This is topic Hatrack Medicos: White spots on tonsils UPDATE 2: Home from Tonsillectomy in forum Books, Films, Food and Culture at Hatrack River Forum.
If any of you medical wonders can help me, I'd appreciate it.
I currently have a case of tonsillitis. Slightly swollen red tonsils with white spots, which I'm assuming are lovely bits of pus.
I'm currently on my second to last day of taking antibiotics (azithromycin), and while the tonsils seem to have shrunk a bit they are still red and one still has white spots. I have no real pain from them.
Am I just worrying over nothing, and the drugs need a bit longer to work? How long do I wait for the spots to go before talking to my PCP again?
Help a hypochondriac, please.
[ March 06, 2009, 09:52 PM: Message edited by: Javert ]
Posted by maui babe (Member # 1894) on :
Did you have a culture done? If you're concerned, call for your test results and ask if the spots are anything to worry about. Your PCP and/or his staff should answer questions without requiring you to come in for a visit.
Is your antibiotic a Z-Pack? My understanding is that while you only take the pills for 3-5 days, the antibiotic stays in your system longer and continues to work.
Posted by Javert (Member # 3076) on :
It is a Z-Pack, yes. And no, we didn't do a culture.
I'll wait through the weekend, I think. Unless there's pain or it looks like they get worse. In which case, that's what my insurance and the ER is for.
Posted by maui babe (Member # 1894) on :
Even without a culture you could still call your PCP and ask. It could save you a lot of aggravation (which is kind of the definition of a trip to the ED).
Posted by Javert (Member # 3076) on :
I'll shoot him an email if it gets worse or remains constant. Thanks. Posted by Lisa (Member # 8384) on :
I would guess that the white spots are strep. You really want to get a culture done.
Posted by andi330 (Member # 8572) on :
That would have been my thought too.
Posted by Shanna (Member # 7900) on :
The first and only time I've ever had tonsillitis, they gave me a Z-Pack and it wasn't enough to kill it off. I felt better for awhile but then it came raging back.
So I got the suckers taken out!
Posted by Javert (Member # 3076) on :
If it doesn't go away, culture is the next step. I'll give the z-pack some time to work.
Posted by andi330 (Member # 8572) on :
Not to trot out an old saying here, but if it's something you need to ask about here, you need to ask your doctor about it. The last time I had white spots in my throat it was strep, and strep bacteria aren't something to mess around with because they can get very serious very quickly. Talk to your doctor, ask if you need the culture. The worst that happens is that he says the Z-pack will kill it if its strep and the call was unnecessary. Or he might tell you it's important to come in right away. Don't take the chance with your health.
Posted by Traceria (Member # 11820) on :
quote:Originally posted by andi330: Not to trot out an old saying here, but if it's something you need to ask about here, you need to ask your doctor about it. The last time I had white spots in my throat it was strep, and strep bacteria aren't something to mess around with because they can get very serious very quickly. Talk to your doctor, ask if you need the culture. The worst that happens is that he says the Z-pack will kill it if its strep and the call was unnecessary. Or he might tell you it's important to come in right away. Don't take the chance with your health.
I second that. Don't wait. Call (or email? that's kind of cool) your doctor and ask what should be done, be it a culture or calling in another prescription.
Posted by ClaudiaTherese (Member # 923) on :
Some points of clarification:
---
1. The major worrisome outcome of strep throat is rheumatic heart disease. Certain heart valves disintegrate. It is a risk, not a certainty, but it is a serious risk. Unfortunately, the risk isn't proportional to the severity of the symptoms.
Let me rephrase that: You can't rely on assuming that if the sore throat gets better or never got very bad, you didn't need antibiotics to protect your heart. And again: Just because your symptoms didn't get bad, doesn't mean you were less likely to get heart disease from it.
And again: You could have strep throat with pain for a few days, then get totally better with no symptoms even without antibiotics, and still find out 3 months later (feeling perfectly fine, meanwhile!) that you now need open heart surgery.
It's a risk. It won't happen to everyone with strep throat that goes untreated. However, it is a serious real outcome that can be prevented if the treatment starts within 9 days of the initial symptoms.
---
2. Penicillin is the right drug for strep throat. That being said, for people allergic to penicillin, azythromycin ("z-pack") is an acceptable alternative. It isn't the drug of choice, but it can be used, too.
---
3. You cannot tell by looking whether or not the sore throat is caused by streptococcus.
I repeat: You cannot tell by looking whether or not the sore throat is caused by streptococcus.
