In which copious claret gets expectorated

There are few occasions in life where a big smile is the appropriate response to coughing up blood.

But hey, this is one. First: a quick update. Pain's been easing off quickly yesterday and today - jaw and earache down to very little, stabby throat pain and difficult swallowing much reduced, though I still can't sleep unless upright, and even then only for a couple of hours at a time. Each time I wake up and it's really hurty, and I have to give it 15 minutes, sipping water until it calms down, before going round again. I guess that will run until my uvula calms down. I don't know how well it came across in the last couple of posts, but days 3 and 4 were really, really bad. Easily the most pain I've ever been through, and I have watched the final series of Lost. There's no sugar coating that side of it, but coming out of that into (relative) comfort is a very good feeling.

There are lots of tonsillectomy blogs/threads/pages on the intertubes, and most of them describe the nasty white scabs falling off on days 7-10 after surgery. Well, this is the evening of day 6, and while I didn't feel or see any whiteness coming up into my mouth, I suddenly tasted blood out of the blue, dashed to the bathroom and let rip. I ate, but that was a good hour beforehand, so I don't think it was the direct cause. 

Sorry to disappoint, but it wasn't an Exorcist-style event. More a constant but manageable flow that had me spitting it out every ten seconds or so, then coughing up the really good scarlet, phlegmy, meaty stuff three or four times total. The stuff that needs encouragement to go down the plug hole. Five minutes of it easing up steadily, couple of swills of water, and done. Not exactly pleasant. Definitely satisfying. And certainly a cakewalk compared to some of the horror stories you can find by Googling 'tonsillectomy scabs'. The dude who bled into his stomach all night and spent two days coughing up organ sized clots? Not the one.

Except mine was red, of course.

I'm not sure what the standard volume measure for blood is in this scenario. I mean, if you're counting pints and you haven't rung A&E yet, you're gonna die, son. So something smaller: I'm going to go with mice, where one mouse is the amount of blood you'd find in one of god's smalliest, furriest wee beasties. Which, as any fule kno, is 1.46ml. So I reckon I've chundered about 60 mice down the sink over the last twenty minutes. Not bad going.

This is a big step in the recovery - apparently losing the scabs and the clotted blood behind them cuts out a great deal of the swallowing pain and general aches. I won't feel like I'm on the home straight until I can lie on my back and sleep a whole night, but I reckon if my uvula goes down a bit (it wasn't that shape before, let alone size) dreamland will be well within reach. So, progress!

I would have got a photo of the blood for you - I know you guys would have loved that - but I was a little preoccupied. With all the blood. So, as standard, here's my new, mostly-scab free throat. 

Not a pretty sight, but a big step forward. Off to see the GP tomorrow morning to check up on everything. I was worried about whether or not they's be willing to top me up on the codeine as I'm about to run out, but you know what? Don't even need it any more; the paracetamol and liquid ibuprofen are seeing me sweet. They also gave me some 'Difflam', a benzydamine mouthwash for gargling that is excellent with the onsets of sharper throat pain and swallowing, and is pretty much instant in taking effect. Might see about another bottle of that.

Night, all.

In which things are better, and worse, and the same

Well, it's now three and a half days since the surgery. This is by far the clearest my head has been in that time. I nearly made a decision earlier, but pulled out at the last second. The pain, however, has been ramping up steadily, though I hope it's either reached its peak this morning or will do in the next day or so. Pictorial update time:

Sorry for blurry, but you get the idea I hope

So, how am I getting on? Woolly Head Syndrome (WHS) first. I'm sure it's a combination of the general anaesthetic, the codeine, and the physical trauma of having the back of your throat all slashed up, but it's certainly had me orbiting a different star the last few days. Even the simplest of questions from Siri (my wonderful wife/nurse/handmaid) has met with a blank look and dead-fish eyes. What kind of soup would you like? Cup of tea? Window open or closed? I can remember what it's like to have an answer to that sort of thing, but whatever part of the brain does 'decisions' must have been connected to my tonsils because it's just not happening at present.

WHS is also probably not helped by my sleeping patterns since surgery. Thursday, Friday and last nights have been a real struggle. The pattern seems to be: fill up on codeine before getting into bed, manage to drift off after a while, then come round when it wears off about three hours later. That's the really unpleasant part - throat and mouth all dried out, head throbbing, either shivery or too hot. So it's another round of painkillers, then back to sleep, and repeat somewhere between 6 and 7 in the morning, by which time it's not really worth trying again. I can't lie on my back as that lets me breathe out through my mouth (but not in) or in through my nose (but not out). Yes, technically there's a combination there that should work, but trust me, it's not workable. So it's a case of building a sort of seat-back with pillows and sleeping bag and propping myself up on that. Which works fine, but my back and neck don't thank me when I come to.

Finally, the pain. This afternoon's not been so bad, but over the last 48 hours I've had some pretty unpleasant spells. The internal swelling now extends from ear to ear to base of neck, and all points in between. That means jaw-ache, ear-ache, throat-ache, tongue-ache, the whole works. It comes and goes, it's manageable most of the time, and the painkillers do help, but it's not nice when it all comes along at the same time. It's also not very helpful that they cut my lower lip in a few places during the surgery. They did warn me it was possible so no complaints, but they're now half-way through the journey from 'cut' to 'ulcer'. So there's that to look forward to as well!

