information for close family and friends · • unfortunately, a few patients do experience...

Updated 2018-04-28

Nationelltkvalitetsregisterföröron-,näs-&halssjukvård,Referensgruppenförtonsilloperation.http://www.tonsilloperation.se

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Informationforclosefamilyandfriends

Thepurposeofthisinformationistohelpeveryonewhoundergoestonsilsurgerytofeelasgood

aspossibleaftertheoperationandtoreturntonormalfoodandnormalactivitiesasquickas

possible.

CommonquestionsabouttonsilsurgeryWhydowehavetonsils?Thetonsilsareapartofthebody'simmunesystem.Theyarelocatedoneithersideofthethroat

andaremadeupoflymphatictissue.There'snoevidencetosuggestthattonsilsurgerycan

affecttheriskofdevelopinginfectionsfurtherdownintheairwayslateron.

Howistheoperationperformed?Tonsilsurgeryisaquicksurgicalprocedurethat'sperformedunderanaesthetic.Theoperation

canbeperformedintwoways:Eitherthewholetonsilisremoved,whichismostcommoninthe

eventofrepeatedthroatinfections,oronlytheprotrudingpartsthatblocktheairwayare

removed.Theear,noseandthroat(Otolaryngology)doctorwho'llperformtheoperationdecides

whichsurgicalprocedureisbestsuited.Thedecisiondependsontheproblemsthetonsilsare

causingyourchild.

Duringtheoperation,thetonsilsareremovedthroughthemouth.Thewoundwherethetonsil

usedtobeisleftopen,andthebleedingisnormallysmall.Thechildisverytiredafterthe

operationandneedstosleep.

Whenaretheadenoidsbehindthenoseoperatedon?Incaseswherechildrenareoperatedonbecausetheirtonsilsareenlarged,thesizeoftheir

adenoids(theglandsbehindthenose)isalsoconsidered.Iftheadenoidsareenlarged,theyare

alsoremoved.Thisadditionaloperationdoesn'tcausethechildverymuchextradiscomfort.

CanI,asaclosefamilymemberorfriend,bepresent?

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Aparent/closefamilymemberorfriendmayaccompanythechildintotheoperatingroomand

staywiththechilduntilhe/shehasfallenasleep.Aftertheoperation,thechildwillbetakento

therecoveryroomwheretheparent/closefamilymemberorfriendcanbepresent.

Arethereanyrisksinvolvedwiththeoperation?• There'salwaysariskinvolvedwhenananaestheticisused,butitissmallandallcareistaken

tomakesurethattheoperationisassafeaspossible.

• Unfortunately,afewpatientsdoexperiencebleedingafterhavingtheirtonsilsremoved.This

bleedingmostoftenstopsbyitself.Sometimes,thepatientmayneedtoreturntothe

operatingroominordertohavethebleedingstoppedunderanaesthetic.Don’twait-

alwayscontacthealthcareserviceifthereisbleeding!

• Thethroatshouldneverbleedoncethechildhasarrivedhomeaftertheoperation.Ifyou

noticeanybleeding,youmustcontactthehealthcareserviceimmediately.

• Therearewoundswherethetonsilsusedtobeandonthesewoundsgrey-whitelayersform

thatarethemucousmembrane'sequivalentofscabsontheskinandareasignof

healing.Theselayerscansmellbadandcancausebadbreath.Thelayersstartto

disappearafterapproximately7–10days.Thereisariskofbleedinguntilthewounds

arefullyhealed;thiscantakeuptothreeweeks.

• Thechildmayhaveaslightfeverthefirstday,butthisisquitenormal.Ifthechildisaffected

bythefever,youshouldcontactthehealthcareservices.

• Ifthepainkillersaren'tsufficient,there'sariskthatthechildisn'tdrinkingenough.Inthat

case,contacthealthcareservice.

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Whathappensnow?Ifyouhaven'talreadybeengivenadateforyourchild’soperation,youwillbenotifiedbypost,

telephoneore-mail.Youandyourchildmayhavetheopportunitytovisittheclinicinadvancein

ordertogetusedtothehospitalenvironmentandnotfinditsooverwhelmingorintimidating.

WhatdoIdoifmychildgetstonsillitis?Ifyourchildbecomessick,forexamplehasasorethroatoracold,wekindlyaskyoutocallthe

telephonenumbergiveninthenotificationyoureceivedabouttheoperationdate.Yourchild's

operationmayneedtobepostponed.

What'simportanttothinkaboutbeforetheoperation?

About14daysbeforetheoperation,thechildshouldn'ttakeanypainkillersorantipyretic(fever

reducing)drugsthatcontainacetylsalicyclicacid(suchasMagnecyl,Bamyl,Treo)orIbuprofen

(suchasIpren)andTrombyl.Thesedrugscangiveanincreasedriskforbleedingduringthe

operation.Ifsomeformofpainreliefisrequired,useparacetamolinstead(suchasAlvedon,

Panodil)duringthisperiod.

