Thursday, September 29, 2016

My Adult Tonsillectomy: Holy hell, that hurt (and still does)

One week ago I had a tonsillectomy, adenoidectomy, and septum (sinus) surgery all in one go. Because, apparently, I'm an overachiever in all things, thank you very much.  Surprisingly, I've had quite a few people I don't know direct message me and ask me to share my experiences because they are considering, dreading, or anticipating the same type of surgery. For the record, I am 41, only 6 years older than Krysten Ritter who plays Jessica Jones on "Jessica Jones" and who, coincidentally, also had a tonsillectomy a few weeks before I had mine. Sorry, if I was going to be throwing my age around I had to also throw in a fun fact to soften the blow.

So, here's a rundown of how it's been for me:

The backstory

I have always had bad allergies and have always had sinus problems, but until a few years ago, I'd never had strep throat before. This year, I've been sick since around July 4 with some sinus crud/sore throat combo. I'd feel better and, boom, sick again, and worse than before, especially in my throat. I saw the doctor a handful of times, was on about six or seven rounds of antibiotics. My sore throat never really went away, and it got so bad I ended up in urgent care one weekend, where I was tested for mono and strep and had negative results for both. The doc said he was surprised I was negative on mono because I had so much puss in the back of my throat. He put me on a new antibiotic and told me I was probably contagious, and I was out of work for a week.

I didn't get much better, so I was back at my family doctor the next week. He said my left tonsil looked swollen and possibly abscessed and that could only be drained by an ENT. I had to wait 2 weeks for an appointment because they were working me in. In the meantime, my throat pain was beyond horrible, and I developed a cough and fever that made things even more fun. I finally saw the ENT, who put a scope through my nose to look at my throat. His first words were, "Do you know you have a sinus infection?" Heh. Then he declared my left tonsil was majorly infected and that I'm in a 2% category of people who have unusually large tonsils and adenoids, and the best thing overall was for me to take them out. Since he was doing that, he wanted to see if my sinuses needed fixing too, so I had a CT scan and planned for surgery on Sept. 21. All I heard back from the doctor's nurse from my sinus scan was that, yes, I definitely needed sinus surgery because I had significant sinus disease, too. I had no idea what that meant though.

I'll be honest. I'd never had surgery before in my life (wisdom teeth not included), so I was a bit terrified at the idea, and once I started reading about how god-awful adult tonsillectomies were, I almost chickened out and canceled my surgery. I continued to be sick, so my hopes of magically improving without surgery began to disappear. In fact, in the two weeks leading up to my surgery, the lymph nodes on the left side of my neck were so inflamed and swollen, I feared my tonsillitis had developed into lymphoma or something.



Day One

I had my surgery at an outpatient surgery center outside of a hospital. It was a small facility and therefore cheaper for me and my insurance. As long as I wasn't getting a Walmart-type surgery, I was fine with that. I giggled a little when they said I was in line behind "the babies" and told to be there at 10:30 a.m. I arrived, and they took me back to pre-op, where they took my vitals, had me change into a very fetching gown, and hooked me up to an IV. Then my dad and best friend were allowed to come sit with me until the doctor took me to surgery. An anesthesiologist and nurse came to ask me questions, and the anesthesiologist told me he wasn't going to lie — I was going to be in a world of hurt when I woke up, but he'd give me as much pain medicine as I wanted as long as I could take a few deep breaths for him to prove I could breathe OK. That scared the bejesus out of me, but I didn't think I could get away without looking like a fool at that point. They didn't give me any drugs or anything until about 15 minutes before the doctor came to take me back to surgery, and I don't know what it was, but it was trippy and I felt like I was floating all around my little room. Good stuff.

Then they rolled me back into the operating room, where the anesthesiologist had me breathe into a face-mask until I went bye-bye. Next thing I know, the anesthesiologist was loudly yelling "Angela? Angela? Angela?" over and over and I wanted to punch him in the face because I was sleeping so nicely and he wouldn't stop yelling my name. I opened my eyes, and he demanded that I take some deep breaths before they slid me onto a gurney. I remember the anesthesiologist saying, "I hate it when they do sinus and tonsillectomies at the same time. It makes it much harder for everyone." Um, OK, Mr. Ray of Sunshine. Whatever. I was alive, and that was all I cared about. I didn't feel the pain until they slid me into the recovery area and the nurse asked me how I was feeling, I swallowed, and holy freaking $%@!, I wanted to die. I told her I was in a lot of pain, she said they had me on a lot of pain meds and couldn't give me any more, and then she went to get my dad and best friend. Instead of my friend, my brother showed up instead, and he's not a brother I like or get along with so for a minute I thought I must have died and gone to hell, but thank God, he finally left and she came back.

