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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

#91

Post by JoeAltmaier »

gwbas1c wrote: post #87
crazygringo wrote: post #80

I'm so confused. From Wikipedia: > Appendicitis is caused by a blockage of the hollow portion of the appendix. This is most commonly due to a calcified "stone" made of feces. Inflamed lymphoid tissue from a viral infection, parasites, gallstone, or tumors may also cause the blockage... The combination of inflammation, reduced blood flow to the appendix and distention of the appendix causes tissue injury and tissue de…

> Or are the antibiotics for dealing with an actual ruptured appendix If your appendix ruptures, it is life threatening and has to come out. Most appendix removals happen before the appendix ruptures. The conclusion of the study is that high doses of antibiotics is an effective way to prevent the appendix from rupturing without surgery.

I still have the question: what about the 'stone'? Do antibiotics cure that somehow? Or is that the reason that 30% of those treated with antibiotics ultimately have the surgery?

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

#92

Post by ectospheno »

Article says sick leave on antibiotics was 11 days compared to 22 with the invasive surgery.

The non invasive surgery only has you taking it easy for 7 days with no lifting anything over 10 pounds for a bit after that. They send you home from the hospital after 2 days. Most people resume work during the initial week.

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

#93

Post by medntech »

lightbyte wrote: post #89
bitexploder wrote: post #59

Earlier quoted context omitted.

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.

>Doc slipped his finger up my bum Is this a standard way to diagnose appendicitis?

I was taught first year of medical school (2017-2018) that it isn't. Some physicians probably still use it though.

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

#94

Post by platz »

bookofjoe wrote: post #84
mr_overalls wrote: post #73

Earlier quoted context omitted.

Are there examples of other fields being so staunchly/abusively conservative? I'm struggling to imagine a physicist, engineer, or attorney being forced to undergo a mental examination for suggesting a radical new theory or procedure.

"I hold that space cannot be curved, for the simple reason that it can have no properties. It might as well be said that God has properties. He has not, but only attributes and these are of our own making. Of properties we can only speak when dealing with matter filling the space. To say that in the presence of large bodies space becomes curved, is equivalent to stating that something can act upon nothing. I for one,…

Perhaps he will be validated when we develop/discover a deeper theory.

After all, we have physicists going around now (e.g. Nima) saying 'spacetime is doomed'

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

#95

Post by eigenstuff »

0xcafecafe wrote: post #75
SECProto wrote: post #70

Earlier quoted context omitted.

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 fo…

I meant the overall principle of maintain rather than remove.

So... braces? It's cheaper just to pull them. You really have to if you're someone like me whose mouth was too small for them to even come in.

My wisdom tooth extraction was a shit show for that reason, but I've had all my 12 year molars removed since then, the last one a couple of weeks ago, and the recovery is pretty easy. (They wanted to root canal it and crown it... I was like bro just pull it because otherwise we're just gonna have this same conversation again in 10 years.)

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

#96

Post by da02 »

fredsanford wrote: post #29
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…

Appendicitis will kill you! And the surgery in most cases will save you. :) At least in my case. I technically died from a ruptured appendix and spent 9 days in ICU. The doctors delayed surgery to see if the antibiotics would work. This was ~10 or so years ago.

Can you give more details of "technically died"? Any after-life experience?

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

#97

Post by rsynnott »

ectospheno wrote: post #92

Article says sick leave on antibiotics was 11 days compared to 22 with the invasive surgery. The non invasive surgery only has you taking it easy for 7 days with no lifting anything over 10 pounds for a bit after that. They send you home from the hospital after 2 days. Most people resume work during the initial week.

Study was in Finland. How much time people take off presumably depends heavily on national laws and norms around sick leave. Some countries have very generous laws around paid sick leave; others, like the US, don’t have mandatory paid sick leave at all.

Finland seems to be a special case; 10 days paid sick leave for a given incident, but in practice this is improved on by collective bargaining agreements in many trades.

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

#98

Post by jawns »

ransom1538 wrote: post #45

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."

About 10 years ago, one study set forth an interesting hypothesis: The appendix is a place where "good" bacteria can safely hide during infection. I'm not sure if there's been any work since then to confirm the hypothesis, but it sure is an interesting idea.

Source: https://www.nytimes.com/2008/06/17/health/research/17appe.ht...

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

#99

Post by takeda »

JoeAltmaier wrote: post #91
gwbas1c wrote: post #87

Earlier quoted context omitted.

> Or are the antibiotics for dealing with an actual ruptured appendix If your appendix ruptures, it is life threatening and has to come out. Most appendix removals happen before the appendix ruptures. The conclusion of the study is that high doses of antibiotics is an effective way to prevent the appendix from rupturing without surgery.

I still have the question: what about the 'stone'? Do antibiotics cure that somehow? Or is that the reason that 30% of those treated with antibiotics ultimately have the surgery?

I thing it is the second one. I don't see antibiotic helping with that.

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

#100

Post by rsynnott »

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…

Depends on the system. Most hospital doctors here (Ireland) are just employees of public hospitals; beyond overtime (and they tend to be right on the legal limits provided by the working time directive for that; the system is understaffed at the moment) they don’t get paid more for doing more procedures. Similar in the UK.
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