Managed a couple of visitors today - cheers to Spumes and the Jizzler for coming round this afternoon. Also helped that England had a good day in the Ashes and United won the Thingybob Shield at a canter. So, there are plenty of reasons to be cheerful, and I know that the end of it all is in sight. Like they say, pain is just weakness leaving the body. So all of this is good stuff, I just wish I didn't have so much weakness inside me.

In which I am two tonsils lighter

I sit listening to the Proms on Radio 3 in a codeine haze. My throat is aflame, my head is swimming and I seem to have lost all capacity to make decisions. I have started writing this blog post four times now and there's no guarantee I'm not going to start again in a minute.

How did things go? They went well. 'Uncomplicated' was how the nice lady surgeon described it, and if I'm honest the throat pain still hasn't reached the heights of a really bad bout of tonsillitis. Still, to quote lady surgeon again, 'it's the sort of thing that gets worse before it gets better'. And when the combo of codeine, liquid ibuprofen and soluble paracetamol wears off it really is unpleasant swallowing. There's no way to lie on my back and breathe at the same time, and lying on my side hurts the throat after a few minutes, so sitting up is how I got most of my sleep last night. I can eat reasonably easily shortly after a codeine hit, so things aren't terrible for the time being. But never mind that, here's the hard evidence.

Mmm, attractive. Those white bits are the scabs, which I think are with me for the next week at least. When they come off there's supposedly one last peak of pain, and then I am most of the way there.

I'll write a bit more about yesterday's events at some point, but for now let me just say that while the NHS might have its knockers - and its serious problems - every single part of yesterday was excellent from a service point of view. Kind, patient, informed, reasonable.

In which tomorrow is the big day

Well, as I type it is Wednesday. By the time I post this, no doubt, it will be Thursday and the day of my operation. Big curry supper down (water only from here on in), bag packed (slippers, dressing gown, Kindle, earphones, tablet, ID) and alarm set (six o'bastard clock). You just know that surgeon will be rolling out of bed at 8:30 and having a big old fried breakfast while I sit in some chilly waiting room with my stomach growling.

Nerves? Not really. A spot of apprehension but I'm not worried about the event itself. Reports on the pain that will follow in the next two weeks have varied wildly, so I have little or no idea what to expect on that score. Hope they load me up with something nice and strong, if only because two weeks of daytime TV with no booze sounds seriously unpleasant. Like the worst bits of long-term unemployment with none of the upsides.... Might make these posts a bit less coherent but maybe that's not a disaster either.

So wish me luck intertubes, the next time I digi-scrawl something here I'll be two tonsils lighter and morphined to the gills. Bring on the cold steel! 

In which the procedure is laid bare

On August 8th 2013 at 0730, I'll be admitted to the Ear, Nose and Throat (and head and neck) unit. I'll have had no breakfast - nil by mouth starts the night before. This is so that I do not vomit up my breakfast while under anaesthetic and get semi-digested Corn Flakes all down the surgeon's scrubs.

After a preliminary assessment and signing a few waivers, I'll be put on a gurney, put under by the anaesthetist, and wheeled into surgery. And this is when the real fun starts.

There are a handful of different techniques for the removal of tonsils. Mine is a bit of a hybrid - cold steel for the actual removal, followed by heat-based cauterisation. Then I'm brought round, and left to wake up over time. They don't keep me in overnight in this cold, impersonal dystopia of a health service, so my lovely wife Siri is taking the day off, to bundle my gibbering, crippled body into a taxi and install me in front of the telly for a couple of weeks. 

There, I'll spend my time trying to force food down myself, and catching up on some tellybox viewing. The Returned, Downton Abbey, couple of movies I've been meaning to see, all good. 

And that is the true story of how my tonsillectomy's going to go down.

In which I'm still waiting for it to sink in

So, in three days’ time I’ll be going under the knife at Guy’s Hospital, right under the towering gaze of the Eye of Sauron Shard. They want me there at 7 in the morning. That means nil by mouth – nothing but water past my lips since 11pm the night before, so I don’t blow chunks all over the surgeon and choke to death, Hendrix-style. Fair enough, I suppose. 

They tell me I’m top of the list for that morning session, which suggests I’ll be whipped into surgery quickly. But a colleague tells me they tend to save the young, sprightly types until later so they can operate on the old, frail and broken and keep them in for a while. To make sure they don’t bleed out or decompose or something. So that suggests I’ll be sitting around, nervous and starving hungry, for a while.

This is a recurring theme: not knowing what to expect. It’s probably as much to do with me trying not to think about the whole affair as anything else. Has it actually sunk in that in a few days I’ll be rendered unconscious and have knives shoved down my throat? No, not really. 

An old uni friend came round for dinner last week, having had her tonsils out a few years back. Her line was ‘you’re overthinking this, it’s a sore throat and ice cream and two weeks off work’. Here’s hoping you’re right Saz….

