Jordan’s Big Guide to Adult Tonsillectomy

OK, so hold onto your boots. Yes, it’s not the most fun you’ll ever have in bed, but a
tonsillectomy can be a worthwhile endeavor. If you’re like me, your tonsils are actually
evil little sponges harboring nasty bacteria, and keeping them in your body is just too
creepy to be right. Getting them out was a brilliant move – I used to get colds, flus, and
strep all the time, and now, 3 months post-op I haven’t had a sniffle. Removal just gets
more painful as you get older, so it’s now or never, folks! Just read my guide ahead of
time, and I’ll help you get through it. Also check out Lisa MP’s guide (click here) for
those caring for the adult getting a tonsillectomy – full of good info as well.
Getting a tonsillectomy is actually primarily a mental challenge, so here’s the info you
need to get your head ready.

Prep
First of all, find a doctor who offers coblation if you can. Coblation is one of several
tools that your doctor can use to separate your tonsils from the rest of you. Coblation uses
some kind of ionic wave instead of cauterization or a scalpel and my internet research
indicated that it may be a less painful way to go. Well I am here to tell you that coblation
clearly saved me an enormous amount of pain and healing time. This is especially good
if you, like me, turn out to be unable to tolerate your pain medication and have to do this
whole thing on Tylenol alone. I had to pay $150 extra for coblation, and it was worth
every cent.

Get your supplies in order ahead of time. This includes the following essential items:

Must Haves
  • A warm mist humidifier (Cool mist humidifiers don’t do a danged thing)
  • Throat numbing spray, such as cepacol (not mentholated!)
  • Your prescription meds
  • Acetaminophen – AKA Tylenol (you can get liquid, I was able to swallow pills without problems
    myself). NOT aspirin, etc – these can thin your blood and cause problems.
  • Something like Miralax to manage constipation (from the pain meds). 
  • Enough ice packs to completely encircle your neck twice (so one set can be freezing while you’re
    using the other set)
  • Some liquid with calories – Gatorade, chicken broth, rice milk, popsicles. . . Just avoid
    anything acidic (unless burning pain is your thing)
  • Heating pad/hot water bottle/buckwheat pillow to be microwaved (for ear pain)
  • Ice
  • Helpful, long-suffering person (more below)

Optional
  • I used a Camelbak, which is a plastic water bladder with a tube and mouthpiece.
    You can just suck on it all day, taking small sips of water. It was ideal. You can buy these at
    camping stores or the camping are of your local giant store (Wallmart, Target, etc.).
  • Scopalamine patch for nausea – prescription, ask your MD
  • Probiotics – get some with Lactobaccilus and Bifidobacterium. Take these both *during* and *after*
    your course of antibiotics. Taking them during reduces the side effects from antibiotics, taken after
    they help reestablish gut flora after antibiotics have killed about 1/3 of them off.
  • Guaifenesin – liquid if possible. Sometimes with the liquid lortab. 
  • Mucinex – helps create mucus which coats the throat and keeps it moist and comfy.
  • Similisan Children’s Earache Relief ear drops
  • Something fun to watch, unless you already get cable, or to read. My sister brought me
    the entire first season of the TV show Heroes, for example.
When you get home, set up a timer to go off every time you’ll need to take a pill. Each time you take a pill,
use it as an excuse to drink as much water as possible with it. The first night you are home, put water,
medicine, and optionally something to line your stomach with (meds bother some people on an empty
stomach – I had a glass of rice milk, because real milk isn’t a good idea for the first few days) by your bed.
Set an alarm for every 4 hours (yes really), and wake up and drink a whole bunch of water, line your stomach,
and take your meds. The alternative is to wake up in major pain and to take much longer to heal. Trust me.
Don’t get behind on your hydration on the very first day – set your alarm for every 4 hours
for the first night or two. Sleep next to the humidifier. Drink, Drink, Drink! Nights/mornings will
be the hardest. You’re drinking less water at night, and you may be breathing through your mouth
in your sleep, which dries it out. So the first morning, if you wake up hating life, take heart that it
will get better.

