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Old 03-16-2018, 08:09 AM
ThelmaLou ThelmaLou is offline
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When and why did tonsillectomies stop being routinely done on kids?

I had mine out in 1958 when I was 10, along with something called my "adenoids"-- what the heck are those? The overnight experience was not a good one. I stayed out of hospitals for the next 50 years.

I have a vague idea that tonsils have, in recent times, been determined to have some value and maybe shouldn't have been yanked so casually from all those little kids' throats.

Not sure if this is a GQ or IMHO. Move if necessary.
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Old 03-16-2018, 08:18 AM
Jasmine Jasmine is offline
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People who have tonsil problems will have them periodically throughout their lifetimes if they are not removed. It is much more profitable for the medical establishment. If you remove them, it's "one and done", so to speak. If you leave them in, you get all that money from doctor visits and drugs for a lifetime.

A couple of years go (give or take), the medical establishment, without much fanfare, lowered the AD1 test level considered indicative of Type II Diabetes. By doing so, they were able to justify putting a whole bunch more people on drugs.

Yes, you're right, I have real trust issues with our "medicine for profit" health care system.
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Old 03-16-2018, 09:10 AM
ZipperJJ ZipperJJ is offline
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As a data point...my brother had his taken out in or around 1982, but I never had mine out (2 years younger) even though I suffered from a lot of earaches and a lot of strep throat. My mom always wondered why they never recommended me for a tonsillectomy but we figured that the early 80s was when the shift to avoiding surgery happened.

My niece had her adenoids out a couple years ago, and just had her tonsils out this past fall. She had to go through a LOT of testing before the tonsils came out, including a full sleep study, to make sure they were absolutely a problem.

I don't see it as a way to get money from needing more care. I see it as reluctance to do surgery on anyone who doesn't need surgery. YMMV.
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Old 03-16-2018, 09:26 AM
gnoitall gnoitall is offline
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Originally Posted by ThelmaLou View Post
I had mine out in 1958 when I was 10, along with something called my "adenoids"-- what the heck are those?
Adenoids are tonsils too; specifically, a set of tonsils at the extreme back of the nasal cavity, where it bends down into the throat (above and behind the soft palate).

Tonsils are lymph nodes (or lymphatic organs) that face into the eating/breathing tract to help catch micro-organisms as they pass by. They're immune system organs.
Quote:
I have a vague idea that tonsils have, in recent times, been determined to have some value and maybe shouldn't have been yanked so casually from all those little kids' throats.
IANADoctor, but that's been my impression as well. I never had tonsil problems, but my wife and one of my kids have had their surgically-accessible tonsils (adenoids and palatine tonsils -- those are the ones people think of as "tonsils") removed because of continuous allergy-based swelling interfering with Eustachian tube flow (constant ear infections).

In the late 19th and early 20th Century, there were a lot of woo-ish tonsillectomy and adenoidectomy surgeries to "solve" issues like bedwetting and mental retardation .

Since the surgeries are usually done under general anesthesia and has a slight chance of dangerously heavy post-op bleeding, the risk is not really justified except for a few fairly clear issues. Certainly not because "let's just take 'em out, they're not useful anyway."

Last edited by gnoitall; 03-16-2018 at 09:30 AM. Reason: wiki linky and close quotes
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Old 03-16-2018, 09:27 AM
dolphinboy dolphinboy is offline
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Anecdotally, I was born in 1954 and by the time I was 8 it already wasn't being done routinely, at least in California. They've finally figured out that what were thought to be useless body parts, like your tonsils and your appendix, do serve a function, and while removing them isn't necessarily detrimental, there' some value in leaving them in your body until they become infected.
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Old 03-16-2018, 09:44 AM
Colibri Colibri is offline
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Originally Posted by Jasmine View Post
People who have tonsil problems will have them periodically throughout their lifetimes if they are not removed. It is much more profitable for the medical establishment. If you remove them, it's "one and done", so to speak. If you leave them in, you get all that money from doctor visits and drugs for a lifetime.

A couple of years go (give or take), the medical establishment, without much fanfare, lowered the AD1 test level considered indicative of Type II Diabetes. By doing so, they were able to justify putting a whole bunch more people on drugs.

Yes, you're right, I have real trust issues with our "medicine for profit" health care system.
Moderator Note

Jasmine, professional jabs are against the rules in GQ. In addition, this does not answer the question in the OP. No warning issued, but don't do this again.

