Come on Doc! Let’s Get Those Tonsils Out!

6 Jun

So now you know why strep isn’t always the worst thing in the world…if you missed that post, check it out here: Do You Want To Have Strep Throat?

What if your child has had “lots and lots” of strep throat infections?

An important thing to note is that “lots and lots” is completely subjective.  I have families ask about tonsillectomy after 2 episodes of strep throat in 2 years and some that don’t blink at eye at having strep every month for 6 months straight.  As usual, somewhere in between is probably the appropriate amount of concern.

For this discussion, I’m going to use the following guidelines:

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Clinical Practice Guidelines: Tonsillectomy in Children

So how many is too many?

According to the guidelines, children should be observed for 1 year if they have had 7 or fewer throat infections in the year: 

“(1) watchful waiting for recurrent throat infection if there have
been fewer than 7 episodes in the past year or fewer than 5
episodes per year in the past 2 years or fewer than 3 episodes
per year in the past 3 years;”

That’s right…7 throat infections in 1 year.  So, it’s important to keep track of the number of times there have been throat infections.  This is one of the reasons that it’s important to keep all your records in one place and one of the reasons for My Questions for Urgent Care Clinics.

Are there other reasons the tonsils should come out?

Yes, definitely.  Sleep apnea and snoring with big tonsils.  Sleep apnea are those periods during sleep where a child (or adult) stops breathing during sleep, catches their breath and then resumes sleep and a more normal breathing patter.

There are several benefits to treatment sleep apnea.  These are mostly related to the poor sleep quality that comes with having multiple periods during the night where your sleep is disrupted: “improved sleep, better nighttime and daytime functioning, improved functional health status, and prevention or improvement of comorbid conditions, including growth retardation, poor school performance, enuresis, and behavioral problems.”

Reminder:

Even though lots of kids get tonsillectomies every day and do quite well, remember that it is a surgery and pushing for your child to have it is not a good idea.  If it is medically indicated, then it’s important but putting your child through the pain and discomfort is not worth it unless it is truly necessary!

 

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