Mental Prep
So my doctor told me that the first three days are the hardest. This was not my
experience. It was day 6ish, when I was hungry and tired of being in pain, and with my
scabs starting to crack, that was hardest. This is something that I’ve read over and over
in posts from other tonsillectomy patients – that it gets worse right when you think you
should be coming out of the worst of it. This can be tough, mentally. I recommend
assuming at the start that you’re in for two solid weeks of nonfun, that it will get worse
around days 5-10, and that you will be miserable. Then, if you’re not – it’s a nice
surprise! A lot of this experience is mental. The pain and lack of food can be quite
wearing on you. I arranged it so that I had something specific to look forward to each
day (pudding, a certain movie, a foot rub, etc.), and it really helped. I also warned my
caretakers that I might be emotional and crabby, and indeed I was. Whatever you can do
to feel taken care of, even pampered, I recommend doing that. Caretakers, consider
bringing home little gifts for your sick friends, and/or asking if they’d like you to read to
them. It will really make their day.
You will have gross breath and possibly a gross taste in your mouth once your wounds
scab over. You will loose weight, which you will promptly gain back once you can eat
because you’ll be so hungry and so in love with the wonder that is food. Also, expect to
feel a little stupid and fuzzy-headed for a while. General anesthesia may affect your
memory and your ability to do basic tasks like spell correctly, just for the first day or two.
Also, the pain meds will make you a little loopy. Nothing permanent.

Pain Management
Start early and hydrate. Drink massive, copious, ridiculous amounts of H2O. Suck ice
chips. Apply ice packs to the outside of your entire throat for at least the first day
(remove every 20 minutes for a bit, then reapply). Dehydration and swelling = big pain.
For ear pain, apply your heating pad/hot water bottle/buckwheat pillow that’s been
microwaved to your ear. Take your meds every 4 hours, even at night. You can always
call your doctor and ask for something stronger than what’s been prescribed – find out
ahead of time how you can reach her or him over the weekend! Take your pain meds and
Tylenol.

Food
It will really help keep the combination of pain medication and antibiotics from messing
with your stomach if you can eat a little something around the time you take your meds.
People have recommended to me that I take the pain meds and then eat 1/2 hour later, but
this made me nauseous. Maybe it will work for you, but I ate and then took my meds.
My doctor recommended cold, soft food, but several internet resources suggested eating
aggressively – ie rough food, to speed the healing process. Who is right? Dunno. I ended
up eating aggressively, in part because I was so hungry, and it seemed to work out OK.
My scabs were thin and sort of got worn away as opposed to peeling off in big gross
chunks. So, what can you eat? Here’s a list of some of things I tried.

Food That Really Worked
Hardboiled egg yolks, mashed up with a little chicken broth (sooo tasty, and great little
protein bombs)
Poached eggs
Yogurt, esp. the drinkable kind
Anything soft with melted cheese on/in it. In general, grease and chicken broth helped
lubricate anything you’re trying to eat and helped it not hurt to swallow.
Applesauce
Chicken broth
Matzo Ball Soup
Butternut squash soup
Smoothies (with only low-acid fruit, like peaches)
Fresh mozzarella was awesome (the kind that comes packed in water, not the Precious
brand cheap stuff you grate up for lasagne)
Club soda (helps settle the stomach)

Food that Kinda Worked
Cupcake with nondairy milk (I was desperate for chocolate)
Carnation instant breakfast
Mashed carrots (add chicken stock to thin it out)
Chocolate pudding
Hummus
strawberries
Avocado
Mashed potatoes (with gravy to thin it out)

Food That Didn’t Work
Dairy for the first few days – creates too much mucus (mmmm . . sexy!)
Milkshakes once my scabs formed – cold made my throat ache
Anything too thick/sticky (clam chowder, for example)
Veggie burger patty (too sticky)
Steamed broccoli (um, bad idea)

OK, Jordan, How Bad Is It Really?
Yes, I too read all the posts about how people wanted to stick a fork in their eye to
distract themselves from the pain. And I too was pretty scared.
But it wasn’t as bad as I feared. I even couldn’t keep the Vicodin or my antibiotics down,
so I did it on liquid Tylenol alone. I’m here to tell you that I, ahem, ‘was unwell’
(vomited) on day 3, and that didn’t even sting as bad as I feared it would. The challenge
for me was not that the pain is overwhelming, it’s just that you’re pretty uncomfortable
for a long time, and some things you take for granted – eating, swallowing, and speaking,
get totally interrupted. That’s hard psychologically, but the actual pain never made me
want to scream. I just got tired of it all. There was one time on day 6 when I walked into
a deli to get some soup, and the deli smells of roasting corned beef and all the other
things I couldn’t eat caused me to burst into tears and flee the restaurant. You get worn
down. But it is really quite manageable, especially if you are prepared mentally for what
is, essentially, a mental challenge. If I could do it, you can too.

And the Final Outcome
Getting a tonsillectomy was one of the smartest things I have ever done. Tonsils are there
to keep you healthy – when you’re an infant. After that they are just useless vestigial bits
that can end up collecting bacteria and making you sick. I was sick all the time, and not
with obvious, tonsil-related stuff. I had constant head colds, flus, annoying aches and
pains, as well as throat-related problems like strep and tonsillitis. After my
tonsillectomy, I am well for the first time in years. I sleep better. I can exercise without
worrying that it will stress my immune system and make me sick. I conquered my fear
and made my body a nicer place to be.