Read this Interview in Russian
Adenoids Without Surgery
An Interview with A. Novozhilov M.D., Medical Director of Clinica Buteyko (Moscow)
Interviewed by Sasha Yakovleva-Fredricksen
- As a rule, children who have enlarged adenoids are plagued by colds and their noses run constantly. In addition, they have periodic earaches. Sometimes, enlarged adenoids can lead to asthma. Is it really possible to alleviate these problems in children by removing the adenoids?
A. N.: No, of course not. Surgery to remove the adenoids often improves a child's condition, but only in the beginning, occasionally for only a few weeks, after which the child begins to get sick again. Furthermore, it often turns out that the adenoids start to grow back after surgery. In one of our young patients, the adenoids were removed four times and each time they came back again.
- Then why do physicians recommend adenoid removal? They must be aware of the limited effectiveness of this operation.
A. N.: Physicians certainly know that an adenoidectomy is not a panacea; however, in many cases, by temporarily improving a child's condition, it postpones the development of more serious illnesses. Aside from that, the physicians cannot offer anything. What else can be done in order to restore proper nasal breathing in a child? After all, the disruption of nasal breathing, ongoing nasal congestion, and the transition to breathing through the mouth are the very things that constitute the root of all evil in this instance. Hormonal preparations? Yes, they are able to eliminate the swelling of the mucus membrane of the nose, as well as to restore breathing ability through the nose, and this frequently proves to be a stepping stone to a child's successful treatment. However, placing a child on hormones isn’t the best idea... For this reason, physicians say: "It's better if we cut out the adenoids, especially since they might become inflamed."
- Is the cause of adenoid growth known?
A. N.: Formal medicine does not know the reason that adenoids grow, but in this regard, Professor Buteyko felt that adenoid growth is a defense mechanism of the body that is brought on by the disruption of the respiratory function. Have you ever noticed how a child with enlarged adenoids breathes? Usually, breathing in such a child is noisy, deep, and through the mouth. This excessive respiration, or in other words "hyperventilation", is capable of inflicting tremendous damage to a child's body, since it causes oxygen starvation (the Verigo-Bohr effect), disrupts metabolism, and impairs immunity. A child's body needs to protect itself against hyperventilation. It does this by blocking the respiratory canals by way of the enlargement of the adenoids and the edema of the mucus membrane; that is to say, a chronic stuffy nose is unavoidable. When the respiratory canals are constricted, the amount of air that a child uses is reduced, and accordingly, the child’s body does not sustain a high level of damage.
- Which is to say that the cause of adenoid growth is hyperventilation. But can removing the adenoids actually halt hyperventilation?
A. N.: No, never. That is why Professor Buteyko called adenoid removal surgery a crime against children. I also believe that, in most cases, the adenoids are removed in vain. Enlarged adenoids are nothing more than a defense mechanism of the body to hyperventilation, and eliminating this defense reaction entails the development of more serious health problems. By the way, other problems that also constitute a defense reaction frequently accompany enlarged adenoids – for example, a stuffy nose, a cough, and so forth. If the adenoids are removed, hyperventilation persists; thus, these symptoms not only don't go away, but sometimes even intensify, since they have to take on a function that the adenoids previously performed. Removing the adenoids often leads to the origination of more serious defense reactions – for example, a child begins to experience bronchial spasms, which can ultimately lead to the development of asthma.
- The belief exists that it is difficult for a child to breathe because his or her adenoids are enlarged, and that if they are cut out, it will then become easier for the child to breathe. But, listening to you, it appears that exactly the opposite is true: it may be that it becomes even more difficult for the child to breathe after the removal of the adenoids.
A. N.: Yes, that is frequently what happens. In other cases, prolonged hyperventilation leads to the serious lowering of immunity and the development of more serious illnesses.
- And what would the result be if parents flatly refused surgery, but at the same time, did not follow the Buteyko Method?
A. N.: More than likely, the lowering of immunity and the development of new illnesses. As time goes by, if a child's nose becomes completely blocked and he or she is only able to breathe through the mouth, personal degradation may set in – the child's skull bones could be deformed, his or her face might change, and he or she might be transformed into an idiot in the medical sense of this term. Incidentally, the expression "adenoid face" even exists in medical circles. The adenoids may also become inflamed and infected; frequent ear infections (otitis) could set in, as a result of which a child might lose their hearing at least partially. It is important to understand that surgery to remove the adenoids is imperative in such advanced cases; however, without using the Buteyko Method, it cannot yield long-term results.
- Okay, but what would Buteyko Method specialists be able to propose in the event of enlarged adenoids?
A. N.: We approach this problem in a different way. The cause of enlarged adenoids is hyperventilation; consequently, it is necessary to eliminate the cause of the illness, then its symptoms will go away on their own. The primary objective of a specialist is to normalize a child's breathing, first and foremost, by restoring breathing through the nose. A child who is not able to breathe through the nose will never be healthy.
- That's easy to say: to restore breathing through the nose! But, after all, a child with enlarged adenoids is scarcely able to breathe through the nose.
