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Monday, July 22, 2024

Tonsillectomy and Adenoidectomy: What to Expect and a Day by Day Pain Scale

In July, our 10-year-old went through a scheduled tonsillectomy and adenoidectomy due to the size of his tonsils, snoring, and sleep apnea. My time spent in the depths of the Internet preparing for the procedure cannot be overstated, and nerves were high for all of us (even his dad, who is a physician). People did not hold back in telling me how terrible recovery was going to be and how intolerable the pain would be. I'm here to offer a totally transparent, overview of our son's recovery process, including a pain scale for each day. This is the information I was after and was never able to find in one place. I'm also including everything that we purchased that significantly helped in his recovery that I would highly recommend having on hand.

Day 0: Surgery Day

Our son's arrival time at the surgery center was scheduled for 11:45am. He was not permitted any solids or fluids outside of water, Gatorade, or apple juice past midnight the night before. He woke up the day of surgery with a ton of nerves and sipped water and Gatorade until 9:45AM, which was the cut off for clear liquids. We arrived at Pre-Op and reviewed medical history and met with the surgical team for about an hour, at which time it was go-time. I was able to head back with our son to anesthesia, where he was given a mask to breathe in to (no pokes or IVs while awake). After a few breaths, he was already sleepy and nearly sedated, and they sent me to the waiting room with a number to monitor his surgical progress on a TV screen.

They had prepared us for a surgery time of 30-40 minutes. However, our son's status moved from PRE-OP to SURGERY IN to SURGERY OUT in 6 minutes flat. I actually called the emergency line thinking that the procedure was not able to be performed, but right as they were reassuring me over the phone, the surgeon strolled down the hall to let us know that everything was over and successful. They had let us know that they would allow our son to sleep for up to an hour post surgery before waking him up and allowing us back to see him, but it only took about 50 minutes for him to wake up on his own. He was still loopy and out of it when we went back, and over the course of the following hour was pretty uncomfortable. Waking up from the anesthesia was probably the hardest part of surgery day. However, about an hour later, he was fully awake and moved to an upright chair to sit in and he felt substantially better (likely from the Fentanyl he was given through IV during surgery). We headed home after about 2.5 hours in Post-Op, and the rest of the day was very manageable in terms of pain. He only ate popsicles and slushies and the hardest part was probably how hungry he was, but did not complain about being in significant discomfort.

Pain Scale: 5/10

Day 1 Post Op:

This day was a harder day. There were tears a few times and he felt discouraged about his pain and swelling. He was hungry but wouldn't eat anything outside of popsicles and Italian ice. Ice cubes were comforting for him to suck on and to chew. He wore his head wrap much of the day and liked the heat as opposed to the ice in the pads within it. This said, the pain was not unmanageable, and we made it through. Now that we've made it fully through recovery, this was the hardest day in hindsight.

Pain Scale: 7/10

Day 2 Post Op:

Pain became much better as compared to day 1. He ate a half of a scrambled egg, finely diced up Ramen noodles, and lots of Danimals smoothies. He was still slow and cautious and mostly spent the day in bed watching TV.

Pain Scale: 5/10

Day 3 Post Op:

This was a good day. He was so much more back to himself and was up, dressed, and building LEGOs. He ate mac and cheese and buttered noodles. He was really feeling encouraged and happy that he was already 3 days through his recovery and said that it wasn't as bad as he thought it would be.

Pain Scale: 3/10

Day 4 Post Op:

The day went very well and he was even outside playing with the neighbors (with MANY reminders from me to make sure he took it easy). He ate the same menu of soft foods. By evening, he was complaining more of pain and wore his headwrap, but after his next dose of meds, was back to the earlier / lower pain threshold he was at. 

Pain Scale: 4/10

Day 5 Post Op:

I was really waiting for things to take a bad turn on Day 5, but he continued feeling good during the day. He was outside playing with neighbors again, eating fluffy pancakes, yogurt, garlic bread, and ice cream, and overall, wandered around the house being bored. At around 6:00pm, some pain hit him pretty hard and he used his head wrap with ice. There were some tears and I was wondering if our luck was going to finally run out, but after his next dose of Ibuprofen a new movie, and some time spent laying down and resting, he felt well again.

