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Tonsillectomy


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Just wanted to give an update. What a long week! She ended up with an infection. Thank goodness I listened to everyone's advice and asked to put her on abx. She started Clindamycin yesterday. Her pupils are so dilated her eyes are almost black. She has beautiful blue eyes. :(. Both her brothers have a sinus infection and one with an ear infection. She is becoming very dehydrated. Not eating or drinking. Now she just vomitted. Spoke with ENT yesterday and said her tonsils were "ugly" when he took them out.

 

 

 

 

 

My dd7 had a Tonisillectomy and Adenoidectomy on Tues. I am noticing some exacerbation in symptoms. She was doing very well before the sx. She is also on Tylenol with codeine. Anyway, ENT sent her tonsils to pathology and microbiology....they cultured negative! She has been on prophylactic abx, but her tonsils were huge and full of pus. The path showed "reactive lymphoid hyperplasia". Anyone familiar with pathology?

Edited by JenniferG
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My dd7 had a Tonisillectomy and Adenoidectomy on Tues. I am noticing some exacerbation in symptoms. She was doing very well before the sx. She is also on Tylenol with codeine. Anyway, ENT sent her tonsils to pathology and microbiology....they cultured negative! She has been on prophylactic abx, but her tonsils were huge and full of pus. The path showed "reactive lymphoid hyperplasia". Anyone familiar with pathology?

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My son was 1st DX with PANDAS at age 2.5, and after multiple Strep infections accompanied by PANDAS responses, we were advised to remove his tonsils/adenoids just before his 4th birthday. We were told by the ENT "No tonsils, no PANDAS". Ridiculous. His symptoms exacerbated severely, and 3 weeks after the surgery he had his 1st acute episode. It was major in that he developed completely out of control facial/vocal tics, chorea form movements, extreme intermittent regression and a "vacancy" (not other way to describe it), for several days. He was on Omnicef for 10 days post surgery, then I requested Augmentin but his ped would only give him a low dose of Amox. Upon the day of his acute episode, I took him to the ped so he could see for himself how sick my son was. He prescribed Augmentin in the therapeutic dose for typical treatment of Strep at my request. 5 days later we were at Childrens Hosp. of Phila., and it was my understanding that the Augmentin was instrumental. Unfortunately, although I requested that pathology test his tonsils for Strep, it did not happen. I believe that he was infected at the time, but I have also been told that the surgery and anesthesia/meds could have kicked off the acute episode. I strongly urge you to get your daughter on a daily prophylaxis of antibiotics ASAP. Best wishes and positive thoughts toward your kiddo!

Edited by Beeskneesmommy
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My dd7 had a Tonisillectomy and Adenoidectomy on Tues. I am noticing some exacerbation in symptoms. She was doing very well before the sx. She is also on Tylenol with codeine. Anyway, ENT sent her tonsils to pathology and microbiology....they cultured negative! She has been on prophylactic abx, but her tonsils were huge and full of pus. The path showed "reactive lymphoid hyperplasia". Anyone familiar with pathology?

 

All "reactive Lymphoid hyperplasia" means is there an overgrowth (hyperplasia) of the lympohid tissue (the tonsils) caused by inflammation (reactive)- likely from recurrent infections. I expect this is probably a very comman and expected finding for any child's tonsils and adenoids being removed for recurrent strep, tonsilittis or gross enlargement from allergies etc.. This is essentially a "benign" finding for pathology- exactly what one would expect.

 

Hope this helps,

Sharon

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Wanted to add, 3 of my children all had tonsillectomy on 4/15/11. 2 of them were positive for strep 2 days before surgery and were on Omnicef just before and after the surgery. I know that they had strep at time of surgery, but pathology said the exact same thing Lymphoid Hyperplasia. I don't think that the pathology reports on these are worth anything. Doc said all 3 were covered with pus. I was hoping that the path results would answer some questions for us to, but I don't think that they are very reliable.

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I would have to agree that it would likely not make a big diff. if we knew of Strep being present on the tonsils post surgery. However, given our experience, it is now my understanding that the Strep can colonize and hit the blood stream when infected tonsils are removed. We think this is what happened with our son. That is why I advocate strongly for a run of strong antibiotics prior to and post surgery...

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I would also say sometimes anesthesia has an affect. My son had a reaction to the anesthesia that lasted a week... although it wasn't pandas symptoms, at least not his pandas symptoms.... but he was not himself, was expressionless, no appetite (not because of his throat hurting), severe night terrors, and just sad... It lasted one week exactly... and then it was like a switch and he was fine.. it was very scary though to see him that way.

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Someone once posted something that said that the anesthesia can open the Blood Brain Barrier.

 

I know when I got both of my daughter's tonsils removed, I had to request a culture. I also requested IV antibiotics during the procedure--our doctor didn't do this as a standard protocol, but he agreed because I was concerned about strep being released into the system. He did it for both girls.

 

Non-PANDAS daughter's tonsils and adenoids were enlarged, and hers were positive for haemophilus influenzae. PANDAS daughter's tonsils looked beautiful and didn't culture positive for anything. She had been on full-strength Omnicef for about 3 months before the procedure, and continued on that for approx another 3 months before we dropped her to 150mg daily.

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