POSTOPERATIVE
INSTRUCTIONS - TONSILLECTOMY AND ADENOIDECTOMY (T&A)
Your child has undergone surgical removal of the
tonsils and/or adenoids. Below you will find home care instructions
which will guide you through the post-operative process.
GENERAL
Most children are groggy the first several (3-4) days after
surgery and will require an ample amount of sleep, approximately
10-12 hours per night. Kids often become constipated due to pain
medications and may require help with bowel movements. Over the
counter glycerin suppositories or prune juice is usually quite
effective.
DIET
The single most important aspect of the patient's diet is
adequate fluid intake. Fever and dehydration will occur if your
child does not drink enough. We recommend 4-6 ounces of fluids at
least every hour for the first 2-3 days. Soft foods can also be
introduced as tolerated. Foods that children seem to do the best
with are: apple and grape juice, Gatorade, scrambled eggs, mashed
potatoes, macaroni and cheese, bananas, popsicles, and of course,
chicken noodle soup. They can also use an Ensure type of drink, such
as PediaSure poured over vanilla ice cream to get extra calories and
protein. Remember, the body needs protein to heal itself. Please
avoid sharp or crunchy foods like chips or popcorn.
PAIN
Throat and ear pain can be severe after surgery. Keeping your
child on a regular schedule of the prescribed pain medication is
quite helpful. Offering meals about 30-40 minutes after a dose of
pain medication will allow maximum relief while eating. Please avoid
aspirin products and Motrin (Ibuprofen) as they may increase
the risk of post operative bleeding. Some kids may also experience a
stiff or sore neck due to the position of the head during the
surgery. Gentle massage to the shoulders or the back of the neck is
helpful. If a severe stiff neck occurs limiting your child's
head movement, please call our office ASAP. This may be a sign of
something more serious.
BAD BREATH
Bad breath or halitosis occurs after surgery from the healing
membrane that forms over the tonsil and adenoid area. This membrane
will look like a whitish/yellow coating and will eventually dissolve
as the area(s) heal. A homemade gargle of 1/2 water and 1/2 peroxide
will help to minimize bad breath. You will be given a prescription
for antibiotics after surgery. We recommend that your child takes
this medication as directed and finish the entire course. This will
prevent any infection from developing during the healing process.
BLEEDING
There is a risk of bleeding from the throat from days 1-14
following the surgery and rarely after 14 days. The most likely time
for bleeding would be days 5-10, when the healing membranes (scabs)
are sloughing off the throat area. If your child does start to
bleed, please call our office IMMEDIATELY at (304) 342-0124 and
press "1" to indicate it is an emergency. If you call after
normal business hours, our answering service will respond. Advise
the answering service, there is bleeding xxx days following
tonsil surgery, it is an emergency, and you must speak with the
doctor on call RIGHT NOW!
FEVER
Fever is quite common after surgery but should not exceed 101.5
degrees. Please contact our office if your child's fever is greater
than 101.5 or if he/she becomes lethargic or dehydrated. Signs of
dehydration include: fever, sunken eyes, pale skin, lethargy,
dry mouth, dark urine, or lack of urine, and lack of tears when
crying. Hospitalization post operatively for IV fluids may be
necessary if dehydration occurs. Your child's throat will not heal
if he/she is not sufficiently hydrated. We recommend restricting
privileges (such as TV or video games) if your child is refusing to
drink. Our staff is well trained on this difficult subject. Please
feel free to call us for advice or ideas. Office personnel will be
happy to speak with your child by phone to encourage him/her.
ACTIVITY
Vigorous physical activity should be strictly avoided for
14 days after surgery. Your child will be at home, on the couch or
bed for the first several days. We recommend a time of reading,
playing cards, movies or video games. Light activity is permissible
the 4th or 5th day after surgery (e.g. a short supervised walk or a
ride in the car should be fine - not a bicycle ride). Be careful to
avoid activities which increase the heart rate to minimize the risk
of post operative bleeding.
FOLLOW-UP APPOINTMENT
You will be given an appointment to return to the office in
approximately 3 weeks. Your doctor will assess your child's throat
and most likely release him/her to full activity at that time. If
you do not already have an appointment, please call the office at
(304) 342-0124. |
