Nafil Mahmood, a vibrant and energetic 5-year-old, had always been an active child. Whether he's zipping around the soccer field as a left-handed player, shooting hoops, swimming or riding his bike at the park, he loves the outdoors. He also enjoys building Lego® creations and gardening with his mom.
However, his mom, Anita, noticed he had trouble breathing during physical activities and continued to struggle to sleep through the night, a concern that would soon lead them to uncover a bigger issue.
The Early Symptoms
Since birth, Nafil had never slept through the night. No matter how tired he was, he’d frequently wake up and wander around, half-asleep, complaining his nose was blocked. "My nose is blocked, my nose is blocked," he would tell his mother, pacing back and forth as if movement might help him breathe easier.”
At first, Anita assumed it was just allergies—something she dealt with herself. As the problem persisted, she began to feel uneasy about relying on allergy medication without understanding the root cause. When Nafil started playing sports, Anita observed even more concerning signs. “Despite being an incredibly fast runner, he would often have to stop to catch his breath,” recalled Anita. “His eating habits were affected too, as he’d take multiple breaths between bites. He began snoring heavily at night.”
Despite trying various remedies, including natural solutions like bone broth and turmeric milk, and carrying a bottle of saline during trips to help with his nasal congestion, Anita couldn't ignore that something was wrong.
Then, a conversation Anita had with a fellow parent at the school where she teaches opened a door for her. "I told her that I was tired because my son doesn’t sleep well at night. My student's mother said, 'Hey, I work with an ENT specialist. Would you be interested in meeting with the doctor?'” Anita recalled. “I was really skeptical. I'm a nervous mom already, but I agreed to take my son to see an ENT specialist."
Seeking Help: The ENT Consultation
Anita was initially hesitant, as she wasn't sure where the referral would lead. After hearing from others who had gone through similar experiences, she and her husband decided it was worth exploring further.
They met with Zi Yang Jiang, MD, an associate professor in the Department of Otorhinolaryngology and chief of Pediatric Otorhinolaryngology at UTHealth Houston as well as a pediatric otolaryngologist (or ENT specialist) affiliated with Children’s Memorial Hermann Hospital. Dr. Jiang examined Nafil’s nose using a camera. When Dr. Jiang looked inside, he was shocked by what he saw—Nafil’s adenoids were severely inflamed and blocked, making it nearly impossible for him to breathe properly. Dr. Jiang explained that Nafil’s symptoms of difficulty breathing, snoring and the general fatigue he experienced were likely caused by his enlarged adenoids. Initially, they tried steroid nasal sprays like fluticasone for three months to address the adenoids, but the treatments didn't help.
“We read a lot, did our research and talked to many people who had gone through it,” said Anita. “We even saw another ENT for a second opinion but ultimately returned to Dr. Jiang. I felt confident that he knew what he was talking about and what he was doing. Nafil said, ‘I want to get this fixed. I don’t like this, Mommy.’ That’s when we decided to move forward with our son’s surgery. Dr. Jiang’s assistant walked us through everything, explaining what to expect both before and after the procedure.”
The Surgery
On the morning of July 23, 2024, nerves and uncertainty filled the air, natural for any parent when their child is about to undergo surgery. Nafil, however, seemed calm and prepared. He had been mentally preparing for the procedure by watching videos and learning about what would happen. Anita recalls how the Children’s Memorial Hermann Hospital staff, especially the anesthesiologists, made Nafil feel comfortable, bringing in toys and engaging him before the surgery.
"The staff was amazing with my son before the surgery. They brought in toys and Legos® to keep him entertained and even asked if he wanted to watch something. He said no, but they still made him feel comfortable. When it was time to put on the gown, they explained the flavors for his mask. He chose bubble gum flavor and then five staff members came together to get him ready,” said Anita.
Despite all the preparation, the emotional weight of the moment hit Anita when the staff came to take Nafil into the operating room. Though the surgery itself was relatively quick, lasting about 10 minutes, the entire process from prep to recovery lasted around two hours.
Adenoids are part of the immune system and tend to shrink naturally as children grow. By adolescence, they often become much smaller or disappear entirely. But for some children, when the adenoids are too large, they can interfere with breathing and sleep, making intervention necessary.
“An adenoidectomy typically involves removing enlarged adenoids that obstruct breathing, cause chronic congestion or contribute to recurrent infections. Removing the bulk of the adenoid tissue can improve airflow and alleviate symptoms” explained Dr. Jiang.
“The staff texted us throughout the procedure, letting us know that Nafil was okay,” said Anita.
Nafil recovered at the hospital for about an hour-and-a-half before he went home.
Post-Surgery Recovery
For the first day after surgery, Nafil’s doctor recommended plenty of popsicles and to use saline every 30 to 40 minutes to keep Nafil’s nasal passages moist. To manage pain, his parents alternated acetaminophen and ibuprofen every four hours for the first three days. Recovery took about a week and a half, during which Nafil had a mild fever and took it easy, avoiding high-energy play.
To help him heal, the family kept things quiet at home, making sure he got plenty of rest. His parents also kept him away from public places to lower the risk of infection.
Fortunately, Nafil’s recovery was smoother than expected. Though groggy at first, he bounced back quickly. After about a week and a half, he was back to his energetic self and his symptoms were nearly gone. “He’s doing amazing now,” Anita shared. “It’s like he’s a whole new kid.”
Nafil no longer wakes up at night complaining about a blocked nose and his snoring is gone. He finally sleeps through the night, breathes easily and has more energy, especially when running or playing sports. His performance in soccer and basketball has soared.
Nafil’s parents saw a big change in his energy and focus. Before, he was so tired he’d fall asleep in the car after school. Now, he’s alert, engaged and back to being the bright, social child they knew.
While Nafil still experiences occasional nasal congestion during allergy season, it’s nothing compared to what he dealt with before the surgery. His overall quality of life has improved tremendously and he’s once again enjoying his hobbies like biking, swimming and playing sports.
A Bright Future Ahead
Now, as Nafil prepares for first grade, his family is looking forward to a future where his health no longer holds him back. He’s a confident, active and independent young boy who loves to keep his space tidy, help in the kitchen and engage in outdoor activities. Nafil’s parents are grateful for the decision to go ahead with the surgery and are thrilled to see their child thriving in ways he couldn't before.
“We’re so grateful to the whole team—the hospital experience was really great,” said Anita. “Our son has a new lease on life, and as parents, it’s amazing to see him thriving and back to doing what he loves.”
Learn more about the pediatric ENT services at Children’s Memorial Hermann Hospital »
1 Affiliated physicians evaluate patients at UT Physicians clinic locations and perform all inpatient procedures and treatments at Children’s Memorial Hermann Hospital.