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Tonsils and Adenoids

What and Why?

Many people, whether as patients themselves or as parents on behalf of their children, at some time face the decision whether to accept tonsillectomy or adenoidectomy as treatment for their children’s repeated infections or nasal blockage. Not everyone feels confident that the surgeon is giving disinterested advice. This is what you need to know to make the decision confidently.

Most of the infections that can occur in your mouth behave quite unlike colds because your gums, your tongue and the skin inside your cheeks are tougher and less sensitive. But your throat is susceptible to virus infection and reacts in much the same way as your nose.

The tonsils are the special lymph glands located there, spread out just beneath the skin on each side of your throat. They are closely allied with your adenoids, which are similar glands on either side of your nose near its back entrance, where it joins your throat. They are only separated from your tonsils by the thickness of your soft palate, which is the arch of skin over the top of your throat; it frames the hole you can see in the mirror, over the root of your tongue.

Virus attack in your nose or throat usually arouses the protective function of both your tonsils and adenoids, making them sore and swollen. Swollen red inflamed tonsils are not usually infected themselves, but actively defending skin under attack somewhere nearby. You deal with most of these attacks locally in the skin itself, and are never made aware of the challenge. But small children come under particularly heavy pressure from the many germs that get shared around playgroups and schools. Frequent tonsillar swelling is not necessarily unhealthy in your early school years, if you keep well and vigorous despite it. It usually lasts only as long as it takes you to encounter and become immune to all the germs that are common in your locality. However, because their tonsils are conspicuous and obviously enlarged they tend to get blamed for these repeated infections, instead of being credited with limiting their damage and fighting them off.

Sometimes of course all the work they do is overwhelming, and your tonsils get worn out. Just as a damaged fort may become a refuge for pirates, so may wrecked tonsils become an infection risk. Then and only then does it make any sense to remove them. Otherwise, focus your attention on supporting them and keeping your immune defences fully efficient.

What can I do?

Advice to maintain and maximise health

1. A diet including plenty of crisp fibrous food needs a lot of chewing and is mildly abrasive. The muscular massage and scraping this gives your throat at mealtimes keeps the hollows in the tonsil surface clean, and stops your lymph circulation from getting sluggish and congested — far the best direct protection against sore throats. They are usually more nourishing too, adding to your indirect defences.

2. Avoid sugary and white floury foods like biscuits, which become pasty in the mouth and can stick in the hollows of your tonsils, making them ideal places for germs to grow. They also nourish you less well, indirectly weakening your defences against germ attack.

3. Try an alternative to antibiotics next time you have a sore throat. A good conventional mouthwash is Thymol Glycerine Compound, which can be used neat or diluted with three parts of hot water. Better for pain is Potassium Chlorate and Phenol Gargle, diluted with an equal part of very hot water; but do not swallow this one, as it is mildly corrosive. Three Dispersible Aspirin in half a glass of water make another good analgesic gargle, but have no antiseptic properties. Red sage tea is a soothing herbal antiseptic gargle; or keep a clove of fresh garlic (see recipes for health) in your cheek as a lozenge. The reek is not too obtrusive provided you keep the outer skins on, and do not chew or bruise it.

4. Homoeopathy is a very promising system of medicine for identifying and neutralizing any personal weaknesses which may make you prone to repeated tonsillitis, but there is no one remedy you can try for yourself: take professional advice.

5. In any case work hard at improving the efficiency of your tonsils and adenoids by eating lots of fresh vegetable produce and seeds, such as wholemeal bread and cereals. Supplement this for immunity, mainly with Zinc, Vitamin C and Vitamin B complex . Once you have this organized, bide your time: six months can make a lot of difference.

6. Think three times before having your adenoids removed. It is a messy operation with an appreciable risk, and they are inclined to re-grow. If your adenoids are blamed for deafness, attend to that separately.

7. Tonsillectomy is a neater operation, but rarely necessary unless the glands have become festering wrecks. This is more likely nowadays in adult life. If you get three or four bouts of genuine tonsillitis each year, ask your doctor if the advice of an ENT Surgeon is worthwhile.

8. Quinsy is an abscess around and beneath your tonsil, which closes your throat, alters your voice, and makes swallowing very painful indeed. You will need medical treatment as soon as possible for this one, and may be offered surgery to remove your tonsils after only one or two attacks. Surgery is, in this case, of low risk, and fully curative; you should probably accept it. Otherwise the condition tends to recur.

9. If you accept surgery, prepare for it.

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