RENEE MONTAGNE, host:
Now to kids and their breathing problems. Up until the mid-1900s, having your tonsils out was a routine part of childhood. And according to NPR's Nancy Shute, that's becoming more frequent again. She tells us why.
NANCY SHUTE: Tonsillectomy was the most common surgery in the '50s and '60s, even for kids in sitcoms like "Family Affair."
(Soundbite of TV show, "Family Affair")
Mr. BRIAN KEITH (Actor): (As Uncle Bill Davis) Sometimes, little kids have to have their tonsils sort of taken out. And in order to do that, you have to...
Ms. ANISSA JONES (Actor): (As Buffy) Go to the hospital?
Mr. KEITH: (As Uncle Bill Davis) That's right.
SHUTE: Doctors used to prescribe tonsillectomy as the treatment for frequent sore throats. But then they started noticing that kids were still getting sore throats, even after the surgery. Richard Rosenfeld is an ear, nose and throat doctor - an ENT - at SUNY Downstate in Brooklyn, New York.
Dr. RICHARD ROSENFELD (ENT, SUNY Downstate): It was becoming unacceptable to just take tonsils out because they were there, or you had a few infections. People were growing up with their tonsils.
SHUTE: But growing up with tonsils can create another health problem.
Dr. ROSENFELD: When you lay down at night and go to sleep and your tongue falls back a little bit, it's going to land right on those two big tonsils.
SHUTE: And that causes sleep-disordered breathing.
Sleep apnea, like you just heard about, is a more severe form. But in kids, plain-old snoring can cause problems, too - like poor school performance, behavior problems and bed-wetting.
Lisa Moran remembers what it sounded like when her son, Tyler Scorza, snored. She and Tyler, who's 7, talk about what she would hear when she stood outside his bedroom door at night.
Ms. LISA MORAN: It was loud. You don't remember a thing, how loud it was?
TYLER SCORZA: No, I don't.
Ms. MORAN: You could hear him through the closed door, down the hall, snoring. That's how loud it was. And so he would exhale...
(Soundbite of exhaling)
Ms. MORAN: ...and there'd be that long pause, and you'd stand there and wait, and he'd go...
(Soundbite of exhaling)
SHUTE: At first, his pediatrician thought he'd outgrow it. But Tyler wasn't sleeping well, and he often didn't have any energy.
TYLER: Sometimes, I did wake up, even by my own snoring.
SHUTE: His parents, who live in Takoma Park, Maryland, took him for an X-ray. The thought was maybe his adenoids was causing trouble.
Ms. MORAN: So he had a head X-ray, and the radiologists report was, well - and we were looking specifically at the adenoids at that point. They said well, no, the adenoids were swollen or enlarged, but it's not that bad.
SHUTE: By now, Tyler had been dealing with this for almost three years. He started getting a lot of nasal infections, so his parents took him to an ENT.
Ms. MORAN: The ENT there took a look at the X-ray and said well, they're right about the adenoids. They are swollen, but the real problem is the tonsils. And he showed us on the X-ray that there was a very tiny passage between the tonsils and the back of his throat very small.
SHUTE: The doctor said: Those tonsils are just too big; they've got to go. But Tyler's parents were worried about tonsillectomy. The surgery is now usually done outpatient, but with general anesthesia. That's never without some risk.
Ms. MORAN: Your child is under completely under. This is not a local.
SHUTE: To help parents decide if a child needs a tonsillectomy, the ear, nose, and throat doctors have issued new guidelines. With sore throats, they recommend watchful waiting, unless a child has more than seven infections in a year.
There's less evidence on tonsillectomy and sleep-disordered breathing. The guidelines say it helps most children, but not all. Tyler's family decided to go ahead.
TYLER: I went over to the hospital with my mom, at about 5 o'clock in the morning.
SHUTE: By lunchtime, Tyler was back home, eating popsicles. Over the next two weeks, his classmates sent him get-well cards.
TYLER: Dear Tyler, I hope you get well soon. Did the surgery hurt? Your friend, Rachel.
SHUTE: A year later, Tyler's feeling great, and his snoring is gone.
Ms. MORAN: Completely gone. Absolutely, 100 percent completely gone. He sleeps like his older brother now. You can hear a pin-drop quiet when he sleeps.
SHUTE: But Tyler and his brother Joe agree: At night, the house is still not completely quiet.
TYLER: Dad snores, and he wakes me up a lot.
JOE SCORZA: Yeah. Definitely.
SHUTE: Which makes them wonder if maybe Dad needs his tonsils checked, too.
Nancy Shute, NPR News, Washington.
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