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.

It was picked up within 12 hours of her first seeing a pharmacist. most tonsillitis is just tonsillitis so everyone will act as if it is just that. Perhaps it wasn’t noticeably more swollen on one side.

It might have been picked up earlier if you had googled ‘tonsils swollen on one side’ to realise it might be progressing. The abscess is called quinsy which I have heard of although didn’t realise it was an abscess. Quinsy is rarely fatal although can be if untreated.

I wonder how many deaths it'll take for the 'pharmacy first' bollocks to be dropped. Pharmacist do not have enough knowledge to distinguish between a 'minor' ailment and something potentially more serious. I can't understand why they've agreed to take on such a huge level of risk.

You did nothing wrong. This is one of the many, many, many instances where the line between serious and not serious is very thin and medical expertise and a physical exam are essential.

I've had these discussions over and over with medical professionals (I'm not a HCP myself but work with them). It takes years of training to be able to confidently say something is not a worry, yet GPs want to offload this because they've been taught that seeing patients who 'don't need' their input is a waste of their time. Seeing patients is to determine whether they are ill or not is the entire role of a GP ffs!

I hope your DD feels much better soon.

That’s tragic. That poor man.

My friend was checked by his father who was a GP who thought he was poorly with tonsillitis but ok. 2 hours later he couldn’t breathe and was rushed to hospital. He was very poorly, then when it looked like he’d turned a corner, he got sepsis, but thankfully was ok in the end.

@Toddlerteaplease you need to be more careful about what you say. Shocking and appalling if you’re a nurse.

I have sympathy for you OP, I have almost killed two people with my lack of medical knowledge, first in very similar circumstances to this. My ex had tonsillitis regularly, so this was not out of the ordinary, I sick of listening to him complain told him to go to bed and try to sleep through it.
He called his mum instead who took him to A & E, turns out he had something called Quincey and if he had gone to sleep his throat was so swollen he could have died.

Second my son ended up in intensive care because I was ignorant of the signs of Type 1 diabetes.

Lesson learnt, if someone says they are unwell, always give the benefit of the doubt and listen to them.

Lots of people very confidently giving incorrect information to the OP here. White spots of tonsils can occur with either viral OR bacterial tonsillitis so does not automatically equal antibiotics. Given 90% of tonsillitis is caused by a virus antibiotics is no longer first line treatment. Correct management would be to do a swab in the first instance unless there were other indicators of bacterial infection. The main issue here is the breathing difficulty and significantly more swelling on one side than the other which should have been picked up by both pharmacist and GP.

But OP, don't beat yourself up. You are not a medical professional but you did seek help. Hope your daughter recovers soon x

Personally when I am ill (or a loved one) I want to see a properly qualified doctor and not a pharmacist, a nurse practitioner or a physician's associate (FFS!). This is all just an excuse to underfund the training and employment of the people we really need - qualified doctors!

When you went to nursing school, did you forget to go inside?

My daughter had Quincy twice, a very distressing and scary experience. The first time she had it, we went to A & E as she had difficulty breathing. The second time, she recognised the symptoms and again had to get it draining A &E. She’s had tonsillitis lots of times but not “enough “ for her tonsils to be removed. I’d never heard of Quincy before but now I do, I wouldn’t entertain gp/pharmacy/111. Hopefully something that won’t happen again.

YABU, stop blaming others. You should have listened to your DD and driven her straight to the hospital the moment she said she was struggling to breathe!!

So you AREN’T a medical professional?

Unless you are lucky then most GPs cba to even see people in person. I have had one in-person consultation with a GP since COVID. They are dismissive and their records don’t seem to be very up to date. I have just changed my GP because I am too intimidated to go there anymore,

I thought that too, but apparently most tonsillitis is viral and can’t be treated with antibiotics.

The irony of laypeople advising on illnesses in a thread about a misdiagnosis

OP isn't a doctor.

But it is a big deal if those aren’t done on time due to delays in diagnosing, and to dismiss a worried parent, as a nurse, well that’s an awful thing to do.

My friend got the treatment and was still very ill. It was a big deal. And then he got sepsis, also a big deal. His parents were told to prepare for him dying at one point.

Some people really are in the wrong job.

She certainly missed the important parts about understanding and respecting patients and their families concerns. Good nurses have empathy, compassion and emotional intelligence. Shit ones don’t.

There is no way you are a nurse.

Unless OP is medically qualified it’s not unreasonable to think that after contact with several services someone would have picked it up.

The pharmacist should have a) given her antibiotics as this is in their new powers to do so where there is white spotting (they can take symptoms and history and/or prescribe antibiotics now, specifically in this case, I know as my daughter has had it and my partner did go but decided not to take the antibiotics) b) said if you can't breathe, this is an A and E job.

I agree completely with you- this is NOT the job of the patient's mother to guess what she had, given she is not a trained health professional, and then send her to the right place.

11 is a triage service, so should have triaged her correctly, the GP should have seen her in person and then realised one was larger than the other (and again, my daughter was seen the same day for a similar profile) and the pharmacist who looked should have prescribed more and/or referred to A and E!

I can't believe everyone thinks it is the sick person's responsibility to diagnose themselves off a website and then make choices, when ill, possibly with fever, and a mum 200 miles away when there were trained professionals specifically with the expertise to diagnose enough to get her on the right pathway.

The NHS is now so shit, everyone expects the patients themselves to be better than the doctors!

This and stuff will get missed

how awful for your daughter I hope she’s on the mend now. I had my tonsils out but I don’t think they do this as much these days.

IME phoning NHS 111 is a total waste of time and I would have gone straight to A and E

You might want to have a chat with the NHS - the advice given is to call 999 or go to A&E (do not drive yourself) if you have a suspected quinsy.

A swab, on the NHS? Of course in other countries they do swab the tonsils and then see if you need antibiotics, specific to that swab (like Spain).

Here, they try to fob you off with some front-like poor person who is not equipped to make this judgment. Then, even if you go to A and E, or minor injuries, they don't always do the swab! Ask me how I know. More often if you keep asking, they will give you some broad spectrum antibiotic to make you go away and because the medical evidence is not that 99% of tonsilitis is viral at all because everyone who went to medical school knows that viral infections can cause bacterial infections in more than 1% of cases (or might have been bacterial to start).

Looking, going 'oh it's a virus', can you go away with a throat spray is literally pointless doctoring when it fails to identify a) what could be going on in mild cases anyway and b) fails to pick up severe life-threatening cases.

My dd ended up being placed on a ventilator with something very similar, as soon as she said she was having trouble breathing you should have told her to ring 999 or go to A&e.