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Old 01-01-2008, 07:36 PM   #1
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Added to Lisa MP's post

This was adapted from Lisa MP’a post which was my bible during my recovery. She really outlined with such accuracy what the recovery would be like. I added a couple of more details about my own experience (ie. Thrush from the antibiotic, anti-nausea medication etc...) which I think are helpful, but seriously, LisaMP did an outstanding job!

It’s important 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 and watch us making funny faces when we swallow. You will be holding down the household and managing visitors, children and pets. 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 it’s 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 as gleaned from others’ experiences and my own recent experience (I’m 33 and on day 10-post recovery). Note, I am not a doctor, just a recent patient

There are 3 STAGES:
STAGE 1: MODERATE PAIN (for me, 6 on a 1-10 with 10 being the worst)
Days 1-3 (NOTE: Day 1 begins the day AFTER surgery) (or thereabouts) are painful

•Pain is usually in the moderate to severe stage. At this point it may lean towards moderate b/c the patient still has traces of the anesthesia in their system and their throats and tongue are coated with a numbing agent. On day one I remember texting my friends and saying, “If this is it, then the pain my doctor prepared me for was over-rated.”
•Doctors generally prescribe Tylenol with Codeine, Percocet, Vicodin, or Morphine and sometimes an antibiotic to help fight off infection. I took liquid Tylenol with codeine and getting that down was TOUGH. My doctor suggested taking a sip of it and letting it kick in before finishing the rest but I took the shot approach. For the first couple of days it burned my throat and I had to chase it with Jell-O. If you receive and antibiotic as I did, take care to take acidophilus or eat yogurt to prevent thrush (Candida infection on the tongue http://www.mayoclinic.com/health/oral-thrush/DS00408
I didn’t and let me tell you, thrush is not fun. I felt like I had a million cuts on my tongue. It was awful.
•The most common method of tonsillectomy is to cut them out and cauterize the wounds (video: http://video.com/videoplay?docid=772201112021682&q=tonsil lectomy&total=51&start=0&num=10&so=0&typ e=search&plindex=0 . 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. To prevent this, I requested an anti-nausea medication in my IV. Vomiting during this stage is very traumatic (so is sneezing). The patient MUST consume a lot of liquids. My surgeon hoped for 64 ounces per day. I drank a lot of Gatorade. Drink no matter how painful it is because dehydration is even more painful. I was dehydrated on day 2 and the headache was just as bad as the throat pain. Of course popsicles, Italian ices, crushed ice and Jell-O count too. Drinking became a game for me… I’d have a glass of Gatorade and look at the clock and pick a time that it had to be consumed by.
•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. Warm broth felt really nice.
•Some people have swollen uvulas, mouths, tongues and throats and this makes sleep, breathing and functioning in general very difficult. The patient may need to sleep sitting up for the first few days due to the swelling (I could only sleep on my side). Get the recliner all cozy with blankets and pillows with a side table for water and meds. Surrender the remote control!
•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 hemorrhaging because of the strain put on the body.
•The patient may experience some mild to moderate referred ear pain during this stage (ear pain often gets worse as the week goes on).
•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 hemorrhaging.
•Avoid ice cream - the dairy produces mucus that sits on the wounds - not a good feeling.
•Drinking water is EXTREMELY IMPORTANT.
•Make sure that you have enough pain medication, have your doctor call in a refill ahead of time. I ran out of medication on Christmas Eve and had to call the pharmacies emergency number

Things to keep on hand and remember for STAGE ONE:

1.cold water/Gatorade- see if you can find water fortified with electrolytes.
2.popsicles/ices/Jell-O - NOT RED - can make it difficult to determine if there's bleeding; ice chips
3.soup broth, oatmeal, cream of wheat, Ensure, pudding, mashed potatoes and gravy, other puréed or soft foods.
4.stool softeners - give to patient right from the get-go to avoid it becoming a problem.
5.humidifier - to keep the throat moist while the patient sleeps
6.gravol (for the nausea)
7.rent movies - have their favorite books and magazines, crossword puzzles. Consider joining Netflix before your surgery so that you are well-stocked with movies AND you can watch movies on-demand online (I watched seasons 1-3 of The Office!)
8.pad for writing as talking is really difficult
9.keep visitors to a minimum (I didn’t want any)
10.recognize that they might not need a lot of assistance in this stage - so take your cue from them.
11.ask them at least 3-4 times a day how they are doing and if there is anything you can do for them.
12.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.
13.keep the kids at bay - make arrangements before hand for neighbors,
friends, family to help care for the kids.

STAGE TWO - MODERATE TO SEVERE PAIN (for me, 9-10 with 10 being the worst)
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 threshold. 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 wean 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 - choose your words carefully because remember, they are miserable and in agony and can be a little touchy and oversensitive - 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. One person remembers crying four times a day and just desperately wanting a 5 minute reprieve from the pain that was so extreme and she was so nauseas from the lack of food and constantly tensing all of 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 hemorrhaging. 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 emergency room 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.tissues - 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.warm water with salt to swish around your mouth if you get Thrush
7.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. The ear pain is AWFUL, worse than the throat pain for me and this little folk remedy REALLY works! Thanks Lisa MP!
8.more movies
9.lots of hugs and kisses and validation of pain and discomfort.
10.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.
11.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.
4. Keep pain medication on-hand... maybe switch to over-the-counter Tylenol

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. I wish you the best. I’m on day 10 and am still not at the point where I think it was worth it but I’m looking forward to the day that I do!

 
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