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Adenoid and Tonsillectomy Days 1-5

*This post contains graphic and disgusting images from post adenoid/tonsillectomy.  Sorry about that.  Do not read this post while eating. You've been warned.

Back in March and April James was extremely sick for the entire 2 months.  He was also on antibiotics for 2 months.  He lost a lot of weight that he didn't have to spare.  He was the sickest we had ever seen him and it was very scary for Brad and I both.  We decided something had to be done.  After visiting with Dr. Honey about it we decided to see an ENT.  Since James had strep 8 times in a year, we decided he should have his tonsils out and his adenoids out also because of his snoring and tendency to stop breathing while he sleeps.  I read every single thing on the internet that I could about tonsillectomies.  Some of it was helpful, some of it was scary, some of it was encouraging.  But this is our experience with it so far...only 5 days into it.  I have to admit that we almost backed out at the last minute because of my fears and because he spiked a high fever the night before.  But we decided to push ahead.  Time will tell if I'm glad we did that or not.

Before the surgery we loaded up on the largest amount of juice, gatorade, ice cream, Popsicles, jello, and soft mushy foods James thought he would eat after the surgery.  We also stocked up on activities and movies to keep him busy for the two weeks post-op that he is supposed to lay around and recover.  Not an easy task for an active 5 year old boy.  That was a big shopping trip.  And Katy Jane did not appreciate it.
 
 
We also loaded up on books and movies from the library.
I purposely was very vague with James about the whole procedure.  He knew he was having surgery and that it would hurt after.  I explained it in terms I knew he would understand but that wouldn't overwhelm him or cause too much anxiety.

That was a good plan until the nurse at Panhandle ENT gave him every gory detail and frightening statistic at his pre-op appointment.  I was not pleased.  This left me with about 6 days of fearful questions from him to deal with. She basically told us all the stats, what to watch for, how important it was for him to drink after the surgery, and to expect a 2 week recovery period.

We were told at his pre-op that he would be given a dose of Versed to help calm him down and forget about what was about to happen before his surgery.  I really played this up to James to help calm his fears as the surgery approached.  It was sort of our "ace in the hole" to help ease his fears.  We also had a small gift for James before the surgery and then told him we had another one for him as soon as he was done.  Sort of incentive to get through it.

Surgery day came and he seemed to be doing well.  We dropped the littles off at Mom and Dad's and headed to the hospital.  Last shot of those tonsils.
 
Hanging out in the room before surgery.  He brought his Hulk to keep him company.
Why are pre-op rooms always SO cold.  Brrr.  Good thing we brought along his blankie.
Playing with his new legos to distract him from what was about to happen.

He had several sweet visitors that came to pray with him before his surgery.  This was a special blessing and meant a lot to all of us...especially Jamesie.
Still working on those Legos with Daddy.

During this time, the anesthesiologist and surgeon, Dr. Morgan came in to have a quick talk with us before the surgery.  We were still waiting for the Versed and I even mentioned it to the nurse. They had ample time to give it to him as we were in the pre-op room waiting for over 2 hours. Unfortunately they never gave it to him as promised.  This was very troubling not only to Brad and I but to James.  To see him so terrified as they wheeled him out and then to hear him screaming behind the doors of the operating room is not something we will ever forget.  They failed BIG TIME here.  Not only was he ripped out of our arms while he was terrified and screaming, but he was alert and aware of them putting the mask on him to sedate him.  He has had nightmares every night because of this. I've videoed them and it's heartbreaking.  He even talks in his sleep saying, "NO DON'T" as he's trying to push the mask off of his face.  He told me that he was so scared because the doctor with the "Thomas the Tank Engine" hat held the bad-smelling mask on his face so tight that he couldn't breathe.  No wonder he's having nightmares.  Their excuse was that the anesthesiologist thought James was so mature and calm that he didn't need it. He was mature and calm because I had assured him they would give him special medicine to help him not be scared.  I wonder how the anesthesiologist and surgeon would've liked it if that had happened to their child.
 