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Old 03-16-2018, 09:48 AM
Jonathan Chance Jonathan Chance is offline
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Hmm. I never had mine out. And last year I had a tumor on my left tonsil. Apparently surgery wasn't recommended as treatment. But I do wonder if it would have been better than chemo and radiation.
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Old 03-16-2018, 09:55 AM
burpo the wonder mutt burpo the wonder mutt is offline
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Hmm. I never had mine out. And last year I had a tumor on my left tonsil. Apparently surgery wasn't recommended as treatment. But I do wonder if it would have been better than chemo and radiation.
Is that kind of an unusual place to get a tumor? Smoker? Chawin' tobaccy? Didn't drink enough hooch to drown it? I'm intrigued.

BTW, I've had mine out three times (bad doctoring the first two), adenoids four (?). Until today, I didn't know it had anything to do with ear infections, which I had many as a tot.
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Old 03-16-2018, 10:01 AM
Bayard Bayard is offline
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Could it be that issues that used to be treated by yanking the tonsils out are now more often (and more safely) treated with antibiotics and other medication? My WAG.
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Old 03-16-2018, 10:02 AM
Jim's Son Jim's Son is offline
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Originally Posted by Jasmine View Post
People who have tonsil problems will have them periodically throughout their lifetimes if they are not removed. It is much more profitable for the medical establishment. If you remove them, it's "one and done", so to speak. If you leave them in, you get all that money from doctor visits and drugs for a lifetime.

A couple of years go (give or take), the medical establishment, without much fanfare, lowered the AD1 test level considered indicative of Type II Diabetes. By doing so, they were able to justify putting a whole bunch more people on drugs.

Yes, you're right, I have real trust issues with our "medicine for profit" health care system.
The real villains are the trial lawyers such as John Edwards (special interest group of the Democrats) who target doctors forcing them to perform unnecessary surgeries and raising their insurance coats, at tremendous fees for themselves (natch).

Capitalism has worked extraordinarily well in providing top quality products at a low cost in other fields. No reason why it shouldn’t work in medicine if given a chance.
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Old 03-16-2018, 10:05 AM
Ashtura Ashtura is offline
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Originally Posted by ThelmaLou View Post
I had mine out in 1958 when I was 10, along with something called my "adenoids"-- what the heck are those? The overnight experience was not a good one. I stayed out of hospitals for the next 50 years.

I have a vague idea that tonsils have, in recent times, been determined to have some value and maybe shouldn't have been yanked so casually from all those little kids' throats.

Not sure if this is a GQ or IMHO. Move if necessary.
I had chronic tonsil stones as a teenager and got my tonsils removed because of it. Considering they make corpses smell like roses in comparison, I have no regrets whatsoever.
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Old 03-16-2018, 10:12 AM
Jonathan Chance Jonathan Chance is offline
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Is that kind of an unusual place to get a tumor? Smoker? Chawin' tobaccy? Didn't drink enough hooch to drown it? I'm intrigued.
Curiously, both my oncologists told me it was a relatively common cancer that is prevalent in middle aged men who don't drink. So you're not far off.

And I've never smoked or done anything with tobacco. So that's out.
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Old 03-16-2018, 10:45 AM
Kimballkid Kimballkid is offline
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I was born in 1967 and have never had either one taken out. I think it was more an economic thing than a 'doctor wouldn't do it' thing as my parents were very poor.
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Old 03-16-2018, 10:47 AM
Kimballkid Kimballkid is offline
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Curiously, both my oncologists told me it was a relatively common cancer that is prevalent in middle aged men who don't drink. So you're not far off.

And I've never smoked or done anything with tobacco. So that's out.
As a middle-aged man who quit drinking a couple years ago, I wonder if I would be susceptible to the same thing.

I also don't smoke or chew tobacco either.

Last edited by Kimballkid; 03-16-2018 at 10:47 AM.
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Old 03-16-2018, 10:49 AM
engineer_comp_geek engineer_comp_geek is offline
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Way back when, if you got too many throat infections, doctors would almost routinely just take your tonsils out. Tonsils were thought of as kinda useless back then, and were just a good way to get a throat infection. As time went on, they started to realize that the tonsils actually did serve a useful purpose as part of your immune system, and in most of those cases, taking the tonsils out actually probably did more harm than good. But they kinda over-corrected a bit and became reluctant to take out tonsils even in cases where they probably should have. I personally was a part of this second wave. I was born in 1966 and should have had my tonsils taken out in the 70s, but my doctor was reluctant to do so and I had constant problems with throat infections. Finally as an adult I went to a different doctor and had them removed, and my health improved quite a bit as a result.

