*This content on tonsillectomy tips is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
Tonsils are large glands in the back of our throat. They are part of our immune system & are the first line of defense when it comes to germs entering our bodies through the mouth. For those that don’t know, a tonsillectomy is the surgical removal of the tonsils. It is a very common and safe operation. In fact, it is the second most common surgery performed on children.
The tonsils are removed for a number of different reasons including recurrent infections, abscesses, allergies, frequent swelling/blockage of airway etc. Usually a ear, nose, throat doctor (ENT) will make that call.
Personal History
My daughter, Kara, has Down syndrome. At two years old, she was diagnosed with a mild case of obstructive sleep apnea. By the time she was four years old, I was noticing light snoring, lots of mouth breathing, and frequent gagging/choking whenever she ate or drank. Believe it or not, none of these things came together in my mind until her speech language pathologist (SLP) mentioned how large her tonsils were during their first session.
On a scale of 1-4 (with four meaning the tonsils are touching), Kara’s tonsils were measuring at a three! It was no wonder she was reacting the way she was! In addition, her SLP suspected this was a big reason for tongue protrusion.
Our visit to the ENT was a quick one. He took a peek at the back of Kara’s throat & agreed with the measurement. I was given the choice to have them removed or not (which is a huge reason I love this ENT of ours). With her history of sleep apnea and low muscle tone, it was an easy decision to make. We scheduled her for surgery.
Surgery
As I mentioned above, this procedure is a quick & safe one. We went through the steps of prepping her for anesthesia, said our goodbyes and sat in the waiting room until we were called into the PACU. She was in the OR by 9:00 and was in recovery by 9:30. This even included the removal of her adenoids, which have the same job as the tonsils, but are more associated with the nostrils.
A lot of kiddos with Down syndrome may qualify for an overnight hospital stay after this surgery. Kara was approved for an extended stay in recovery so we stayed in her recovery room until she was cleared to leave by her nurses and doctor. Going home was only going to happen if she could get enough fluids.
Kara has a hard time processing anesthesia and she was hurting. She refused all forms of fluid including slushies, applesauce, & juice. Eventually we convinced her to eat some ice cream with the promise of going home to cuddle. We were heading home by 1:30 that afternoon.
Recovery
I’m not going to sugar coat it here. Watching Kara recover from her tonsillectomy/adenoidectomy (T&A) was awful. She was miserable.
Below are my daily notes during her tonsillectomy recovery. Even though it was a rough couple of weeks, I am SO glad we had her tonsils & adenoids removed! It made a HUGE difference in the way she eats, drink, sleeps & speaks!
Day of Surgery
Day 1 – After the procedure, Kara was hurting. She was disoriented and needed lots of comforting in the recovery room. She wasn’t cleared to go home until she got enough fluids in her & we finally accomplished that with ice cream (which counted as liquid to the nurses).
Once we finally got her home, we let her sleep & lounge as much as she wanted. I feel like she was recovering more from processing the anesthesia at this point. It wasn’t fun, but it was bearable.
Day 2 – Kara was given meds every four hours around around the clock which seemed to really help her pain level. We kept her in our bed for the first few nights so the nighttime meds were more convenient. It was worth it – I was surprised when she agreed to eat some mac & cheese later on! We kept her drinking as much as possible & encouraged rest. She was taking long afternoon naps at this point, but was in fairly good spirits.
Turn for the worse
Day 3 – Right when we started to feel like we were getting a break, Kara took a turn for the worst. It was honestly hard to recognize her. Her spark was gone. She slouched on the couch, refused liquids, and let her saliva run out of her mouth rather than swallow it. We called the ENT clinic & they instructed us to take her to the E.R. for dehydration. She was put on IV fluids & given a dose of oxycodone for the pain. On top of that, they found the smallest trace of a UTI so we started her on antibiotics. We left the E.R. that night with a slap-happy Kara! Click to see the video I took of her after her pain meds!
Day 4 – Poor baby had a rough night after the E.R. trip & had trouble keeping anything down. I don’t want to imagine what vomiting feeling like after a tonsillectomy, but Kara did at least twice. She also continued to be very lethargic. As rough as this day was, it was still LOADS better than Day 3. We pushed fluids like crazy and let her rest. Cuddling & OTC pain meds were our top priorities.
Back on her feet
Days 5 thru 6 – Kara started to get back on her feet! She was still taking long naps in the afternoon, but was now sleeping in her own bed and skipping overnight pain meds. She also started eating ‘better’ foods like sweet potato & avocado. This made my mama heart happy as I hated seeing her eat all those sweets and unhealthy carbs!
