2009-03-10

Tonsilloliths

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Among the other popular topics in my last near1000 posts are my tonsils. But it's been nearly two years since they were last under discussion (and my Google hits show that lack), so I suppose it's time for me to revisit the topic---especially since I only just finally learned the technical term for what ails me. (Thank you, Wikipedia!)

Previously.....

    In Whited Sepulchers, I referred to stuff "Completely digested and completely disgusting" caught in the back of my throat.

    And in Enema in my mouth, I looked forward to "A lifetime of happiness free of feces-smelling cheese-curd-looking food particles"---

    Then in Porous tonsils, hooray! I cursed my "Freaking mortal tabernacle" because the enema-in-my-mouth solution proved imperfect.

Early last summer when we went on water rationing, I decided the water lost while warming up water for my throat could be cut, so I stopped the nightly washes.

Then last week I changed my mind. I realized I could save the warming-up water for the toilet and thus tonsilrinse guiltfree.

A few things got me thinking about doing this:

    1. Lady Steed said my breath stunk, and she said it pretty much all the time.

    2. I read the above linked-to Wikipedia article.

    3. In scraping my tonsils clean with the buttend of my toothbrush I discovered a secret compartment full of crap.

I'm not kidding. With a stripped Q-tip I pushed my left tonsil towards the center of my throat and I discovered a cave as big again as my tonsil and filled with small yellow curds.

It was a horrifying discovery.

And so I'm back on the oral enema regimen. Whee.

So. Tonsilloliths. Apparently--and this doesn't surprise me--they are not merely food but also dead bacteria and white blood cells. I've suspected for a while that they were being generated within my body rather than arriving from without only to undergo a metamorphosis. And that raises the question: what good rinsing?

Link-following on Wikipedia led me to Tonsillectomy. Now, I've been opposed to a tonsillectomy on the grounds that they take famously long for adults to recover from. Besides, tonsils serve important immune purposes and, allegedly, tonsilloliths can still be formed in the tonsilless soul.

But then I was Wikipedia and I began to realize that there are many, many surgical options when it comes to tonsil removal. Here are a few of the most appealing:

    Radiofrequency ablation: Monopolar radiofrequency thermal ablation transfers radiofrequency energy to the tonsil tissue through probes inserted in the tonsil. The procedure can be performed in an office (outpatient) setting under light sedation or local anesthesia. After the treatment is performed, scarring occurs within the tonsil causing it to decrease in size over a period of several weeks. The treatment can be performed several times. The advantages of this technique are minimal discomfort, ease of operations, and immediate return to work or school. Tonsillar tissue remains after the procedure but is less prominent. This procedure is recommended for treating enlarged tonsils and not chronic or recurrent tonsillitis.

    Thermal Welding: A new technology which uses pure thermal energy to seal and divide the tissue. The absence of thermal spread means that the temperature of surrounding tissue is only 2-3 °C higher than normal body temperature. Clinical papers show patients with minimal post-operative pain (no requirement for narcotic pain-killers), zero edema (swelling) plus almost no incidence of bleeding. Hospitals in the US are advertising this procedure as "Painless Tonsillectomy". Also known as Tissue Welding.

    Carbon dioxide laser: Laser tonsil ablation (LTA) finds the otolaryngologist employing a hand-held CO2 or KTP laser to vaporize and remove tonsil tissue. This technique reduces tonsil volume and eliminates recesses in the tonsils that collect chronic and recurrent infections. This procedure is recommended for chronic recurrent tonsillitis, chronic sore throats, severe halitosis, or airway obstruction caused by enlarged tonsils. The LTA is performed in 15 to 20 minutes in an office setting under local anesthesia. The patient leaves the office with minimal discomfort and returns to school or work the next day. Post-tonsillectomy bleeding may occur in 2-5% of patients. Previous research studies state that laser technology provides significantly less pain during the post-operative recovery of children, resulting in less sleep disturbance, decreased morbidity, and less need for medications. On the other hand, some believe that children are adverse to outpatient procedures without sedation.


Hey! Lasers!

Anyway, my point is that I think one of these types of surgery might be the way to go. I'm sick sick sick of dealing with this and if modern medicine can give me a more permanent solution with a minimum of pain or danger, then why not? Now I just need to get Kaiser on board and we'll be good to go.

