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Second...and third...opinions
I decided to do further research. I spoke to Carrie Souhrada, whose daughter Ciena's symptoms are similar to Mia's. Carrie also visited multiple ENTs and was advised to pursue surgery, but has opted for a less invasive approach. After trying a number of antibiotics without positive effects, Carrie took Ciena to a child acupuncturist and herbalist. The herbalist believes that Ciena is "sensitive," but not allergic, to dairy, wheat, soy, mold, and dust. From the herbalist's perspective, this sensitivity is the cause of Ciena's enlarged tonsils and adenoids, as well as her constant infections and dark undereye circles.
Most homeopathic doctors believe that the tonsils and adenoids are the body's first line of defense against infection, and that by removing them you are compromising the child's autoimmune system. The herbalist prescribed a high-fiber diet, which is also free of dairy, soy, and wheat. Carrie reports that, after about a month on the diet, Ciena's symptoms seem to be improving.
While the homeopathic theory intrigued me, I still felt the need for another medical opinion. We again saw Dr. Cohen, who concluded that Mia's tonsils "are not overly enlarged" - but that her adenoids are the issue. He urged us to make an appointment with Dr. Max April at The Weill Cornell Medical College, Pediatric Otorhinolaryngology Department. I was hopeful that he would clear up our confusion.
Dr. April quickly observed that Mia's speech is very nasal, something that as parents we have always found endearing. He used a scope for a clearer picture; Mia's nose was numbed and then a little camera attached to a long, thin tube was placed into her nostril. She was a little uncomfortable, but quickly became distracted by the picture on the computer screen.
What we saw was an almost completely obstructed airway. Mia's adenoid is 90 percent enlarged. Her tonsils seemed to be elongated, and one is partially covering her larynx. I was surprised that no other ENT had bothered to scope Mia before recommending surgery. Dr. April recommended adenoid removal and tonsil shaving.
Decision Time
Wading through the wealth of often contradictory information out there was overwhelming. We felt paralyzed, incapable of making any decision. Because we wanted to avoid surgery for our little girl, I checked in with an ayurvedic practitioner, who prescribed herbal therapy and a special diet. I spoke with another NYC mom, Jill Geisinger, whose daughter Lucy successfully underwent the same procedure Dr. April recommended. And I read a tremendous amount online about how useful the tonsils are (or aren't - quite a controversial topic!) in today's world at fighting infection.
But what tipped the scale for me was one more round of discussions with parents whose kids had tonsillectomies - all of whom agreed that the surgery alleviated their children's symptoms.
We decided on an adenoidectomy and tonsil shaving to reduce recovery time, our decision guided by my concern about the time it may take to treat Mia holistically, and the strain her continued sleep apnea could have on her heart. Ultimately, we followed our parental instincts.
Mia just had surgery at the end of this month. We prepared her by explaining everything in advance, which helped tremendously. We were probably more scared about the anesthesia (which was fine) than Mia was about the whole experience. And other than grabbing the pesky IV in recovery, Mia handled it all like a trooper. Her voice has changed a bit, but our surgeon tells us that it should return to its normal lower pitch soon, just without the nasal quality. Most importantly: she's breathing through her nose - and sleeping quietly.
