Autism Answer – Easy Lasagne (low texture)

Yummy and Healthy Lasagne

ASD friendly Lasagne

This new recipe  was a breakthrough moment for me. The last two years have largely (by necessity) revolved around food from the point of view of food allergies and nutrition. I’m now finding myself needing to go a step further and think about recipes from a sensory point of view. Getting Miss 3 to eat meat and protein is an ongoing challenge; her soy allergy alone (especially because it extends to emulsifiers and vegetable oil) mean that I can hardly take her to a McDonalds in desperation and order her a cheeseburger. The secret to this recipe is minimising textures (and a food processor!)

She has until now mostly refused to eat mince (of various flavours and in various forms) although sometimes I’ll get lucky. She quite liked the process of making the Chinese Pork Koftas and it helped that I’ve found a soy & preservative free plum dipping sauce. I was over the moon when she actually ate this and asked for more!

Oh, and to any Italians reading this – I apologise. This recipe is not so much lasagne as it is one of those movies ‘inspired’ by a true life story. I know it would make the judges on MasterChef squirm but the main thing for me is getting a whole pile of nutrition into us simply and easily.

Easy Lasagne

Ingredients

  • 500g beef mince
  • Rice bran oil (for cooking)
  • Garlic powder
  • Salt
  • Onion flakes
  • Tomato Passata (400ml)
  • 1 x carrot (grated)
  • Bunch of silverbeet (finely chopped)
  • 400g tin of brown lentils (washed and drained)
  • Dry sheets of lasagna (as many as needed)
  • Parmesan cheese (grated)
  • Tasty or Colby cheese (grated)

Allergies: gluten free*, soy free, egg free, nut free.

Where’s the milk you say? I didn’t make a Bechamel sauce for this recipe for two reasons. One:  she had a sensory anxiety attack at the supermarket (damn those refridgeration unit motors!) so I had to abandon the shop and didn’t get the milk I needed. Two: sometimes when shooting for the stars, you need to aim for the moon first. I was concerned about having three different tastes / textures in a single dish.

Why not use fresh onion and garlic? Because she doesn’t like them (I do). If you’ve ever watched an adult with an aversion to onion try to remove each individual slippery sliver from their plate then you know it’s sometimes better to find a compromise and not sweat the small stuff.

How do I make this gluten free? There are gluten free lasagne sheets available (although they are pricey). For instance, Explore Cuisine do an Organic Green Lentil Lasagne.

Directions

  1. Brown the mince in a frying pan (or electric wok) with a little oil + garlic, salt, and onion.
  2. Add the tomato passata, carrot, silverbeet, and lentils. Simmer for 20-30 minutes on a low heat. Stir as needed.
  3. Grate in some parmesan cheese to taste.
  4. Let this very non-traditional beef ragu cool down for a bit and then blitz it in a food processor. It doesn’t need to be a smooth paste but it should become much more evenly textured (as seen in the photo).
  5. Layer the mince mix in your favourite lasagne dish (or dishes) alternating mince, the pasta sheets, grated cheese. Note: for the top layer of (dry) pasta you may want to add a few tablespoons of water every 10 minutes or so during cooking.
  6. Bake at 160’C for 3-40 minutes. Basically, you’re cooking the pasta and heating the mince. If you’re using a fresh pasta then it will probably cook quicker.

 

Tip: I liked the cheesy crunchy pasta topping and the textural difference on my plate of having both that and the soft pasta. Depending on the textural / sensory preferences of your ASD child, you may want to serve just one of those. I gave Miss 3 the soft pasta and the mince.

 

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Mass Consumerism and the Endless Quest for the New

Mass Consumerism: New and Shiny!

New and Shiny!

I’m drafting this at 3.30am in the morning. I’m sitting in pyjamas with my daughter curled up next to me, laptop on my knees, lamplight casting a low glow to contrast the light of the tv; ‘Magic School Bus‘ is teaching us about viral invaders. It sounds all warm and cosy; it is…. except it’s 3.30am in the morning!

