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Diet for the day of and following surgery:

• On the day of surgery, there is usually nausea and, at times, vomiting because of the anesthesia. On the day of surgery, it is best to take in only clear liquids such as ice chips, Popsicles, Jell-O and water. It is very helpful if the patient holds a piece of ice or Popsicle in their mouth as much as possible. The cool substance will decrease the pain and swelling, and at the same time allow the patient to get fluids in. The more this is done, not only on the day of surgery but for the first 3-4 days after the surgery, the better the patient will feel. Fluid intake is EXTREMELY IMPORTANT, even though it can be uncomfortable.
• On the first postoperative day, the diet can be changed to a semi-liquid diet to include foods such as pudding and ice cream. Some patients try more substantial foods such as scrambled eggs or mashed potatoes and this is fine. Do not be surprised, however, if after 1-2 bites of solid food the patient does not want anymore. The goal for the first 3-4 days after the surgery is for the patient to drink.
• On the fourth postoperative day, soft foods can be added, such as mashed potatoes, soft meats, spaghetti, macaroni and cheese, rice and most soft vegetables. The patient should remain on a soft diet until the postoperative visit.

Activities:

• For the first 3-4 days after surgery, the patient should be kept as quiet as possible. About the 2nd or 3rd day, the patient can begin to walk although it is very important that they engage in no strenuous activity until the postoperative visit. Often after a strenuous day, the throat pain will increase.
• After surgery, the patient will be given a prescription for an antibiotic and a pain medication. TAKE THE ANTIBIOTIC AS DIRECTED! The patient should be on the antibiotic for 7-10 days after the operation.
• The most commonly used pain medication after this procedure is Tylenol with hydrocodone. The main side effect of Tylenol with hydrocodone is nausea and stomach upset, and at times, even vomiting. This occurs especially if the stomach is empty so it is very important for the patient to have something to eat or drink before taking the pain medication. At night, the patient will often awaken with a very sore throat and it is very important for the patient to have something to eat or drink before the Tylenol with hydrocodone is given. A cup of water or ice is very effective in decreasing the nausea from this medication. The pain medication should be used only as needed and does not have to be given around the clock. You should find the pain medicine is needed less and less as the patient gets further and further away from the surgery date.
• The pain often increases about three days after surgery. This is muscle pain and is often referred to the ears. Be sure to stay well hydrated and use the pain medicine as needed.

General:

• Fever after the procedure is not an unusual condition. The most common cause for a temperature increase is poor fluid intake. Increasing fluid intake often controls the fever. If the fever does not respond to increasing fluid intake and Tylenol, PLEASE CALL THE OFFICE.
• As much as possible, coughing and clearing of the throat should be avoided.
• Bad breath often occurs after a tonsillectomy. Fluids will help to decrease the bad breath. This will improve as the white patches on the tonsil beds dissolve.
• Some people find that an ice bag is helpful for pain control and this should be applied over the front for the neck. The recipe for the ice bag is:
• One-third portion rubbing alcohol
• Two-thirds portion water.
• Place in zip-lock bag about half filled with this mixture.
• Freeze and then apply to the throat.
• This mixture will have the consistency of a Slurpee; and when this melts, it can be refrigerated and reused.
• On the 4th or 5th day, at times, the patient will often complain of pain in the ears.  This is common and is "referred" pain that can be helped by drinking or eating something warm and using the pain medication as prescribed. It is also very helpful to start chewing gum on the 2nd or 3rd day after the surgery to loosen the muscles in the neck and throat.
• After the surgery, white patches will form over the tonsil beds; these are the scabs that form over a wound in the mouth. These are normal and will dissolve within 2-3 weeks of the surgery.
• Most children are able to return to school about one week after surgery.  Adults can usually return to non-strenuous work or school in 7-10 days after surgery.  In general adults are in more pain and take longer to get back to normal than children.   There should be no heavy lifting or straining until after you are seen at your postop appointment and your surgeon allows you to resume full activity.

Bleeding:

It is unusual to have significant bleeding after this surgery. If there are streaks of blood in the sputum, this should clear up quickly. Often gargling with ice water will stop the streaking. If the bloody streaks persist for more than 15-20 minutes, PLEASE CALL THE OFFICE (867-7800).

 If the patient spits up a mouthful of bright, red blood or vomits up a large quantity of blood,

CALL THE OFFICE IMMEDIATELY (867-7800).

IF YOU HAVE FURTHER QUESTIONS OR DO NOT FEEL THAT THINGS ARE GOING THE WAY THEY SHOULD, PLEASE CALL THE OFFICE AT 867-7800.