The problem will be getting me to a doctor. I'm terrible about getting to doctors. But the longterm benefits of this seem worth it.

I just hope I get a doctor who doesn't mind printouts from Wikipedia.....

17 comments:

  1. Ew ... I've had these things -- although not very frequently, thankfully. I wonder, though, if I'm having similar cause for my on off-and-on halitosis?

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  2. One time when I had mono, my tonsils were covered in white sores. I tried scraping one off with my toothbrush (suspecting that it might be removable similar to one of those tonsilliththingys), and spent the next ten minutes dry heaving.

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  3. Because it triggered my gag reflex, not because there was anything particularly disgusting about it.

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  4. .

    Yeah, I've spent a lot of time lately working on overcoming my gag reflex. I'm getting pretty good at sticking things in the back of my throat now. Which is good as I don't want to thrown up on a medic with a laser.

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  5. I had my tonsils out when I was ten, and reading these posts of yours has convinced me that it was one of the best things that has ever happened to me. For the sake of your blog readers, please go see a doctor and get it taken care of.

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  6. I have found that since I have reduced my carbohydrate intake to just 1 bowl of grape nuts a day, that I have not had any of these episodes. Maybe surgery is not the answer....

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  7. First off, I've never been so grateful to be without tonsils. I had them taken out (because of multiple bouts of Tonsilitis) when I was little. The only thing I remember is that I couldn't see my knitting after they gave me a shot in my butt (I passed out quickly at that point) and I REALLY wanted a burger about an hour after waking up (which my dad totally got for me against nurses orders).

    You know, I bet my Dad could totally weld your tonsils. He does laser surgery on pets and a tonsil is a tonsil right? All you'd have to do is take a scenic tour of Alberta...much better than going to a Doctor :)

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  8. .

    I hear Alberta's lovely this time of year.

    Actually, I don't. I imagine it's still pretty cold?

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  9. It is definitely still cold there -snowing, in fact. White is a lot better looking than brown and dead, though :). One year it snowed in mid-July so there are really no guarantees!!

    P.S. I'm guessing you've heard about the Big Love episode airing this weekend...if not, ask Recession Cone to send you the email I forwarded to him and 'Spoza. Yikes!

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  10. .

    Yeah, I've heard about it. I've decided the best thing to do is to say nothing. At least for now. I'll wait and see how things go.

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  11. probably should have followed that tactic myself.

    anyway theric, in the wikipedia photos the white tonsilliliths are visible in the mouth - was yours visible before you started messing with it? could you feel in on the inside? where exactly in my mouth am I supposed to feel if I were to check for these things? thanks in advance.

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  12. .

    Well, that's the kicker. I get some in visible locations and some that I can't see. The visible ones are obviously easier to deal with. I can attack them with the back of my toothbrush and squeeze them out, or use a syringe and suck them out.

    But, like I said, I just found a big flap that can hide several at once. And sometimes I have one fall into my mouth, origin unknown.

    I haven't figured out yet how to deal with the ones I can't see. The salt wash seems to help prevent them in the first place, but it's not perfect.

    I'm thinking I need to see an earnoceandthroat guy to restrategize.

    Anyway, to your question about feeling them, sometimes it does feel like something's stuck in my throat, but not always. And when it's been there a long time, sometimes it starts making the area around it sore, and that can be a clue too. If I have an invisible one that's starting to fester like that, I start making horrible noises and trying to squeeze my throat muscles everyway I can in hopes of popping it out. The Wikipedia article claims that some people can use those muscles almost artistically, but my methods are more random and hopeful. And don't always work. It seems to me like it's mostly a waiting game, waiting for my tonsils to just expel them.

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  13. I typed in a really long comment, but decided it was definitely too much info.

    Just know I feel your pain.

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  14. .

    That's what this post is all about: TMI.

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  15. This comment has been removed by the author.

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  16. Theric,
    I asked horninf last night if he'd seen this post, and since he had not, I explained to him what it was about. He immediately exclaimed that he has these too, and then proceeded into detail about how it works.
    So, if you guys ever talk, now you know what you have in common.

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  17. .

    Tonsilloliths and earthquakes. What more would we need?

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