Don’t get me wrong, Miss 3 is a crap sleeper but tonight (and the night before) isn’t because of her health concerns. We’re awake because yet another nappy company decided to get on the train of ‘New and Improved!’, ‘All New Look!’, ‘Amazing New Technology!’. I could give two shakes of a rat’s tail for their heavy use of the word ‘new’; what I want in nappies is a reliable steadfast product that works. I have enough sleep deprivation in my life without needing to spend time in the supermarket re-evaluating nappy brands.

It’s not that long since popular nappy company Treasures changed their design causing an uproar amongst parents that eventually moved from social media parenting platforms to the mainstream news. I watched with interest (and respect) as one determined mother took our concerns to the news outlets and with our permission shared our crappy experiences (pun intended).

Now another nappy company, Kiddicare, has decided to follow suit and change their design to a dramatically new look that is eerily similar in look to the new design Treasures nappies. Their website claims “Our new five layer ultra-thin absorbent inner core made from hi-tech fibre makes for a better performing nappy.” Their ‘breakthrough technology’ and ‘non traditional materials’ are presumably meant to attract additional customers and justify a price increase.

The reality is that their old nappies worked. They were well priced and effective which is all I actually want in a nappy. I have had countless leaks from the new ultra-thin nappies during both day and night. Tonight I tried double layering the nappies and her pants; they still leaked (despite her only having a few sips of water before bed!) and I was woken yet again by her feeling cold and chilled in the middle of the night. I’ve already complained to the company (firing off an email at 2.30am yesterday) but that still leaves me having paid for a large box of nappies that have no functional purpose.

I’m frustrated and tired (and regretting that mug of coffee now) by lack of sleep and needing to strip bed sheets in the middle of the night. My ASD daughter does not sleep easily and is very routine focused. To her wake up time means a bottle of formula and cartoons; I know from experience that she will be awake for several hours before I have a chance of easing her into a nap. If I’m super lucky I can sometimes get her back to sleep when she wakes during the night but not once I’ve had to change clothes and sheets.

The question arises why multiple nappy companies are feeling the need to change their design in the first place (and why they haven’t done more product testing before release!). One can only assume it’s because they feel the need to dangle something new and shiny in front of consumers to attract their attention (like we’re nothing more than magpies indiscriminately collecting anything from tinfoil to gold watches) and have forgotten that their core purpose should be deliver something that works. I wish they would instead go with the maxim of ‘If it ain’t broke, then don’t fix it’ and instead focus on aesthetics. Why can’t they just release limited edition runs of new prints with collectible cards inside the packs? Tell me all about the wonders of pandas and leopards with accompanying cute prints but have the nappies actually work!

Rewards for Potty Training

Reward Charts can help potty training.

Reward Charts can help potty training.

When starting potty training it’s a good idea to think about how you’ll keep your toddler motivated. Some toddlers will simply want to be ‘just like my big brother/sister’; others will respond to lots of praise; others need something tangible to work towards and that’s where reward charts can be useful.

Potty Training! It’s something that we all experience as parents as we help our children transition out of nappies. I’ve posted previously on:

Reward Charts

Sometimes toddlers need a little extra positive reinforcement to start (or stick with) potty training. Reward charts can be a great way of helping them to see progress, learn about delayed gratification, and learn about working towards achievable goals at a young age.

There are lots of great ideas online for printing out your own reward chart that you can stick on the fridge (like these free to print charts). The important thing is to choose a theme that will tie in with your toddlers interests. I liked this magnetic one from Kmart because I knew Little Miss would like moving the magnets around.

Tip: If you have multiple children, it’s a good idea to instigate reward charts for siblings as well to prevent tantrums, jealousy, and rivalry! If your 2 year old is toilet training, maybe your 5 year old can have a reward chart for homework or chores.

Rewards

These need to be relevant to your child’s interests, realistic for your budget, and appropriate in scale. A trip to the park, a book, a small toy, are more realistic then promising a trip to Disneyland! Also, keep in mind that a reward comes after the action has been successfully taken (and a bribe comes before).

Sit down with your child and be really clear:

  • what they will receive points for (i.e. stickers on their reward chart),
  • what rewards they are working for, and,
  • how many points they need to obtain those rewards.