Pain Scale: 3/10 (day); 8/10 (for a few hours at night)

Day 6 Post Op:

This day was an overall grumpy, cranky, and discouraging day for him. He was tired of having a sore throat, tired of having no outlet to wrestle and play soccer, and tired of not being able to eat the food he loves. His pain was generally fine, but there were a few times where it spiked, accompanied with tears. Again, the head wrap, lots of water, and pain medicine took the edge off. It was at this point that I realized the mental part of recovery was just as hard as the physical one.

Pain Scale: 6/10 (day); 8/10 (for a few hours at night)

Day 7 Post Op:

Another tougher day mentally. At this point, he was just done feeling not himself and really started to feel frustrated which came out through crying several times. His pain was fine during the day but increased in the evening. Sucking on ice and wearing the head wrap always do the trick. 

Pain Scale: 6/10 (day); 8/10 (for a few hours at night)

Day 8 Post Op:

The scabs are officially coming off. Lots of complaints of burning and stinging. Intermittent pain as a result. Nothing unmanageable through Tylenol and Ibuprofen, but modified diet to remove anything that might increase his throat even more irritation (acids, Gatorade). He was frustrated from the pain this day but also hopeful that his recovery now had an end in sight.

Pain Scale: 7/10

Day 9 Post Op:

Almost back to normal. He said the pain was minimal but I still gave him his Ibuprofen and Tylenol through the day. He ate almost completely normally--welcome back pizza!

Pain Scale: 2/10

Day 10 Post Op:

Nearly 100% with the exception of still needing pain meds. I went with the strategy of only giving them when he complained of pain, but as it turns out, this was like clockwork as soon as the previous dose ran its course. He still has some scabbing in the back of his throat (though almost gone), so I figure there's a reason why they call it a 10-14 day recovery. I'm sure the meds will be needed less and less over the next few days, but overall, I'm calling this thing COMPLETE.

Pain Scale: 2/10

BIGGEST RECOVERY TIPS:

  • Sleep upright on a wedge pillow with a humidifier blasting and take sips of water throughout the night. We never had any issues with sleep (other than the fact that it was often interrupted by alarms going off for Tylenol and Ibuprofen).
  • Never miss a dose of Ibuprofen/Tylenol (this is all we were given, and it was sufficient). Make sure you record/log your doses because it all gets confusing, especially through the night. Continue meds through at least Day 10.
  • Stay hydrated. I strongly feel this was the biggest factor. Continuing to keep your throat moist keeps pain under control. Chewing gum also helps.

LIST OF MUST-HAVES FOR RECOVERY:

Heated Wrap for around neck: https://amzn.to/4d3dRyt

Heated or iced head wrap: https://amzn.to/3W6otG7

Wedge Pillow for sleeping upright: https://amzn.to/3zJDvKm

Extra syringes for medicine: https://amzn.to/4cykgSt

Humidifier to run all night at their bedside: https://amzn.to/4bPyuNw

Clear water bottle so you can keep track of fluid consumption: https://amzn.to/3WniYnF

Ice machine has been really helpful and a nice-to-have: https://amzn.to/3SaDKEC

Stock up on dye-free ibuprofen and Tylenol (WAY more than you think you will need. I'd recommend 8 bottles of each). Red food dye must be avoided in case your child vomits so it can be determined easily whether there is blood.

Overall, this experience was such a shockingly and significantly more positive experience than I thought we were doomed for. Prepare for good days with some tougher moments built in. You can definitely make it through these moments. If you're prepared for the worst, I think you'll be pleasantly surprised. All this said, it was a solid 10 day recovery and then some. If you're on the fence, it is absolutely worth it to give your child the gift of having this taken care of before they reach adulthood, when this surgery is significantly harder and more painful. 

Wishing anyone in the tonsillectomy boat a speedy recovery--please reach out with any questions!


 
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