Four Things I Wish I Knew About T & A (That No One Told Me)

A week and a half ago, my daughter had a T & A (tonsillectomy and adenoidectomy).  While both my husband and I knew there would be about a week of some significant TLC, there were a few things we learned along the way that we wished we would have known about before hand.

1. Waking up from anesthesia
This was not pleasant.  At all.  About 20 minutes after the procedure was complete, we were taken to the PACU (post-anesthesia care unit).  We walked into the room to see our daughter curled up on the nurses's lap.  She commented, "She is such a good cuddler."  Whew.  This is going to be great.  Lots of cuddles from our sweetheart.  WRONG!  As she handed our little girl to us, she began to cry.  Hysterically.  She flailed.   It took two nurses and myself to make sure she didn't injure herself.  She cried unconsolably for 30 minutes.  She was confused and scared.  It was so hard to watch this, and yes, I did cry (but just a bit)!  And then suddenly, she was herself…well kinda given the circumstances.   Shortly thereafter we were discharged to begin our recovery adventure.

2. Lack of sleep…(stress on the LACK)
Up every several hours to manage pain, give more meds, and console, felt just like having a newborn again.  Keep your coffee stash plentiful or whatever means of caffeine you chose.  YOU WILL NEED IT!

3. Narcotic withdrawl
We were given a prescription of hydrocodone for pain management.  We tried to balance the pain with tylenol and ibuprofen, but that was an epic fail.  Well, maybe not epic but a definite fail.  She really hated it, and our normally great-medicine-taking-daughter refused it like something horrible.  After much pleading, bribing, and patience, she eventually took it, and we could see a dramatic difference in how she felt.  After day six, we were able to manage her pain without it, but soon she complained of her arms and legs hurting.  She frequently complained of her "belly hurting," but it turned into such severe stomach cramping that she was up three to four times per night, crying unconsolably.  She would wake up covered in sweat but complain that she was cold.  Two days later at our post-op visit with the ENT, he shared that our daughter was going through withdrawal symptoms which could last for two to three days.  Say what?  Withdrawal symptoms?   Apparently my husband and I were in such a fog when we got home from the surgery that we failed to read that hydrocodone is a narcotic, much more potent than codeine. Her withdrawal symptoms included yawning and sleeplessness (no wonder she didn't want to take a nap!), abdominal cramping, fever, runny nose, and excessive sweating.  I wish we would have known about this beforehand.  It wouldn't have changed our mind in giving it to her, but we could have been more proactive when the withdrawal symptoms set in.

4.  Taking medicine
Our ENT warned us that some children do not take their meds well post-surgery.  Our daughter is a champion when it comes to taking medicine, even if it's horrible-tasting.  I wasn't worried about it and never even gave it a second thought.  Boy, was I wrong.  By day two, she refused to take it.  Even with both my husband and I trying to hold her down to take it, our little three-year old demonstrated incredible strengths.  Wowzers.  We had to get creative, and came up with a few "tips and tricks" that helped us!

• Keep your child (legally and safely) medicated.  Do not let time lapse between times when you are suppose to administer meds.  I asked one of the nurses if I should wake up our daughter to give her medicine in the middle of the night.  She said she didn't think that was necessary.  BIG mistake.  She would wake due to the pain, of course, but by that time, she had no desire to take it because it hurt to swallow.  (Note: I am not a medical doctor (obviously).  My recommendations are only based on our experience.  Always seek medical advice before trying anything.)
• Bribing is ok.  We had to swallow our pride on this one.  Seriously, managing her pain was our top priority.  I keep a small stash of clearance items that I find throughout the year, so I sorted through them as a "last resort."  Toys/games that required several parts/pieces worked well.  She was able to earn one part/piece every time she took her meds.  She was more motivated to take them to earn the rest of what she needed.
• We put  meds in her juice, giving her only a little juice to make sure she drank it in an adequate amount of time.
• Let your child help measure the medicine and combine it with something like juice or applesauce.  But be careful because if you do this, then your secret is out!
• We had medicine races.  We would mix the medicine with juice and prepare a glass of "medicine" and juice for ourselves and see who could drink it the fastest.  We always lost. 

We are now 11 days post-op in our house, and the difference is amazing.  Our daughter is now able to sleep quietly and well.  In fact, my husband and I often find ourselves checking in with her to make sure she is ok because we are so used to her snoring and making the "choking" noises associated with obstructive sleep apnea.  If you have any other thoughts, advice, or tips and tricks, I'd love to hear them!