Encourage your child to brainstorm with you what those rewards are going to be. Possible rewards include:

  • Items (toys / books)
  • Activities (trips to the park, library, the zoo)
  • Food (jellybeans, McDonalds, restaurant)

You may want to start off with reward stickers for:

  1. each wee / poo in the potty (or toilet), and then move towards
  2. stickers for staying dry at home that day,  then,
  3. staying dry at kindy, then,
  4. staying dry overnight.

The important thing is to scaffold your expectations and help your child towards success at a pace that’s realistic to them. Remember that every child is different.

Items

Toys or books can be easily tailored to your child’s interests. It’s a good idea to have a mix of rewards that they can work towards (with larger or more expensive items requiring more points).  If you take them to a store to choose rewards, it’s a good idea to guide their choices by offering them a few options and letting them select one.

It’s also a good idea to guide them towards choosing toys that you were thinking about getting them anyway and which you can afford. Consider items that will encourage open-ended imaginative play and remember that you don’t need to buy ‘branded’ items for your kid to have fun.

We chose a (non-branded) My Little Pony and a wooden pizza – each slice and topping has to be earned so it has a good mix of short and long term gratification.

Activities

Again, these can be easily tailored to your child’s interests. You may want to have activities close to home, or that are free, cost fewer reward points and then have costly activities be something they have to save more points to earn. Not all activities have to be away from home either!

  • At home: build a tent out of sheets & chairs; make a collage; parent play with cars / dolls / animals / trains for 20 mins without distractions; have a tea party with toys; invite a friend over for the afternoon.
  • Free: go to a park; feed ducks; favourite playground; go to a beach; bike ride; art gallery; museum.
  • Paid: go to an indoor attraction (like a playground or trampoline park); go to zoo; go to observatory to see stars; movie.

Food

Food can be a controversial choice because it risks weighting food choices to show that some foods are inherently more desirable than others. In saying that, plenty of parents have chosen to use a jellybean or other small treat as a reward.

For more creative options, why not choose food related activities instead. Reward points could be saved towards things like:

  • doing baking together,
  • helping to make dinner (or choosing from a list of dinner options),
  • buying and planting vegetable seedlings, or micro-greens for the windowsill,
  • going to a cafe for a fluffy or scone,
  • going to a restaurant for lunch / dinner.

Jungle Stories by Miss Almost-3

Once upon a time in the very noisy jungle a bird flew through the air singing “Tweet, tweet, tweet”. It went to a beautiful waterfall for a drink of water but SPLOOSH an elephant shot water out if it’s nose (trunk) and got it all wet to be silly. The birdy told the elephant a joke. The end.

Once upon a time in the very noisy jungle there was a crocodile and some fishes swimming in the river. The crocodile was very hungry so he ate the fishes, SNAP. his tummy was very full and he was happy. BURP. The end.

Once upon a time in the very noisy jungle there was a giraffe. He stretched his long neck up and ate the juicy leaves. YUM. They went through his tummy and he did a big poop out his anus. The end.

Once upon a time in the very noisy jungle there was a snake. She went round and round in the warm sun. She says Sss to her FRIENDS, the butterflies. She has a nice cup of tea and reads a book. Then elephant, giraffe, crocodile, and monkey come over for tea. They have a party and give her presents. The end.
Haha she cracks me up! She’s also going through the phase where she LOVES talking about body parts, wee, poo, and farts. What stories do your kids tell you?

What are the benefits of all natural shampoo?

It’s funny how invisible ingredient labels have become in our modern lifestyle. We take for granted that there are lots of words, chemicals, compounds, and numbers that we don’t recognize. The dynamic journey that I’m on with my daughter means delving into those labels to find out more.

I posted recently about glycerin and how it’s found in many body and beauty products. The difficulty for me is that it’s often soy derived (and Miss 2 is allergic to soy). My options are to either exhaustively ring manufacturers every time I buy a product (to check if they know their source / that their source hasn’t changed) or aim to eliminate glycerin from our home so that the risk simply doesn’t exist.

Looking into bathroom & beauty products also found me reading articles about other commonly used additives. Wider scientific debates aside, some people are sensitive to parabens and/or sulfates (SLS = Sodium Lauryl Sulfate and Sodium Laureth Sulfate). If you have a child with sensitive skin or eczema then it’s worth considering natural products.

So I set off on a search to see if I could find a shampoo that was free of glycerin, parabens, and sulfates.  This turned out to be more of a challenge than I thought it would be!

