Appendicitis Symptoms are not always “Typical”

Appendicitis isn’t a big killer in the US, but knowing more about it could save your life.  Having an unusual case of appendicitis myself, I wrote about it at Yahoo! Voices:  Appendicitis Symptoms Are Not Always “Typical.”  Since Yahoo! Voice shut down, I’m posting the full (but short) piece below.  Under it is a bit of additional appendicitis-related information that I find interesting and helpful.  I  hope this post helps with whatever you came here for.  Since my word-count for Yahoo!’s post short by requirement, not everything that I would have liked to have written is included; feel free to comment with questions if you have any.

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Appendicitis Symptoms are not always “Typical”

I have irritable bowel syndrome (IBS) so when I noticed a small but different feeling in my abdomen, I wasn’t sure if it was anything to worry about. The next day it was still there, but I didn’t know what “it” was. On the third day, I knew that what I was feeling couldn’t be OK; appendicitis came to mind, but I wasn’t experiencing the typical symptoms.

My symptoms were not average

I did not experience the pain—which is often severe–near the belly-button that then travels down to the lower right abdomen.   I didn’t have nausea, nor did I ever vomit. One common symptom is a change in digestive behavior, having either diarrhea or constipation, but these are normal with IBS. I did have a low fever, however.

Having symptoms of something, I went to an urgent care center. The blood tests ordered by the doctor revealed that my white blood cell count was elevated, but not as much as is “normal” with appendicitis. My fever was also lower than it should’ve been. Nevertheless, thinking I might have appendicitis, the doctor told me to get to the emergency room (ER) while he called ahead so I’d be examined quickly. His call seemed to be ignored by the ER intake nurse, however, and I stressfully waited minute by ticking minute to be seen. Because I wasn’t writhing in pain, vomiting, or running a high fever, I felt a bit invisible to the staff–but significantly, my abdomen became more and more tender.

The long awaited diagnosis and surgery

Hours later, after being granted entrance to the bowels of the ER, my symptoms confused the staff. (This is not necessarily surprising since every year up to a third of child-bearing age women are misdiagnosed; AHRQ 2013.) The area affected was not the right place, they told me. Then there were delays: a gunshot victim was admitted and drew the doctors away, and, though a CT scan was ordered the scanner needed repair (!). So I waited, again.

Once the CT scanner became available appendicitis was solidly confirmed, and not something like an ectopic pregnancy. The lead doctor was very kind and acknowledged to me that a high degree of tenderness in that area can be just as indicative of appendicitis as much pain. I never did have much pain.

I was immediately attached to an IV with antibiotics and admitted to the hospital. Though my appendix had already perforated and I had a very long wait for the typical laparoscopic surgery, it went well. Due to modern medicine, I feel very fortunate to be alive. By sharing my experience, I hope that readers won’t ignore this potentially life-threatening condition simply because they don’t have typical symptoms. To learn more, go to the NDDIC’s Appendicitis page or the pediatric Appendicitis/Appendectomy page of CHOPS.

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Age-standardised disability-adjusted life year...
Age-standardised disability-adjusted life year (DALY) rates from Appendicitis by country (per 100,000 inhabitants). (Photo credit: Wikipedia)

Deaths from appendicitis in the USA are at about 400 per year.  This hard-to-get figure is from the latest WHO statistics, which aren’t all that recent (2008 data published in 2011).  I assume that this statistic includes deaths from people who didn’t go to the doctor in time, as well as deaths from post-operation complications.  There are over 250,000 appendectomies done in the US each year (about 8% – 10% of all people will develop appendicitis in their life times).

Besides my story of not being sure when and if I should see a doctor about the abdominal pain I was having, here is another story about a father-to-be who wasn’t so fortunate.  I am glad to be able to share this article about (partially) Paul Hannum, who lost his life due to appendicitis and lack of insurance.  He deserves to be remembered, and I wish his daughter had been able to know him.  In case you’re interested, here is a wiki list that might lead you to more anecdotal information:  Deaths from Appendicitis (list).

 

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