Join Date: Jan 2008
Location: San Francisco, CA
Jordan‚Äôs Big Guide to Adult Tonsillectomy
I had my tonsils removed recently and wanted to share the best practices that I compiled and write a pretty definative guide for what to expect and how to prepare.
OK, so hold onto your boots. Yes, it’s not the most fun you’ll ever have in bed, but a tonsillectomy can be a worthwhile endeavor. If you’re like me, your tonsils are actually evil little sponges harboring nasty bacteria, and keeping them in your body is just too creepy to be right. Getting them out was a brilliant move – I used to get colds, flus, and strep all the time, and now, 3 months post-op I haven’t had a sniffle. Removal just gets more painful as you get older, so it’s now or never, folks! Just read my guide ahead of time, and I’ll help you get through it. Also check out Lara MP’s guide (on HealthBoards.com) for those caring for the adult getting a tonsillectomy – full of good info as well.
Getting a tonsillectomy is actually primarily a mental challenge, so here’s the info you need to get your head ready.
First of all, find a doctor who offers coblation if you can. Coblation is one of several tools that your doctor can use to separate your tonsils from the rest of you. Coblation uses some kind of ionic wave instead of cauterization or a scalpel and my internet research indicated that it may be a less painful way to go. Well I am here to tell you that coblation clearly saved me an enormous amount of pain and healing time. This is especially good if you, like me, turn out to be unable to tolerate your pain medication and have to do this whole thing on Tylenol alone. I had to pay $150 extra for coblation, and it was worth every cent.
Get your supplies in order ahead of time. This includes the following essential items:
• A warm mist humidifier (Cool mist humidifiers don’t do a danged thing)
• Throat numbing spray, such as cepacol (not mentholated)
• Your prescription meds
• Acetaminophen – AKA Tylenol (you can get liquid, I was able to swallow pills without problems myself). NOT aspirin, etc – these can thin your blood and cause problems.
• Something to manage constipation (from the pain meds)
• Enough ice packs to completely encircle your neck twice (so one set can be freezing while you’re using the other set)
• Some liquid with calories – Gatorade, chicken broth, rice milk, popsicles. . . Just avoid anything acidic (unless burning pain is your thing)
• Heating pad/hot water bottle/buckwheat pillow to be microwaved (for ear pain)
• Helpful, long-suffering person (more below)
• I used a Camelbak, which is a plastic water bladder with a tube and mouthpiece. You can just suck on it all day, taking small sips of water. It was ideal. You can buy these at camping stores or the camping are of your local giant store (Wallmart, Target, etc.).
• Scopalamine patch for nausea – prescription, ask your MD
• Probiotics – pills with L acidophilus etc in them – in the refrigerated section of health food stores. Helps reestablish gut flora after antibiotics.
• Guaifenesin – liquid if possible. Sometimes with the liquid lortab. Also sold as Mucinex – helps create mucus which coats the throat and keeps it moist and comfy.
• Similisan Children's Earache Relief ear drops
• Something fun to watch, unless you already get cable, or to read. My sister brought me the entire first season of the TV show Heroes, for example.
You should either have an icemaker or buy some ice. I’d go the extra mile and empty/clean out your icemaker two days before if I were you, so the ice is nice and fresh - you will be nauseous and old, skanky ice will suck. Also, have some way to crush the ice; sucking on ice chips may be your thing.
And finally, procure a long-suffering friend/family member/person who owes you a large favor. You will need help – getting home from the hospital, getting packed in ice, etc, for at least the first day and most likely after that. There is also a very small chance that you could start bleeding after surgery, and then you’ll need to get to the doctor STAT, so having someone around for the first day is really the smart thing to do.
Wear warm socks. Mine were knee-high and stripey, because I am cool.
If you’re nervous, let the nurse/anesthesiologist know. They can help talk you through it.
Good news – this will probably be the least painful day of your whole journey. They do something to the back of your throat so that you feel no pain for hours after you wake up. It’s awesome. Keep this in mind, however, if you feel like talking when you wake up. Bad idea. It doesn’t hurt now – but it certainly will later!
One tip - don’t take your purse/wallet into the hospital past the waiting room– personal items are routinely stolen at Hospitals (sad but true), and you’re going to be too out of it to notice their absence. Give it to your ride home to hold for you.
OK, listen up – this is the most important paragraph of this entire guide. You have a few hours after you wake up where your throat doesn’t feel so bad. Take advantage of it! Your first 5 hours post-surgery is all about one thing – getting ahead of the game. You have 3 tasks ahead of you.
1) Drink water continually; far more than you think you need.
2) Wrap the outside of your entire neck in icepacks,
3) Eat as much (liquid or very soft food) as you can,
Go whole hog – a little effort here will make a huge difference in a day or two. If you do as I suggest you will start out your healing process hydrated, avoid swelling, and get your stomach lined with something so that it can handle the pain meds. Set a big goal (mine was 4 liters) for how much water you want to get down that first day and have your caretaker see that you do your best to meet it. It may hurt to swallow, but that doesn’t mean that you shouldn’t be swallowing. Drinking more water than you think you can, right away, is key to avoiding pain!
That night, put water, medicine, and optionally something to line your stomach with (meds bother some people on an empty stomach - I had a glass of rice milk, because real milk isn’t a good idea for the first few days) by your bed. Set an alarm for every 4 hours (yes really), and wake up and drink a whole bunch of water, line your stomach, and take your meds. Sleep next to the humidifier. Drink, Drink, Drink!
