Oh how I remember the joy of swollen glands. "Me glands are up again, Mum", I would proudly announce. I would wake up in the morning, and straightaway could feel that familiar tenderness on both sides just below my jawline.
Prodding my neck, there they were - tender little pea-sized lumps. It meant at least three days off school, a whole week if I could produce a convincing enough performance. Eventually an ear, nose and throat specialist became involved, and I had to cast aside my boyish glands, along with the tonsils that had caused them. My duvet days (or in those times, candlewick bedspread days), were over.
Superheroes of the immune system
There are lymph glands all over the body but the ones that most commonly swell up are in the neck. Part of the immune system, their main job is to defend the body against infection. They are the superheroes of the body, containing white blood cells and antibodies, ready to fight any criminal bacteria or viruses (germs) swanning around the neighbourhood looking for trouble.
So infection is a major cause of swollen lymph glands. In most cases, they swell up for a week and then go down. I've already mentioned tonsillitis as a cause of swollen glands in the neck, but any infection in that area, such as throat infections, the common cold or tooth infections, will also cause them to don their crime-fighting capes.
Infections in other areas can lead to swollen glands. Scalp infections and infestations (such as head lice) can result in swollen glands at the back of the head. Infections of the skin of the arm can cause swollen glands in the armpit. Infections of the leg or genitals, or nappy rash, can cause glands to swell in the groin.
Glands all over
There are some infections that bring out the whole force. These mainly involve viruses - flu (influenza), chickenpox, and glandular fever (infectious mononucleosis), Off the record, some lymph glands told me they think this is an over-reaction, but when Captain Thymus orders you to jump, you say 'How high?'
"So that's it, Dr Knott," I hear you say. "Swollen lymph glands equals infection. Can we go play Angry Birds now?"
Well, no. Unfortunately, that's not the whole story.
When swollen glands mean trouble
When swollen glands persist or are in an unusual place, cancer is the main concern. Cancer cells can break off from a tumour, pass through the lymph channels and settle in the lymph glands, causing them to swell.
Nature can be cruel, not only to patients but also to medical students. Just when you think you've got this swollen gland lark pinned down, along comes a whole bunch of rarer causes that you wouldn't dream in a million years could cause lymph glands to swell.
For instance: as a reaction to phenytoin, an anti-epileptic medicine - who knew? Glycogen storage disorders (conditions in which there is a problem in the processing of glycogen, a storable form of glucose) can do it. Then there's sarcoidosis, systemic lupus erythematosus (SLE), and rheumatoid arthritis (all inflammatory conditions), as well as less common infections such as HIV, tuberculosis and Kawasaki disease.
So when should I start to worry?
If you do develop swollen glands, don't panic. In most cases, it's just the superheroes of the immune system doing their job. The cause will most likely be a simple infection and they will go down in a week or two.
However, if your glands come up for no reason (for example, you have no symptoms or signs of an infection, it's time to see a doc. Glands that persist for more than a couple of weeks or come up in an odd place (for example, in that little space between the base of your neck and your collar bone (clavicle), are also reasons to seek medical advice.
What can I do to make swollen glands go away?
Well, not a lot. It's either a question of waiting for them to go away by themselves, or seeing a doctor to get the cause diagnosed and treated. Take ibuprofen or paracetamol to control the discomfort in the meantime if necessary.
There's nothing you can do to make the glands stay swollen for another 24 hours either, but you can say they still feel tender. After all, the Lone Ranger screened on a Friday, and I didn't want to miss that, did I?