Medical (ENT) Case of the day

Here's my test 4 months after contracting Covid19 moderately badly. As you can see the line at IgM has now disappeared as expected, but the line at IgG, which is the memory antibody, remains strong. Certainly I'm going to deduce from that I'm immune, also to the Kent variant (which I probably had) and the South African one. But how do I get a passport saying this?   

 Large, red tonsils like these are not normal and are likely to be causing quite a few symptoms. These range from chronic fatigue to tonsillitis, tonsil stones, bad breath, catarrh, sleep apnoea and snoring. To remove them completely is dangerous with a high bleeding risk, and very painful (NHS/dissection tonsillectomy). To shrink them right back by removing >90% by sequential intracapsular laser vapourisation under local anaesthetic spray is far nicer. 

Today I have seen and used the future. In the form of a flexible rhinolaryngoscope (nose/throat endoscope). Here it is pictured wrapped up with its screen behind. The wrapped bit is the scope and it is recycled after use on one patient only. So it is never used on another patient and comes out of the wrapper sterile. So almost no chance of nosocomial (hospital acquired) infection. Cost £130. Cost of sterilising a digital HD rhinolaryngoscope £7. View: Bearable as against brilliant with the HD scope. The future: Is much more expensive, not as good but probably a fraction safer.  

 I see a lot of adults with snoring and sleep apnoea. The cause is usually weight, sleep posture, blocked nose due to the septum, large tonsils or long soft palate. Today though a 25 year old lady came with big obstructing adenoids causing snoring. I was able to get a good view through the mouth and up into the back of the nose using the HD digital flexible endoscope. I have booked her for a day case adenoidectomy. 

This is the back of the nose, seen from a view through the mouth and up behind the soft palate, using a high definition flexible digital endoscope. The greyish, swollen uneven structure towards the top is the very back of the inferior turbinate. It is causing post nasal drop, bad taste and the need to snort / clear the back of the nose. If it doesn't respond to salt water douches and steroid sprays, a posterior laser turbinoplasty operation will shrink it down.