[mvvette97]

Have to go in the 6th of Feb for the surgery. Kinda freaked out and starting to worry myself sick. I'm 40 years old so that doesn't help. Had a surgery when I was like 16 and was also put out for an upper scope for stomach problems and didn't have a problem bit not liking the idea of being put under for fear I won't wake up or something. Anybody have this done and what was it like? Is it a safe surgery?

[upstatedoc]

Make sure you ask for plenty of narcs.

[Templar]

Eh, I was 21 I think when I had mine done, so kind of an adult. It wasn't a big deal. The surgery itself is pretty quick, I think I was out for maybe a couple of hours at most.

Just be careful with what you eat afterwards, since anything crusty or hard can cause bleeding. If you start bleeding you may want to go to the ER... Typically they cauterize the spots in your throat nowadays but if you open them back up they really won't stop bleeding. I didn't have any issues, but heard of others that didn't follow advice and went right back to eating hard foods and were in the ER soon after because blood was gushing from their mouths.

They gave me a ton of tylenol with codeine too but I never used half of what they gave me so I gave it back to the pharmacy. The pain really isn't that bad.

[kscarrol]

Had a friend go this closer to 50 and he was miserable! The surgery is simple so wouldn't worry about that. It's the days after... My friend lost 7 pounds because he had real trouble swallowing after the surgery.

Templar gives good advice, stick to soft foods for a few days to avoid bleeding. Take your pain meds regularly. Don't wait until it starts to hurt! If the prescription says take every 4 hours, take it every 4 hours! At least for the first couple days... Once it starts to hurt, it's too late.

[mvvette97]

This sure doesn't sound good to me

[dreamingat30fps]

We had a friend in college who had his tonsils removed. When he came back he was full blown gay, now I'm not saying there's a correlation between having your tonsils removed and loving men, but... maybe.

I still have mine, however I dread these ticking time bombs in my throat, although I have never had any issues with them thus far (except tonsil stones) knock on wood.

[kscarrol]

Nah, you'll be fine. Just follow the doctors orders and take your meds... I will say I'm glad I had this done when I was six years old! Of course that was back in the sixties and they took them out at the first sign of trouble. A day of bed rest and ice cream and I was good to go.

[mvvette97]

Originally Posted by dreamingat30fps

We had a friend in college who had his tonsils removed. When he came back he was full blown gay, now I'm not saying there's a correlation between having your tonsils removed and loving men, but... maybe.

I still have mine, however I dread these ticking time bombs in my throat, although I have never had any issues with them thus far (except tonsil stones) knock on wood.

Your first comment about being gay i got a kick out of, haha. my friends have been giving me a hard time making gay comments about it as well. haha

[///3dkn]

Are you sure you want to do this??

I'm 31 years old and I'm actually on day 5 of my recovery. Surgery was safe. But let me tell you, this shit sucks! For medication, I was given oxycodone, liquid Tylenol, and a codeine mouthwash. Take your meds! You're going to need it and make a simple alarm clock schedule to help you log and keep track of when to take your meds.

I'm not hating life as much as I did on day 3 but it still sucks right now nonetheless. My tongue and throat is sore as shit and I can't swallow anything without it hurting. It's hard to talk. My scabs are still there and hopefully they fall out soon. Also my breath stinks really bad right now and the irony of it is that, my reason for getting them removed is tonsil stones.

The first few days I was eating apple sauce and jello and yogurt and Popsicles. Day 3 I started eating mashed potatoes and scrambled eggs, and last night I had a real dinner but I took forever to eat it coz it still hurts to swallow. But I feel like the pain has plateaued and hopefully I've seen the worst and I've lost about 8 lbs so far.

I don't wish this on anybody. I'm glad I did it but I would never want to do it again. And I wouldn't recommend this to anyone. The funny thing is, before my surgery, all the doctors involved with my surgery came up and asked me the reason why I came in for surgery today. I could have sworn I said "...to get a tonsillectomy." about 7 times.. Knowing in the back of their minds they knew the awful pain and aftermath this surgery provides and how much I'll be hating life.

Good luck to ya.

[1fastdoc]

Originally Posted by ///3dkn

Are you sure you want to do this??

I'm 31 years old and I'm actually on day 5 of my recovery. Surgery was safe. But let me tell you, this shit sucks...
Good luck to ya.

