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In the year In the summer of 1983, Katie Golden's mother stocked her kitchen in suburban Detroit with Popsicles. and bubble gum. Golden was 5 years old and was going to have her tonsils out to help with some ear problems she had had since she was a baby.
The procedure looks good; Her recovery was similar to many other children she knew who had their tonsils removed, and she was back to her talking body in seemingly no time.
But a few weeks ago Golden stopped at a supermarket Because she was about to pop her tonsils out to pick up two packs of grape bubble gum – again.
In the last 40 years, they have grown back – the left tonsil is almost full size – and it once caused a problem.
Golden has had dozens of surgeries to address inner ear problems in her life and is no stranger to sore throats, but if she sees an otolaryngologist, also known as an ear, nose and throat or ENT doctor.
“For years I knew there was a little flap or something, but I didn't understand what it was. I thought, I am not a doctor myself. I don't know much about mouth structure. That's the way it is,” said Golden. But if I got sick and had a sore throat or something, the back of my mouth would really burn, and it would be hard to swallow. And I thought: 'Well, obviously it's not my tonsils. I took those out. Now it's my throat that hurts.'
In September, she developed a particularly painful sore throat and made an appointment with Dr. Cynthia Hayes, an ENT with an office about an hour northwest of Detroit.
As Hayes examines her throat, she describes what she sees for a medical scribe to take notes. And when Hayes mentions the size of the tonsils, Golden says, disbelief and shock, “Hit [her] Like a ton of bricks.
“I looked around like, 'Yeah, no, I don't have tonsils.' I looked at her like, 'Maybe I picked a dude,'” Golden said.
Hayes said she was seeing inflamed tonsils, and Golden was adamant that it couldn't be true.
“I didn't think it would happen. I was in shock and disbelief that my tonsils, which I thought were gone, were causing my pain,” Golden said. “She said, 'Well, they have to grow back.' And I thought that was the weirdest answer ever.
Tonsil is part of the human immune system. “The back of the throat is made up of lymphoid tissue that helps filter and fight pathogens that enter the mouth and nose,” says Dr. Adva Buzi, MD, assistant physician in the Department of Otolaryngology (ENT) at Children's Hospital. of Philadelphia, told in an email. She did not enter the golden case.
Tonsil removal helps with breathing-related sleep disorders and frequent infections. Tonsillitis has been on the decline over time, but surgeons in the US still perform more than half a million procedures each year, as of 2015. Cleveland Clinic.
Tonsil regrowth is rare. The few studies that have tried to quantify the risk have put it at between 1% and 6% of those who have intracapsular tonsillectomy, a procedure that removes most of the tonsil tissue.
Practices for tonsillectomy are not standardized, experts say, making it difficult to understand all the nuances.
Many methods can be used to remove tonsils. The most common are microdebridement, which uses an instrument to suction and shave tissue, and ablation, a “hot technique” that involves the use of radiofrequency to remove tissue. Some doctors, especially those who have been trained for decades, prefer “cold techniques” only with a scalpel or other taped equipment.
“Furthermore, the amount of tissue removed can vary greatly from surgeon to surgeon and is difficult to control in a study,” Buzy said.
“Tonsillar regrowth occurs when the remaining tonsil tissue is exposed to new inflammation. A properly performed tonsillectomy aims to remove all tonsil tissue, and regrowth is rare.
In eight years of practice, Hayes said, Golden is only the second patient to have her tonsils grow back. But she knew right away that that was what was happening.
“Looking back, it was pretty obvious,” Hayes said. “In a person's throat, it's in front of the back pillar, and that's where the tonsils sit. When a person's tonsils come out, it should be very soft. But he was very good with her. Like a new growth, it just sits there and looks like tonsil tissue.
Hayes said she feels strongly that Golden is more prone to tonsil regrowth because of the method used when she was a child. When Golden had her first surgery decades ago, “cold techniques” were common, which included the use of a guillotine instrument that cut the tonsils with two blades. But Hayes says “fresh techniques,” like the one she used for Golden's surgery this year, create greater precision.
“I actually cut right down to the tonsil capsule and removed all that tissue,” Hayes said. “Of course, I don't have a magic ball, but I don't expect her to repeat herself.”
Neither Golden nor Hess can be sure when the tonsil regrowth began or how long it took, but Hess's best guess is that they have been there for at least a decade.
Although the regrown tonsils were inflamed and uncomfortable, there was no other medical urgency to have them removed; Golden chose the procedure after discussing all the risks and benefits.
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Tonsillectomy recovery is often longer and more difficult for adults because children generally tend to heal faster, experts say.
In the two weeks since her procedure, Golden has been supported by the people she loves, but she's surprised by how brutal her recovery has been.
“I didn't have any bleeding, but the back part — think of it as a cancerous tumor about the size of your first thumb,” she said. “It's more painful than I expected. “It's taking longer than I thought.”
Still, the payoff — no longer having a sore throat that “feels like swallowing a cactus for a few days” — is worth it, she says.
Bubble gum was recommended during her childhood recovery to stimulate saliva production and strengthen her jaw after a long operation, but this nostalgic experience did not help the second time around. Chewing hurts for the first few days, Golden says.
Hayes says her expert advice to help with the healing process is the same regardless of the patient's age.