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After century of removing appendixes, doctors find antibiotics can be enough

arstechnica.com

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Re: After century of removing appendixes, doctors find antibiotics can be enough

#51
post #39
post #33

Earlier quoted context omitted.

The "Semmelweiss reflex" https://en.wikipedia.org/wiki/Semmelweis_reflex

I found this definition very strange, from its choice of words and mentioning “undeveloped planets”?! "Mob behavior found among primates and larval hominids on undeveloped planets, in which a discovery of important scientific fact is punished"

It was irony.

Re: After century of removing appendixes, doctors find antibiotics can be enough

#52
post #39
post #33

Earlier quoted context omitted.

The "Semmelweiss reflex" https://en.wikipedia.org/wiki/Semmelweis_reflex

I found this definition very strange, from its choice of words and mentioning “undeveloped planets”?! "Mob behavior found among primates and larval hominids on undeveloped planets, in which a discovery of important scientific fact is punished"

The article concedes that it is a "polemical definition" -- it may still be the first documented usage.

Re: After century of removing appendixes, doctors find antibiotics can be enough

#54
post #47

Somewhat OT but interesting: "When [Kurt] Semm introduced laparoscopic surgery at the University of Kiel, he had to undergo a brain scan at the request of coworkers as 'only a person with brain damage would perform such laparoscopic surgery.' On September 13, 1980, Semm performed the first laparoscopic appendectomy, opening up the path for a much wider application of minimally invasive surgery. At first, his operatio…

It's weird in retrospect. When my grandfather had his gall bladder removed (late 1960s, I think), he spent about 4-6 weeks in hospital and another couple of weeks at home recovering; last year, I had my gall bladder removed, they sent me home after three days. Now that's progress!

It is indeed progress, all that time spend among the sick and not moving around is very hurtful to the human body. It is mainly that realization that causes the difference, and not better surgical techniques I think.

Re: After century of removing appendixes, doctors find antibiotics can be enough

#55
post #47

Somewhat OT but interesting: "When [Kurt] Semm introduced laparoscopic surgery at the University of Kiel, he had to undergo a brain scan at the request of coworkers as 'only a person with brain damage would perform such laparoscopic surgery.' On September 13, 1980, Semm performed the first laparoscopic appendectomy, opening up the path for a much wider application of minimally invasive surgery. At first, his operatio…

It's weird in retrospect. When my grandfather had his gall bladder removed (late 1960s, I think), he spent about 4-6 weeks in hospital and another couple of weeks at home recovering; last year, I had my gall bladder removed, they sent me home after three days. Now that's progress!

I was home the next day after having mine out. It sucked for a couple of days as my body absorbed the gases they pumped my body up with, but then it was fine.

Re: After century of removing appendixes, doctors find antibiotics can be enough

#56
post #44

It's interesting, an acquaintance of mine had this happen. Hospitalized, with antibiotics, but just fine, no knife. Definitely surprising to hear about, but I'm glad we're still learning about these kinds of things. Imagine all the things we take for granted that are simply superstition when examined closely.

In Australia, where public hospitals provide a free service, antibiotics are first line for uncomplicated appendicitis. Most people recover just fine. It's amazing how things are different when a surgeon doesn't want to do a procedure since it means more work for them, compared to where a surgeon wants to do a procedure since that's how they get paid. Obviously, it's much better for the patients if they avoid unneces…

Even in socialized medicine systems, doctors who do more stuff get paid more. 'Single Payer' usually means the government runs insurance not the doctors office. So the doctor bills more in both cases.

Both of those inscentives are maligned though - the doctor should do 'what's right'.

What's also nutbars is that there isn't a standard playbook for this stuff.

There should be specific procedural research on all of this stuff with the 'best practices' updated all the time.

There should be ongoing debate and churn around the practice, but once it's published, the doctors should all be in sync.

Doctors, like judges, have too much leeway. I think they feel that 'every case is special' and they are to some extent, however, I feel that they are playing against a statistical game and that their 'gut' is not right.

Just like airline pilots go through massive 'checklists' ... so should doctors.

I've been misdiagnosed for heart burn (doc thought it was heart palpitation) and for wound infection (was not infected, just a little red) - which is tragic because those are very common things.

Re: After century of removing appendixes, doctors find antibiotics can be enough

#57

Somewhat OT but interesting: "When [Kurt] Semm introduced laparoscopic surgery at the University of Kiel, he had to undergo a brain scan at the request of coworkers as 'only a person with brain damage would perform such laparoscopic surgery.' On September 13, 1980, Semm performed the first laparoscopic appendectomy, opening up the path for a much wider application of minimally invasive surgery. At first, his operatio…

You’d be surprised to learn what happened to the person who suggested it is better if the surgeons wash their hands between patients (Ignaz Semmelweis)

Re: After century of removing appendixes, doctors find antibiotics can be enough

#58
post #47

Somewhat OT but interesting: "When [Kurt] Semm introduced laparoscopic surgery at the University of Kiel, he had to undergo a brain scan at the request of coworkers as 'only a person with brain damage would perform such laparoscopic surgery.' On September 13, 1980, Semm performed the first laparoscopic appendectomy, opening up the path for a much wider application of minimally invasive surgery. At first, his operatio…

It's weird in retrospect. When my grandfather had his gall bladder removed (late 1960s, I think), he spent about 4-6 weeks in hospital and another couple of weeks at home recovering; last year, I had my gall bladder removed, they sent me home after three days. Now that's progress!

I had my gallbladder out in 2010, three day stay as well, and while I took a few days to get back to being able to walk comfortably (this was pre-lifting so I was a scrawny weak guy generally so took longer to recover) it was still amazing how quickly you could bounce back from having an organ removed.

Re: After century of removing appendixes, doctors find antibiotics can be enough

#59

I found this conversation unnerving at 13 years old: Doctor: "Does all this make sense? We need to remove your appendix.. now." Me: "Doctor, ok, so you need to remove my appendix cause if you don't I could get really sick. " Doctor: "Yes." Me: "What does the appendix do?" Doctor: "We don't know."

Doctor: in your case, kills you in about 24-48 hours.

I had mine out as well. I was 19. My dad drove me to the hospital. Doc slipped his finger up my bum, said, “you have appendicitis. You need surgery. Now.” I was being operated on quickly after that. It had ruptured. So it goes.

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