- The pain. I'm not going to lie. I knew it was going to hurt, but the actual level of pain that I had was unexpected and unbelievable. On a scale of 1-10, with 10 being the worst pain you can imagine, I had expected a pretty consistent 2-3 pain level. My pain level the first 9 days was consistently a 5-6, with spikes that regularly hit 7-8 and I had one really solid 10 pointer at one time. I had read a lot of stories online about adult tonsillectomy pain, but I told myself two things: 1) I surely have a higher pain threshold than these randoms, and 2) only people who have extreme experiences feel compelled to get online and talk about it. I assured myself that I was reading about worst-case scenarios and that mine would be different. It wasn't. The recovery was significantly worse than I expected. I can't sugarcoat it, the pain was really bad...it was just really bad the first 9-11 days, and got worse at some points.
- Sleep was my worst enemy. This is the complete opposite mentality of recovering from any other illness/procedure! Normally sleep is your friend: it helps time pass, it let's you get away from pain for a little bit, and helps you heal. After a tonsillectomy, you have to chew ice or sip water constantly to keep your throat moist. Sleep prevents you from being able to do this, and the worst pain I've felt in my life is when I slept too long -- too long meaning one continuous hour of sleep. I had a 48-hour period where I set my alarm every 15-20 minutes because I was so terrified of the pain associated with sleeping any longer than that (finally we called the doctor and just insisted on more pain meds, which then did allow me to get more sleep).
- I really couldn't talk for awhile. I thought this would last maybe a day or two, but I don't think I talked for the first 8-9 days. Perhaps I could have pushed it and tried to talk more, but I was in so much pain that the thought of producing sound from that area of my body seemed impossible. The safer route was to keep quiet. This reinforces the need for a nurse; even in today's technological age of texting and e-mails, it's still amazing how much you need your voice! I needed my mom to represent me on the phone when it came to asking questions of the doctor, sorting out refills at the pharmacy, and dealing with my short term disability company.
- My uvula swelled. A lot. It was like a big square tag hanging down the back of my throat, and was the worst on the second day. I hadn't read that anywhere online and called my doctor (had my mom call the doctor) because it was slightly gagging me and I was concerned that it was going to keep swelling. It turns out it is normal, and he offered me steroids to help it, but I turned down the steroids as I've experienced some bad side effects from them in the past. In retrospect I am very glad I just dealt with the uvula and turned down the steroids.
- It took me a long time to fully recover. Today is day....23? And I'm still not back at the office. If I had a less-demanding job, or a role where I didn't need to talk as a function of my position, I think I could be back, but honestly I'm still just not up to it. Not to mention I've really taken my time weaning slowly off the Vicodin (my doctor and the internet stories about withdrawl symptoms have scared me into taking the weaning seriously). I'm still on an extremely low dose of it, and hope that tomorrow is my first day without meds and back to "normal."
- If at all possible, enlist a friend/family member to be a nurse. You'll need it. I was insanely fortunate that my mom is retired and was able to fly in the night before the procedure to help take care of me. When we asked the doctor how long she should plan to stay after the tonsillectomy, he said "honestly, the entire 2 weeks." She booked her ticket to leave on day 16, and I was in tears the night before she left because I wasn't quite ready to be kicked out of the nest. My mom slept with me in my bed for the first 14 nights to help with pain meds as well as getting food, additional ice, etc. from the kitchen downstairs. I realize as I write this that I sound like a huge baby, but honestly it was nice to have a co-pilot for that amount of time. For the first 8-9 days, I really feel like she kept me alive!! I was in so much pain, so frustrated, and couldn't vocally communicate... I feel like I'm a practical person, and relatively low-drama...but this experience was way worse than I expected and there is simply no way I could have gotten through it without help. From drying my hair for me after a shower, to refilling ice packs with fresh ice at 4am, to getting a cold washcloth for my forehead when the pain meds made me nauseous -- I really needed my mom!
- ICE. ICE ICE ICE. If you remember nothing else from this site, it's have a nurse and have lot's of ice. I found that pellet-size ice works the best, and we bought 10lb. bags of it from the Sonic fast food restaurants. Throughout the recovery time period we went through over 250 lbs. of ice. Not exaggerating.