In which Glastonbury 2010 is (nearly) spoiled

For those who aren't aware, Glastonbury is the best festival.

Out of all the festivals, that is. I've been three times, and I'll be there again for the last weekend of June 2013, some six weeks before the surgery. But this post, I'm going to talk about the last time I was there: the summer of 2010.

It was the third time we (my crew of assorted wreckheads) had scored tickets, and we thought we'd steal a march on the (reasonable but still pricey) on-site booze setup. You can essentially bring onto the campsite anything you can drink. Or, you can let other people bring things, and then buy the things, then drink those things. We decided to buck the trend by buying 24 litres of Burrow Hill scrumpy cider, letting the brewers bring the tubs onto the site (where they have a bus they sell from) then picking them up. It was a flawless plan, and it went off exactly as we'd hoped. 

We arrived on the Wednesday. The festival takes place on the Friday-to-Sunday but we're a keen bunch, so we got in early, set up our tents, and trekked through the blazing sun to the Burrow Hill bus. There was already a queue of overheated revellers queuing for expensive pints in a paper cup. Their faces were a picture as we sidled past them and around the bus, then emerged carrying four big cardboard boxes, and wandered back towards our tents, a good half mile away.

By the time we were back, it was certainly cider o'clock. We set down one box, ripped off the tape, and unfolded the cardboard box lid. The next bit, as the sun illuminated the contents, is best explained by Mr Tarantino:

We were happy. Lids were unscrewed, glasses were poured, cider was necked. Everything was perfect, except one thing. I was still getting over a mild bout of tonsillitis, and the glowing amber goodness was like battery acid on my throat - I physically couldn't swallow it. Disaster. 

I went and saw the on-site medic and had a word. After peering down my throat, it was her opinion that I was probably on the mend, but as she put it, 'things don't heal here'.

Doctor: "So basically, you'll be okay. Enjoy your festival, but..."
Me: "...don't get smashed to bits?"
Doctor: "Yes. Don't get smashed to bits."

And I didn't. I couldn't touch a drop of our awesome, cheap cider (or any other alcohol for that matter) and I spent the whole festival sober as a judge. Don't get me wrong, it was still brilliant, and I saw so much excellent music, but it was one of the many times my tonsils have done their best to spoil a weekend. So roll on the surgery.

In which surgery is confirmed

Well.

In May 2013, a nice consultant at Guy's Hospital in London advised me that given my medical history, a tonsillectomy would be a good idea.

Following a physical exam that same day (testicular MRSA swab! ahem, self-administered...) I had a phone call to arrange a date for surgery. That date is the morning of August 8th, 2013. This is going to be a blog about the build-up, event, and aftermath to that day; in the hope that it will give other sufferers some idea of whether or not surgery is The Way Out. As I write, I genuinely don't know the answer to that question. 

A bit of background.

My name is Ben Jones. I live in South London, but grew up in (heavily) rural West Wales. I'm married to Siri, who will be guiding me back to health in about ten weeks' time. I've had tonsil trouble for as long as I can remember. At its worst - when I was 12 and 13 - that was about once a month. An average bout would mean a day or two off school, a course of antibiotics (usually Amoxycillin), and so many painkillers I rattled when I walked. "Oh no," they said, "we don't operate any more. It's barbaric! The antibiotics will deal with the infection, and by adolescence it'll stop completely."

Would it bollocks. I kept getting ill, right up until now, when I'm staring the big three-oh in the face. It happens less often since I hit adulthood, and most occurrences don't even keep me off work - just a miserable 3 or 4 days in most cases. But not all. The most recent bout, Easter '13, was a bad one. It had me off work for four days, and laid out for six, and I spent (bank holiday) Easter Monday shivering like a junkie. People think of tonsillitis as a severe sore throat, and they're not wrong. What doesn't leap to mind so quickly are the blinding headache, aching limbs, tender skin, and hot and cold flushes a bad case bring. At it's worst, it's a full-on feverish shitfest of misery. Symptoms ordained by the devil himself, your tonsils dragging in a rogue's gallery of susceptible body parts for the ride.

It works the other way, too. Got a bad cold? Have a throat infection, too! If there's one thing I can confidently predict about catching flu or a cold, it's that once it's faded, swallowing will hurt like hell for a few days while my tonsils climb back down off their high horse. Think of it as a memento of the original illness; a reminder that when one bit of you breaks, any other chronically broken bits will join the party.

Looking back as far as memory reaches, it's been a completely unpredictable, completely predictable blight on my life, and it's time for it to end. I've read some truly harrowing accounts of adult tonsillectomies online of late. But no matter how severe the pain might be in the two weeks after surgery, if it means I get ill half as often, it'll be worth it. 

If it means I never get tonsillitis again, I will consider myself to have won the medical lottery. 

Oh, and it's free. Yeah, living in the old U-of-K ain't so harsh. 

More to follow, people of the internets. If you've had the procedure, or the illness, or you're considering the procedure, (for god's sake don't consider the illness) then hit me up in the comments.

- Ben