I am a recent med school graduate going into EM. My neighbor came over and asked for my advice on having her tonsils out. I normally give my stock " I cant help you, talk to your doctor" line, but this particular case struck me as interesting so I figured I would see if any of my ENT colleagues have an opinion on the matter.
23yr old female, no PMHX/PSHX, No FMHX, Meds or allergies. No smoking/drinking/drugs. Works around kids and at a bar on weekends.
Three months ago got a URI, chalked up to virus, got better in 3days. 2months ago had "pretty bad tonsillitis" went to urgent care, rapid strep neg, mono spot neg, chalked up to virus, got better in 5 days but had lingering lymphadenopathy. Went to urgent care because of swollen nodes on neck a few weeks later, did another strep and mono, and sent her for US of neck (?). Eventually she got two USs showing enlarged anterior nodes but they never changed size. Sent to ENT who noted unilateral swelling of tonsil and recommended tonsillectomy to "Rule out lymphoma."
This girl claims that she has felt great for the past 1.5 months, no sx at all, and didn't even notice that her tonsil was swollen. She claims that she was just worried about her swollen lymph nodes and is going to be out of the country for a few months pretty soon.
Part of the reason I ask this is because I know the ENT and he/she is known to jump at the chance to cut.
I, of course, told her that I couldn't help her and told her to talk to the ENT if she felt unsure about it.
But it does seem to strike me as a bit soon to yank out tonsils on a healty girl with two URIs, works around kids, has no R/F for cancer, and who has absolutly to Sx. So how long do you wait for swollen tonsils to go down before you start testing for stuff?
Tell me I'm wrong?
DanZ
23yr old female, no PMHX/PSHX, No FMHX, Meds or allergies. No smoking/drinking/drugs. Works around kids and at a bar on weekends.
Three months ago got a URI, chalked up to virus, got better in 3days. 2months ago had "pretty bad tonsillitis" went to urgent care, rapid strep neg, mono spot neg, chalked up to virus, got better in 5 days but had lingering lymphadenopathy. Went to urgent care because of swollen nodes on neck a few weeks later, did another strep and mono, and sent her for US of neck (?). Eventually she got two USs showing enlarged anterior nodes but they never changed size. Sent to ENT who noted unilateral swelling of tonsil and recommended tonsillectomy to "Rule out lymphoma."
This girl claims that she has felt great for the past 1.5 months, no sx at all, and didn't even notice that her tonsil was swollen. She claims that she was just worried about her swollen lymph nodes and is going to be out of the country for a few months pretty soon.
Part of the reason I ask this is because I know the ENT and he/she is known to jump at the chance to cut.
I, of course, told her that I couldn't help her and told her to talk to the ENT if she felt unsure about it.
But it does seem to strike me as a bit soon to yank out tonsils on a healty girl with two URIs, works around kids, has no R/F for cancer, and who has absolutly to Sx. So how long do you wait for swollen tonsils to go down before you start testing for stuff?
Tell me I'm wrong?
DanZ