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Tonsil Surgery or Tonsil and Adenoid Surgery: Caring For Your Child After the Operation

Your child needs an operation to take out his tonsils​. Your child may also need an operation to take out his adenoids at the same time. These operations are called a tonsillectomy and an adenoidectomy.

What are tonsils?

The tonsils are small pieces of tissue at the back of the mouth, beside the tongue. They help fight germs. There is 1 tonsil on either side of the throat.

What are adenoids?

Adenoids are lumps of tissue up behind the nose. You cannot see your child's adenoids when looking in the mouth.

Tonsils and Adenoids
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Tonsils and adenoids are made of lymphatic tissue and are part of the body's defense system against infection. They may become enlarged after repeated infections.

Removing enlarged tonsils and adenoids

After many infections, the tonsils and adenoids often become enlarged. This can interfere with breathing. Enlarged adenoids can also affect the tubes that connect the middle ears and the back of the nose. When tonsils or adenoids become too large, they may need to be taken out.

Removing the tonsils and adenoids improves breathing. It may also help your child have fewer ear and throat infections.

An otolaryngologist/head and neck surgeon will do the operation. An otolaryngologist (say: OH-toe-LAR-ing-GOLL-oh-jist) is a doctor who specializes in problems with the ears, nose, and throat.

Before the operation

Several hours before the surgery, your child will need to stop eating and drinking.

The doctor or nurse will tell you when your child must stop eating and drinking.

Write this information down here:

  • The date and time of the operation:
  • When your child must stop eating:
  • When your child must stop drinking clear fluids:
  • Other things to remember:

Surgery to remove the tonsils and adenoids

The doctor will give your child a special "sleep medicine" called a general anesthetic. This will make sure your child sleeps through the operation and does not feel any pain.

While your child is asleep, the doctor will remove the tonsils through your child's mouth. If your child is also having an adenoidectomy, the doctor will take out your child's adenoids at the same time. The doctor will then stop the bleeding. Your child will not get stitches.

The operation usually takes from 45 to 60 minutes.

You will be able to see your child as soon as he is fully awake

A volunteer from the Surgical Waiting Room will bring you to see your child.

After the operation

After the operation, we will take your child to the recovery room, also called the Post Anesthetic Care Unit (PACU). This is where your child will wake up. Your child will stay in PACU for about 1 hour. We will then move your child to a room on the nursing unit.

Your child will be closely monitored on the nursing unit

  • Your child will be encouraged to take fluids by mouth. Your child will start with sips of clear fluids (liquids you can see through, such as water or apple juice), ice chips, or freezies. Once your child can take sips, he can then drink liquids from a cup.
  • Your child’s temperature will be taken often.
  • Your child will still have an intravenous (IV) tube in his arm. When it is no longer needed for fluids or medicine, it will be taken out.
  • Your child will be given pain medicine when needed.
  • The nursing staff will watch your child for vomiting (throwing up) or bleeding.
  • The nurses will tell the doctor if there are any complications.
  • When your child is fully awake, he can get up with help to use the washroom.
  • Your child may throw up thick, brownish-coloured liquid if he swallowed some blood during or after the operation. This is normal. If your child keeps throwing up, we will give him medicine through the IV to help settle his upset stomach.

Managing your child's pain after the operation

When your child has pain after the operation, he will be given pain medicine:

  • by a liquid to swallow
  • if he cannot swallow the pain medicine, we can give your child a suppository that goes into your child's rectum

These are ways you can help make your child more comfortable:

  • humidified air to keep the throat moist
  • raising your child’s head and shoulders to help reduce swelling

Usually just one day in the hospital

Most children are ready to go home from the hospital about 6 to 8 hours after the operation. Sometimes, children need to stay for a longer time.

You should take your child home in a car or a taxi. For your child's comfort and safety, do not take your child home by bus or subway.

Caring for your child at home

Pain

Your child will have some pain after the operation.

Your child will have a sore throat. He may also have an earache, which is caused by the sore throat. Five or 6 days after the operation, your child's sore throat or earache may get worse for a short time. This is normal.

Your child may also have a stiff neck. If this becomes bad, call your doctor.

Follow these instructions when your child goes home after the procedure.

You may give your child medicine for pain.

