Tonsillectomy and adenoidectomy is the most common operation done by any ENT surgeon. If your child gets recurrent throat infections or obstructive sleep apnea, you need to get the Tonsils and Adenoid removed. Always parents ask me if any side effects. I say Not at all. I have been doing Tonsil and Adenoid surgery for 35 years, in 3 generations, till now I never have seen any long term problems. So go for it and get your child free from constant antibiotics which itself will harm by getting resistance to several bacteria.
The Surgery is done Under General Anesthesia, a pre op blood examination and pre anesthetic check up is a must. Lots of parents ask me about the post op care, so I have decided to post this, to help those parents.
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Immediate post op, I keep the patient in a Post operative Recovery Station where there are experienced nurses attending each child. Vital signs are monitored every 15 minutes, watch for breathing and bleeding. If any pain the sedations are given as prescribed by the anesthetist. After 4-6 hrs the child start drinking fluids, IV fluids are discontinued and a good “treat” of ice cream is a bonus!!!.
The evening of operation, the child can be transferred to the ward. Night sedation is given after food and they are discharged home after having breakfast.
It is very common for a child to sleep on and off for the first day or two. The most important thing is to have your child drink liquids, otherwise dehydration can sometimes occur. Solid foods are not as important to take as are liquids for this reason. Also, there may be too much soreness to swallow solids. Stay away from foods which are sour, salty, sharp or hot since this may cause pain and discomfort.
Not Recommended: Solids, orange juice (any citric drink), spicy foods. The important thing is to have your child swallow liquids. Whatever works is the best thing to give. Milk products may increase mucus secretions but if the child will only drink a milk shake and eat ice cream then it is OK to give them.
There is usually not too much bleeding during the operation, but there is always a chance of bleeding after surgery. This will be monitored in the Post op recovery station and action taken if needed. The most common time for a child to bleed after tonsillectomy or adenoidectomy is 4 to 8 days after surgery. Usually this early bleeding occurs within the first 2 hours. However, bleeding can occur at any time, until everything is healed, which takes about two to three weeks. Most children do not bleed afterwards, but every year a few do. If this occurs, have the child swallow some ice water. If the bleeding persists, you should bring your child to the Emergency Room for evaluation. Sometimes, the child may have to return to the operating room to control the bleeding.
Pain after Surgery
There is no operation without pain. Mild to moderate pain will be there for a week, which is controlled by analgesic tablet or syrup. Most children are nearly fully recovered after 7 to 10 days. A sore throat is very common after a tonsillectomy, but the ears sometimes hurt as well because the tonsils in the mouth are so close to the ears-referred otalgia. As the mouth heals, the ear pain will go away. Adenoidectomy does not cause as much pain and a child usually recovers in 3 to 4 days. Chewing gum may also be helpful.
A small fever (100 or 101 degrees) is common after surgery, if not well hydrated. Often, fever goes away in a few days. You may give Paracetamol. Stay away from aspirin and other non-steroidal pain relievers since they can increase bleeding.
Make sure you are giving the pain medicine often. The other thing to do is give your child more liquids to drink. These tricks usually work and will keep your child comfortable.
Any Antibiotics needed
I usually give a five day course of broad spectrum Antibiotics after surgery which will help the healing process. It will also prevent infection after the surgery. It is very important that your child take both antibiotics and pain medications.
Getting back to normal
Your child should rest for the first few days. They don’t have to stay in pajamas or in bed. Running around, playing, and jumping are not good, stay at home for a week. Your child can go back to school 7 days after surgery, but not to gym class for another 3 weeks after returning to school.
Ask your doctor when your child should come back for a check up, usually the first visit should be made one week after surgery.
Post op recovery station
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