A rock in my throat The story of a terrible tonsil stone

I got a minor, nagging sore throat in the spring of 2014. By the winter it was a full-blown chronic pain nightmare. It felt like something was stuck in my throat, a shitty phenomenon called “globus sensation.” My pharynx and esophagus started to spasm and clench regularly. I often felt like swallowing was an awkward, painful chore.

My throat stayed about the same as 2015 progressed, sometimes a little better, sometimes a little worse, but never good. I wrote a very popular1 article about the sensation of a lump in the throat. I get heart-wrenching email about it from people grappling with the same dilemma I’ve had: is there really something in there? Or is it “just” stress and anxiety?

And then, in August, I found a stone in my throat.

Absolutely the damndest thing that has ever happened to me

I felt a sharp catch in the back of my throat, like I’d swallowed a burr or a scrap of rough sandpaper. It was a familiar symptom, but an unfamiliar intensity: sharper, catchier than ever before. I rushed to the bathroom and performed a procedure that has become familiar, a stupid human trick I’ve picked up over the last few months: using a plastic syringe, I flushed my tonsil with salty water, chilled and distilled. This has often been a great source of temporary relief.

And a rock came out. A bloody rock came out of my tonsil! A rock! From my tonsil!

A hard, jagged stone popped out of my tonsil onto my tongue. I watched it happen. There’s no question where it came from. I was using a tongue depressor, and had a bright flashlight shining on the scene.

I scooped it out of my mouth with a Q-tip. And I have it in an envelope now. Picture below, but I need to explain something before you see it and think, “What, that’s it?”

There is no such thing as a “small” rock in your tonsil

It’s like a tiny asteroid. If it hit the atmosphere at 30,000 kph, it would make a lovely shooting star.2 It is not imposing…but you would not want it in your eye, your tonsil, or any delicate crevice.

Imagine finally scratching the worst itch of your life. Imagine the end of Chinese water torture. Imagine something stuck between your teeth for a year, finally pried loose. Think about how much the lion suffered from a thorn in his paw. In this case, it was a thorn I couldn’t see or touch, just a maddening irritation deep in my throat.

Close-up of my tonsil stone, a grey, craggy little tonsillar calculi resting on a Q-tip.
Yeah, smaller than a Q-tip head. But sharp as a burr, hard, and stuck in a fleshy crack. You do not want this. (The colour is unusual, by the way. Most tonsil stones are a yellowed white.)

Tonsil stones: a disgusting crash course

Tonsilloliths or tonsillar calculi are totally a thing. A thing I wish I’d never heard of.

Like kidneys and gall bladders, tonsils can form nasty little calcifications. Tonsils are roughly mushroom-shaped glands behind your molars, full of nooks and crannies (tonsillar crypts). Tonsilloliths can grow and fester in there, like crud stuck between your teeth that never gets flossed.

Photograph of a tonsil stone in situ: an off-white, lumpy mass portruding from the back of a tonsil.
Not my mouth, not my tonsilloliths. But this is probably the best picture of a tonsillolith in situ I’ve seen online. They are not always this obvious. In my case, my troublemaker was clearly buried deep in a crevice, out of sight (but very much in mind).

People just get them from time to time, like canker sores or cavities, and they may cause some bad breath or temporary mild discomfort. They are mostly just gross, not painful. They are typically the texture of hard feta cheese. I had gotten several of this type out of my tonsil over the last few months — I know: sexy, right? — and they didn’t impress me as the likely cause of my troubles.

My doctors didn’t think so either.3 But wait until they see what I found in there! I bet they’re going to be so impressed!

Tonsil stone update 2018

The stone came out Aug 5, 2015. Three signature acute symptoms4 vanished the moment the stone came out. Other than a couple nerve-wracking relapses the following week, their defeat seemed decisive. Some significant diffuse soreness and hoarseness also backed off over about a month — a truly traumatized throat, slowly calming down.

However, I continued to suffer from globus sensation and general pharyngeal freak-out intermittently for another couple years. A milder version of the “raw catch” also haunted me occasionally, a zombie symptom that just wouldn’t die. It was never as life-alteringly harsh as the original, but it did make a few disconcerting partial comebacks. Another stone? A little collection of them? Or maybe just a sensory vulnerability in a traumatized tonsil? I was afraid the persistent troubles might be related to an ongoing high rate of upper respiratory infections in 2015 and 2016, and continued to consider tonsilectomy for a long time.

And then in 2017 I didn’t have a single infection — I’ve never gone an entire year without a cold — and all the lingering symptoms started to get milder and further apart. There was one last period of annoyance in 2018, and it has now been about 6 months since I was last aware of the slightest problem with my tonsil or throat.

I am now somewhat optimistic that I have probably seen the last of it. But I wouldn’t exactly be shocked by another comeback either.

  1. About 40,000 readers so far, with a high-average reading time, and steadily increasing. It’s actually one of the most technically interesting success stories in my publishing history: I expected it to get basically no attention whatsoever, but Google has steadily ranked it higher and higher, making it my best-ever example of high-ranking content without inbound links↩︎

  2. Astronomer Phil Plait: “The vast majority of the meteors you see at night are actually smaller than a grain of sand.” ↩︎

  3. Four separate MDs — two of them ear, nose, and throat specialists — had told me decisively that tonsil stones were extremely unlikely to be the cause of my problem. Despite the fact that I kept saying, “It really just feels like there’s something stuck in my tonsil.” ↩︎

  4. (1) The “raw catch” was what I settled into calling the original symptom; (2) a sharper pain that I could feel every time I flexed the back of my throat; (3) a patch of “hot coals” that would glow brighter every few exhalations, like I was blowing on a fire. ↩︎