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Tonsillectomy and Adenoidectomy

The following is a general guide and should cover most of the common situations which may arise. If special problems occur, please call and leave a message for our Triage Nurse at 703-573-7600 ext. 1106, Monday through Friday 9AM-4PM. A physician is on call for after-hours problems which cannot wait until the office reopens.

Activities: Resting at home for the first 48 hours is desirable. This does not mean absolute bed rest, but activity should definitely be restricted. After the second day at home, activity can be gradually increased and the patient may go outside on the fifth day. Children may return to school no sooner that 1-2 weeks following surgery, if they have been free of symptoms and have not taken narcotic pain medications for 48 hours. Strenuous activity, sports or swimming should be avoided until after postoperative day 14. Airline travel is not allowed for 2 weeks after surgery.

Diet: A high daily fluid intake is essential. Try to avoid using straws. Due to throat soreness and swelling, the patient’s appetite may be poor for the rest of the first week. Liquids, Jell-O, ice cream, pudding, yogurt, soups, and other soft foods taken in small frequent feedings are preferred. Advance the diet as the patient tolerates. Citrus juices (i.e. orange, grapefruit, tomato,) salty and spicy foods should be avoided, as they may irritate the throat. Milk products and soft drinks are acceptable. The patient may return to a regular diet 14 days after surgery.

Pain and Sleep: Until the fifth or sixth post-operative day most patients, especially children, will be listless and lack energy during the day, and may not sleep comfortably during the night. Throat soreness can be treated with cool compresses or an ice collar applied to the neck, sucking on ice chips, chewing gum, or use over the counter Tylenol (acetaminophen or abbreviated as APAP) taken as directed if not taking a narcotic pain medication with Tylenol already in it. Older children and adults generally experience more pain and may be given a prescription pain medicine with Tylenol when they leave the surgery center. Ear pain is not uncommon and rarely indicates an ear infection. It is due to referred pain from the throat which is swollen following the removal of the tonsils. It is best treated with Tylenol and/or a hot water bottle applied to the ear. The use of Aspirin, Ibuprofen, Motrin, Advil, or Aleve should be avoided until after post-operative day 14. Patients should not drive or operate machinery while taking prescription pain medication. Some patients may notice a higher pitch or nasal quality to the voice after surgery. This is temporary and should resolve spontaneously by 6 weeks after surgery. Pain may fluctuate from day to day and may increase between day 5 and day 8.

General Information: A yellowish-white membrane will form in the throat where the tonsils were removed. This may create an odor to the breath which will go away as the throat heals. The patient may resist swallowing saliva, causing the patient to spit frequently or to cough. Normally, the patient will have a low grade fever (to 101 degrees) for the first week, which will disappear as fluid intake is increased. Slight bleeding from the mouth or nose may occur between the sixth and tenth day after surgery, when the membrane separates from the area where the tonsils and adenoids were removed. This should not be a cause for alarm unless it is persistent. It is best to avoid contact with people who have colds or upper respiratory infections during the post-operative period. Gargles and tobacco use should be avoided. Brushing teeth is permitted.

Persistent bleeding/Persistent vomiting/Persistent cough/Persistent fever


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