So, late 60s to early 70s is probably where the shift occurred. By the 80s they realized that they needed to take tonsils out more often than they had been in the 70s, but they never went back to just taking them out at the drop of a hat like they had been doing originally.

At least that's my experience with it, in the West Virginia area. The timeline may be shifted a bit for other areas.
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Old 03-16-2018, 10:50 AM
Colibri Colibri is offline
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The real villains are the trial lawyers such as John Edwards (special interest group of the Democrats) who target doctors forcing them to perform unnecessary surgeries and raising their insurance coats, at tremendous fees for themselves (natch).
Moderator Warning

Jim's Son, since I just gave a note on professional jabs, and you chose to throw in a political jab on top of it, this will be an official warning.

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  #17  
Old 03-16-2018, 10:54 AM
Kimballkid Kimballkid is offline
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they started to realize that the tonsils actually did serve a useful purpose as part of your immune system,
That may be why I seem to have an ironclad immune system.

Maybe I should thank my parents for not having mine removed.

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Old 03-16-2018, 10:58 AM
Qadgop the Mercotan Qadgop the Mercotan is offline
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These days, T & A is indicated if there are significant problems with obstruction or infection. Current recommendations per UpToDate:
Quote:
Adenotonsillectomy is considered the first-line treatment for obstructive sleep apnea in otherwise healthy children over two years of age with adenotonsillar hypertrophy.

The benefits of tonsillectomy (with or without adenoidectomy) in patients with recurrent throat infections depend on the frequency and severity of previous episodes. For children with recurrent throat infection who are severely affected (ie, ≥7 episodes in one year, ≥5 episodes in each of two years, or ≥3 episodes in each of three years), we suggest tonsillectomy (with or without adenoidectomy) as an option. However, given the natural decline in tonsil-related problems with increasing age, watchful waiting and provision of symptomatic care and antimicrobial treatment (as indicated) for recurrent episodes is a reasonable alternative to surgery. For children with recurrent throat infection who are only mildly or moderately affected, we suggest not performing tonsillectomy
There are other reasons to have the procedure, but it certainly is de-emphasized over what it was prior to the early 1970's. In origin, it was felt that prophylactically removing tonsils before they became a problem would prevent not only a lot of strep throat, but also rheumatic heart and kidney disease. Doctors of earlier eras saw a lot of kids get damaged, or die, from strep infections.
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Old 03-16-2018, 11:02 AM
Bayard Bayard is offline
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Originally Posted by Qadgop the Mercotan View Post
These days, T & A is indicated if there are significant problems with obstruction or infection. Current recommendations per UpToDate:


There are other reasons to have the procedure, but it certainly is de-emphasized over what it was prior to the early 1970's. In origin, it was felt that prophylactically removing tonsils before they became a problem would prevent not only a lot of strep throat, but also rheumatic heart and kidney disease. Doctors of earlier eras saw a lot of kids get damaged, or die, from strep infections.
So, might one say... ahem:
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Originally Posted by Bayard View Post
Could it be that issues that used to be treated by yanking the tonsils out are now more often (and more safely) treated with antibiotics and other medication? My WAG.


Also, I'd like to point out that T&A is always indicated.

Buh-dum-tsss!

Seriously, thanks for sharing your expertise.
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Old 03-16-2018, 11:03 AM
puddleglum puddleglum is offline
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Tonsillectomy used to be used to treat recurrent sore throats or strep throats. They have fallen out of favor due to doctors realizing that most throat problems in children are resolved by age. They are still used if a patient has strep throat more than seven times in one year or has a form of sleep apnea caused by swollen tonsils. Treating strep throats with antibiotics instead of surgery is much cheaper and less dangerous to patient.
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Old 03-16-2018, 11:11 AM
bob++ bob++ is offline
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In the UK tonsillectomies are rare. I was always told that this is because the operation is riskier than the cure. I can't find any evidence to confirm this.
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Old 03-16-2018, 11:11 AM
Hari Seldon Hari Seldon is offline
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I had mine out when I was six years old in 1943 and it was done routinely. They sweetened the pot by promising ice cream after. It did soothe the sore throat. I have the impression that it was just a reluctance to put kids under general anesthetic. Like any such procedure there were very rare deaths.
When I had to have my appendix out in 1950, they did it under local (spinal). None of my kids ever had it done.
  #23  
Old 03-16-2018, 11:12 AM
Marvin the Martian Marvin the Martian is offline
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In first grade (1966) I missed so days due to multiple bouts on bronchitis that technically I was not supposed be promoted to second grade (fortunately it was a Catholic school, and the principal/Mother Superior could do whatever she damned well pleased and fudged the record since I had the highest grades in the class of 64). Over the summer I had my tonsils out and had perfect attendance in second grade.