Thechildisallowedtoeatupuntilsixhoursbeforetheoperation.Afterthat,thechildisallowed

todrinkCLEARliquidsupuntil2hoursbeforetheoperationandnothingmoreafterthat.Clear

liquidsaredefinedaswater,clearcordials/fruitjuicesWITHOUTpulp.Theliquidmustnot

containfatandNOTnormalmilk,powdermilk,gruelorpablum.

Showerandwashthechild'shairtheeveningbeforetheoperationoronthemorningofthe

operation.Don'tuseanymake-up,perfumeornailpolishonthedayoftheoperation.Ontheday

oftheoperation,removeallitemsfromthemouthandalljewellery,e.g.removablebrace,

piercings,earrings,rings,bracelets,necklaces,wrist-watchandcontactlenses.

Whathappensonthedayoftheoperation?Beforetheanaestheticisadministered,yourchildundergoesamedicalcheck-up.Thisistosee

thatyourchildisingoodshapefortheoperation.You'llreceiveinformationaboutwhatto

expectfromthedayandhowyourchildwillfeelaftertheoperation.

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Whencanmychildgohome?Yourchildisallowedtogohomethesamedayastheoperationorthedayafter,dependingon

theroutinesatyourhospital.Thechildisdischargedwhenhe/shehashadsomethingtoeatand

drinkandfeelswellenough.Thenursingstaffdecideswhenthechildcangohome.Evenifonly

oneparent/closefamilymemberorfriendcanbewiththechildatthehospital,ifyou're

travellinghomewithyourowncar,itisimportantthatanadultsitswiththechildwhileanother

adultdrivesthecar.

Whathappensaftertheoperation?

Thethroatispainfulaftertheoperationandthereforeit'simportanttofollowtheprescription

andtakepainkillersregularly.It'snormalfortheintensityofthepaintoincrease4–7daysafter

theoperationandthentobecomeless.Thepainisnormallymuchlesswhenonlypartofthe

tonsilshavebeenremoved.

Thepainisworseinthemorning;thisistrueforseveralreasons.Partlybecausethechildhasa

drythroatfromnotswallowinganythingduringthenight,butalsobecauseit'sbeenalongtime

sincethelastpainmedicinewastaken.It'smorecomfortabletosleepatnightwithaslightly

highersupportundertheheadthannormal;theswellingofthemucousmembranesurrounding

theareaoperatedisdiminishedandthepainisthereforereduced.

Thetonguemayfeeluncomfortableforthefirstfewdaysaftertheoperation,becausethetongue

hasbeenpresseddownwithaspecialinstrumentduringtheoperationtomakeiteasiertogetto

thetonsils.Itwillusuallyfeelbetterifyoucangetthechildtomovehis/hertongue,thereforeit's

goodtogetthemtoeatanddrink.Also,theearsmayachewithouttherebeinganearinfection.

Chewinggumcansometimesalleviatetheache.

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PainreliefAftertheoperation,it'sveryimportanttotakepainkillers(medicinestostoppain).Thesemust

betakenaccordingtothedoctor’sinstructionsandatregulartimesforthemtohavethebest

effect.Getthechildtoeatapproximately30–60minutesafterhe/shehastakenthepainkiller,

sincethatiswhentheeffectofthepainkillerisatitsbest.Healthychildrenreceiveparacetamol

(forexample,Alvedon,Panodil)togetherwithanti-inflammatoryanalgesics(forexampleIpren,

Diklofenak)asbasicpainreliever.Additionalordifferentmedicinemaybeprescribedbythe

doctor.

Buythepainkillersinadvancesothatyoualreadyhavethemavailablewhenyouandyourchild

returnhomeaftertheoperation.YoucanbuyParacetamolandanti-inflammatoryanalgesics

withoutaprescriptionfromthechemist/drugstoreandinmanyshops.Youmayneeda

prescriptiontobuyotherrecommendedpainkillers;you'llbegivenadviceandanynecessary

prescriptionsbythedoctorinchargeforyourchild’streatment.

SicknessSicknessandvomitingarecommon,especiallyduringthefirsteveningaftertheoperation.Many

timestherecanbesomeoldbloodinthevomit(itlooksdark),sincebloodoftenrunsdowninto

thestomachduringtheoperation.Thesicknessusuallydisappearsthedayaftertheoperation.

FoodanddrinkIt'simportanttoencourageyourchildtoeatanddrinknormally.Ifthethroatisdry,thechildis

likelytofeelmorepain.Givethechildwhathe/shewishestoeat.Liquidandsoftfoodisusually

bestjustafterthedayoftheoperation.Hotfoodandfoodthatcanscrapethethroatshouldbe

avoidedforthefirstfewdays.

Howlongdoesmychildneedtostayathome?Thetimethatthechildneedstostayathomevaries.Whenonlytheenlargedpartsofthetonsils

havebeenremoved,thechildshouldbehomeforatleast4days.Whenbothtonsilshavebeen

removedcompletely,thechildshouldbehomeforatleast8days.

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Bedrestisn'tnecessary.It'sgoodforthechildtobeupundercalmconditionsevenduringthe

firstfewdays,andthere'snoreasontopreventthechildfromgoingoutsideifthechildfeelsup

toit.Ifatallpossible,avoidbeingwithpeoplewhohaveacold.

