Well, my super healthy significant other, Angela, is having her tonsils out at the age of 35, so I thought I would share some information about this process in case anyone was interested in knowing more about this proceedure. Ill keep this post running and update it before, during and after in hopes that some of this information might help others out.
Diagram of your tonsils
Angela maintains a whole foods, detox friendly diet throughout the year, exercises and is a master of supplementation. With all that, we noticed that she would come down with illness quite often including sore throats and strep throat. A visit to the doctor uncovered a hole in her tonsils “bigger than he has ever seen”. The doctor mentioned that this could be a big factor in her overall health, and by removing them she would likely see improvements in so many other areas.
Removing the Tonsils
What exactly are tonsils? They are located in your oral cavity and play a role in fighting off inhaled and or ingested pathogens. In Angela’s case, the ‘crater’ in her tonsils would allow food particles to get stuck and pave the way for infections. Her body would seem to be fighting a low grade infection for most of the year and leave her feeling run down, not to mention prey to colds and flu. For much of Angela’s youth she was plagued from chronic fatigue, which may also be caused by her tonsil crater.
As Angela worked on finding out a good time where she could get this procedure done and how much time she would need to get off work, she asked family members and friends who had their tonsils removed as an adult about the experience, and most of them remarked about how unpleasant this was. Most of them said it would lay her out for about a week, however when researching several sites on the subject we came across this article:
Introduction:There is a MAJOR difference between a child having a tonsillectomy and an adult having a tonsillectomy, and no it’s not that adults are bigger babies. The reality is that the older you are, the longer it takes for the body to heal; that adult tonsils are much larger than children’s and deeper rooted. Therefore there is more skin removed and more trauma. Even though they are the same surgery, DO NOT begin to compare the adult procedure to the child’s. If you start off recognizing that this is surgery and a traumatic experience to the body then your loved one will feel much more supported and it will HELP their healing process.
There are a lot of commonalities in the healing process. I’m hoping that other people who have had a tonsillectomy as an adult can add to this thread…Here is a quick run down on the very general healing process: There are 3 STAGES:STAGE 1: MODERATE PAINDays 1-3
(or thereabouts) are painful – Pain is usually in the moderate to severe stage. Doctors generally prescribe codeine, percocets, vicadin, or morphine, etc. and somtimes an antibiotic to help fight off infection. The most common form of tonsillectomy is to cut them out and cauterize the wounds. Drinking water is EXTREMELY IMPORTANT. The blood vessels that have been sealed are directly connected to the main artery in your neck. Sometimes there is nausea after the surgery (within the first 3 days). This is often from medication and the anesthetic leaving the body. Vomiting during this stage is very traumatic. Keep pushing water – no matter how painful it is for the patient to drink – have popsicles and crushed ice available to supplement the water. Usually the patient can eat some foods, even though it ranges from uncomfortable to outright painful. Tomato based products and anything else that contains acid (even bananas!) need to be avoided. Cold temperature and luke warm temp. are preferred. Some people have swollen uvulas and tongues and this makes sleep, breathing and functioning in general very difficult. Constipation from the medication can often be a problem, and constipation can increase the pain and discomfort for the patient and can increase the risk of hemorraging because of the strain put on the body. The patient may experience some mild to moderate referred ear pain during this stage. The white marks on the tonsil holes ARE the scabs – they are white because they are wet – keep them wet- aim for 100oz of water a day (even if they can’t consume that much, keep it as a goal). Swallowing is painful but by not getting enough water the pain becomes worse, thus less water intake, therefore higher risk of increased pain and hemorraging. Avoid Ice Cream – the dairy produces mucus that sits on the wounds – not a good feeling. The patient may need to sleep sitting up for the first few days due to the swelling of the mouth/throat. Get the recliner all cozy with blankets and pillows with a side table for water and meds. Surrender the remote control!
Things to keep on hand and remember for STAGE ONE:
1) cold water – see if you can find water fortified with electrolytes.
2) ice chips, popsycles – NOT RED – can make it difficult to determine if there’s bleeding;
3) soup broth, oatmeal, cream of wheat, jello, ensure, pudding, mashed potatoes and gravy, other purreed or soft foods.
3) stool softeners - give to patient right from the get-go to avoid it becoming a problem.
4) humidifier – to keep the throat moist while the patient sleeps
5) rent movies – have their favorite books and magazines, crossword puzzles.