Let's spend some time on this. Ice was critical for me for the following reasons:-- For the first few days, all I wanted to do was chew ice. It was the only thing that helped with the pain. I'd slightly chew the ice and then hold it in the back of my throat. Anytime my ice cup got even close to empty, I would get extremely nervous as I needed this constantly for the first week.
-- Everything I did sip, I wanted ice with. Water with ice, Gatorade with ice, chicken stock with ice, applesauce with ice. If it wasn't ice-cold, I couldn't handle consuming it.
-- MOST MOST MOST IMPORTANTLY: ice packs. I asked my doctor about ice packs in advance, and he was very neutral about them; he said they didn't help but didn't hurt. At the hospital they gave me two ice packs for my neck, and I could hardly let those ice packs leave my side the first few days. Then, for the entire first 12 days, I had ice packs ready day and night. Tips for ice packs: 1), we wish we would have asked the hospital for extras of their refillable ice packs as they worked great but one started a leak pretty early-on, 2) we bought re-freezable ice packs from Target in the first aid section, 3) from Amazon, I bought a "Imak Neck Support - Hot Cold Wrap Around Neck Support," it had a furry cover that felt really good when I wanted slight cooling for long periods of tme. Any time I felt sharp pains, which was often, I'd clutch ice packs to my neck for 10+ minutes and the pain would get under control. I cannot emphasize how much they helped. While they just "felt good" for the first week, they were absolutely critical once the scabs started to come off. I would be in tears when a scab came loose or when I woke up with a dry throat, and after 10 minutes with ice packs, the pain would be manageable. I used re-freezable ice packs (wrapped in dish towels) from CVS, as well as refillable pouches with pellet ice.
Managing this much ice is an issue. We found the best way was to get 3-5 bags at a time (asking people to go on ice runs and deliver it to us) and store it in coolers, because even if we could fit in the freezer, it would freeze too hard and my mom/nurse would be downstairs at 3am trying to chip off ice. In the coolers, you do get some melt but it stays loose enough for scooping and general use. And at $1.59/bag, it's well worth it.
- Be OCD about your pain meds schedule, and chart your pain meds. My great nurse instilled this in me. We charted EVERYTHING. I was on a Vicodin/codeine liquid solution and was taking 3 teaspoons every 3 hours. It seems like overkill to create a schedule and write down the time, dosage, and a check mark once you swallow it, but once you throw in a secondary pain med (like I did on Day 7) and sleep exhaustion caused by staggering meds every 1.5 hours day-and-night, that charting thing comes in really handy. We consider ourselves lucky that we had no major accidents that involved double-dosing!
- Get your prescription filled for your medications in-advance of your procedure.
- INSIST on more pain meds if it's bad. Don't ask, insist. I had an out-patient cobalation procedure, I was in pain within 30 minutes of waking up from the surgery. I just laid there, frowning hard with my eyes shut, wondering what I had just done to myself. I mentioned the pain to the nurse and she gave me some Demerol. About 30 minutes later I mentioned it again, and she responded "oh I can give you another Demerol hit, I'm glad you said something just in time because we're going to release you in 30 minutes, and we have a 30-minute cutoff before that where we can't give you any more medication." I was in tears on the drive home from the hospital, and immediately wanted my first Vicodin dose as soon as I walked in the door of my house.
Later the same day of my surgery, my mom called the doctor (I couldn't speak) asking if we could increase the meds dosage as I was at a pain level 5-6. He said no. [*NOTE: I'm still angry at my doctor for this when I think back. He said I was on the strongest dosage, and in retrospect we should have insisted upon a different medication at that point, because I then dealt with a consistent 4-6 pain level for the following week.]
The night of Day 5 was rough. For the first 6 days I rarely slept more than 15-30 minutes at a time simply due to the discomfort of my throat. I'd wake up to sip ice water or put ice packs on my throat, day or night. Finally the night of Day 5, I fell asleep for over an hour. When the alarm went off for my meds I woke up and felt the worst pain of my life. It felt like someone was pushing their thumbs into open holes in my throat. I had tears running down my face and ice packs pushed against my throat, trying to help the pain subside. After that experience, I set my alarm for every 15-20 minutes to force myself to wake up and sip water -- I refused to let my throat dry out again. This went on for 2 nights (in retrospect, the ridiculousness of this sleep deprivation was not conducive to my healing) and finally my mom and I called the doctor, both of us in tears (mine were silent) insisting on more pain meds. He prescribed liquid over-the-counter Ibuprofen, which made me cry more because I thought it was a complete BS token gesture. I was wrong. That Ibuprofen made a bigger impact than I could have EVER imagined! We staggered the Ibuprofen with the Vicodin, and I started sleeping again.
