TONSILLECTOMY AND/OR ADENOIDECTOMY
Your doctor has recommended that you have a tonsillectomy and/or adenoidectomy surgery. This surgery is suggested when there are chronic throat infections involving the tonsils and adenoids, or the tonsils are so large they cause a blockage of the throat or airway. These procedures will be performed at ASC Durango Surgery Center under general anesthesia and you will be able to go home about 2 hours after surgery.
The following BEFORE and AFTER instructions can help you obtain the best possible results from your surgery. If you have any questions, please call one of the nurses. Make sure all of your questions are answered before surgery!
BEFORE SURGERY
1. Tell your doctor all the medications and herbal supplements you are taking. This includes both prescription and over the counter medications.
2. DO NOT take any aspirin containing products for ____ weeks before and ____ weeks after surgery, unless this has been specifically prescribed by a physician (see below). Some arthritis medication and drugs like Advil, Motrin, Ibuprofen and Aleve act like aspirin and should NOT be taken. These medications may cause increased bleeding during and after surgery. It is okay to take Tylenol during this time period.
If you are taking Aspirin, Coumadin or Plavix, special instructions will apply.
3. If you develop a cold or any other infection during the two days prior to surgery, please notify our office immediately. The doctor may or may not prescribe an antibiotic instead of postponing your surgery.
4. Plan to spend 10-14 days away from work or school after surgery. This time frame is provided as a guideline since each individual’s recovery time will vary. Please postpone out of town plans for two weeks after surgery.
NIGHT BEFORE SURGERY
DO NOT EAT ANYTHING AFTER MIDNIGHT UNLESS INSTRUCTED TO DO SO. IF YOU EAT AFTER MIDNIGHT, YOUR SURGERY MAY BE CANCELLED!!!
1. Continue to drink fluids (clear liquids only) up until ____ am/pm. Clear liquids consist of: water, apple or cranberry juice (no orange juice), Gatorade, Chicken Broth, Coffee or tea but no cream or sugar, popsicles and jello. You will feel much better on the day of surgery if you drink clear liquids up until the 4 hours before your scheduled surgery time.
Then nothing to drink after ____ am/pm.
2. OK to take important medications the morning of surgery with a small amount of water.
3. Remove all nail polish and make-up. Get a good night’s rest.
4. Wear loose comfortable clothing.
Arrange to have someone drive you to the surgery center and stay with you at home on the night of your surgery. That individual should stay in the waiting room area until you have been discharged back to them. (you are NOT allowed to drive yourself home)
AFTER SURGERY
After surgery your throat will be quite sore and you will experience pain with swallowing. You should expect to have a sore throat for one to four weeks. You could experience a low-grade fever of 99.0-100.9F. You may also notice some white patches in the back of your throat. These are the scabs from where the tonsils were removed. Try to prevent coughing or clearing of the throat. Throat lozenges and/or hard candy may be used to keep the throat moist.
Bleeding can be a serious complication and is most likely to occur 7-12 days after surgery or the first 24 hrs following surgery. Try not to panic if bleeding occurs. Begin by gargling with ice water and then ice tea repeatedly. We recommend regular tea such as Lipton or Tetley tea. It may take 20-30 minutes for the bleeding to stop. You may wish to have some brewed ice tea ready in your refrigerator. If you leave home you should carry a teabag with you at all times.
It is strongly advised that you not travel out of town until after the two week post operative period as by then the risk of bleeding will have passed.
You may experience ear pain after surgery. This is referred pain from your throat. This often occurs about the time the scabs disappear from the back of your throat.
MEDICATIONS:
1. ANTIBIOTICS: Your physician may or may not prescribe an antibiotic. If you are given a prescription, please take it as directed until you finish the supply. This is important in wound healing and in preventing infection. You will NOT need a refill.
2. PAIN MEDICATION: The pain medication that is prescribed is usually Tylenol based with a narcotic, so you may experience some drowsiness. You should NOT go to work or school, nor drive a car as long as you are taking the pain medication. Your pain medication should be taken as directed, but DO NOT exceed the prescribed dose. If severe pain persists, please call the office.
– * Pediatric patients: For the first week, administer pain medication (liquid Lortab) around the clock. Set alarm clock to wake child during sleep hours and do not go more than 6 hours since their last dose.
