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PRIOR TO SURGERY:
- Avoid all aspirin, salicylates, salicylamide, and ibuprofen-containing products for two weeks prior and two weeks after surgery (see separate list). Tylenol is an acceptable alternative.
- Schedule pre-op appointment with our office 1 – 2 weeks prior to surgery.
- Fill all prescriptions for post-surgery medications prior to the day of surgery.
- Usually no pre-op blood work will be required for children undergoing surgery.
- Do not eat or drink anything after midnight.
- You will need to arrive one hour prior to your surgery time.
- You will be contacted by the surgical facility 1 – 2 days prior to surgery regarding specific instructions and possible alterations to the instructions above.
THE DAY OF SURGERY:
- Wear comfortable, loose fitting, clothes (children may wear pajamas).
- Children may bring a favorite stuffed animal or blanket.
- Do not wear any jewelry.
- Remove all make-up and nail polish.
- Parents will stay with their children in the pre-op area until we are ready for surgery.
- Parents will not accompany their children into the operating room.
- In general, most younger children will be put to sleep using anesthetic gas delivered through a mask. This is a quick and painless process. However, beyond a certain age and weight, it becomes safer to place an IV prior to administering anesthesia.
- The operating room time (including time to go to sleep, time to set up, time for surgery, time to wake up, and time to transport) is approximately 45 minutes for adenoidectomy and 1 hour 30 minutes for tonsillectomy and adenoidectomy.
AFTER SURGERY:
- Parents will be brought back to the recovery room soon after surgery, and they will be present when their child wakes up.
- Most children wake up from anesthesia disoriented, agitated and upset. Although it may seem like they are awake, they continue to feel the effects of anesthesia for approximately 30 minutes.
- Recovery room time will vary between 1 and 3 hours, depending on the patient.
- Pain medication will be given in the recovery room, and you will be instructed when the next dose may be given at home. Do not take pain medication on an empty stomach (will cause nausea). Use of narcotic pain medication can lead to constipation and may require the use of stool softeners.
- Antibiotics should be started the evening following surgery.
- Diet: cool liquids and soft foods (jello, apple sauce, popsicles, smoothies, etc.). You may advance to more regular foods as tolerated. It is most important to maintain hydration with adequate liquid intake.
- A cool mist humidifier in the bedroom, and ice packs around the neck can be helpful with pain control.
- Call the office immediately if you experience any bleeding (after hours, Dr. Feinfield can be reached through the answering service).
- Avoid all physical activity / exercise / straining / lifting for 1 week following adenoidectomy alone and 2 weeks following tonsillectomy and adenoidectomy.
- Most patients can return to school or work in 3 – 5 days following an adenoidectomy and 7 – 10 days following a tonsillectomy.
- Schedule a 2 week follow-up visit after surgery.
HEALING ISSUES:
Any of the following may be experienced after this type of surgery. Do not be alarmed. They will usually resolve on their own as healing progresses.
- Bruising or soreness on or under the tongue. This is due to the device that is used to hold the mouth open during surgery.
- Ear pain. This is called referred pain and is due to the pathway of nerves to the throat and ears. There is nothing wrong with the ears themselves.
- Bad smell from the nose or throat. This is due to the cauterized tissue and scab, and it does not signify infection.
- White coating where tonsils used to be. This is the normal color of the scab-like protective coating that forms. It will go away as healing progresses.
- Fever. This is related to the inflammatory reaction that takes place after surgery. It does not signify infection.
- Swelling of the uvula or tongue. This is usually temporary. However, if it is severe enough to cause difficulty breathing, contact Dr. Feinfield immediately.
- Change in voice. Some alteration is expected as sound is now able to resonate up through the nose. However, other alterations are only temporary due to swelling of the soft palate.
- Change in swallowing. This is related to swelling of the soft palate initially or tightening of the soft palate later on, but it usually resolves on its own.
- Alteration in head / neck posture. Some patients will experience a temporary pulling of the head to one side or the other due to inflammation of the ligaments under the adenoid gland.
If you have any questions or concerns after surgery, please call our office. After hours, Dr. Feinfield can be reached by calling the office and having the answering service page him.