- Food is doable. If you're like me, you may actually be looking forward to losing weight from the recovery (only silver lining of the whole thing) but perhaps because I had such a great nurse, I really didn't lose any significant weight. Here's what worked for me:
-- On advice of the hospital, I bought Icee-brand frozen slurpee cups (in the freezer section of Frys/Kroger) that are like convenience-store slurpees. Those were the most substantial thing I got down the first 1-2 days, and they tasted better to me than most other things.
-- I couldn't sip pure liquid (just chew ice), but my nurse/mom made "Gatorade Slushes" in the blender with ice and Gatorade, and those went down well at-times.
-- Drinkable yogurt/yogurt smoothies (I liked Stoneyfield Organic, sold at Super Target and Whole Foods), frozen into styrofoam cups and then microwaved for 15-20 seconds. Like a yogurt icee.
-- Unsalted chicken stock with ice. It's hard to find, but our Super Target had unsalted chicken stock which is loaded with nutrients but very low sodium (much lower than reduced-sodium stock). I found that high-sodium foods irritated my throat. We tried pureeing (liquifying) Chunky soups to get more nutrition, but the sodium level just made them too hard to get down.
-- My genius nurse cooked Campbells chicken noodle soup, poured out all the high-sodium broth that the noodles are canned with, and put just the drained chicken/noodle mixture in a blender. She then added unsalted chicken stock to make it back into a soup, and pureed the whole thing. The pureed noddles and chicken made the consistency creamy and flavorful -- it was AMAZING! I think we started this on day 3 or 4 and I wanted it for every meal. With ice :-) I wasn't brave enough to try it warm for quite awhile,and put ice in everything including my soup. She would make batches at a time and we just kept it in the fridge at all times.
-- Once we figured out the utility and versatility unsalted chicken stock, we started making soups. I have a great butternut squash soup recipe that we modified, and that tasted amazing as well.
-- Applesauce. Great staple.
-- After the first week, Jello with whipped cream.
-- Other second-week foods: pureed creamed corn (homemade), polenta cooked very soft/mushy with lot's of chicken stock, mashed potatoes with gravy to keep them moist.
-- I didn't really like popsicles for some reason (they work great for most people) and the ice cream I had on-hand always had little chunks of stuff in it, which bothered me. To boot, I simply have never had a sweet tooth. So that's why I had to get inventive with the savory options above!
- Prepare your healing space. I knew I would be in my bedroom a lot, and the week before the procedure I was lucky enough to have a friend in town who helped me select some fun new lamps, hang new art, etc. which sounds silly but it was nice to spend time in a place that I enjoyed being. Most importantly, on the advice of my doctor, I purchased a high-powered humidifier (from Costco.com). I really think this helped with sleeping because I live in Arizona and the dry air can make it painful to breathe solely through my nose at night. Because the humidifier kept the air in my room so moist, I could comfortably breathe through my nose and keep my mouth closed tight while I slept! Falling asleep with mouth open = breathing through mouth = dry throat = worst nightmare.
- Entertain yourself. My iPad became my best friend, and I went through a ton of content via Netflix and HBO GO apps (so much so that my internet provider contacted me about data usage). Because I was up so much throughout the night, I watched a lot of classics on my iPad and drifted in and out of sleep with my headphones on. My mom and I also tried to have "movie nights" with rentals that we both wanted to watch. Because the pain meds make you operate in 24-hour cycles, it's nice to have some things to look forward to.
- Keep a flashlight by your bathroom sink and look in the mirror at the progress in your throat. I just thought it was really interesting to see WTF was going on back there that was causing so much pain. I would always have my mom look first, and as it got closer to day 6-7 she told me I probably didn't want to look! So I let the bliss of ignorance play out for a few days. But for the most part I found it fascinating.
- Try to keep a positive attitude. As my doctor said, the good news is that they don't grow back! So eventually the pain DOES end, and your voice DOES come back, and you will slowly start to feel normal.