Removal of tonsils and/or adenoids is one of the most frequently performed throat operations. it has proven to be a sate and effective surgical method to resolve breathing obstruction, throat infections, and manage recurrent childhood ear disease. Pain following surgery is an unpleasant side effect, which can be reasonably controlled with medication. It is similar to the pain patients have experienced with throat infections, but often is also felt in the ears after surgery, There are also some risks associated with removal of tonsils and or adenoids. Post-operative bleeding occurs in about 2% of cases; most often immediate, although it can occur at any tame during the first two weeks after surgery. Treatment of bleeding is usually an outpatient procedure, but sometimes requires control in the operating room under general anesthesia. In rare cases, a blood transfusion may be recommended. Because swallowing is painful after surgery, there may be poor oral intake of fluids. If this cannot be corrected at home, the patient may be admitted to the hospital for IV fluid replacement. Anesthetic complications are known to exist; they are quite uncommon however, since patients are usually young and healthy.

Pre-operative Instructions:

HOW TO PREPARE:

•      Your child will cooperate with you and the operating room staff better if they have a basic understanding of what will happen on the day of the surgery. Review in simple, easily understood terms the information that Dr. Rosane and his staff have given you. Reassure your child that you support the doctor and the staff in their effort to help your child through this experience. If you show your trust, the child will too. Please have all your questions answered prior to the surgery date so that you will feel more at ease with this experience also.

•      Emphasize prior to the surgery the importance of drinking a lot afterwards. Make an outing of going to the grocery store and let your child pick out some juices or popsicles to be eaten after the surgery.  

•      DO NOT TAKE ASPIRIN OR ANY ASPIRIN CONTAINING MEDICATIONS FOR TWO WEEKS PRIOR TO SURGERY. These may increase your risk of serious bleeding after the surgery.

WHAT TO EXPECT:

•      Severe throat pain that may increase for the first two days before beginning to subside.

•      Earaches.  These are just referred pain from irritation in the throat.

•      Fevers to 101°F are common the first 24 hours after surgery because the infected tonsils can shed bacteria into the bloodstream when they are removed.

•      Grayish/white cavities where the tonsils used to be are expected for the first week following surgery. These represent the"scab" the body forms after surgery.

•      Very swollen uvula (feels like mucus stuck in the back of throat) is expected. To combat this swelling, keep head elevated.

WHAT TO FEED:

•      Initially, liquids. Whatever the patient likes best is fine. Avoid acidic foods (citrus) and hard sharp items (pretzels, popcorn, or chips). Carbonated liquids may be uncomfortable to swallow.

•      Encourage eating and drinking approximately 30 minutes after taking pain medications.

•      Avoid red liquids and foods in the initial post operative period because these can be confused with blood, and can cause undue anxiety if spit out or vomited.

•      Hot and spicy foods may be uncomfortable to swallow.

•      Dairy products may cause an increase in thick throat secretions in some children, which may be difficult and painful to clear from throat.

WHAT ACTIVITIES TO AVOID:

     Bed rest or "couch rest" is encouraged for the first day after surgery.

     Activities may be increased as tolerated, but adequate rest time is encouraged.

     Strenuous or vigorous activities should be avoided in the first week after surgery, and ample opportunities for rest should be made during the usual two (2) week recovery period.

WHAT TO DO IN CASE OF PROBLEMS:

     Bleeding: If bleeding occurs after the first day, go to the Emergency Room. They will call Dr. Rosane.

     Pain: Expect pain and give pain medication every 4-6 hours. Some children refuse pain medication because they refuse to swallow; don't let this happen. It is easier to get adequate pain relief by staying "on top" of the pain. Playing "catch up" with pain medications by increasing the dose or decreasing the time between doses is inappropriate and dangerous. After a couple of days the medication intervals may be spread out.

     Earaches: These may be expected as long as the throat hurts.

     Refusal to eat or drink: Encourage fluids; Popsicles, Icies or Slushies may make the child more interested in drinking. If your child becomes lethargic, is not urinating at least three times a day and is not drinking, he or she may be dehydrated. An IV may be required if your child is unwilling or unable to drink an adequate amount of fluids. We leave it to your judgment as to whether or not your child should be evaluated for dehydration. Just remember it is better to be safe than sorry. Please call our office for advice if you have the postoperative concern.