Long-term health risks after having adenoids or tonsils removed in childhood • Hacker News Board

Re: Long-term health risks after having adenoids or tonsils removed in childhood

#191

Post by goldenkey » Thu, Jun 14, 2018, 11:20 PM UTC

evincarofautumn wrote: post #183

code_duck wrote: post #103

Earlier quoted context omitted.

It would be better if most scent diffusers used essential oils, but unfortunately, most are made with VOCs and synthetic fragrance compounds that are known or suspected to cause many health problems, like Glade plugins. Febreze and Lysol are the same but with more VOCs. I have severe sensitivity to fragrance and cannot tolerate synthetic fragrances, incense, or essential oils. Simply being near people who use artific…

Same—I can’t tolerate most artificial fragrances, as they make my sinuses block up and irritate my eyes & skin. Sadly they’re everywhere —between perfumes, deodorants, lotions, laundry detergents, fabric softeners, air fresheners, odour removers, shampoos, body washes, hand soaps, household cleaners, &c., a lot of people and their homes are just covered in them. I’ve been trying to figure out the specific compounds t…

Well it's already known that even natural extracts like lavender oil are estrogen amplifiers. And the thermal receipt paper used for years, contained BPA, also an endocrine disruptor. There are tons of chemicals that we use willy nilly without any knowledge on their real and complex outcomes on life. I'd mostly prefer natural but its somewhat specious because having artificial additives means usually the whole mixture will have 10 or 15 chemicals instead of the 103485 in a plant extract. But I'd trust mother nature's 100000000000 years and human civilizations' many years of trials over an Ames test.

https://en.wikipedia.org/wiki/Ames_test

Re: Long-term health risks after having adenoids or tonsils removed in childhood

#192

Post by mmt » Fri, Jun 15, 2018, 1:49 AM UTC

gamblor956 wrote: post #188

refurb wrote: post #167

Earlier quoted context omitted.

What was exactly incorrect? I would agree that "you can see any specialist you want" is an exaggeration, but as someone with good insurance, I have about 100+ different ENTs in the bay area I could bring my daughter to, Stanford and UCSF included.

Most of America is not like the Bay Area with its overabundance of specialists. There are many places in the US where the closest doctor is a few hundred miles away, and many more where the only doctors within a few hours are primary care physicians.

> many places in the US where the closest doctor is a few hundred miles away

Although this statement may be true, it may also be irrelevant if there are no people in those places. That said, I'm not just being pedantic: my point is that lack of availability is far more likely to be a result of low population density than of being in the US.

Moreover, your comment fails to respond to the original point, which is that of affordability/availability to families with middle income. Poverty combined with low population density would likely result in even less availability, but, then, poverty is incompatible with "middle income".

Re: Long-term health risks after having adenoids or tonsils removed in childhood

#193

Post by tankerslay » Fri, Jun 15, 2018, 3:07 AM UTC

robbiep wrote: post #26

nailer wrote: post #25

Earlier quoted context omitted.

Weird to hear tonsilectomies being spoken of in thw present tense. It stopped being routine in Australia in the 80s.

There are more than 35,000 tonsillectomies done in Australia every year (and more than half a million in the US). This is a highly routine procedure. In fact there is very clear guidelines on when GPS should refer for tonsillectomy: Tonsillectomy is indicated When young children have had >7 episodes in one year or >5 episodes in either of the last 2 years, or quinsys, or obstructive sleep apnoea. Tcj_pcx for some rea…

>The treatment cures (in around 97% of cases) tonsilitis.

I feel like this is a kind of doublespeak and a rather misleading way of phrasing things. It of course stands to reason that excising an organ in toto will be very effective at preventing a person from having continued inflammation of that organ, as it is no longer part of their body, in the same way that toenail fungus can almost certainly be "cured" by amputating the affected toe.

The latter rarely happens, because people understand the value of their toes and realize that having toenail fungus is typically better than having no toe at all. But for organs inside the body, whose function is less plain to the lay person, patients are largely at the mercy of doctors to give them an honest appraisal of the life-long risk of removing them, and whether it might be warranted in a particular situation.

It seems that in many of these cases, it would be far more straightforward and honest to simply say "If [organ X] is really bothering you, I can cut it out," rather than cite some pseudo-scientific percentage purporting to describe how often surgery can "cure" some abstracted set of symptoms or "chief complaint." Doctors (especially specialists!) seem reluctant to move beyond this rather myopic way of conceptualizing health care. The idea that medicine is simply a game of "complaint whack-a-mole" might be psychologically comforting to a doctor (as well as financially lucrative in fee-for-service jurisdictions), but, from the perspective of the patient, it makes little sense to fix one symptom only to acquire five more of greater severity.

The question people really want answered is: "If I cut out [organ X], is it going to cause me other problems down the road?" But this is the very thing that doctors/surgeons so often seem so curiously (willfully?) ignorant of, even for "routine" procedures. Isn't it rather bizarre that, despite tonsillectomies and adenoidectomies being performed on millions of children over many decades, often for the most trivial of justifications, the analysis described in the linked paper took until 2018 to be completed, by a trio of PhDs no less?

Is it just too psychologically burdensome for surgeons to worry about the long term health of their patients or the long-term consequences of their procedures?

I think tcj_phx certainly does have a point, that people are not so much interested in "treating symptoms" as they are in doing what will preserve their whole-body health well into old age. If doctors can't say what will best achieve that, either because they don't know or haven't bothered to look into it carefully, they need to be very upfront about their ignorance and inability to provide a well-considered recommendation.

