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Tonsillectomy ideal in some cases Peter gott, M.D.
Reader asks Dr. Gott if surgery is recommended for daughter who has tonsilitis.
Dear Dr. Gott: My daughter, age 11, was diagnosed with tonsillitis last winter. Should we consider surgery?
Dear Reader: I suspect that you shouldn't, but the answer to your question depends on how frequently your daughter suffers from tonsillitis.
The tonsils are basically lymph glands in the throat. Because they're continually exposed to the air we breathe, they can easily become infected - especially with streptococcus bacteria, which should be treated with antibiotics to reduce the risks of kidney damage and rheumatic fever, two serious consequences of untreated strep infections.
Ordinarily, the tonsils begin to shrink during the preteen years; thus, childhood sore throats and tonsillitis become less of a problem in adolescence and adulthood.
Nonetheless, some young people persist in being troubled by recurring tonsillitis. In such instances, tonsillectomy may be considered. The general rule is: two or more bouts of strep tonsillitis (diagnosed by throat cultures) per year should indicate the need for surgery.
Unlike physicians a decade or two ago, today's doctors recognize that the tonsils actually play an important role in children's developing immune systems; therefore, tonsillectomy is not as widely practiced as it was in the past. Nonetheless, the risks of repeated strep infections far outweigh the benefits conferred by the tonsils. Follow your pediatrician's advice.
Dear Dr. Gott: I've had excessive urination for the past year, especially at night, when I have to go as many as eight times. I've had an IVP, urinalysis and cystoscopy. All tests have come back negative. Any suggestions?
Dear Reader: You bet.
Excessive urination, especially at night, has many potential causes, ranging from inordinate consumption of fluids in the evening to serious medical conditions such as diabetes, urinary infection, heart failure, prostate disease and others.
You appear to be under the care of a urologist, who appropriately examined your urinary tract. Now, it seems to me, your doctor should take a step back and refer you to an internist (diagnostic specialist) in order to investigate some other causes of frequent urination. For example, you need a blood test for diabetes, a cardiogram, a chest X-ray (to rule out heart failure) and a urine culture (to identify any infection).
While you're waiting for an appointment with the specialist, try a little experiment: Don't consume any fluids after dinner. If your problem is as simple as fluid overload, this trick may substantially reduce your urinary frequency, a finding that would delight your internist and save you the expense and nuisance of further testing.
Let me know the outcome.
To give you related information, I am sending you a copy of my Health Report "Bladder/Urinary Infections." Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.
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