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    Old 08-19-2007, 05:02 PM   #1
    Leanne84
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    Question Adult tonsillectomy pain management

    My tonsillectomy is scheduled for August 29th, and I am looking for which medications are most commonly prescribed. During my consultation, my ENT mentioned that most patients are sent home with Tylenol 3. Unfortunately, I have been prescribed Tylenol 3 in the past, and have not had much luck when it came to pain management. When I mentioned this, he said that "we can negotiate". I just want to ensure I am leaving the hospital with an adequate pain medication.

    From reading the posts, it seems that Percocet (Oxycodone/Acetaminophen) and Lortab (Hydrocodone/Acetaminophen) are fairly common for pain management. Did anyone require medication for the nausea?

    Does anyone else have any suggestions? I am hoping that knowing that I will have decent medication might make me less nervous for the long road ahead!

    Thanks!

     
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    Old 08-19-2007, 05:30 PM   #2
    fourtyoneantz
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    Re: Adult tonsillectomy pain management

    I am on Lortab right now and it works pretty well

    Ask him if he can prescribe that for you. I was nervous for the same thing, I was afraid my doctor was going to under-prescribe my meds. It's working out alright though! Good luck, you'll be okay!

     
    Old 08-19-2007, 08:04 PM   #3
    HRWade
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    Re: Adult tonsillectomy pain management

    I had my tonsils out Sept 26 of last year & my doctor was good to me. I have a very low tolerance for pain so I was concerned about adequate pain management. He prescribed the lortab liquid 2 tbs every 4hrs with another capsule of demerol with phenergan for breakthrough pain. I also had phenergan suppositories in case of nausea. The only time that the pain got unbearable & I had to take the demerol was when the scabs were coming off & I wasn't drinking as much water as I should have been. The main advice I can give you is KEEP DRINKING WATER!!!

    I don't think I would have made it with Tylenol 3, but if you handle pain better than I do, you may be ok with it. Just make sure that if it isn't working he will prescribe something stronger later on.

    Good luck!!

    ~Heather

     
    Old 08-20-2007, 11:27 AM   #4
    Leanne84
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    Smile Re: Adult tonsillectomy pain management

    Thanks for the suggestions! I think I need to stop reading all the tonsillectomy posts, I am terrified already and my surgery is more than a week away. It seem that 90% of people have an incredibly painful recovery. I will try to be positive, and I think with a decent pain medication that things will be tolerable as long as I don't have issues with bleeding (which I thought was quite rare before reading the message board!).

     
    Old 08-20-2007, 09:54 PM   #5
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    Re: Adult tonsillectomy pain management

    Leanne84, I just had my tonsills out on 8/14 (just finishing up day 7 post op). I too was very anxious prior to surgery after reading about painful recoveries here. I am 30 years old & want to reassure you that it's not as bad as I expected it to be - and I have no tolerance for pain, I'm a big wus.

    I've been taking 1 percocet every 4 hours with good results. I've needed to take 2 only a few times after waking up in the middle of the night when the pain seems to be worst. Make sure you set an alarm to take your meds & drink fluids at night - it's no fun to wake up in pain. Eat at least a mouthful of something with your meds so they don't make you naseous. But then try eating/drinking more about 30min-1 hour after taking your pain meds - it's more comfortable after they kick in. Staying hydrated is key & the more you eat/swallow, the faster the dead skin in your throat will slough off & you will feel better. Good luck!

     
    Old 08-21-2007, 04:20 PM   #6
    acoelho
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    Re: Adult tonsillectomy pain management

    Hi Leanne,

    I am on Day 5, which is by far the worst day for pain for me. I consider myself to have a high tolerance for pain and wasn't totally worried up front about having enough pain medicine, but I was smart enough to realize that I better have all of my options covered. Most doctors think of this, too, but some get so routine with their procedures you have to be careful.