The two companies that I narrowed my search down to were Blue Earth (based in Ashburton, NZ) and Natural Us (based in Christchurch, NZ).  Both have a great range of products! My decision to go with Blue Earth is that they are available in over 65 stores throughout New Zealand so I was able to avoid paying for shipping. I still have products that I’d like to order from Natural Us – like their Goats Milk soap, Argan Shampoo bar, and their natural tooth powder! For international readers,  both companies ship internationally!

The first shampoo that we’re trying is Blue Earth’s Shampoo Smoothie Bar.

Ingredients: Castor bean, coconut, rice bran and olive oils, cocoa butter, rain water, soda lye, hempseed and avocado oils, essential oils of lavender, rosemary, tea tree and peppermint.

I have to confess that I was a bit doubtful – simply because I’m so used to the idea of shampoos being liquid! This worked amazingly well, You only need a small amount on wet hair and the castor bean oil creates a satisfyingly frothy (and conditioning) lather. It’s mildly scented but not enough to notice (although the tea tree oil would hopefully discourage nits if you have school age children!).

It occurs to me this would be brilliant to take with you if you were travelling as it would be so portable and last for ages!

What are turbinates and why do they need surgery to reduce them? (Are you sleeping badly? This may be why!)

What do swollen turbinates look like

What do swollen turbinates look like

If you’ve never heard of turbinates before then you’re not the only one! As long as they’re working well then the subject is unlikely to ever come up; they are also not something that your regular doctor (GP) is able to review – finding out there’s a problem first requires a referral to an Ears Nose Throat (ENT) specialist because of the symptoms you are experiencing.

Your turbinates can have a surprisingly large impact on your quality of sleep; this is especially true in young children and the problems are even more exacerbated if they also have troubles with their ears, adenoids, and tonsils.

What are turbinates?

Turbinates are bony structures (covered in moist tissue called the nasal mucous membrane). Inside your nose there are three sets of turbinates: upper (superior), the middle, and the lower (inferior).

Lateral nasal airway

Lateral Nasal Airway: Turbinates, Adenoids, Eustachian Tube Opening

Why do we need turbinates? What do turbinates do?

The turbinates have several important functions:

  • Help warm and moisturize air as it flows through the nose.
  • Protect the openings into your paranasal sinuses.
  • Help create airflow through your nose (important for your sense of smell!).
  • Trap micro-organisms (like viruses) and pollutants (like pollen).
  • Help the voice to resonate (i.e. they affect how we sound).
  • Produce mucous to help clean out the nose and assist the cilia in their work.
  • Help to regulate pressure in the sinuses.
  • Help the nose and sinus cavities to drain.
  • The turbinates play an important mechanical function when we sleep.  When you sleep on the right side, with the right turbinate down, over time the right turbinate fills up with fluid and expands so that it pushes against the septum; this makes you turn on the left side until that side fills up and turns you again. If the turbinates are not functioning correctly then you may wake up feeling cramped and sore with achey muscles.
Turbinates and sinus cavities

Feeling the pressure? Healthy turbinates help regulate pressure and drainage of the sinus cavities.

What causes turbinates to swell?

One of the most common causes of swollen turbinates (turbinate hypertrophy) are airborne allergies (allergic rhinitis) such as grass or weed pollen, birch tree pollen, or dust mites.

Other causes can include repeat upper respiratory infections, hormones, drugs, medication (i.e. as a complication from long-term nasal spray use).

Healthy inferior turbinate

Healthy inferior turbinate – you can see quite clearly that there is a tunnel for air to flow freely past the turbinates.

Swollen turbinates

Swollen turbinates – you can see how they have swollen and are bulging out across the airway to the nasal septum.

What are the possible side effects of swollen turbinates?

