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

arstechnica.com

111–120 of 212 posts

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

#111
post #101

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I'm glad it worked for you but usually appendicitis is caused by an infection which will cause sepsis if the appendix ruptures, and fasting won't fix that. If you think you have appendicitis at least talk to a doctor, because if it ruptures there is a high probability you will get sepsis and die.

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

#112

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.

I had the surgery via laparoscopy ~10 years ago; go to the ER at 8AM, surgery at Noon, and home by 9PM the same day.

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

#113

Earlier quoted context omitted.

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

I was taught by a computer game that it's diagnosed by palpating the four quadrants of the abdomen and doing an ultrasound. A lot of the decoy cases were just gas; hold for observation until they fart it out. This wasn't in the game, but I presume it may also be necessary to do a pregnancy test (ectopic?), urinalysis for urinary tract infection, swabs for genital tract infection, blood draw for white blood cell count…

Was it "Life & Death"? That game was difficult as a kid. If surgery was involved, the patient always died.

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

#114
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?

One of my kids had his appendix out last year, and I asked a similar question. My recollection was: Blockages can form and resolve on their own -- it's possible he'd had blockages before, felt pain, but they resolved before an infection could occur. You could be having this happen right now, but it could resolve later in the day and you never notice anything. Or the blockage could be too severe and never resolve on its own.

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

#115

Earlier quoted context omitted.

Wait is that a requirement?

From the Australian Government - Department of the Environment and Energy, Australian Antarctic Division: The answer is no, however doctors who are wintering at Australian Antarctic stations are required to have their appendix removed. This is because there is usually only one doctor on station during winter, and evacuation back to medical care in Australia is impossible for at least part of the year. The requirement…

That perfectly aligns with my personal stereotypes of Australians and Russians.

The Americans, of course, would just attempt surgery on site using remote assistance from stateside surgeons, do the horrendously expensive evacuation when it goes wrong, try to bill the patient for the entire multi-million dollar amount, and then base a screenplay or teleplay on the story.

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

#116
post #109
post #96

Earlier quoted context omitted.

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

That's not a phrase a physician would typically use. Laypeople sometimes use it to describe respiratory and/or cardiac arrest.

Thanks. I have no medical training, so that helps. So the brain can still function for a while during cardiac arrest?

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

#118
post #116
post #109

Earlier quoted context omitted.

That's not a phrase a physician would typically use. Laypeople sometimes use it to describe respiratory and/or cardiac arrest.

Thanks. I have no medical training, so that helps. So the brain can still function for a while during cardiac arrest?

Yes. In fact you can be "dead" for rather a while and still get better under very specific circumstances, typically involving hypothermia.

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

#119
post #98

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...

Oh, yeah, I remember reading about that! I think that's seeped into my head as 'leading reason we think we have an appendix.'

This is the great thing about HN -- there's a very good change somebody will come along and update my intuition.

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

#120
post #98

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...

Papers please. Bacterial edition
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