i hate my tonsils.
April 13, 2011 8:00 PM   Subscribe

Just had my tonsils removed. The liquid Vicodin I was given keeps wearing off every two hours. I can only take it every four. Help me prolong the pain-relief (and survive the next few days).

Adult female who just had her tonsils removed today. Was given liquid vicodin. It a) burns when it goes down and b) wears off mighty quickly. Eating applesauce and babyfood accelerate the decay. (and leave a nasty film in my mouth... little bastards. so, so hungry...)

How can I improve the longevity of this drug's effects so my pain is more effectively managed? Just how much acetaminophen can someone my age handle and will "cheating" the times be harmful or not as bad as some might think? YANAD/MD, etc.

Also, I'm a vegetarian (and in remarkably good health according to my surgeon). Would sipping lukewarm chicken broth give me a healing boost over the vegetable variety?
posted by patronuscharms to Health & Fitness (31 answers total) 5 users marked this as a favorite
Is there acetaminophen or motrin with the liquid Vicodin? If not, you can alternate them every two hours.

I had my tonsils out when I was 19 and the pain was really only terrible for a couple of days. I found that salty foods helped. Oddly enough, tuna fish sandwiches were a big craving for me (after the first 48 hours). Salty broth, also. Not sure if you're going to get a healing boost, but extra protein probably won't hurt, right? Although I found that my stomach was prone to upset and nausea (and that is HELL) the first couple of days, so if you've been keeping strict vegetarian for a while and suddenly switch, it might disrupt your system, so tread lightly.

Feel free to MeMail me with questions and I'll see what else I can dredge up from my memory!

Oh, one other thing - they do make a long-lasting hydrocodone liquid for coughs called Tussionex - maybe call your doc and see if you can switch over, if it's even feasible to use for pain?
posted by Addlepated at 8:10 PM on April 13, 2011

Can you swallow tablets? If you can, I highly, highly recommend naproxen (Aleve). For me, it works so much better than Vicoden and lasts 10-12 hours. I also have a nurse friend who cares for post-op patients and she has told me that ibuprofen is often their first and best line of pain control before narcotics.
posted by corey flood at 8:12 PM on April 13, 2011

IANAD, but don't exceed the recommended dose of acetaminophen. Trust me on this, your liver will thank you.

You can double team the pain with acetaminophen and ibuprofen if you need to. The two drugs work differently, and don't affect each other in terms of toxicity to your system. (Again, don't exceed the recommended dose of any OTC drug without talking to your actual doctor.)

Also, don't forget temperature is a useful tool for pain management. Popsicles, ice cream, ice packs applied externally, etc.

I'm a vegetarian too, and for the love of God, I avoid opening up that can of worms on the Internet at all costs. Sip whatever kind of broth you like.
posted by mere at 8:15 PM on April 13, 2011

Oops, hit post too soon. I forgot to say that if you can't swallow tablets, you can either crush tablets and mix them with something you can swallow (my mom's go-to was jelly) or you can poke a hole in liqui-gels and squeeze the liquid into something you can swallow.
posted by corey flood at 8:15 PM on April 13, 2011 [1 favorite]

Beware the acetaminophen recommemdations, and don't double up ... "vicodin" is hydrocodone with acetaminophen mixed in.
posted by Metasyntactic at 8:20 PM on April 13, 2011 [2 favorites]

Adults are generally not supposed to exceed 4000mg (4g) of acetaminophen in 24 hours. That also does NOT mean that it's safe to take anywhere near that much all at once if it's your only dose for the day. Acetaminophen is really hard on your liver.

I agree with the other advice to try another over-the-counter pain reliever alternated with the Vicodin, as long as you make sure the other drug doesn't contain acetaminophen. Try warm or cool drinks to see if either helps.

If this doesn't get you relief, call your doctor's office and tell them you need a new strategy for pain management. They should be able to adjust your prescription directly with the pharmacy, without you even having to pay for an office visit. Don't just start taking more than you've been prescribed -- as my very wise grandmother put it once, "Only a fool would pay a doctor for advice and then ignore it."
posted by vytae at 8:21 PM on April 13, 2011 [1 favorite]

Antihistamines are supposed to augment the effect of opiates, though I've never noticed the effect myself. Try taking your next dose with benadryl, but be prepared for some extra fatigue.
posted by dephlogisticated at 8:28 PM on April 13, 2011

Response by poster: Fair enough. I didn't get the chance to really talk to my doctors before they put me under -- I was really exhausted from not sleeping well for the past week, so I wasn't able to ask educated questions. What about coughing? I know I'm allowed to cough, just not clear my throat. What exactly do I have in my mouth then that could be disrupted? Sutures/stitches? Would getting a pain reliever with a cough suppressant be kosher or is coughing actually kind of okay?

