Adenoidectomy

Post-Operative Instructions for Adenoidectomy

Activity Level:  Light activity and adequate rest are recommended for the first few days. Patients are encouraged to get up and walk around the house several times a day to maintain circulation in their legs. Children should be under close supervision by a responsible adult.

Breathing Exercises and Walking:  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. Also try to have the patient take a 5-10-minute walk every 2-3 hours during the day. These walks may be done outside. This helps prevent fever.

Pain:  Most younger children experience only mild discomfort for a few days. Older children may have moderate discomfort for 7-10 days. Use of alternating doses of acetaminophen (Tylenol) and ibuprofen (Motrin) usually provides enough pain relief. Have patient take each one of these medications every 6 hours so that one or the other is taken every 3 hours. Be sure to use dosing instructions on the label for age and/or weight to determine proper dosage amounts.  More severe pain in older children might require a narcotic pain medication and this may be provided by your doctor on an as-needed basis.

Ear Pain:  Ear pain may occur in some patients. This pain does not indicate an ear infection and will resolve as recovery continues.

Fever:  It is common to have brief temperature elevations (fever) of 99-101 degrees during the first 3-7 days. To minimize fever, please:

1. Encourage the “deep breathing exercises” and walking described above.
2. Take the full acetaminophen and/or ibuprofen doses as described above in heading Pain. Follow the bottle’s guidelines using your patient’s weight for dosing amounts. OVERDOSES OF THESE DRUGS CAN LEAD TO LIVER AND/OR KIDNEY PROBLEMS.
3. Encourage adequate fluid intake. If the patient’s temperature remains above 102^o F one hour after receiving a full dose of acetaminophen or ibuprofen, please call our office during office hours for further instructions. For emergency questions after hours, call our office number and our answering service will page the doctor on call.
4. Take a cool bath, minimize clothing.

Fluids:  Adequate fluid intake is essential for recovery. Encourage drinking fluids throughout the day.

(½ ounce per pound of body weight). The patient should drink enough to urinate every 3-4 hours. The urine should be clear to light yellow. If the patient’s urine is small amounts of dark yellow, then he/she is showing signs of dehydration and you should push more fluids and crushed ice. Call the office if there is no improvement over the next 3-4 hours.

Nausea and Vomiting:  Nausea and vomiting are common during the first 24 hours after surgery. Ongoing nausea and vomiting are unusual if acetaminophen and ibuprofen are used for pain control. If nausea and vomiting occur while taking narcotic pain medication, the medication should be stopped until the vomiting goes away. Try to substitute the acetaminophen/ibuprofen combination for the narcotic. If use of a narcotic seems necessary, cut the previous dose in half and give it every 3 hours instead of every 6 hours, as the nausea is often related to the size of a given dose. Never give narcotic pain medication on an empty stomach. For persistent or excessive nausea and vomiting in spite of these measures, please call our office for further instructions.

Bleeding:  Minor bleeding may occur anytime during the 2-3-week healing period. This is usually self-limited. A small amount of blood will turn the patient’s saliva red but will not produce large clots. A trickle of blood from the nose can also be seen during healing. Avoid swallowing the blood as this may later lead to nausea or vomiting. Please stop any ibuprofen after such bleeding as it may slow blood clotting.

• If the light bleeding does not stop in 10 minutes, follow these instructions:

1. Have the patient in a supine position with head slightly tilted back.
2. Instill drops of Afrin into each nostril as directed:
   • a. 2 drops each nostril if less than 10 years of age
   • b. 4 drops each nostril if 10 years or older
3. Repeat application in 5 minutes if bleeding does not stop.

• Call the office (503-581-1567) if the light bleeding has not stopped in 15-20 minutes.

Bad Breath:  When the adenoid is removed a moist scab develops initially. The mouth’s bacteria will settle on this layer and produce bad breath (halitosis). As healing occurs, this layer falls off and the bad breath resolves. ANTIBIOTICS ARE NOT NEEDED.

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.

Diet: Resume diet as tolerated.

Oral Hygiene:  You may brush and floss your teeth as usual.

Constipation:  PATIENTS MAY EXPERIENCE CONSTIPATION WHILE TAKING NARCOTICS AND EATING A LOW FIBER DIET. PLEASE TRY TO AVOID OR MINIMIZE NARCOTICS. TRY TO EAT SOME SOFT FOODS WITH FIBER:  E.G. APPLE SAUCE, PRUNES, and BERRIES. ONE CAN BLEND SOME FRUITS WITH ICE FOR A COOL “SMOOTHIE” DRINK.

Other Questions:  For non-emergent questions, please call our office, (503) 581-1567, between 9:00 am and 4:00 pm Monday through Friday. For emergency questions after hours, call our office number and our answering service will page the doctor on call. We have a doctor on call 7 days a week.