Seeking Help for Long-Term Tonsillitis: Finding the Right Path
Hello everyone! I’m a 22-year-old female, and I’ve been dealing with diagnosed tonsillitis since I was nine. Throughout these years, I haven’t received any medications, and here’s a brief rundown of my experiences: At the age of nine, I was diagnosed after coughing up tonsil stones. The physician warned me that treatment could be excruciating and advised my mother that it was best to leave it untreated unless it worsened. So, I was sent home with instructions to gargle warm saltwater every night. During my teenage years, starting at 13, I made several trips to various clinics but stopped seeking help at 18 due to financial constraints. Through a total of eight visits, mostly with different doctors, I consistently heard that the recovery would be too painful, and my only realistic method was to continue the saltwater gargling until the situation improved. After my first two visits when I was 13 and 14, I was told to return in a couple of weeks to evaluate if surgery might be necessary. Each follow-up concluded with the same advice—to wait and see, citing the significant discomfort associated with recovery as the reason not to proceed with treatment. Since I turned 17, I haven't seen a doctor because of the high out-of-pocket costs. I managed to cope with my nightly saltwater routine and occasional coughing up of stones until a few months ago when my condition deteriorated alarmingly. It started with larger stones and a severe sore throat that led to my tonsils swelling to the point where it felt like I was breathing through a straw. Eventually, the tonsils began to bleed whenever a stone was expelled, and they have swollen so drastically that now, when I eat, food gets stuck and is pushed up into my nasal cavity. I’ve also been experiencing sinus infection symptoms, such as bloody mucus containing food remnants, and there are days when I struggle to eat at all, resulting in a weight loss of about 10 pounds. I’m truly desperate for a solution but feel lost regarding whom to approach for help. I fear that I may be advised to simply wait it out once more, which is disheartening given my financial situation and ongoing pain. Can anyone advise me on what type of doctor would be the most appropriate for treating this issue? Additionally, how can I convey all my concerns effectively to ensure they are taken seriously?
Answers (1)
9/7/2025, 11:30:51 PM
OpenHealth AI
It sounds like you are experiencing significant distress and challenges with your chronic tonsillitis, which has worsened over time. The combination of pain, difficulty swallowing, and complications from tonsil stones certainly requires attention, and it's understandable that you're seeking clarity on how to proceed.
Summary of Main Points:
- You need to see an Ear, Nose, and Throat (ENT) specialist (otolaryngologist) who can evaluate your situation effectively.
- It’s crucial to communicate your symptoms clearly to ensure your concerns are addressed promptly during your visit.
Explanation:
Tonsillitis, especially when recurrent or chronic, can lead to severe complications if left untreated. The increase in the size of your tonsils, the bleeding, and food getting stuck are signs that you may need more than conservative management like saltwater gargles. An ENT specialist is trained to manage conditions related to the tonsils and may discuss options like medication or, if deemed necessary, surgical removal (tonsillectomy).
Next Steps:
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Find an ENT Specialist: Look for an ENT who accepts your health insurance plan, as many specialists understand financial constraints and might offer payment plans or sliding scale fees. You can search online or ask for recommendations from pharmacies or health centers.
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Prepare for the Appointment: Write down all your symptoms, including:
- When each symptom started
- Frequency and severity of sore throats and tonsil stones
- Any changes in your ability to eat or breathe
- Your weight loss and any occurrences of blood in your mucus.
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Express Your Concerns Clearly: During your appointment, express:
- Your long history with tonsillitis
- The recent increase in severity
- Your struggles with eating and weight loss
- Your concerns about possible solutions and the need for an actionable treatment plan.
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Explore Financial Options: Ask about financial assistance programs either at the clinic or through local health resources. Many hospitals have programs to help with care costs.
Being well-prepared will increase the chances of your concerns being taken seriously, and it will help you find an effective path forward for relief from your symptoms. Please let me know if you need more guidance!
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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.