 
This is the look I will never forget.  The terror on his face.  I felt horrible because I knew he was feeling like I was letting them take him from me when he was so scared. 

After the surgery we met with Dr. Morgan in a consult room.  The surgery only lasted about 20 minutes.  Dr. Morgan told us that James' tonsils were far more attached over a larger area than she had expected.  This means a larger scab area and therefore more pain.  The tonsils were also much larger than she had anticipated.  She apologized for the anesthesiologist failing to give James the Versed. 

About 30 minutes later we were allowed to go back to see James.  He was agitated and disoriented and in a lot of pain.  He seemed almost paranoid and scared.  All he wanted to do was get the IV out of his arm and get out of there and go home.
Look at these giant tonsils.  Gross!
 
The recovery nurse told us she had given him Propofol and ibuprofen.  Yikes.  She advised us to continue to give him Tylenol and Ibuprofen every 3 hours, alternately.  So after a few sips of water, we were sent on our way.

Thankfully, I had touched base with our pediatrician and happened to mention the medicine and dosages they told us to give him.  She was surprised they told us to give Ibuprofen as that can make bleeding worse.  She followed up with Dr. Morgan's office and sure enough, we weren't supposed to give that until after Day 3.  Praise the Lord that Dr. Honey is on top of things and has our back.  The hospital recovery nurse had also given us the wrong dosages to give James.  We could give him a full 3.5 ml's MORE than what she told us.  That makes a big difference when your child is in so much pain.

Day One Post-Op:
When we got home, Nana had delivered some special surprises for James.  He slipped right into some new jammies and went to snuggle down in Mommy and Daddy's bed.  His new home for the next 2 weeks.
 
Day one at home was by far his best day yet.  He felt like coloring and playing and was overall cheerful.  
Pictures of throat first day, right after surgery.
Throat immediately post-op day 1
Throat post-op day 1
The first night after surgery he took a drastic turn for the worse.  I was so scared.  He looked like he was nearly dead.  His color was yellowish-green.  He was weak.  He looked like he had bruises all over his face and under his eyes.
Once James fell asleep Brad and I were even more scared.  He would stop breathing periodically.  We decided it would be best for us to take shifts staying awake to watch him.
 
 
The first night was horrific.  Every time we woke him to give him a drink and pain meds, he was out of his mind in pain and completely inconsolable.  This was one of the scariest and worst nights of my life.

The next day he popped up in bed and cheerfully asked me if I was ready to get up.  Although I had had only a few minutes of sleep I was so very grateful that he woke up cheerful.  It was such a huge relief after the night we had before.

Day Two Post-Op:
Lots of laying around and lots of drinking.


Throat post-op day 2
After such a horrible night the first night we decided to give James the Hydrocet.  We didn't want to because of the risks involved but decided he needed the pain relief and hoped it would help him rest better.
 
During night 2 James spiked a fever of 101.8.  At the pre-op appointment, the nurse had told me to call the office if his temp got above 101.  She told me that the office number is answered 24 hours a day and we could always call it with any concerns or problems.  So I called at 2:00 am.  James had a high fever and was again inconsolable with pain.  We couldn't settle him down and he was burning up. I was able to bring James' temperature down with meds and made him more comfortable with a cold cloth on his head.  I got a total of 50 minutes of sleep that night.  I knew this was going to be difficult, I just didn't realize how much.

Day 3 Post-Op:
James continued to drink very well!  One of mine and Brad's biggest concerns going into this was that James would become dehydrated.  When he gets sick, we generally have a difficult time getting him to drink and have had to hospitalize him in the past for dehydration.  What we didn't count on was his great desire to please us.  He gets much praise and appreciation (and sometimes bribery in the form of toys) for drinking so he's been doing exceptionally well!  So thankful!