You may receive a prescription for pain medication before you leave the hospital. Follow the dosage instructions give to you by the pharmacist. Although these prescription pain medications can be beneficial, they are also potentially very dangerous if not used properly.

When using these medications, if you notice any changes in either breathing or level of drowsiness that concern you, stop the medication and seek medical attention. If your child is unresponsive, call 911 immediately.

Do not give your child over-the-counter medicine that may have a sedative effect (makes people sleepy) while giving the prescription for pain medicine. Examples of these medicines are decongestants and antihistamines. Discuss these medications with your pharmacist.

You may give your child acetaminophen (such as Tylenol or Tempra) if he has pain. Give the dose printed on the bottle for your child's age. Do not give your child ibuprofen (Motrin, Advil, or Midol) or ASA​ (Aspirin) for 2 weeks after the surgery. These medications could increase your child's risk of bleeding after the operation. Check with the nurse or doctor first before giving these medicines to your child.

Drinking

It is very important that your child have lots to drink after the operation. Try to get your child to drink at least 4 glasses of liquid a day over the first few days after the operation. Let your child drink as much liquid or liquidy foods, such as Jell-O and yogurt, as he wants.

Do not let your child have orange, lemon, or grapefruit juices or citrus fruits for 7 to 10 days. These contain acid, and your child may find them painful to drink.

Eating

When your child can drink liquids without throwing up, he may eat soft foods such as noodles, eggs, and yogurt. When your child can eat soft foods comfortably, he may eat regular foods.

Your child should not eat hard foods, such as toast or pizza crust, for 2 weeks after the operation. These foods may scratch his throat and cause pain and bleeding.

Mouth care

Your child's mouth may smell different for 2 weeks after the operation. Have your child rinse his mouth with water or gently brush his teeth. Do not let your child gargle, or swish anything around in the back of his throat.

Your child may have white patches where the tonsils were for several days. This does not mean that your child has an infection. To protect your child's throat, make sure your child tries not to cough, talk loudly, or clear his throat a lot for 7 to 10 days. Teach your child to sneeze with his mouth open. Do not let your child blow his nose for at least 1 week after the operation. He should dab his nose with a tissue if it is dripping.

To help your child breathe more comfortably, you can use a machine called a humidifier. This machine makes the air moist with a cool mist. Put it at your child's bedside.

To reduce swelling and make your child more comfortable, try raising your child’s head and shoulders.

If your child also had his adenoids taken out, your child's voice may sound as if he is talking through his nose. This is normal. This may last for a few weeks or up to 3 months, if the adenoids were very large.

Activity

Your child should be as quiet as possible for about 1 week after the operation. Do not let your child play rough sports or contact sports.

Your child can shower or bathe as usual. Your child should stay away from crowds and people with infections and colds.

Your child can go back to school or day care in 1 week to 10 days after the operation. You should not let your child go on long trips out of town for 2 weeks after the operation.

Your child may need a follow-up appointment

The otolaryngology clinic nurse will call you within 2 weeks of the operation to find out if your child has any problems and needs to see the doctor again. If your otolaryngologist has asked to see your child again in the clinic, we will make you an appointment for your child.

Reasons to call the doctor

Please call your child's otolaryngologist, the otolaryngologyclinic nurse, or your family doctor if your child has any of the following signs after going home:

  • fever of 38.5°C (101° F) or higher
  • vomiting (throwing up) that does not stop
  • pain that gets worse
  • refusing to drink
  • child does not urinate (pee) within 12 hours of the operation
  • fresh blood in the nose or mouth

If your child is bleeding or having trouble breathing, or if you are worried, do not wait. Take your child to the closest emergency department right away.

Write down contact information here:

Otolaryngologist's name and number:

Otolaryngology clinic nurse's number:

Family doctor’s name and number:

Key points

  • Your child will have an operation to take out his enlarged tonsils, and possibly his adenoids.
  • Your child will be asleep and feel no pain when his tonsils and adenoids are removed.
  • Most children can go home on the same day as the operation.
  • It will take about 1 week to 10 days before your child can go back to his regular activities and diet.

Kathy Eres, RN
Tomka George, RN
Pauline Lackey, RN
Paolo Campisi, MSc, MD, FRCSC, FAAP

11/10/2009
 




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