6) keep visitors to a minimum
7) recognize that they might not need a lot of assistance in this stage – so take your cue from them.
ask them at least 3-4 times a day how they are doing and if there is anything you can do for them.
9) YOU DO the laundry, dishes, etc., if they say they can handle a chore, then let them, but don’t assume that if they can do the dusting one day, they can handle it the next day.
STAGE TWO – MODERATE TO SEVERE PAIN
Days 4-9 Just when you think your loved one is on the mend (and believe me, they’ll think so too!) the scabs start to come off. The pain this causes pretty much pushes the patient to and beyond their pain threshhold. The pain is not only in the throat, but in the ears – and is EXTREMELY painful – the patient will not be able to eat much – cold HURTS so warm tea and soup broth is generally preferred at this stage and this is generally when the patient becomes an emotional basket case, crying at the drop of a hat (which just further aggravates the throat). This stage is so disheartening and discouraging. The patient may have been in the process of trying to ween off pain meds, when all of a sudden they are hit by this awful stage. Please be very nurturing and understanding to the patient during this time – as you can imagine, there is nothing like feeling like you’ve had a major set back in your healing process. The good news is, this excruciating pain is a sign of healing – very gently remind the patient of this – chose your words carefully because remember, they are miserable and in agony and can be a little touchy and over sensative – whatever you do, do not minimize their discomfort or express confusion over the sudden decline. When you have already been suffering a significant decrease in food intake, constant discomfort – ranging in moderate to severe pain, disrupted sleep and lots of potent medication, it can only be expected to be emotionally at your worse during this stage. I remember crying four times a day and just desperately wanting a 5 minute reprieve from the pain that was so extreme and was so nauseas from the lack of food and constantly tensing all my muscles in an attempt to manage the pain. RISK OF HEMMORAGING at this stage is high. Drinking water is very painful – therefore increasing the risk of dehydration and hemorraging. This is when you lay down the law and make sure the patient is drinking at 18 oz of water every hour and a half. The scabs can come off in big chunks and if the loved one bleeds more than two teaspoons, get them to emerg. ASAP. Have them spit the blood into a cup (gross I know) but the doctor will need to know how much blood has been lost. This stage feels stagnant with regard to high degree of pain – it can last around five days so brace yourself and try to remember how brutal this is for the patient. Even though the patient is aware that it gets worse before it gets better, it’s still a major shock to the system when you hit rock bottom, and stay there.
Things to keep on hand and remember for STAGE TWO:
see list for stage one in addition to:
1) WATER – room temp.
2) warm liquids – tea, broth.
3)) kleenex – for the crying fits
4) anti-nausea medication
5) peroxide and water – to gargle if bleeding starts; also ICE cold water to gargle to seal the wounds
6) mineral or baby oil to heat and place in the ear canal and sealed with a cotton ball for the ear pain – which gives the throat pain a run for its money.
7) more movies
lots of hugs and kisses and validation of pain and discomfort.
9) keep visitors away – send a fresh flowers to your loved one – remember this stage is extremely depressing and feels like it lasts forever.
10) let them vent their little hearts out – they need to get it out. Remember “This too shall pass in the fullness of time”
STAGE THREE – MODERATE TO MINOR PAIN AND DISCOMFORT
Day 10 (or thereabouts) - The patient tends to experience a significant improvement that almost catches them off guard on day 10 or a few days afterwards. Their hope is recharged and they feel better emotionally. They can eat more and therefore have more energy. They tend to steadily progress from this point on. Although there will continue to be some minor discomfort and possible residual affects for weeks to come. Just because the pain is gone, doesn’t mean the throat is done healing.
Things to keep on hand and remember for STAGE THREE:
1) things are looking up! Keep pushing the water.
2) do not seek sex (seriously let them tell you when they’re ready)
3) encourage light activity – going for a walk, etc.
The surgery may also cause trauma to the taste buds. This will affect the way foods tastes for a while – sometimes a few months.
Angelas whole food strategy:
(Avoiding dairy, gluten, soy, corn)
· No aspirin or anti-inflammatory, 10 days prior to surgery (or after surgery).
· No food or water after midnight. Follow any additional directions your physician gives to avoid complications during surgery. If you feel your throat is extremely dry, rinse with water, but do not swallow.
· No food or water until anesthesia wears off (usually 4 hours). Do not drink any fluids until approved by a medical professional.
