Friday, August 22, 2008

Tonsillar Abscess Day

Warning: this post contains pus.

Another one. A day of three. This time it was three tonsillar abscesses. Unrelated, but with the same story. "I was fine until yesterday, when one side of my throat just blew up!"

When I looked in said throat, sure enough, the opening was lopsided, with one half practically obliterated by a big red bulge coming in from the side and covered in pus. Nice. Fortunately, pus doesn't bother me. Well, pus rarely bothers me, I should say. I have learned, however, not to use that word when discussing someone's throat with them. People don't like to hear that they have pus in their throat. I told one gal that and the next thing I knew I was scraping her off the floor. Oops.

So, what happened in the throats that day was that an infection dived deep, under the tonsils, like prairie dogs digging a labyrinth of safety under the earth. The result? Tissue swollen with prairie dogs. Or, rather, with Streptococci. And fluid. And pus. And pain. That s^^t hurts! People with tonsillar abscesses also talk funny, as if they have a- well, a mass in their throat, which they do. We in medicine give this the technical term, "hot potato voice." And they make a face every time they swallow, because they are in pain.

Back in the day, we used to call the Ear, Nose and Throat people to come and stick a very long needle--uh oh, there went another reader. Someone scrape her off the floor, would you? Yep, a very long needle into the prairie dog town and drain out all the sewage. Yowser. Nobody's idea of a picnic, right? Thankfully, nowadays we're much more humane. Someone figured out that the Strep dogs can be flushed out with chemicals. Mere pills! Who knew? So now we give heavy duty antibiotics, steroids to decrease the swelling, and, of course, last but far from least, narcotic pain medication. Decreases pain, misery and awareness of misery, for which the patient will thank you profusely when you see them back two days later for a recheck.

Two days later, I hardly recognized any of them, which reminded me how pain changes one's whole appearance and demeanor. Fevers down, pain at bay, and a throat as open as San Francisco Bay. Whew! Thank goodness for chemistry!

Wonder what "threebie" next week will bring?


Lisa said...

Thanks for the warning, Peg - I waited until breakfast was done.

When I was a teenager, I was constantly sick. This was back when the philosophy was, "If a little antibiotics is a good thing, a lot can only be better."

I was on one antibiotic or another for almost two years, managing to develop allergies to pennicillin, sulfa and the mycin families. And then a neighbor recommended we go to her children's pediatrician, a sweet Asian man who barely spoke English.

He told my mom, "She need tubes. And tonsilectomy."

He told me my tonsils were rotting on the underneath side when he took them out. After the surgeries to drain my ears and with my tonsils gone, I started to finally get well.

And yes, you're right - being in pain and sick completely changes our looks and demeanor!

Cool post - even with the pus!

origin said...

Hi Peg, it's been a while since I checked in on you - oh the time-starved life of a resident.

Cool post on tonsillitis. I've had surprisingly few cases in my whopping year and a half of "practice-practice".

Anyway, my blog addy has changed - if you care to, please update me on your blog roll. My new URL is:

Peg Spencer said...

Lisa, thanks for visiting! You're a peach.

John, long time no see! Thanks for the update - I added your new site to my blogroll. Good luck with residency!

Connie said...

Hi Peg. Great to read your story about treating tonsillar abscess. Add me to the list of patients - you just described me. I have been looking for info on the web about how this condition is treated and thought, for sure, I was facing needle aspiration. Two antibiotics haven't helped. Off to see an ENT tomorrow - we shall see. Thanks for giving a morepersonal glimpse at an MD's day.

Anonymous said...

i had 3 in 18 mths an the 2nd one woz drained with needle-nowt to it-barely felt a thing and the relief woz instant-many thanx 2 the doc at stepping hill

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