A. N.: You are right, Sasha: the restoration of nasal breathing in a child is quite a difficult task, and therefore, it must be accomplished under the supervision of a specialist. Indeed, it is hard for a child with enlarged adenoids to breathe through the nose. This is true for two reasons: on the one hand, the adenoids block the flow of air through the nose, while on the other hand, it is blocked by the swelling of mucus membrane in the nose. Edema severely constricts the respiratory passages and can ultimately cover the adenoids themselves, at which point the nose ceases breathing altogether. That is to say, the problem consists of two parts: enlarged adenoids, which cannot be reduced in most cases once they grow, and edema of the mucosa, which can be reduced. If the edema goes away, a child will once again be able to breathe through the nose, while the adenoids themselves atrophy by the age of 12.
- But what happens if the edema does not go away?
A. N.: As a result of edema, the natural ventilation of the nasopharynx (ears, nose, throat area) is impaired, and so is natural fluid drainage (discharge), as a result of which the adenoids become inflamed, and if microbes enter the picture, pus is created. The edema starts to spread, gradually engulfing the entire ear, nose and throat area and affects the ventilation openings of ears. When edema covers these openings, inner ear inflammation then sets in, frequently accompanied by hearing loss. But this is not a true deafness: the child is in a condition such that his or her ears are "stuffed up", as is the case, for example, in an airplane. Eliminating the mucosal edema leads to a situation wherein children say during their Buteyko sessions that their "hearing has returned." To the parents, this usually sounds like a "miracle cure." But it has to be wistfully observed that parents, through lack of knowledge, often take the child to a physician, and a surgeon cuts out the inflamed adenoids. Consequently, a sort of "hole" is shaped within the nose and it becomes easier for the child to breathe. However, the edema is still there... in a certain amount of time, it will again cover this hole and the child's nose will again be clogged. History repeats itself! By the way, edema also makes it very difficult for a surgeon to cut out the adenoids completely, as a consequence of which, a small piece of tissue is occasionally left behind and it re-grows. Therefore, in six months or so, the child will again face adenoid removal.
- So, it turns out that the most important thing for the successful treatment of a child with enlarged adenoids is to eliminate the swelling of mucus membrane.
A. N.:That's exactly right!
- And how is this done?
A. N.: There are two ways. One of them is the use of steroids, which ultimately inflict considerable damage on a child's health. But the second method is safe and does not have any adverse consequences – that is to get rid of hyperventilation or "deep breathing" through the use of the Buteyko Method. We teach a child how to eliminate the excessive ventilation of the lungs; that is to say, how to eliminate hyperventilation and to normalize the respiratory function as a whole. Thus, the body no longer has to produce an excessive amount of mucus, which defends against "deep breathing", and the child is afforded the opportunity of continuously breathing through the nose. Nasal breathing restores the natural ventilation of the ear, nose and throat area, as well as natural drainage, and the inflammation of the adenoids is halted. In addition to this, the adenoids stop getting bigger in size or, as is sometimes the case, even get smaller due to the elimination of the mucous membrane and tissue puffiness.
- And so, it is my understanding that parents go to an E.N.T. doctor, who measures the adenoids and then on that basis says that surgery is no longer necessary for this child.
A. N.: Yes, Sasha, that is so. In the large majority of cases, the Buteyko Method makes it possible to avoid adenoid removal surgery.
- And what, on the whole, happens to a child's health when he or she starts to apply the Buteyko Method?
A. N.: The Buteyko Method is holistic; that is to say, it restores health in general and does not just eliminate a specific symptom. When the respiratory function is normalized, the child's immune system begins to recover and he or she stops hurting. His or her memory and ability to pay attention improves, in addition to which the child becomes calmer. It usually becomes easier for teachers and parents to work with a child and his or her progress in school improves. Moreover, other problems also dissipate – for example, bed wetting (nocturnal enuresis), from which many children with adenoids and impaired nasal breathing suffer. Incidentally, the attention of parents should be drawn to the Buteyko Method for treating bed wetting. If a child has sustained a partial hearing loss as a result of ear infection, it then begins to be restored. As previously stated, it often happens that during the first few breathing exercise lessons, a child will say with astonishment: "I can hear again!” This occurs due to the fact that the periods of Buteyko breathing exercises clear up the edema of the ears, nose and throat. I already mentioned it but the effect is so striking that I can speak about it over and over again.
- And how do children take the Buteyko breathing exercises?
A. N.: We primarily work with the children in motion and use various physical exercises, which the children like very much. The child sees the treatment as a game and develops a trusting relationship with the specialist, which helps achieve a desirable result quite a bit faster. The alleviation of a child's condition frequently occurs during the first or second lesson and the children perceive this as favorable experience.
- And what is the role of the parents?
A. N.: There will always be parents who are looking for an alternative to surgical intervention and who are willing to fight for a child's health. These parents take part in a child's Buteyko lessons without question, learn the Buteyko Method, and continue to use it in the home. In this instance, success is inevitable! Sometimes, however, we get other parents, who say something like: "I have paid you, and in return, you must give me back a healthy child, and however he becomes healthy does not matter to me – I don’t care whether it is through surgery or breathing exercises." These apathetic parents often prove to be an impediment to the healing of their child, therefore the participation of the parents in learning the Buteyko Method is the key to a child's recovery.