Scheduling your child to have their tonsils removed can be very nerve wracking, especially if they’ve never been under general anesthesia. There’s so many unknowns and questions. But have no fear! You’ve landed in the right place! This post will walk you through what to expect after a tonsillectomy, shed some light on the recovery process, suggest a few tips and hopefully offer you peace of mind as you prepare for T-day.
My youngest son recently had his ginormous tonsils removed at the age of five. They were causing sleep disturbances, affecting the development of his facial structure and impacting his speech.
Cue the ENT! As soon as the physician gave us the green light, we put a date on the calendar to have those bad boys taken out.
After going through it with my son, hearing so many stories from other friends and having a handful of people ask me for advice, I wanted to compile a list of what to expect after a tonsillectomy.
What to Expect After a Tonsillectomy
Please know that I am not a physician nor do I know your child’s current health nor individual medical history.
I am, however, a mom with a medical background (I am a physical therapist) who just recently helped her 5 year old son recover from a tonsillectomy.
I can only speak to the ins and outs of what we experienced and what our doctor told us.
It is up to you to use discretion and direct any questions you may have to you physician.
The day before the surgery, pack a small bag with you child’s favorite lovie, stuffed animal or blanket. Make sure to wash the item beforehand so it is nice and clean and germ free! Surgeons will usually let your child be wheeled back with the comforting toy although I’m sure they pluck it out of the sterile field before actually beginning the procedure.
Also include in the bag a few things to do while you’re waiting to be called back to the operating room. Perhaps a few books, coloring pages, crayons or a tablet with games or movies downloaded on it.
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Take note that there is absolutely NO food or drinks allowed after midnight the day of the surgery.
This “empty belly” rule may seem odd but it’s a very important safety precaution. If your child were to have food in their stomach and vomit while knocked out under anesthesia, they could possibly choke or aspirate (where foods/liquids go into the lungs).
Thus, make sure your kid has a good meal with things they love to eat and goes to bed with a contented belly the night before the surgery. It may be their last “real” food for a good week or two.
Make sure at least one parent or guardian has taken the entire day off from work. Your child will need someone home at all times who is familiar, attentive and caring.
Last, your doctor may prescribe medications that can only be filled after the surgery. Try and have a spouse, grandparent or other family member on call to go and pick that up if needed.
If your child has never been put under general anesthesia for a surgical procedure be warned that, when are coming out of it (usually 45 minutes to an hour after the surgery), they can be very cranky, agitated, groggy and confused. They may thrash about and try to pull at their IV line.
This state of agitation usually doesn’t last long (maybe 30 minutes to an hour) but it can be hard to watch and even harder to deal with. Just know it will end and be over soon. Do your best to hold them and comfort them. The doctor will most likely want you to try and encourage them to drink some water or suck on a Popsicle.
Most surgeons will not allow this anyway but plan to ONLY have the child’s parents or primary caregivers present at the surgical center. Too many bodies and voices before and after the surgery can be confusing and overwhelming. At this point, your child needs a quiet, calm environment full of gentle, comforting words.
Requirements to go home
Every doctor and child is different but plan to be at the surgical center for at least an hour after your child has come out of surgery.
The doctors and nurses will want to monitor their vital signs (blood pressure/heart rate/oxygen saturation) for an hour or so after the tonsillectomy. They will also want your child to be able to drink something or eat a popsicle before they will allow them to go home.
There will be pain and discomfort and, again, every child is different. Based on my own experience and stories I’ve heard from others, how a child will handle pain after the surgery is pretty comparable to how they handled pain before the surgery.
Are they pretty resilient and recover quickly after falling down and tearing up their knee? Then they should do fairly well handling the pain following a tonsillectomy.
Immediately following surgery, the discomfort is typically not that bad because they are still groggy from all the anesthesia. However, I recommend staying on top of it from the get-go and offering a dose of Children’s Motrin (Ibuprofen) or Tylenol as soon as they can swallow.
Check with your physician of course but we were able to alternate every 3 hours between Motrin and Tylenol.
Thus, if you gave Motrin at 7 am, you could give Tylenol at 10 am, Motrin again at 1 pm and Tylenol at 4 pm (and so on and so forth).
Needless to say, we followed the dosage recommendations on the back of the box based on our child’s weight and age.
In addition, our doctor prescribed a heavy duty narcotic to use as needed. After filling it, however, and reading all the side effects I decided… NOPE! I’ll just stick to the over the counter drugs. We never used it. That stuff is no joke.
