There are risks to having your tonsils removed. Risks include bleeding both at the time of surgery and again in 5-10 days, infection, dehydration due to poor oral intake, painful or numb tongue, difficulty breathing, the possibility of small burns to the throat or mouth, and risks due to general anesthesia. Some people may need to spend the night in the hospital if it is felt to be safest for the patient.
Pain is a normal consequence of surgery. Pain is felt in the throat, ears and neck. Controlling pain will allow for adequate fluid intake. Dehydration can worsen pain, increase the risk of bleeding, and prolong healing. The pain is worst in the first 3 days and can increase again on day 5-6 when the scabs in the throat fall off. Pain in children can last 10-14 days and up to 3 weeks in adults.
You will have a prescription for narcotic pain medication. You can take it every 6 hours. This will help reduce the pain and make it more tolerable, but it will still be painful. For the first 2-3 days, it is important to take the medication on a scheduled basis—try to stay ahead of the pain rather than “play catch-up.”
You can also take acetaminophen. This is over the counter. Follow the directions on the packaging. Acetaminophen can be used immediately after surgery. Do not take more than 4 grams (4000 mg) of acetaminophen in a day including the amount that may be combined in the narcotic pill.
You may start ibuprofen 24 hours after surgery (do not take more than 2400 mg of ibuprofen in a day). You can get this over-the-counter. Tablets are 200 mg each. We recommend 600 mg (3 tablets) every 6 hours or 800 mg (4 tablets) every 8 hours.
There is also a prescription for gabapentin. This medication is used to calm inflamed nerves and can help with postoperative pain control. Take as directed every 12 hours. If pain is well controlled, then this can be taken as needed. Side effects are drowsiness and dizziness but are not common.
Avoid driving and alcohol intake while using narcotic pain meds. Narcotics can cause constipation. I recommend an over-the-counter stool softener like docusate to help prevent it. Stay Hydrated!
DRINK! DRINK! DRINK! Force fluids. Adequate fluid intake cannot be stressed enough. Low amounts of liquids can lead to worse pain, fever, risk of bleeding, and poor healing. If there is nausea, then try sips and small amounts. Options are water, popsicles, apple juice, smoothies, grape juice, and sports drinks. As pain allows, you can add ice cream, yoghurt, sherbets, applesauce, Jell-O, protein shakes and other smooth foods. Eggs and pasta are also easy to swallow.
Avoid acidic foods (citrus, tomatoes, carbonated beverages) and crunchy/rough foods (chips, pizza). Some feel that chewing gum can prevent excessive pain by keep the throat muscles from spasming. Milk products can cause phlegm that is hard to clear and cause discomfort.
A small amount of blood smeared in spit or mucous can be normal. This can be coughed up or come from the nose. Small amounts of blood can be controlled with sucking on ice cubes or gargling with ice water. Fresh blood, clots, or vomiting blood should be evaluated immediately. Call the clinic. There are doctors on all 24 hours a day. You may need to go to the Emergency Room. If bleeding is severe, you may need to call 911. Up to 5% of patients may need to go back to the OR for cautery.
Constipation after surgery is very common. It is caused by the anesthetic and narcotics. It is very important to stay hydrated. Drink plenty of fluids. It can be prevented with stool softeners (Metamucil, Citrucel, Colace) or laxatives (MiraLax). These are over-the-counter and do not need a prescription. Use as directed on the packaging.
Activity should be kept to a minimum for 2-3 days. Children can play quietly. Excessive or prolonged activity should be avoided. Post-op side effects will often keep people from over doing it. No strenuous activity (heavy lifting, bending, working out, running, gym) for 10 days. School or work can resume in 7-10 days, but it is not unusual to need 14 days. Avoid travel out of town for 14 days.
Pain, nausea, ear pain, white scabs on the sides of the throat, fever up to 101 degrees F, bad breath, congestion, voice changes (nasal or high pitched).
Strenuous activity, hard foods, bending, nose blowing, acidic foods and drinks, excessive narcotics (follow instructions on the prescription), aspirin.
A follow-up office visit with your doctor should be about 3-4 weeks after surgery. This is usually arranged while scheduling your surgery. You can call the clinic to confirm the date and time.
Note: Some pain medications require a written prescription at the pharmacy, so call for refills before you run out of medication.
For questions, concerns, medications, or emergencies, call our office day or night.
Dr. Wolfe – (206) 838-8345
Same and next day appointments available
Proliance Surgeons Puget Sound ENT
Care Center
21911 76th Ave W Suite 211
Edmonds, WA 98026
Proliance Surgeons Puget Sound ENT
Care Center
515 Minor Avenue Suite 140
Seattle, WA 98104
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