    I had my prescriptions filled the day before surgery -

    I got two antibiotics - one liquid amoxicillin and the other a "pack" which you take all at once - both to prevent infection, thrush, etc... (make sure you get either a pro-biotic pill or something else to replace the healthy bacteria in your body as these will kill all bacteria and either give you diarrhea as some people have posted or leave you prone to further infections i.e. UTI) and trust me you won't want to eat yogurt to do this (just the idea of yogurt makes me sick - you will understand, its a mucus thing)

    I got one bottle of Liquid Hydrocodone (generic for Lortab) which was for 1 TBSP every 4 hours (it only lasts for 2 hours, by the way) and I was half way done with the bottle on Saturday afternoon (surgery was on Friday) and started freaking out. I had my husband call on Sunday morning to get it in because I knew I wouldn't make it thru the night and he had to "negotiate" with the doctor (not my ENT - the on-call one) who said they normally don't fill prescriptions over the weekend. My ENT was the one who gave me the 2 day supply over the weekend - not a good idea - this ENT said he always give at least a 4 day!! So, he called it in and I got another 2 day supply of this time Liquid Lortab with Guaifenesin (ask for this one - the hydro numbs the pain and the guaif is an expectorant which helps coat the throat but not in the annoying mucus kind of way - after taking this one - I was able to sleep for 3 full hours (not like the average of 45 minutes to an hour before)

    I also got a prescription for Promethazine - this is for the nausea/vomiting. I have only taken this one three times. One right after I got home from the hospital (I think the car ride made me sick), and the other two times were after force feeding myself in the morning in order to take the other pills.

    I also asked for Liquid Lidocaine to gargle with after surgery. My ENT said that this only works for 1/2 of the people and I thought why not give it a shot. I have to tell you that there were a couple of times that this has helped, but it is really challenging to gargle because it is so thick and if you swallow it, you can't eat or drink anything for 30 minutes after so you have to be super careful.

    Leanne, here are the things that I think really saved my butt.

    Similisan Children's Earache Relief ear drops - these are safe to use with antibiotics and when your ears go haywire like dry sockets this was the only thing that made me a nice person again. I bought them at Rite Aid and they are considered homeopathic, so at least its not "another" drug in your body.

    Ice Packs - this one sounds so basic, I know, but let me tell you that it feels so good to have one draped across your throat or tucked on one side if you are sleeping - it helps with the ears, the throat and your general sanity.

    Chloraseptic/Cepacol - this is a really good one. When you just can't take it anymore and it feels like swallowing broken glass, give yourself 10 sprays of this baby, gargle it as long as you can, spit it out and rinse with water, and you will get about 10 minutes of relief, which is long enough to get some water, food and pills down.

    I have not had any vomiting or bleeding issues, so far, thank goodness, which is what scared me. The pain is rough, but it can be managed. I just keep thinking, this is my one last painful tonsillitis/strep throat attack and after this, there will be no more.

     
    Old 08-22-2007, 06:40 AM   #7
    Leanne84
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    Re: Adult tonsillectomy pain management

    Thank you for all of the responses! I am so lucky to have my Mom coming to stay with my husband and I during this time (my husband has an incredibly demanding job). She has ensured me that I will not leave the hospital without adequate pain medication. Unfortunately my ENT did not write any prescriptions just yet, so it will be a surprise what I am sent home with (which is the LEAST BIT comforting).

    I have absolutely no pain tolerance, especially for pain in your throat. Every time I get strep or tonsillitis, it is a nightmare, and there have been too many times where I needed to be taken to the urgent care centre because of dehydration.

    One more question, does anyone remember waking up from the procedure? Are you in agony at that point or does it just feel like a regular sore throat? Is it true you wake up on your side?

    Thanks again!

    Leanne

     
    Old 08-22-2007, 08:41 AM   #8
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    Re: Adult tonsillectomy pain management

    Hey Leanne,

    Trust me when I say that you will be so happy to have your Mom there because there is nothing like Mom taking care of you - I don't care how old you are!! I wish I had my Mom with me...

    As far as waking up from surgery, for me, this was deceiving. I woke up on my back (not sure about the side thing) and only had a little sore throat, but could speak perfectly and without pain. I just felt extremely drugged up. So, I chatted up the nurses, my doctor, and then after being transferred to the recovery room, talked to my husband and a friend who came by.

