Sunday, March 22, 2015

Days 10-11 Post-Op - March 21-22

Energy Returns

I feel like my energy is back now. I can go out for a pretty long walk and get groceries and whatnot without needing to take a nap the moment I get home. Day 10 post-op I had some ear pain after eating that spiked to about a 4 out of 10, but nothing above the pain levels I've felt so far. Day 11 I again only had pain after eating. I'm confident the worst is over, which is good, since I'm back to the office tomorrow!

Acid Problems

I still haven't been able to bring everything back to my diet yet, the main problem being acid. I tried a sip of wine when I went out on day 8, but I wasn't quite ready for it yet (not sure if it's the acidity or the alcohol). On day 10 I got a tasty-looking cherry-ginger drink to the store, but I took a few sips and it was a little too tart. On day 11 I tried some aloe drink, which I bought because I thought it'd be soothing, but it's also just a little too tart right now. So, it seems I still have some sensitivity to acid. It's not painful, but it is uncomfortable, so I still have a ways to go. At least I know I don't have to avoid tomatoes. And that makes sense. I just refreshed my memory of the pH scales, and while tomatoes (pH 3.5-4.7) are more acidic than bananas (pH 4.5-5.2) and coffee (pH = ~5), tomatoes are on average less acidic than wine (pH = ~3.5, though the alcohol is also an irritant) and cherries (pH 3.2-4.1). I'll try the cherry drink again soon, and I'm sure I'll be trying wine by next weekend if not before. :-)

Note that honey, with a pH of 3.9, is more acidic than many tomatoes, and agave is slightly more acidic than that, at around a 3.7. With sweeteners, you're presumably only putting a relatively small amount into a much bigger drink, so the acidity is not a problem in the drink. But you might not want to lick the honey off the spoon if your throat is still sensitive to more-acidic foods (sugar, maple syrup, and molasses are much less acidic if you're just dying for a sugar rush). Likewise, if you're thinking about drinking apple juice, that's also more acidic than tomatoes on average, with a pH range of 3.35 to 4, so beware.

Friday, March 20, 2015

Days 8-9 Post-Op - March 19-20

Day 8 - Surprise

On day 8 post-op, I went with a friend to an Italian restaurant to try to get out of the house. I ordered pasta with a braised meat sauce, figuring the meat would be relatively soft from the braising and that I've have no problems getting it down, even if this would be my first time attempting to eat meat after surgery. Since I've been avoiding acidic foods, I specifically order a pasta that didn't include tomato. Well, the menu wasn't so descriptive, because when the dish came out, I saw that the sauce contained a good bit of tomato. But I let it cool a bit and took a bite, and I had no problem with it. In fact, I ate the entire dish without any irritation from the tomatoey sauce. I guess tomatoes are OK now!

I also tasted something a little spicy, and I had no problem with that. But I'm used to ordering spicy things and burning my mouth out, so maybe 8 days was enough healing to get back to mild-to-medium spicy things, even if my mouth is still sensitive. I won't be trying hot Buffalo wing sauce or this honey-habanero sauce I love, but it seems that a lower amount of spice is OK.

Day 9 Snowstorm

On day 9 there was a snowstorm--hopefully the last of the season since spring is officially starting--so I was glad to be inside working from home. Nothing new, really. Even though I'm starting to be able to eat a wider range of foods, I'm not sure I'll be able to branch out too much this weekend. Not only do I need to stay hydrated, but I need to clear out all the liquids and soft foods out of my fridge and pantry!

