You and your doctor have decided that your child needs a tonsillectomy. The following information will help you to have a better understanding of what to expect.
Tonsils are lymphoid tissue. They are one of the body's many sites producing antibodies that are important in the body's defense against infection. The tonsils are located at the back of the throat on each side. During a bacterial or viral infection, it is normal for the tonsils to enlarge. Tonsils are usually removed due to frequent tonsil infections or enlargement that may cause disturbed breathing patterns. When chronically infected, the tonsils may be the source of throat infections rather than a defense against them.
Possible complications of a tonsillectomy, as discussed by your physician, include:
- Post-op bleeding
Change in voice
Once surgery is scheduled, during the following two weeks your child should not take any aspirin or aspirin-like compounds (Advil, Ibuprophen, Aleve or Naprosyn), or some over-the-counter cold medicines for fever or pain. These medications will interfere with blood clotting and may contribute to bleeding. Please tell your physician as soon as possible if there is ANY family history of bleeding or bleeding syndrome. Your physician will advise you if current antibiotic therapy should continue. Under most circumstances there is no blood work required. Transfusion is very rare during a tonsillectomy, so it is not routine to determine your child's blood type. You will be with your child until he or she goes to surgery.
Recovery in the hospital
In certain circumstances your child may be admitted overnight following surgery. An IV will remain in place until your child can tolerate liquids without nausea or vomiting. Nausea and/or vomiting are common complaints after surgery and is due to the anesthesia or swallowing of blood during or after surgery. Medication is available if vomiting is a problem. Your child will have a sore throat, making swallowing and talking difficult. An aspirin substitute, such as Tylenol, will be given every three to four hours. Clear liquids, such as jello, apple juice and popsicles, are encouraged to help maintain hydration. The diet will be advanced as tolerated by your child.
Upon discharge, you will be given your child's prescription for an antibiotic. It is recommended that Tylenol be given every three to four hours for the first five to seven days after returning home. This will minimize the throat pain and encourage oral intake. If needed, Tylenol may be given in suppository form.
- Post-op bleeding: Though rare, bleeding can occur most frequently within the first post-op day or seven to10 days post-op. Generally, bleeding occurs when the scab has been dislodged from the healing site. If bleeding is suspected, please call our office immediately or go to nearest emergency room.
- Fever: It is common to run a low grade fever (99 to 101 degrees) after surgery and the following week. Inadequate fluid intake is the most common cause. If high fever (102 degrees or above) develops, call our office for instructions.
- Diet: The liquid diet can be advanced to soft solids as your child tolerates. Avoid giving your child foods such as potato chips, pretzels, crackers and dry toast because they may scratch the healing sites of the throat and cause bleeding. If your child refuses solids, do not be concerned but continue to encourage fluids.
- Fluid intake: Inadequate fluid intake is the most common cause of dehydration and dryness of the mouth. Dryness of the throat will make swallowing more difficult and increase throat discomfort.
- Bad breath: White patches, similar to a scab, will form where the tonsils were removed. Frequently your child will have bad breath but brushing the teeth regularly will help reduce this odor. If bad breath suddenly increases after one week, please call the office. Avoid using strong mouthwashes.
- Ear/Throat pain: Frequently throat pain will be transferred to the ears and may be observed more at night. Most often this discomfort does not mean an ear infection. Oftentimes, discomfort waxes and wanes during the four to seven post-op days. This is normal and will decrease by the end of the period. It is important to take the antibiotic as prescribed, give Tylenol every three to four hours and encourage fluids.
Activity: Your child should avoid vigorous play for about two weeks after surgery. School-aged children may return to school after one week. Quiet activity is encouraged at home, but your child need not stay in bed. Complete recovery generally is not expected for 10 to 14 days. Your child may resume physical education class, recess and contact sports after two weeks.
Within three to four weeks after surgery, your child will be evaluated for healing of the throat.