POST-OP INSTRUCTIONS: Tonsillectomy and adenoidectomy 

Most of these instructions relate to patients who have had a tonsillectomy. Patients undergoing an adenoidectomy generally have fewer problems with post-operative pain and swallowing due to the location of the operative site high in the throat.


1. LIMIT ACTIVITY.
Your child should not return to normal vigorous play or to school for approximately one week following the operative procedure. Keep in mind that your child will likely not feel completely recovered for at least ten days to two weeks after a tonsillectomy. Your child can pursue quiet activity at home and need not stay in bed.


2. YOUR CHILD'S DIET.
Your child may eat ANYTHING as long it is not dry and crusty like pizza, hard pretzels or nachos. Just be certain that he or she is eating and drinking. Stock up on favorite foods. Dairy products such as ice cream, milk shakes, and yogurt are fine. By the end of a ten day to two week period, your child should be back to a completely normal diet.


3. PUSH FLUIDS.
I cannot stress strongly enough that fluid intake must be maintained. This will prevent your child from becoming dehydrated. Dryness will slow the healing of the throat and make swallowing even more uncomfortable. Inadequate fluid intake is also the most common cause of a fever occurring once your child goes home.


4. PAIN.
Plan to give your child Tylenol™ four times a day for the first four to seven days to minimize throat pain. I will recommend a dosage based on your child's weight. I will also prescribe a narcotic pain killer. Use this medication as seldom as possible as narcotics tend to create abdominal cramps and constipation. Be aware that throat pain often refers to the ears. For this reason, it is common for persons to develop pain in one or both ears which intensifies on swallowing. Such pain during involuntary swallowing at night may awaken your child from sleep. Be assured that in most cases patients experiencing such sensations do not have ear infections. If, however, the pain is intense and unrelenting, please notify us.


5. NO MOTRIN™, ADVIL™, OR IBUPROFEN CONTAINING PRODUCTS.
Ibuprofen containing products such as Motrin™ and Advil™, like aspirin, will interfere with your child's blood clotting capacity. This could lead to uncontrollable bleeding during the post-operative period. Read the labels of any medications that your child is taking to be certain that they do not contain any of these medications.


6. IN THE EVENT OF BLEEDING.
If you notice any evidence of bleeding, PLEASE NOTIFY ME BY CALLING MY OFFICE. In most cases I will ask you to bring your child immediately to the hospital emergency room. I or one of my associates will meet you and your child for an emergency examination.

In children, slight oozing will occur from the tonsil beds as the scab falls off at about the sixth through the ninth days. This type of bleeding is very slight and is usually self-limited. If it occurs, give your child a small glass of ice water to drink and wash out the throat. If the bleeding persists, contact me.


7. POST-OPERATIVE EVALUATION.
I will routinely schedule several post-operative visits during the first two to four weeks following the operation. At these visits, I will assess your child's general progress as well as the degree of healing within the throat. An additional visit may be necessary at about 8 to 10 weeks following the surgery to be certain that the throat is completely healed.


8. GOOD COMMUNICATIONS.
Good communications are important and parents are the best judges of how their child is progressing after surgery. If you feel that your child's post-surgical course is worrisome, please contact me as soon as possible. Write down your questions or concerns in order to be certain to ask me about them.