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

Thanks!
XXXXXX
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.


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
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.


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

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