Would you go through with a tonsillectomy for this kid?

[Anonymous]

4 years old, snores lightly in his sleep and has for at least 2 years. A sleep study revealed “mild obstructive sleep apnea” - it showed him having 1-2 apnea events per hour (for a child, apparently even 1 is not normal). The ENT says his tonsils are a 3 on the size scale (which goes from 1-4). But he’s not getting sick a ton or anything. He’s never had strep in his life. We mostly investigated this because his dad his sleep apnea and I know snoring isn’t normal. He DOES have more tantrums/little outbursts than his sister did at this age (…possibly indicative of poor quality sleep?), but I don’t know that it’s anything way out of the norm - maybe like 3-4 meltdowns a week? I do definitely sometimes feel like he’s overtired.

The ENT at children’s says “I think he is a good candidate for this surgery; if it was my kid, I would have the surgery. But it’s up to you, I’m not pushing you into surgery.” We are really torn! I’m very hesitant to have any kind of surgery done on a 4 year old, for obvious reasons. But if it’s going to continue to be an issue, do we need to just go ahead and do it? Thoughts / advice very welcome - thanks

[Anonymous]

I would do it. Ours ended up with tonsils and adenoids out at age 3 after I waited thinking he would grow out of it. Best decision ever! Slept better, and was a different kid (sunny/happy)

[Anonymous]

I would do it. I assume they will also take out the adenoids too? My child had it done when they were 5 and it was great. Although in addition to snoring/apnea they also had repeated strep cases. Recovery was not difficult. The younger they are when you do this surgery the better. I would do it before the onslaught of illness come your way in kindergarten.

[Anonymous]

I would do it if they are taking our adenoids too. Better to get it over with before kindergarten.

[Anonymous]

I can’t give an opinion about this, unfortunately. I did want to raise the possibility that more tantrums than his sibling at the same age might be because, in part, younger siblings hav to deal with sharing and less attention in a way that the eldest doesn’t necessarily have to do. Just one thought as you consider your options.

[Anonymous]

We decided against it for my mild sleep apnea kid who at age 12 still does not sleep well. Honestly, it was the association with weight gain that really gave me pause. We may think it’s a useless organ, but the body is too dang complicated for me to do it unless there was an assured benefit.

[Anonymous]

Anonymous wrote:4 years old, snores lightly in his sleep and has for at least 2 years. A sleep study revealed “mild obstructive sleep apnea” - it showed him having 1-2 apnea events per hour (for a child, apparently even 1 is not normal). The ENT says his tonsils are a 3 on the size scale (which goes from 1-4). But he’s not getting sick a ton or anything. He’s never had strep in his life. We mostly investigated this because his dad his sleep apnea and I know snoring isn’t normal. He DOES have more tantrums/little outbursts than his sister did at this age (…possibly indicative of poor quality sleep?), but I don’t know that it’s anything way out of the norm - maybe like 3-4 meltdowns a week? I do definitely sometimes feel like he’s overtired.

The ENT at children’s says “I think he is a good candidate for this surgery; if it was my kid, I would have the surgery. But it’s up to you, I’m not pushing you into surgery.” We are really torn! I’m very hesitant to have any kind of surgery done on a 4 year old, for obvious reasons. But if it’s going to continue to be an issue, do we need to just go ahead and do it? Thoughts / advice very welcome - thanks

I would do it. Ours is 6 yo but similar in no documented strep but sleep issues and mouth breather with ear fluid issues. I wish we had done it sooner. His speech and learning has probably been impacted.

[Anonymous]

DO IT! I have very rotten tonsils and so does dh. I had strep nonstop and then the final nail in the coffin was mono in college. There is no recovery for my tonsils and now I'm too old to get them out.

Good friends of ours are both ENTs. They said that previously ENTs stopped doing tonsillectomies as much (in 90s/2000s/2010s), but they realized that the pendulum had swung too far. There is no benefit to having tonsils. They said that they see lots of cases with adults who have bad tonsils and there isn't much to be done for them.

[Anonymous]

Anonymous wrote:DO IT! I have very rotten tonsils and so does dh. I had strep nonstop and then the final nail in the coffin was mono in college. There is no recovery for my tonsils and now I'm too old to get them out.

Good friends of ours are both ENTs. They said that previously ENTs stopped doing tonsillectomies as much (in 90s/2000s/2010s), but they realized that the pendulum had swung too far. There is no benefit to having tonsils. They said that they see lots of cases with adults who have bad tonsils and there isn't much to be done for them.

Why would you be too old? I had mine out at 37 and it was painful but so worth it.

[Anonymous]

Semi-related: does anyone know if getting your tonsils out as a child can help prevent a genetic tendency towards adult sleep apnea ? Or are these two things entirely unrelated

[Anonymous]

I guess I've never really thought about tonsils or what they do (i.e. had no idea it was somehow related to sleep issues), but to the extent it helps - I had my tonsils out as a kid (maybe 5 or 6?) and my only memory of it is eating ice cream after and a gift a friend gave me. I haven't had any issues as an adult and have never had strep. (I also had tubes as a kid and assume it was ear-related but honestly not even sure why I was a candidate as a kid).

[Anonymous]

DD was a snorer. She had her adenoids out at 2. It helped a lot. Then around age 8 she started getting more sore throats for whatever reason, sometimes strep sometimes something else. Plus the snoring was back although not as bad. We did a sleep study and she had mild sleep apnea. That combined with the throat infections made her eligible so we did it. She was 9. The few days after were rough, but we’re glad we did it and so is she. I guess the adenoids can grow back a bit too, because he took some more out when he did tonsils. I would do it now, the younger the better..

[Anonymous]

Anonymous wrote:We decided against it for my mild sleep apnea kid who at age 12 still does not sleep well. Honestly, it was the association with weight gain that really gave me pause. We may think it’s a useless organ, but the body is too dang complicated for me to do it unless there was an assured benefit.

I guess I didn't do my research enough, because I didn't know about this. But good sleep is related to so many things, including weight. Our child who had the surgery at age 3 is now 18. He's an athlete, and weight is 100% not an issue

[Anonymous]

Anonymous wrote:

Anonymous wrote:We decided against it for my mild sleep apnea kid who at age 12 still does not sleep well. Honestly, it was the association with weight gain that really gave me pause. We may think it’s a useless organ, but the body is too dang complicated for me to do it unless there was an assured benefit.

I guess I didn't do my research enough, because I didn't know about this. But good sleep is related to so many things, including weight. Our child who had the surgery at age 3 is now 18. He's an athlete, and weight is 100% not an issue

Right. And just to be clear, my point was in the cases where it’s not clear what effect it might have. With mild sleep apnea, docs are like “it might help! Or not! We can’t really predict”

There are tons of cases where there is a clear indication and potential long term side effects are outweighed by the benefits.

[Anonymous]

we waited and did it at 7 and regretted waiting. things just got worse, chronic illness. initially was just sleep apnea.