HF 4486

Home Care After Adult Tonsillectomy

A tonsillectomy is surgery to remove the tonsils. Tonsils are the lymph tissues that lie on each side of the back of the throat.

Pain

Expect to have a lot of throat pain, especially when you swallow. Your pain may also seem worse when you talk. We will give you medicine and other tips to help reduce your pain, but it will not go away completely until your throat heals. Throat pain can last for 1-2 weeks. You may also have ear pain for 7-10 days.

Bleeding

You may have blood-tinged mucus for a week. This is common. Avoid lots of coughing and clearing of the throat. Active bleeding is serious. You should seek emergency care if you have bright red, active bleeding from your throat or nose. If you are not sure if you are having too much bleeding, it is best to call or go to the emergency room. Do not take aspirin or NSAIDs such as ibuprofen, Aleve, Motrin, Advil or naproxen until your doctor says it is okay.

Wound

If you look in your throat, you may see a grey-yellow membrane where the tonsils were removed. This is a scab. It will slowly go away as you heal. This often takes 2 weeks. When the scab comes off, you may notice increased pain again. This often happens around 7-10 days after surgery. Please call or seek urgent care if you notice active bleeding.

Bad Breath

Bad breath is normal while your throat heals. Drinking lots of fluids and good oral care will help decrease this odor.

Pain Relief

For throat and ear pain, take the pain medicine you are prescribed as directed. It is very important to stay on a schedule with your pain medicines. Do not wait until your pain is severe to take pain medicine. This can make it harder to control the pain. Keep paper by your medicine to write down the time you take a dose to prevent going too long between doses or taking a dose too soon. You may need to set an alarm or have someone wake you to take your pain medicine during the night.

Other Pain Relief Tips

  • Alternate your stronger prescribed pain medicines with acetaminophen. Do not take them at the same time. This allows you to have some pain relief medicine more often.

  • You may also want to use an ice pack or ice collar.

  • Once you start eating more regular meals, take pain medicine ½ hour before meals to decrease the pain when you swallow.

  • Suck on ice chips or popsicles and let the fluid drizzle down your throat to provide comfort and hydration.

  • Use a humidifier or vaporizer to decrease dryness in your throat and provide comfort.

Tonsillectomy Diet

Follow this diet for 1-2 weeks.

  1. Begin with clear liquids (water, broth, apple juice, iced tea, Gatorade, Jell-O, ice chips and popsicles). Cool or lukewarm liquids are easier to drink at first. Avoid red colored liquids.

  2. Advance to full liquids (smoothies, cream soups, sherbet, cooked cereals) when ready. Use caution with milk or milk products as they may cause you to have more phlegm (mucus) in your throat.

  3. Add soft, bland foods when you can swallow them (scrambled eggs, macaroni and cheese, mashed potatoes).

Foods to Avoid

  • Acidic foods (orange or grapefruit juice, tomatoes)

  • Spicy foods

  • Rough foods (dry toast, popcorn, peanuts, potato chips, cold cereals, crackers)

Fluids

Drink lots of fluids to avoid dehydration. This will also help you to heal. You can start eating more solid foods and drinking thicker liquids as soon as you feel able, but don’t forget to keep pushing clear fluids like water and juices.

Because it will hurt more when you swallow, you may not be drinking as much as you think. Keep track of how much fluid you are drinking. Use bottled water so you can keep track of ounces. Drink 8 to 10 8-ounce bottles per day or keep a pitcher of water in the fridge with a goal of drinking 64 to 80 ounces of water each day.

Activity

  • Limit your activity for 1-2 weeks. Avoid heavy exercise, swimming or lifting more than 25 pounds.

  • Get plenty of rest. The pain medicines will make you feel tired.

  • Keep moving. Short walks and light activity are important to prevent other complications such as constipation.

  • Elevate your head with an extra pillow for 1 week to help decrease swelling.

  • Plan to be out of school or off work for about 1-2 weeks.

Constipation

Take a stool softener while you are using the narcotic pain medicines. Your doctor may prescribe a stool softener for you, or you can ask your pharmacist which one to use. Your goal should be to drink 8 to 10 8-ounce glasses of water or juice each day.

When to Call

Call if you have:

  • Active Bleeding: Spitting out/coughing up more than 2 tablespoons of blood or blood clots. If you are not sure if you are having too much bleeding, call or seek emergency care.

  • Nausea and vomiting that doesn’t get better.

  • A fever over 101º F (taken by mouth).

  • Pain not controlled with medicine.

  • A feeling that you are not healing as you should. It takes about 7-10 days before you will start to feel better.

Who to Call

University Hospital ENT Clinic

(608) 263-6190

S. Park St. ENT Clinic

(608)-287-2500

After clinic hours and weekends, the clinic number is answered by the paging operator. Ask for the ENT resident on call. Leave your name and number with area code. The doctor will call you back.

The toll-free number is 1-800-323-8942.