Sunday, November 11, 2007

Peritonsillar abscesses Is Latin for "You're Screwed"

I have had the good fortune to be a relatively unblemished health record. With the exception of the occasional bout with the common cold, an annoying icky eye disease and the ongoing issue of being allergic to the world I’ve suffered very little at the hands of illness. I have never broken a bone, been bit by a dog, been stung by a bee or had any body parts removed. But there is one instance of horrible sickness in my past.

In 2002 kissing my new boyfriend (one of few not ever featured in the Winner’s Parade) resulted in the punishment of a standard issue sore throat. This was fine as it allowed the boyfriend and I to bond over my illness through me lying on his futon (which was located on the floor which was not really ok) and him feeding me raspberry sorbet (aka the only food that my throat was not currently revolting against). After a couple of days of nursing I mostly recovered and jaunted off to a weekend of early spring hiking with a girlfriend in Northern CA.

Then the cold came back. I figured my gallivanting with the boy toy and skinny dipping in a chilly river had deservedly resulted in a relapse. So I spent a couple of days in bed with hot tea and popsicles and hoped for the best. At the time I was working as a contract employee and thus did not have health insurance so rather than go to the doctor like a big girl I choose to call my nurse mother once every 3 hours to cry on the phone. Next time you have a cold do not look to an emergency room nurse for sympathy. Mom’s general reaction to each phone call was “oh, your throat hurts? Poor baby. Today at work someone DIED.” Eventually my throat hurt badly enough that the thought of a $300 doctor bill seemed worth it in return for some prescription meds so on the 6th day of my illness I drove across town to the clinic to find out just what was wrong with me.

When you get any minor illness your body sends out the good bacteria to march in the war against the evil germs and usually these valiant warriors fight back the tide of illness so you can return to a life of tempting disease by drinking too much and only sleeping on weekends. But occasionally when the tide of war turns too sharply in favor of the invaders your own army turns against you. I know because this happened to me. Apparently one night half way into my standard issue cold my good bacteria were getting killed in droves and, war weary and saddened by the death of so many loved ones they decided “fuck this body, let’s join the other side!” The invaders were happy to have the size of their army increased and assigned my traitors to the task of building a huge bacteria fort on my tonsils. At the time of my visit to the doctor the fort was housing millions of troops and through numerous remodels and expansions had grown to almost fill my throat. A few more barracks and I would no longer be able to breathe. This accursed condition is called a Peritonsillar abscess – Let’s see what Wikipedia has to say about it.

Peritonsillar abscesses are widely considered one of the most painful complications, primarily the surgical draining of the abscess itself. The patient is operated on awake, surgically slicing open the tonsil and draining the abscess.


The clinic doctor took one look at my throat and announced that I needed to take a trip to the Ear Nose and Throat specialist. My na├»ve request for directions so I could drive myself there was all but laughed at, “Silly girl, you can’t drive, you’re body is currently revolting against you, who’s to say that your foot won’t join the dark side and rocket your car through the front of the hospital?” And so after receiving a huge needle full of steroids in my ass (an effort to stave off the growth of the abscess until I could get to the hospital) I called my friend John and pleaded for a ride to the Stanford Hospital.

The ENT doc peered down my throat and then leveled with me about the extent of the damage. “Ok, so the first thing we’ll have to do is drain the abscess with a large needle. Unfortunately we can’t put you to sleep for this procedure because twilight sleep causes the throat to relax too much to get the needle to the abscess. I’m going to try to numb your tonsils but because the abscess is so large I don’t know if I’ll be able to get around it in order to use this other huge needle to give you the anesthetic.” Doctors are really super duper smart so I was unsurprised when this prediction turned true. The (in retrospect miniature) anesthetic needle poked around somewhere near my gag reflex but was incapable of delivering its sweet nectar. Next the doctor eased the HUGE drainage needle down my throat as the nurse who was letting me squeeze her hand into hamburger whispered, “I’m sorry honey, this is the worst thing we do here.” The doc was able to drain the abscess even though I passed out near the end and had to be revived with smelling salts (who knew they still used those?). As I came to the doctor assured me that she thought she was able to completely drain the abscess but that she was worried that if she didn’t lance it the abscess would fill back up. Do you know what lancing means? It means someone shoves a knife down your throat and hacks off bits of your body. Luckily the always supportive nurse assured mid slicing, “now you know you can get through child birth since this is much more painful!”