One of my biggest goals is to stay ahead of the pain.  I am careful to make sure I give him his medicine at the right time to keep the pain under control.  That along with the large amount of liquids have been the best thing.  Brad had the great idea on the first or second day to start giving James his drinks in the little Dixie cups...like the kind you use in the bathroom for after you brush your teeth.  They are 4 ounces and are a manageable amount for James.  It is an easily accomplished goal for him.  We also discovered that the ice cold drinks are ok for him to sip on throughout the day, but for him to drink down 4 ounces at a time, it helps for it to be room temperature or only a little cold.
We spend a little bit of time outside each day just to break up the monotony of laying around for him.  James is super-active and outdoorsy and being cooped up inside is torture for him.  He finds so much joy and beauty in being outside.

Throat post-op day 3
That night James helped me write his thank you notes to his visitors.  We've continued to give him the hydrocet only once a day at bedtime.  The rest of the time I manage his pain with Tylenol and very occasionally Ibuprofen.  This night he woke again in a great amount of pain and thrashing around.  It is hard to reason with him as he is groggy and in so much pain.  After getting him to drink and take his meds, he settled back down and went back to sleep.
 
Day 4 Post-Op:
We met Nana and Papa at Orange Leaf for some ice cream.  I think it helped James just to be out and around people.  He is such a people person that he cheers right up with he has visitors and seems to wither when he's stuck at home recovering.
 
More ice cream just before bed to coat his tummy for the hydrocet.  He said, "This ice cream has changed my life."  Good thing he's not dramatic.

Yes, his throat is getting worse every day.  The "scabs" get thicker and lumpier each day.  It is more than I can stomach so I generally make Brad check them.  We have to check them every day for bleeding.  And as if the scabs weren't bad enough...the breath that goes along with them in unbearable.  I can't even think of words to describe it.  I've read that it will subside somewhere around day 14 and trust....that day cannot come soon enough.  Heaven help me.
Throat post-op day 4
I'm glad someone around here is getting some rest!
Actually, that night was my best night with James since the surgery.  He was not in a great deal of pain when he woke up for his meds and drinks in the night.  I was so very thankful!  He seemed to rest better last night than the nights before.

Day 5 Post-Op:
Our sweet friend Elaine brought dinner tonight along with a big box of our favorite cookies. 
The scabs are much thicker and seem to be yellowish today.  I read that the scabs start sloughing off around day 5 and that the pain might increase on this day.  His pain definitely did increase...not sure about the sloughing.  I can barely type it without gagging.  I've heard that the large amount of drinking helps the scabs to slough off in layers as opposed to in big chunks with would be more painful and possibly cause bleeding.  Oy.
Throat post-op day 5
That gets us up to date.  I am praying for an uneventful night and for the Lord to spare him too much pain for the rest of this recovery period.  I had no idea how involved and challenging this would be.  When I thought of a tonsillectomy, I though it was a fairly easy surgery with lots of ice cream and Popsicles.  Not so.  It is excruciating pain that requires 24 hour, round the clock care and attention.  Combine that with a 5 year old that wants to be up and playing and is sick of eating mushy bland food and a sleep-deprived Momma, and it's very challenging.  Each child tolerates pain differently and figuring out a plan for the medicine is trial and error for the first 2 or 3 days.  It's not easy.  But I trust it will be worth it.

I read before hand that he would loose a lot of weight because he wouldn't want to eat due to the pain.  I tried to feed him all sorts of fattening foods before the surgery to fatten him up.  He has actually managed to gain weight over the past 5 days but I think that may be from the 80+ ounces of liquid he's drinking a day.  And I've heard that day 5-9 are the worst for pain so who knows what lies ahead.

Right now James is sleeping beside me, snoring loudly and coughing and choking periodically.  I look forward to the day he is all better and sleeping back in his own bed.  Today at lunch he asked if he could always sleep with me.  I told him that Mommy and Daddy need to sleep together in our room once he's all better.  He said, "It's ok Mommy!  I don't mind if Daddy sleeps with us!"  

Comments

Jaimee Sperry said…
I'm so sorry you guys are having to go through this! We did it with Brock when he was three and we have a surgery scheduled for Chase next month. So, I feel your pain. Hopefully this will all be worth it and James will be a much healthier little boy. Brock has gone from being sick every 4 to 5 weeks to only two sick trips to the doctor in 18 months!
I'm praying for James and hoping these next few days are easier.
Love you guys!