Also, I need to avoid acidic foods, right? I tried something really alkaline (lentil babyfood) and that made things pretty gnarly for about 5 min. Where's my happy place in terms of chemical makeup and how can I get that in foods I can eat?
posted by patronuscharms at 8:29 PM on April 13, 2011

I'll be watching this thread closely -- I need to have my tonsils out (I get tonsilitis about five to seven times a year) but I've heard so much about how painful it is to have them out as an adult.

I had oral surgery (of a different variety) 10 years ago, and they gave me liquid Tylenol with coedine. When I got my wisdom teeth pulled a few years ago, they gave me FIFTY Vicodin, which were hard to swallow what with all my swelling. I took them more often than every six hours or whatever - there was no way to eat (chew) if I didn't take something.

Try to eat foods that you can mush, as in crush them with your tongue and then swallow with minimal effort. Steamed broccoli, and the like.

For MY tonsilitis hot liquids (or a hot towel presses against the area) work wonders - so broth and tea and soups are perfect. But they give kids popsicles and Jell-O after surgery, mainly to keep the swelling down?? Try both and nix the one that causes any pain!
posted by polly_dactyl at 8:30 PM on April 13, 2011

Take a half dose every 2 hours instead.
posted by powerbumpkin at 8:33 PM on April 13, 2011 [1 favorite]

Can you take NSAIDs like ibuprofen or naproxen? I was in a lot of pain after my wisdom teeth were extracted in January (jaw pain, not socket) and the Vicodin wasn't cutting it at ALL, so I gave in* and took two Advil - the pain was almost gone after that.

* I'm not supposed to take NSAIDs but I was desperate.
posted by elsietheeel at 8:44 PM on April 13, 2011 [1 favorite]

I was going to suggest taking half the dose twice as often, too.
posted by two lights above the sea at 8:48 PM on April 13, 2011

I had my tonsils out as an adult and I think they told me I could take advil, too, but the Vicodin was enough for me, as I didn't have bad pain (but man, the hunger was the worst, I feel your pain there, jello gets real old real fast).
You don't need to worry about crushing up pills, just by the liquid version and take the adult dose.
If you're concerned, you can probably call a pharmacy or if your health insurance has a 24-hour nurse line (or same deal if you go to college), you can call and ask.
posted by elpea at 8:51 PM on April 13, 2011

Oh, and the cold stuff suggestion is really good. Drink cold drinks and eat popsicles. I don't think you're supposed to have hot/warm stuff at first, but I can't really remember. Your post-op stuff probably says. Cold stuff definitely helped me. Also, sleeping as much as possible.
posted by elpea at 8:52 PM on April 13, 2011

Best answer: Sore throat comfort strategies, from a not-your-nurse who used to take care of a lot of tonsillectomy kids:
1. Use tepid or slightly warm liquids for drinking, not cold or icy. It will be more comfortable long term, even tho cold drinks may feel good for a few minutes. Go for bland bland bland foods, not too sweet, not too salty.
2. Don't take tiny sips. Take medium sized gulps. They say it actually hurts less, plus you have to swallow fewer times for the same amount of fluids/food. Tip your chin down towards your chest to swallow. It open up the throat and makes it easier.
2. Time your liquids and meals for about a half hour after your pain medicine. Plan ahead. Make sure to get liquids in first, before solids.
3. You may want to avoid milk and ice cream. They often cause mucus in the throat.

But really, it sounds like you need your pain medication adjusted. Talk to your doc as soon as possible.
posted by SLC Mom at 8:55 PM on April 13, 2011 [1 favorite]

Best answer: Pharmacist here. The Vicodin works after you absorb it from your digestive tract and it gets into your bloodstream. The liquid isn't working just by sliding down your throat. Taking half the dose twice as often might not get high enough blood levels to relieve your pain; you could try the half-dose once to see if it's enough (should kick in in ~15 min), if not, go ahead and finish up the full dose.

Could you tell us the dose you're supposed to be taking?

Barring any other medical conditions, a healthy person should take no more than 4000 mg of acetaminophen in 24 hours. If you really need to supplement with something, you can take ibuprofen (this will help with swelling). I'm not sure about the cough suppressant part...

You don't need to compromise your beliefs by eating chicken soup if you don't want to. In general, protein helps with wound healing since those are the building blocks of the body. If you can get some silken tofu down, that might help.
posted by watch out for turtles at 8:57 PM on April 13, 2011

I've had my share of crashes, injuries, and surgeries, and my body processes opiates like no other - I don't even do recreational drugs. I always have to ask for Percocet ahead of time, because I have the same problem as you. Agreeing with the above of asking for a new Rx, although at least here in CA, I have to take the Percocet Rx to the pharmacy myself, since they can't call it in like they can with Vicodin.

