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Sterilizing tonsils before T&A


sptcmom

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Our recent visit with our PANDAS doc- he recommended T&A for DS. He mentioned to be sure the ENT followed the pre surgery sterilizing protocol with Clindamycin and Rifampin to destroy intracellular organisms to minimize post surgical compications, ramp ups etc.

Did you guys have to go thru the same procedure if you had T&As on your children?

Any other info on post surgical complications to expect would be greatly appreciated.

Thanks so much

Jodie

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Hi Jodie,

 

Well, I've never heard it described that way before... but I would definitely say that any kind of antibiotics you can get before and after are a good idea to protect your child from whatever may be in the tissue.

 

I will tell you something we experienced. The anesthesiologist wanted to give my dd a "sleepy" medicine while in the waiting room. I asked why and what was it. It is so that the child is sleeping when they get into the surgery room. And they wanted to give her versed sp? and that did a number on my son in the past for another surgery he had to have. It was long lasting and he was an emotional and moody mess. I refused the med after speaking with the ENT about it and he was very comfortable with her not having it as she was not overly nervous or anxious. IMHO, I think they like to give it to make it easier on them in the surgery room when they put the mask on the child to put them to sleep. Certainly, if your child is a mess and the procedure would be close to impossible or emotionally taxing to your child, then certainly it could be warranted/necessary. I will say that without it our child recovered the quickest in the recovery room because she was awake and aware and not emotional or crying. She was able to take small sips of water regularly and go home earlier than the others, who all had had the versed sp?.

 

My advice would be to not make a big deal of the procedure leading up to it, emphasizing that it is easy, won't hurt much and is the best thing for him/her. The hurting part is a lie of course, but if you can keep the anxiety down, it will be easier on everyone.

 

My child only needed regular tylenol the night of and the next morning and then didn't need it any more. The drinking of fluids is very important. Just constant for days and days. I read on the internet about people who recommended hard foods to speed the healing process and get the throat working again. I completely disagree with this and believe the healing has to be slow and natural. It is important to eat soft foods and drink so psychologically they don't become afraid of eating, but you don't want bleeding to occur.

 

Good luck

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Hi Jodie,

 

Well, I've never heard it described that way before... but I would definitely say that any kind of antibiotics you can get before and after are a good idea to protect your child from whatever may be in the tissue.

 

I will tell you something we experienced. The anesthesiologist wanted to give my dd a "sleepy" medicine while in the waiting room. I asked why and what was it. It is so that the child is sleeping when they get into the surgery room. And they wanted to give her versed sp?

 

 

What is versed sp? I got confused with that one. Is it a calming med?

The rest of your advice is fantastic. I understand abot the slow and steady. I've also heard about PANDAS symptoms ramp up after T&A.

Jodie

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I know nothing scientific on the issue- wish I did! But I can share our experience. My daughter (not PANDAS) had her tonsils out at a young age (3) and the day after she had them out she had a COMPLETE psychotic episode. I know that is what is was-- I have seen it many times in my PANDAS child! She was paranoid, ran around our yard like she was on speed, destroyed her bedroom and was screaming completely uncontrollably and inconsolably.

Fast forward to now (2 years+ later) and that child has her first possible PANDAS appt in a few weeks. I mentioned her tonsillectomy to the PANDAS doc during an appt with my other affected child and the doc asked, "was she worse after the tonsillectomy?" I said, yes, how did you know? the doctor just nodded. Now she has serious seperation anxiety, SID, wetting, obsessive thoughts. I think the molecular mimicry "part" may have pre-tonsillectomy and removing those sick things just aggravated her greatly. Time has passed and strep has been in our house; one sibling is a carrier and another sibling with strep twice in less than a year.

For what it is worth, my very severely affected PANDAS child had her tonsils removed and we saw no change either way. Her tonsils were sent to a special lab and were clear for lyme, mycoP and strep. She was on antibiotics (I do not remember what- it was almost 2 years ago) at the time.

 

So to summarize, if another child had sick tonsils and/or PANDAS, and was preparing for a tonsillectomy, I would take extra antibiotics for them in a heartbeat. hope that helps a little

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We did not know enough to sterilize my son's tonsils before he had them removed, but they were white and icky, so the doctor put him on lots of antibiotics before surgery. We did not have PANDAS problems afterwards (I should say we did not have an INCREASE in PANDAS afterwards). The pathology report showed no bacteria in the tonsils, but there were very large folicles and crevices where bacteria was likely lingering. I guess they were "sterilized".

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I know there was someone who posted a few mo. back...their child had been on Azith, and later Augmentin for a few mo. b-4 tonsilectomy but when cultured, the tonsils still grew a bunch of stuff. Hmmm. I wish I could remember who it was!

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Jodie,

 

I don't know how it is spelled but it is pronounced "ver sed" and it makes you go to sleep.

 

I will also say that my pitands dd showed no symptoms whatsoever for 3 days after the surgery. Have no idea why. But then her tic did return, but it was more mild.

 

Another piece of advice, if you choose to look in your child's throat, it isn't pretty. Lots of white stuff which is how the throat scabs and heals after surgery. And the uvula was really swollen for a long time. Also, my dd did throw up once from getting up too quickly, and there was a little blood - normal if it is just a little. Drink lots of ice water. drink drink drink

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