I was told my surgery would last about an hour. Instead, it took two hours because I was so messed up all up in there. My friend relayed later that the doctor had told them I did well, but he had to do a LOT of major surgery on me. Both of my tonsils were abscessed and filled with puss — not just the left one — and that on a scale of 1 to 4 with 4 being the largest, my tonsils were a 5. He said my throat pain would have never improved without surgery, so it was good I'd made the decision to do it. He also had to do a lot of major work to my sinuses, too. Most of my sinuses were blocked, so he had to clean out my sinuses, open up those blockages, and he made some passages bigger or something? I don't know. Something about my septum. Whatever. There was this alien feeling of having straws glued to the inside of my nostrils. I actually couldn't feel my face at all, and asked the recovery nurse if he'd done sinus surgery because the only pain I felt was in my throat. She said the benefit of doing both at once was that the pain of my throat overrode the pain of the sinus surgery. Apparently sinus surgery is not fun in and of itself. The tonsillectomy was so bad, I probably wouldn't notice it as much though. She gave me a blood-red popsicle shaped like Michael Myer's knife so I silently named it Michael, and Michael helped numb some of the pain (shhhh, I'm still on drugs, so just go with my weird whimsy).

Giving a thumbs-up sign in recovery,
with Michael, my first popsicle.
I was in recovery maybe 40 minutes before they let me go home. I don't know. I was pretty out of it, between the pain meds and the pain. Speaking of pain medicines, I was given 50 mg Demerol for severe pain and 7.5 mg of hydrocdon-acetamin for lesser pain along with Zofran for nausea. I was told to start taking the Demerol as soon as I got home and to take a Zofran as well, so I did. Also, I needed to keep my throat as moist as possible, so I needed to constantly sip on water, which hurt like hell, if I'm honest. The Demerol and Zofran are pills. Oddly, it was easy to swallow them at first, but I do advise having a pill crusher handy in case you need to crush them up and take them with water. It seems to be different for everyone.

That first day I remember thinking the pain was bad but that I had expected much worse, and on pain meds, it compared to the worst of the throat pain I had already experienced while sick so I thought I could handle it. And that's the truth. Unfortunately, the night following my surgery, I started vomiting. I know, TMI, but you need to know it's a possibility. The first few times, it just sort of happened and it didn't make the pain any worse or better. It was just ewww. My best friend stayed over to help me (thank God for her, too) and we deduced that an hour and 15 minutes after I took each dose of Demerol and Zofran, I got sick. So she called the doctor in the middle of the night, and he told me to switch to the hydrocdon-acetamin, which was a liquid, and gave me Phenergan instead. I took the hydrocodon, but then I had a reaction to that as well. Not vomiting, but my face became red and flushed and it didn't touch the pain at all, or if it did, OMG, I can't even imagine what the pain would have been without it. I ended up not taking a Phenergan because it makes you sleep, and I didn't know how I'd handle keeping my throat moist. So early the next morning, we called my doctor again, and the nurse called me in Acetamin-COD, which is a liquid. It doesn't help with pain as much as Demerol, but it helped some and without any nasty side effects. I basically bunkered down and braced for the pain. Oh, and because I had sinus surgery, too, I was told I would need to remain sitting up for at least five days. My brothers had moved one of my dad's recliners into my bedroom to be my new "bed" for a while. My father has a heart and lung condition, so I live with him, but I haven't been much use to him lately — and now I've stolen one of his recliners. Poor guy.

Days 2-4

These days were pretty rough. The pain is constant, but made much worse when you swallow, especially water, ice, or any liquid. I was taking 5 ml of Acetamin-COD every two hours. The throat pain was so bad, I didn't sleep much at all the first two days. My friend stayed over to make sure I took my medicine on schedule and that I sipped water every 15 minutes or so. Setting an alarm in your phone helps. It gets to be annoying after a point, but it helps. Also, after the first 24 hours, I really started to feel pain in my face, too. Plus, I was bleeding around the splints in my nose. Those splints were supposed to help me breathe through my nose so I didn't have to breathe as much through my mouth, but they kept getting so clogged with blood and scabs, I simply couldn't breathe through my nose. And those splints are damned uncomfortable once you start to feel them. Using a cold moist towel across the bridge of your nose helps. My cat did head-butt me in the nose one time — not hard — but sweet mercy, I thought I was going to die from the pain. So if you have an affectionate cat, for the love of god, don't let him near your face if you have the sinus work done, too. Anyway. The few times I dozed off during this period, I woke myself up doing a gurgling-trying-to-breathe thing that made me feel claustrophobic.  The worst pain in the world is dozing off, sleeping 30 minutes without taking a sip of water or sucking on ice, and then waking up. Your throat is dry and OMG does it hurt. Dozing off and going past your scheduled pain medicine time is also the worst kind of pain you will experience. So, keep your throat moist and stay on top of your pain meds. Ice packs on you neck are also a blessing from God. You'll be uncomfortable and miserable, but it's nothing you can't handle. Everyone and their brother will want to bring you something to try to eat because they're worried about you. I tried applesauce. It made me cry. I tried yogurt. It made me cry. I tried a watery smoothie. I wanted to die. Through trial and error, I discovered I can handle sipping on chicken broth at a lukewarm temperature, and Frostys from Wendy's are God's little angels sent down from heaven to help tonsillectomy patients survive. I am convinced of that. So my diet has been chicken broth, popsicles, and Frostys. 

