Postoperative Instructions Following Tonsillectomy/UPPP

This information is designed to answer questions about what to expect and what to do following tonsillectomy.  Should you have questions not covered in these instructions or adverse events you need to report, please call our office number (228 863 6617).  Calls for answers to routine questions should be made during our regular office hours.  For emergencies, a Coastal ENT physician is on call 24 hours a day/ 7 days a week and can be reached by calling our office number.

Before Leaving the Outpatient Surgery Center

Prior to discharge from the surgicenter, please check with your nurse and make sure you have a postop appointment scheduled.  The initial visit following tonsillectomy is usually scheduled between 1 and 2 weeks after surgery.  Also ask for any medications or prescriptions you will need.  You should receive a prescription for pain relief and antibiotics prior to discharge.  Occasionally other medications will be recommended in addition to the pain medicine and antibiotics.  Whatever medication you are given, TAKE YOUR MEDICATION AS DIRECTED ON THE PRESCRIPTION BOTTLE.

The Recovery Period

1) Diet:  Swallowing will be painful the first few days following tonsillectomy, and therefore, one will tend to eat and drink less than usual.  It is important to maintain one's hydration, and to encourage children and adults to take adequate fluids.  Cool, bland liquids are usually tolerated best, and certainly avoid citrus (acid) juices, and hot, highly seasoned foods.
          Day 1 and 2:  Abundant clear, bland liquids, jello and small amouts of milk, ice cream, or sherbert given frequently. Popsicles and Italian ice treats taken slowly are generally well tolerated.  By the second day, soft cereals, puddings, custards, broth (beef or chicken), and bouillon can be given.
          Day 3 through 7:  The pain should begin to improve about the 3rd or 4th day following surgery.  Bland soft such as mashed potatoes, grits, soft boiled or poached eggs should be tolerated by day 3.  Duing the rest of the week, the diet  should be gradually progressed from a dental soft diet (nothing requiring chewing) to a regular soft diet (minimal chewing) by the end of the week.

2) Activity: The first 2 to 3 days should be restful with minimal activity.  You should stay inside the house and not exert yourself.  After a few days you can gradually do more activities in the home with an occasional short ride in the car as a passenger.  DO NOT DRIVE while you are still taking pain medication.  After the first week you can start returning to more normal activities including returning to school.  Avoid vigorous physical activity such as sports, singing, shouting  and hardy laughter for a minimum of two weeks following tonsillectomy.  Also restrict visitors during the first week following surgery -- especially anyone with a "cold" or other illness.

3) What to expect:  As outlined above, expect a sore throat with painful swallowing that is usually at its worst the first 2 to 3 days after surgery.  One will commonly experience ear pain following tonsillectomy -- this is "referred" pain form the tonsil area and is seldom an indication of ear problems.  Avoid gargling, excessive throat clearing, and hard coughing as these activities will aggravate one's pain.  You will have a pain medication prescribed that you should take as needed.  It would not be unusual to have to take pain medication every 4 to 6 hours the first few days.  After the first few days, the pain will gradually subside and tylenol like medications may prove to be adequate -- AVOID ASPIRIN OR ANY MEDICATION WITH ASPIRIN IN IT for at least 2 weeks following surgery.  Cool compresses applied to the neck and sucking on ice chips or popsicles will also help relieve the pain.  Foul breath, change in bowel habits (fewer bowel movements than usual), and a low grade temperature (up to 101 F) is also to be expected.  You may notice some blood tinged mucous on occasion during the first week after surgery.

4) What to report: 
          Any bright red bleeding that lasts more than a few minutes should be reported immediately.
          Temperature greater than 101 F.
          Inadequate fluid intake over a 24 hour period.
          Excessive pain not controlled by medication.