Introduction
Tonsillectomy is a very common procedure performed in both children and adults. It may be performed alone or with an adenoidectomy.
The most common indications for this procedure include recurrent tonsillitis or snoring and sleep apnoea, but there are other less common indications.
Before the Surgery
Reading Materials
Please read this page and the Royal Australasian College of Surgeons’ information sheet (“Surgical removal of the tonsils and adenoids”) so you understand the procedure, the benefits and risks associated with this procedure and the expected outcomes of surgery. The information sheet will be given to you when booking your operation.
Blood Thinners and Herbal Medications
Please make sure you have informed me about any blood thinners or herbal medications you are taking, and that we have discussed a clear plan about when to cease and recommence blood thinners. These may include (but are not limited to): Advil, Asasantin, Aspirin, Astrix, Brufen, Cardiprin, Cartia, Clexane, Clopidogrel, Coumadin, Dispirin, Heparin, Ibuprofen, Indocid, Iscover, Marevan, Naprogesic, Naprosyn, Nurofen, Panafen, Persantin, Plavix, Pradaxa, Rafen, Viclofen, Voltaren, Warfarin and Xarelto.
The following natural or herbal medications can increase bleeding: fish oil, krill oil, garlic tablets, ginger, ginkgo biloba, ginseng and St John’s Wort.
Fasting
As you will be fasting prior to surgery, drink plenty of fluids and have a good meal before your fast begins.
After the Surgery
Recovery Room
You should not be in pain immediately after the surgery as I will have injected local anaesthetic into the operation site, and my anaesthetist will have given strong pain relief during the procedure.
Drip (intravenous cannula)
You will wake up with a drip in one of your hands. The needle of the drip has been removed and what is left is simply a plastic tube to deliver further fluids or medications through this route - you can still move and use that hand gently.
It will be removed by nursing staff before you are discharged from the hospital.
Diet
Avoid hot foods and drinks for 2 weeks as these can increase the risk of bleeding. I am referring to the temperature of the food, not spiciness. Cooked meals are fine, but let the food cool down before eating it. Apart from the above, you can enjoy all your favourite foods and drinks!
Citrus (acidic) drinks such as orange juice and spicy foods may cause some throat discomfort but are not dangerous to have. Often milk, ice cream and yoghurt are soothing for the throat.
Do not worry if you don’t feel like eating large amounts after the surgery – this may relate to the anaesthetic on the first day, and some throat discomfort on the following days. It is more important that you are drinking good amounts of fluids. Apart from preventing dehydration, keeping the throat moist by drinking helps prevent pain associated with a dry throat. Remember, flavoured icy poles and ice blocks are excellent at soothing the throat and they count as fluids!
Pain Relief
Alternating Panadol with Nurofen is very effective. Optimal pain control is achieved by giving these at regular intervals. Panadol should be given every 6 hours and Nurofen can be given every 8 hours if required. There is excellent evidence showing that Nurofen does not increase the chance of bleeding after this procedure and can be used safely.
Stronger medication will also be prescribed for you and can be taken with the Panadol and the Nurofen.
Expected Recovery
You should avoid sports for 2 weeks. This is because there is about a 4% chance of bleeding in the first 2 weeks after the operation, and physical exertion will increase this risk. If you cough up more than a teaspoon of fresh red blood, you need to attend your nearest hospital with an Emergency department. You may need to call an ambulance to take you there if you are worried. The hospital will then contact me.
The recovery from tonsillectomy can be like a “roller coaster” with good days and bad days; you might feel like you are getting better and then feel more discomfort between about days 5 and 10.
You may experience some ear pain following tonsillectomy – this is referred pain from a shared nerve supply and is very common. Following the pain relief regime above should assist with this.
If you look in the back of your throat you may see it looks white/black/yellow-green – this is normal and part of the healing process; it does not signify infection. Once the throat has finished healing it will look exactly like the rest of the mouth.
Bad breath is common after tonsillectomy - this improves after about 2 weeks. Your voice may sound slightly different while the palate and throat heal. This is generally temporary and returns back to normal once the discomfort resolves.
Please do not make any travel plans during the first 3 weeks after tonsillectomy.
Follow Up
I will inform you when you need to see me following the procedure – please contact my rooms to schedule this appointment.