    Leanne, DON'T DO THIS! Keep your talking to a minimum because although I felt fine, I sure paid for it the next day!! The hospital will have you on all the good stuff and by the time you get home and it wears off, the damage has already been done. Just take it easy!

    And remember most importantly, the first couple of days are easy in comparison to what comes next. I am on Day 6 (counting the day of surgery)... Today is worse than yesterday. I have not really spoken since Sunday night. And I was the biggest chatterbox right after surgery.

    It will be painful, period. Do whatever you can to maintain hydration. Even if it is only eating ice chips - it is something. Also, unlike my previous episodes with strep/tonsillitis, I actually want to drink water. It does feel good. The swallowing is what hurts!!

    You have one more week to go! Do yourself a favor - about two days before hand, stop reading these posts and come back to it after the surgery is done.

     
    Old 08-22-2007, 09:31 AM   #9
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    Re: Adult tonsillectomy pain management

    Leanne,

    Acoelho is right, there's nothing like your mom taking care of you. My mom stayed with me for the first few days after surgery and it was so nice. As far as waking up after surgery, I woke up on my back. I wasn't in any pain, just felt like my throat was really closed off from swelling. It was hard to swallow my own saliva. Kind of like when you have strep, I had to spit into kleenex for awhile until my throat would cooperate. Just stay relaxed and know that they will give you as much pain medication as it takes to keep you comfortable. They had me eat a popcicle and a little applesauce, then take a pain pill before being wheeled out to the car to go home. Some advice: the short car ride home made me nauseous. Have your mom drop you off at home and then go fill your prescriptions to minimize your time in the car. And bring some sunglasses.

     
    Old 08-22-2007, 09:49 AM   #10
    Leanne84
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    Re: Adult tonsillectomy pain management

    Thank you for your support, it is greatly appreciated. There is a week left, and I am so incredibly nervous that I find it difficult to concentrate on anything else. I just had a long conversation with my Mom and she thinks that Tylenol with Codeine (Tylenol 3) will be sufficient (I beg to differ), and that we may have difficulties getting anything stronger. The ENT nurse said that Tylenol 3 is their standard and they generally do not prescribe anything stronger.

    I am sure everyone can understand my fear of the amount of pain during recovery (possibly quite severe). My Mom will only be here during days 1-3, and I will be alone for the remainder (I am so thankful!)

    I suppose it will be the worse 10 days I have ever experienced, but then it will be over, and look forward to being able to stay healthy for four or even six weeks!

     
    Old 08-22-2007, 12:01 PM   #11
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    Re: Adult tonsillectomy pain management

    Leanne,

    My suggestion to you is that you try the T3 and if it's not cutting it to have your mom call (before the weekend) to ask for something stronger. T3 may be enough, but if you try it and it's not working, they can't say no to giving you something stronger. I needed to take the pain meds every 4-5 hours for the first 6 days so make sure you get enough. Days 3-5 were the worst for me.

    I too was very anxious a week before surgery thinking about how bad the pain would be. I think because I expected the worst, it really wasn't that bad. I would say that it has been more uncomfortable than painful. I've only had real pain a few times, and I just took more pain medication, iced my throat & put a heating pad on my ears and the pain eased within 15-20min. It really won't be as bad as you're thinking. Today is day 9 for me and I'm almost out of the woods. Still hurts when I eat, but I'm happy to have come this far.

     
    Old 08-22-2007, 12:24 PM   #12
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    Re: Adult tonsillectomy pain management

    Thank you Rachel for being my light at the end of the tunnel!

    Leanne, Rachel is right - please don't stress yourself out like crazy. Either you are having the surgery or not and all you can do is be prepared for the worst. Then, hopefully, you will be one of the few that breezes through this!

    Tylenol w/ Codeine is actually pretty strong. It should do the trick.

     
    Old 08-22-2007, 01:13 PM   #13
    Leanne84
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    Re: Adult tonsillectomy pain management

    Everyone has been so helpful. I actually found a few posts of people who have had fairly easy recoveries which has put my mind at ease. I think this is the last day I will look at these boards prior to the tonsillectomy (in all honesty, I wish I wouldn't have read anything until after my surgery). Thank you once again, and I wish everyone well!

