Q: My daughter is 9 years old and suffering from tonsils since the age of 6. I took her for treatment to many doctors and ultimately decided to get it operated. For the past 8 months she is under homeopathic medicine. Both her tonsils were joined at the small tongue, but after taking the homeopathic medicine for a month, one side recovered. She faces a lot of problem while going to bed. Her nose becomes blocked. Earlier she had frequent cold and fever, mainly during the change of season but this has stopped for the past one year. Should I undergo operation or is there some medicine by which she can be cured? Her treating doctor says that with the homeopathic medicine, it will take 2 years to recover.

A:You have written that your daughter has tonsil problem. This is very vague. However I will take up all the possible problems that are clubbed as tonsil problem and explain to you. Background information: The tonsils are two almond shaped organs situated in the mouth, on either side of the tongue. You can see the tonsils, if you open the mouth and look in a mirror. Tonsils can get infected. This is quite common in school going children. Generally such infection is manifest as throat pain, cold, cough and even fever. When they are given some medicines, they usually get better. Again, after several days, they may again contract another infection and suffer the same way. Occasionally, such illness may even prevent them from attending school. There is a quite similar organ called the adenoids, situated just behind the nose. These adenoids also may also get enlarged, due to infections. Once infected and enlarged, these two organs i.e. the tonsils and the adenoids may stay enlarged due to low-grade continuance of infection. 1. When infectious episodes become very frequent, doctors suggest removal of tonsils - tonsillectomy operation. Usually, 6 or more episodes in a year are considered as significant for this purpose. Sometimes, even a number less than 6 may be considered sufficient to advise surgery, when the episodes are severe. 2. Sometime, even in the absence of a current infection, the tonsils may be enlarged. This physical enlargement alone may lead to blockage of nasal air passages and breathing passages. When such block is severe, it may cause snoring and disturbed sleep. In a child, such disturbed sleep may reflect in continued poor health and stamina. Sometimes the children may become fretful and even lag behind in their class. This condition is known as Obstructive Sleep Apnoea. 3. The adenoids, because of their anatomical situation behind the nose and nearer to the ears, may lead to sinusitis and some ear infection (ear discharge). In all the above conditions, it is better to get operated. Generally before any surgery, the ENT surgeon and the Anaesthesiologists will do several laboratory tests to assess the fitness of the child to undergo surgery. Only when it is safe, they will proceed with the operation. It is considered prudent to avoid this tonsillectomy and adenoidectomy during periods of acute cold. In addition, by the age 3 to 4 years, the ENT surgeons avoid doing these operations because during this particular interval period, the tonsils may become enlarged due to normal lymphoid organ growth. The adenoids do regress by age 11 years to 12 years. Hence, for your daughter aged 9 years, if you wait for another 2 years, the adenoids will themselves regress and disappear. Quite possibly, your homeopathy doctor certainly knows this fact and is suggesting that you wait for two years (of course, with homeopathic medicines). The single snag in waiting for two years is that you really do not know how much suffering your child can endure with recurrent infective episodes. In the light of the above facts, what should you do? I will suggest the following solution. Take a record of the past medical history of your daughter. Find out how many times your daughter had infective episodes during the last two-year period of homeopathic medicines. If it had been more than 5 or 6 episodes, your decision-making is simplified. Also, critically examine whether your child has any complications as described above. Again, your choice will be obvious. Finally, one more piece of sensible advice: Take your own Family doctor (if you have one) into confidence. Let him examine your child and give a second opinion. Stick to his advice. Your question describes a common conundrum faced by many parents. I am sure that with this answer, they will get a clearer idea about their children's tonsils. Many such parents would get a clearer idea about their children tonsils.