Tonsillectomy (cont.)
What happens after surgery?
After surgery, you or your child will be taken to the recovery
room
where a nurse will monitor you or your child. You will probably
be invited
into the recovery room as your child becomes aware of their
surroundings
and starts looking for you. You, or your child, will be able to
go home
the same day as the surgery once you, or they, have fully
recovered from
the anesthetic. This usually takes several hours. You will need
a friend
or family member to pick you up from the surgical facility to
take you
home. They should spend the first night after surgery with
you.
When you arrive home from the surgical facility, you or your
child
should go to bed and rest with the head elevated on 2-3
pillows. By
keeping the head elevated above the heart, you can minimize
edema and
swelling. Applying an ice pack to the neck may help decrease
swelling.
You, or your child, may get out of bed with assistance to use
the
bathroom. Visitors should be kept to a minimum since they may
unknowingly
bring infection and cause over excitement. Avoid straining, if
you are
constipated, take a stool softener or a gentle laxative.
It is best for you, or your child, to eat a light, soft, and
cool diet
as tolerated once you or they have recovered fully from the
anesthetic.
Avoid hot liquids for several days. Even though one may be
hungry
immediately after surgery, it is best to feed slowly to prevent
postoperative nausea and vomiting. Occasionally, one may vomit
one or two
times immediately after surgery, however if it persists, your
doctor may
prescribe medications to settle the stomach. It is important to
remember
that a good overall diet with ample rest promotes healing.
Weight loss is
very common following a tonsillectomy. You need not worry about
nutritional requirements during the recovery so long as you, or
your
child, is drinking an adequate amount of fluid.
You, or your child, will be prescribed antibiotics after
surgery, and
should finish all the pills that have been ordered. Some form
of a
narcotic will also be prescribed (usually acetaminophen/Tylenol
with
codeine), and is to be taken as needed. If you require
narcotics you are
cautioned not to drive. If you have nausea or vomiting
postoperatively,
you or your child may be prescribed anti-emesis medications
such as
phenergan. If you have any questions or you feel that you or
your child is
developing a reaction to any of these medications, you should
consult your
doctor. You should not take or give any other medications,
either
prescribed or over-the-counter, unless you have discussed them
with your
doctor.
General Instructions and Follow-up Care
An appointment for a checkup should be made 10 to 14 days
after the
procedure. Call the office to schedule this appointment.
The most important thing one can do after a tonsillectomy to
prevent
bleeding and dehydration is to drink plenty of fluids. At times
it may be
very difficult to swallow. If you, or your child, drinks, they
will have
less pain overall. If it takes one hour to drink a glass of
water then do
it. Try to drink thin, non-acidic drinks or frozen popcicles.
Soft foods
like gelatin, ice cream, custards, puddings, and mashed foods
are helpful
to maintain adequate nutrition. Hot, spicy, rough, and scratchy
foods such
as fresh fruits, toast, crackers, and potato chips should be
avoided since
they may scratch the throat and cause bleeding. If
dehydration
occurs and attempts at home cannot correct the problem, then
admission to
the hospital for intravenous fluids will be necessary.
Pain is common after a tonsillectomy. It is often hard to
predict who
will recover quickly or who will have prolonged pain.
Immediately after
surgery, many patients report only minimal pain. The next day
the pain may
increase and remain significant for several days. Often times
at one week
following surgery, patient's will appear to relapse when their
pain
becomes significant again. They usually report pain in the ears,
especially when they swallow. The scabs are often falling off
at this
time. If bleeding is going to occur, this is the most common
time. This
pain is usually the last type of pain experienced. Overall,
most patients
will have recovered fully by two weeks after surgery, however
for up to 6
weeks they will occasionally have throat tenderness with hot or
spicy
foods.
You will notice white patches in the back of the throat where
the
tonsils were removed. These are temporary scabs which occur
during the
healing process. They are not a sign of infection, and will
fall off
within the first two weeks following surgery. No attempt should
be made to
remove them. They will give the patient bad breath which will
go away when
everything is healed. It will take up to 6 weeks for the throat
to return
to the normal pink color. It is not unusual to have nasal
stuffiness
following surgery. The nasal stuffiness may last for several
months as
swelling decreases. Saline nose drops (Ocean Spray) can be used
to help
dissolve any clots and decrease edema. You may notice
persistent or even
louder snoring for several weeks. A temporary change in voice
is common
following surgery, and will usually return to normal after
several months.
They, of course, will sound less "nasal" following
surgery.
Bleeding occurs in 1-3% of patient's after a tonsillectomy.
Although it
can occur at any time, it almost always occurs 5-10 days after
the
operation. Dehydration and excessive activity increases the
chances of
postoperative bleeding. If bleeding occurs, try to remain calm
and
relaxed. Rinse the mouth out with cold water and rest with the
head
elevated. If the bleeding continues, call your doctor.
Treatment of
bleeding can be simple, or it may require a trip back to the
operating
room under general anesthesia. In very rare situations, a blood
transfusion may become necessary. Conversely, bleeding is rare
following
an adenoidectomy. There may be some bleeding from the nose
following
surgery. If it occurs, pediatric Neosynephrine nose drops can
be used. If
it is persistent and bright red in color, call your doctor.
Most patients require at least 7-10 days off from work or
school. After
3 weeks exercise and swimming can usually be resumed, but no
diving for 6
weeks. You should plan to stay in town for at least 2-3 weeks
to allow for
postoperative care and in case you have bleeding.
Notify Your Doctor If You Or Your Child Has:
- A sudden increase in the amount of bleeding from the
mouth or nose that lasts more than a few minutes.
- A fever greater than 101.5 degrees F which persistent
despite increasing the amount of fluid you or they drink and acetaminophen
(Tylenol and others). A child with a fever should try to drink approximately
one-half cup of fluid each waking hour, and an adult should drink one cup per
hour.
- Persistent sharp pain or headache which is not
relieved by pain medications prescribed.
- Increased swelling or redness of the nose, neck, or
eyes.
- Tonsillectomy and adenoidectomy is a surgical
procedure performed to
- remove the adenoids.
- The tonsils and adenoids are masses of lymphoid
tissue located behind
- the nasal passages.
- All surgical procedures have risks and potential
complications.
- Understanding what is involved before, during, and after
surgery can
help you or your child recover from surgery as comfortably as
possible.
Last Editorial Review: 9/27/2002
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From the Doctors at MedicineNet.com  |
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