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Old 05-02-2006, 09:28 AM   #1
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Question Adult Tonsillectomy - Guide for Friends and Family

Hi all, I thought I'd start a thread for those who have a loved one or a friend going through a tonsillectomy. I think I can safely say that very little information is provided to us patients by the medical community regarding what to expect, and that is likely due to everyone experiences pain and healing differently. This makes it especially difficult for those taking care of us post surgery to understand what we're experiencing. Before I begin - a BIG THANK YOU to those taking care of us. This will be a painful experience for you as well. You are going to get snipped at and cried on, and forced to look at disgusting scabbing throats. You will be holding down the household and managing visitors and children. You are taking on a lot and we are extremely thankful!

Introduction:

There is a MAJOR difference between a child having a tonsillectomy and an adult having a tonsillectomy, and no its not that adults are bigger babies. The reality is that the older you are, the longer it takes for the body to heal; that adult tonsils are much larger than children's and deeper rooted. Therefore there is more skin removed and more trauma. Even though they are the same surgery, DO NOT begin to compare the adult procedure to the child's. If you start off recognizing that this is surgery and a traumatic experience to the body then your loved one will feel much more supported and it will HELP their healing process.

There are a lot of commonalities in the healing process. I'm hoping that other people who have had a tonsillectomy as an adult can add to this thread...

Here is a quick run down on the very general healing process: There are 3 STAGES:

STAGE 1: MODERATE PAIN

Days 1-3 (or thereabouts) are painful - Pain is usually in the moderate to severe stage. Doctors generally prescribe codeine, percocets, vicadin, or morphine, etc. and somtimes an antibiotic to help fight off infection. The most common form of tonsillectomy is to cut them out and cauterize the wounds. Drinking water is EXTREMELY IMPORTANT. The blood vessels that have been sealed are directly connected to the main artery in your neck. Sometimes there is nausea after the surgery (within the first 3 days). This is often from medication and the anesthetic leaving the body. Vomiting during this stage is very traumatic. Keep pushing water - no matter how painful it is for the patient to drink - have popsicles and crushed ice available to supplement the water. Usually the patient can eat some foods, even though it ranges from uncomfortable to outright painful. Tomato based products and anything else that contains acid (even bananas!) need to be avoided. Cold temperature and luke warm temp. are preferred. Some people have swollen uvulas and tongues and this makes sleep, breathing and functioning in general very difficult. Constipation from the medication can often be a problem, and constipation can increase the pain and discomfort for the patient and can increase the risk of hemorraging because of the strain put on the body. The patient may experience some mild to moderate referred ear pain during this stage. The white marks on the tonsil holes ARE the scabs - they are white because they are wet - keep them wet- aim for 100oz of water a day (even if they can't consume that much, keep it as a goal). Swallowing is painful but by not getting enough water the pain becomes worse, thus less water intake, therefore higher risk of increased pain and hemorraging. Avoid Ice Cream - the dairy produces mucus that sits on the wounds - not a good feeling. The patient may need to sleep sitting up for the first few days due to the swelling of the mouth/throat. Get the recliner all cozy with blankets and pillows with a side table for water and meds. Surrender the remote control!

Things to keep on hand and remember for STAGE ONE:
1) cold water - see if you can find water fortified with electrolytes.
2) popsycles - NOT RED - can make it difficult to determine if there's bleeding; ice chips
3) soup broth, oatmeal, cream of wheat, jello, ensure, pudding, mashed potatoes and gravy, Kraft Dinner, other purreed or soft foods.
3) stool softeners - give to patient right from the get-go to avoid it becoming a problem.
4)humidifier - to keep the throat moist while the patient sleeps
5) gravol (for the nausea)
6) rent movies - have their favourite books and magazines, crossword puzzles.
7) keep visitors to a minimum
8) recognize that they might not need a lot of assistance in this stage - so take your cue from them.
9) ask them at least 3-4 times a day how they are doing and if there is anything you can do for them.
10) YOU DO the laundry, dishes, etc., if they say they can handle a chore, then let them, but don't assume that if they can do the dusting one day, they can handle it the next day.
11) Keep the kids at bay - make arrangements before hand for neighbours, friends, family to help care for the kids.