Some physicians think they can. Unfortunately, studies do not bear this out, no matter how skilled and experienced the physicians believe themselves to be, and some of them have seen literally tens of thousands of sore throats.
Strep is called one of the great mimics: it can look like nothing, or it can be "classic," or anything in between. And a "classic strep throat look" can be caused by adenovirus, monovirus, all sorts of other things. Yes, perfectly "classic" -- white patches, flaming red all around, dark spots on the palate -- still has a good chance of not being strep.
-----------------------
In summary: sore throats deserve a culture, especially with other risk factors. Also, the z-pack might well have covered you, anyway -- but that doesn't mean your physician shouldn't be updated now. [See below]
quote:The U.S. Food and Drug Administration (FDA) has labeled a five-day course of azithromycin as a second-line therapy for streptococcal pharyngitis. [The first-line choice is still penicillin.] Azithromycin is associated with a low incidence of gastrointestinal side effects, and three- and four-day courses of this antibiotic have been shown to be as effective as a 10-day course of penicillin V.19,20 However, azithromycin is expensive, and its effectiveness in preventing acute rheumatic fever is unknown.
We aren't sure about the longterm heart protection, but the z-pack does seem to kill off the bacteria in the throat. Your own physician should make the decision about whether that is sufficient in your case.
[ January 30, 2009, 10:52 AM: Message edited by: ClaudiaTherese ]
Posted by rivka (Member # 4859) on :
quote:email? that's kind of cool
I can email my doctors at Kaiser too -- through the Kaiser webpage, not directly.
Posted by Traceria (Member # 11820) on :
quote:Originally posted by rivka:
quote:email? that's kind of cool
I can email my doctors at Kaiser too -- through the Kaiser webpage, not directly.
Guess my PCP has a ways to go. Ah well. Evil phone it is for the time being.
Posted by Javert (Member # 3076) on :
I shot my PCP an email and I await his response. Thanks everybody. Here's hoping my heart doesn't disintegrate. Posted by ClaudiaTherese (Member # 923) on :
*rueful grin
Usually, it doesn't. Posted by Javert (Member # 3076) on :
Got an email back. He's given me a name of an ENT and told me to go see him in the event that my throat isn't better by Monday.
In case anyone was curious.
Posted by BelladonnaOrchid (Member # 188) on :
I was curious. I hope you get better soon. Being sick is not the funnest thing in the world.
Posted by Javert (Member # 3076) on :
Quick update. Saw the ENT this morning. He did a check-up, ran some tests, and has put me on clindamycin for the next 10 days.
Huzzah for more antibiotics, eh?
He also told me to investigate if I might have sleep apnea and that if the infection recurs a few more times we may consider a tonsillectomy down the road.
So yeah, not dying. I'm sure you're all thrilled. Posted by Javert (Member # 3076) on :
quote:Originally posted by Traceria:
quote:Originally posted by rivka:
quote:email? that's kind of cool
I can email my doctors at Kaiser too -- through the Kaiser webpage, not directly.
Guess my PCP has a ways to go. Ah well. Evil phone it is for the time being.
The funny thing is that while I can email my PCP and he emails me back very fast, he's so old school that you can only pay the copay with cash. No cards.
Posted by ClaudiaTherese (Member # 923) on :
quote:Originally posted by Javert: So yeah, not dying. I'm sure you're all thrilled.
Well, yes, indeed. Posted by Traceria (Member # 11820) on :
quote:Originally posted by Javert: The funny thing is that while I can email my PCP and he emails me back very fast, he's so old school that you can only pay the copay with cash. No cards.
Yeah, that is kind of backwards. Huh.
Glad to hear you're still alive and are taken more doctor prescribed drugs. Posted by aiua (Member # 7825) on :
Mmm.. clindamycin. I remember getting that for something or other and breaking out in horrible hives that lasted for what seemed like ever. But! I was lucky -- I had taken my school picture the day before.
Posted by rivka (Member # 4859) on :
quote:Originally posted by ClaudiaTherese:
quote:Originally posted by Javert: So yeah, not dying. I'm sure you're all thrilled.
Well, yes, indeed.
Yeah, we'd rather avoid the paperwork.
Posted by Javert (Member # 3076) on :
Soooooo, that clindamycin? Didn't work.
And it's not strep. It's tonsillitis. Which means (drum roll please)...
I"M GETTING MY TONSILS OUT!
Huzzah.
Posted by Lyrhawn (Member # 7039) on :
I had mine out when I was a kid.