Wednesday, March 18, 2015

Days 6-7 Post-Op - March 17-18

Walking and Italian Pastries

Good progress on days 6 and 7. It still hurts to swallow, but the ear pain is becoming less frequent, and the scabs are visibly wearing down. I definitely have more energy too. Since Monday, I've been able to stand for much longer periods of time without feeling pooped. I even went out for a walk yesterday and today. Yesterday I ended up walking to Whole Foods to get some more bananas and then to an Italian bakery, so it ended up being a pretty long walk, but I walked slowly and carried a big bottle of ice water with me so I wouldn't get dehydrated (and it gave me a bit of solace that I had to pass by the ER if I had any problems...). On the way there I popped into a coffee shop and got a smoothie and sat down so I could rest a bit, and on the way home I sat in the park to rest a bit as well, so I think I was able to avoid overexerting myself during this critical period. I got a zeppola (St. Joseph's Day pastry) at the bakery, since it's that time of year, and found that I can eat it, but with relatively small bites and making sure to chew a lot. I ate about half of a chocolate-filled one and then ate the pastry cream from the other half, which tasted amazing.

Deviled Eggs

Today I made deviled eggs, which I figured would be soft enough to eat. I didn't use pickles or pickle juice or relish, but I did put a little dijon mustard in. I actually took a little taste of the mustard by itself, and even though it has vinegar in it, it wasn't enough to bother my throat, which is great to know. I made 3 variations: cumin, garlic & cumin, and garlic & tarragon, and I sprinkled sweet paprika on them (I figure cayenne or hot paprika is probably a bad idea right now). I think I liked the garlic & cumin version the best.



Not bad considering I've never boiled an egg before!

Back to Work

Well, tomorrow (Thursday) I begin working from home, and I plan on being back in the office on Monday. I'll try to post an update by the weekend. Happy St. Paddy's Day!

Monday, March 16, 2015

Days 5 Post-Op - March 16

Well, it's the dreaded day 5 post-op, but I haven't had any trouble. The scabs are starting to wear down, but the pain swallowing is about the same, and the mild ear pain comes and goes. I definitely have more energy, though. I was able to spend more time in the kitchen today without feeling like I should rest. So, that's a nice improvement.

Pasta and Beans!

I actually mustered the energy to make pasta e fagioli in bianco (pasta with beans - in chicken stock instead of with tomato), which was soft enough for me to eat. And thank god, cause I'm already sick of mashed potatoes. I was out of onion, but I had half a shallot left, so I diced it finely and sauteed it in olive oil, added salt, pepper, garlic, oregano, and a can of cannellini beans*, then added some chicken stock, let that come to a boil, and added 2oz of spaghetti that I broke into smaller pieces. I cooked the pasta right in the pot with the beans*. It was great! Very simple, and not pretty-looking, but I can't handle a big kitchen project right now. It was soft enough to eat--and still way more interesting than instant mashed potatoes! It actually reminded me of my my grandmother's pollo in bianco (chicken in "white" sauce, meaning oil-based rather than tomato), which she basically just seasons with garlic, oregano, and black pepper. So, I'd call it a win!



The thing is, I could only eat half of it. With all the liquid and the fiber in the beans, it's very filling. Plus, I got fatigued of swallowing, which is still painful (though not unbearable). The entire bowl was only 500 calories (yes, I added them up), and I could only manage half of it. A step in the right direction, but guaranteed I'm still losing weight in this whole ordeal (which is fine for me).

*Cooking notes

  • Usually I'd add the beans later just to warm them through, but right now I need them to be cooked until very soft.
  • I let the pasta go 2 minutes longer than the package instructions, since I need to be eating soft foods right now; this is no time for al dente pasta. Note that the proper cooking time would actually be less than what the package indicates, because I broke them into smaller pieces.


A Decadent Tahini-Date Shake

I also made a tahini-date shake this morning, courtesy of this recipe on yummly. The amount of tahini in this probably makes up for the calories I missed out on by only eating half of my pasta & beans. I'd probably cut the tahini in half next time. I also thought it needed to be a little sweeter, so I added some agave, but honey would be great as well (honestly, agave is easy to work with and honey is messy and slow, so I'd much rather not deal with honey right now). Since I wanted to make sure I didn't have any big chunks of date left, I buzzed the dates with the almond milk first, then added the rest of the ingredients before setting on smoothie mood. It was great, but the tahini taste was prominent. I think that post-surgery everything is tasting a little more bitter than usual--the tahini notably so--so I'd dial back that ingredient at least until everything tastes normal again.