– After the first week, try substituting a dose of plain liquid Tylenol instead of the Lortab. You may begin decreasing the Lortab medication and using only Tylenol if your child can drink adequately and is taking soft foods. During the second week eventually your child may require only Tylenol during the day and Lortab at night, then no pain med during the day and Tylenol at night.
– *Adult patients: Oxycontin 1-2 tablets every 12 hours will be prescribed. You may wish to take the pain med consistently for 1 week. If one tablet is not sufficient then increase to two tablets. DO NOT CRUSH or CHEW PILLS!
– You must pick up the Oxycontin script from our office. This medication can not be called in.
– Also, take Tylenol between Oxycontin doses for added comfort. Generally, by the second week, Lortab can be used for pain and we can call in that specific medication to a pharmacy of you choice. If you are still taking 2 tablets of Oxycontin at the end of the first week you may need to pick up another prescription of Oxycontin. Please call ahead for refills!
– *Have liquid Benadryl on hand. The pain reliever Oxycontin may cause
– Itching and the Benadryl taken prior to your Oxycontin dose will provide relief.
– *Watch for constipation. You may need to adjust your diet: increase fiber and push fluids:
– You may wish to eat a little something before taking your pain medication; If not you may develop an upset stomach. Suggestions: Yogurt, applesauce, saltine crackers in broth.
3. ANTI-NAUSEA MEDICATION: You may or may not have been given a prescription for suppositories to alleviate the nausea. If you were not given a prescription and you experience nausea and/or vomiting, please call the office.
You may also try pour coke or ginger ale between two glasses to drink flat coke which will help with nausea/vomiting. If your child can not tolerate the liquid Lortab, then you may need to give anti-nausea suppositories.
4. Avoid alcoholic beverages as long as you are taking prescription medications.
5. DO NOT take Aspirin, Motrin, Advil, Ibuprofen or Aleve for 2 weeks after surgery. These products can thin the blood and may cause bleeding.
6. Refills must be approved by your doctor. Plan ahead and allow the office 48 hours to refill your prescription. Be sure to mention any drug allergies, as well as the name and location of the pharmacy at the time of your refill request.
ACTIVITIES AND COMFORT MEASURES:
1. Rest with head slightly elevated on 2-3 pillows for the first couple of days to prevent internal swelling.
2. An ice pack to your neck can bring some relief and help with swelling. Apply ice as tolerated on/off 15-20 minutes while awake for the first few days.
3. You may take a bath or shower at any time.
4. During the first 7-12 days, quiet indoor activities are recommended.
5. NO heavy lifting, straining, athletic activities or sports for 2 weeks. DO NOT stay bent over for prolonged periods.
6. You may use a humidifier at night while you are sleeping.
7. A low-grade fever of 99.9-100.9F is common. To help control your fever, drink plenty of fluids. If the fever exceeds 101.7, call the office.
DIET:
1. Slowly progress to full liquids such as pudding, cream soups, ice cream, etc. then to a soft diet as tolerated. You may need to eat a soft diet for a few weeks. Soft foods include pasta, eggs, potatoes and bread. Avoid foods like pizza, potato chips and toast and other scratchy foods for two weeks. Your fluid intake is very important throughout your recovery.
*You must be very assertive in having your child drink an adequate amount of fluids to prevent dehydration.
2. You may want to keep a drink at your bedside to help clear your mouth. You can use a straw if you like.
3. Mouth care is very important. Rinse your mouth often with water and clean your teeth as often as you wish.
FOLLOW UP APPOINTMENT:
The doctor will want to see you between 2 and 3 weeks after surgery. Again, please postpone any travel plans until the first postoperative visit. Your follow up appointment will be made before you are discharged home on the day of surgery. If an appointment was not made, or if you need to reschedule, please call our office.
REASONS TO CALL YOUR DOCTOR AFTER HOURS:
1. Fever of 101.5 degrees or greater; call during office hours only.
2. Increased bleeding or drainage from the nose or mouth.
3. Severe pain not relieved by medication.
4. Vomiting 2 or more times in one day, after the first 24 hours.
5. Difficulty breathing or swallowing.
6. Welts, Hives or Rashes that appear after taking prescription medication(s).
*If you need to reach the Doctor for an urgent medical issue after hours please call our office number (385-7272). Select option #7 to reach the on call doctor.
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