Whether or not you wake your child up in the middle of the night to administer medicine is completely up to you but I highly recommend it for at least the first few nights.
If you do wake them up at night, measure out beforehand the proper doses of medication and have them ready with notes about which medicine it is and the right times to give them underneath (see picture below).
I don’t know about you, but I am a groggy, confused mess when I wake up in the middle of the night. The less critical thinking I have to do at 2 am, the better.
Perhaps the most shocking thing to me after the surgery was the way my child’s voice sounded. The first day, he could barely talk and would wince every time he opened his mouth to speak.
After that, I was shocked to see (or hear) that his sweet, slightly gruff 5-year-old-boy voice had been transformed into a high pitched voice reminiscent of someone who had inhaled a helium balloon.
It slowly got progressively better but lasted for longer than I had expected. Almost a month. Our doctor told us that this was normal but, if it persisted, speech therapy may be needed.
Foods to Eat
Second only to pain, this is perhaps a parent’s biggest worry following the surgery.
But… what on earth will they eat??
Take a look at my recent post, Foods you Can Eat After a Tonsillectomy, for a big list of food, drink, snack and meal ideas as well as some crucial things to avoid.
Suffice it to say, however, that a gradual progression of soft foods and a continual supply of cool drinks is key!
Our doctor ordered that we keep our son home from school for at least the first week following surgery. I honestly thought this was a little excessive but, after entering into the recover process, I could see that it was necessary.
Your child will be very lethargic the week following surgery. Expect and plan for a lot of rest time napping, watching TV, reading books or doing small crafts.
I will say that, for us, the second week was almost more challenging than the first in terms of energy level and discomfort.
I think it had to do with the fact that my son had reentered real life. He was back at school and expected to “perform.” He was getting way less meds than he was at home because school’s (at least ours) aren’t allowed to administer medications throughout the day.
The first three days back to school following surgery, my son came home and took a two hour nap. He was exhausted!
Thus, don’t over plan! Keep activities throughout the day and after school at a minimum for those first few weeks.
For the first week after the tonsils have been taken out I can almost guarantee that your child’s sleep will be disturbed.
You know how it is when you have a bad head cold…
You wake up and feel really congested. As the day evolves and you get moving, your congestion lessens and you feel a little better. Then, as the day winds down, the temperature outside drops and you become less active. Things in your head and chest start to settle and you feel worse.
The same cycle applies here following a tonsillectomy with kids feeling worse at the beginning and end of each day, often waking in the middle of the night due to discomfort.
Not only that but, at night, your child isn’t awake to take sips of water. The back of the throat can get very dry which is painful after a tonsillectomy and makes swallowing even harder.
They’re also not getting as much pain medication as they might be during the day.
Side note: for the first three nights we did wake my son up to give him medication every three hours. However, he’s a hard sleeper and it was incredibly hard to wake him up and was causing such a dramatic disturbance that we decided to stop after that. We concluded that it was best to let him tell us if and when he needed pain medication during the night.
Surprisingly, the worst days following a tonsillectomy are typically days 5 through 7.
I was surprised to hear this, of course, thinking things would obviously get better and better over time.
However, days 5, 6 and 7 are when the scab that has formed at the back of the throat is peeling away and sloughing off.
Clearly, this would be very uncomfortable and unnatural for a child to experience. Hence, the increase in discomfort and distress that typically peaks around those three days.
Your child will have pretty bad breath for the first two weeks after surgery and you may be wondering if you can brush their teeth.
Yes, you can! But carefully!
Brush their teeth for them that first week and be gentle! Don’t go too far back and risk jamming the toothbrush into the surgical site. Also, you don’t want to elicit their gag reflex and cause them to vomit. That would not feel good to someone who just had their tonsils removed.
Your child will need to avoid running around and any activity that would cause them to breath heavily or sweat for the first two weeks. Strenuous exercise can irritate the throat and, earlier on, can increase the risk of bleeding at the surgical site.
Again, I thought this was a bit excessive and, again, I was proven wrong. The biggest thing they need is rest and plenty of liquids.
I hope your child’s surgery goes well and they recover quickly! As for you, parents… may your compassion and patience level be at an all time high! God speed!
RELATED POST: Foods to Eat After a Tonsillectomy
Thank you for visiting The Flower Donkey today! I am honored that you stopped by and hope to see you again soon. As always, happy reading!