Tonsillectomy care after surgery

What happens after a tonsillectomy

After the procedure, the patient is taken to the recovery room where the patient’s family or caregiver can meet the patient and be with him or her till the action of the anesthetic wears off. Once the anesthetic loses its effect, the patient is generally allowed to go home with someone to assist. It is advisable to have a caregiver for at least the night of the surgery.

At home, the patient needs to take complete rest and only get up to go to the toilet, but that too with assistance. It is advised that the patient lies with his or her head elevated to a point where the operated site is higher than the heart. This will reduce the risk of swelling and edema. In case of swelling, an ice pack applied to the neck may help.

A soft and cool diet is recommended for patients just after the surgery, but that too should be taken slowly in order to prevent nausea and vomiting, which are quite common after the surgery. Hot or warm diet should be avoided till the doctor gives permission.

The patient is advised to drink a lot of fluids, even if it hurts a little, in order to prevent dehydration. A sore throat and vomiting for a couple of times are normal post procedure reactions. If the sore throat or vomiting persists, the patient should immediately inform the physician, who can then give medications accordingly. Apart from these medications, the patient is also given some antibiotics and maybe some narcotics too. These medications have to be taken as prescribed and no other medications should be given to the patient without the permission or information of the physician.

Risks and complications

T&A, like any other surgery may have certain risks and complications associated with it. Though these are very rare but it is better to be aware of the potential risks in order to find faster solutions. The potential risks and complications are as given below:
– bleeding
– infection
– dehydration
– prolonged pain
– improper healing (this might lead to further hospitalizations and/or surgery)
– deformed speech (change in voice or nasal speech)
– burns (caused by electrocautery)
– failure to improve nasal passage
– failure to resolve problems like sore throat, snoring, sleep apnea, ear infection, sinus infection, nasal drainage etc.

Follow-up care after a tonsillectomy

A major problem that may arise after a tonsillectomy (T&A) is that of bleeding which is mostly caused due to dehydration. In order to avoid this, the patient should drink lots of fluids. Even if it is a bit painful, the patient should try to drink diluted cool drinks or frozen popsicles. Intake of food becomes a problem for the patient but proper nutrition should be maintained. So, soft foods such as puddings, custards, gelatin, mashed food, ice creams should be given. Hot, spicy and coarse foods should be avoided during this period as this will only aggravate the pain and cause bleeding. Excessive activity may also cause bleeding. At least 7-10 days of leave should be taken post-surgery from office or school. Exercises and swimming should be avoided for at least 3 weeks. In case of bleeding, the patient should be calm and rince the mouth with cold water and lie with the head in an elevated position. If the bleeding is persistent then the physician should be consulted for further cauterization.

Another problem post-surgery is that of pain. Usually the day following the surgery, the patient can hardly feel any pain but after a couple of days the pain starts coming back. The pain may radiate upto the ears, especially while swallowing. However, this pain lasts for a maximum of 1-2 weeks following surgery and will slowly wear off. There could be throat tenderness, even after the pain has gone, with hot and spicy food. So, these foods should be avoided for at least 6 weeks or so.

Often there are white patches seen at the back of the throat at the location where the tonsils had previously been. These layers occur during the healing process and slowly wear off on its own within a week or two from surgery. This might lead to bad breath also which will go off once the area is completely healed, and that might be around 6 weeks.

Nasal stuffiness, which is associated with the surgery is usually due to post surgery swelling of the area. Saline nasal drops can be used to decrease the edema and/or clear nasal clots, if any. The patient may also experience a change in voice, persistent or louder snoring post-surgery, but all these will resolve as the area heals and the patient can get back to the normal state within several months.

Time to call a doctor

A tonsillectomy (T&A) is usually well tolerated by most patients. However, in case of any of the following emergencies, the patient should seek medical advice at the earliest. Complications requiring medical advice are as follows:
– Bright red bleeding either from the mouth or nose, which is persistent for over a minute.
– Constant pain along with headache, which is not relieved with medications.
– Persistent or increased swelling of the neck, nose or even the eyes.
– A fever of 101 degrees and above.

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