STAGE TWO - MODERATE TO SEVERE PAIN

Days 4-9 Just when you think your loved one is on the mend (and believe me, they'll think so too!) the scabs start to come off. The pain this causes pretty much pushes the patient to and beyond their pain threshhold. The pain is not only in the throat, but in the ears - and is EXTREMELY painful - the patient will not be able to eat much - cold HURTS so warm tea and soup broth is generally preferred at this stage and this is generally when the patient becomes an emotional basket case, crying at the drop of a hat (which just further aggravates the throat). This stage is so disheartening and discouraging. The patient may have been in the process of trying to ween off pain meds, when all of a sudden they are hit by this awful stage. Please be very nurturing and understanding to the patient during this time - as you can imagine, there is nothing like feeling like you've had a major set back in your healing process. The good news is, this excruciating pain is a sign of healing - very gently remind the patient of this - chose your words carefully because remember, they are miserable and in agony and can be a little touchy and oversenstive - whatever you do, do not minimize their discomfort or express confusion over the sudden decline. When you have already been suffering a significant decrease in food intake, constant discomfort - ranging in moderate to severe pain, disrupted sleep and lots of potent medication, it can only be expected to be emotionally at your worse during this stage. I remember crying four times a day and just desperately wanting a 5 minute reprieve from the pain that was so extreme and was so nauseas from the lack of food and constantly tensing all my muscles in an attempt to manage the pain. RISK OF HEMMORAGING at this stage is high. Drinking water is very painful - therefore increasing the risk of dehydration and hemorraging. This is when you lay down the law and make sure the patient is drinking at 18 oz of water every hour and a half. The scabs can come off in big chunks and if the loved one bleeds more than two teaspoons, get them to emerg. ASAP. Have them spit the blood into a cup (gross I know) but the doctor will need to know how much blood has been lost. This stage feels stagnant with regard to high degree of pain - it can last around five days so brace yourself and try to remember how brutal this is for the patient. Even though the patient is aware that it gets worse before it gets better, it's still a major shock to the system when you hit rock bottom, and stay there.

Things to keep on hand and remember for STAGE TWO:
see list for stage one in addition to:
1) WATER - room temp.
2) warm liquids - tea, broth.
3)) kleenex - for the crying fits
4) anti-nausea medication
5) peroxide and water - to gargle if bleeding starts; also ICE cold water to gargle to seal the wounds
6) mineral or baby oil to heat and place in the ear canal and sealed with a cotton ball for the ear pain - which gives the throat pain a run for its money.
7) more movies
8) lots of hugs and kisses and validation of pain and discomfort.
9) keep visitors away - send a fresh bouquet of flowers to your loved one - remember this stage is extremely depressing and feels like it lasts forever.
10) let them vent their little hearts out - they need to get it out. Remember "This too shall pass in the fullness of time"

STAGE THREE - MODERATE TO MINOR PAIN AND DISCOMFORT

Day 10 (or thereabouts) - The patient tends to experience a significant improvement that almost catches them off guard on day 10 or a few days afterwards. Their hope is recharged and they feel better emotionally. They can eat more and therefore have more energy. They tend to steadily progress from this point on. Although there will continue to be some minor discomfort and possible residual affects for weeks to come. Just because the pain is gone, doesn't mean the throat is done healing.

Things to keep on hand and remember for STAGE THREE:
1) things are looking up! Keep pushing the water.
2) do not seek sex (seriously let them tell you when they're ready)
3) encourage light activity - going for a walk, etc.

Conclusion

Well, that's it folks! Obviously not a fun two weeks for anyone, but again, thank you for taking the time to read up on how to best help your loved one through this process.

Last edited by LisaMP; 05-02-2006 at 09:38 AM.

 
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Old 05-05-2006, 07:32 AM   #2
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Re: Adult Tonsillectomy - Guide for Friends and Family

This was brilliant!
Really...I wish I had this to give to my husband a month ago!
In my opinion, you were dead-on describing the stages of pain.

 
Old 05-07-2006, 06:51 PM   #3
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Thumbs up Re: Adult Tonsillectomy - Guide for Friends and Family

thank you so much for that post LisaMP - I'm getting my tonsils out in 2 days and have given a copy of your post to both my parents and boyfriend! Sounds like they're in for just as much of a ride as i am!

 
Old 05-18-2006, 02:21 PM   #4
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Re: Adult Tonsillectomy - Guide for Friends and Family

Bumping this up to make it easier to find for a recent poster looking for just this type of information. Thanks for posting it; it has helped me tremendously.

 
Old 05-19-2006, 11:37 AM   #5
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Re: Adult Tonsillectomy - Guide for Friends and Family

Wish I'd had this, so I'd known what to expect. Also, to give to my mean coworkers who made snotty comments about my taking two weeks off from work. They thought I was faking it even though I had a note from my doctor explaining about the potential for bleeding. Grrr!

 
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Old 05-24-2006, 08:51 AM   #6
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Re: Adult Tonsillectomy - Guide for Friends and Family

I'm glad people are finding this post helpful. RE: co-workers being insensitive, that is soo frustrating...luckily I work with a bunch of social workers, so I didn't have problems in that department. I think something to remind those around us of is the amount one uses their throat on a daily basis...from something as minor as breathing, to talking, swallowing, eating, coughing, etc. It's one thing to have surgery on a part of your body, like your arm, which you can immobilize a lot more easier than your throat. The other thing to remember is by cauterizing, the doctor is essentially giving you third degree burns on your throat...honestly, what can be more painful?? Having sites like this helps a lot in getting through such a painful procedure. The other suggestion I'd like to make is ask your doctor for antibiotics as part of your post-surgery drug regiment...I landed myself a nasty case of bronchitis during my second week of recovery, which I'm still struggling with (I'll be one month post op on May 26th). My general practitioner told me it's very easy to get infections even from the brief stay in the hospital (4 hrs. post op for me) and also from your immune system being depleted during recovery.
The surgery itself is a breeze - given you're unconscious and notfeeling a thing, but the recovery is long, excrutiating and down right draining. Good luck to all!

