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Suffering from chronic acute bronchitis and recurrent pneumonitis. Safe to go for tonsillectomy?

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Practicing since : 2009
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Hi i am suffering from chronic acute bronchitis followed by recurrent pneumonitis. in 2012 alone i would have had 5/6 episodes of pneumonitis. All those episodes were preceded by sore throat,cough attacks,with very high fever .Lately i have been having severe throat pain with discomfort breathing, ear pain, the ENT Surgeon has decided to remove my tonsils saying they might be the cause for my repeated pneumonitis episodes. I am scheduled to undergo the procedure in the next 4 days , but i am truly worried about aspirating during the procedure and post operative possibility of cough attacks,chest infection,pneumonia. How risky is this procedure on a person with my medical history and age. I am 50 now and is it safe to take long flight to Asia , about 22 hours of flight, 2 weeks after the procedure and what are the precautions i have to take. what to expect, eat,how to prevent bleeding,aspiration and cough attacks? Please advise me. Thanks
Posted Thu, 21 Feb 2013 in General Health
Answered by Dr. Shoaib Khan 2 hours later
Hello and welcome to XXXXXXX

Thank you for your query.

You should not be worried about aspirating during the procedure, as all experienced surgeons will ensure this won’t happen, with the help of continuous suction and drainage equipment. Also, you will be under the effect of anesthesia, thus your cough reflex will also be paralyzed.

Let me help by listing the post-operative complications of a tonsillectomy:

-Permanent change to voice (this was one the most common complications as there are two nerves that could possibly be damaged during the procedure, and both these nerves are responsible for pitch and hoarseness of voice. This is not common nowadays as all surgeons are well trained)
-Dehydration (due to difficulty in swallowing)
-Prolonged pain
-Failure to relieve from the cause (snoring, sleep apnea, sore throat, etc.)
-Bleeding (very rare)

Your history will not complicate the procedure or post-operative healing process in anyway; do not worry.

Your doctor has suspected your sore throat to be the cause of the recurrent pneumonitis. You need to understand that this is just an assumption, but is his best shot. If this truly is the cause of the recurrent pneumonitis, then your future pneumonitis attacks should be prevented. Let us hope for the best. This is a safe procedure, and with very rare complications. All procedures carry a certain amount of risk. This is one which carries a very less amount of it.

All long flights are both exhausting and in some or the other way effect the traveler. Although, the only difficulty should be cabin pressure in the flight, it would be best to take all precautions before travelling (medications, prescription, etc). 2 weeks should be sufficient for recovery from the surgery.

Please carry all required emergency medication and a doctor's prescription in order to keep flight attendants and other authorities informed of your condition.

In terms of expectations, we are hoping this is the cause of your pneumonitis, and if it is, you should be relieved of future attacks.

Diet: Your doctor might advise soft cold food, like ice cream for a day after surgery, and you might notice blood stained saliva, which you can spit out for a day or two. This is normal. Voice rest for 2-3 days will also help. You will be advised a liquid diet to start off with. Later soft food will be introduced. A follow up visit with the doctor at 7 and 14 days will help him visualize the healing and you will then be allowed to introduce normal food into your diet and can also accordingly plan your travel.

Aspiration should not be a problem, both during the procedure and after. Rest assured, you should be able to eat and drink comfortably soon. Spitting out your sputum for a day or two after the procedure should be sufficient, and from there on you can swallow your saliva as usual.

If your pneumonitis is under control, with the help of medications, cough should not occur. Recurrence should also be avoided if all our assumptions are right.

Please do not worry, as age is not a factor for this procedure. The doctor's are only going in for the procedure to help relieve you of your recurrent infection.

I hope I have helped in clearing your doubts. If there is anything, I have missed out or if you have any more clarifications, I would be happy to clear them for you.

Wishing you lots of luck and a speedy recovery.

Best wishes.
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