If you're lucky, you'll get mint chocolate chip ice cream and California Raisin PJs as a reward...unless the reward system has changed in the last couple decades.
Posted by ClaudiaTherese (Member # 923) on :
I hope this makes things all better for you.
Posted by Javert (Member # 3076) on :
quote:Originally posted by ClaudiaTherese: I hope this makes things all better for you.
Thanks CT.
Funnily enough, I've started gargling with hydrogen peroxide at the suggestion of my ENT (and doing so very carefully with mostly warm water) and the tonsils are looking a bit better.
Which is not to say I shouldn't get them taken out anyway. But at least I don't feel too disgusting any more.
Posted by Tante Shvester (Member # 8202) on :
Ask the surgeon to let you keep them after they come out. Then, when you are convalescing, you can show them to all your visitors. Later, you can have them bronzed, and keep them on the mantelpiece.
Anyway, good luck with everything, and I wish you a speedy and complete recovery.
Posted by BannaOj (Member # 3206) on :
You'll probably get sick much less frequently after they come out, at least that's what I've found.
When you have the surgery as an adult the recovery is *excruciatingly* painful. You'll be wondering why the heck you agreed to this torture.
But, in the long run... definitely worth it.
Posted by Javert (Member # 3076) on :
quote:Originally posted by BannaOj: You'll probably get sick much less frequently after they come out, at least that's what I've found.
When you have the surgery as an adult the recovery is *excruciatingly* painful. You'll be wondering why the heck you agreed to this torture.
But, in the long run... definitely worth it.
Do they at least give you pain drugs?
Posted by BannaOj (Member # 3206) on :
Yes they do.
I have since found out due to a genetic condition, I have a significant resistance to pain drugs.
So, it might not be quite as bad for other adults, as it was for me, but when I've compared notes it is still pretty bad. I would describe it as "raggedly intense". It was a very different kind of pain, than all of the other surgeries I've had.
The Campbells "soup at hand" cups which have noodles small enough that they are totally drinkable was the only semi-solid food I could bear to swallow for two weeks. I highly reccommend them, although you will be totally sick of them by the time you recover.
Icey gelatos and sorbets, were easier for me to eat than more "cream" based frozen products at first.
I'd also make broth from beef or chicken bullion cubes which completely dissolve so there isn't anything to scratch. And I drank lots of herbal teas.
Posted by breyerchic04 (Member # 6423) on :
I wasn't allowed to have icecream, it coats your throat and can lead to infection or something. I could have as many popsicles as I wanted.
I was twelve so not a young kid but really an adult either. It was 8 days before the start of middle school, so I knew I had to get better fast. I guess I am sick less often now but not lots less.
Posted by Shanna (Member # 7900) on :
I couldn't eat tonsils after I got my tonsils out (I was 21 at the time, I think.) The cold hurt too much.
My boyfriend at the time would put chicken noodle soup in a blender for me. It sounds disgusting but it worked.
The pain meds were a bother. The pills kept getting stuck in my throat. It was terrible. I just remember that once I got off the harder drugs, I was still chugging liquid tylenol on a regular basis.
Posted by Tatiana (Member # 6776) on :
Shanna, were the tonsils frozen or something? I guess that's how they preserve them but you could warm them up maybe before you ate them and they wouldn't hurt so much going down. Posted by Shanna (Member # 7900) on :
Why let them throw perfectly good body parts away? For all the trouble they caused, I just couldn't stand to part with my tonsils.
But yeah, that first instance of "tonsils" was supposed to be "anything cold." I am sick at the moment so I wish I could blame the cold meds for the loopiness but sadly, I do not have any Nyquil to dope myself up with.
Posted by DDDaysh (Member # 9499) on :
My son is finally, finally, FINALLY (little happy dance here) getting his tonsils out next Monday. I understand the surgery is supposed to be MUCH easier for kids than for adults, so I'm not too worried. When my cousin got them out this summer she was back to normal by day 3.
We've been on a LONG road to get the suckers taken out (well, them and his adenoids too). I've had doctors bickering back and forth about whether to take them out for nearly 2 years now. It is really very un-fun to feel like a gofer between three specialists and a pediatrician who cannot agree on what is best for your child.
The funny thing is, after all the worry over the impact it has on his asthma, after more strep infections than I can count, after all of that... the reason they finally decided to take them out is because of his speech! Isn't that weird?
Posted by Javert (Member # 3076) on :
quote:Originally posted by DDDaysh: I understand the surgery is supposed to be MUCH easier for kids than for adults, so I'm not too worried.