Sunday, March 15, 2015

Days 2-4 Post-Op - March 13-15

Friday the 13th, but no bad luck here. Pain was still about the same level, but got annoying late in the morning, so I took another dose of Tylenol. I was getting used to the feeling of swallowing, so I was able to drink a lot more. On this day, I managed to have:

  • 1 20oz bottle Gatorade
  • 16oz coconut water
  • 1 pre-boxed vanilla vegan shake
  • 1/2 C vanilla almond-milk ice cream
  • carrot-banana smoothie (carrot juice, banana, almond milk, agave, and ice)
Mid-afternoon I was feeling pretty groggy, and I figured that part of my discomfort was not having any coffee, like I'm used to. Coffee does dehydrate you , but I though a little would be OK, especially if I'm taking in all these other liquids on top of tons of ice water. I didn't have any coffee to brew and didn't want to go out, but I found some instant espresso powder, which I'd never drink but must've had from making a dessert one time. I put not even 1/4 tsp (I figure maybe 20-30mg caffeine) of that into some almond milk and sweetened it a bit to see how I'd feel. Still a little tired, but better. I could probably add some more without risking dehydration. Luckily I only usually have 1 cup of coffee a day--maybe 10oz of coffee--and I often do half-decaf, so it's not like major withdrawal symptoms, just a bit of morning grogginess.

On the 14th, I managed without any pain-killers at all, and I added mashed potatoes to the diet:
  • coconut-almond milk w/ espresso powder
  • 16oz coconut water
  • 1 pre-boxed vanilla vegan shake
  • 1/2 C vanilla almond-milk ice cream w/ chocolate syrup
  • chocolate-banana smoothie (Hershey's unsweetened cocoa powder, banana, almond milk, agave, and ice)
  • 1 round of mashed potatoes made with almond milk and olive oil (instead of butter).
  • 1 round of mashed potatoes made with almond milk and and mix of olive oil and coconut oil (not any better or worse, but just thought I'd try it to see how it tasted; luckily I didn't make it too coconutty)
I needed to add salt to the mashed potatoes, which luckily didn't bother my throat at all.

Today, the 15th, I managed to avoid pain killers again and to eat a good deal as well:
  • coconut-almond milk w/ espresso powder
  • 1/2 bottle Revive Vitamin Water - This is still a little too acidic. I'll try it again another day.
  • "carrot cake" smoothie (carrot juice, almond milk, dates soaked in almond milk, banana, agave, cinnamon, and ice) - I blended it twice to get the dates small enough to swallow. If I do one of these again, I'd suggest blending the dates with almond milk well, then adding other ingredients, then running smoothie mode.
  • mashed potatoes made with chicken stock (in place of water), almond milk and olive oil (instead of butter).
  • Gravy for mashed potatoes, which I made with chicken stock and corn starch. It was pretty bland, so in addition to plenty of salt I added mixed pepper, garlic powder, dried oregano, and dried sage. Not bad, but would've been better if I had better stock.

We'll see how the infamous Day 5 post-op goes.

Day 1 Post-Op - March 12

Pain was back to about a 3/10 and went down throughout the day for the most part, with maybe a brief spike at 4/10. I even called in for a work meeting where I wanted to hear what was going on but told them I'd be on mute and wouldn't be able to talk. I spent the day watching Netflix and Food Network, jealous of all the delicious things on the screen that I wouldn't be able to eat for weeks.

