Home Care after Tonsillectomy and Adenoidectomy - Adult

Tonsillectomy is the removal of the tonsils. Adenoidectomy is the removal of the adenoids. Both surgeries may be done together or only one may be done.

General Information
You may lack energy for several days, and may also be restless at night. This will improve over 3 to 4 days after an adenoidectomy, and 10 to 14 days after a tonsillectomy. Recovery from an adenoidectomy alone is easier than recovery from a tonsillectomy. It is quite common for you to feel progressively worse during the first 5 to 6 days after surgery. You may also become constipated during this time for three reasons: you will not be eating your regular diet, you will be taking pain medications, and you may be less active.

Diet
It is important for you to drink plenty of fluids for the first 3 days. You should try to drink one drink every hour you are awake. You may not feel like eating after several days. This is alright, as long as you drink lots of fluids. Signs that you need to drink more are when the urine is darker in color (urine should be pale yellow). A high fever that persists may also be a sign that you are not taking in enough fluids. As your appetite improves, solid foods and chewing are strongly encouraged. There are no limits on the sort of foods you can eat. You cannot damage the throat by eating any particular type of food. Favorite liquids can be consumed such as popsicles, slushes, and soft drinks.

Activity
You should rest at home for the first 48 hours. Activity may increase as strength returns. Generally, you may return to work approximately 10 days following a tonsillectomy, and about 3 days after an adenoidectomy. You should avoid vigorous activity for 14 days after surgery. 

Pain
Throat and ear pain can be severe after a tonsillectomy. Take regular doses of pain medicine as prescribed. Tylenol or the prescribed narcotic pain medicine should be taken as instructed. 24 hours after your surgery, you may add ibuprofen for pain control. NO Aspirin or other blood thinners are to be taken for 2 weeks after surgery. Chewing gum may be helpful in lessening muscle spasms and is encouraged. Take an oral steroid, if prescribed; one on day 3 or 4 after surgery may also help with pain.

Bad Breath/Snoring
Bad breath is very common due to the healing in the back of the throat. You may gargle with a mild salt water solution to improve the bad breath (1/2 teaspoon table salt to 8 oz. of warm tap water). You may also chew gum. Most patients breathe through the mouth and snore during the recovery period due to swelling. This may last 2-3 weeks. It may be helped by propping up with pillows and using an ice collar. Turning on a humidifier at bedtime may lessen throat dryness caused by mouth breathing. Avoid over-the-counter mouthwashes (Cepacol, Scope, Listerine, etc.), as they tend to dry the throat and cause discomfort.

Bleeding
There should be NO bleeding from the nose or mouth. If you have any bleeding at all, sit upright and begin swishing the mouth out with cold ice water. This may help stop the bleeding (rinse and spit over and over). If there is anything more than very minimal bleeding, go to the nearest emergency room. Between 5 and 10 days after surgery, the white or grayish membrane (soft scab) breaks off in the back of the throat. A small amount of bloody mucus may be spit up. If this continues after a few minutes, please call the doctor. If you are unable to reach the doctor quickly, please go to the emergency room.

Fever
It is normal for you to have a slight fever (99.0° to 101.0°) for the first few days following surgery. Good fluid intake and Tylenol will help keep the fever down. If the fever is over 101 degrees, contact your doctor.

Nausea/Vomiting
It is not unusual for you to feel sick following a tonsillectomy. You may take the medication prescribed for nausea at this time. If vomiting persists into late evening, you may want to contact your doctor for another medication to help you feel better. If you are still vomiting the day after surgery, you need to notify the doctor or go to the emergency room.

Medications
Take the following medications as prescribed to you:

• Narcotic pain medication: Norco or Lortab (Hydrocodone/Acetaminophen) are generally prescribed to adults. This is a narcotic medication to be used every 4-6 hours as needed for severe pain only. After the first few days, you should attempt to use OTC Tylenol in place of this medication. Do not exceed 4g of Tylenol in 24 hours.
• Antibiotic: Sometimes a penicillin antibiotic such as Amoxicillin is prescribed to be used a few days after surgery. If you are allergic to penicillin, you will receive a different antibiotic.
• Carafate: This medication is prescribed in liquid form. It is used to coat your throat to provide a soothing effect. Take as prescribed.
• Prednisone: A steroid taper is often prescribed to help with post-operative pain. Take as prescribed.

For Questions or Emergency Care
Call the office at 601-984-5160. You may need to speak with the doctor on-call.

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