Tonsillectomy

WHAT YOU SHOULD KNOW

Risks

IF YOU'RE HEADING FOR THE HOSPITAL...

Before You Go

• The Week Before Surgery:
• You'll probably be told to stop giving the child over-the-counter pain killers. In any event, you shouldn't give aspirin to a child with a viral infection, since taking it at such times can give the youngster a very serious neurological disorder called Reye's syndrome.
• Your doctor will tell you whether blood samples will be needed.
• The Night Before Surgery:
• Your physician may suggest a sleeping pill.
• Just before surgery, it's important not to eat or drink anything (even water). Your doctor will tell you when fasting should begin.

When You Arrive

• Check with your doctor before using insulin, diabetes pills, or any other medication on the day of surgery.
• Contact lenses should not be worn to the hospital. Glasses are OK.

What to Expect While You're There

• Taking Vital Signs: These include temperature, blood pressure, pulse (counting heartbeats), and respirations (counting breaths). A stethoscope is used to listen to the heart and lungs. The blood pressure is taken by wrapping a cuff around the arm.
• Blood Tests: The doctor may want blood taken for tests. It can be drawn from a vein in the hand or from the bend in the elbow. Several samples may be needed.
• Emotional Support: Children feel safer in the hospital if their parents are nearby. You'll be encouraged to stay and give your youngster comfort and support.
• Chest X-ray: Adults may require this x-ray before the operation. The doctor will check it to make sure your heart and lungs can handle the stress of surgery.
• Heart Monitor: (Also called an electrocardiogram [e-LEK-tro-KAR-di-o-gram] or EKG). Typically, three to five sticky pads are placed on different parts of the body. Each pad has a wire that is hooked to a TV-type screen or to a small portable box (telemetry unit) that shows a tracing of each heartbeat.
• IV: A tube placed in a vein for giving medicine or liquids. This tube will be capped or connected to tubing and liquid.
• Medicines:
• Antibiotics: These medicines may be prescribed to help fight bacterial infection. They may be given by IV, as a shot, or by mouth.
• Pain Medicine: To ease pain after the operation, this medicine may be given by IV, as a shot, or by mouth. If the pain returns or won't go away, alert the nurses to the problem.
• Anti-Nausea Medicine: Pain killers sometimes upset the stomach. If this happens, the doctor can prescribe drugs to calm the stomach and control vomiting.
• Pulse Oximeter: With a little clip connected to the ear, finger, or toe, this machine measures the oxygen level in the blood.
• Anesthesia: Children are put to sleep for this operation. The anesthesia is given either as a liquid in the IV or as a gas through a face mask or endotracheal (END-o-TRA-kee-ull) tube placed in the mouth and throat. Adults may require only local anesthesia, given as a shot near the site of the surgery. If you choose local anesthesia, you'll be awake throughout the procedure.

During the Surgery:

After Surgery:

• Oxygen: Extra oxygen may be needed after the operation. It is given either through a plastic mask over the mouth and nose or through nasal prongs. If the oxygen dries out the child's nose or the nasal prongs seem to be an irritation, tell the nurse, but don't take off the oxygen on your own.
• Coughing: Coughing and throat-clearing should be avoided after the operation, because they can cause bleeding.
• Deep Breathing: Recommended for adults, this exercise helps prevent a lung infection after surgery. It opens the tubes going to your lungs. Take a deep breath, hold it as long as you can, then let it out. Do this 10 times in a row every hour you're awake.
• Drinking: 1 to 2 hours after surgery, it's OK to start sucking ice chips to prevent dehydration. Ice also cools a sore throat and eases the pain. Once any vomiting has stopped, it's safe to drink water or fruit juice, or suck on popsicles.

After You Leave

• To ease pain, you may put ice in a plastic bag, cover it with a towel, and place it over the throat for 15 to 20 minutes out of every hour as long as necessary. Remove the ice pack before sleep. Treatment with ice is most effective when started right after surgery and used for 24 to 48 hours.
• A cool-mist humidifier in the bedroom will help to reduce throat soreness and coughing.
• Always use medicines exactly as directed. If they don't seem to help, let the doctor know, but keep using them until told otherwise. Use up antibiotics, even if the condition improves. If a medicine causes drowsiness, avoid driving and don't use dangerous machinery.
• It's OK to rinse the mouth out, but avoid gargling, which can cause bleeding.
• Until the throat feels better, it's important to drink plenty of fluids, such as water, fruit juice, milkshakes, instant breakfast milk drinks, or soups. Ice cream is also OK.
• For the first 2 days after the surgery, allow for as much bed rest as needed. Schedule daily rest periods for a week thereafter. Normal activity can usually be resumed in about 2 weeks.
• To prevent infections during recovery, avoid people who have colds, sore throats, or the flu.

Call Your Doctor If...

• An earache develops.
• A high fever develops.
• You see blood or pus draining from the back of the throat.
• You notice itchy, swollen skin or a rash. This could be an allergic reaction to a medicine.

Seek Care Immediately If...

• Increased bleeding in the throat.
• A bad headache.
• A stiff neck.
• Chest pain.
• Trouble breathing or swallowing.
• Bad throat pain with drooling or voice changes.

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