To think this should have been picked up sooner?

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DD has been ill the last few days with tonsillitis. She called me yesterday morning at 5 a.m., telling me her tonsils were so swollen she couldn't breathe. She has anxiety, so I assumed it was a panic attack, and she did seem to breathe more easily once she calmed down, but she still maintained her breathing was restricted because of her tonsils, so I directed her to the pharmacist (still believing it was a panic attack/anxiety)

The pharmacist looked in her throat and told her that her tonsils were swollen and that he could see "white stuff," but ultimately, there is nothing that can be done for tonsillitis, so he sent her home with a throat-numbing spray and advice to rest and contact her GP if it got worse.

She came home very distressed, which I still believed was anxiety, but I told her to contact her GP if she was in enough pain that she felt she needed to be seen that day. I heard her on the phone telling them one side of her throat was more swollen than the other side, and it was making her "feel" like she couldn't breathe easily. She also told them she'd not eaten in 48 hours as she couldn't swallow but was managing small sips of liquid with difficulty. She was told there were no appointments and nothing could be done for tonsillitis, so try to rest, drink plenty of fluids, and call 111 if it gets worse.

She tried 111 immediately but kept getting directed to a voice message giving her details on how to find an emergency NHS dentist. She was in too much pain to keep trying, so she put the phone down and went to bed in tears. I did manage to get through on 111 on her behalf, who also said it was tonsillitis and to rest/drink fluids, but to call back if it got worse.

The second I finished work, she was up begging me to take her to the walk-in center. I did, but at this point, not being a medical professional, I still thought it was tonsillitis and anxiety.

As soon as she was seen, they told us to go to A and E immediately and to call 999 if she felt like the swelling was worsening on the way there. The on-call ENT specialist was called out to meet us there.

It turns out she had an abscess on her tonsil, which is very serious because it can worsen rapidly and prevent breathing. People have died from not getting treatment quickly enough, apparently.

AIBU to think this should have been picked up by the pharmacist, the GP, and the 111 algorithm? The main warning sign is one tonsil being significantly more swollen than the other, which she told all three services, along with trouble breathing and swallowing.

I realise I didn't help by dismissing it as anxiety, but I am not a medical professional and wasn't aware that tonsil abscesses were a thing, let alone a potentially life-threatening thing.

Does she normally see/speak to so many health professionals when having a panic attack?

She had the abscess drained and was given strong painkillers and antibiotics. She felt better as soon as it was drained, but was still refusing to eat because of the pain, so I made her protein shake with ice when we got home and made her drink that.

Maybe if your child tells you repeatedly they feel they cannot breathe on multiple occasions you should take it seriously.

It takes 5 years to become a Pharmacist including a Master degree - I wouldn’t call that ‘little knowledge’.

I’m a Pharmacist and I have told someone to go to A&E previously who I suspected had a quincy (and it turned out they did). I don’t work in community pharmacy but if it were me and I didn’t immediately suspect a quincy (they can develop really quickly), I would’ve explained ‘red flag’ symptoms and when to go to A&E v GP as part of safety netting.

No, she usually refuses to speak to anyone but me and her sister, so that should have been a red flag for me, but she has been improving over the last year. My other DD went with her to the pharmacist and spoke for her. She called the GP herself.

Taking herself to the urgent care center is beyond what her anxiety would allow her to do. Her sister would have gone with her had she asked, and obviously, if I'd realised it was possible for tonsilitis to be so serious, I would have left work early and gone with her.

In future, read the NHS pages for the problem you have.

The tonsillitis page clearly states when you need to go to GP/111 and when you need A&E.

You've all had a scare. You owe your DD an apology for not listening and leaping to 'anxiety' and you both need to make a better plan for accessing help in future.

If I left work every time DD told me she felt like she couldn't breathe, which is what she was saying, I would be off work more times than I was at work.

This clearly shows she wasn’t saying ‘exactly what she says when she has anxiety’ at all, you don’t need medial training for your part, so everyone missed it. Main thing is she got the help she needed and is ok now. And it’s a lesson for you in listening to her.

Disagree with all those blaming OP.
You're not a trained medical professional, why would you disbelieve them and be expected to diagnose something you never knew existed.
The professionals should have been able to diagnosis this properly.

No she's not. She's not a health professional

Fair point I was perhaps blunter than I meant to be.

i meant if she is complaining of shortness of breath, WITH legitimate physical symptoms of an infection it would be best to take the cautious path and treat it as if it could be something serious.

I suffered with tonsillitis for years and one side was often larger than the other. I never had an abscess, so it can obviously be normal with tonsillitis. I also used to feel like I couldn’t breathe well and swallowing was very difficult. I would lose lots of weight when I had it as I couldn’t eat at all. Based on that, I wouldn’t necessarily have expected it to have been noticed sooner.