Funny. My ENT told me specifically that the tonsillectomy isn't that much harder for adults than it is for kids. I think he said that children might be able to deal with the pain easier because adults will dwell on it more.
Which I can understand, as being out of commission with pain as a child means Mommy and Daddy can wait on you and you don't have to go to school. As an adult, you may not get Mommy and Daddy, and you miss work and thus the income from it.
Posted by BannaOj (Member # 3206) on :
Um, that's directly opposing what my ENT said.
What I heard (not official medical advice in any way shape or form) is that because the tonsils are larger in adults than they are in children, the actual *wound* is that much larger when they scrape them out.
But I could be wrong.
Posted by DDDaysh (Member # 9499) on :
What the ENT told us is that in Adults the tonsils are bigger, so the scab is bigger, thus is more prone to bleeding & pain. He didn't really go into any other reasons why it was easier with children, just that they usually responded better. I know my little cousin who was 5 when she had hers out was feeling perfectly fine by day 3 (except for some tenderness swallowing) while a coworker's daughter who was 11 had to be coaxed to even drink anything for almost a week, and another coworker I talked to who had them out as an adult said she was out of commission for nearly two weeks and had to stay in the hospital for several days. Of course, part of that might just be that different people respond differently, but so far the empirical evidence seems to indicate that younger is better.
My main concern is that he'll be having his adenoids out as well. We don't know exactly how big they are but there is a good chance that he has been relying on them to help seal his throat while he swallows. (The way he makes many of his words indicate that he doesn't close his airways correctly.) So I'm worried we're going to be seeing alot of liquid in his nose, and I'm hoping he doesn't start choking on all of it and set off his asthma... But I guess there is a downside to everything. Mostly I'm just happy they're finally going to do it because both his pedi and pulmonologist think it will help his inclination to illness.
Posted by Tante Shvester (Member # 8202) on :
When my son woke up from the anesthesia after his tonsillectomy, the first thing he said was "Put them back!!"
He liked eating icy treats (smooth mango sorbet was a favorite), but also soft boiled eggs and flan. Flan, he said, was better than pudding because it slid down better.
Posted by Noemon (Member # 1115) on :
My ENT mostly just told me "HOOOOM" repeatedly, and then went on to say something so ponderously slow that I eventually got bored and left.
Posted by rivka (Member # 4859) on :
*snort*
Posted by Noemon (Member # 1115) on :
I've been itching to make a joke like that here or at sake for a while. A week or so ago Kristy texted me saying that she had been able to get an appointment with her ENT for the next day. I'd been expecting him to be booked solid for a good week or two, and replied with "Wow, his name must be Quickbeam!".
She got it, of course, but was not terribly amused. Or if she was she didn't mention it in her reply.
Ever since then, I've been waiting for the right opportunity to come along.
Posted by Liz B (Member # 8238) on :
Posted by ClaudiaTherese (Member # 923) on :
quote:Originally posted by Liz B:
Agreed. Posted by Javert (Member # 3076) on :
quote:Originally posted by BannaOj: Um, that's directly opposing what my ENT said.
What I heard (not official medical advice in any way shape or form) is that because the tonsils are larger in adults than they are in children, the actual *wound* is that much larger when they scrape them out.
But I could be wrong.
Perhaps my doctor was just trying to be nice and calming, and didn't want to send me screaming from the office.
And it looks like it's going to happen March 6th. Less than two weeks! And, suddenly, I'm nervous.
Strange, as I was never nervous about my wisdom teeth surgery.
Posted by rivka (Member # 4859) on :
They have to reach in a tad farther to yank these babies out.
Posted by Javert (Member # 3076) on :
Hey everybody,
So I had my tonsillectomy today.
And I am in pain!
Well, not constant pain. That would suck. But whenever I swallow (and I've been drinking a ton of water), it hurts quite a bit.
I have my orders from my doctor, but any recommendations on how to act post-op would be welcomed from you lovely people. Welcomed though not necessarily followed, of course. Posted by ketchupqueen (Member # 6877) on :
Oh, ouch. I hope you feel better soon.
Eat popsicles and ice cream?
Posted by Javert (Member # 3076) on :
Phew. Thought I was bleeding for a bit, but really it was just that I didn't (couldn't) drink a ton of water before taking a nape and didn't wash the area out.
Yay! Now it's time for some more pain medication! Posted by breyerchic04 (Member # 6423) on :
In a few days you're going to have scabs start going down your throat, it's a really weird unique feeling, sort of hurts but its also really cool.
![[Smile]](smile.gif)
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