preparing for tonsillectomy/adenoidectomy

1. Pre-surgical history and physical form:
   • If your child's appointment was more than 30 days before surgery: Ask your primary care provider to fill out this form and fax it to the surgery department. It may also be helpful for you to bring a signed copy of the form with you on the day of your child's surgery.
   • If your child's appointment with us was within 30 days of surgery: You do not need to do this.
2. FMLA paperwork
   • If you need any FMLA paperwork completed, please ask us before your child's surgery.
3. Insurance checks:
   • Check for pre-certification, second opinion and pre-existing clauses that may be in your policy.
   • Check to see if your child's surgery is a covered procedure.
   • We will call your insurance company to check if pre-certification is necessary for your child's surgery. If it is required, we'll attempt to get that authorization.
4. Watch the video below and join Riley as he prepares for a procedure at Dayton Children's! 
   
   

   preparing for surgery at Dayton Children's

    Surgery can be a scary time for children, but Riley will walk you through what to expect when coming to Dayton Children's for a surgery or procedure.

5. Pre-surgery tour
   • If you would like to do a pre-surgery tour to help make you and your child more comfortable, call 937-641-4532.

• Avoid these medications two weeks before surgery:
  • No aspirin (including Pepto Bismol)
  • No ibuprofen (Advil, Motrin)
  • No anti-inflammatory medications (Aleve, Naprosyn)
  • No products containing Gingko Biloba or St. John's wort
• One of the surgery nurses will call to discuss your child's medical history. Please let the nurse know if there is a family history of bleeding tendencies or your child tends to bruise easily. 
  • Your child's medical history will be shared with the pediatric anesthesiologist who will use it to plan for your child's care.
• If your child is old enough to understand, it is important to prepare them for the procedure. Explain as much as you feel they can understand. View our tips for preparing your preschool to early elementary schooler, or late elementary schooler to teenager for surgery. 

Check this page for COVID-19 testing guidelines.

• Your child's surgery time will be confirmed the day before surgery. Make sure you know if you're going to the main or south campus. If you haven't heard from us by 4:00 pm the day before surgery, call 937-641-4269.
  • If you cannot make the scheduled surgery call, call 937-641-4647 right away to let our office coordinator know. We will reschedule the surgery.
  • We will do our best to keep your child's surgery at the scheduled time, but sometimes a need arises and we will need to change your time. For example, another patient may cancel and we may move your time up, or cases may need to be moved ahead of you to meet the requirements of our operating room. We will let you know as soon as possible if we need to change your time.
• Eating/drinking instructions before surgery
  • It is very important to follow these instructions. If they aren't followed, we may have to delay or cancel your child's surgery. Even a small amount of food or drink in your child's stomach during surgery can cause very serious problems.
  • No solid foods, candy, chocolate, chewing gum, or any form of tobacco products 8 hours before surgery. Examples include:
    • ​Crackers
    • Bread
    • Meat
    • Milk products, including yogurt
    • Fruits
    • Vegetables
    • Applesauce
  • ​Formula and non-human milk (ex: white milk) are permitted until 6 hours before surgery.
  • Breast milk is permitted until 4 hours before surgery.
  • Clear liquids are permitted until 2 hours before surgery. Examples include:
    • ​Water
    • Apple juice
    • White grape juice
    • Sprite
    • Pedialyte
    • Gatorade
    • Avoid any red-colored liquids
  • ​The following beverages are not clear liquids and should not be given after midnight the day before your child's surgery:
    • Orange juice
    • Banana juice
    • Pineapple juice
    • Grapefruit juice
    • Purple grape juice
    • Mountain Dew
    • Broth
    • Milk
    • Pediasure
    • Formula
  • Nothing is to be taken by mouth two hours or less before surgery.
• ​You may give your child a bath and wash their hair the night before surgery.
• Pack 1 or 2 of your child's favorite toys, blankets, stuffed animals or activities to help your child relax before and after the procedure.
• Bring the names and amounts of any medications your child is taking.
• Check our current visitor restrictions and COVID-19 policies. 

getting to the surgery center

Please arrive 1 hour before your surgery time so your surgeon and anesthesiologist can meet with you beforehand and we can complete any lab work or IVs that might be needed. Double check whether you are going to the main campus or south campus:

• Main campus: Park in the free parking garage and come in the main entrance. Your first stop will be the welcome center in the main lobby. They will guide you to the surgery center on the second floor.
• South campus: Park in the center of the free lot. The surgery entrance is on the right side of the building. Take the elevator or stairs to the second floor surgery registration area.
• We have made some changes due to COVID-19, including screening visitors and requiring face masks. View our most current processes here.