My wife (same age), in a different state and obviously with different doctors, had a pediatrician who did not believe in tonsillectomies and still has hers. She also has frequently recurring sinusitis (3-4 times per year), not sure if there is any connection.
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Old 03-16-2018, 11:14 AM
Marvin the Martian Marvin the Martian is offline
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They sweetened the pot by promising ice cream after. It did soothe the sore throat.
I remember having as much ice cream as I wanted. Plus I got a Lego set, so I felt it was worth it.
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Old 03-16-2018, 11:23 AM
Jackmannii Jackmannii is offline
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The pro side of tonsillectomy involves patients with repeated tonsillitis and breathing impairment which can be fixed by removing the offending organs.

The negative has to do with pain, surgical risks, post-op infection and not so much with long-term greater susceptibility to infection, though there's some evidence that those who've had tonsils removed are more prone to deep neck infections.

I am happy to say I still have tonsils and the rest of my original equipment, although that's akin to a vintage Chevy with all-original parts.

Last edited by Jackmannii; 03-16-2018 at 11:24 AM.
  #26  
Old 03-16-2018, 11:34 AM
ThelmaLou ThelmaLou is offline
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Originally Posted by Jasmine View Post
...
A couple of years go (give or take), the medical establishment, without much fanfare, lowered the AD1 test level considered indicative of Type II Diabetes. By doing so, they were able to justify putting a whole bunch more people on drugs. ....
Factual correction: the test is called A1c. And the threshold guidelines have just been raised again.


This has been an illuminating discussion. Thanks.

Last edited by ThelmaLou; 03-16-2018 at 11:35 AM.
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Old 03-16-2018, 11:47 AM
JohnM JohnM is offline
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Originally Posted by engineer_comp_geek View Post
I personally was a part of this second wave. I was born in 1966 and should have had my tonsils taken out in the 70s, but my doctor was reluctant to do so and I had constant problems with throat infections. Finally as an adult I went to a different doctor and had them removed, and my health improved quite a bit as a result.

So, late 60s to early 70s is probably where the shift occurred. By the 80s they realized that they needed to take tonsils out more often than they had been in the 70s, but they never went back to just taking them out at the drop of a hat like they had been doing originally.

At least that's my experience with it, in the West Virginia area. The timeline may be shifted a bit for other areas.
I was born in 1959, also in West Virginia, and my experience was pretty much the same. Annual or more hospitalizations for runaway tonsillitis, until my parents finally took me to a different doctor when I was around twelve, and I had both the tonsils and adenoids removed.
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Old 03-16-2018, 11:54 AM
DavidwithanR DavidwithanR is offline
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What the reason should be - and actually I think in most cases it is being done properly - is that the patient and the doctor consider the risks and the benefits, and do what will be best overall.

Overall, the change in how often the answer is "take them out" comes from the fact that now we have access to the huge data sample created when people were getting them out more often. In hindsight, we can see exactly how it did or didn't improve the lives of all those patients, and we take that into account. Plus the fact that different treatments are developed or discovered over time.

