Home Care after Removal of Tonsils and Adenoids
After removal of the tonsils and the adenoids, a period of approximately ten days is required for the return of appetite, relief of sore throat, and general recovery. Since there is also a wide individual variation on the time required for complete recuperation, no hard and fast rules can be laid down. The following remarks should be used only as a guide.
Usually a liquid or soft food diet for the first 48 hours followed by the gradual addition of other solid foods is more acceptable. Patient should not eat hard foods like chips or tacos for two weeks. Some patients may not eat solid for several days. This is okay as long as they drink plenty of fluids.
During the first 24 hours at home, fluids should be offered every hour when the patient is awake. Adequate fluid intake is very important.
If the throat is very sore, do not expect the patient to drink a large glass of fluid all at once. It is better to give small amounts frequently and in a small glass.
Usually, the fluids most easily taken are water, milk, ginger-ale, and coca cola (which may be diluted in half with water). Ice cream, Jell-O, custard, soft boiled eggs, and cooked cereals can often be taken early.
Orange juice, grapefruit juice, and tomato juice usually causes stinging, but some patients like them well enough that they can drink them anyway. They will not hurt the site of surgery!
CARE OF THE THROAT
Other than the frequent administering of liquids, usually no special care is required after a tonsillectomy. Chloraseptic spray may be used to help with throat discomfort.
If the patient has not had a bowel movement by the end of the second day at home, a mild laxative such as milk of magnesia or mineral oil may be given. IF THE PATIENT HAS ABDOMINAL PAIN, DO NOT GIVE ANY LAXATIVE BEFORE CONSULTING YOUR DOCTOR.
For the first 24 to 48 hours, the patient should remain in the bed or on a couch, but is allowed up for bathroom privileges. After this time, a child is usually anxious to be up and around and they may be with discretion.
They should, however, remain indoors and reasonably quiet for four days after returning home. At the end of the time, they may be allowed outdoors for a short time for quiet play, if the weather is warm and sunny.
It is well to insist upon a rest period in the middle of the morning and after the mid-day meal for a week or longer depending on how well recovery is taking place.
Full normal activity may be resumed at the end of ten to fourteen days but return to school should not occur before four days and may take a week or more. In instances where convalescence is slow, two full weeks may be allowed for recovery.
Swimming or other forms of exertion is not safe for two weeks from the date of operation.
As in any other operative procedure, certain minor events occasionally follow removal of tonsils and adenoids. Those occurring most frequently are listed:
1. Difficulty breathing – patients who have had upper airway surgery and seem to have a problem breathing should call us.
2. Pain in the ears – in the absence of other signs, this is almost always due to referred pain from the site of surgery. It is often more severe on the fifth, sixth, or seventh day than on earlier days. It tends to occur spasmodically and clear up quickly. The child may wake up at night, briefly complaining of his ears, and soon go back to sleep; or, the swallowing of food and liquids may cause momentary discomfort in the ears. This is of no permanent significance and should disappear within a few days.
3. Vomiting – if this occurs on the first day after the patient has returned home, nothing should be given my mouth for an hour or so. After this time, small amounts of fluid should be given until larger amounts can be tolerated. IF VOMITING PERSISTS, CALL US OR GO TO THE EMERGENCY ROOM.
4. Night terrors – occasionally a child will have some difficulty sleeping because of nightmares or night terrors. These can usually be controlled by reassurance at bedtime. If this does not resolve in two or three days, call the nurse at our office.
5. Fever – Most children will have a slight elevation of temperature at sometime during the day for several days after returning home. If recovery is otherwise normal, a rectal temp of 99.9 to 100.8 is usually of no significance during the first three to four days. If an elevation persists, get in touch with our office.
6. Bleeding from nose or throat – this event occurs in 1-3 percent of patients, and it is well to remember it is not usually of a serious nature.
There are certain points, which, if observed, will make the handling of a bleeding patient much simpler for all concerned and is far less frightening for the child.
Maintain a calm and reassuring manner and your child will usually respond with similar behavior. Sit the patient up in bed and forward over a basin which is placed in the patient’s lap. If the bleeding either lasts longer than ten minutes or measures more than 2 tablespoons, go to the emergency room. With any bleeding, let us know.
We will call on the day after surgery to check on the patient and we will call to check on the patient two weeks after surgery. We appreciate your calling the office with any questions that you may have.