Monday, December 8, 2014

Surviving the Toddler Tonsillectomy

Tomorrow morning will mark three weeks since Reagan's tonsillectomy. Three. Full. Weeks.

Today marks one week since I feel like I got the real Reagan back.

Thirteen days. Thirteen days. THIRTEEN DAYS.

When we agreed to the tonsillectomy (initially, we were only planning on an adenoidectomy which has a much easier recovery), we were told a rough 7-10 days of recovery, and a total recovery period of about two weeks. We were warned that the pain (and subsequent foul mood) would peak around day 3-4 and again around day 6-7.

That ended up being true, despite all my prayers that we'd have the easier end of the spectrum.

Here's how our timeline played out.


There's not much you can do to prepare a two year old. Especially a two year old who doesn't really like doctors touching her to begin with. All we did was tell her that she was going to a special doctor to fix her nose and throat. We actually spent more time prepping Madison for what her little sister would go through and how she could help out afterward.

Since we were planning on an overnight, I packed two of Reagan's own cups, a new binky (shush, she only gets it at bedtime and I certainly wasn't going to take that away), her well-loved Baby Anna and a special gift of Baby Cinderella. We had her iPad, fully charged. We let her going on a "shopping spree" in the library's DVD section. I packed her own blanket so she could snuggle in something other than icky hospital bedding. I got this charger from Amazon so we could plug in my phone, her iPad, my Kindle, and anything else we might need.

At home, we stocked up on comforting food. I'd read online that dairy was a no no, but our particular ENT said that wasn't necessary. If she wanted it, she could have it. We had chocolate milk, apple juice, jello, pudding, ice cream, popsicles. We also bought two huge bottles of children's Motrin, all ready to go.


We had the happiest kid in the world pre-surgery. It was actually pretty awesome. Fortunately, she's not a huge eater, so keeping her off food until our 8:30 departure time wasn't actually hard. She was allowed to drink apple juice until we left the house, and she was fine with that. 

Our Children's Hospital was pretty awesome pre-surgery as well. She was assigned a child life specialist who brought her games, crafts, toys, and books as she needed them. A lot of pre-op is sitting and waiting for the medical people to come in, ask a few questions, and leave again so all the distractions were key.

Right before she went in, the anesthesiologist suggested she partake in a little cocktail. She was pretty energetic, and she's, you know, two, so they thought she might fight the sedation or have a tantrum going into the OR. Adam and I jumped on this chance and spent the next twenty minutes laughing as Reagan went from a happy kid to a super happy kid who was amused by everything, even her new inability to stand up. I gowned up, carried her in, and she drifted off in a sea of contentment.

To anyone in this situation - TAKE the cocktail. Rather than fighting and crying, she willingly went LAUGHING into the OR. You will have plenty of time for tears and fighting AFTER the surgery. Trust me.


Yeah, not nearly as much fun as pre-op. They came to get us from the waiting room (we were there about an hour) and told us she would hopefully be sound asleep for another hour. She was not. By the time we got to her bed, she was awake, being held by a nurse and screaming her head off.

Neither of my girls do all that well waking up from anesthesia, so this was to be expected, but she's a real fighter. This part wasn't fun. They actually ended up giving her some pretty heavy meds just so she'd drift back off to sleep. We sat with her for about four hours as she dozed and cried, dozed and cried. She didn't want apple juice. She didn't want popsicles. Or Jello. Or ice cream. Or anything.

Advice to anyone in this situation - BRING food for yourself. She was out of the OR a little after noon and we didn't leave post-op until almost 4:30. We were STARVING and neither of us felt like we could leave. And with all the kids there fighting nausea we wouldn't have brought in take out. A couple of granola bars would have helped a lot. We didn't expect to be there that long.

Because Reagan was so young, they wanted her to spend one overnight. I don't know that she needed to (unless our insurance company is reading this, in which case she totally needed to), but since she was still refusing to drink it was nice to know the IV was there. And frankly, it was nice to let the nurses be the bad guys and give her the medicine.

