Postoperative Instructions for Tonsillectomy and Adenoidectomy
Activity Level: Strict rest in bed, on a couch, or recliner chair with the patient’s head elevated 30-60 degrees is important the first day following surgery. Very light activity with emphasis on “adequate rest” is recommended thereafter. In general, for the first 10-14 days, do not lift, strain, or engage in aerobic activity such as running, jumping, climbing, workouts, or any strenuous activity. Minors, specially children should be under close supervision by a responsible adult.
Breathing Exercises: Every 15 – 30 minutes while awake, have the patient take a deep breath in and cough once or twice to expand and clear the lungs. This assists in recovery and helps prevent temperature elevations (fever). Pain: Pain for the first 3-7 days is moderate to severe, and then begins to subside thereafter. Pain varies widely between patients. Some patients experience only moderate discomfort for a few days while others have severe pain up to 10-14 days. Most patients are somewhere in between. Children often do better than adults. Use the pain medications prescribed by your doctor as directed. However, when your pain begins to lessen try to reduce your pain medication usage. The faster you come off your prescription pain medication the more rapid will be your recovery.
Ear Pain: Ear pain occurs in nearly all patients. This is “referred” pain from the tonsillectomy site. This means the patient’s pain is at the tonsillectomy site but it feels as if the pain is in their ears. This pain will resolve as recovery continues.
Fever: It is not uncommon to have brief temperature elevations (fever) of 101 degrees or even 102 degrees during the first 3-7 days. If a fever occurs be sure the patient is having good fluid intake, and is taking a deep breath and coughs once or twice every 15-30 minutes while awake. If a fever persists longer than 2 hours, call our office for further instructions.
Fluids and Diet: Adequate fluid intake is essential for recovery. Encourage drinking fluids throughout the day. Hot, ice cold, or acidic (e.g. grapefruit, tomato, or pineapple juice) liquids may hurt. Popsicles are often a good source of fluid. Older children and adults may chew sugarless gum to promote swallowing and decrease pain.
Nausea and Vomiting: When nausea and vomiting occurs, it is not uncommon to have 1-3 episodes of vomiting. Fortunately, nausea and vomiting generally subsides within 24 hours. Pain medication can be a continued source of nausea and vomiting. If this is suspected, try to take the prescriptions pain medication with food, as well as try and reduce its use as much as possible. If nausea and vomiting is excessive or persistent, call our office for further instructions.
Bleeding: Bleed may occur anytime during the 2-3 week healing period. Minor bleeding is often self-limited. A small amount of blood will turn the patient’s saliva red, but will not produce large clots. Encourage the patient to gargle with ice water and spit it out. Avoid swallowing the blood as this may lead to later nausea or vomiting. Spitting the old blood into a bowl will let one estimate the actual amount of blood. Call the office (503-581-1567) if the light bleeding does not stop in ten minutes. If significant bleeding occurs, start the ice water gargles, and call our office day or night. The doctor will give you further instructions. Come to either our office during office hours or to the Emergency Room at Salem Hospital after office hours. Please call our office (503-581-1567) to alert us if possible.
Bad Breath: If you look at the area where tonsils were removed you will see a white membrane (scab). This is normal, as is an enlarged swollen uvula (the thing that hangs down in the back of your throat). A malodorous breath is sometimes detected and is normal. These will resolve as healing occurs.
Nose Blowing: You can blow your nose lightly to clear mucous. Nasal saline spray can be used if desired to moisten the nose to help loosen mucous. Nasal saline spray is sold “over the counter” at pharmacies.
Oral Hygiene: You may brush and floss your teeth as usual. Avoid mouthwashes (contain alcohol). Do not gargle (e.g. salt water). This can be very irritating to the tonsillectomy site.
Other Questions: For non-emergent questions, please call our office, 503-581-1567, between 9:00 am and 3:00 pm Monday through Friday. For emergent questions, call our office and our answering service will page the doctor on call. We have a doctor on call 7 days a week.