YANMD, But Is It Worth Finding One?

March 12, 2014 9:07 AM

I am sick on vacation and need to decide if it's necessary to see a doctor.

I have a really painful sore throat with swollen and ucky tonsils and (new this morning!) a gigantic swollen uvula. It hurts a lot- 7/10- to swallow. I feel like I'm producing an unusual amount of saliva. Ibuprofen helps a bit. No fever. This has followed on the tail of an unpleasant GI experience. Something similar is going around the petri dish where I work (a school)

I'd really rather not go to the doctor if I can avoid it, because time and money. I'm guessing that they will tell me that I'm a gigantic baby and that a) it's viral, b) try to drink lots of fluids and c) take ibuprofen.

Is there a chance that this is, I don't know, strep or something? I've never had strep, so I have no idea if it could be. Is it worth going solely on account of the enormous uvula, which is something new in my experience of sore throats?

posted by charmcityblues to Health & Fitness (25 answers total)

Are you in your home country?

Could you go to, like, one of those walk-in clinics at Walgreens?
posted by Madamina at 9:14 AM on March 12, 2014

Go check out an urgent care clinic, if you can find one. Even if insurance doesn't cover it, the bill is only likely to be a hundred bucks or so.

And yes, they'll probably tell you that you have a cold. But it's worth ruling out strep, which is a pretty nasty little bugger.
posted by valkyryn at 9:14 AM on March 12, 2014 [1 favorite]

Is a "quick sick" or "minute clinic" an option? I went to one of those when I was on vacation last summer and it was relatively quick and useful.

(Or, what the others have already said, on preview!)
posted by cheapskatebay at 9:15 AM on March 12, 2014

If your uvula is swollen, it is most likely infected. If the agent of the infection is strep or some other bacteria, antibiotics will help, and only a doctor can give you those. I would go to a clinic, as suggested above.
posted by ubiquity at 9:16 AM on March 12, 2014

Give it a couple of days. It could be strep, but it's more likely irritation from the stomach acid as it passed by your throat or a viral infection. Rest, fluids, and ibuprofen. If it's still lingering in 2-3-4 days, or if it gets worse, definitely see a doctor. Also, rest. A lot. Sleep does wonders for getting through these things.
posted by Capri at 9:16 AM on March 12, 2014 [1 favorite]

Are you near a health clinic? Call and ask how long it takes to get in. It probably won't take too long.

Gargling with salt water may help you feel a little better.
posted by dragonplayer at 9:18 AM on March 12, 2014 [1 favorite]

I hate throat pain. That alone would send me to the doctor, let alone being on vacation. Find an urgent care and go. Could be strep, could be tonsillitis, could be a garden variety cold. But if it's something that can be treated with antibiotics, I would prefer to start them sooner rather than later.
posted by cooker girl at 9:20 AM on March 12, 2014

Response by poster: Difficulty level: small Alaska ski town. There is a small clinic but it has limited hours and I fear it will be $$$.
posted by charmcityblues at 9:20 AM on March 12, 2014

Totally could be strep. If you're vacationing with anyone, you could infect them. If you're not vacationing with anyone, you still could infect other people. And if it is strep, you want to find out and start treating it now, or you're just going to keep feeling crummy until you get it diagnosed and get antibiotics.

Rapid strep tests are available in most walk-in clinics.
posted by pie ninja at 9:21 AM on March 12, 2014

Also, I bet if you called the clinic they could tell you what the cost would be.
posted by pie ninja at 9:21 AM on March 12, 2014 [1 favorite]

I've never had a painful sore throat for which they didn't give me antibiotics and which didn't make me feel better pretty quickly. Just think, how much money did you pay for vacation that's now being wasted because you're miserable? It can't be more than a rapid strep test and a bog-standard antibiotics prescription.
posted by bleep at 9:22 AM on March 12, 2014 [2 favorites]

Best answer: Here is a chart to help you identify if you have strep throat.
posted by Houstonian at 9:22 AM on March 12, 2014 [5 favorites]

Response by poster: Oh, wow, Houstonian, the strep example looks exactly like my poor throat. Clinic it is!
posted by charmcityblues at 9:24 AM on March 12, 2014 [4 favorites]

Is the swelling interfering with your ability to breath? If it is, go to the doctor right away.

I had something like this in the 1990's. It turned out to be a swollen infected cyst in the back of my throat. I was put on IV antibiotics + morphine. When that didn't help they lanced the cyst (that was when it got really painful) and gave me more IV antibiotics. After that it started to get better.

