Tonsils

[Cjplus]

Good morning and thanks in advance for your help. I'm a 34 year old male, non-smoker, very rarely drink alcohol and a little overweight.

I have health related anxiety that is being treated successfully via meds for the most part but I still have "flare ups"

My questions are pretty basic.
1. Are your tonsils suppose to look identical shape wise. (mine don't)

2. What do tonsils look like. Mine have all kinds of crevices and bumps. Is that normal?

3. I had my tonsils checked out 3 years ago because I noticed a little bump on the right tonsil that wasn't on the left   tonsil. The ENT I went to saw it too and wasn't really worried but sent me to get a cat scan anyway. Everything came back fine on the CAT scan. I was just there again for a sore throat that was lasting a little over a week so he checked them again. He said nothing about them at all except that the right one was a little bigger than the left but only minimally and I think it's more just a different shape rather then a different size. So the question here is should I just accept what my ENT and GP seem to think which is that nothing is wrong other than I have a virus or bacteria of some kind. I don't ask them too much about it but they again they don't seem concerned.

4. The globus effect - I'm taking Biaxin right now since my GP thinks I may have a bacterial infection. The pills are humungous and each time i swallow them I feel like they're stuck in my throat. Could I be having some sort of a physical issue there or is it probably this Globus thingy? I have the feeling right now while I'm typing this to you. I didn't before. hmmmm? If it is just a sensation is it normal for it to switch sides of the throat?

5. Is it ok to take Biaxin and Paxil together?

Any help would be appreciated. I certainly have somewhat of an OCD/Anxiety disorder but it always helps me to talk it through. Thanks

[J.M. Keyes, MD]

Hi there,
I apologize I did not get to answer your question yesterday- my internet connection was down.
It is very common for your tonsils to not be exactly the same or perfectly symmetrical, and it is normal for them to have all kinds of bumps and crevices, so don't be concerned about that.  I think if you have seen your GP and ENT and both have examined you, I would not be concerned with further testing beyond what they have done at this point.

It is also quite common to have the feeling like something is stuck in your throat when when taking large pills, and globus can affect you even when you aren't taking the pills.  Make sure that you take the pills with a large glass of water so that they get washed all the way down the esophagus and not stuck along the way.  If this feeling of something blocking your esophagus isn't resolving after you have finished your prescription, or it's getting worse, or you are starting to feel like it is affecting your breathing, see your doctor about it.   Certainly at your age, anything more serious would be very rare.

There is no listed drug interaction between Biaxin and Paxil, so I would advise taking both prescriptions as directed by your doctor.  

If you are still concerned, or you are having new symptoms follow up with your GP.

Good luck, I hope this makes you feel a bit better.

JMK MD

[J.M. Keyes, MD]

Hi,
thyroid nodules can cause feelings of something being stuck in your throat- but they are likely benign based on your ultrasound report.  you should ask your doctor if they think a follow up ultrasound would be necessary to see if there is any change in your thyroid gland that could be causing your symptoms.

Hope you are feeling better soon.

JMK MD

[Cjplus]

Are follow up questions allowed?

[Cjplus]

Thanks so much for getting back to me and yes your professional opinion certainly helps to keep my worrying to a minimum.

I don't know if this is cheating but it's in the same vein. The one thing I forgot to mention was that when the ENT ordered the CT scan of my neck they found "a 5mm hypondense nodule in the left lobe of the thyroid gland." Again this was 3 years ago.
An untrasound was ordered to further characterise the nodule.

The ultrasound results were as follows "A 5 mm thyroid nodule with mixed echogenic charateristics probably representing an adenoma on the left side. Smaller nodules are seen on the right. The thyroid echogenicity is normal and there is no thyromegaly."
Could these be causing the feeling of something stuck in my throat all of a sudden? Should I have these checked out again? I also have cysts on my testicles and have had them for many many years. I believe that the thyroid and the testicles both fall into a simliar category as to how they're made up. Could it be that I'm just predisposed to growths in my endocrine system. Did that make sense?

I'm over the tonsils and on to worrying about thyroid cancer. I feel bad for my family while I'm like this so I want to be through with it as soon as possible.

[Cjplus]

When do the doctors normally respond?