Never take advice about a surgery from someone who is in the acute recovery phase, lol. I have an adult ENT practice so most of the tonsillectomies I do are on people 20-40. I always see them back after 3 weeks -- because that's when they like me again.

I've never had an adult regret a tonsillectomy (after 3 weeks).

My spiel:
3rd week is scratchy and annoying but well tolerated.
2nd week is like strep throat.
1st week is worse.

I prescribe 60 percocet. I recommend taking them every 4-6 hours for the first few days to stay ahead of the pain. Catching up is almost impossible. I also don't care what you eat, but drink THREE LITERS of water daily. Dehydration will dry the throat and make the pain infinitely worse. Tonsillectomy is a 10 lb weight loss plan, but I don't charge extra for that. I've had a few pts come into the ER at day 8 in agony. They get 2L of IV fluids and walk out feeling fine. It makes that much of a difference.

Greatest bleed risk is day 7-8 as the whitish exudates slough off. A little spotting is ok. A frank bleed needs to be seen in the ER.

If you have a deviated septum and don't breath well through your nose, get a humidifier because mouth breathing at night will dry out the throat and make it much worse.

Tonsillectomy sucks. But, for those who have chronic problems from the little buggers, 2 weeks is a small price to pay (plus the $6-8k) to make them go away forever.

[dreamingat30fps]

Originally Posted by 1fastdoc

Never take advice about a surgery from someone who is in the acute recovery phase, lol.

Says the guy who bought an M3 with tonsil money.

[lebreeze]

Ice is your friend. I had mine out at 26. For the first couple days I would always have ice bags on my neck area it helped a lot. 8 yrs later never get sick anymore and gross stones are gone forever. Best thing I ever did

[1fastdoc]

Originally Posted by dreamingat30fps

Says the guy who bought an M3 with tonsil money.

Actually, for an insured pt I get about $240 for a tonsillectomy. It's under $200 for Medicaid. With turn over time in the OR it accounts for about a 1 hour block. My overhead is $202/hr. If I made a living on tonsillectomies I'd be driving a used Kia.

[NemesisX]

Originally Posted by 1fastdoc

Actually, for an insured pt I get about $240 for a tonsillectomy. It's under $200 for Medicaid. With turn over time in the OR it accounts for about a 1 hour block. My overhead is $202/hr. If I made a living on tonsillectomies I'd be driving a used Kia.

What drew you to otolaryngology over other specialties, and would you recommend the field to current day medical students?

[jstnstr]

Well I haven't had my tonsils out but I am an anesthetist so I can reassure you its a pretty routine low risk procedure like others have mentioned. Don't be afraid to take your pain meds post op and definitely don't ignore any bleeding.

Waking up from General anesthesia is never an enjoyable experience, and you will have to be intubated for a tonsillectomy. Ask whoever is doing your anesthesia to use an LTA (laryngotrachealanesthetic). It'll help numb up your vocal cords so you don't do so much hacking and coughing when you are waking up and they are removing the endo tracheal tube. That should help reduce any risk of immediate bleeding and may actually help with some post op pain.

Also if you get nauseous easily ask for extra anti-emetics because this procedure has a higher incidence of post op nausea and vomiting; mostly due to the fact some blood drains into your stomach. Definitely ask for Zofran and Decadron, maybe some Reglan too.

Best of luck. You'll do fine.

[1fastdoc]

Originally Posted by NemesisX

What drew you to otolaryngology over other specialties, and would you recommend the field to current day medical students?

I like surgery, I hate medicine. Head and neck is the most interesting and it offers a lot of variety, which I need.

With medicine changing at a violent pace and gov't intrusion causing overhead costs to skyrocket, which has driven many physicians into employed models, I would recommend a field that is as shielded as possible from that mess.

That has really come down to anesthesia. They are usually found in big groups that have a lot of negotiating power. The reimbursement is good and it is balanced with a pretty good lifestyle. I have yet to meet an unhappy anesthesiologist. A friend who has only been "partner" for a couple years makes over 300k and has 9 weeks vacation/year. I take 2 weeks, max.

Radiology varies, many are employed. Reimbursement has gone down and they face many of the same struggles. But they don't have to deal with whiny people, which is a plus.