    Leanne

     
    Old 08-23-2007, 12:27 PM   #14
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    Re: Adult tonsillectomy pain management

    Quote:
    Originally Posted by Leanne84;316***9
    Thank you for all of the responses! I am so lucky to have my Mom coming to stay with my husband and I during this time (my husband has an incredibly demanding job). She has ensured me that I will not leave the hospital without adequate pain medication. Unfortunately my ENT did not write any prescriptions just yet, so it will be a surprise what I am sent home with (which is the LEAST BIT comforting).

    I have absolutely no pain tolerance, especially for pain in your throat. Every time I get strep or tonsillitis, it is a nightmare, and there have been too many times where I needed to be taken to the urgent care centre because of dehydration.

    One more question, does anyone remember waking up from the procedure? Are you in agony at that point or does it just feel like a regular sore throat? Is it true you wake up on your side?

    Thanks again!

    Leanne
    no, i didn't wake up on my side, i ws laying flat on my back, with a pillow under my head.
    the first thing i said wheni woke up was *how long have i been in here*
    and also asked why didn't the remove the left tonsil, because i felt no pain on that side.
    the pain that i did feel on my right side, was a dull ache. i had no problem talking at all, talked the entire time i was in the recovery room, and was talking when they brought me back to my room.
    i found that the more i talked, the better i felt.
    if you keep you mouth moving that keeps your salva flowing.
    i was not in much pain at all, and i'm still not going into day 4
    be sure to take the pain medication as directed, set your alarm clock and take it around the clock.
    drink, drink, and drink.
    you'll be fine.

     
    Old 08-23-2007, 12:35 PM   #15
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    Re: Adult tonsillectomy pain management

    I replied earlier on another post but will put my thoughts in this one also. I am 58 years old and on day 16. I also read these posts and almost passed out with fear before my surgery. I called my ENT and said there is no way I'm going through that. She immediately said okay ask me what scares you. I went through all the horrible things I read and she said most of those things don't happen. She said your tongue will not swell, which was my worst fear, and it didn't swell, and most people do not bleed after. She said you will hit a wall at day 5, but with the meds you will get through it. So ahead I went. Still scared to death. On the day of surgery they gave me something to relax me immediately because I was shaking so. That was nice because when they wheeled me in I was so happy. Then it seemed like a short time I was in recovery. Not so bad at all. Ice pack aroung my neck and sipping on something cold. The nurse said your doctor is great. She sprays the throat after the surgery that last for a long time. Don't ask me what. I just remember her saying that. And she gave me meprozine. Combination of demerol and phenergan. Said take it every 4- 6 hours for around 10 days. She actually gave me about 15 days worth but I didn't need it after 10 days. She said some of her partners only give meds for 5 days but she said you need them longer. Also amoxicillin for 10 days. I drank a lake full of water. I printed out the guide from Lisa. Taped it on the fridge and told my husband to read it. Said make me drink water even if I say I can't. And make me take my meds. My ENT said take them, don't skip a dose even if you think you can. You can't catch up with the pain. So I set 2 alarm clocks for night time. Believe me, I didn't want to skip them. It wasn't nearly as bad as I thought it would be. Yes, it was painful on day 5 until day 9. Then on day 10 it was like, wow, what just happened. I ate a chili dog and soft french fries that night. I felt like a new person. Get a travel pillow that fits around your neck. It's wonderful and keeps your head up just where it should be. I'm still using it. Drink, Drink, Drink. Keep the throat wet at all times. Get a cold mist humidifier and start running it a couple of days before the surgery. Keep it full at all times. Put it beside your bed or wherever you are going to sleep. Keep the house cold. Very cold. Your electric bill will go up some but it's worth it. My ENT said I should have had my tonsils out 15 years earlier. She said there was not enough antibiotics to get rid of the infection that I had. I'm glad I did it. I feel better already. Also don't spit. Swallow everything. My ENT said I know that's gross but do it. Spitting makes it worse. So I swallowed everything. Eat even if you think you can't. It takes the scabs away. Soft things only. Nothing scratchy.

    Last edited by gtarran; 08-23-2007 at 01:13 PM.

     
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