All That I Have Written Is Straw. . .

Meanderings of a Catholic Devout

My adult tonsillectomy diary and Malt-O-Meal saves the day

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There’s a lot of material out on the Internet that will drive you ill with worry if you think too much about having an adult tonsillectomy. I know that I was on the verge of nausea just thinking about the pain I would be experiencing before I even went into the operating room. The fact is, each person’s experience is different. I had an adult tonsillectomy along with a partial destruction of the lingual tonsil. Here’s my diary.

Preliminary days:

Two weeks prior to the surgery, I started an intensive vitamin regimen that I found from a surgeon for general surgery and verified with a doctor classmate of mine (no, I’m not studying medicine, he just happens to be a doctor who’s taking the same course I am for a variety of reasons). This I think helped my situation.  Here was my regimen (but please verify with a doctor before taking any vitamin supplements prior to surgery).

  • 60 mg Zinc (2 x 30 mg)
  • 60 mg Co-Q10
  • 1,200 mg Calcium
  • 1,000 mg Magnesium 2 x 500 mg)
  • 1,000 mg L-Cystine (2 x 500 mg)
  • Vitamin C – up to 10,000 mg daily, but I only taking 3,000-4,000 mg due to what I get from dietary intake
  • Vitamin K – 100 mcg pill (not to exceed label dose and only for the weeks surrounding surgery–this can be overdosed, so be careful)
  • Garlic (after surgery only) – 500 mg
  • Vitamin E (after surgery only!!!)
  • Echinacea herbal supplement (after surgery only)

It’s extremely important to note that Vitamins A, D, and E (among others) are fat soluble vitamins and must never be taken in the two weeks prior to surgery. Garlic, also, can thin the blood, so, like aspirin, shouldn’t be taken prior to surgery.

The garlic and Echinacea herbal supplements made me feel nauseated within 45 mins of taking them and only for about 4 minutes or so, even when I ate food.  None of the others made me nauseous; however, I did take them at night prior to bed time (that was most convenient for me).

Also, a couple of days before, I went online and printed out an Advance Directive and a Medical Power of Attorney. I know that this is “minor surgery,” but because I’m not married, it was important to me to be able to give I— a chance to make decisions for me. My sister is the primary decision-maker, of course, but I named him as the alternate since she couldn’t physically be in town for this.

The pre-op foods I made sure to have at home: popsicles, chicken broth, butternut squash soup, tomato soup and jello mix.

Spiritually: any surgery like this allows for Catholics to receive the sacrament of the Anointing of the Sick (which includes reconciliation).  I obtained this sacrament from my priest a day and a half before the surgery. Can’t ever be to sure of anything, but having received this sacrament made me feel 150% more at ease.

Day One: Surgery

No food or liquid after midnight. I didn’t think this would be terribly hard, but I have class on Thursday evenings and my surgery was scheduled on a Friday. On the night before my surgery, some classmates asked me to stay late to discuss a group presentation we’d be doing in a couple of weeks. I hadn’t eaten dinner and I wanted to eat a delicious, completely-bad-for-me dinner from Taco Cabana, so I didn’t get home until 10:45 with dinner in hand. I was worried about little stuff like laundry getting done because I didn’t know how I’d feel coming out. I threw in a load and dried it. I probably feel asleep around 12:45 or so, with a wake-up around 5:50 am.

By 7:15, I— had driven me to the surgery center, where it wasn’t much time at all before I was escorted to pee in a cup for a pre-surgical pregnancy test. One can never be too sure and I appreciated that!

By 8 am, I was taken to the pre-operation area, asked to undress to all but my knickers and warm socks, and to put on a gown. A nurse soon hooked up the vitals monitor to my chest. Then, she took about 15 minutes trying to find a vein she was comfortable with to use. That got my blood pressure up—not because of the stick, but because the nurse was so nervous about it. When she did stick me, she missed the vein and had to scope around a bit, which is painful, but she found it and breathed a noticeable sigh of relief, joking that she’d earned her money for the day.