I really like the Ensure High Protein flavors. :)
posted by kcm at 8:58 PM on April 13, 2011

When I was on Percocet for elbow surgery, they gave me an in-between pill to take the edge off until I could take the "real" pill again. I think it was a non-acetaminophen pill so as to prevent toxicity. Do they have something similar they could give you?
posted by Madamina at 9:03 PM on April 13, 2011

Best answer: I'm going to suggest something entirely different based on my experience.

Water. Get it in you, get it in the air. You can get caught up in a "throat hurts, won't drink ... throat gets dryer, hurts more ... won't drink ..." spiral very quickly. My solution was to have two humidifiers running full blast with distilled water and fans pushing it all around, constantly, until everything was damp. If you leave the bedroom of blessed moisture, your throat will begin hurting again in about fifteen minutes.

I took my pain meds only three or four times after I had my tonsils out (and a rhinoplasty, and septoplasty, and turbinate reduction, all in one shot). Just keeping my airways wet was effective. I nagged my friend who had his out later as well to do the same and he, too, noticed the effect: leave the humidity, suffer the pain.

Oh, and since you had it today, sleep upright and get a few towels ready. You might do the "drooling blood because your tongue is swollen" thing. They may have used a device called a tongue blade to press down on your tongue during surgery to keep it out the way. If so, you may have some swelling of the tongue overnight. Mine was fairly intense, such that my tongue protruded out of my mouth and kept making it difficult to breathe. So, sleep upright with your head propped over a pillow if that happens, and have a towel on that pillow. You might luck out and not get the tongue thing, though.

Stay hydrated, stay damp. Annoyingly damp. Yes, you'll have to dry out your room afterward and worry about mold and whatnot, but you'll heal quickly this way. I was back to the usual foods on day four.
posted by adipocere at 9:30 PM on April 13, 2011

Polly - had mine out 7years ago which meant I was... 33. Was a miserable recuperation for four days, didn't feel normal swallowing for weeks. And was worth every second of it. After twice yearly strep most of my life I haven't had a throat infection since. If you need it don't hesitate. I wish I'd done it sooner.

I got through mine with liquid codeine... And taking tablespoons rather than teaspoons because my now-wife misread the label. I primarily slept for those first three days. Given that codeine is supposed to be a resperatory suppressant I don't recommend it as a strategy but I will admit it passed the time.

Call your doc, patronus. People respond differently and you won't be the first person to say they're not getting what they need from their initial prescription. They may have a backup solution at the ready.
posted by phearlez at 10:39 PM on April 13, 2011 [2 favorites]

Definitely call your doctor and ask, they will undoubtedly have a suggestion. Personally I find that ibuprofen works much better as a painkiller for me, than opiates do. So you can probably alternate with ibuprofen half way through your vicodin cycle. However I am not a doctor, etc. But after my C-sections, I found that ibuprofen helped way more than the darvoset I was prescribed.
posted by Joh at 10:44 PM on April 13, 2011

Response by poster: Oh, darvocet -- I miss darvocet. Best pain management for my migraines EVER. Pity it's been taken off the market.

I am going to have my caregiver (aka mi madre) call my doctor tomorrow and ask for something stronger. Forcing myself to drink plenty of water, and god help me, I actually looked inside my mouth with a flashlight and seeing the empty space where my tonsils once were is disturbing. Mine were the size of golfballs in their natural state -- I am looking forward to having no more tonsilliths ever again!!!!! That alone makes it worth it.

So far, here's what I've discovered (in case this assists others with their adult tonsillectomies):

> Cold water hurts. Go for lukewarm. Lukewarm everything, actually.
> Carefully consider what you're eating when you venture into soft foods. Apple sauce, for example, while initially soothing, needs to be reblended so as not to leave residue inside your tonsil cavities. Trust me on this one.
> Avoid all dairy.

Am going to make fresh juices (beets, carrots, parsley, apple, and banana) to see if that doesn't help, too.

Keep the remedies coming, folks.
posted by patronuscharms at 11:01 PM on April 13, 2011 [2 favorites]

If you're already nauseated, be careful taking any meds you haven't taken before. Naproxen upset my stomach.

Call your doctor and ask if you are allowed to use Chloraseptic sore throat spray, or Zetts lozenges. I have only ever found Zetts at CVS, either individually wrapped at the pharmacy counter (white package with green text) or in bags of 5 next to the other cough drops. They're benzocaine and they numb like crazy. 20 cents each but sooooo worth it, the strongest numbing lozenge I've ever found.
posted by IndigoRain at 11:32 PM on April 13, 2011

Arriving at this party a little late, I'm afraid. I had my tonsils out when I was 14 and the magical medicine was Aspergum - chewing gum with an aspirin/sugar coating. Best. Thing. Ever. I still can't belive that the first thing they gave me to eat in hospital was... cornflakes!! Unfortunately (according to the Wikipedia entry), it's no longer sold :-(
posted by HarrysDad at 7:57 AM on April 14, 2011

I would say call the Dr and get another bottle of Vicodin. My wife went through 2 big bottles when she had her removed recently. You're in a ton of pain, and this stuff is really the best for you right now.