  • Stuffy nose
  • Headache
  • Facial Pain
  • Pressure (often in forehead). In young children this may result in behavioural issues, trouble concentrating, or head banging.
  • Nasal drip
  • Loss of Sense of Taste and/or Smell
  • Mouth breathing, noisy breathing, and/or snoring. This is especially problematic if adenoids and/or tonsils are also swollen and obstructive sleep apnea develops.
  • Fatigue. Children might seem like they’re getting enough hours of sleep but in reality the quality of sleep is poor because their body is struggling to get enough oxygen through the night. It’s a bit like starting each day on a half tank of gas.
  • Sore, cramped, achey muscles in the morning. Healthy turbinates play an important mechanical function when we sleep; they are key to helping us unconsciously change which side we are sleeping on through the night.
  • Developmental delays. Sleep is critical for young children. During those early years, they are rapidly growing and learning. They need sleep to focus during the day; to have time for their brain to make connections between all the things they have learned or experienced; and their brain releases a growth hormone while they sleep. Poor sleep, fatigue and pain/discomfort, trouble hearing: these can make it harder for them to stay on track.
  • Behavioural difficulties. Poor sleep, fatigue and pain/discomfort, trouble hearing: these can result in daily misery that children don’t know how to express.

Why do turbinates need surgery?

An Ears Nose Throat (ENT) specialist will be able to examine the interior of the nose quickly and painlessly during outpatient appointments; they may also opt for imaging scans such as x-ray or CT.

It is likely that they will suggest trying non-invasive means initially to see if this reduces the swelling, This is likely to involve a steroidal nasal spray and anti-histamine medication (in the case of allergic rhinitis). They may also recommend additional saline spray / drops to help keep the nose irrigated, or using a humidifier.

If these options do not work an symptoms have not been alleviated then they are likely to recommend surgery. Note: it is important that turbinates are reduced (not removed) and they will slowly regrow; in order for them not to become swollen again, any other underlying issues must still be addressed.

What does turbinate reduction surgery (turbinoplasty) involve?

Turbinates perform highly important functions and removing them entirely can cause a raft of new issues; surgeons will normally opt to reduce the turbinates. There are different methods that can be used; some remove tissue and others aim to shrink them through other means.

A procedure called submucosal resection is a common technique used to treat enlarged turbinates. With this procedure, the lining of the turbinate is left intact, but the “stuffing” from the inside of the turbinate is removed. As the turbinate heals, it will be much smaller than before surgery. Sometimes, this resection can be performed with a device called a microdebrider. This device allows the surgeon to remove the “stuffing” through a small opening in the turbinate. In some instances, more of the turbinate is removed.

Some of these methods shrink the turbinates without removing the turbinate bone or tissue. These methods include cauterization, coblation, and radiofrequency reduction. In each of these methods, a portion of the turbinate is heated up with a special device. Over time, scar tissue forms in the heated portion of turbinate, causing the turbinate to shrink in size.

Turbinoplasty is generally an outpatient procedure performed under general anaesthetic and patients can go home the same day.

Want to find out more about surgery or risks? The American Rhinologic Society has useful information.

What happens after surgery?

You can expect to have pain, fatigue, nasal stuffiness, and a clear fluid nasal discharge for several days after surgery. If this was the only surgery being performed then pain is generally mild  and typically well controlled with pain medications. A saline spray and/or steroidal nasal spray are likely to be recommended to use for several weeks after the surgery.

Swelling as a result of the procedure means that there may still be snoring for a week or two after the surgery, as well as a general feeling of stuffiness. The fluid discharge will generally begin to improve and crust after the first week.

Patients may be off school or work for a week and are recommended to avoid strenuous activity for two to three weeks afterwards.

 

What are tonsils and why do they need removing? (What is a tonsillectomy or adenotonsillectomy?)

How inflamed tonsils compare with normal tonsils

How inflamed tonsils compare with normal tonsils

What are tonsils?

Tonsils are soft tissue located at the back of your throat; they are part of the body’s lymphatic system (so are adenoids). When they are working properly, they help to recognise bacteria and viruses entering through the mouth and produce white blood cells to fight off infection.

Tonsils are particularly useful during childhood while the body is still encountering new bacteria and viruses for the first time and building up the immune system. Doctors seem to be of differing opinion as to how useful they are as adults; I’ve some that have called them redundant and unnecessary, I’ve also met other doctors who view removing them as an absolute last resort.

Why do tonsils need removing?

Tonsils may temporarily swell while fighting infection, sometimes they become so swollen that they result in a very sore throat and fever (tonsilitis), they may also partially obstruct the airways and not respond to non-invasive treatmeants.