Re: Long-term health risks after having adenoids or tonsils removed in childhood

#194

Post by tankerslay » Fri, Jun 15, 2018, 3:40 AM UTC

laretluval wrote: post #132

stareatgoats wrote: post #52

Earlier quoted context omitted.

> "cases were no less healthy than controls presurgery in the first 9 years of life" Looks like they addressed that (heading: Testing for Biases in General Health Before Surgery)

> Participants in the case and control groups were selected such that their health did not differ significantly prior to surgery. And yet some of them got the surgeries and some didn’t, so it’s unclear if the control was adequate.

>And yet some of them got the surgeries and some didn’t, so it’s unclear if the control was adequate.

It is what it is. The documented evidence suggests that the medical histories of the two groups diverged strongly at the moment of surgery.

It is possible that the decision to have surgery depended primarily upon an arbitrary judgment of the surgeon, in which case the randomization is adequate.

It is also possible that the pre-surgery health of the two groups diverged in a way that was not well-documented in the medical record, in which case the control is inadequate.

However, this latter possibility is still not flattering to the medical community. If the conclusion of the study is even possibly correct, it raises a serious question of why such a flimsy paper trail accompanied such a momentous cost-benefit decision in the lives of these children.

Re: Long-term health risks after having adenoids or tonsils removed in childhood

#195

Post by zaarn » Fri, Jun 15, 2018, 7:01 AM UTC

barking wrote: post #172

zaarn wrote: post #32

Earlier quoted context omitted.

Anecdotal data is not a good source of medical advice.

It's not anecdotal because I was giving own experience. Also I wasn't offering any advice.

Your own experience is anecdotal.

Re: Long-term health risks after having adenoids or tonsils removed in childhood

#196

Post by manmal » Fri, Jun 15, 2018, 10:29 AM UTC

dade_ wrote: post #170

manmal wrote: post #72

My son had adenoids removed last year because his hearing was VERY bad because of some kind of mucus blockage. Doctors explained to us that he would hear perfectly without the adenoids, because inner ear measurements were very good. So during the OP they cut away the adenoids, and made a hole into each eardrum, so fluids could exit. After the OP his hearing was so good that he told us not to scream at him when we bar…

Just anecdotal, but I think this simple study supports the idea that it is worth exploring the cause of non-critical health issues before we start slicing and cutting. I grew up with the worst ear infections. Tonsils were removed, and various drugs and treatments. I even needed a speech therapist because of hearing problems that were caused. My family doctor was very opposed to putting holes in the eardrums though, s…

Funnily, I have the same reaction to whey protein, and also if I eat very (!) large amounts of swiss cheese or even joghurt. I anecdotally found out that drinking a small amount of apple cider vinegar mostly resolves my stuffy ears after that. Forgot to mention that I also had my adenoids removed as a kid.

Re: Long-term health risks after having adenoids or tonsils removed in childhood

#197

Post by manmal » Fri, Jun 15, 2018, 10:30 AM UTC

downrightmike wrote: post #180

manmal wrote: post #72

My son had adenoids removed last year because his hearing was VERY bad because of some kind of mucus blockage. Doctors explained to us that he would hear perfectly without the adenoids, because inner ear measurements were very good. So during the OP they cut away the adenoids, and made a hole into each eardrum, so fluids could exit. After the OP his hearing was so good that he told us not to scream at him when we bar…

I had tubes put in my ears when I was little for drainage. Eventually they were removed and I don't have the problems.

Did they only put in the tubes, or also take out the adenoids?

Re: Long-term health risks after having adenoids or tonsils removed in childhood

#198

Post by manmal » Fri, Jun 15, 2018, 10:35 AM UTC

darkerside wrote: post #83

manmal wrote: post #72

My son had adenoids removed last year because his hearing was VERY bad because of some kind of mucus blockage. Doctors explained to us that he would hear perfectly without the adenoids, because inner ear measurements were very good. So during the OP they cut away the adenoids, and made a hole into each eardrum, so fluids could exit. After the OP his hearing was so good that he told us not to scream at him when we bar…

Sorry to hear you're going through this. I can't imagine how frustrating it must be. Are you concerned about side effects from all these interventions? Do you have a hypothetical point at which you would simply choose to accept your child's hearing impairment?

I'm trying to be a stoic, and I will deliberately try to accept anything that I cannot influence in this very moment. Approaching medial issues, I think that the only thing you have to accept (until your death) is that your previous attempts at improving have failed; so as long my son's hearing is not good, I'll keep on looking for things to try out. There are time and cost constraints of course; sometimes I go for weeks without researching anything to improve the situation. But the motivation to do something returns naturally when he's in pain again, or is misbehaving very badly because of this.

Re: Long-term health risks after having adenoids or tonsils removed in childhood

#199

Post by barking » Fri, Jun 15, 2018, 10:52 AM UTC

zaarn wrote: post #195

barking wrote: post #172

Earlier quoted context omitted.

It's not anecdotal because I was giving own experience. Also I wasn't offering any advice.

Your own experience is anecdotal.

Your own experience cannot be anecdotal

Re: Long-term health risks after having adenoids or tonsils removed in childhood

#200

Post by gvurrdon » Fri, Jun 15, 2018, 12:07 PM UTC

headmelted wrote: post #178

gvurrdon wrote: post #165

Earlier quoted context omitted.

I'm not exactly sure (it was rather a long time ago), but IIRC everyone else in the ward was there for tonsillectomy and someone must have got it wrong when the surgeon called for "next, please". No Ben & Jerry's back in those days!

"No Ben & Jerry's back in those days!" That's the real scandal in all of this! :-) In seriousness, I'm sorry for your experience.

Thanks. I think that your experience sounds worse; I hope it hasn't left any lasting impression.