SURGERY PREPARATION

For children: Talk to your child about the surgery in words he/she will understand.  Τell them a story such as Good-bye Tonsils! .

For adult patients: Make plans to take 1 ½ to 2 full weeks off from school or work.  You may feel like going back sooner than that, but just plan for the worst case scenario.

Note: Don’t take ibuprofen or aspirin for 2 weeks before and 2 weeks after the day of surgery.  Ibuprofen  increases the risk of bleeding during and after surgery.

THE SURGERY

A tonsillectomy and adenoidectomy are often done at the same time and are commonly referred to as “T&A”.  T&A is an outpatient surgical procedure that takes between 30 to 45 minutes and is performed under general anesthesia .  A metal retractor called mouth gag is used to hold the mouth open to perform the procedure. The tonsils are grasped and removed from the surrounding muscle and tissue by using a coblation radiofrequensy or cold instruments . After the tonsils and/or adenoids have been removed, any bleeding is controlled .The anesthesiologist will wake you up and transfer you to recovery. The recovery nurses and anesthesiologist will monitor you until you’re ready to go to your room. Normally, young patients will remain at the hospital for about 10 to 12 hours after surgery for observation.

For the adenoids, the soft palate is retracted and a mirror or camera is used to look into the back of the nose where the adenoids are located.  The adenoids are remove with cold instruments or shaver.  Adenoidectomy recovery is 2 -3 days.

Follow-up:

I will see you 6-7 days after surgery.

RECOVERY FROM A T&A:

Recovery time: most children require 10 – 15 days to recover some may recover more quickly; others can take up to 3 weeks for a full recovery .  Let them go back to school after 15 days. Also no travel within 14 days of surgery.

Drinking/Eating: You/your child MUST drink plenty of fluids- this is the most important thing you can do for you/your child’s recovery!!  Some don’t like to drink milk products because it does increase the thickness of your mucus- but I’m not going to argue with you if you want a glass of milk with every meal.  For kids, try juice, soft drinks (non-caffeinated), popsicles and Jell-O for the first couple of meals- if they’re eating this well and want something more substantial, go for it!  Also try pudding, yogurt, ice-cream, mac & cheese, and luke warm soup.

Try to avoid high acid content food (citrus) and spicy food. The sooner you/your child eats and chews, the quicker the recovery.

Fever: A low-grade fever is common for several days after surgery.  Fever is often related to dehydration – so drink more fluids if fever is present.  Contact me if the fever is greater than 38,5°C

Activity:  Activity may be increased slowly, with a return to school after normal eating and drinking resumes, pain medication ceases, and your child sleeps through the night.  Travel away from home is not recommended for two weeks following surgery.

Breathing:  You may notice your child still snores or mouth breathes after surgery.  The snoring should subside  around 5-7 days after surgery.

Scabs:  Scabs will form where the tonsils and adenoids were removed.  These scabs are thick, white, and cause bad breath for 10-14 days after surgery.  This is not an infection!

Bleeding:  With the exception of small specks of blood from the nose or in the saliva, bright red blood should NEVER be seen.  If such bleeding occurs, contact me immediately or take your child to the emergency room.  The most common time to bleed is 10 – 14 days post-op.

Pain:  Nearly all children undergoing a tonsillectomy/adenoidectomy will have mild to severe pain in the throat after surgery.  Some may complain of an earache (this is “referred” pain from the throat that is felt in the ears) and a few may have complaints of pain in the jaw or neck. The pain is usually worst on post-op day 5, so beware!

Medications after surgery:  For children, I will prescribe pain medication such as Paracetamol . For adults, I usually give Paracetomol with codeine. Take your pain medicine/give pain medicine to your child on a scheduled (every 4 or 6 hour) basis for the first 6-7 days.  Stay ahead of the pain, don’t wait until there’s pain to take the medicine; you’ll be miserable and may get dehydrated.  Antibiotics are given to help with the bad breath.  Steroids may be given to help with the swelling and/or pain.

When to Call the Doctor

If you have any bleeding.

If you have persistent pain not relieved by the medication.

Elevated temperature over 38,5°C orally.

If you have nausea/vomiting more than 4 hours after you leave the hospital.

Dr. Kyriakides can be reached by calling at 99353873 . The doctor can also be reached by calling his secretary 22200638.