Surgery may be recommended to help treat:

  • Multiple case of tonsillitis (seven cases of tonsillitis or strep in the last year, or five cases or more over each of the last two years).
  • Breathing problems related to swollen tonsils
  • Frequent and loud snoring
  • Periods in which you stop breathing during sleep (sleep apnea)
  • Bleeding of the tonsils
  • Trouble swallowing chewy foods, especially meats
  • Cancer of the tonsils

Back in the 1980s, having your tonsils out was kind of a childhood rite of passage. It was a very common procedure and often parents had already experienced a tonsillectomy in their own childhood. Medical opinion has now swung in a different direction and there is a more stringent list of criteria that often needs to be met (as well as requiring parent consent / advocacy). For a balanced medical opinion, try this post by Christopher Johnson (a pediatric intensive care physician) .

What is tonsil grading?

Surgery is most likely to be recommended if tonsils are consistently swollen at Grade 3 or Grade 4 coupled with other complications (such as snoring and/or sleep apnea).

What are the 4 grades of swollen tonsils

What are the 4 grades of swollen tonsils?

Basically tonsils are graded based on how much of the airway they block.

  • Grade 0 = tonsils are within the the tonsillar fossa
  • Grade 1 = tonsils obstruct 0-25% of oropharyngeal airway
  • Grade 2 = tonsils obstruct 26-50%
  • Grade 3 = tonsils obstruct 51-75%
  • Grade 4 = tonsils obstruct 75%

What are the possible side effects of swollen tonsils?

  • Fever / temperature. Keep in mind that children can react in their own individual ways – they may keep getting low grade temperatures instead of a fever.
  • Runny nose and congestion (as well as the sore throat).
  • Difficult or painful swallowing.
  • Swollen and tender glands (lymph nodes) on the sides of the neck.
  • Bad breath.
  • Fever and chills.
  • Tiredness and headache.
  • Stomach upset or pain.
  • Mouth breathing, noisy breathing, and/or snoring (due to enlarged tonsils blocking the airways). Obstructive sleep apnea. The swollen tonsils and/or adenoids can intermittently block airflow. It sounds like your child is silent and then there’s a big noisy sucking in of air.
    • In Miss 2 it can be so loud that I can hear it through her closed bedroom door and can sound like something’s fallen off a shelf and hit the floor! It’s a crappy and frightening thing as a parent that can result in just sitting with them in the dark either to check that they are breathing or to give them a gentle nudge to help them breathe again. If you’ve spent time with them hooked up to an oxygen saturation monitor then you’ll be familiar with what a stark difference there is between their oxygen levels when alert and upright versus lying prone to sleep.

  • Fatigue. They might seem like they’re getting enough hours of sleep but in reality the quality of sleep is poor because their body is struggling to get enough oxygen through the night. It’s a bit like starting each day on a half tank of gas.
  • Developmental delays. Sleep is critical for young children. During those early years, they are rapidly growing and learning. They need sleep to focus during the day; to have time for their brain to make connections between all the things they have learned or experienced; and their brain releases a growth hormone while they sleep. Poor sleep, fatigue and pain/discomfort, trouble hearing: these can make it harder for them to stay on track.
  • Behavioural difficulties. Poor sleep, fatigue and pain/discomfort, trouble hearing: these can result in daily misery that they don’t know how to express.

Keep in mind that young children (i.e. toddlers) may not be able to describe their symptoms to you and it may not even occur to them to do so (especially if they chronic health issues). They may also be confused by referred pain; the ears and throat share nerves (as well as being linked by eustachian tubes) so they may say their ear is sore when the infection is actually in their throat. Another possibility is if they keep exhibiting teething type behaviour well after all their teeth are in (i.e. chewing on fingers or a dummy constantly, lots of drool) combined with a temperature and bad breath – the cause may actually be their tonsils!

What does surgery (a tonsillectomy) involve?

Surgery will normally take place at a hospital (probably as an outpatient). The doctor will review medical history in advance and make recommendations about pausing medications. You will normally be advised not to take anti-inflammatory medications within 7 days of surgery. They will also discuss post-operative pain medication.

