Tonsillectomy In Children

WHAT YOU SHOULD KNOW:

A tonsillectomy is surgery to remove your child's tonsils. Tonsils are 2 large lumps of tissue in the back of your child's throat. Adenoids are small lumps of tissue on top of the throat. Tonsils and adenoids both fight infection. Your child may need his tonsils removed to improve breathing and asthma, and to reduce throat, sinus, and ear infections. His adenoids may be taken out at the same time if they are large or infected.

Picture of a normal mouth

INSTRUCTIONS:

Medicines:

  • Pain medicines: Know how often your child should get his pain medicine and how much. You may be directed to give it on a set schedule or only when he needs it. It is important that your child gets his pain medicines when he should. Watch for signs of pain in your child. Expect that the medicine will reduce his pain, but not take it away completely. Expect that his pain will be worse in the morning. Tell his surgeon if his pain continues or gets worse. Also tell him if your child does not want to swallow his medicine.

    • Acetaminophen: This is an over-the-counter (OTC) medicine that is used to decrease your child's pain and fever. Do not give your child OTC acetaminophen if he is already getting pain medicine ordered by a doctor. Caregivers will tell you the right amount of medicine to give to your child, and how often to give it. Too much acetaminophen can hurt your child's liver.

    • Ibuprofen: This OTC medicine may be given to decrease your child's swelling, pain, or fever. Do not give your child ibuprofen unless his surgeon says it is okay.

    • Do not give your child aspirin after his surgery: Aspirin can increase his risk of bleeding.

  • Antibiotics: Your child may be given antibiotics to prevent an infection caused by bacteria. Give your child his antibiotics as directed until they are all gone, even if your child seems to feel better.

  • Give your child's medicine as directed: Call your child's primary healthcare provider if you think the medicine is not helping or if he has side effects. Tell your child's primary healthcare provider if your child takes any vitamins, herbs, or other medicines. Keep a list of the medicines he takes. Include the amounts, and when and why he takes them. Bring the list or the pill bottles to follow-up visits.

Bleeding:

Some children have bleeding after a tonsillectomy. Most commonly it happens 4 to 8 days after surgery, but it can occur any time up until about 3 weeks after his surgery.

  • If your child has bleeding:

    • Small amount of bleeding: Have your child drink ice water and sit down and rest.

    • Large amount of bleeding or bleeding that does not stop: Bring your child to the emergency department immediately .

  • Prevent bleeding: Do the following to prevent or reduce the risk of bleeding from your child's tonsil areas:

    • Do not smoke around your child, or take him to smoky areas after surgery.

    • Do not let your child do rough or active play activities. No wrestling, running, or yelling.

    • Use ice and ice packs on your child. Put ice in a plastic bag and wrap the bag in a towel. Have your child hold it to the front of his neck or use as directed.

    • Avoid letting your child drink liquids or eat foods that are hot, spicy, or have sharp edges (such as chips).

    • Help him brush his teeth gently. Help him rinse his mouth gently to remove blood and mucus. He must avoid harsh gargling or tooth brushing.

    • Tell your child not to cough, clear his throat, or blow his nose.

Food and drink:

Liquids and foods that are cool or cold will help decrease pain and swelling. Avoid giving your child milk and dairy foods if he has problems with thick mucus in his throat. This can cause him to cough, which could hurt his surgery areas.

  • Liquids: It is important that your child drink liquids often after his surgery. He needs to do this to prevent fluid loss, keep his temperature down, reduce his pain, and speed his healing. Your child should drink cool liquids including water, juices such as apple or grape, popsicles, gelatin, and soft drinks. Avoid orange juice or grapefruit juice. These may bother your child's throat.

  • Foods: If he can drink liquids easily and his stomach is not upset, he can then have soft, plain foods. Examples are applesauce, oatmeal, soft-boiled eggs, macaroni, gelatin, and ice cream. Once he can eat soft food easily, he may slowly begin to eat solid foods. He needs to avoid anything spicy, hot, or with sharp edges, such as chips. These can hurt his tonsil areas.

Care for your child:

  • Make sure your child rests and limits his activity as directed. He may read, watch movies, and play board games or computer games.

  • Place a cool humidifier in your child's room to help moisten the air and soothe his throat.

  • Keep your child away from people with colds, sore throats, or the flu. He may get sick more easily after surgery.

Follow up with your child's surgeon in 1 or 2 days or as directed:

Write down any questions about your child's care or recovery so you remember to ask them during your visits.

Contact your child's primary healthcare provider or surgeon if:

  • Your child has throat pain or an earache that is worse than expected.

  • Your child still has pain even after taking his medicine.

  • Your child has a high fever. Ask what temperatures are a concern.

  • Your child's neck or face is more red over time.

  • Your child has itchy skin or a rash. This may mean he is allergic to his medicine.

  • You have any questions or concerns about your child's care.

Return to the emergency department if:

  • Your child has bright red bleeding from his throat, nose, or mouth or his bleeding worsens. This may be life-threatening.

  • Your child feels weak, dizzy, or like he will faint when he sits up or stands. He may need fluids or he may be bleeding. This may be life-threatening.

  • Your child has pus or blood draining down his throat.

  • Your child is not able to drink or is passing very little urine.

  • Your child has bad throat pain with drooling or voice changes.

  • Your child has a stiff, painful, or more swollen neck.

  • Your child has sudden swelling or pain in his face or neck.

  • Your child has back or chest pain.

  • Your child has trouble breathing or swallowing.

Copyright © 2012. Thomson Reuters. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Tonsillectomy In Children (Aftercare Instructions)

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