Tonsillectomy recovery is painful for children and usually even worse for adults. Adults should plan on missing up to two weeks of work, and children, about one week of school. During your tonsillectomy recovery, care should be taken to avoid strenuous activity as it may increase pain and can also increase the risk of bleeding.

What to Expect

• Severe sore throat for 10-14 days after surgery. This may improve between days 5-7, but then get worse again. Children tend to recover slightly faster than adults. Some adults may have throat discomfort for up to 12 days.
• Ear pain is expected, usually starting 2 days after surgery.
• A slight fever is normal, if it is over 102, please call our office.
• White or grayish "scabs" in your throat for up to 14 days.
• Pain with eating/talking/drinking. This will be worse when you first wake up from sleeping.
• After the adenoidectomy it is normal to have some scant bloody nasal drainage. A headache can also be common. Call our office is this is persisting over 3 days.

Instructions

• Take your recommended pain medication as instructed.
• It is OK to take Ibuprofen (Advil) and Naproxen (Aleve) at home as directed by the instructions on the bottle for age and weight.
• Do NOT use Aspirin.
• Fluids: The most important part of healing and pain control is your fluid intake. The patient should be drinking 1/2 oz of fluid per pound of body weight per day. Water, popsicles, diluted Kool-Aid and diluted Gatorade are best. Milk and milk products are also fine. If the patient doesn't drink adequate fluids, the pain will be more severe and the patient will likely end up back in the ER with Dehydration and possible bleeding.
• Food: Do not worry about solid food intake. Fluids are the most important. The patient may eat when they feel up to it. A soft/bland diet is recommended.
• Activity: No strenuous activity for 14 days. No activity that raises the heart rate for 14 days. No weight lifting for 3 weeks.
• When to call our office: Bleeding from the throat/nose that does not stop within a few minutes or after drinking cold water. Fever above 102. Vomiting.

Recovery Tips

Here are a few tonsillectomy recovery tips that can help you have a smoother recovery after your tonsillectomy:

Liquids are key. Your throat will be sore, but just like a stiff muscle, the more you use it, the less stiff it will remain. Drinking large amounts isn't necessary, but frequent swallowing is. Every time you wake from sleeping, the first swallow will always be more painful. Expect it and reassure yourself the next swallow will be better. If you aren't getting enough to drink, the pain will increase and you will be at risk for dehydration. Some of the symptoms that come with dehydration are decreased amount and darker urine, increased pain, lethargy and fever.

The next tip is to stay ahead of your pain with your pain medication. Children usually will not receive narcotics, but adolescents and adults usually do. We recommend taking your pain medication on a scheduled basis (be sure to make note of the time) for the first 4 days or so, to include awakening in the middle of the night for a dose. Be very cautious taking scheduled pain medication when narcotics are involved and substitute acetaminophen as much as possible. In children, we recommend taking acetaminophen (or Tylenol) at a dose of 10 mg per kg of weight and ibuprofen (or Motrin or Advil) at a dose of 7 mg per kg (see table). Both medications can be taken at the same time every 4 hours, or staggered so one or the other is taken every 2 hours.

All doses are based on 160mg/5ml of acetaminophen and 100mg/5ml of ibuprofen (standard liquid forms, NOT INFANT)

For adults or anyone taking narcotic pain medications, the process is a little different. If the pain is mild to moderate, take acetaminophen and ibuprofen every 4 hours. If the pain is moderate to severe, take the narcotic and ibuprofen every 4 hours. Narcotics should not be taken with acetaminophen because they usually already contain acetaminophen. Reassess pain every 4 hours to determine if acetaminophen or the narcotic will be taken with the ibuprofen for the next dose. The standard doses of medicines for adults are 2 regular strength acetaminophen (325 mg each) or ibuprofen (200 mg each) every 4 hours.

Changes that are normal after tonsillectomy are pain in the throat and/or ears, bad breath, swelling of the tongue or uvula, shaggy-white appearance of tissue where the tonsils were (scabs), fevers and a small amount of blood in the saliva.

Changes that are not normal are bright red blood coming from the mouth, high fevers, lethargy and low and/or dark urine output.

Hopefully, this helps make the recovery easier. Above all, use common sense and call your doctor or go to the ER for anything abnormal or worrisome.