Hello! (Small)Tonsillectomy recovery is painful for children and usually even worse for adults. Adults should plan on missing up to two weeks of work, and children, about one week of school.  During your tonsillectomy recovery, care should be taken to avoid strenuous activity as it may increase pain and can also increase the risk of bleeding.

Here are a few tonsillectomy recovery tips that can help you have a smoother recovery after your tonsillectomy:

Liquids are key. Your throat will be sore, but just like a stiff muscle, the more you use it, the less stiff it will remain.  Drinking large amounts isn’t necessary, but frequent swallowing is. Every time you wake from sleeping, the first swallow will always be more painful.  Expect it and reassure yourself the next swallow will be better.  If you aren’t getting enough to drink, the pain will increase and you will be at risk for dehydration.  Some of the symptoms that come with dehydration are decreased amount and darker urine, increased pain, lethargy and fever.

The next tip is to stay ahead of your pain with your pain medication.  Children usually will not receive narcotics, but adolescents and adults usually do.  We recommend taking your pain medication on a scheduled basis (be sure to make note of the time) for the first 4 days or so, to include awakening in the middle of the night for a dose. Be very cautious taking scheduled pain medication when narcotics are involved and substitute acetaminophen as much as possible.  In children, we recommend taking acetaminophen (or Tylenol) at a dose of 10 mg per kg of weight and ibuprofen (or Motrin or Advil) at a dose of 7 mg per kg (see table).  Both medications can be taken at the same time every 4 hours, or staggered so one or the other is taken every 2 hours.

Dose of acetaminophen or ibuprofen 
Weight teaspoons    ml
10-13kg
22-29lb
3/4 tsp 3.75 ml
14-18kg
30-40lb
1 tsp 5 ml
19-23kg
41-50lb
1.5 tsp 7.5 ml
24-28kg
51-61lb
1.75 tsp 8.75 ml
29-33kg
62-73lb
2 tsp 10 ml
over 40kg
over 87lb
2.5 tsp 13.75 ml

All doses are based on 160mg/5ml of acetaminophen and 100mg/5ml of ibuprofen (standard liquid forms, NOT INFANT)

For adults or anyone taking narcotic pain medications, the process is a little different.  If the pain is mild to moderate, take acetaminophen and ibuprofen every 4 hours.  If the pain is moderate to severe, take the narcotic and ibuprofen every 4 hours.  Narcotics should not be taken with acetaminophen because they usually already contain acetaminophen. Reassess pain every 4 hours to determine if acetaminophen or the narcotic will be taken with the ibuprofen for the next dose.  The standard doses of medicines for adults are 2 regular strength acetaminophen (325 mg each) or ibuprofen (200 mg each) every 4 hours.

Changes that are normal after tonsillectomy are pain in the throat and/or ears, bad breath, swelling of the tongue or uvula, shaggy-white appearance of tissue where the tonsils were (scabs), fevers and a small amount of blood in the saliva.

Changes that are not normal are bright red blood coming from the mouth, high fevers, lethargy and low and/or dark urine output.

Hopefully, this helps make the recovery easier. Above all, use common sense and call your doctor or go to the ER for anything abnormal or worrisome.