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Cramping, Tightening In Throat, Tongue. Undergone Tonsillectomy. Suggest Medication

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Posted on Mon, 29 Apr 2013
Question: I had my tonsillectomy done 6 days ago and have been feeling a lot if cramping and tightening in the fronting my neck and back of throat/tongue. Why is this and what can I do to prevent it because it is extremely painful.. Along with my ears but I know nothing can be done about those at this point. Anything would be helpful as my doctor has not been reachable and it's the weekend.
Thanks!
XXXXXX
doctor
Answered by Dr. Sumit Bhatti (9 hours later)
Hi,

Thank you for your query.

1. It is unusual to have severe pain at the back of the throat/ tongue and cramping in the throat one week after tonsillectomy. I usually discontinue medication after examining the patient post-op at one week.

2. Some possible reasons for persistence of pain are:
a. Excessive fibrosis often encountered in tonsillectomy in an adult.
b. Excessive bleeding during the procedure leading to excessive handling of tissue. This may be known to the surgeon or mentioned in the operative notes.
c. Infection. This will show up on examination. Do you have any fever?
d. No anti-inflammatory medication. What is your current medication?
e. Dehydration.
f. Diet is not bland/soft.

3. The ear pain is probably referred pain from the throat. AN ear examination will settle the issue.

4. Check your throat and tonsil area in a mirror. You may share a close-up image here. Take an OTC pain-killer and and a medicated gargle. See your doctor as soon as possible. Keep yourself well hydrated and eat a bland, soft diet.

Hope, I have answered your query. Please accept my answer in case you do not have further queries.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumit Bhatti (24 minutes later)
I can understand some of those things. My check up isn't for four more days so unless I go to the ER I won't know anything until then. The doctor who did my surgery is over an hour away so my check up will be in my town with a different doctor. I hope someone can see me soon and can help me out. I guess if is easier if you saw a picture to tell how I'm healing, I will try and upload one. I am on a pretty soft diet although I do suck on saltine crackers before swallowing because they help with nausea. I am drinking plenty of water but increasing wont hurt so I will do that.
Thank you for you reply. Again, I will try posting a picture and if you can share with me what you can see as far as the image shows, that would be great.

XXXXXX
doctor
Answered by Dr. Sumit Bhatti (4 hours later)
Hi,

Thank you for writing back.

1. The white slough in the tonsillar fossa (bed) on both sides is normal at a week post-op. It will clear up in another week or so.

2. The red congestion around this slough is slightly more than normal. Hence your symptoms are due to some inflammation or infection. I would ensure continuation of medication, including an antibiotic, pain-killer and a medicated gargle.

3. Usually one tonsillar fossa is easily visible. This is your left tonsillar fossa. The other one (in your case the right tonsillar fossa) is deeper and not fully seen. A direct examination is required to check whether the dark area is a shadow or a clot. On the right side, consequently, the middle portion of the anterior pillar has been removed (possibly for a better view into the fossa while dissecting).

4. In a post-op tonsillectomy, it is better to be extremely careful. Call and inform your surgeon immediately and get this examined soon.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumit Bhatti (25 minutes later)
Interesting. When I look in the mirror my throat is white and then on top of the white is a greenish spotty color. If I'm understanding correctly this could be clotting underneath the white stuff? The redness could be inflammation or infection. This would make sense with my symptoms. Thank you for your reply I really appreciate the time you have taken to talk with me.

I will call my doctor first thing in the morning and hopefully be seen today.

XXXXXX
doctor
Answered by Dr. Sumit Bhatti (5 hours later)
Hi,

Thank you for writing back.

1. Yes, that is correct.

2. You need to verify this possibility and treat it, even if it brushed aside by your surgeon.

I must emphasize that unless there is fever or bleeding, only continued medication is required.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Sumit Bhatti

Otolaryngologist / ENT Specialist

Practicing since :1991

Answered : 2685 Questions

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Cramping, Tightening In Throat, Tongue. Undergone Tonsillectomy. Suggest Medication

Hi,

Thank you for your query.

1. It is unusual to have severe pain at the back of the throat/ tongue and cramping in the throat one week after tonsillectomy. I usually discontinue medication after examining the patient post-op at one week.

2. Some possible reasons for persistence of pain are:
a. Excessive fibrosis often encountered in tonsillectomy in an adult.
b. Excessive bleeding during the procedure leading to excessive handling of tissue. This may be known to the surgeon or mentioned in the operative notes.
c. Infection. This will show up on examination. Do you have any fever?
d. No anti-inflammatory medication. What is your current medication?
e. Dehydration.
f. Diet is not bland/soft.

3. The ear pain is probably referred pain from the throat. AN ear examination will settle the issue.

4. Check your throat and tonsil area in a mirror. You may share a close-up image here. Take an OTC pain-killer and and a medicated gargle. See your doctor as soon as possible. Keep yourself well hydrated and eat a bland, soft diet.

Hope, I have answered your query. Please accept my answer in case you do not have further queries.

Regards.