The downside was that it was a pretty sleepless night (which seems to be pretty standard for hospital overnights). Reagan had slept all afternoon and once she was settled in her room upstairs with a good dose of pain meds, she was ready to "make a cake" with all her cold, soft foods. Instead of dashing out for Starbucks and a snack once she dozed off, the two of us stayed awake, watching endless DVDs until her next dose of pain meds. I think we each clocked a couple of two hour stretches. It was a long night.


And then came recovery.

Reagan was home by 10:00 the next morning. We had instructions to medicate her every three hours, alternating Motrin and her prescription pain med so that we could stay on top of the pain. And basically, the rest of our instructions were to pretty much let her dictate what she wanted to do, eat, drink, whatever. If she wanted a popsicle, give it to her. If she wanted a cracker instead, let her try it. Oh, and to not look at her throat because it would be a mix of white, black, and gray patches with foul breath and they couldn't recommend that we put ourselves through that. Her ENT has a fantastic sense of humor, and the post op paperwork reflected it. I thought that was pretty awesome.

We found that Reagan likes to be sick by herself. Occasionally she would snuggle, but more likely than not, if she uncomfortable, she didn't want to be cuddled. She wanted to go upstairs, climb in her bed, pop her bink in, and either play with her iPad or doze. This was incredibly frustrating for Madison. Madison either wanted to be a caretaker or have her playmate back. Reagan was neither. She was cranky.

Here's what we did to survive.

We set the alarm at night.

I did the 10:00 pm and 1:00 am meds, Adam did the 4:00 am and 7:00 am. It was kind of like having an infant again, but instead of warm cuddly nursing sessions where everyone drifted back to sleep, it was like waking a feral animal who was going to clamp her hands over her mouth and kick and flail and scream. After a few of these, Adam and I decided that maybe it was better to let her sleep, rather than wake her just to be upset. We did that once. She woke up screaming and was awake for another hour throwing a fantastic meltdown.

Give each other breaks.

One of the temporary side effects is a slightly changed voice. Reagan's changed into the whiniest voice I have ever heard, on any child, of any age, ever. I had a few friends try to tell me that their children were whiny. No. No. No. I have heard these children. They do not hold a candle to this extremely nasal, high pitched whine. It was brutal. Both of us knew, intellectually that a) the actual whining was well justified and b) the voice was temporary, but in reality, it was like living in a house where there is a consistent scratching of nails on a chalkboard. When we just couldn't take it anymore, we'd take a break and go somewhere quiet for a while.

Bend the rules.

We are definitely a little more permissive on sugar on screen time that some, but we do have limits. All of those limits went out the window. Reagan basically had unlimited iPad time, and she was allowed to watch Netflix in her bed. If she was willing to drink KoolAid, she got it. If she wanted to suck on lollipops, she got them. If she wanted ice cream at 7:00 am, it was fine. We skipped about five days of baths and several tooth brushing sessions. We let her stay in her jammies. She got to pick the show or movie downstairs.

I was a little nervous that we'd be developing bad habits, but shockingly, none of that stuck. She's back on milk and water and asking for less juice than she did prior to the surgery. She's fine with limits on her iPad and it hasn't gone back into her bedroom. She's right back into the evening routine.

Call when you need to.

After she'd been medication dependent for a week, with crazy whining, I called her ENT. This couldn't possibly be normal. She shouldn't still need a narcotic! Shouldn't we be weaning her off it? WHEN WOULD WE GET OUR KID BACK????

Our ENT's nurse talked me off the ledge. It's a long recovery. Still needing medicine at a week wasn't concerning, or even uncommon. Crabbiness was still expected. Eating wouldn't be great. But she assured me that we wouldn't have to keep medicating her forever. We would know when she didn't need it anymore. And we did.

Know that it's worth it.

We're three weeks from surgery, one week back to "normal". Reagan is already sleeping better, speaking better, and eating better. She still has her share of two year old meltdowns, but she's not always on the verge of one anymore because she's not constantly overtired. She breathes through her nose now, which she was never able to do before. She's showing a lot of interest in the potty.

We joked before the surgery that we'd be getting "Reagan 2.0" - a great sleeper, a great eater, a great talker. I don't know that we truly have that. We still have our feisty Reagan. But did it make a huge difference? Absolutely.

 You will survive. And it will be worth it.

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