Nights/mornings will be the hardest. You’re drinking less water at night, and you may be breathing through your mouth in your sleep, which dries it out. So the first morning, if you wake up hating life, take heart that it will get better.
So my doctor told me that the first three days are the hardest. This was not my experience. It was day 6ish, when I was hungry and tired of being in pain, and with my scabs starting to crack, that was hardest. This is something that I’ve read over and over in posts from other tonsillectomy patients – that it gets worse right when you think you should be coming out of the worst of it. This can be tough, mentally. I recommend assuming at the start that you’re in for two solid weeks of nonfun, that it will get worse around days 5-10, and that you will be miserable. Then, if you’re not - it’s a nice surprise! A lot of this experience is mental. The pain and lack of food can be quite wearing on you. I arranged it so that I had something specific to look forward to each day (pudding, a certain movie, a foot rub, etc.), and it really helped. I also warned my caretakers that I might be emotional and crabby, and indeed I was. Whatever you can do to feel taken care of, even pampered, I recommend doing that. Caretakers, consider bringing home little gifts for your sick friends, and/or asking if they’d like you to read to them. It will really make their day.
You will have gross breath and possibly a gross taste in your mouth once your wounds scab over. You will loose weight, which you will promptly gain back once you can eat because you’ll be so hungry and so in love with the wonder that is food. Also, expect to feel a little stupid and fuzzy-headed for a while. General anesthesia may affect your memory and your ability to do basic tasks like spell correctly, just for the first day or two. Also, the pain meds will make you a little loopy. Nothing permanent.
Start early and hydrate. Drink massive, copious, ridiculous amounts of H2O. Suck ice chips. Apply ice packs to the outside of your entire throat for at least the first day (remove every 20 minutes for a bit, then reapply). Dehydration and swelling = big pain. For ear pain, apply your heating pad/hot water bottle/buckwheat pillow that’s been microwaved to your ear. Take your meds every 4 hours, even at night. You can always call your doctor and ask for something stronger than what’s been prescribed – find out ahead of time how you can reach her or him over the weekend! Take your pain meds and Tylenol.
It will really help keep the combination of pain medication and antibiotics from messing with your stomach if you can eat a little something around the time you take your meds. People have recommended to me that I take the pain meds and then eat 1/2 hour later, but this made me nauseous. Maybe it will work for you, but I ate and then took my meds. My doctor recommended cold, soft food, but several internet resources suggested eating aggressively – ie rough food, to speed the healing process. Who is right? Dunno. I ended up eating aggressively, in part because I was so hungry, and it seemed to work out OK. My scabs were thin and sort of got worn away as opposed to peeling off in big gross chunks. So, what can you eat? Here’s a list of some of things I tried.
Food That Really Worked
Hardboiled egg yolks, mashed up with a little chicken broth (sooo tasty, and great little protein bombs)
Mashed potatoes, plenty of thin gravy
Yogurt, esp. the drinkable kind
Anything soft with melted cheese on/in it. In general, grease and chicken broth helped lubricate anything you’re trying to eat and helped it not hurt to swallow.
Matzo Ball Soup
Butternut squash soup
Smoothies (with only low-acid fruit, like peaches)
Fresh mozzarella was awesome (the kind that comes packed in water, not the Precious brand cheap stuff you grate up for lazagne)
Club soda (helps settle the stomach)
Food that Kinda Worked
Cupcake with milk (I was desperate for chocolate)
Carnation instant breakfast
Mashed carrots (add chicken stock to thin it out)
Food That Didn’t Work
Dairy for the first few days – creates too much mucus (mmmm . . sexy!)
Milkshakes once my scabs formed – cold made my throat ache
Anything too thick/sticky (clam chowder, for example)
Veggie burger patty (too sticky)
Steamed broccoli (um, bad idea)
OK, Jordan, How Bad Is It Really?
Yes, I too read all the posts about how people wanted to stick a fork in their eye to distract themselves from the pain. And I too was pretty scared.
But it wasn’t as bad as I feared. I even couldn’t keep the Vicodin or my antibiotics down, so I did it on liquid Tylenol alone. I’m here to tell you that I, ahem, ‘was unwell’ (vomited) on day 3, and that didn’t even sting as bad as I feared it would. The challenge for me was not that the pain is overwhelming, it’s just that you’re pretty uncomfortable for a long time, and some things you take for granted – eating, swallowing, and speaking, get totally interrupted. That’s hard psychologically, but the actual pain never made me want to scream. I just got tired of it all. There was one time on day 6 when I walked into a deli to get some soup, and the deli smells of roasting corned beef and all the other things I couldn’t eat caused me to burst into tears and flee the restaurant. You get worn down. But it is really quite manageable, especially if you are prepared mentally for what is, essentially, a mental challenge. If I could do it, you can too.
And the Final Outcome
Getting a tonsillectomy was one of the smartest things I have ever done. Tonsils are there to keep you healthy – when you’re an infant. After that they are just useless vestigial bits that can end up collecting bacteria and making you sick. I was sick all the time, and not with obvious, tonsil-related stuff. I had constant head colds, flus, annoying aches and pains, as well as throat-related problems like strep and tonsillitis. After my tonsillectomy, I am well for the first time in years. I sleep better. I can exercise without worrying that it will stress my immune system and make me sick. I conquered my fear and made my body a nicer place to be.
Last edited by JordanSF; 01-02-2008 at 12:33 PM.