Post-Operative Instructions

for adenoidectomy

Diet

It is not unusual for patients who have received general anesthesia to have some nausea and occasionally vomiting, especially on the first night after surgery. Beyond this, please contact our office to see if any medication is indicated. It is preferable to have clear liquids for the first meal, then thick liquids or a soft diet (macaroni and cheese, mashed potatoes, soups, jellos, popsicles, smoothies, sorbets and ice-cream etc) as tolerated for 1-2 weeks. *Avoid drinking orange juice, grapefruit juice, and tomato juice for 1 week after the operation, as they make the throat burn. Gatorade or any flavored electrolyte drinks, apple, mango and grape juices made into ice blocks are very soothing. Please, no sharp, fried or hard foods that have a crust or hard, sharp edges for at least 2 weeks as this increases the risk of bleeding.

Wound care and other information

Your child may spit up specks of blood or may feel it dripping down the back of their throat in the first 48 hours after surgery, this is okay. In about 2% of patients there is some bleeding after 6 or 8 days. If this happens, do not become excited, for this bleeding is usually slight and stops spontaneously. Have the child drink iced water, or suck on ice chips and remain quiet.

If the bleeding does not stop within 15 minutes or multiple episodes occur, please call our office to speak with your surgeon or the on-call surgeon.

In the unlikely event that a doctor is not available and bleeding continues, please take your infant go to the nearest Emergency Room and have them contact our office. Please, also call our office the next morning to notify your surgeon of such bleeding.

Please note, bleeding may be increased if you eat hard, sharp foods as it removes the healing covering on the wound.

Showers are allowed with lukewarm (not hot) water beginning on the day after surgery. Please make sure to provide assistance even with adolescents, especially the first night as the pain medications often makes patients drowsy and occasionally dizzy.

General information and instructions

• Children should be kept indoors and relatively quiet for the first few days after surgery. Indoor play is allowed, as is use of the swimming pool as long as there is no strenuous activity.
• Frequent coughing and clearing the throat should be avoided, as this increases the risk of bleeding.
• An objectionable mouth odor is commonly observed and is relieved by abundant fluid intake. It usually resolves within 1- 2 weeks as healing progresses
• An earache may be expected, typically around days 3-5. It is usually not an ear infection. It is referred pain from the throat. Please contact your surgeon, if it is not relieved by the pain medication that was recommended.
• Occasionally, a transient neck stiffness may occur in children following adenoidectomy. It usually resolves within 1-2 weeks as healing progresses.
• Patients may return to school or daycare 1 week after surgery, though some patients may need a limited schedule in week 2.
• Fever - Most children experience a low grade temperature after surgery. This is usually caused by dehydration. Encourage fluid intake and if needed, use Tylenol (NOT ASPIRIN). If the temperature goes above 102.2 (39.0 Celsius) and does not respond to Tylenol, or if the child refuses to drink, then IV fluids may be required. Please call our office or go the closest Emergency Room.
• Do not use any ibuprofen (Motrin) related products for 2 weeks, unless cleared by your surgeon, as it increases the possibility of bleeding.
• Please do not allow your child to participate in any heavy lifting, exercise or physical contact for at least two weeks unless cleared by one of your surgeons. These activities increase the risk of bleeding. Usually, travel is not recommended within two weeks of surgery.
• If your child develops an upper respiratory infection, especially with coughing, please start Robitussim DM elixir, if over the age of six years. Call our office, if there is no resolution in 48 hours, or for infants less than six years old, as this may also increase their risk of bleeding.

Medications

• An antibiotic is occasionally prescribed following the surgery. Use as directed. If a rash or diarrhea occurs, this may represent an allergy, please stop the medication and contact your surgeon during office hours. If there is any difficulty breathing, please contact your surgeon as this may require being seen in the nearest Emergency Room.
• Regular children's Tylenol may be used for pain. The dose is usually titrated based on weight (10mg/kg) and may be alternated with codeine. You may also receive a prescription for painkillers in the form of Tylenol with codeine elixir (Tylenol #3). Use as directed.
  The codeine may cause somnolence, drowsiness and constipation. It is okay to use prune juice or over the counter laxatives for brief periods.
• Occasionally, if nausea or vomiting is severe beyond the first day after surgery, you may need to call the office for a prescription for anti-nausea medications.

Follow-up

Please schedule an appointment to be seen in the office in one-two weeks. PHONE: 310-657-6420

Note, it is difficult to refill pain prescriptions after hours, so please call during office hours and ask to speak with our nurse or medical assistant.

If your child has significant bleeding from the nose or mouth, develops high fevers or develops the worst headache of their life that is not relieved by the pain-killers, please call our office for the doctor on call or visit the nearest Emergency Room.