Post-Operative Care for Tonsillectomy and Adenoidectomy

1) The recovery from tonsillectomy is a very painful period, often the worst pain people can recall, so please be understanding and patient with yourself, or the patient you are caring for. There are generally two periods to recovery, the first severe and the second less so, before returning to normal health. The first period lasts 5-7 days in children and 7-10 days in those over about twelve years old, and is the time the throat is “re-growing” its covering. If you look at the throat then, it is red and white and swollen, especially the uvula that hangs down in the middle of the throat. The second period lasts another 5-7 days in children or 7-10 days in those over twelve years old and has less pain, although you will still find that yawning, coughing, and sneezing will cause sharp twinges of pain. During this time the swelling improves and the tissue looks gray.

2) Dehydration is the biggest enemy of the recovery period. It will increase the pain, increase the risk of bleeding or infection, and delay the healing. It usually happens because the pain of swallowing keeps the patient from drinking enough liquids. Therefore, the key is to force fluids, and that works best when pain control is maximized. You may find it helpful to take pain medicine during the night, especially if the patient awakens. These are usually best taken with some other liquid or soft food, because they can be irritating to the stomach. The worst pain is usually in the morning, especially beginning a day or two after the operation. Please be aware that no combination of medicines will eliminate the pain the patient will need to continue eating/drinking in spite of the remaining discomfort.

3) Bleeding can occur in 5-7% of patients.  It may come from the nose, the mouth, or be vomited or coughed up. In a small number of cases it may require treatment in the emergency department or operating room.

4) Fever: A low-grade fever (less than 38 degrees) following surgery may occur and should be treated withacetaminophen.
It is important that you drink plenty of fluids after surgery. This helps the healing process and helps reduce the chance of fever. Fever may indicate that you have not taken in sufficient fluids or may have an infection.

5) Remember that the patient should only have liquids or soft foods for the first ten days.  Any liquid or soft food is safe, but most people will prefer cold over warm, and most find acidic things (citrus, carbonated soda or tomato products) will be more irritating. Favorites among our patients are popsicles, ice cream, sherbet, jello, pudding, applesauce, yogurt, eggs, potatoes, pasta, and soups. Definitely avoid hard, crunchy and chewy foods – they will increase the risk of bleeding.

6) Remember, no strenuous activity for 10 days following the operation.

7) Since moisture helps soothe the healing throat, a room humidifier (hot or cold) is suggested when the patient is sleeping.

8) The adenoid tissue is at the back of the nose and upper throat; healing is improved and foul odor reduced by flushing, spraying or dripping salt water (saline) into the nose every 3-4 hours.