Clear Liquids (24 hours)
|· Water (room temp)
· Ice chips (crushed ice from Sonic)
|· Coconut water pops
Once given the okay, start with clear liquid served at room temperature. Do not drink ice-cold beverages or hot beverages, which will irritate the throat. The first few days after surgery, you will not likely feel like eating or drinking anything; however, it is very important that you start drinking fluids as soon as possible to avoid dehydration. Aim to drink 4 oz. of fluids every 30 minutes, to avoid dehydration. Furthermore, drinking and swallowing frequently speed your recovery. Until you are more comfortable drinking fluids, serve beverages at room temperature. You should avoid hot beverages in the first few days following surgery.
Ice chips and ice pops are encouraged. Do not drink dairy-based beverages for at least 24 hours after surgery as milk often creates phlegm or thick saliva that will irritate the throat. Avoid acidic juices from citrus or tomato drinks and carbonated beverages because they create a painful, burning sensation in the back of the throat. These include orange and tomato juice.
|· Rice protein with green superfoods and borage oil. (pops?)
· Vegetable broth (pops?)
· Good Belly probiotic beverage (pops?)
|· Chocolate almond milk pops
· Coconut milk pops & smoothies
· Sleepytime tea (room temp)
After the clear liquid diet, your doctor will advance you to a full liquid diet. This diet consists of liquids and foods that turn into liquids at room temperature. Foods allowed on the full liquid diet after the removal of your tonsils include juice, water, tea, milk, ice cream, ice pops, fruit ice, gelatin, milkshakes, strained soups, broth and pudding. A full liquid diet is more adequate in calories and protein than the clear liquid diet. It may provide inadequate amounts of vitamins and minerals, however, and if you need to continue on a full liquid diet for several days owing to issues with swallowing after tonsil removal, your doctor may suggest a vitamin and mineral supplement. You can also consume nutritional supplement drinks on a full liquid diet, and these can provide the missing vitamins and minerals.
|· Mashed sweet potatoes
· Mashed butternut squash
· Pumpkin Pudding
· Pureed: Berries, bananas
· Coconut yogurt
· Coconut ice cream
When you feel ready, you can begin a soft food diet. Traditional soft foods include gelatin dessert, pudding and ice cream. However, if you would like to have something a bit more substantial, eat a noodle soup, scrambled eggs or mashed potatoes. Be careful about adding too much seasoning, as a lot of spice may irritate the throat making eating difficult. While this diet of soft foods seems to lack basic nutrition, this is fine for a couple of weeks as you heal; weight loss is common during this time.
Broths and Soups
Broths, such as chicken, vegetables and plain broths, provide your body with important nutrients. You should start with plain broths and progress to broth-based vegetable soups later in your recovery process. This ensures that any surgical site stitches are not disturbed during the digestion process. For best results, blend or chop your soup vegetables into small pieces for easier swallowing.
It is important to consume fruits after tonsil removal because they contain antioxidants, vitamins and minerals, which are important during the recovery process. You can puree fruits in a blender or food processor to achieve a smooth texture. You also can buy pureed peaches, bananas, papayas, blackberries, blueberries, strawberries, raspberries, peaches and pears. Applesauce also is a good option. Avoid citrus fruits as they may irritate the throat.
Probiotics, or “good bacteria,” are found in fermented and unfermented milk, kefir, miso, soy drinks, yogurt products and several cultured dairy products. Including probiotics in your diet might strengthen your immune system, promote digestion and assist in the recovery process. Choose products that contain “live and active cultures” for best results.
|· Scrambled eggs
· Steel cut or rolled oats
· Brown rice
|· Steamed veggies
· Salmon Sashimi
· Creamy peanut butter
After the body tolerates the initial soft foods, add more nutritionally dense items such as pasta, oatmeal, rice or steamed vegetables
You should avoid eating solid foods in the first week of recovery. Solid foods, especially like popcorn and cold cereal, may scratch or irritate the throat, potentially causing pain and bleeding. After a week or two, you can resume eating normally. It is important to ask your doctor what she suggests after tonsil surgery. You should also ask when she suggests introducing solid foods, as some doctors prefer to do a follow-up appointment first.
Foods to avoid include cookies, pizza, hard breads, crackers and nuts. Eating hard foods may scratch the back of the throat and cause bleeding. Do not eat pineapple, grapefruit or tomatoes. Choose easy-to-chew meats such as shredded chicken, tuna or sausage. If pain is associated with eating, take acetaminophen 30 minutes to an hour before your mealtime.
Stay tuned for more updates on Angela’s Tonsillectomy!