Days 5-8

I managed to find the strength to take a shower before my doctor's appointment, which was heaven since I hate not showering every day. I had to go in to have my nose splints removed the Monday after my surgery. When he removed them, it was so painful I immediately felt nauseous but did not lose my lunch, which would have only been water anyway, but still. It was this very painful feeling followed by immediate relief, but I still wanted to cry. He cleaned out all of the dried blood and scabs, too, which was a huge relief and helped me feel better. He said I could expect 10 more days of misery and then I'd start to feel better because my tonsils were still healing. He kept insisting he knew how bad I felt, it was normal, but he didn't want to change my pain medicine because there's too much risk of overdosing and pain meds can stop your breathing. Instead, he told me to up my dosage to 10 ml of the acetamin-COD every four hours and to take two Tylenol every two hours. I switched to this as soon as I got home, and the pain did begin to improve some. I went from dozing here and there to sleeping for about 2-3 hours at a time. The problem is the same though. When I wake up, I'm in intense pain because my throat is dry, and it takes extra effort to get it feeling moist again. I go back and forth between a floaty-zombie-like feeling and utter drowsiness throughout the day. I guess it's the pain meds. I also feel incredibly weak, but I did eat my first cup of chicken noodle soup and got down some mashed potatoes last night, so things are starting to look up. However, I have to keep my sinuses moist with nose spray at all times, too, and have been experiencing drainage of mucus-y blood clots into my throat, which is quite nasty and unpleasant, believe me. I'm still experiencing face pain, which I'm not sure is normal or not at this stage. I also have difficulty blowing my nose at all. The doctor encouraged me to gently blow my nose if needed, but I feel congested and can't manage to blow anything at all. I'm sure this means there's a problem somewhere, but I don't know. I'm just basically dealing with it until I can't anymore.

Me and Dusti watching Netflix

Day 9

Last night I slept in two 4-hour increments, and I still feel exhausted. I feel worse today than I did yesterday, actually and I'm not sure why. I know I tried talking some yesterday, and maybe that was a mistake. Up until now I haven't spoken much after my surgery because it hurts so damn much to try. I know the scabs in my throat should be coming out any day now, and I hope that when they do, I don't gag on them and the pain doesn't get worse. I've read some people who say it improves immensely and some who say it gets worse after the scabs falls off. I'll let you know when I get to that point.

Edited 10-10-2016:

Days 10-19

In regards to my tonsillectomy, I've slowly improved and can now eat pretty much any food I want. I started eating regular food again last week, around Day 13. I started with pasta and mashed potatoes and moved through other soft foods slowly. If I never see applesauce, yogurt, or chicken broth again, it will be too soon. However, I can't taste anything, so I'm afraid my taste buds were damaged in the surgery. I've read on other blogs that the tools they use to hold your tongue during surgery can cause this, and that many people experience a return in taste after about 2-3 months. I hope that's the case for me. Well, I hope I can taste sooner than that, but I hope it returns.


While my throat is significantly better, my sinuses are not. Three days ago I awoke in the worst pain of my life. I pretty much cried, there was so much pain and pressure in my face. Then I was hit with nausea. I've also been running a low-grade fever. After a handful of calls to the doctor, in which I was told everything I described was normal recovery, I finally went back and was told I had an infection. My sinuses were too severely swollen for him to insert the thingamajig that looks around in there, but he judged by my symptoms and the fact that my lymph nodes on my neck are again swollen and tender that I have an infection. I was told the excruciating pain was likely from the swelling, and that the nausea could be from my dissolvable packing draining from my sinuses and upsetting my stomach. I was also told that I had major surgery and that it will take time to feel better. It could take up to three months to feel like human again. Three months!?! Right now my sinus surgery recovery is my obstacle, and it is kicking my tail. My throat is also slightly swollen and I sound like a chain smoker sometimes when I talk, but overall, it is much, much better.

So, my summation is that an adult tonsillectomy is no walk in the park, but the fear and anticipation of it is much worse than the actual thing itself. There is pain, but if your doctor has determined you need the surgery to end your throat pain, you are probably already in tremendous pain and the pain after surgery won't be anything you're not used to, as long as you stay on top of your medicine. Use the time to watch Netflix or read. My cat and I've caught up on "The Flash," "Doctor Who," "Penny Dreadful" and about a dozen weird movies already. I've also read a handful of books.

I am hopeful this experience is almost behind me. I'm tired of being sick, but I think I can see the light at the end of the tunnel now. *fingers crossed*

 

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