Enlarged tonsils and tonsilectomy?

[mjbcmom]

My 3 1/2 yr old has REALLY enlarged tonsils - they almost touch each other and her airway is smaller than a dime. I took her to the ped and was referred to the ENT. I shared with the ENT that since we had moved (to VA from CA) she has been snoring much more and in the prior month was so disturbed in her sleep that she was waking up every 4th breath. She just couldn't get air... it was scary. Based on thier size and my description of the sleep apnea, he said he strongly recommended we take her tosils out and, because she had fluid behind her ears that had been there since an ear infection almost a month and a half before, that she also get tubes in her ears. I hesitated to go along with the surgery and he gave us allergy meds to use, a course of steroids, and allergy testing. Immediately after starting the allery meds (singulair and nasonex) she began sleeping better, not great, but much better. Her tonsils have not gotten any less swollen, though!

The allergy testing (multiprick followed by intradermal) showed that she was allergic to three different kinds of mold, maple tree, a type of grass and a type of weed.

I have a follow-up appointment with the ENT in a couple of days and I know he is still going to want to take out the tonsils, but I feel really uncomfortable with that. We will only be here in VA for 2 years and she wasn't experiencing this in CA, so I feel really awful taking out a part of her body when this mught not be an issue in two more years. Will they ever get smaller?!?! Also, I don't want her on allery meds forever, either! What are your experiences/feeling on allergy drops (like shots, but administered at home once a day)? Anyone else have to make this decision?

[SubliminalDarkness]

I'd take them out. 

When I was a kid, I got strep a lot. The doctor said if I got it one more time that season, the tonsils needed to come out. I didn't get it that one last time, so I kept my tonsils.

But, I was always prone to allergies, strep, sinus infections, on and on... I was sick a lot. It was lousy.

Finally my senior year of high school I just got sick over and over. My tonsils were enlarged, even when not "sick" so they needed to go. I have been sooooo much healthier ever since. I rarely get any of those illnesses, actually, haven't had strep at all, and it's been nearly 10 years. Only had a handful of other things, too. Even my allergies are better. 

The thing I was told about the enlarged tonsils is that it basically makes you a magnet for germs. There's so much more surface area and it's so much more prominent that you absorb all these things you encounter, and makes you really likely to continue to get sick. Not fun. And the breathing thing? That's really scary. 

[tanyalynn]

OP, have you considered a food intolerance?  Not a traditional allergy, the kind that you had tested for, but just an intolerance.  My DD's tonsils weren't as big as you described, but I was really surprised to see them just shrink down to a normal size by a month after we cut gluten and dairy.  I saw a lot of other changes sooner than that, a variety of sleep and behavior improvements as well as digestive improvements, but the tonsils took about a month, they were the last thing to improve.  It may help with the fluid in her ears as well, though I'd probably try chiropractic or cranial-sacral in addition to help with drainage for that. 

Moving to a new location with different allergens, or just the stress of a move itself, can amplify the effects of food intolerances.  Over the years, my kids' symptoms have changed, that seems to happen quite often. 

[mjbcmom]

Subliminal: That sounds awful. I am concerned, however, that if I take them out, I may be setting her up for the same experience because from what I understand, to not have tonsils leaves you open to more illness because they are a first line of defense against bacteria for children. After about age 16 (?) they aren't quite as integral, so I would be more willing to take them out later. This is what I *think* I know at this point, so please feel free to inform me more - that is why I posted!  I certainly don't want to keep the status quo, so if I can't get them to shrink, I probably will opt for surgery, but I won't feel good about it unless I investigate all my options.

That said, tanyalynn, I did try to eliminate dairy for two weeks and only lasted a week  It is such a part of our diet! I am 28 weeks pregnant, have twin 5 yr olds that I am attempting to homeschool, and the enlarged tonsil 3 yr old ~ I am exhausted and just couldn't handle the switch. It sounds terrible because I REALLY want to fugure this out but I just don't feel like i have the energy to cut out dairy and gluten. Interesting what you said about a move making an intolerance worse... I keep telling myself it can't be a food intolerance because we didn't have a problem with it in CA, but I guess I can't say that now  Also when we had her tested, the food wasn't reactive at all, but that doesn't mean anything in regards to intolerances, right? Is there an easy way to explain this? Any recommendations for making an "easy" switch to no gluten/dairy? I feel anxiety just thinking about it...

[kittynurse]

Is there any possibility you can take a vacation back to CA to see if she improves while she's there?  If she does, that might give you a bit of insight into whether you want to do anything permanent to her body.  Also, you said she's allergic to mold - have you had your house tested?  We've removed large amounts of mold from our home and it has made a huge difference for us.

Martha

[mjbcmom]

We are actually taking a vacation out there in January for a week and I will be anxious to see if that makes any difference! We live in a rental here in VA and so I would not AT ALL be surprised with old carpet and vents if the house was an issue. How do you get your house tested and how did you get it removed? I am going to look into getting the vents cleaned...  

[EVC]

We are in the same boat, except dd is 5. She's always been a snorer, but it has gotten so much worse in the past few months and she now has episodes of apnea. She's also had A LOT of infections--in fact, woke up this morning with one :( Looking into her throat, I can see that it is almost entirely obstructed by her tonsils at this point. We've been to the ENT and he strongly recommended a tonsillectomy. We have tentatively set up an appointment for March, but I also have a lot of reservations about this (both in terms of how traumatic it will be for dd, as well as for the possible effects on the immune system). I very much suspect she has allergies, but we haven't been able to figure out to what (she's been tested for mold, dust mites, pet dander, etc--everything has come up negative so far). 

I've been thinking of trying to eliminate diary (and possible gluten) but haven't really figured out HOW. This kid lives on cheese and yogurt. So cutting out dairy is going to take some major planning (unfortunately, she is a VERY picky eater--so it we offer alternatives to what she likes and is used to, she just refuses--she can literally go for DAYS without eating and is already in the 5th percentile for weight for her age, so, well, we have a lot of eating issues here as it is). 

But something clearly must be done. I guess I have until March to figure out alternatives to surgery. 

[kittynurse]

Originally Posted by mjbcmom 

We are actually taking a vacation out there in January for a week and I will be anxious to see if that makes any difference! We live in a rental here in VA and so I would not AT ALL be surprised with old carpet and vents if the house was an issue. How do you get your house tested and how did you get it removed? I am going to look into getting the vents cleaned...  

 We didn't actually get the house tested.  Some of the mold we physically found ourselves and some of it was sniffed out by my super-sensitive pregnant nose a few years ago.  I did get some names of testing companies but I'm in Canada so that won't help you much.  I found the names by poking around on some government websites that had related material on them.  You could even try calling city hall in your town and start there.

Sorry to say but the carpets are a huge huge huge issue with allergies.  If it were me, I would be talking to the landlord about getting them removed.  I know, easier said than done but removing the carpets makes all the difference in the world.  If he does agree, just make sure she is out of the house for a few days and that the house gets cleaned really well afterwards.  When we removed a particularly bad carpet in our house our son ended up in the hospital (he has asthma on top of his allergies).  Oh, and putting new carpets in isn't an option.  Really, for proper allergy control, hard surfaces are the way to go.

Personally, if it were my child, I would hold off on doing anything surgically until after your trip.

Hope this helps

Martha