Good luck!
posted by alms at 9:29 AM on March 12, 2014

The good news is that if it's strep, they can treat it with amoxicillin, which is cheap as chips and incredibly effective against strep. My daughter had full-blown scarlet fever last year and was INCREDIBLY ill, and they gave her high-dose amoxicillin and she was right as rain 36 hours later. (Don't stop taking the antibiotics just because you feel better, obviously, but you will be astounded at how much better you feel, and how quickly.)
posted by KathrynT at 9:35 AM on March 12, 2014

I don't know what I had six weeks ago, but it was one of the most painful sore throats I ever had. I happened to have an unused z-pack of antibiotics which helped, but it was literally a week I should have spent in bed. The sore throat was horrible. It's gone now, but I am still coughing six weeks later, though it's finally getting better. Here's what helped tremendously with the painful throat.

Gargle with salty hot water as much as possible. It was the most immediate relief. All day, as much as possible.

Follow up with a cup of Throat coat tea (lemon and echinacia flavor) with a ton of honey and lemon juice.

Then throat lozenges - Cold Eeze worked well.

Repeat.

The chloroseptic throat spray at night time about 30 minutes before going to bed, so I didn't lie in bed thinking about how much my throat hurt.
posted by HeyAllie at 9:46 AM on March 12, 2014

The sooner you get antibiotics the sooner you can back to enjoying your vacation which I'm guessing wasn't cheap either. Also this is a quick trip for a sore throat not surgery or an overnight hospital stay.
posted by whoaali at 10:03 AM on March 12, 2014 [1 favorite]

If your in a rural area most likely the clinic is set up to deal with low income populations either by a sliding scale fee or just low costs. If you have insurance it may cover the visit.
posted by AlexiaSky at 10:16 AM on March 12, 2014 [1 favorite]

Had exactly the same thing happen to me in San Francisco in the middle of the night. Forced myself to go out to this clinic while minimizing all the way. Turned out it was strep morphing into pneumonia. I suggest you dont hesitate.
posted by Xurando at 10:21 AM on March 12, 2014

Best answer: The criteria I often use when evaluating patients in the emergency department for strep throat are called the Centor Score. The calculator gives you odds of having strep if you meet certain research-proven criteria.

I put in your age as 15-44 and checked yes for "absence of cough" and "exudate (white stuff) or swelling on tonsils". With 2 points, your odds of having strep pharyngitis are 11-17%. The recommendation is to culture you for strep, and only treat you with antibiotics if the swab is positive. Your odds go up to about 50% if you also have fever and tender lymph nodes in your neck, at which point the criteria recommend you just get treated with antibiotics regardless of testing.

The swollen uvula is called "uvulitis," by the way. It can be caused by either viral or bacterial infections.
posted by treehorn+bunny at 10:32 AM on March 12, 2014 [3 favorites]

If you've got the white spots on your tonsils/back of your throat then it's bacterial, and most likely strep. You could try to treat it yourself, but what you really need are antibiotics. Go to the clinic and let them look in your throat. When they see the spots, they'll probably write you a prescription right there.

In addition to that (or instead of, if you insist) you should also get on the hot salt water gargling train. Make the water up hot and dissolve a huge amount of salt in it. Gargle once an hour (carry it around in a thermos if you have one) and don't rinse. It will taste foul but I've found that if I really go all-out with the salt water thing then it helps a lot. If I do it halfheartedly then it makes no difference.

But yeah, go to a clinic. This isn't life threatening, but it's ruining your vacation and they can probably fix you right up.
posted by Scientist at 10:49 AM on March 12, 2014

For what it's worth, white spots on tonsils don't 100% mean bacteria. My sister and I both get tonsilliths when we're sick that look like bacterial colonies, but aren't.
posted by town of cats at 11:54 AM on March 12, 2014

Response by poster: It's strep. Hopefully the antibiotics start working soon!

Thanks to all for your good advice. I am really, really good at convincing myself I don't need to go to the doctor, and you guys helped kick me in the butt and get me there! It was a $328 hit but worth it.
posted by charmcityblues at 1:50 PM on March 12, 2014 [4 favorites]

Response by poster: Oh, and the PA said I currently have the largest uvula he's EVER seen. So I guess I can feel proud about that.
posted by charmcityblues at 1:52 PM on March 12, 2014 [1 favorite]

Not only the largest uvula, but the best good sense - you were wise enough to take the 'see a doctor' advice. Happy healing.
posted by Cranberry at 2:08 PM on March 12, 2014