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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

#61

Post by Cthulhu_ »

krylon wrote: post #47
bookofjoe wrote: post #32

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!

My GF had a laparoscopy a few years ago where they removed a 10cm cyst. She was home the next day, and that was only because they had a slight concern. She had another one a few weeks ago, first one under the knife, home the same day.

Still 4-6 weeks of recovery, but that's mostly due to them having to inflate the abdominal cavity to be able to see / work and a bit of bruising and shifting of stuff.

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

#62

Post by Cthulhu_ »

algorias wrote: post #17

That's great to hear. However, keep in mind that appendicitis is still an extremely serious condition that will kill you if left untreated. The fact that you can avoid surgery in some cases doesn't mean that surgery is not an adequate treatment. It's amazing how medicine has advanced: We can now cure illnesses with very minimal amount of invasiveness required in most cases. Even before this news, open surgery was alr…

In this case, would they keep you in hospital for a while to see if the antibiotics work, while being on standby to do emergency surgery?

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

#63

Post by Cthulhu_ »

sureaboutthis wrote: post #34

This reminds me of when tonsils were removed at the first sign of trouble. When I was in my early 20s, in the 1970s, I went to my doctor about a bad sore throat. He advised me to see an ENT who barely bothered to look down my throat for more than a second and automatically declared I needed mine removed. That bothered me but I very much respected my personal doctor who said he respected this ENT. When I mention this…

Growing up, I felt like getting tonsils removed was as common as changing teeth, it must've happened to a third or so of my classmates at the time.

It seemed harmless enough from a distance, they pull out some stuff from your throat and you get ice cream.

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

#65

Post by pjc50 »

Cthulhu_ wrote: post #63
sureaboutthis wrote: post #34

This reminds me of when tonsils were removed at the first sign of trouble. When I was in my early 20s, in the 1970s, I went to my doctor about a bad sore throat. He advised me to see an ENT who barely bothered to look down my throat for more than a second and automatically declared I needed mine removed. That bothered me but I very much respected my personal doctor who said he respected this ENT. When I mention this…

Growing up, I felt like getting tonsils removed was as common as changing teeth, it must've happened to a third or so of my classmates at the time. It seemed harmless enough from a distance, they pull out some stuff from your throat and you get ice cream.

I had mine out as an adult and it was a pretty painful week of recovery.

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

#66

Post by seszett »

sonnyblarney wrote: post #56
jazoom wrote: post #44

Earlier quoted context omitted.

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 thi…

Actually, at least in the medicine systems I know (France and Belgium) doctors can either be independent or employed. It's about 50% each in both countries.

Independents are paid more when they do more stuff, but employed doctors are usually paid a fixed salary depending on fixed work hours. Depending on the system, the practice either bills patients directly per consultation, or the social security organization, or gets a fixed income from social security or from the ministry of health that does not directly depend from how many patients they see. All three systems exist.

Best practices and procedures are usually handled at the hospital or... "medical house" (maison médicale or wijkgezondheidscentrum, the place where several non-independent doctors work as a team) level. It is indeed not something that really gets standardised at a higher level, although doctors also have a number of mandatory meetings that get conducted with attendees from different practices and that help with diffusing procedures, best practices and knowledge.

They don't all get in sync at the same time, but knowledges and best practices do diffuse through all doctors. Although independents usually try to attend the bare minimum because meetings directly translate to missed income for them.

I don't think the current model is wrong, although I think independent doctors are ill equipped to stay up to date, and not enough incentivised to do so.

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

#68

Post by odyssey7 »

tinus_hn wrote: post #57
bookofjoe wrote: post #32

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)

I just looked this up and oh wow, and I don't perceive that this situation could have only happened back then.

In the modern day, a lot of people with a lot of education will scoff at anything that hasn't been produced by science, or even anything that simply wasn't taught to them in medical school. Meanwhile, the medical system is full of inefficiencies and outdated practices because of politics and resistance to accepting or learning newer scientific findings. Worthwhile questions about simple ways to improve things often go unanswered, because nobody has been able or willing to do a large, randomized trial about it.

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

#69

Post by [deleted] »

qwerty456127 wrote: post #30
fredsanford wrote: post #27

Earlier quoted context omitted.

A tl;dr summary... > A US Special Forces soldier bought fish antibiotics at a pet store to treat his sinusitis. It did not work out. -- I grew up in an area with 6 to 8 different military bases and it is fairly common knowledge in military areas that you can sometimes get away with using fish antibiotics to treat human infections. And in a lot of cases the pills are exactly the same. But sometimes not.

Thanks. A nice-to-know lifehack, I just really hope I'm not going to need it but who knows... BTW I've actually bought pure butyric acid in a fish food store to produce sodium butyrate in my kitchen and take it instead of the human-approved supplement which is available on Amazon but is fairly expensive by the east-European income standards (and, according to the scientific papers I've found so far, hardly does anyth…

[deleted]

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

#70

Post by SECProto »

0xcafecafe wrote: post #67

I wonder if this would eventually be extended to wisdom teeth, something dentists are too trigger happy to remove.

Not quite sure I understand - give antibiotics instead of pulling wisdom teeth? They pull them because wisdom teeth often grow in at an angle to a mouth of fully developed and settled adult teeth. Sort of a "why mess with a good thing" (the teeth there already) approach. I certainly see an issue with the rampant pulling of wisdom teeth for cosmetic reasons, but don't see how it's relevant to a new treatment method for a life threatening illness.
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