I am 29 years old and I suffer from chronic acute tonsillitis. I am being referred to a specialist to have my tonsils removed. I am wondering what I can expect as to the recovery time -- the amount of time I should take off work and when I will be able to go back to day-to-day activities. Also, will I have swelling, bruising, etc.?

Brenda

I am not sure what you mean by "chronic acute tonsillitis." You may have "recurrent acute tonsillitis," in which you have frequent bouts of tonsillitis, but are well between bouts. Or, you may have "chronic tonsillitis," in which your tonsils are always painful. Some unfortunate folks actually have both problems. Their tonsils are always bothersome, but are at times acutely worse. The treatment options for these problems are essentially the same:

1. Do nothing. Just live with it.
   
2. Treat each acute exacerbation with a short course (seven to 10 days) of antibiotics.
   
3. Try to "clear it up" with a longer course (20-30 days) of antibiotics.
   
4. Try to prevent exacerbations by taking a low dose of antibiotics on a daily basis. (This is known as "prophylaxis.")
   
5. Tonsillectomy.
   

Tonsillectomy tends to be a very painful operation in adults. Children fare much better. In my experience, children will usually "bounce back" in four or five days (sometimes sooner), teenagers in seven to 10 days, and adults in 10-20 days. Some adults continue to have significant throat pain (such that they limit their diet) for a month or more. Some fortunate adults recover more like children, however. It is not clear why this age variation exists. It may be due to a change in the nerve input of the throat as we age.

How long should you take off work? If you have a desk job, you may be ready to go back after a week to 10 days. If physical exertion is part of your work, I would be much more cautious than this. This also applies to resumption of daily activities. Anything that might tend to increase your blood pressure (exercise, strenuous chores, sex and so forth) could cause a hemorrhage (bleeding). Once again, discuss these issues in detail with your surgeon.

You will have some swelling within your mouth. The tongue and uvula occasionally swell following a tonsillectomy. Bruising is very uncommon. If you bruise or bleed easily, you must share this with your doctor! Also, if you are taking aspirin or nonsteroidal antiinflammatory drugs (such as Motrin), you must tell your doctor. Give your doctor a very complete list of all of your medications, including vitamins and herbal remedies. You would be surprised how many different things can decrease the blood's ability to clot.

These are my opinions regarding what to expect after tonsillectomy. Please see my column on the risks of tonsillectomy to learn more about the hazards of the procedure, which include dehydration as well as pain and bleeding. It is essential that you discuss these issues with your surgeon. Only then can you weigh the discomfort of having to live with your bothersome tonsils against the risks and discomfort of tonsillectomy. Then you can decide whether to proceed with surgery or investigate nonsurgical options.