I know someone who had quinsy and he went from ok to very much not very quickly. His dad was a GP and had checked him over himself before things got worse and my friend ended up in hospital. His dad felt horrendous for ‘missing’ it.

I know you probably feel angry which comes from a place of worry, but I don’t think it’s a case of anyone necessarily missing anything, just a case of things progressing. I hope your daughter is feeling better soon.

I think she needs treatment for her anxiety so that she has a better baseline for functioning in her normal life. She might not be fobbed off so much then.

I suspect you feel very stressed and scared.

You've all had a nasty scare. The difficulty is you've got accustomed to dismissing your DD but this time it was real.

Take some time to process, blame won't help anyone really - you all need to learn from this.

Maybe some of the answer lies in how the panic attacks are dealt with too.

Good luck - and hope your DD feels much better soon!

I wouldn't expect the pharmacist to know but the GP and 111, yes.

I'm also surprised that you didn't realise that severely swollen tonsils can cause difficulty breathing, so thought it was anxiety instead.

If this happens again

1. GP for antibiotics
2. If they dont work within a day AND she has difficulty breathing or drinking, go to A&E.

Someone not being able to breathe or drink is an emergency. I've been admitted to hospital 3 times for this.

I really feel for your DD as she would have been in immense pain and no one took her seriously.

@LesSanglotsLonguesDesViolonsDAutomne I lasted 5 days before i gave up and went to GP. Sent me straight up to A&E...it was quincy. Never heard of it, I thought that was a 1980's detective series! Had to have it drained...bloody awful!

This viral tonsillitis thing is just nonsense.

If you’re a tonsillitisy person then yes perhaps these people can get viral tonsillitis but surely you know that.

If your an average person who doesn’t have this tendency then for gods sake it’s blatantly strep throat.

I had a recurrent infection from strep that took 4 courses and multiple arguments with people to give me the antibiotics. Who would then give a short course to fob me off until another day.

MONTHS! Later they ring me up urgently. You have strep!!! This is a very serious illness for your internal organs. Hello! I KNOW. I have been telling you!

Get well to your daughter OP. If it starts to come back then go straight back. You also need to change the toothbrushes. Buy disposable and throw them out each day for a 3 week period.

She should have sort help at A&E / or Urgent Care Centre near her friends as she in pain and struggling to breathe. She’s an adult and responsible for her own health.

Of course the pharmacist should know about quinsy. It's not a rare infection. Telling someone there's "white stuff" on their tonsils is perhaps indicative of the poor quality of education that's taking place on these courses. Someone with a masters degree shouldn't be this sloppy. They should also know about complications and direct them to the hospital. I knew all this as a second year student nurse.

She is finally getting help for her anxiety. I think that actually made me more dismissive of her this time. If she'd been worried enough about her health to phone her GP herself instead of asking her sister or me to call on her behalf, this time last year, I would have immediately paid attention, but making phone calls for herself is one of the goals she set with her MH team, so I didn't pay any attention to her doing that.

There’s no point in torturing yourself. A lesson to be learned here. It’s a shame she experienced this as it will make her worry if it happens again.
I went through similar with my son when he had a broken arm and was in pain the whole night. And was sent home from hospital. When we went back to hospital the following day his X-ray the bone in his wrist was broken in several places. And required surgery with K wires. It didn’t show in first X-ray as there was too much swelling.
I try to act on my instinct now. Hope your daughter recovers and is ok.

This isn’t necessarily correct. You can have white spots from a viral infection.

Well no. It was discovered by an ENT specialist. Which means the others who saw it were not specialist enough to diagnose this condition. They don't have the knowledge, the equipment or the authority to do so.

If someone presents with swollen tonsils and keeps mentioning tonsillitis, that is what will be taken as the condition. Until a specialist has a chance to look at it. They did all say to escalate it if it got worse. Which you did.

Same as a GP or 111 or pharmacist couldn't diagnose a lump as cancerous.

Yes that's quite poor. 111 will often triage certain things which are likely to be no complex that a pharmacist can provide advice/treatment for. But if they identify it as complex they are meant to send you back to 111.

Had this with my child's ear infection. 111 sent us to pharmacist. She had one look and said it's a complex ear infection and beyond my remit. So back to 111 and got a doctor's appointment, then a prescription. That's how it should work.

White stuff on tonsils needed escalation beyond painkillers.

Hi op unfortunately the nhs just fob people off now. dr appointments need booking at 8am ridiculous if you get sick after this time. I would go the walk in first. I would be grateful the walk in did there job properly and go to them in future. Pharmacies have limited experience on few issues. 111 can take forever to get you heard.