Tonsillectomy

Tonsillectomy is the removal of the tonsils. Tonsillectomy patients lack energy for several days and may be restless at night. This will improve over the next five (5) to fourteen (14) days.

Breathing

Snoring and mouth breathing are normal after surgery because of swelling. Normal breathing usually returns 10 to 14 days after surgery. Sleep with two pillows under your head. A cool mist humidifier at bedtime can help, but is not mandatory.

Pain

Throat and ear pain can be severe after a tonsillectomy and may last for as long as two weeks after surgery. Ear pain is “referred pain” from the tonsil area and does not mean that anything is wrong with the ears. A prescription for pain medicine will be given and should be filled and given as ordered. Tonsillectomy patients often complain of increased throat pain 7 to 10 days after their surgery when the scabs come off the throat. No aspirin or aspirin-like products, such as Bufferin®, Excedin® or Alka Seltzer® should be taken for 10 days before and after a tonsillectomy as they can cause bleeding. Chewing gum, in moderation, can help lessen muscle spasm. Tylenol® is recommended at any time. Nonsteroidal anti-inflammatories such as Motrin®, Advil®, Aleve®, Ibuprofen or Naprosyn® can be started 48 hours or two (2) days after surgery.

In order to manage postoperative pain, we recommend alternating between acetaminophen and ibuprofen. Children’s dosing is weight dependent; please see attached dosing chart for each medication. The best way to effectively manage post-operative pain is to stay ahead of the pain. You should alternate the acetaminophen and ibuprofen every six hours – they should not be taken together. Alternate the medications so that the patient receives a dose every three (3) hours. You do not need to wake the patient if you find them resting comfortably.

Bad Breath

Scabs form where the tonsils were removed. They are thick and white and can cause bad breath. Rinsing out the mouth with cool - NOT HOT - water can be done as long as the water can be spit out. Avoid mouthwashes (Scope®, Cepacol®, Listerine®, etc.) as they cause a burning to occur and dry out the mouth.

Diet

Tonsillectomy patients need to drink a lot of liquids to help healing occur. Patient should have at least 4 oz to drink every half-hour. Avoid citrus juices (orange, lemon, pineapple, grapefruit, cranberry or tomato) as they may burn the throat. Kool-Aid®, water and pasteurized apple juice are good choices. Eat cool, soft foods such as:

Jell-O
Sherbet
Oatmeal
Custard
Tuna/egg/chicken salad

Eggs
Mashed potatoes
Rice
Ice Cream

Applesauce
Popsicles
Italian Ice
Macaroni and cheese (thinned down)
Pasta with butter, margarine or oil
Pudding
Winter squash
Yogurt

These are suggestions – you may have any soft food.

Avoid foods that might scratch the throat such as potato chips, corn chips, bread sticks, cookies, crackers and pizza.

Activity

Limit activity to quiet play. Avoid bike riding, rough play, running and skateboarding, as doing these can cause bleeding to occur. You can generally return to school or work 7 to 10 days after a tonsillectomy. No swimming or vigorous activity for two weeks. Children will be given a physical education, outside recess, and contact sport restriction for two weeks after they return to school.

Fever

It is normal for tonsillectomy patients to run a slight fever (99° to 101°) for one to seven days after surgery. If the temperature goes above 102°, call the office and speak to one of our medical assistants. Good fluid intake helps keep the fever down. An antibiotic may be prescribed to prevent a post-operative infection and must always be given with food.

Nausea and vomiting

It is not unusual for a tonsillectomy patient to feel sick following a tonsillectomy. Give the patient ice chips or a popsicle and add fluids slowly. Try fluids with a lower sugar content such as water, diluted Kool-Aid®, etc. If the vomiting persists the day after surgery, call our office and talk to one of the medical assistants.

Voice changes

There may be a nasal quality to the tonsillectomy patient's voice after surgery. This is normal and may last for several weeks. Encourage talking, as it helps with the healing process.

Warning signs

If any of the following problems occur, call the office and talk with one of the medical assistants:

  • bleeding from nose or mouth
  • vomiting blood or material that looks like coffee grounds
  • a croupy (barky) cough/cry or wheezing that is persistent
  • a fever of 102° degrees or higher
  • vomiting that lasts more than six hours, or if the vomiting is severe

Bleeding

No bleeding is expected after a tonsillectomy. Bleeding usually means the scabs have fallen off too early and need immediate attention. If you see any bleeding from the nose or mouth, call the office immediately. If the bleeding is severe or you are unable to reach us immediately, go to the nearest emergency room. * ST VINCENT HOSPITAL EMERGENCY ROOM *

Follow-up

A check up will be scheduled for seven to 10 days after surgery. It is important that you keep this appointment.

If you have any questions or concerns, please call our office.


Ibuprofen
Infants, Children’s & Junior Strength

Dosing Chart

Weight

Age

Oral Drops
50 mg/
1.25 mL

Suspension
100 mg/5ml

Chewable Tab
50 mg

Chewable Tab
100 mg

Caplets
100 mg

Caplets
200 mg

lbs

kilos

years

mL

Teaspoon

Tablets

Tablets

Caplets

Caplets

12-17

5-7.9

6mo-1

1.25 mL

18-23

8-10.9

1-2

1.875 mL

24-35

11-15.9

2-3

2.5mL

1

36-47

16-21.9

4-5

1 ½

3

48-58

22-26.9

6-8

2

4

2

2

60-71

27-31.9

9-10

2 ½

5

2 ½

2 ½

72-95

32-43.9

11

3

6

3

3

>96

4

8

4

4

2

Do not use on infants less than 6 month of age. If possible use weight-to-dose; otherwise use age-to-dose.
All dosages may be repeated every 6 to 8 hours.


Acetaminophen
(non-aspirin)
Infant, Children’s & Junior Strength
Dosing Chart

Infant’s Oral Suspension
160mg/5 mL
Children’s
Suspension
Liquid & Elixir
160 mg/5 mL
Children’s
Chewable
Tablets
80 mg each
Junior Strength
Chewable
Tablets/Caplets
Meltaway
160 mg each

mL

Teaspoon

Tablet

Taplet/Caplet

6 - 11 lbs

0 - 3 mos.

1.25 mL

12 - 17 lbs

4 - 11 mos.

2.5 mL

½

18 - 23 lbs

12 - 23 mos.

3.75 mL

¾

24 - 35 lbs

2 - 3 years

5 mL

1

2

36 - 47 lbs

4 - 5 years

1 ½

3

48 - 59 lbs

6 - 8 years

2

4

2

60 - 71 lbs

9 - 10 years

2 ½

5

2 ½

72 - 95 lbs

3

6

3

96 lbs & over

4