On the Coast – Families Issue 103 I December 19/January 20 | Page 31

These grow rapidly between the ages
of 2 and 7 years old. Having them
removed cures 80-90% of cases. Other
reasons for children to have OSA include
obesity, allergies, and underlying medical
conditions such as Down’s syndrome,
which can have associated low muscle
tone, causing floppy airways. These may
respond to sensible weight management,
medication and CPAP respectively.
Key Point – If your child is a loud
snorer, with pauses in their breathing,
choking or gasping in their sleep, if they
wake in the morning tired, or with a
headache, they may have OSA. Take
them to your GP to discuss the next step!
Tonsillitis
Tonsillitis, a common and generally
innocent condition. The average GP
will see more than 100 cases a year. But
it can become dangerous if it causes
dehydration, or an abscess, or repeated
absence from school.
Tonsils sit as a pair at the top of the
throat, you can usually see them when you
open your mouth, and act as part of the first
line immunity defence. If they become
infected and inflamed, this is tonsillitis.
Symptoms generally consist of a sore throat,
which is often accompanied by fever,
headache, tiredness and pain on swallowing.
Most cases of tonsillitis will get better
by itself. Even if it has been caused by a
bacteria. Taking antibiotics will generally
only shorten symptoms by a day, and
this isn’t worth the risk of side effects,
such as diarrhoea, and hypersensitivity,
and the creation of superbugs. If your
child can get better by themselves, it will
help them develop a better immunity and
reduces the chances of getting sick from
that bug again.
Obviously there are some situations
when children must be brought to see
their doctor.
ƒ ƒ Children of aboriginal and Torres
Strait Islander descent and those from
the Pacific Islands, due to an increase
risk of complications
ƒ ƒ Children with a past history of
rheumatic fever
ƒ ƒ Children with a severe form, especially
if there is a rash (Scarlet Fever)
ƒ ƒ Children showing difficulty with
breathing, including increased snoring
ƒ ƒ Children showing difficulty opening
their mouths
ƒ ƒ Children with difficulty swallowing
and showing signs of severe
dehydration.
If your child has severe dehydration,
they may be:
ƒ ƒ extremely thirsty
ƒ ƒ lethargic or less active than usual 
ƒ ƒ pale and have sunken eyes, tears may
be absent when crying 
ƒ ƒ cold – especially their hands or feet 
ƒ ƒ breathing faster than usual and have a
fast heart rate 
ƒ ƒ irritable, drowsy or confused.
If your child shows signs of severe
dehydration, see your GP or go to your
closest hospital emergency department.
If they exhibit none of these features
and you are not worried, they can be
cared for at home, which includes plenty
of rest, fluids (hydrolyte icy-poles are
a good way to do this) and simple pain
relief, in the form of regular paracetamol
and ibuprofen. Your child should stay
home until the fever stops and they are
able to swallow easily again. This can
often take up to a week.
If your child has repeat infections,
the option of seeing an ENT surgeon to
explore the possibility of a tonsillectomy
may be sensible. It is a common operation
and generally one with a great outcome,
but there are some risks, including post
operative bleeding and infection which
need to be discussed with the surgeon
before signing the consent form.
Current guidelines suggest
considering a tonsillectomy after seven
infections in 12 months, or five infections
in two consecutive years, with these
infections affecting normal life, eg the
ability to attend school or daycare.
Key Point – most children don’t need
antibiotics for a sore throat, but get them
assessed if they are in the ‘at risk’ group
or you are worried.
You’re pretty much guaranteed that
someone in your family will be affected
by one of the conditions mentioned
in each of these articles! The advice
mentioned is only that and does not
replace seeing your GP if you are
concerned.
Dr Pethen is a GP at your Family Doctors at Erina, a doctors surgery that aims to deliver high quality
care with a personal touch, find them at www.yourfamilydovtors.com.au or phone [phone]
DECEMBER 19/JANUARY 20 – ISSUE 103
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