The day of the surgery will involve a period of fasting; food or water won’t be permitted because they can impact the anesthetic. It’s a good idea to have family support and a game plan of how to distract your child; an older child may understand why they can’t eat but a toddler is likely to just focus on the fact that they are off routine and they are HUNGRY!

During surgery, your child will be under a general anesthetic. The surgeon will enter through the mouth and the tonsils will be removed with an electrical cauterizing unit.  You can watch videos of surgery on YouTube but they can be a bit difficult to stomach; I preferred this video of a digital tonsillectomy surgery.

adenotonsillectomy

Adenoids and tonsils

Often the adenoids will be removed at the same time as the tonsils (if they are also swollen); this is termed an adenotonsillectomy. Click here for information about the adenoids.

What happens after surgery?

Depending on the age of your child, they may keep them in the hospital overnight for monitoring or they may go to a recovery room and then go home the same day. You should be given a pamphlet with information about post-op care (i.e. like this tonsillectomy guide).

Your child may feel quite groggy and tired for the next few days and also have some nausea; vomiting once or twice is normal but contact your doctor if vomiting persists.

A light, cool diet for the next few days is generally recommended (avoid hot liquids or spicy food) but doctors will often recommend that children eat whatever they want – the abrasion from bread or crackers will actually help to clean the area. (That’s not to say there won’t sometimes be screaming pain because a sharp cracker edge has just struck the surgical site).

Some doctors will prescribe antibiotics. They will normally be prescribed painkillers (like Pammol and Tramadol) and anti-inflammatories (like Nurofen); if your child won’t take the fully funded options consider buying over-the-counter replacements (for kids) that have been flavoured.  It is important to keep on top of their medication (including waking them up around the clock for a few nights) as the pain is severe; it will often peak somewhere around around Days 5-9 due to the way the membranes heal and can be excruciating.

It’s important to keep them rested and hydrated – even if this means just getting small regular sips of water, lemonade ice-blocks, or melty ice=cream into them; overall, the fluids are more important than food.

Common side effects will include:

  • Swollen tongue
  • Bad breath (like a hyena!)
  • White coating on the tongue
  • White scabs over the tonsils

Your doctor will talk you through potential complications and when to seek immediate medical care – i.e. if bleeding occurs (it can be life threatening); they may be able to resolve with medication or surgery may be required.

They need lots of rest for two weeks to promote healing and will be off school during this time due to the risk of infection.  They will also generally have several weeks off sports, exercise, and swimming.

Keep in mind that removing tonsils may only be one part of a wider treatment plan. If the chronic inflammation was linked to allergies then you will still need to work with a doctor to create an ongoing allergy treatment plan.

In Splendid Isolation

Autumn wonderland

Autumn wonderland

“He who is certain he knows the ending of things when he is only beginning them is either extremely wise or extremely foolish; no matter which is true, he is certainly an unhappy man, for he has put a knife in the heart of wonder.” Memory, Sorrow, and Thorn

I drafted this a week ago…little did I know that life would throw up complications and we’d be looking at a minimum of fours weeks in isolation.

Today marks the end of two weeks of isolation leading up to Miss 2’s surgery. She spends the night in my bed (she’s refused to sleep in hers since we were rushed to hospital by ambulance for Mother’s Day) and is awake all day with it just the two of us. There is a distinct lack of personal space and it’s challenging for both of us. The only time that I have to myself is an hour or so in the evening, after finishing up cleaning the house, before collapsing into bed beside her.

Week 1 was a particularly vicious head cold with rivers of snot that covered her face no matter how often I wiped it away. Her facial dermatitis was miserable, her already swollen airways blocked up, and she’d give up on sleep entirely somewhere between 2am and 4am when the fluid build-up got too much (and she needed to be upright to have it drain away). Being awake around the clock was beyond exhausting, I got sick too, I dragged myself through each day, I was grateful whenever she was willing to listen to audio stories that might give me a break for twenty minutes.

She hit rock bottom after about 7 days and then slowly started to improve. Her doctor advised that with her surgery so close we were best to spend another week away from playgroups, Sunday School, gatherings of kids, and, well, anywhere germy, to try and prevent her from catching a secondary infection. Historically. her compromised immune system has meant a rolling series of viral infections for weeks at a time.