OK, I admit that's the rosy idealistic picture, and of course there are hasty decisions, and of course there are decisions made for the wrong reasons. But overall, we have to hope that "study the statistics, and weigh the risks and benefits" wins out.
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Old 03-16-2018, 12:03 PM
DavidwithanR DavidwithanR is offline
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One obvious problem with this very good method: if the statistics are not kept carefully enough, or if something important didn't get recorded because we never knew it was important. Like they used to say about computers - garbage in, garbage out.
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Old 03-16-2018, 12:10 PM
jz78817 jz78817 is offline
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I had mine out when I was about 5 (this would have been in the early '80s.) I was having frequent middle ear infections and subsisting on a steady diet of amoxicillin for a while. Septra for the stubborn ones; hated the incredibly bitter taste of that one.

once they yoinked my tonsils and adenoids, no more ear infections.

however, within the next 10-15 years is when that seems to have stopped being standard practice. my younger cousins with ear infection issues got the "tubes" instead.
  #31  
Old 03-16-2018, 01:00 PM
Leo Bloom Leo Bloom is offline
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Originally Posted by ThelmaLou View Post
I had mine out in 1958 when I was 10, along with something called my "adenoids"-- what the heck are those? The overnight experience was not a good one....
1964-ish/5-6-year-old-ish. First hospital stay and scared shitless.

My Dad: "What did one tonsil say to the other?"
SPOILER:

"Get dressed honey, we're going out tonight."

God bless my Dad.
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Old 03-16-2018, 01:25 PM
WOOKINPANUB WOOKINPANUB is offline
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I had mine out at 18, and to be honest, I don't remember having more instances of sore throat than the average bear. I had terrible earaches as a child but I must have outgrown whatever caused that. In any event, I ended up at an ENT doc and he said they should come out and that was that. Holy cow, the recovery hurt a gajillion times worse than any sore throat I've ever experienced (though I'd take it over an earache any day).

On a side note - and I think I might have shared this before - when I went in for some kind of pre op exam / blood test or whatever, the doctor did a full breast exam on me It seemed . . . weird, but I was young and naive and also unaccompanied by any adult. I remember telling my mother about it, years later and apropos of nothing, and she about flipped her lid. I think if I'd have said something at the time she would have killed him. Or sued.
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Old 03-16-2018, 01:40 PM
ThelmaLou ThelmaLou is offline
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Originally Posted by WOOKINPANUB View Post
...
On a side note - and I think I might have shared this before - when I went in for some kind of pre op exam / blood test or whatever, the doctor did a full breast exam on me It seemed . . . weird, but I was young and naive and also unaccompanied by any adult. I remember telling my mother about it, years later and apropos of nothing, and she about flipped her lid. I think if I'd have said something at the time she would have killed him. Or sued.
Damn! That bastard! I wonder how much of that sort of thing went on that we, as young people, didn't know was inappropriate. I wish your mom had removed his tonsils.

Haven't crossed paths with you in a while, my friend. Glad to see you in my thread.
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Old 03-16-2018, 01:44 PM
nightshadea nightshadea is offline
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my brother had tonsillitis off and on for years and the doctors refused to take them out saying they were beneficial to helping avoid throat problems I think throat cancer was mentioned which was little comfort to my brother when it felt like his throat was on fire ........
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Old 03-16-2018, 02:04 PM
Ignotus Ignotus is offline
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As most Europeans of my age (I'm going on 51!) I remember as a kid reading American stories with references to "tonsils" and the ectomy thereof. Much as the "circumcision", I always gathered it as one of those peculiar tribal rituals they have in those foreign lands...
  #36  
Old 03-16-2018, 02:58 PM
Blue Blistering Barnacle Blue Blistering Barnacle is offline
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Hmm. I never had mine out. And last year I had a tumor on my left tonsil. Apparently surgery wasn't recommended as treatment. But I do wonder if it would have been better than chemo and radiation.
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Originally Posted by burpo the wonder mutt View Post
Is that kind of an unusual place to get a tumor? Smoker? Chawin' tobaccy? Didn't drink enough hooch to drown it? I'm intrigued.

BTW, I've had mine out three times (bad doctoring the first two), adenoids four (?). Until today, I didn't know it had anything to do with ear infections, which I had many as a tot.
Pretty common place for oropharyngeal cancer. Very good place for cancer to hide- many occult tumors found there (by biopsies looking for tumor in people with cancerous neck nodes).

The Radiation-Chemotherapy protocols developed over the past 30 years have revolutionized treatment of head and neck cancer. Good outcomes with less morbidity and disfigurement. The advent of robotic assisted surgery may start to swing the pendulum back to surgery for some cases.

