A few weeks ago five year old Hunter Mosher from Michigan passed away after having a laser tonsillectomy. Mosher was having his tonsils reduced to cure his sleep apnea. A very rare complication, a pseudo-aneurysm of his carotoid artery, occurred and he died a week later. I read this story about a week ago and was saddened and concerned by it. In part because my own two children are going in for surgery this week but also because of the many children I send home after tonsillectomies every day. My heart went out to Hunter's family. Now that I can put my feelings aside I hope that some of what I have to say on Mosher's case might make a difference.
While the complication that is said to have caused Hunter Mosher's death is indeed very rare his story has prompted me to reiterate the risks associated with tonsillectomies and what parents need to be on the look out for. Because of their location in the throat the tonsils are in direct proximity with a major artery. The risk of hitting this artery is a major concern in removing the tonsils. Different methods of removing the tonsils have been developed all aimed at reducing the risk of bleeding and pain. These include laser removal, microdebridement and plasma technology. Physicians have questioned the use of laser surgery in Mosher's case. To make matters worse, because the laser surgery is supposedly painless medical professionals discounted complaints by Mosher's mother that he was having severe pain.
Before my patients leave the hospital I use a flashlight and a tongue depressor to view the tonsil beds. I am looking for any signs of bright red blood. You can do this at home using a popsicle stick. Let me explain that there are two types of blood, old blood and new blood. It is common to see old blood with tonsillectomies as the patient will swallow it during surgery and it will later come out in their saliva or even vomit. Old blood looks brown and is sometimes described as looking like coffee grounds. It is normal to see a small amount of old blood. Bright red blood at any time is unacceptable and needs to be reported to a physician immediately. It may manifest in saliva, or you may see streaks of bright red blood from the tonsil beds running down the throat. If there is a lot of bleeding there may be a considerable amount of vomiting. This is an emergency.
The last thing I want to say is that as a parent, if you feel that there is something wrong with your child, do not hesitate to insist that your child be seen by a doctor. You know your child better than any doctor or nurse. You are the first one who is likely to discover any complications. Do not discount your own intuition. The best doctors and nurses listen to parents. If yours isn't listening find someone who will.
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