She missed her friends. She missed her rountines. She stomped around the house (literally) telling me, “I’m a grumpy old troll! I’m ANGRY! I want (insert names of friends)”. I’m proud of her emotional recognition and expression; I’m glad that teaching her to stomp (as opposed to kick, hit, bite, or throw) as a healthy way of venting her feelings seems to be helping. It’s exhausting and it sucks for both of us.

It’s been a mental challenge each day trying to work out where we can for the morning that ideally doesn’t cost money, will interest her, doesn’t involve kids, and can’t be an indoor playground / attraction (because let’s face it those things hardly ever get disinfected!). Oh, and it’s winter, cold, and rain keeps threatening on the weather forecast.

Each day I have to try and be cheerful, positive, and zen. Some days I do better than others. Some days I’ve burst into tears in public toilets while she just keeps tantruming and I can’t even have 30 seconds to pee in quiet (not alone, just peacefully). Some days it feels overwhelming that not only do we have to get to the surgery but then we’re still going to need to be careful about post-op infection. Some days the logistics of our upcoming hospital stay, needing to take all our food with us, needing to look after her alone (and just physically carrying everything!) seems overwhelming.

So I’ve tried to find the beauty in each day for us. She delights in the small details – the differing colours and shapes of leaves, throwing seed cones into the ocean and watching them bob like boats, stopping to listen to birds sing.

Autumn dreaming

Autumn dreaming

Autumn explorer

Autumn explorer

We’ve walked through parks of imported oak trees with their beautiful autumn leaves still covering the ground like snow.

We’ve spent hours exploring Botanic Gardens admiring the hidden mazes and the surprise of colourful roses even though it’s winter.

New Zealand beaches in winter

New Zealand beaches in winter

What is New Zealand like in winter?

What is New Zealand like in winter?

We had one morning that saw me teaching her chess in the library while the wind and rain swirled outside, only for it to suddenly be replaced by a little beachside microcosm of warm blue skies and sunshine. We walked on the sand, splashed in the waves, and drew pictures in the sand creating beach art.

Being isolated was anything but splendid (although it makes for a catchier title) but looking for the beauty in each day and seeking a positive focus made it more bearable. We can’t always change our circumstances, we can only change how we choose to view our circumstances and how we react within them.

How to give your toddler a spa bath in winter!

Spa bath in a flexi bucket

I love flexi buckets! I have two: one big pink one and a small yellow one. They can be used for so many things from hanging out laundry, to clothes hampers, packing stuff to visit relatives, toy storage, and winter spa baths!

Miss 2 loves asking for a bucket bath when the temperatures start dropping. Just sit the bucket in your bath, fill it to a nice warm temperature from the taps, add a gentle-on-the-skin bubble bath, and pop in your toddler.

The Goldilocks principle applies when choosing your flexi bucket: not too big, not too small, but just right. You want your toddler to be able to sit upright comfortably and have water up to their armpits (parental supervision is recommended as per any bath). You’ll find that you use much less water than a normal bath and they’re warmer because more of their body is consistently covered.

The great thing is that this also works in a shower! I’ve also seen friends put multiple buckets in one bath (of assorted sizes) so that siblings can spa together (and without fighting).

You can even do this during summer! Put the empty bucket outside on the lawn (water is heavy) and ferry warm water to it. Presto! An outdoor bath in the sun and a happy excited child!

Tip: These are also great to take to a beach so that you can create a mini pool for younger siblings or wash off sandy feet.

Spa bath fun!

How to display your child’s artwork without damaging the walls!

How to display kids art work

How to display kids art work

There are lots of great ideas on how to display your child’s art work. There’s only so many pieces that you can attach to the fridge with magnets, so why not hang some in their rooms where they can admire what they’ve made!

How to display children's art work

How to display children’s art work

Some ideas include using curtain rails but those (although sturdy) require drilling holes into the wall which isn’t a great idea if you’re renting.

How to display kids art without damaging the walls

How to display kids art without damaging the walls

The solution is to use hooks with a removable, damage free, adhesive backing. Tie some pretty coloured wool between the hooks and peg up your child’s beautiful creations!

Decorative clips for hanging art work

Decorative clips for hanging art work

Also check out these totally adorable decorative clips on AliExpress for US$3 and free international shipping!