemingly much better.
All things day 10 and on
That's where we are now. He woke up the morning of day 10 like a whack-a-mole, ready to rock and roll. Day 11, He's still a little uncomfortable and we're doing tylenol/advil 6-8 hours apart (the advil really upset his stomach) but he seems mostly back to his old self, but better. He's demanding pancakes while singing a mashup of "This is Me," "All things Minions," & "Frozen," of course. And back to punching his brother and stealing his sister's dolls. It's fine.
We're hoping the biggest rewards for him will be better sleep and speech. Already his voice has changed SO MUCH! It's a totally different pitch and he can hear way better. "I CAN HEAWW IT!" He repeats regularly. The smallest sounds from another room. The subtle sounds like heaters turning on, fans turning off, keyboards clicking, zippers on jackets, the birds in the morning. He is energized by all of it and developing language rapidly!
We'll keep you posted in another month or so and report back in on his sleep and speech.