hello and welcome to HCM,
Tonsils and adenoids
are common in his age group and do not worry you are not alone. Four years is however too small to remove the tonsils and adenoids unless they are causing problems like hearing loss
and also difficulty in eating and swallowing and also if there is breathing difficulty in the day time.
Since you are already giving him so many medications, any more will not help. He will either outgrow the block due to adenoids in a year or two or we can think about surgery at the time.
Meanwhile do the following:
1. Avoid giving him head bath daily and also body bath should be only with hot water
2. Never allow him to sleep under the direct blast of the AC or the fan
3. Before he sleep, let him do some steam inhalation which will improve his breathing.
4. Watch out for any hearing loss which necessitates surgery at an earlier date.
5. Avoid anything cold
and always give him warm anything especially water and especially in the night
take care and dont worry too much
Dr Sriram Nathan