 
Old 05-25-2006, 01:23 PM   #7
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Re: Adult Tonsillectomy - Guide for Friends and Family

LisaMP,
We just wanted to thank-you for posting this very helpful information. So far, my experiences have been identical to what you've described. I'm 42 and currently in day 7 of my recovery. (Sonic scalpel procedure) About 2 days ago (it's all a fog) I was starting to feel human and then started having severe ear pains unlike any I've ever experienced. Just like you described, it was very demoralizing. As it was late at night, my wife started searching the net and found this post. It has alleviated much of our concern and has definitely helped us through the recovery.

Two things to add, when experiencing the ear pain, I tried the Chloraseptic drops out of desperation and had almost immediate relief. Not sure if there are problems with that but....any port in a storm. Secondly, although this is very good information and should probably be a sticky, Iím not sure I would have wanted it BEFORE the surgery

Thanks again for the help.

 
Old 05-25-2006, 01:45 PM   #8
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Re: Adult Tonsillectomy - Guide for Friends and Family

Good point! I certainly don't want to scare anyone off pre surgery.... On the up side, a point I'd like to make is that although all the side effects and trials we go through in the healing process, I always felt it sounded worse when describing it, than actually going through it. Fortunately people are resilliant and I've yet to come across one person who didn't feel the procedure wasn't worth it! To all of those about to go through the surgery, you may find yourself suprisingly relieved when your experience is not as bad as you thought. The good news is there is a fairly predictable end in sight, and it is not long-term pain and discomfort.

Last edited by LisaMP; 05-25-2006 at 02:04 PM.

 
Old 05-25-2006, 02:06 PM   #9
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Re: Adult Tonsillectomy - Guide for Friends and Family

I think the worst part for me is that I felt pretty darned good after the surgery -- the ENT later told me that they paint the back of your throat with an numbing agent, so you feel pretty good for the first 24 hours -- gee wonder why they don't just make something like that in lollipop form. So I went from thinking that it wasn't going to be all that bad, then lost my voice, but still felt okay and then when you think you're going to round that corner -- the ear pain and/or pain after eating. I just kept telling myself that this isn't back surgery, heart surgery, brain surgery -- I'm going to be fine in a few weeks. The surgery itself wasn't bad -- was fine, I slept thru it.

 
Old 06-01-2006, 10:16 AM   #10
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Re: Adult Tonsillectomy - Guide for Friends and Family

Hello. I'm in day 10 of my tonsillectomy. I have already been through the scab falling off part around day 7. I started to feel pretty good yesterday...probably the best I've felt until last night when I was eating. I was eating little bites of hamburger when suddenly I felt an extremely sharp pain in on the left side of my throat from swallowing. It felt like I had swallowed a needle or something. There was no bleeding or anything and the pain went away after 10 seconds or so. But I had trouble sleeping...for the first time...and now today my pain feels like I am back at stage 1. Actually, it comes and goes...sometimes I feel pretty good swallowing, other times it is painful. I am very frustrated. Is this something I should go see my doctor about?

 
Old 06-01-2006, 04:09 PM   #11
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Re: Adult Tonsillectomy - Guide for Friends and Family

Thanks for the reply. That makes me feel alot better. I have just heard stories of people feeling 100% after two weeks, but it will probably take me longer. Just wanted to make sure I am on the right track.

 
Old 06-05-2006, 01:34 PM   #12
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Re: Adult Tonsillectomy - Guide for Friends and Family

I'm 5 days out of my tonsillectomy (33 years old) and this is the best info anywhere. I thought I was being a wimp because the pain came back with a vengence. Thanks again for this awesome info.
Jesus Loves You!!!

MeBo

 
Old 06-10-2006, 07:25 PM   #13
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Re: Adult Tonsillectomy - Guide for Friends and Family

oh I wish the doctors & nurses had set these stages out for me before my surgery! I hit day 7 & was shocked at the increase in pain! I was sure it was my fault, perhaps the diet mountain dew I had been indulging in. Now I find out how normal it is. Why then is my own doctors office giving me such trouble about me asking for more pain meds :*(
Maybe it will get better eh? I hope so, I'm on day 9 now!

Vicky K.

 
Old 06-12-2006, 09:49 AM   #14
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Question Re: Adult Tonsillectomy - Guide for Friends and Family

WOW!! What a wonderful post, thank you so much!
I do have one question though; not to rush the healing process, but how long, genrally speaking, before one can talk after a tonsillectomy?

I know I will be following all of your advise and doing my best to take care of my loved one!

 
Old 06-12-2006, 10:59 PM   #15
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Re: Adult Tonsillectomy - Guide for Friends and Family

I was able to talk soon after the surgery but not very well. You'll find that you can't move your mouth that much and your tongue will be swollen for a few days.

 
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