Throat spray could be awful as well.
posted by eggm4n at 8:03 AM on April 14, 2011

How about speaking with your surgeon, or his staff? It's a weekday.

Frankly, it's a little bit dangerous for people to be recommending you take motrin/advil/ibuprofen/aleve not knowing your medical history, the exact procedure done to you, and any other medications you're taking. NSAIDS like ibuprofen or Aleve/naproxen increase your risk of bleeding, and post-tonsillectomy hemorrhage can end you up intubated in the ICU getting a transfusion.

Ask Metafilter: Free, uninformed, potentially life-threatening medical advice!
posted by gramcracker at 12:39 PM on April 14, 2011

Response by poster: Honestly, Gramcracker, I appreciate the words of warning but do you honestly think that the average adult that comes here and requests assistance regarding a medical issue is going to immediately start dosing themselves up with whatever someone else suggests? Please, give the folks here some credit. The purpose of this inquiry was to determine if there are some common things that I could further research myself and then bring to my doctor for approval. And quite frankly, I can't really speak to my surgeon right now because my voice box closed up, so the more information I have to look into now, the better. The suggestions regarding food and moisture were by far the best. I am feeling better already and I'm scabbing over -- and it's only day 2.
posted by patronuscharms at 3:18 PM on April 14, 2011 [5 favorites]

Response by poster: In case anyone is still following this: I've completely scabbed over and now the only thing causing me pain is a swollen uvula, a sore jaw, and referred ear pain. I also developed thrush on my tongue which sucks so, so much. Avoiding dairy has helped with the recovery. I also never realized there were so many ways to swallow. I keep having to plug my nose to get water to stop going up my nose or down my windpipe. That of course is nauseatig. Oh, and then there are the hiccups!

It's basically hell. Be prepared to be in hell if you're embarking on this horrible journey.
posted by patronuscharms at 6:16 PM on April 15, 2011 [1 favorite]

Feel better soon patronuscharms!
posted by IndigoRain at 1:48 AM on April 18, 2011

I'm late to the party, but I'll share my experience and strategy. I had mine removed last year, at age 34, along with septoplasty, turbinate reduction, and a couple of sinus procedures I can't remember the names of. My 5 year old son had his tonsils removed last Thursday, and we used the same strategy with some success.

First - accept that things are going to hurt. My job was to manage the pain so it didn't become so unbearable that I couldn't swallow my meds and keep myself hydrated, and throat wet. Having a dry throat just made things unbearable.

So I:
1) Took my pain management mediation as prescribed. I'm sure there were a couple of instances where I took the meds 30 - 60 minutes early because of the pain. I really didn't want to fall behind on pain management. Swallowing them was a chore. Swallowing anything was a chore. I always tried to swallow "normally".
2) Was constantly drinking water - in medium sized sips as suggested above.
3) If I wasn't drinking water, I was swallowing crushed ice, which seemed to numb the pain
4) Gargled with a prescribed antiseptic / numbing solution. Stung like I couldn't believe during, but gave some relief after.
5) For the first three days, I only slept for a maximum of an hour - always waking to drink. This was after falling asleep for four hours and waking up on the first day. I never made that mistake again.
6) Find that place within yourself to put the pain. Warm comfy cloths, a quiet room, and happy thoughts... It will get better (and likely has!)

Some say the procedure is easier on children. After watching my five year old go through it, I'm not so sure. I have a feeling they just have trouble articulating their pain after the experience. The only difference we've seen so far is he seems to be about a day ahead of my schedule for healing. It took me three days before I had the extra capacity to think about something other than pain management. It seemed to only take him two.

In the end, it was worth it for me, as I imagine you will also find!
posted by csmason at 8:13 AM on April 18, 2011

Response by poster: Secondary update:

One week since surgery. Still no sore throat. Uvula swelling gone. Can completely open jaw, have 50% of scabs still, but can't eat anything except baby food and garbanzo beans. Developed rotten, rotten case of thrush and exacerbated it by eating pretzels and mango sorbet. Am now avoiding anything with sugar/honey/yeast in it and have been given a gargle (Nystatin) to rinse with but it tastes like eucalyptus so I feel like a starving koala at the moment. :(

Ended up chronicling some of my discoveries on a blog that I'm developing to a) pass the time and b) give other people some insight into some of the subsequent illnesses one can contract after having your tonsils removed. I would love to incorporate the insights so many of you have provided, so I'll be contacting some of you shortly for permission if there's specific verbage I want to use from your comments. :)

posted by patronuscharms at 8:46 PM on April 19, 2011

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