Days 7 thru 9 – After a whole week of recovery, Kara was popping up in the morning and trying to roughhouse first thing. She was back! At least for an hour or so. By afternoon she would feel pretty crummy & would crawl into a ball in my lap to take a nap. At this point in recovery, we noticed the Tylenol was not helping much at all. We immediately ditched it, but kept her on regular Ibuprofen. On her second week, she was eating things like hot dogs (cut up into tiny bites), oatmeal, sweet potato, applesauce, pudding and ice cream. Getting her to drink fluids was a whole lot easier as well!
Day 10 – Not only did Kara not wake up in the middle of the night, she woke up feeling GREAT! She ate a fantastic breakfast of scrambled eggs, avocado, and mandarin orange slices. She also drank some milk & only touched on a small nap!
She’s back!
Days 11 thru 12 – By this time, Kara was feeling fine in the evenings. She was bouncing around, giggling and refusing bedtime. This was the point in recovery where we said “Okay, she’s back!” We took her completely off the pain meds about this time.
Days 12 thru 14 – All in all, it took Kara about 12-14 days of recovery until she was fully, completely, 100% recovered. There was no more soreness, no more medication, no more long afternoon naps and she was no longer restricted on active play.
Tips & Take-Aways
Keep them sipping
If there is one thing to take away from this post, its this. You want them to stay hydrated, sure, but you also want to keep their throat moist. If it starts to get too dry, the scabs are more likely to separate from the skin & start bleeding. If the bleeding gets bad enough, another surgery is required and could even mean stitches. Ugh, sounds like a nightmare I never want to live. That being said, find something that works & use it.
Kara, like a lot of kids with Ds and a lot of 4-year-olds, can be very stubborn. She would drink for NOTHING. Right before we resorted to holding her down and administering water by syringe, we turned on her favorite show. That’s when my husband hit the pause button. Kara turned around whining. He said “Take a sip of water & I’ll push play.” Sure enough, it worked. She took a sip, cringed, then turned her attention back to the show. He did that every ten minutes for days on end & it worked wonderfully.
Stay on top of medications
When you come home from the hospital, they will most likely send you with some prescriptions for acetaminophen (Tylenol), ibuprofen (Motrin), and possibly something a little stronger. Set your timer & never miss a dose. You will be glad you stayed ahead of the pain. Day three was so bad for us because Kara was in agony. Even with the medications we were giving her, she needed something more. When we gave her oxycodone in the E.R. that night, she was finally able to get re-hydrated.
My point is, don’t underestimate the pain they are in.
Stock up on Tylenol suppositories
This was some advice from a friend of mine & turned out to be one of the best tips. Kara refuses to take medication & its especially difficult to trick her when its in liquid form. It’s just not a fight you want to take on at 4:00am. Kara got a suppository every four hours throughout the night. She slept through it almost every time.
Try different foods
Maybe your kid normally likes chocolate pudding & popsicles, but don’t count on those to see you through tonsillectomy recovery. Grab a range of things from pasta to applesauce to slushies. Kara lived off of mac & cheese for a few days before she got comfortable enough to even give ice cream a try. Make sure to avoid anything red in color – if there is bleeding, you want to be able to see it.
These were our go-to’s: mac & cheese, minced hot dogs, applesauce, yogurt, pudding, ice cream.
*A lot of people will say that dairy burns the throat. It didn’t seem to bother Kara, but its something to keep in mind.
Try varying temperatures
Sometimes the only way Kara would drink water is if it was ICE cold. Others she could only tolerate lukewarm liquids. If your kiddo isn’t taking in liquids, keep changing it up until something works. Drinking fluids is incredibly important to recovery.
General Tonsillectomy Information
Pain will most likely spike 3-4 days after surgery & again 7-9 days after surgery because of the scabs falling off.
White patches on the back of the throat is normal.
Scabs will form on the back of the throat. They will fall off about 7 days post-op.
Side effects of the surgery are: sore throat, neck &/or ear pain
Bad breath (a.k.a. The Breath of Death) is common & can last a few weeks.
Active play should be avoided for two weeks.
It is very important for them to drink a LOT of fluids after this surgery.
When to call the doctor:
- When pain is not controlled with medication
- If they are vomiting or lethargic from the medication
- If they are vomiting 2-3 times in two hours
- Has no fluids for 6-8 hours
- If they aren’t urinating 2-3 times a day
- Has urine that is dark or strong smelling
- Has a temperature of 101-degrees F or higher
When to go to the Emergency Room:
- If you see red drainage from the nose, mouth or ears
- When they are vomiting blood
- If there is active bleeding in throat (look for them swallowing more frequently)
