Not Your Mother’s Tonsillectomy

Ever since early childhood, I seemed to bounce between never-ending occurrences of strep throat and tonsillitis. I’m pretty sure my tonsils were considered New York City landmarks.  Upon first meeting my tonsils, my otolaryngologist (ENT) actually said “My God! Those are positively the hugest tonsils I have ever seen."  

To give you a visual, I would say they fell within that bitty space between ping pong and golf balls, depending on the day. Apparently when you get to a certain age, your tonsils stop growing and may actually decrease in size. Mine did not get the memo.

And so, at the age of twenty, my tonsils made their exit. When I asked what I could expect in terms of pain I was told to imagine the worst sore throat I have ever had. Then multiply that by a gazillion,  give or take. Mind you, I have a relatively high pain threshold, but I can honestly say that the post-operative pain was the worst I have ever experienced. And yes, I have had two biological children.

My tonsillectomy was done in the traditional way, that is—the tonsils were removed with a scalpel, then the area was cauterized (burned) to seal off the incision. Essentially, when the anesthesia has worn off, you feel as though you’ve swallowed a piping hot coal. And, due to the fact that the underlying throat muscle is exposed, it’s extremely difficult to move your head. Okay, try to lie down and then sit back up without using your neck muscle. See what I mean? 

My recovery was slow and painful. The worst part? I could not manage to down my pain medication. It was a liquid that contained alcohol, so you can imagine how pleasant that must have felt. I couldn’t speak or eat for a couple of weeks and I did experience severe dehydration and post- op bleeding.

When I found out my son needed to have his tonsils out, I wanted to do whatever I could to avoid having him go through the same experience. They say the younger you are when you have the tonsillectomy, the less pain you have—so he had that going for him. My tonsillectomy was done over 20 years ago—might there be another way?

It turns out that yes, there is another way. I had never heard of it, but it’s called PITA (Powered Intracapsular Tonsillectomy and Adenoidectomy). It basically involves an instrument called a microdebrider, which has a rotating head and results in the surgeon’s ability to be more precise in targeting the tonsils. This, in turn, allows the surgeon to remove the tonsils without exposing the underlying throat muscle. This results in less pain and quicker recovery. 

Why aren’t more ENT’s offering this procedure? Three reasons: 

1) The equipment is pricey. 

2)  The training to use the equipment is pricey. 

3)  There is a small chance of tonsil regrowth (less than four percent occurrence). PITA removes about 95 percent of the tonsil tissue vs. 100 percent via the traditional method.

We decided to go with the PITA technique. After my son’s surgery, he did not complain of any pain—just some mild discomfort, and let me just say that his pain threshold appears to be on the low end. He felt fine in exactly two days, although he was not allowed to eat crunchy foods for 10 days post-op. I know that many parents opt to go the traditional route, but I was extremely pleased with the outcome and I am a big fan of advances in medical procedures. If the technology is there, I have no problem straying from the traditional methods if the benefits outweigh the risks. While the PITA technique may not be for everyone, it’s nice to know that there are options. It doesn't hurt to ask your ENT if they offer a choice.