Thechildshouldnotbeallowedtodothingsrequiringheavyphysicaleffortduringthe14days

thatarenormallyrequiredforthethroattohealcompletely.

Follow-upMosthospitalsdon'thavearoutinetohaveplannedfollow-upvisitsaftertheoperation.All

tonsiloperationsinSwedenaremonitoredviatheNationalTonsilSurgeryRegisterinSweden.

TheQualityRegistryhelpsustoimprovehealthcare.

Youwillreceivetwoquestionnaires,thefirstafterthirtydaysandthesecondaftersixmonths.

It'simportantthatyouanswerbothquestionnaires!

Howyourchildcanhavethebestpossibleexperience

withhis/hertonsiloperation• Youcanavoidanyunnecessarystress/anxietybythoroughlypreparingyourchildbefore

his/hertonsiloperation.Acalm,well-preparedchildwithapositiveattitudetowards

whatwillhappen,experienceslesspain,handlespainbetterandrecoversmorequickly.

Thereareseveralthingsthatyoucandotogetherwithyourchildinordertomakethe

experienceaspositiveaspossible.Forexample,

• UsetheinformativematerialandthestoriesaboutEliasandMoaonwww.tonsilloperation.se

tohelpyourchildunderstandwhytheoperationneedstobedone.Youcanalsoenter

theAnaesthesiaWebwebsiteatwww.narkoswebben.se.Here,youandyourchildcan

learnmoreaboutwhatit'sliketobeinhospitalandwhathappensbefore,duringand

afteranaesthesia.

• Explainthathe/shewillfeelalotbetterafterhavinghadthetonsilsandpossiblyeventhe

adenoidsbehindthenoseoperatedon.Gothroughallthestepsthatwillhappenbefore,

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duringandafterthetonsiloperation.Themoreyourchildknows,thelessworried

he/shewillbe.

• Explainthatyou'llbethereatthehospitalduringthevisit.Letthechildknowthatyou'llbe

therewhenhe/shefallsasleepandwakesup.He/shewillsleepduringtheentire

operationandwakeupwhenit'sover.Assureyourchildthathe/sheneverneedstobe

alone.Everyonewillexplainwhattheyaregoingtodotomakeitfeelasconfortableas

possible.Askyourchildifhe/sheisworriedaboutanything.Thestaffcanthenexplain

moreanddoeverythingtheycantohelpcalmyourchild'sanxiety.

• Keepcontrolofyourownanxiety.Aworriedparentcaneasilytransferhis/heranxietytothe

child.Actcalmlyandinspireconfidence.

• Bepreparedthattheremaybewaitingtimesatthehospital.Bringsomethingalongtohelp

yourchildandyourselfpassthetime.

• Makesurethatyourchildbringsalongafavoritebook,acuddlytoy,asecurityblanketor

anythingelsethatmayhelpthemfeelsecure.

• Aftertheoperation,it'sagoodideatotalkabouthowthingswereatthehospital,ifitwas

toughand,ifso,why.Thechildcanexplainthroughdrawingapicture.Preferablyusethe

storiesonwww.tonsilloperation.seorwww.narkoswebben.se.

• Inadditiontoreceivingpainkillers,it'simportantthatthechildreceivesmoreattentionthan

usual.Byreading,playinggamesandwatchingTVtogether,thechildisdistractedfrom

thepainintheirthroat.

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TIPSonmorefunandexcellentinformationEntertheAnaesthesiaWebwebsiteatwww.narkoswebben.se.Here,youcanlearnmoreabout

whatit'sliketobeinhospitalandwhathappensbefore,duringandafteranoperation.Youcan

clickon"Read!"ifyouwanttoreadaboutwhathappens.Youcanalsoclickon"Hospital

Adventure"whereyoucandocraftsandpainting,watchafilmorplaygamestogetherwiththe

hospital'sclowns.

Important!

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Themostseriousthingthatcanhappenaftertheoperationisthatthereisbleeding.Inthatcase,

youmustcontacthealthcareservicesIMMEDIATELY.

Otherproblemsincludeinfectionorinsufficientpainreliefthatcanpresentproblemswhenit

comestodrinkingenough.

Isthechild's/person'sthroatbleeding?

IfYes,contacthealthcareservicesIMMEDIATELY!

Isthereanybloodinthesaliva?

IfYes,contacthealthcareservicesforadvice.

Doesthechild/personhaveahardtimedrinkingliquid?


Doesthechild/personsufferfrompaindespitetakingtherecommendedmedication

regularly?


Doesthechild/personhaveafever?

Aslightfeveraftertheoperationisnotdangerous.Ifthepatienthasafeverandisaffectedbyit,

contacthealthcareservicesforadvice.

Importantthatyoutomakesureto

• bringhomeaccurateinformationfromthehospitalwheretheoperationwasperformed

aboutWHATyoumustdoandWHOMyoushouldcontactintheeventofany

problems!

• haveanyIMPORTANTtelephonenumbersreadyifyouneedthem!

information for close family and friends · • unfortunately, a few patients do experience...

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