P.S.- Hooch is more likely to cause cancer than drown it. Human Pappilloma Virus (HPV) is ever more commonly recognized as a cause of oropharyngeal cancer- fortunately it responds a bit better to treatment, although there is still no "good
' cancer to get.
  #37  
Old 03-16-2018, 04:22 PM
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I had mine out when I was about 5 (this would have been in the early '80s.) I was having frequent middle ear infections and subsisting on a steady diet of amoxicillin for a while. Septra for the stubborn ones; hated the incredibly bitter taste of that one.

once they yoinked my tonsils and adenoids, no more ear infections.

however, within the next 10-15 years is when that seems to have stopped being standard practice. my younger cousins with ear infection issues got the "tubes" instead.
My daughter got tubes in 1985 or so, and the problem went away.
No one even mentioned the tonsils.

I grew up in the 50s, and tonsils got yanked on a routine basis. My brother got his out, and he was not frequently sick. Neither was I, but I was scheduled for it. I got sick just before the date of the operation and my mother decided that this was a sign I shouldn't go through the operation. I've never had a problem.

My wife's aunt was a nurse, and the first operation she assisted in was a tonsillectomy where the patient died. No way in hell was she going to let my wife have one.
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Old 03-16-2018, 04:26 PM
ThelmaLou ThelmaLou is offline
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...
My wife's aunt was a nurse, and the first operation she assisted in was a tonsillectomy where the patient died. No way in hell was she going to let my wife have one.

Oh god. How absolutely awful.
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Old 03-16-2018, 04:52 PM
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I was six years old when my tonsils and adenoids were taken out. I hemorrhaged, I recall it being the only time I saw my dad look scared. Anyway, later in my teens when I had my wisdom teeth removed I remember my parents had to be assured many times by the oral surgeon that I’d be fine having the procedure done in his office and the hospital was across the street if necessary. They thought I should’ve been hospitalized for it, I wasn’t and I was fine, but it speaks to me of how scared they were especially since older siblings had been through the wisdom teeth procedure. I was little and recall being a bit freaked but it took a toll on them.
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Old 03-16-2018, 07:18 PM
Morgyn Morgyn is offline
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My brother had tonsillitis a lot and so his tonsils were removed sometime around 1971 while we were living in the UK. I recall being quite jealous, because they said he'd get to eat nothing but ice cream for several days. I think he did, too.

Still got mine. When I was little someone told me that tonsils served as hooks to catch germs before they got into your system, so for YEARS I thought tonsils were like these weird rose-thorn shaped hooks in the back of the throat.
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Old 03-16-2018, 07:52 PM
UncaStuart UncaStuart is offline
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Born in '47, had adenoids and tonsils out around '52. My memory is that it was more or less SOP at the time. I don't recall any strep or ear issues leading up to the procedure, and with the parents and the surgeon not around to ask anymore, that'll remain a mystery.

I do recall the surgeon saying that he "took a hat-full of adenoids" out. With me being diagnosed with sleep apnea at 64, I wonder how much sooner that would have appeared if I still had had the hat-full hanging around.
  #42  
Old 03-16-2018, 09:22 PM
Andy L Andy L is offline
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Here's some data https://www.healthguideinfo.com/ear-nose-throat/p33464/

"Tonsillectomy and adenoidectomy rates in the United States have varied over the last fifty years, following a general pattern of decline. In hospitals in 1965, the tonsillectomy rate in the U.S. was 63.4 per 10,000 for all age groups, and 165.6 per 10,000 for children under 15 [1]. Two decades later (1986), these rates had dropped to 11.7 per 10,000 for all age groups and 33.9 per 10,000 for children under 15 [1].

Between 1990-91 and 2000, the hospital tonsillectomy rate for children under 18 dropped from 10.7 per 10,000 to 2.1 per 10,000 [2]."

Had mine out in 1968 or so - barely remember it. It was pretty routine back then as I recall (note that Cindy Brady and Little Ricky both had tonsils out on TV).
  #43  
Old 03-16-2018, 10:40 PM
nearwildheaven nearwildheaven is offline
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Originally Posted by Bayard View Post
Could it be that issues that used to be treated by yanking the tonsils out are now more often (and more safely) treated with antibiotics and other medication? My WAG.
You nailed it! Tonsils and adenoids are not removed nowadays unless they are obviously chronically diseased. Even though kids usually go home the same day, and adults the next, it is NOT a "minor" procedure just because it doesn't involve a skin incision.