checking in and meeting your care team

• When you check-in at the registration desk, you and your child will get an ID bracelet. This is for your child's safety, so please leave it on and make sure your child leaves it on.
• Then you and your child will be taken to your room to prepare them for their procedure.
• You will meet with your child's care team, including a nurse, the anesthesiologist (doctor who gives medicine to make your child sleepy) and surgeon (the doctor who will do the procedure).
• The surgeon will talk to you about the procedure and answer any questions you have.
• Please leave your cell phone number so we can call you when your child is waking up. You can also track your child's progress during surgery by looking at the TV monitors in the waiting area. If you leave the waiting area, please let us know.

the tonsillectomy/adenoidectomy

• The surgery will be performed under general anesthesia either as an outpatient or with overnight observation. 
• The surgery usually lasts 10-20 minutes. 
• Your child will be in the hospital for up to 4 hours, or overnight for observation if needed.

school note

• Please ask for a school note after your child's surgery, before you are discharged.

Your child will have some discomfort and pain in their throat, jaw, ears, neck or mouth. The pain may be moderate to severe. Your child may have bad breath or snore. Their voice may sound different or may be hoarse, raspy or have a nasal sound. Here are tips for pain control:

• Place an ice collar around the front of your child's neck.
• A humidifier in your child's room will help keep the air moist. 
• Make sure your child drinks throughout the day. They should drink at least 3-4 ounces per hour (or a half cup) of any fluid (except red liquids) to stay hydrated. It will be uncomfortable, so you will need to work with your child to get them to drink.
• Your child should not use straws for 10-14 days after surgery. Sippy cups may be used if the valve inside the lid is removed so your child can drink without sucking.
• Nasal drainage may be wiped, but keep your child from blowing their nose and do not use a bulb syringe for 10 -14 days after surgery.
• All of the above symptoms are usually gone within 10-14 days.

pain control with medication

For two weeks after surgery, continue avoiding:

• All Aspirin medications (including Pepto Bismol)
• Anti-inflammatory medications (Aleve, Naprosyn)
• Products with Gingko Biloba or St. John's wort.

Ibuprofen and acetaminophen can be used for pain control. You should alternate acetaminophen and ibuprofen every 3 hours to control pain. For children 12 years old and older, prescription pain medicine may be given as well. If so, give as directed. If you have any questions about pain medications, let the office nurse know.

• Do not give your child any over-the counter cold/cough medicine or aspirin products.
• Keep track of all medicines given so you do not double dose your child.
• Always read the bottle label for instructions before giving your child any medicine.
• Do not use other medicines with acetaminophen or ibuprofen at the same time.
• Generic products are the same medication as their brand name products. Acetaminophen and Tylenol are the same product. Ibuprofen, Advil and Motrin are the same product. You can save money by buying the generic products.

Oxycodone/roxicodone:
Children continue to have pain even though they are taking acetaminophen and ibuprofen. For children 12 years and older having both tonsils and adenoids removed, the doctor may give another medicine called oxycodone/roxicodone. Below are some guidelines:

• Children given this medication may not begin using it until the day after surgery.
• Give the first dose during daytime hours. Watch for four hours for any changes in breathing (slowing of breathing rate) 
• If your child is sleepy or hard to wake up, DO NOT use this medicine and call the office. 
• Only give this medication if the acetaminophen and ibuprofen do not help your child's pain. We call this severe breakthrough pain.

diet

Begin with a clear, liquid diet. Then go to a light diet, then a normal diet as your child feels like eating.

activities

Your child needs to rest after surgery. Quiet activites are best for 14 days. Your child should not plan to go to school for at least 7-10 days. Scabs will still be present until about day 14. There should be no recess, gym or organized sports until 14 days after surgery.

If you need a school note, please ask for it after surgery, before you are discharged.

If your surgeon recommends a post-operative appointment 4-6 weeks after surgery, please call us soon after surgery to schedule. The number is 937-641-4647, option 2 for the office coordinator. You may come into the office, or a nurse may call you to do the follow-up instead. If an in-person appointment is needed after speaking with the nurse, the nurse will let you know and will schedule the appointment.

Call the ENT office (937-641-4647) if your child has any of the following:

1. Fever over 102 Fahrenheit
2. Nausea and/or voming that continues past the first day after surgery
3. Unable to drink
4. Urine is dark
5. Bleeding from the mouth and/or coming from the nose

urgent after-hours calls

If you have an urgent need after hours, call the main hospital operator at 937-641-3000 and ask for the ENT doctor on call.