Post-Operative Tonsillectomy Surgery Instructions

Tonsillectomy (Removal of the tonsils)

The tonsils are found in the back of the throat on each side of the mouth cavity behind the tongue. They are frequently removed for obstructive breathing or repeated bouts of tonsillitis (infected tonsils).

General Instructions:

Medication

• Throat pain is to be expected after a tonsillectomy. Additionally, it is not uncommon for there to be ear pain.
• I want you to administer children’s Tylenol® – every 4-6 hours around the clock – for the first 10 days after surgery (follow the dosing instructions on the bottle to ensure you do not over-dose your child). If the pain is so intense that it prevents your child from drinking, then administer the narcotic pain medication that was prescribed at surgery instead of the Tylenol®.  Do NOT administer both pain medications simultaneously.
• Taking the medicine one-half hour before eating may help your child to be more comfortable while swallowing. The more your child swallows, the sooner the throat discomfort will disappear.
• DO NOT use ASPIRIN or IBUPROFEN-containing products ( e.g. MOTRIN®, ADVIL®, ALLEVE®, NAPROXEN®) because they WILL CAUSE BLEEDING. Please only use the medications I prescribed – please call the office if you have any questions.

Diet

• Drinking is very important to insure healing.
• Apple or apricot juice and popsicles are suggested. Soft foods like Jello and mashed foods are helpful to maintain adequate nutrition.
• Avoid hot, spicy, rough or scratchy foods such as toast, potato chips, pretzels, crisp bacon or foods of similar consistency. They may irritate the healing throat and cause bleeding.

Rest

• No strenuous physical activity for the first 14 days after surgery (light play is OK, though).
• NO OUT OF TOWN TRAVEL/VACATIONS FOR AT LEAST TWO WEEKS AFTER SURGERY.

The Operative Site

• When you look into the throat following a tonsillectomy, you will see yellow or white patches where the tonsils were. This is not a sign of infection. This is a temporary, expected, normal process. This scab, or “eschar”, will come off after 5-10 days. Some slight bleeding may occur; however, profuse bleeding is not normal and warrants immediate attention.
• A foul odor is common from the mouth/nose.
• Teeth brushing is allowed and recommended.

Warning Signs

• Fever over 103°
• Bright red bleeding that lasts for a few minutes (blood tinged mucous is usually of no consequence)

Exercises For Tonsillectomy/Adenoidectomy

Some children may use a nasal voice following surgery in an effort to avoid pain. This is caused by limiting movement of the muscles near the surgical site. These exercises are designed to help your child exercise those muscles in a fun way in order to regain maximum movement following surgery.

These exercises should begin before surgery and continue after surgery. Begin slowly (1 or 2 times each exercise once a day). Increase length of practice as tolerated by your child. Goal should be to practice 8-10 minutes twice a day.

• Blow bubbles
• Blow out candles
• Blow cotton balls across a table
• Blow a scarf off your face
• Say “ahh” and hold it as long as you can
• Say “eee” and hold it as long as you can
• Say “ahee” as many times as you can
• Say “coca-cola” five times
• Say “key, key, key” five times
• Blow up balloons (children 5 years and older)