Chronic Tonsillitis Concerns
Age: 38, Weight: 220 lbs, Medical Conditions: Asthma, Anxiety Disorder Current medications include Naltrexone, Bupropion, Hydroxyzine, and Famotidine to counteract some side effects from Bupropion. I also carry a rescue inhaler and a steroid inhaler. Background: During my childhood, I was often labeled a "strep baby," indicating a higher susceptibility to tonsillitis and recurrent strep throat infections. In my early adulthood, I began to notice instances of strep throat occurring annually, typically once or twice each year. However, I realized that after intimate contact, such as kissing someone new, I frequently ended up with tonsillitis shortly thereafter. Even apart from such situations, I find that I tend to develop tonsillitis, whether viral or bacterial, at least once yearly, if not more often. Recent Developments: Now that I have a 2-year-old, who frequently brings home various illnesses, I am experiencing a resurgence in these infections. Since mid-January, I have battled with flu A, which caused swollen tonsils, and have gone through two consecutive rounds of strep throat. Just two weeks ago, I completed another course of antibiotics, yet this week, I am facing swollen tonsils again, accompanied by some congestion and a slightly sore throat. It's becoming clear to me that these recurrent episodes are not typical. During a recent visit to an ENT urgent care for a repeat occurrence of strep (just a day after finishing my first antibiotic course), the doctor observed that my tonsils were notably enlarged and suggested they might be harboring bacteria, resulting in my increased vulnerability to these infections. Additionally, I’ve recognized several symptoms occurring when my tonsils and throat are inflamed: * Airflow blockage while trying to blow my nose; it feels as if my throat is constricted, preventing effective nasal clearance. * A significant amount of greenish phlegm accumulates when I brush my teeth and tongue in the morning, leading to large mucus chunks when I clear my throat. * My tonsils can swell to such an extent that it feels like I can hardly breathe, and swallowing becomes incredibly painful. I worry about the possibility of needing a tonsillectomy, but I’m eager to understand why this is happening and if there's a way to prevent it, aside from maintaining good hygiene, which I consistently practice. Any insights you might have would be greatly appreciated. If anyone here has undergone a tonsillectomy as an adult, I would be grateful for any insights into your experience, as I keep hearing horrendous stories. However, the persistent sore throat and repeated antibiotic treatments I endure are also intensely uncomfortable and painful. Thank you in advance for your help!
Answers (1)
4/4/2025, 1:01:08 AM
OpenHealth AI
It sounds like you're experiencing a frustrating and concerning cycle of recurrent tonsillitis, especially in light of your childhood history and your current situation with your young child bringing home various illnesses. Given your recent struggles, it's understandable to be worried about the overall impact this has on your health and quality of life.
Main Points:
- Chronic tonsillitis can lead to significant discomfort and repeated infections.
- Close monitoring of symptoms and potential interventions are important.
- There are strategies for managing symptoms and possibly reducing the frequency of infections.
Explanation: Your history of recurrent tonsillitis, especially following close contact with others, and your recent experiences with flu and strep throat suggest that your tonsils might not be effectively eliminating bacteria or viruses as they should. Enlarged tonsils, especially when they obstruct airflow or swallowing, can contribute to a cycle of infection and inflammation. It's important to understand that chronic tonsillitis may eventually warrant surgical intervention (tonsillectomy), especially if lifestyle impacts and recurrent infections continue.
Next Steps:
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Self-Monitoring: Keep a detailed log of your symptoms (when they occur, their severity, duration, and any triggers such as contact with certain individuals). This will help you and any healthcare provider understand your condition better.
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Hydration and Humidification: Ensure you are well-hydrated and consider using a humidifier to reduce throat irritation and assist with clearing mucus. This can help ease throat discomfort and congestion.
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Mucus Management: Gargling with warm salt water may help alleviate some throat inflammation and assist in thinning mucus. This can also keep your throat more comfortable.
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Consider Allergy Testing: Since you have asthma and allergies can contribute to throat irritation, it might be beneficial to explore this further. Managing underlying allergies can sometimes reduce episodes of tonsillitis.
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Discuss Tonsillectomy with an ENT Specialist: If your symptoms continue to interfere significantly with your daily life, a consultation with an ENT specialist might provide more personalized insights. They can assess if a tonsillectomy is right for you, which often leads to a significant reduction in infections for many adults.
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Preventive Health Measures: Continue practicing good hygiene, especially when dealing with common illnesses from your child. Frequent handwashing and avoiding close contact when individuals are sick can help reduce your chances of infection.
If you're feeling overwhelmed about the potential for surgery, it’s natural to want to hear from others who have had the experience. While some stories may sound daunting, many people report relief post-surgery. Each person’s experience differs, and discussing these concerns with a healthcare provider can also help ease anxiety.
Please don’t hesitate to reach out for more guidance or support as you navigate these symptoms. Your health and comfort are the priorities.
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - 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7 Months Old) - **Weight:** 9 kg (good growth rate in spite of condition) - **Jaundice:** Continues to be present (yellow skin) - **Stools:** Remain pale/clay-colored - **Development:** Achieving appropriate milestones - **Energy:** Appears to have a good energy level - **Feeding:** Normal appetite --- ## QUESTIONS FOR r/AskDocs We have been informed this is **Type 2 Abernethy malformation** (portal vein present). **Three treatment avenues have been proposed:** ### Option 1: **Endovascular Coil Embolization** (minimally invasive approach) - A catheter is inserted via the leg vein to access the shunt and deploy coils/plugs to close the abnormal vessels - Pros: No surgical incision, minimal discomfort, short hospital stay (2-4 days), no scars, enhanced safety - Duration: 1-2 hours - Recovery: 2-4 weeks for jaundice to show improvement ### Option 2: **Open Surgical Intervention** - An incision in the abdomen to ligate abnormal vessels and redirect blood to the liver - Pros: Direct visualization, effective results - Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.