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The Doctors Lounge - Primary Care Answers

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Forum Name: Ear Nose and Throat

Question: Tonsils are huge and interrupt sleep

gttx1458 - Tue Feb 21, 2006 12:29 am

My best friend has huge tonsils. They are at the point to where they touch and she can't swollow food without choking every few minutes. On one of them she has this soft bump that has seemed to grow over the past few months into larger than pea size. She has gone to her doctor at the community clinic, but they keep saying that she has tonsilitis, and give her Antibiotics. She is a student with only a part time job, so she can't keep affording to go to the doctor for this problem if the treatment isn't helping. She has no pain, no Fever, and she snores so loud at night she wakes herself up. When she stays at my house I notice that it seems like she quits breathing when she sleeps. Her speach also seems muffled and slurred when she talks. I also notice that she gags a lot as well. The last time I went with her to the doctor and suggested to him that he refer her to specialist so she can get state assistance to pay for the medical bills. He said that referral does not seem neccessary, and feels her sleep problems are due to the fact that she is overweight. He also stated that removal of tonsils is not usually recommended anymore.

She is 19 years old and weighs 360 lbs. She has lost 45 lbs by diet and exercise over the past 2 and 1/2 months, and still has not improved in her sleeping or her problems that I feel stem from her tonsils. She has given up. I also feel that her weight loss is due to not being able to eat meals without choking. Do you agree with the doctor, or should she get a specialist to look at her tonsils?

Any advice will help.

Thank you
Theresa Jones, RN - Tue May 23, 2006 11:53 am

Hi gttx1458,
An evaluation by a specialist (ENT) is warranted. Recurrent episodes of tonsilitis are treated with removal (tonsilectomy). If she is snoring loudly and having episodes of interrupted breathing when she is sleeping it certainly may be related to the enlarged tonsils causing obstructive sleep apnea. I would again suggest an evaluation by the above mentioned specialist and there are programs in most states that provide free or reduced cost health care to those eligible (usually based on income).
Theresa Jones, RN
rjshprabhakar - Tue May 23, 2006 2:01 pm

Hello gttx 1458,.
Your friend definately has a problem. She is suffering from obstructive sleep apnoea syndromeThere are various causes for it, obesity and enlarged tonsils being 2 of the many causes. sleep apnoea is the term used when the patient stops breathing for few seconds during sleep as in case of your friend. sleep apnoea can have various short and long term effects on the body like Hypertension, day time sleepiness which can make a person more prone to accidents, decrease in sex desire, certain heart rythm disorders, Headaches etc.
Ideally your friend requires invetigations in a sleep lab overnight where all the body parameters are monitored while sleeping. Then there are some medical measures and assistive devices for countering this problem, but I think your friend will require surgery in the form of uvulo palato pharyngo plasty which includes removal of tonsils. Weight reduction is must.
yours sincerely

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