A few minutes later, they let I— in the room (thanks to that Advanced Directive giving him rights to be as family). He was frustrated all morning because of his job. He was working remotely on his staff’s payroll (normal payroll clerk was out) and he was simultaneously trying to reach people to schedule shifts that needed immediate filling. I felt horrible for him because he was having a hard time finding a signal. It was very frustrating for him and it couldn’t have come on a worse day—when I needed his support to get through this. But it’s ok that he was pre-occupied—his presence there just made me smile and feel better.

After what seemed like an hour, the anesthesiologist gave me a “cocktail” to relax. They wheeled me into the operating room and I was already loopy. I remember the last thing I joked about to my doctor, “I’m here for my liposuction” and then I shifted onto the operating table. A mask was on my face and I was being told to breathe deeply.  Lights out.

Next thing I know, I— was next to me. I was so sleepy and a nurse was asking how I was doing. I didn’t know. My neck was swollen to the touch, but I didn’t really feel anything. Contrary to all those Internet stories, I didn’t immediately vomit or feel immense pain. I could still talk, it was just difficult to talk in anything louder than a whisper.

I— had texted my boss and my sister and let them know that surgery was ok. The doctor was able to give I— an update before I even woke up (thanks to the Advanced Directive, I’m telling you).  She told him that I woke up “wildly” and had to be re-sedated, but I have no recollection of that. I was given some orange-syrupy slushie to sip on, but ice water is what I craved. The post-op nurse came through.

A few mins after I left, I— helped me get dressed and escort me to the restroom. Then I was wheeled out to the vehicle and off we were.

Our first stop was the compounding pharmacy for a Tetracaine lollipop to numb any hurting parts of my throat. (There’s a long story about why I wasn’t able to get my meds prior to surgery due to complications with the pharmacy and the doctor’s office). Then we stopped at Sonic Drive-In so that I— could get a burger (poor guy) and I got a shake out the deal. Finally, we went to Walgreen’s Pharmacy to pick up the Hydrocodone/APAP Solution and Ondansetron (an anti-nausea medicine). We had to yell a little at the clerk from the drive-through (I was in no condition to walk) because he at first claimed that he didn’t have the pain meds, but then he checked a warehouse delivery and there they magically were.

At home, I immediately laid down to rest. My body was sluggish.  I had managed only to swallow about a quarter of the shake. It was time for the pain medicine, which, contrary to the nurse’s advice, I didn’t mix with a popsicle. It burned going down. Lesson one learned.

After a couple of hours of rest, I— went out to get some extra goodies: milk, ice cream, yogurt and mashed potatoes. While he was out, I took an anti-nausea tablet because I slowly got a Jello-brand chocolate mousse snack pack. I felt hungry, but not uncomfortably so. A few minutes later, I was throwing up the mousse. So much for the anti-nausea meds.

I laid down, obviously. By the time I— got home,  I stood up to see what he bought. Then I violently vomited again. By this time, there was nothing in me to vomit and some blood was in there. I laid down again.

Later, I threw up a third time of pure liquid stomach bile and water–all that I had ingested since the last vomit episode.  No blood, but still violent. This time, however, I felt much better afterwards. We are supposing it was probably caused from the anesthetics.

After another nap later, I rested in the living room in front of the tv. My throat still wasn’t hurting as much as I thought it would.  Swallowing, while slow, wasn’t hard. I made I— make me a half-cup of lukewarm chicken broth and it tasted so delicious! That made my entire soul feel better. I took my last dose of medicine and went to sleep with my humidifier on full blast just three feet from my bed side.

Just prior to falling asleep, I said day one of a novena to St. Blaise, of whom my boss, of all people, reminded me is the patron saint of throat ailments. So far, his intercession is working.

Day two:

On the positive side, I’m already down 5.8 lbs. During the night, I set my alarm to go off every 45 minutes to sip on low-cal Gatorade (also, which helped after vomiting). I did wake up around 4:30 am to take another dose of the pain medicine because the pain, though not completely unbearable, was enough to keep me awake.

