Ask a Doctor: 8 Answers to Your Post-Tonsillectomy FAQs

David Cuthbertson, MD

Doctor checking tonsils because child won't drink after tonsillectomy

There’s no way around it. Recovering from a tonsillectomy, especially as an adult, is just plain miserable. Children fare slightly better, but the process is hard.

Your surgeon will do everything they can to help you stay as comfortable as possible during your recovery. But regardless of how prepared you are, recovery from a tonsillectomy is usually unpleasant and painful. Because of this, most patients (and the parents of our tiniest patients!) have a lot of questions and concerns about the recovery process.

My child won’t drink after her tonsillectomy. Why does my ear hurt? Why am I coughing? Is it normal to a have a fever after a tonsillectomy?

These are all incredibly common questions. Below, we’ll answer eight of the most frequently asked questions we hear about tonsillectomy recovery.

common patient questions about tonsillectomy recovery

Question #1: Why Won’t My Child Drink After a Tonsillectomy?

Answer: Children often refuse to drink after a tonsillectomy. Although they may feel okay in the immediate postoperative period, their pain increases as their anesthesia wears off. Eventually, they don’t want to eat, drink or swallow. They might even hold their saliva in their mouths to avoid the pain that comes with swallowing.

Because hydration is important for tonsillectomy recovery, you may have to get creative to find ways for your child to take in enough fluids. Good hydration aids in healing, decreases overall pain, and reduces the risk of bleeding. The good news is, popsicles count as hydration.

Popsicles, slushies, ice cream and any other kind of cold, sugary drink you can imagine can all be good to get your child to “drink” enough fluids for a few days. The cold soothes their sore throat, and the sugar makes them want more.

If your child prefers warm fluids like tea, hot chocolate or broth, that’s fine too, although it’s good to make sure the liquid isn’t scalding. For now, we recommend setting aside worries about a nutritious diet; the most important thing for a few days is to keep your child hydrated so they can heal.

If you or your child absolutely cannot swallow, IV hydration is an option, but requires a trip to the ER or an urgent care center. We like to avoid this if possible as it’s always better to keep the throat moist and hydrate naturally.

Question #2: Why Am I Experiencing Voice Changes After My Tonsillectomy?

Answer: If your voice changes after your tonsillectomy, it could be for a couple of reasons. Because of the pain in your throat, you could be moving your tongue and throat less than usual, guarding the area. In this case, your voice will return to normal when the pain and swelling recede.

If your tonsils were really enlarged before your tonsillectomy, they may have muffled your voice. In that case, removing the tonsils changes the way your voice sounds by giving it more space to resonate and project.

Question #3: What Can I Do About Bad Breath After a Tonsillectomy?

Answer: There’s good news and bad news here.

The bad news is that there’s not much you can do to make your breath smell better in the days right after your tonsillectomy.

The good news? That unpleasant smell is actually an integral part of the healing process. As your throat heals, your body produces its own biological “dressings” for the wounds. As the healing process progresses, tissues slough off and can sometimes cause an unpleasant odor.

This smell will eventually go away. But in the meantime, we don’t recommend you use products like alcohol-based mouthwash to try to improve your breath. These can be incredibly painful on a healing throat!

Question #4: What Should I Eat After a Tonsillectomy?

Answer: We recommend you eat soft foods after your tonsillectomy surgery. Yogurt, pudding, Jell-O, soups, scrambled eggs, mashed potatoes, smoothies, macaroni and cheese: these are all good options that can slide down your throat with ease.

It’s best to avoid any foods that could scratch or irritate your throat, like chips, pizza or crusty breads. These could even scrape off your scabs before they’re fully ready. It’s a good idea to avoid carbonated drinks in the beginning phases of healing because the bubbles can cause pain in your throat. Spicy foods can also have the same effect.

Avoiding red drinks or foods like strawberry Jell-O is also a good idea. It’s important to keep an eye out for blood after a tonsillectomy. If you wind up vomiting or spitting and you see red from the food or drink, it might look like blood and cause an unnecessary panic. On the other hand, you’ll want to be able to tell if you do develop a bleed, which the red food coloring could conceal!

We also advise against using straws or sippy cups that require strong suction in the days after a tonsillectomy. This is because, theoretically, the suction from drinking through these could pull the scabs off your throat prematurely. (This is similar to the advice to avoid drinking through straws after a tooth extraction.)

Question #5: Do I Have To Stop Smoking After a Tonsillectomy?

Answer: While we don’t ever recommend smoking, it can be especially dangerous after a tonsillectomy. Smoking can dry out the tonsillar beds where your tonsils used to sit while they’re trying to heal. This drying can increase your risk of bleeding.

Smoking also decreases the supply of oxygen to your tissues. Since your tissues are in the midst of a difficult healing process, smoking can prolong that already difficult process.

Question #6: Why Do I Have a Cough After a Tonsillectomy?

Answer: Intermittent coughing after a tonsillectomy isn’t necessarily something to worry about, and it can happen for a variety of reasons.

When you’re intubated for surgery, a tube passes down your throat and between your vocal cords. This can cause quite a bit of irritation in your throat and can lead to a cough.

You may also have extra drainage in your throat. You would normally swallow it, but now your throat is tender and you can’t swallow easily. Consequently, the drainage hangs around, irritating your throat and causing a cough.

Or, your cough may just be a natural reaction from your throat in response to the insult it received during surgery.

Coughing can put pressure on your healing scabs, though. If your cough becomes frequent or powerful, you’ll need help to suppress it. Be sure to talk with your doctor before you take any cough medicines. It’s important to make sure anything you take won’t interact with your pain medications.

Question #7: Why Do I Have Ear Pain After a Tonsillectomy?

Answer: The ears connect to the throat by the nervous system, so it’s extremely common to have ear pain after a throat surgery. We call this type of pain referred pain. The pain actually originates where your tonsils were, but the nerves refer it to your ears.

(As an educational side note, because of this phenomenon, ear pain is one of the most common presenting symptoms for throat cancer.) 

Question #8: Why Do I Have a Fever After a Tonsillectomy?

Answer: We most often associate a fever with an infection. But a fever is just part of the body’s general immune response, and it’s closely linked to inflammation. After a surgery, as your body rushes to heal your surgical wounds, inflammation accompanies that healing process and can sometimes result in a low-grade fever.

A low-grade fever is fairly common after a tonsillectomy, especially in children. If the fever persists or becomes a high fever, contact your doctor to make sure it’s not a sign of infection.

Be sure to talk with your surgeon before you or your child take any medication to reduce a fever. The pain medications you’re already taking for the surgery may contain drugs like Tylenol, and it’s very important to make sure you’re not taking too much.

Still Have Unanswered Questions About Tonsillectomy Recovery?

ENT Associates of Lubbock is here to help answer your tonsillectomy questions. We perform tonsillectomies on patients of all ages, and we’ve walked beside all of them in the healing process.

Tonsillectomy recovery is never fun, but we try to make you as comfortable as possible so you can rest well, heal and be back to your normal routine before you know it.

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