I got through the rest of the bottle of Gatorade and the banana smoothie during the day, and for dinner I had a vegan chocolate shake I picked up. That was enough for me that day. I took 2 Tylenol before bed and that was it.  My 1:30 and 3:30 alarms didn't sound (stupid buggy iPhone), but I ended up waking up around 4:15 having to use the bathroom and was pleasantly surprised that my throat was still hydrated and not in pain. I figured that from now on I can drop it to 1 middle-of-the-night alarm after about 4 hours to force a few sips of water, unless there's "breakthrough" pain I need to manage.

Day of Surgery - March 11

I was my surgeon's first patient of the day, so I had to be at the hospital at 5:30 a.m. for 7:30 surgery. After getting ready and getting showed to my pre-op gurnery, a couple of nurses introduced themselves and I started signing the paperwork. The surgeon came over around 7:10, followed by the anesthesiologist and the rest of her team. Even in the somewhat dark room, the anesthesiologist could see how big my tonsils were, even though they weren't inflamed. After that, they started the sleepy drug into my IV, which, exactly as they said it would, felt like I'd had a couple of drinks. They began wheeling me towards surgery, and it's as if the room was not meant for wheeling those beds through; I remember annoying asking who designed the space, which one of the nurses wheeling me explained to the other was a natural though for me since I'm an engineer (she got my whole life story while putting the IV in).

I woke up in the PACU, and after a few minutes of boredom I turned around and saw a clock. It was 8:38, so I don't think I'd been asleep for more than half an hour. After a few more minutes, I saw the anesthesiologist, and I giddily waived to her because I wanted to talk to someone. No problems, she said, and she was surprised at how awake I was. I just had some ear pain, what I'd get with tonsillitis--or similar to a mild ear infection. I described it to a nurse as a 3 on a 10 scale. I had to wait in the PACU a while longer than I needed, because they had to wait for a recovery room to open up. In recovery, I was greeted to a cup of water with crushed ice, which I gladly sipped, and some applesauce. The smell of applesauce has made me nauseous for as long as I can remember, so they took it away. They offered Italian ice, but they only had citrusy/acidic flavors (I tried asking for chocolate or coconut), and ginger ale, neither of which I could have. Clearly they didn't know my surgeon's suggestion of no bubbles. Interestingly, avoiding citrus and bubbles are not on the official discharge instructions, though that would probably be helpful. In any case, I stuck with ice water. There was some pain swallowing, but I got used to it after a few sips. I've had far worse pain swallowing, though. When I was 19 I had some kind of blisters on the roof of my mouth, and when they popped, I couldn't drink anything--not water, not chocolate milk--and I lost 13 pounds in barely a week. That was the worst throat pain I've had, totally unrelated to tonsils or this surgery. So, while I didn't have the same pain after surgery that many people do, I've had similar pain before, and I remember what it's like to not even be able to sip water.

The nurses said I'd stay in recovery for probably a half hour to 2 hours, depending on how I felt, so I got my phone and my book out of my bags of belongings, which were there waiting for me. Of course, I spent the whole time on my phone. So much for the book. But I couldn't watch TV; the sound hurt my ears, which were already hurting.

By a little after 10, I was OK to leave, so I texted my friend to pick me up, and we were gone by 11. I was prescribed an antibiotic as well as 1-2 5mg oxycodone every 4 hours as needed for pain and told to I could add Tylenol as needed. Still at a 3/10, the pain was an annoyance but nothing horrendous. I decided to wait and see whether I really needed pain meds, and around 9:30 p.m. I took 2 Tylenol so I could sleep a little better. As of Sunday evening, I still haven't needed any oxycodone. I took a 2nd dose of Tylenol on Thursday night and a 3rd dose late Friday morning, but that's it so far. I should also note that this was with the classic electrocautery method which is supposed to be more painful than the coblation method (which my surgeon chooses not to do, due to higher risk of post-operative bleeding).