I woke up around 8:30 and my throat still didn’t hurt as much as I was expecting. My tongue hurts, though. I didn’t take any pain meds until around 10 am, when I decided to put the Tetracaine pop to use. The arch in the back of my throat hurts more today, but again, not unbearable. After I downed a lite yogurt with vitamins mushed into it, I took my pain med and another nap.

As the day wore on, I realized my back rib cage hurt from the previous day’s vomiting episodes. It hurt to the touch, but still no more vomiting.

I slept more, off and on. I didn’t have much of an appetite still and so I stuck with extremely small portions. I tried a little pre-made macaroni and cheese—it’s very important that food is so lukewarm, it’s on the verge of being cold again.

At the end of the day, I only took about two doses of the pain meds throughout the day and one tablet for anti-nausea (just to be safe).

Day Three:

This day was much more painful. I followed the doses of the pain medicine strictly.  The experts are correct: pain is a lot worse in the morning. It was a Sunday, so it was a rather lazy day of television and more naps.

I mixed vitamins into vanilla pudding—disgusting! Vitamin C does not go well with vanilla pudding. Duly noted.

My friends stopped by and brought me two pints of ice cream (solid flavors, with no mix-ins). I’ve never been a huge fan of chocolate ice cream, but the Starbucks Hot Chocolate ice cream went down quite nicely.  What made me feel better most of all was the fact that my friends stopped by in the first place. One of them had the nerve to look at my throat, which is grossly white and slimy.

Day Four:

Pain is worsening without meds. My ear pain has increased.  I observed that I prefer to eat about 10 minutes or so after drinking the pain medicine doses because the medicine numbs my throat and that makes eating easier. I can also swallow my vitamins now, though not too many at once.

This was also the first day I was by myself. I had to occupy myself with working on a research paper for school, which I desperately needed to finish, but I found it frustrating because I couldn’t focus for long periods of time. I ended up taking two naps within a 5-hour span.

I couldn’t afford to miss a class at school, so I had I— drive me to school.  Daylight savings time ended, so it was darker than I am used to. I took pain meds about two hours before I left. Even though my dosing schedule is every four hours, I find that I can usually go about five hours before the pain is noticeable. But attending class was definitely a challenge because we were asked to work in groups, which required that I speak, even if in a low voice.

Some classmates who knew what I had undergone were astonished that I was in class. And I think I was fine except for that talking requirement. By the end of class, I could feel the pain creeping back and my mouth was exhausted from trying to talk. So much so, I was quite grumpy and whiney to I— when class dismissed. I apologized to him later, but he just writes it off as me being sick. The pain, by then, was enough to bring tears to my eyes.

Day Five:

Today just may be my chance to make this tonsillectomy all worth it.

I woke up in extreme pain and still a good half-hour to go before my next dose. It was the first night that I didn’t wake up early enough in the middle of the night to take a dose until about 4:30 am. (Normally, it’s around 2:30 am). So this threw me off schedule. When I— was getting ready to leave for work, I woke up in tears. This time, though, it’s not throat pain that brings the tears, it’s the ear pain.

I worked all morning on my research paper again, but again found myself taking about an hour-long nap. Around noon, I was able to eat a half-bowl of macaroni and cheese, which is the largest quantity of food I’ve eaten in five days. I was stuffed!

I am going to try to meet one of my football heroes today, Houston Texans Middle Linebacker DeMeco Ryans (#59). He’ll be signing autographs today at a time when I normally wouldn’t be able to make due to work, but being home for this tonsillectomy has its advantages. We’ll see how the pain management goes. I can’t take it before I drive for obvious reasons. I think I’ll have it prepared for when I get home, though.

Days Six — Ten:

More of recovery.  Each day, the pain lessens.  No nausea.  Drinking ice-cold fluids triggers ear pain.  Warmer fluids (not hot) are better tolerated.

Days 11, 12:

Scabs are starting to come off in my throat and it’s disgusting. And that’s made more so because some of the scabs are making me feel like I’m gagging. I’m making my throat sore trying to swallow to remove them. I forced myself to eat a taco (because of the crunchy shell) in order to scrape the throat. I know it probably isn’t advisable, but I have a super-sensitive gag-reflex and I feel like I’ll vomit in my sleep if I don’t do something about it.  Hurt like hell to swallow but I succeeded in getting part of the scab down (I know, more dégueulasse!).