John drove me from the doctor directly to the pharmacy where they handed me a 1 quart bottle of liquid Vicodin which I chugged like Gatorade. Apparently the peritonsillar abscess healing process is supposed to be very quick so the next day the doctor called me at home to see how I was feeling. She was perturbed that my voice hadn’t returned and asked that I come back to the hospital in case she “didn’t get all of it and had to go in a second time.” I remember thinking “no thanks, I’ll just die. How painful can asphyxiation be really?” Luckily I was just a slow healer and was not forced to pull a second stint as knife swallower.

A hilarious aside to this story -- a couple of days after the hospital visit I realized that if I didn’t want the huge bill I ran up at the pharmacy to overdraw my bank account I needed to go into the office and get my paycheck. Despite my illness and my general hatred for talking to people in the service industry I decided to physically go into the bank in order to expedite the delivery of emergency funds to my account. When I reached the front of the line the teller started talking at me in that characteristic very loud and slow voice that people reserve for the mentally challenged. It took me a moment to figure out why I was being given the courtesy ‘tard treatment but then I thought about how my voice sounded and I sighed and angrily slurred at her, “I’m not deaf I’m SICK.”


Anonymous said...

i just found out today thats what i have!! =( it doesn sound fun... they didnt mention any knives down my throat yet but i do have to go to the hospital every twelve hours and cant work for two weeks....

Anonymous said...

I just had this done yesterday, is it normal for the cut in the mouth to have a slight bruise around it? I just hope I am healing ok, I dont have anymore money to fix anything that might happen next haha.

Amy said...

I just got through a week of throat and whole-body hell similar to what you have described. I also do not currently have health insurance, and waited until swallowing hurt so bad it made me cry before I went to the hospital. They said it wasn't strep, but they wouldn't say what it was. I told them I had an ear ache on the same side as the most swollen part of my throat, but they just stayed silent and prescribed antibiotics and sent me home (two nights ago).

Now I'm worried I have a peritonsillar abscess, and I'm quite scared now that I will have to go back for the slice and dice drainage procedure. Most of my pain has gone away except the ear ache and white mass near my tonsil - both still there. I'm wondering whether I can afford to wait and see whether it somehow resolves itself...or eats into my windpipe or something.

Anonymous said...

Yep that's definitely an abscess

Tina said...

I dragged my boyfriend to the urgent care doctor last night and the doctor confirmed that he has a peritonsillar abscess :( The doctor recommended that he go see an ENT doctor to drain the abscess.

I was wondering how much did your procedure cost? He currently doesn't have health insurance.

Thank you so much!

Brianna said...

my procedure was years ago but it ended up costing me $1200 plus prescriptions (I also didn't have insurance at the time).

Brandi said...

Omg! I was in the statcare yesterday. But they wouldn't drain mine! Gave me my shot in my ass and antibiotics and then told me to be careful my throat doesn't swell shut. I waited and slept on the waiting room sofa for 3 hrs to be told this! Can only imagine what people thought walking in see me! Lol!! Loved ur post tho, the end made me laugh the best I could. Thanks!

adventureswithsavannah said...

You guys sound like you have it pretty easy.... I had 4back to back ER visits with multiple steroid shot and antibiotics shots and prescriptions and nothing was working. On the fourth day I went in I could almost not breath! They kind of laughed at me cause they couldn't see anything just that my tonsils were swollen. The tried to discharge me and my mom refused to leave with me. They ended up ordering a CT scan and found that I not only had an abscess but I had two huge ones under my tonsils where you could not see them. They were so big they were basically touching... They immediately did the drainage which on one side they got out 10cc's of pus and on the other 5cc's... Once that was done and I could breathe they hiked me up on a ton of pain meds and sent me to Oakland children's hospital which was 2hrs away. I stayed in the hospital for 3 days where I was monitored 24hrs and I had a surgery to remove the remaining puss and abcesces. Healing was terrible and I was on antibiotics for a week and a half... Fast forward to 3days after I finished my last dose. I woke up the next day and my throat was hurting again. I though oh know maybe I'm just sick... In a matter of 24 hrs I had to go back to Oakland children's hospital where they found yet another large abscess that they had to drain in the office... Hopefully this sis the last of it but my swelling has yet to go down and its day 3 of me being drained and on new medicine. Hope my story helped