Any clinical specialty is going to have to deal with Meaningful Use, which consists of jumping through lots and lots of hoops created by politicians and docs that work with politicians (and probably haven't seen a clinic in decades). They are destroying the concept of the doctor-patient relationship. I have had ins companies deny meds and I've gotten to the point that I've asked them what they would like me to prescribe. They then tell me that I'm the doc and it's my decision. Yeah, bullshit. But I'm not bitter.

The other option is to go for the highest paying specialties and hope for the best. Interventional Cardiology pays very well and with most Americans living on shit diets, it will be a highly needed field for decades to come. Those guys make 3x what I do at my hospital and I make above average for an ENT.

Ortho will always be in need. However, their reimbursement has also dropped and the call can really suck.

If I was to go back to the beginning, I'd go Anesthesia in a heartbeat.

[1fastdoc]

Originally Posted by jstnstr

Also if you get nauseous easily ask for extra anti-emetics because this procedure has a higher incidence of post op nausea and vomiting; mostly due to the fact some blood drains into your stomach. Definitely ask for Zofran and Decadron, maybe some Reglan too.

Best of luck. You'll do fine.

I haven't seen the LTA make much of a difference. From a comfort standpoint, they never remember. I've been under 4 times and all must have been "smooth" wake-ups as I have no memory of anything but the PACU. And if they buck on wake up and don't bleed, I sleep better that night. I'd rather the bleed happen when I can deal with it without screwing up my schedule. To date, I've taken back 1 tonsil from PACU and another one that had a bleed that night.

Decadron has been linked to increased bleeding so beyond the 4mg standard, I don't usually request any more. If I suspect a lot of palate swelling then I might bump it to 10mg.

Zofran is one of the best drugs on the planet. 8mg ODT (orally dissolving tablet) can be your best friend. Ask for 20 of them. They're blister packed and will keep for a long time. They tend to come in handy if you get a GI bug or after drinking a bottle or 3 of wine. I always have Motrin, Afrin and Zofran on hand.

[PINeely]

Originally Posted by 1fastdoc

I haven't seen the LTA make much of a difference. From a comfort standpoint, they never remember. I've been under 4 times and all must have been "smooth" wake-ups as I have no memory of anything but the PACU. And if they buck on wake up and don't bleed, I sleep better that night. I'd rather the bleed happen when I can deal with it without screwing up my schedule. To date, I've taken back 1 tonsil from PACU and another one that had a bleed that night.

Decadron has been linked to increased bleeding so beyond the 4mg standard, I don't usually request any more. If I suspect a lot of palate swelling then I might bump it to 10mg.

Zofran is one of the best drugs on the planet. 8mg ODT (orally dissolving tablet) can be your best friend. Ask for 20 of them. They're blister packed and will keep for a long time. They tend to come in handy if you get a GI bug or after drinking a bottle or 3 of wine. I always have Motrin, Afrin and Zofran on hand.

I see you're in Nashville, do you work at VUMC by any chance?

[1fastdoc]

Private group. I operate at St Thomas.

I know a good chunk of the Vandy guys though.

[jstnstr]

Originally Posted by 1fastdoc

I haven't seen the LTA make much of a difference. From a comfort standpoint, they never remember. I've been under 4 times and all must have been "smooth" wake-ups as I have no memory of anything but the PACU. And if they buck on wake up and don't bleed, I sleep better that night. I'd rather the bleed happen when I can deal with it without screwing up my schedule. To date, I've taken back 1 tonsil from PACU and another one that had a bleed that night.

Decadron has been linked to increased bleeding so beyond the 4mg standard, I don't usually request any more. If I suspect a lot of palate swelling then I might bump it to 10mg.

Zofran is one of the best drugs on the planet. 8mg ODT (orally dissolving tablet) can be your best friend. Ask for 20 of them. They're blister packed and will keep for a long time. They tend to come in handy if you get a GI bug or after drinking a bottle or 3 of wine. I always have Motrin, Afrin and Zofran on hand.

Well, I have worked with some surgeons who standby to glare at you if the patient bucks on extubation so I suppose each to their own. You do raise a valid point about bleeding but opinions vary as widely as personalities in medicine as I've come to see.

Zofran is definitely one heck of a drug, I give it to 98% of my patients and about the same amount wake with no immediate nausea or vomiting. As far as what happens In the pacu I can only say so much because I am rushed to wrap it up, write orders, and start the next case. But OP, definitely request a script for Zofran post op especially if you are taking narcotics.