When the tonsils are removed sutures are usually not used to close the raw area. These raw surfaces are allowed to heal from the edges. During the healing period a small amount of blood tinged mucous may be coughed or spit up. If the adenoids have been removed, there may be a small amount of bloody nasal discharge as well.
You can diminish the chances of post-operative bleeding by remaining relatively inactive for the first two post-operative weeks. Specifically, you should avoid heavy lifting, bending over, straining and any form of vigorous exercise. Adults should plan on remaining home from work for ten to fourteen days until they feel well. Children should remain home from 7-10 days. They may return to school after this period of time but are not allowed to participate in any physical activity for an additional week. For adults, it is helpful to gargle with a solution of equal parts hydrogen peroxide and water every four to six hours while awake for the first two days. This cleanses the throat and helps to prevent bleeding.
There can be a considerable amount of discomfort associated with the removal of the tonsils. Tylenol will help children through this period. Aspirin and Advil tend to promote bleeding after surgery and should be avoided. Adults may require stronger medication as may children. Your physician may prescribe a pain medication for you. Sometimes the pain from the removal of the tonsils is felt mostly in the ears. This does not mean that you are developing an ear infection. For the first few days there may be a slight to moderately elevated temperature. This is normal. A cold washcloth around the neck may help some of the discomfort. There is often a bad odor to the breath for one to two weeks following surgery. This is due to germ growth in the raw, healing surfaces.
Initially, liquids are better tolerated than solid foods. It is very important to maintain adequate intake of fluids during the post-operative period. This will keep you both well hydrated and keep the tonsil area clean. Avoid hot liquids and soups for the first few days. Cold substances are generally better tolerated and help to prevent bleeding. You may eat solid foods whenever you feel ready but the sooner you eat the better your recovery will be. For the first week after surgery we encourage patients to chew gum between meals. This helps to keep the muscles of the throat relaxed and promotes greater ease of swallowing.
As the tonsil heals, a gray, sometime white membrane forms over the raw surfaces. This later turns red. This is part of the normal healing process and does not mean that any infection exists. Sometimes, a scab will dislodge from the healing surface 2-3 weeks after surgery causing some bleeding. If this occurs gargling with peroxide solution and remaining quiet with the head elevated will help.
Should the bleeding seem excessive or persist (2 tablespoons), you should contact the operating surgeon through the office. Should the problem occur after office hours, please come to the St. Joseph Mercy Hospital emergency room where the physician in charge will evaluate you and contact our physician on call.