The tonsils are located on each side of the back wall of the throat, just above and behind the tongue. The adenoids are found above and behind the soft palate (roof of the mouth) where the nose and mouth join. Theses tissues help defend the body against infection. When they are overcome by chronic infections, or when marked enlargement blocks breathing, tonsils and/or adenoids may need to be removed. During surgery, the tonsils and adenoids are removed from the wall of the throat. The adenoids are reached by lifting the soft palate. The operation takes about 30 minutes.
After this operation, your child may lack energy for several days. Many children are restless and don’t sleep through the night. This will gradually improve over 7-14 days. Constipation may also occur. This is due to less food and fluids taken and/or the use of pain medications with codeine. To avoid nausea, give your child food/drink with this type of medication.
No new bleeding (BRIGHT RED blood) is expected from the nose or mouth after you return home. Please check your child for bleeding during the night after the operation. If fresh bleeding occurs after you have returned home, take your child to the closest emergency room for examination. If the adenoids are removed do not allow your child to blow his or her nose for 3 days. This may cause bleeding. It is safe to sniff gently as needed. 5-10 days after the operation your child may spit up a small amount of dark, bloody material. The white membrane that formed across the back of the throat has broken away. If the bleeding does not stop within a few minutes, take your child to the closest emergency room.
Encourage your child to drink clear, cold liquids every waking hour for the first 2 days. Good choices include cold water, fruit juice, Jell-O, popsicles, slush, Gatorade, and Pedialyte. You may advance the diet to soft, the sold foods at any time after surgery. If your child is nauseated and vomits DO NOT provide any food or drink for 30-45 minutes. Then begin with clear liquids again, progressing to solid foods once your child tolerated clear liquids without vomiting.
A slight fever is NORMAL for 24-48 hours after surgery. Giving your child plenty of fluids will help keep the fever down. If the fever rises above 101.5 F, contact your doctor.
Throat pain and/or ear pain can be severe after a tonsillectomy. Expect your child to experience pain in the ears between the 3rd and 7th day after the operation. The nerve that goes to the tonsil also goes to the ear causing pain to be felt in the ear. After the operation give pain medication 4-5 times a day. Do NOT use aspirin, medications containing aspirin, or ibuprofen (Motrin, Advil) – they increase the chance of bleeding. Acetaminophen (Tylenol, Tempra) of a prescription item advised by your physician can be used. Sometimes a short course of prescription steroids may help with pain and swelling. Other ways to decrease throat pain are:
Bad breath is common after a tonsillectomy. It is caused by the white-yellowish membrane that forms in the throat where the surgery took place. Bad breath may be improved by gargling with a mild salt-water solution. This is made by adding Ѕ teaspoon of table salt to 8-ounces (1 Cup) of warm tap water.
Promethazine (Phenergan), or prochlorperazine (Compazine) suppositories may be used to control nausea and vomiting. The dose may be repeated after 4-6 hours. If vomiting continues after the 2nd dose, call your child’s doctor or the local hospital emergency room.
Your child can be up and dressed after going home. But do NOT allow your child to resume normal activity for about one week. Your child may experience alternating “good” and “bad” days for 2 weeks after surgery. It is a good idea to keep your child away from crowds and ill people for 7 days, since the throat is highly susceptible to infections during this period.
Restrict TRAVEL to within 30 minutes of a medical center or E.R. for 2 weeks following surgery. Finally, FOLLOW your doctor’s orders if they differ from these instructions.