Tonsillectomy With or Without Adenoidectomy After-Surgery Discharge Instructions

Tonsillectomy is a surgery to remove tonsils. Adenoidectomy is a surgery to remove adenoids. Doctors often do tonsillectomies and adenoidectomies together. 

For 24 hours after surgery, patients often have an upset stomach, and they might vomit (throw up). 

Your child might have a sore throat for two weeks, making it difficult to eat. The soreness might get better after a few days and then get worse again. Your child’s voice might change a little after surgery. 

The ear and throat share a sensory nerve. That means ear pain is common after surgery, especially when swallowing. Jaw spasms (uncontrollable movement of the jaw) also might occur and cause pain. Your child’s neck might be sore after an adenoidectomy. The soreness typically lasts a week. 

Your child will have bad breath for a few weeks. You may rinse the child’s mouth with clear, warm water containing one-half teaspoon of salt per cup. Do not use mouthwash that con¬tains alcohol. White patches in back of the throat are normal while your child is healing. Snoring is common after surgery because your child’s throat is swollen. It will go away in about two weeks. 

Try to get your child to drink plenty of liquids (at least two or three ounces an hour). Keep¬ing the throat moist will help make your child more comfortable and prevent dehydration. Dehydration means the body gets dried out. It is a dangerous condition. Monitor your child for signs of dehydration such as: decreased urine output, lack of tears when crying or dry/cracked mouth and/or nose.

Give pain medicine regularly, as your child’s doctor directs. Give it before bed and first thing after waking in the morning. Giving pain medicine 30 minutes before meals will help your child swallow more easily. Use Tylenol or other pain medicine as ordered by your doctor. Ask your doctor if Ibuprofen is allowed.

Coughing, nose blowing, throat clearing and spitting might cause bleeding. Wipe your child’s nose gently, as needed. When sneezing, encourage your child to open the mouth and make a sound to prevent pressure from building. Keep your child away from people who have colds, flu or infections. 

On the day of surgery, your child can have cool clear liquids such as: apple juice, Jello®, Kool-aid®, Popsicles®, water or soda pop that’s been stirred to remove bubbles. Your child may advance to dairy products or applesauce, as tolerated, after a few hours.

If your child’s stomach is upset, keep offering small amounts of liquids quite often. (If your child vomits after drinking red liquids, the vomit will be the same color.) You might want to avoid red foods and fluids so you can be sure that vomit doesn’t contain blood. 

After the first day, add more dairy products and soft foods if your child wants them. These foods might include ice cream, milk shakes, pudding or smooth yogurt. Make sure your child is drinking a lot. Liquids are more important than food. 

Add other soft foods (food without rough edges) when your child wants them. (See the chart.) If food is not on the list, ask yourself: Is it easy to chew? Does it soften up a lot when chewed? Is it free of rough or crispy edges? If the answer is yes, your child can likely eat it. 

Be sure to cut foods into very small pieces, and encourage your child to chew them well. Continue the soft diet for one week after adenoidectomy and two weeks after a tonsillectomy. 

Don’t give your child citrus fruits and juices, such as orange juice and lemonade. They might sting the throat. Avoid foods that are spicy or hot in temperature. 

Pain medicine and lack of physical activity might cause constipation. Encour¬age your child to drink non-citrus juices to prevent this. 

Healing takes about two weeks. Help your child play quietly indoors for three to five days after surgery. Your child should not play actively (gym or running) for two or three weeks. Children usually return to school or day care in seven to ten days. 

In case your child needs to see the doctor, you shouldn’t travel a long distance for two weeks. Scabs come off in about 7 to 14 days, and your child’s throat might become more sore and uncomfortable. If slight bleeding occurs, have your child lie down and suck on ice chips. Keep the head elevated higher than the heart (at least 30 degrees). Encourage your child to rest. Call the doctor if bleeding does not stop with ice and rest. 

Call your doctor if your child has: 

• A temperature higher than 102.5F 
• ANY bright red bleeding 
• Vomiting (throwing up) bright red blood (not pink-colored fluid) 
• Nosebleed 
• Pain that doesn’t go away with medicines =Upset stomach and vomiting after 24 hours =Signs of dehydration 
• Sunken eyes 
• Dry, sticky lips 
• No urine for more than eight hours 
• No tears