Tonsillectomy and adenoidectomy are fairly painful and you may have a bad sore throat for around two weeks.
Some children bounce back fairly quickly, but older children, teenagers and adults often have a more difficult time. The pain seems to peak after a few days, and then gradually subsides. You may also have a bad taste in your mouth and bad breath as the scab breaks up and falls off. Ear pain is very common, as the same nerves bring sensation to your throat and ears. It doesn’t mean you have an ear infection.
Antibiotics aren’t necessary, but pain control is important. One good option is paracetamol. Codeine can be added, but doesn’t improve pain relief significantly and some people have bad reactions to it.
In the past, anti-inflammatory drugs like ibuprofen were avoided because of concerns they’d increase bleeding, but recent research shows they’re safe and effective for pain relief after surgery.
The best approach is to combine these drugs, alternating paracetamol and ibuprofen every three hours.
In adults, opiate pain relievers may be recommended but they must be used carefully, and you shouldn’t take them if you’re groggy or sleepy.
It’s better to take your painkillers regularly, as prescribed, rather than waiting for your pain to get bad.
After your anaesthetic, you may feel nauseous and rich foods like milk may cause vomiting. This feeling usually goes after a few hours. Ice cream is good, as it’s cold (reducing pain), liquid (preventing dehydration) and rich in calories (important since you may not be eating well).
Some surgeons recommend strict dietary guidelines after surgery, but others just recommend avoiding “sharp” foods like pretzels, toast or chips for the first two weeks because they can cause pain and bleeding. Acidic foods like fruit juice can also irritate your throat. Usually, eating as normally as possible is best.
If you don’t drink enough after surgery, you may become dehydrated. You can prevent dehydration and boost your calorie intake by drinking liquids such as milk shakes or smoothies.
If you’re dehydrated you may feel excessively tired or dizzy, have a dry mouth, and urinate less often. If so, you should contact your doctor, who may recommend you go to hospital for intravenous fluids.
Active bleeding (with bright red blood) is potentially serious, and you should immediately go to the hospital for evaluation.
For this reason it’s very important to have easy access to a hospital in the two weeks after surgery. This is why travelling by air or ship, and activities like camping and hiking, aren’t allowed. You’ll normally be advised to take two weeks off school or work, although you may feel well enough to work from home after a week or so. You should take things easy for two weeks, avoiding strenuous exercise.
Other red flags
Contact your doctor or hospital emergency department if you experience:
- Difficulty swallowing
- Difficulty breathing
- Dark-coloured urine.