When I was growing up in the 1970s, our parents were asked more than once, "So, when are you going to have your kids' tonsils out?" and they always replied, "When and if it needs to be done." As it turned out, none of us did, and some of that came from my dad remembering his own tonsillectomy when he was a little boy. He said it was a very traumatic experience, especially because it may not have been necessary.

I've personally known several people, including a high school friend, who were thought to have assorted chronic or even "psychosomatic" diseases, until they were discovered to have abscessed tonsils. They were creating atypical symptoms, but removing them led to vastly improved health.
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Old 03-16-2018, 10:43 PM
nearwildheaven nearwildheaven is offline
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Originally Posted by Qadgop the Mercotan View Post
These days, T & A is indicated if there are significant problems with obstruction or infection. Current recommendations per UpToDate:


There are other reasons to have the procedure, but it certainly is de-emphasized over what it was prior to the early 1970's. In origin, it was felt that prophylactically removing tonsils before they became a problem would prevent not only a lot of strep throat, but also rheumatic heart and kidney disease. Doctors of earlier eras saw a lot of kids get damaged, or die, from strep infections.
Rheumatic fever - now, THAT'S a disease that (it seems) nobody gets any more, and thank heavens! In 18 years of active pharmacy practice, I never encountered a case, although I did work with one pharmacist who would now be in his early 70s, and before I met him underwent a heart valve replacement due to rheumatic heart disease.
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Old 03-16-2018, 10:45 PM
nearwildheaven nearwildheaven is offline
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Originally Posted by Hari Seldon View Post
I had mine out when I was six years old in 1943 and it was done routinely. They sweetened the pot by promising ice cream after. It did soothe the sore throat. I have the impression that it was just a reluctance to put kids under general anesthetic. Like any such procedure there were very rare deaths.
When I had to have my appendix out in 1950, they did it under local (spinal). None of my kids ever had it done.
General anesthesia was much more dangerous back then, especially for children, than it is now.
  #46  
Old 03-16-2018, 11:15 PM
Ignotus Ignotus is offline
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Is there, in fact, any such thing as "tonsils", or is it just a doctor's buzzword for any designated part of the mucous membrane of the throat, just as arbitrary as the hymen?

Last edited by Ignotus; 03-16-2018 at 11:17 PM.
  #47  
Old 03-16-2018, 11:19 PM
Beckdawrek Beckdawrek is offline
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My oldest is the only one to have his tonsils out. We pretty much had to beg pediatrician to refer us the ENT. When he got mononucleosis we insisted. The ENT took one look at his throat and said "those tonsils are diseased, should of been removed a year ago". He did great and never had sore throat again. This was in the 90s.
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Old 03-16-2018, 11:22 PM
TSBG TSBG is offline
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I'm not a medical historian, but there seems to have been a sort of inflection point where doctors started realizing "tonsillectomies/adenoidectomies may not be necessary." No doubt the doctors here will correct me. But I remember fairly vividly as a child (US, early 70s) hearing from my parents that my tonsils and adenoids (and appendix) would have to be removed. None ever were though. I haven't had problems with any so far.

OTOH, my wife gets tonsil infections a lot and wishes they had been taken out. She's a only a few years younger than me but it seems the anti-removal wave broke over us, for good or ill.

I have a friend whose 2-yr old seems to have a chronic tonsil infection and it may be that removal is the best solution. I'm more worried than he is--he's the "I don't go to the doctor" type and I worry he doesn't realize how serious an operation is. However, it may be the best option for her.
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Old 03-16-2018, 11:43 PM
gnoitall gnoitall is offline
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Quote:
Originally Posted by Ignotus View Post
Is there, in fact, any such thing as "tonsils", or is it just a doctor's buzzword for any designated part of the mucous membrane of the throat, just as arbitrary as the hymen?
There is no tonsil conspiracy.

Tonsils are very specific lymphoid organs. They're not part of the mucosa, the same way the tongue or salivary glands aren't.
  #50  
Old 03-16-2018, 11:50 PM
Ignotus Ignotus is offline
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Originally Posted by gnoitall View Post
There is no tonsil conspiracy.

Tonsils are very specific lymphoid organs. They're not part of the mucosa, the same way the tongue or salivary glands aren't.
So, how come they're not a problem here in Europe? Sure, we've all had sore throats once or thrice: it usually comes with a dripping nose, and goes away with it. But I've never heard a doctor suggest that removal of some part of the epithel of the throat would serve to lessen that problem!
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