As far as eating and drinking on Wednesday, I had to get used to things. I tried some Gatorade but found that it made my saliva very thick, I think because it's pretty sweet, so I was slow to drink it. After adding plenty of ice to thin it down, it was much easier to drink, especially alternating with ice water. For dinner I made a banana smoothie (1 banana, 1 C almond milk, ~2 tsp maple syrup, and ice). In all, I got through about half of a 20oz bottle of Gatorade and about a quarter of the smoothie that day.

I set an alarm for every 2 hours that night to take a sip of water and to sense if I needed any pain meds. Interestingly, since the moment I woke up from surgery, I was able to breathe through my nose without issue, even though I'm usually a heavy mouth breather. At first, I'd wake up after 15-20 minutes of sleeping, I think at the moment my mouth opened and I started breathing in. It's as if mouth breathing felt bad--or maybe my brain knew how detrimental it would be and I woke up. After a couple of rounds of that, I went to sleep until my alarm went off. Each time I woke up, my throat felt well-lubricated. I seemed to be able to manage to breath exclusively through my nose. Maybe I got lucky with this, but my mouth hasn't dried out at all. One thing I will say is that I have not spit or drooled once; I always make sure to force a swallow, even when it's uncomfortable. On surgery day, I got used to the mild pain of swallowing, which I think has helped me keep my throat lubricated while I'm asleep and just in general. When my alarm woke me at 3:30, 6 hours after I took the Tylenol, the pain was almost non-existent, so I went back to sleep without another dose.

Pre-Op

Before my surgery, I wanted to make sure I had all my ducks in a row, so I made a shopping list based on everything I read online. Based on what I read on various tonsillectomy-recovery blogs and comments, I decided to avoid dairy. I like almond milk, so that will do. Here's what I bought:
  • coconut water
  • clear (cherry) Gatorade
  • almond milk: I bought the original flavor as well as a coconut-almond blend in both regular and unsweetened forms so I could mix things up a bit
  • bananas (for smoothies)
  • almond-milk pudding
  • almond-milk ice cream
  • chocolate syrup (dairy-free)
  • jello
  • instant mashed potatoes
  • low-sodium chicken stock
  • unsalted vegetable stock (interestingly, this "unsalted" stock has more sodium than the "low-sodium" chicken stock)
  • some flavored waters (unsweetened) to mix things up: cucumber, pear, lavender-mint, etc.
  • a cooler to hold bags of crushed ice
  • a cool-mist humidifier, since I've always been a heavy mouth breather at night and I don't want my scabs to dry out while I sleep, lest I be left in the horrendous pain so many people have written about (humidifiers are not recommended for people who are allergic to mold, as I am, since they can harbor mold, but I figured a brand new one would be OK for a week or 2)
I also picked up some "Revive" Vitamin Water and some pre-bottled vegan shakes, which have both vitamins and protein, and some carrot juice, which I figured wouldn't be too acidic. I also found some aloe juice, which I thought could be very soothing, so I picked some of that up as well.



I also made my list of things to avoid. Besides dairy, which I read about online, the list is based on my ENT's recommendations: dairy: milk, yogurt, butter, cheese, ice cream, cheese (I figure that when I feel ready I'll try a bit of butter on something and see how it goes); citrus; bubbles/soda; spicy foods; hot foods; "sharp" foods like pretzels and chips; straws

I figured smoothies would become my main "meal", and probably banana since it's soft and not acidic like orange or berries. I got a new blender I hadn't used yet, so I pulled it out and made a smoothie for dinner the night before surgery. I figured I didn't want to eat too much so I couldn't sleep that night, and I didn't want to have to be figuring out how to work the blender or what proportions would be OK while I'm recovering. BTW, it's a great blender with a smoothie mode and a self-cleaning mode (!), which is just smoothie mode but with warm soapy water. It also has a citrus-juicing lid. I got it at Williams-Sonoma, where it's one of the lower-priced blenders, and in any case it's far cheaper than any Vitamix. Check out the Breville Hemisphere Twist Blender if you're looking for one.

