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Tonsil and Adenoid Surgery

Discharge Instructions

What are the tonsils and adenoids?
The tonsils are grape-sized pieces of tissue in the back of the throat on each side . The adenoids are small pads of tissue at the back of the nose above the throat. The adenoids can’t be seen when you open your mouth because they are behind the soft palate. Both tonsils and adenoids produce antibodies to fight infections. They are usually removed if they become so large that they interfere with breathing or swallowing or if they are contributing to recurrent infections.

How long will it take to recover?
After removal of the tonsils and adenoids, your child may lack energy and tire easily for several days. Your child may be restless at night and not sleep well. These problems gradually get better in 3 to 14 days. Your child may have problems with constipation for several days because of the hydrocodone in the pain medication and because he will not feel like eating much.

How can I take care of my child?

  1. Diet. The most important thing for your child to have in the first 3 days after surgery is liquids. This will help lessen problems with fever, constipation, and healing. Make an effort to give your child a drink (2 or 3 ounces) every hour during waking hours for the first 2 days after surgery. Soft drinks, fruit juice nectars, Jell-O, custard, Popsicles, or Gatorade are good choices. Frequent small feedings of soft foods and cool liquids usually are most comfortable. As your child’s appetite gets better, encourage him to eat solid foods. There are no limits to the foods you may give your child, except chips or popcorn. You can’t hurt the throat by giving your child the wrong foods. Let your child have his favorite foods. Your child may use a straw for thin liquids after surgery until his throat is completely healed. This may increase the risk of bleeding. Your child may feel sick to his stomach, throw up, or feel tired and cranky after surgery. This should get better within a few hours. Occasionally, nausea and vomiting is due to the codeine in the pain medication.
  2. Pain Medicines. A very sore throat or ear pain is normal after the tonsils are removed. Expect pain in the ears between the 3rd and 7th days because the same nerve that goes to the tonsils also goes to the ear. Give regular does of pain medicine (any acetaminophen medicines
    or Motrin) 4 to 5 times a day for a week. If your child has severe pain, use the prescription pain medicine as labeled. If the pain continues to be severe, it is appropriate to alternate the prescription pain medicine every 2-3 hours with Motrin. You can use cool compresses or ice packs on your child’s neck to help your child feel more comfortable. You can also have your child suck on ice chips or chew gum. If your child awakens during the night, it is appropriate to give pain medicine but a sleeping child should not be woken to administer pain medicine.
  3. Fever Medicines. It is normal for children to run a fever between 99°F (37°C) and 102°F (39°C) for the first few days after surgery. The fever will be worse if your child doesn’t drink enough liquids and becomes dehydrated. Give Motrin for the fever. Do not give acetaminophen in addition to the prescription pain medicine as it already contains acetaminophen.
  4. Bad Breath. This is normal. It comes from a white to yellowish scab that forms over the tonsil surgery site. You can help your child’s breath by giving him a mild salt-water mixture to gargle. After gargling, your child may spit up some bloody mucus. The scab breaks off during healing within 5 to 10 days and the bad breath will go away.
  5. Bleeding. There should be no bleeding from the nose or mouth after your child returns home. Get up to check on your child once or twice during the first night after surgery. If there is any bleeding, take the child to the emergency room immediately. The ear, nose, and throat (ENT) doctor on call will check your child. Between the 5th and 10th days after surgery, the scab breaks off the surgery site and your child may spit up some bloody mucus. If this occurs, have the patient gargle or drink ice water in an attempt to decrease the bleeding. If the bleeding does not stop in 20 to 30 minutes, bring your child to the emergency room.
  6. Activity. It is best for your child to rest at home for the first 48 hours after surgery. Activity may be slowly increased as your child’s strength increases. There is no rule for the right time to go back to school, but a guideline is 7 to 10 days after the tonsils are taken out. Rough play and contact sports should not be allowed until 14 days after tonsil or adenoid surgery. Contact your child’s school for make up work.

When should I call my child’s ENT doctor?
Call IMMEDIATELY if:

  • There is any bleeding form the mouth or nose that does not respond to drinking or gargling with ice water
  • The fever goes over 102°F (39°C)
  • There are any signs of dehydration.
  • Your child has vomiting that lasts more than 12 hours.

Call during office hours if:

  • A fever lasts more than 3 days.
  • You have other concerns or questions