I’ve also been weaning off the medication by taking a half-dose (day 11) and a third-dose (day 12). The medicine does nothing to stop the gag feeling.  My throat, otherwise, is still sore, but very tolerable pain. In fact, I find that I don’t really notice the pain unless I eat or if I talk a lot.  We entertained people over the weekend and celebrated E—’s birthday, which didn’t help much.

Day 13, onward and the Importance of Taking Post-Surgical Iron Supplements:

I feel set back.  I feel awful today. My throat isn’t the issue, though, and the scabs are no longer gagging me. In fact, the pain in my throat is barely noticeable at all. No hydrocodone/APAP medicine at all today, I’m done. It’s my first day back at work.

No, today I felt lethargic. I had cold chills/sweats.  My heart raced at times. I felt nauseated, almost diarrheal. I couldn’t find energy from anywhere (mind you, I haven’t had any more caffeine than from iced tea).  I felt OK in the morning, but as the day wore on, I spiraled downward.

I did finally get a burst of energy for a few hours around 3 pm, perhaps because my CEO and I started chatting about football, my boss’ wife chatted with me about theology—two of my passions to get me worked up.

When I got home, I— brought me get-well flowers (bonus!) and made me an omelette and had strawberries and my favorite gourmet cheese in stock. I don’t know what I did to deserve those other than whine the last 13 days. But alas, no rest to be had, as I had class and term paper to turn in.

About 10 minutes into class, I began to gag. I gagged so much, I had to get up, run to the restroom and kneel over to pot to dry-heave.  I thought I was going to die. Cold sweats galore! I cried a bit in self-pity (probably from the side effect of losing the narcotic meds).  After 10 or so minutes, I pulled myself together, washed my face, wet a paper towel to bring with me back to class.  It was uneventful thereafter, except for an occasional bout of chills and unceasing headaches (not migraines, though). Even my chest was sore, though that could be from all the dry-heaving.

As I lay down for the night, I had an epiphany. I’m iron-deficient. I have all the classic symptoms of it. I mentioned this to I— and he and I looked it up. Verified—I had all the symptoms of iron deficiency. I’m not anemic normally, but I’ve always had trouble with keeping iron high anyway. Furthermore, my google search yielded that 90% of people suffer mild anemia after surgery. I did the old look-at-the-lower-eye-lid trick and it was almost white—hardly any pink to be found at all! That couldn’t be good.

In hindsight it makes sense. Where would I have gotten iron from while recovering? I lost blood during the surgery and hardly ate anything for the two days following it. No meat or green, leafy vegetables. No black-eyed peas or broccoli. Fortunately, I— took care of me and at 11:30 at night, he raided the kitchen for anything we had in stock with more than 10% iron in it. The solution: Malt-O-Meal® (60% iron per serving). There I was, eating Malt-O-Meal in bed around midnight. ENT surgeons should include Malt-O-Meal on the list of recommended foods after tonsillectomies. Easy to swallow and combat hypoferremia. Seriously.

In the morning, I felt less lethargic, but I still felt like crappola. No cold sweats, though. On the way to work, I grabbed a PowerBar® ProteinPlus chocolate/peanut butter bar. Still hurt a bit to eat, but it had 45% iron/serving. A couple of hours later, I’m feeling better. I’m thinking of leaving work early to sleep, but stopping at a vitamin store to grab some iron supplements or pre-natal vitamins.

All in all, I had time to let the pain recover, but not the time to let my body recover. If I could take more time off of work, I would definitely take a couple of days to rest my body. I was so focused on healing my throat, I neglected the exhaustion toll it takes on the rest of the body.

Written by Written Straw

November 15, 2011 at 10:48 am

One Response

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  1. I really wish I had read a post like this before my adult tonsillectomy, I had no idea what I was signing up for!


    November 15, 2011 at 12:39 pm

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