I laid out all the non-perishable food items I'd need so I wouldn't have to go searching for them during recovery: the stocks, mashed potatoes, bananas, agave, tea, and cocoa powder. I also cleaned my apartment and made sure all my laundry was done. All my bills are on autopay, so the next thing I'd have to worry about is my rent, and I know I'll be fine by April 1 when it's due (and it only takes a minute to pay online anyway). I wished I'd filed my tax return, but I figured I still had over a month to file, so even if I couldn't do that during recovery, I'd still have plenty of time for that.

Background

Hey there,

I'm a 34yo male who had a tonsillectomy on Wednesday. Today is Sunday, so it's day 4 post-op, and I thought I'd share some of my experiences to help those of you who want to read about the procedure and recovery before going through with it. I know I did--and yes, the horror stories scared me, but so far my case is nothing like those (see future posts). I'll also share some of the foods I've been eating so you can get some recipe ideas.

First, some background:

I started noticing tonsil stones a few years ago after I finally looked in the mirror when I felt something stuck in the back of my throat. At that point, probably 2008 or 2009, I also started noticing that my tonsils were often enlarged. The tonsil stones and tonsillitis continued frequently, though I didn't have to take antibiotics for a bacterial infection too often--maybe once a year. However, the tonsillitis, which could last weeks at a time several times a year, would often cause an earache, and the tonsil stones, while they never hurt, were smelly and annoying (though I'd coax them out with dental tools). I also suffer from continual post-nasal drip (allergies), a snoring problem, and possibly also a mild case of obstructive sleep apnea (though I've never done a sleep test). All of these things pointed me to a tonsillectomy for relief of tonsillitis and tonsil stones, and possibly to the other ailments.

After a cough and congestion accompanied by tonsillitis that lasted almost a month this past November, I got sick again towards the end of December, this time with congestion and major sinus aches--and both tonsils notably swollen even more than the previous month. I went to the doctor, but it wasn't clear that it was bacterial, so I was told to call later in the week if it got worse. It didn't, so I thought I'd ride it out. About 2 weeks later, one tonsil had mostly retreated, but the other was even bigger than before, just about to the middle of my throat, and it was clearly infected, coated in white. At that point, I went back to the doctor and got some antibiotics, but I also asked about whether I might be a candidate for tonsillectomy and whether I should see an ENT. The NP who was filling in that day, who listened to my history, said I might as well, and that quite frankly she was glad when she had her kids' tonsils out even though they were older than usual. At the very least, I could introduce myself and the ENT could monitor me over a period of time. Note that I had mentioned my enlarged tonsils to 2 doctors prior to this, as well as to an allergist, but I had to go in with an infected tonsil and specifically ask about tonsillectomy and whether I should see an ENT. No one suggested it to me. Perhaps that's because my case isn't as severe as some of the clear-cut cases, which I freely admit, but it illustrated, but it illustrates how z

About 2 weeks later, I saw an ENT. He looked at my throat, still red even though my tonsils were back to normal--not huge, but definitely larger than most people who don't have tonsil problems--and I told him my history. He told me I was definitely a candidate for tonsillectomy and that it was up to me if I wanted to endure the notorious recovery. My job gives me a bank of over 4 weeks of sick days per year, which I've never used in 5 years. That's on top of my vacation time. Given those benefits, it's silly not to use them to take care of my problems. Given that February into March tend to be slower times at work for me and that it's before spring allergies really kick in, I landed on the March 11 date for surgery. It's doubly perfect because  I'll be travelling for work in May and June with my own vacation in between, so I want to be fully recovered before then.

Given my time-off benefits at work and the fact that I don't have kids, it was a relatively easy decision to go ahead with the surgery. I can even start back by working from home before I actually go back into the office. So, I have a lot of flexibility. I never could have done this in my previous jobs without using most of a year's worth of vacation or taking time off without pay--a position I think many of you reading this may be in. I count myself lucky.