Is T&A something you do as a last resort?

[laure]

Very interested to know what folks say here. I would love to know if it would bring anti B dNase titers down for my Dd. She has had strep many times and not symptomatic.

I had mine out at 18 after getting strep every other month for years. I never got strep again after that. Occasional bronchitis, but nothing like before. After that we were able to zero in on bad seasonal and food allergies that were weakening my immune system in the first place. Personally I did not see any downside at all.

[airial95]

Got them out for both of my PANDAS kids (5 yo son is severe, 6 yo daughter is very mild).

 

Prior to T&A, my then 4 yo son had over 2 dozen positive strep infections in just about 2 years. Was on full strength abx prior to surgery (cefdinir - which was already failing) and IV abx during surgery - followed by augmentin post-op (watited to switch abx until post op). My son was 100% INSTANTLY. The ENT only ordered 7 days of post-op abx, but our ped and Dr. M extended it to 30 days. It was amazing the difference in my son. At the end of 30 days, we tried to take him down to a proph dose of Augmentin - and one of his tics came back very mildly (hardly noticeable). So we immediately went back to full strength. Unfortunately - at the 6 week mark, he caught strep again, and we saw a full recurrance of symptoms. In the 15 months post-op he's had 4-5 + infections (down from 6-7 per year previously), and his flares are less severe than they were prior. All in all - I would do it again in a heartbeat!!! Tonsils were cultured and negative for strep (although positive for Influenza B - I think)

 

My son's surgery was such a sucess, that at my daughter's ENT follow up 2 weeks later (regular follow up from adnoids/tubes done in that Feb), I asked about it - she had just been dx with PANDAS, and had her 4th strep infection the week before my son went in for surgery. The doc said that while he normally likes to see 6+ infections in a 12 month period before recommending - considering the PANDAS history in both her and my son, he recommended it. One week later - we were back at the surgery center with my daughter. Same abx protocol - but she did all cefdinir (allergic to penecillin). She was 5 at the time. Since surgery - she's had 2 + strep infections, and a couple of mild flares from exposure at school (this fall it was crazy multiple kids with strep in her class EVERY WEEK!! ugh! AND she lost 4 teeth in a 5 week span in the middle of it!) We haven't seen much of a difference in her symptoms - but she's always bounced out of a flare within 7-10 days of a 30 day course of abx, and hasn't needed proph to maintain steady progress.

 

It's a personal decision based on what you feel is best for your child. Some docs recommend it - others don't unless there is a reason to. Dr. M supported our decision with both kids - because of the chronic strep history. Some parents hav efound their kids have had a serious flare from the surgery, others have found it to be the magic puzzle piece.

 

For us - like I said, I would do it again in a heartbeat because it did help - and with our chronic strep history, it was the logical next step.