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Tonsillectomy Surgical Instructions

Before the Operation

  • Complete any blood work or other doctor appointments, as directed by your surgeon, in a timely manner.
  • Do not take aspirin or ibuprofen-containing medications within 7 days of the operation.
  • You may not eat or drink anything, including water, after midnight on the day of the operation.
  • You may, however, take medications with a sip of water the day of the operation if directed specifically by your doctor.

The Day of the Operation

  • Arrive at the time given by the surgical center. This may be a while before your operation, but arriving early is important as a lot needs to happen before the operation.
  • Wear comfortable clothes that are easy to change.
  • Do not wear jewelry, rings or earrings of any kind.
  • A child may bring a comforting toy or blanket.
  • For adults, someone will need to drive you home after the operation, so arrange in advance for that person to come with you or to be waiting at the hospital for you.
  • Bring any papers, forms or blood work requested by your surgeon.
  • You should bring any medications you regularly take with you to the surgical center, especially asthma inhalers.

Care After the Operation

Activity

  • Limit to quiet activities for 3 days.
  • Children may return to school after one week.
  • Adults may return to work after 3 days if it does not involve strenuous physical activity.
  • No gym, sports, heavy lifting or brass/woodwind instruments for two weeks.
  • Stool may be tarry for a few days initially from swallowed blood.
  • Try to avoid coughing, sneezing, clearing the throat or blowing the nose vigorously for two weeks.

Diet

  • Start with clear liquids (water, non-citrus juices).
  • Then, advance to soft mushy foods (noodles, pudding, apple sauce) for 10 days before resuming a regular diet.
  • Avoid spicy hot and temperature hot foods.
  • Avoid dry food like chips and toast.

Vomiting

  • If vomiting occurs, stop feeding for 1 hour, then give clear liquids and advance slowly to a regular diet.

Medication

  • Take medications as prescribed by your surgeon. This may include pain medication or an antibiotic.
  • Use the prescription pain medication regularly (every 4 hours usually) for the first three days.
  • Eating may be easier if the pain medication is taken about one hour before a meal.
  • After the third day, switch to Tylenol (acetaminophen), as directed on the bottle, during the day, and use the prescription pain medication before sleep at night and when waking in the morning.
  • No ibuprofen or aspirin for two weeks after the operation.

Voice

  • Often the voice sounds abnormal, almost like “Donald Duck.” This is normal for up to 3 to 4 weeks and then resolves.

General

  • There may be a slight amount of bleeding from the nose on the first or second day.
  • Spitting up a small amount of blood is normal. This includes blood-tinged or streaky saliva. More than a small amount is not normal.
  • There may be a bad odor coming from the mouth or nose for 7 to 10 days during the healing process. The antibiotic will lessen this smell.
  • Throat and ear pain are common after having the tonsils removed. In addition to using the pain medicine, try placing a warm towel over the ear.
  • An ice pack on the neck may also help.
  • Consider using a humidifier while sleeping to help reduce mouth pain.
  • A fever of up to 101.5 for a few days is normal. If fever persists for over 3 days or is higher than 101.5, please call the office.
  • The first 7 to 10 days can be full of “ups and downs”. You or your child will seem pain-free at times, and may even eat food you think would hurt the throat. Later that day, you or s/he may seem to be in a great deal of pain, and may refuse even liquids. Keep using one of the medicines every four hours, and try cold drinks or Popsicles. Things will get better!
  • It is normal for the back of the throat to look white for up to 2 weeks after surgery.

Problems

  • If there is any bright-red bleeding from the nose of mouth that does not stop within two to three minutes, you or your child should call your surgeon or be evaluated in the nearest emergency room right away.
  • Pain can lead to decreased liquid intake and dehydration. This can lead to more pain and bleeding from the mouth. Focus on staying hydrated by drinking lots of cool liquids.

Phone Numbers

If you have questions or problems, call your surgeon's office: