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Tonsillectomy Overview: what are tonsils, when do we take them out, post op diet & pain control

I'm Jean Loup and I'm an

otolaryngologist head and neck surgeon

or your nose and throat doctor here in

Los Angeles

and I wanted today to talk about

tonsillectomy and give you a little

overview of what it's like to take out

the tonsils taking out the tonsils is

still one of the most common procedures

of son in the United States every year

so chances are you've heard some family

or friends how tough it can be but if

you have enough problems from the

tonsils it probably makes sense to take

him out the most common reasons to take

out tonsils center around either

infections or obstructive symptoms or

blockage type issues from an infection

standpoint it can mean that you're

getting a lot of episodes of tonsillitis

where they're getting swollen and red

and drippy over and over and over again

if you have enough of those episodes it

might make sense to take them out

sometimes we take it out for chronic or

severe infections so even if you only

have one or two episodes if they're bad

enough if they last long enough

certainly if you get an abscess it might

make sense to take them out as well some

of the obstructive reasons where we may

take out the tonsils if for obstructive

sleep apnea which chops up your sleep

and gives you poor sleep quality

swallowing problems where you're gasping

or choking or having trouble getting

things down speech issues where it's

very muffled and hooked understand hard

to understand then those are all reasons

from an obstructive standpoint that we

may take out tonsils chronic mouth

breathing can also lead to changes in

jaw and facial development so in kids

sometimes we're doing it to prevent

growth and development issues of the

jaws some more rare reasons to take out

the tonsils would be for tonsil stones

or for a lump or mass and a concern for

cancer ultimately the surgery itself is

pretty easy it only takes ten or fifteen

minutes but you've got to be completely

asleep it is the back of your throat it

is kind of sensitive and for people or a

wide awake is just to gaggy and

sensitive so once you're asleep under

general anesthesia though it's a pretty

straightforward process that takes ten

or fifteen minutes we reach in the back

of the throat when we peel the tonsil

out from the muscle that's underneath

once that's done you've got an open raw

area in the back of your throat that

needs to heal

most people who get their tonsils out

get to go home the same day but for

small children under three years old or

for people who have bad and

sleep apnea and sleep issues they may

need to stay overnight once you get home

the main issue that people deal with is

a sore throat and trouble swallowing

generations of kids have gotten through

with popsicles an ice cream because cold

things that melt can be soothing help

with swelling but it's also the easiest

thing to swallow within a few days you

get to soft foods like mashed potatoes

and grits that are at room temperature

and then to semi solids like mac and

cheese that are slightly lukewarm

eventually you get back to solid foods

that are hot like hamburgers or pasta

ultimately though it might take you

three weeks to get back to Doritos in

general there's enough pain and

discomfort that people are taking

tylenol and motrin around the clock that

first week you're marching it out

usually in a six hour cycle so if you're

taking Tylenol every six motrin every

six and you alternate them you're taking

something every three hours so if for

example Tylenol at noon motrin at three

tylenol at six motrin at nine the older

you are the more likely you are to also

need a narcotic like morphine on top of

that if you end up taking a narcotic

that's fine but it's on its own schedule

and doesn't replace the Tylenol or

motrin most people are able to

dramatically taper down on the pain

medications after the first week because

of the pain and discomfort and trouble

swallowing and trouble sleeping for that

first week almost everyone is home from

school or work the second week most

people are able to go back as long as

there's not significant strenuous

physical activity so for children this

may mean no swimming no trampolines no

PE for adults this means no sports no

working out no swinging sledgehammers

and they're doing construction but if

what you have is a desk job or you're

going to school and sitting at circle

time

that's fine whether you go back to

school or work that second week is up to

you in general as long as you're not

doing anything really strenuous from a

physical activity standpoint it's fine

not having been said we all know people

that can't function when they're a

little bit sick or under the weather and

other people who are able to power

through everything medically it's safe

to go back whether you feel up to it as

a different story for children that

first week is very tough it's going to

test all of your parenting skills and

patience to get through the process but

you will get through it

the more you stay ahead of the pain the

better the more you force liquids and

stay hydrated the better it actually

doesn't matter if you can eat anything

for a whole week or so you might lose a

little bit of weight but medically

you're gonna be fine

the most critical thing though is that

you're able to get liquids down and stay

hydrated that's going to be crucial to

your successful recovery most patients

worry about the pain most doctors worry

about the bleeding risk so once you've

taken out the tonsils and you have the

open raw areas that are trying to heal

during that healing process the scabs

can fall off and you can start coughing

and spitting up blood thankfully it's

pretty rare it only happens about 3% of

the time when it happens it can be any

time from the moment you hit the

recovery room all the way through a

two-week healing process once you've hit

that two-week mark the bleeding risk is

gone but during those two weeks we don't

want you to be on an airplane on a boat

or camping in the middle of nowhere we

basically just want you somewhat near

civilization and on the ground and near

healthcare should anything happen most

of the time if you start coughing and

spitting up something red it's gonna be

mild and just little flecks of blood in

your spit or your phlegm if that's the

case sucking on some ice chips or

popsicle or gargling with ice water may

get it to stop the risk where the

bleeding is significant enough where we

need to reach back in there and

cauterize or put in a stitch is only

about 1% in older children and adults we

can generally do that in the office and

freaked out little kids or even anxious

adults who may perhaps have a very

sensitive gag reflex might need to go

back to sleep in the operating room

under anesthesia for five minutes just

to get in the back of the throat the

likelihood where you bleed enough where

you get a transfusion is less than one

in a thousand it's not high at all but

it's not zero almost always in children

they've completely recovered in two

weeks for quite a few adults it can take

three full weeks to be completely

recovered I know it sounds like a rough

recovery and it is but everybody gets

through it okay if you're the reasons

that you're gonna consider taking out

the tonsils is bad enough then another

way to think about it is packing in all

of your future suffering from the

tonsils into those two or three weeks

biting the bullet getting it a

with and moving along with the rest of

your life one last note we almost always

take out the adenoids when somebody's

getting their tonsils out adenoids are

very similar to tonsils but live behind

the nose in what we call the nasal

pharynx if you think about the area

where you're drinking a soda you lap and

it squirts around the back that's where

the adenoids live because you can't see

them easily by just opening your mouth

in the office people a lot of times

forget or don't even know that they're

there but taking out the adenoids is the

super quick and easy procedure and if

you're going through a tonsillectomy and

if you have any adenoid tissue at all we

pretty much always take it out at the

same time I hope this gave you some

useful information about what the

tonsils are and when we would take them

out if you have any additional questions

please leave it in the comments below

additionally if you want more

information about kids and surgery the

bleeding risk the post-op diet and the

post-op pain control I do have other

videos that go into each one of these in

more detail in my channel