I'm a 27 year old female in relatively good health aside from complicated migraine and chronic leukopenia (low white blood cell count). I consider myself relatively STD-aware but I stupidly did not get the Gardasil vaccine out of sheer ignorance. I did not know HPV could cause cancer. Like many other women will experience in their lifetime, I have high risk (and possibly low risk) HPV of the anogenital tract contracted 18 months ago. I also practiced oral sex with the partner I contracted this from. Most recently I developed an enlarged left tonsil noticeably larger than the right, and the extreme lumpiness of it concerns me--there are growths on the tonsil, along with 4-5 scattered papilloma (I think) on the left tonsillar pillar and extreme redness compared to the right. I am referring to the palatine tonsils.

I don't know if this matters but I also have genital herpes. I only relay this information to show that my body apparently very easily contracts these problems. Please don't judge me. I and my partners have all been tested for the gamut of STDs with clear outcomes (except for HPV, which men cannot be tested for and women could only recently be tested for), but a freak accident occurred: one of my former partners is apparently a false negative. I am not kidding, that minute chance actually happened to me. My mind is still reeling from this, two types of STDs despite testing and precautions.

Please tell me the most definitive testing I should request to determine what if anything is going on with my tonsil. I saw him 3 months ago when I had trouble swallowing on that side and he stuck a light down my nose into my throat, and said he couldn't see anything suspicious. I did not tell him about my source of concern (HPV)--too ashamed.

Can an ENT do a brush biopsy? Is that available everywhere? I know he will not have a Velscope light (sp) nor will any dentists or oral surgeons in my area. I live in a smaller town in the south and I am 100% positive my ENT (and every other doctor for that matter) has never heard of the HPV/oral cancer connection. I am sure he is going to look at me in shock and disbelief and disapproval. He has followed me since I was a little girl and it's going to be difficult telling him my history. Doctors here run on the conservative side and I want to keep a good relationship with him because it's hard to get in with another doctor. What should I do, say, and ask for? Sorry for the length. Thanks very much for all you can advise.