Tonsils are bothersome.
May 17, 2010 3:40 PM   Subscribe

Some questions (and some of them are kind of gross) about getting over tonsillitis.

My tonsils are terrifying right now. I just went to my doctor, who prescribed a Z-pack, so with any luck I'll get better over the next few days. I asked her lots of questions, but there are a few I either forgot or that I didn't have yet which I think folks here might be able to help with.

1. When will I know I'm not contagious anymore? Specifically, when should I feel safe to kiss (and otherwise be intimate with) my (non-insured) boyfriend again?

2. This is where it gets gross. My doctor told me that I could remove the pus from my tonsils by gargling salt water, but that didn't work. Is it safe to try to remove it another way (with a toothbrush, for example)? Or should I just leave it alone? (It's really bothering me. Perhaps it would bother me less if I knew the physiological reasons it's there. Anyone care to enlighten me?)

3. Other than taking my antibiotics, what should I do to aid my recovery? How quickly do most people get over tonsillitis? Would staying home another day or so from work and resting help me recover faster, or should I go ahead and go back in if I don't feel absolutely horrible?

4. What can I do to avoid getting tonsillitis again?
posted by ocherdraco to Health & Fitness (9 answers total) 1 user marked this as a favorite
 
Weird, I am just now dealing with a bout of tonsillitis myself. On the second question-- I don't know if it's harmful, but in my personal experience, physical methods won't really remove the pus, and will just aggravate the tonsil, often releasing a bit of blood. So I wouldn't bother.

I never had any tonsil problems whatsoever as a child, and then I had some sort of weird mono-y/streppy bug (tested negative for both, but positive for the kind of strep found in babies-- the doctor seemed confused) two years ago, and now whenever I skimp on sleep or otherwise don't treat myself well, my tonsils act up. It kind of freaks me out (I like feeling healthy) but it's good to know other adults deal with tonsil issues.
posted by threeants at 3:53 PM on May 17, 2010


It's really bothering me. Perhaps it would bother me less if I knew the physiological reasons it's there. Anyone care to enlighten me?)

Pus is mostly made up of neutrophils, a type of white blood cell. Their job is to migrate to the site of an infection and mount a fast immune response. They form about 70% of the white blood cells present in your blood and hang around for about 12 hours (for each cell) so it's the acute fast cleanup stage of the infection. I'm not 100% sure of how it works but I know they phagocytose the bacteria, i.e. engulf them and break them down, so I think the pus is the dead neutrophils which have done their job (and are then cleaned up by macrophages or just generally lost by sloughing off the pus). Having the pus there means your body is fighting well against whatever's in your tonsils and is a good sign. I don't know about removing it. I imagine that using a toothbrush will irritate an already inflamed area so personally wouldn't try, but I'm a wimp so YMMV.

Rest as much as you can until the infection is really sorted out rather than go back to work early, if possible. Part of the acute phase response, all the signaling in your body that is working to fight the infection (and causing the aches and fever and tiredness) is designed to make you feel tired so you rest. Making all those neutrophils and other immune cells and proteins take resources so don't divert them elsewhere just yet. I always find taking that extra day off when I feel borderline makes a difference down the line even though I'm pretty bored with being at home by then (I realise not everyone has the luxury of taking extra time off so do the best you can and don't beat yourself up over it, stress can be an immune suppressor too). Also avoid other immune depressing activities like exercise and alcohol for the meantime too, although I imagine you don't feel like going for a run right now!

Sorry I can't help with the rest.
posted by shelleycat at 4:05 PM on May 17, 2010 [4 favorites]


Response by poster: Fascinating. I've done some more gargling, but won't try to remove the stuff otherwise.

And thanks, threeants, for relating your experience.
posted by ocherdraco at 4:33 PM on May 17, 2010


From what I remember of my last bout of tonsillitis, you should be non-contagious 24 hours after starting antibiotics. So unless you've got superhuman capacity for recovery, you'll be non-contagious well before you actually feel like kissing anybody.
posted by EvaDestruction at 4:57 PM on May 17, 2010


Good grief, AskMe is apt some days-- just discovered the tell-tale pus on my tonsils this evening. Whenever I come down with tonsillitis, it almost always goes from symptomless to "oh zombie Moses, there are aliens in my throat!" in just a few hours. Similarly, once I start on antibiotics, the extraterrestrial horror disappears just as quickly, but it takes a least a few days for me to get back to 100%.
posted by hip_plumber at 7:56 PM on May 17, 2010


Get well soon! I haven't seen your tonsils, and I'm not your doctor, but that's more likely than not tonsilliths, not pus.

I would give it 10 days at least until you're "not infectious," as most tonsil infections are actually viral, not bacterial, in nature. (But there's no definitive answer.)

Warm water gargles, warm liquids, tea with honey and lemon, motrin, plenty of rest and fluids. Probably nothing you can do to make it go away any faster.

Hand washing is probably the most important way to prevent getting sick.
posted by gramcracker at 8:12 PM on May 17, 2010


Response by poster: These aren't tonsilloliths—it's definitely pus.

(eeeeewwwwwwww)
posted by ocherdraco at 8:47 PM on May 17, 2010


Not to hijack the question, but my tonsillitis (in one tonsil) hasn't died down after about four days. I'm not insured; should I take the financial hit and go see a doctor, or will this probably resolve itself? I really don't have a very good understanding of how serious tonsillitis is.
posted by threeants at 4:08 AM on May 18, 2010


Response by poster: You must go see a doctor. See here:
Untreated tonsil or throat infections can lead to problems with the heart and kidneys, such as rheumatic fever. If tonsillitis is untreated, a condition called peritonsillar abscess can develop, in which swelling from the abscess can become large enough to obstruct the airway. The infection can also spread into the neck and chest and become fatal.
Tonsillitis is an infection; infections are dangerous.
posted by ocherdraco at 8:28 PM on May 19, 2010


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