Live data from Hacker News

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

arstechnica.com

121–130 of 212 posts

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

#121
post #33

Earlier quoted context omitted.

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

An aspect of this that is seldom remembered is that Semmelweiss was a HUGE jerk, which didn't help adoption. Instead of telling or showing other doctors how things could be better, he called them barbarian murderers for not washing their hands. It was a decade before he'd even have a civil conversation about it, or publish for peer review. There's a lesson in that...sometimes being right isn't enough on it's own.

Semmelweis also couldn’t explain why his procedure supposedly worked. Again that’s hugely problematic: a sound theory requires an explanatory framework. Otherwise it’s just not convincing.

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

#122

Earlier quoted context omitted.

Would you mind telling what's there? It says "Unfortunately, our website is currently unavailable in most European countries..." as I open it directly and shows no article body as I open it through us.ixquick-proxy.com.

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.

Article also states that aquarium antibiotics are more expensive than prescription antibiotics, while conveniently omitting the copay and time cost required for the doctor's office visit, which was needed to obtain the prescription.

As such, it is also an uncommon practice to lie about symptoms during an office visit that was required for some other reason, to get a prescription for antibiotics that is not immediately needed. I don't actually know anyone who has done this, so it may be just rumor. I do know people who have used aquarium antibiotics, because their copay for a $150 office visit is $150 until their $8000 annual deductible is met. US health care is bananas.

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

#123
post #96

Earlier quoted context omitted.

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?

Technically died likely means cardiopulmonary arrest aka a heartrate of zero. Medical personnel refer to this as "a code" or "code blue"

I drowned as a kid in a friend's pool when I was 7 or 8. I was "technically dead" as well. No afterlife experience, but as I was thrashing underwater, my entire body felt like you feel when your leg goes to sleep, and before I went "to sleep" I got really calm and everything was peaceful. The only thing I could feel other than whole body numbness was a strong warmth. I took one last look up at the sun sparkling on the ripples of water above and closed my eyes.

A few minutes later, I awoke puking water and choking with my best friend shrieking hysterically as her mother frantically performed CPR on me. For some reason, my parents never ever let me swim in her pool again or go to her house unsupervised.

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

#124

Earlier quoted context omitted.

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.

That was it, I think. I could even do the aortal aneurysm surgery without killing the patient. And my boss hardly even yelled at me for mistakes.

It came in a bundle with Beyond the Black Hole, which came with 3D glasses that worked with CRT monitors. The feelies for L&D included a surgical mask. Maybe it came with Chessmaster, too?

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

#125
I recall reading sometime in the past that appendectomies are the perfect cash crop at hospitals. Most are not needed but it's not worth the risk so everyone gets them, they are a low risk easy surgery, and they can charge a lot for them. I also recall that the cost for the surgery varies widely across hospitals.

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

#126

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…

I was 13 when I had it. I had a high fever and puking out an entire day. When I went to the doctor, i think he didnt even look at my face: just poked my abdomen. Even I understood immediately it was appendicitis.

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

#127
post #40
post #18

Earlier quoted context omitted.

Yeah, so unfortunately regarding medical science "formalized truth-values finding process" is actually about as far from reality as you could be. "Politicized agenda-propelled random search" would be closer. However, we still slowly are making progress thanks to new technologies, so all is not lost...

I understand that, looking at individual scientific problems, it's easy to get cynical. It's even fashionable to be so. Deaths attributable to heart disease in 1970 were just shy of 800k per annum. As of 2010, it was about 600k. A 25% drop in the leading cause of death, in less than a generation. Life expectancy was 70.8 years in 1970, and 78.7 in 2010 - an increase of more than 10% in a single generation. Science is…

That's mostly because smoking has been stigmatized.

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

#128
post #40

Earlier quoted context omitted.

I understand that, looking at individual scientific problems, it's easy to get cynical. It's even fashionable to be so. Deaths attributable to heart disease in 1970 were just shy of 800k per annum. As of 2010, it was about 600k. A 25% drop in the leading cause of death, in less than a generation. Life expectancy was 70.8 years in 1970, and 78.7 in 2010 - an increase of more than 10% in a single generation. Science is…

That's mostly because smoking has been stigmatized.

And nothing to do with the pile of research that’s been done in the past few decades identifying exactly which medications actually provide mortality benefit in cardiac disease and which don’t, of course.

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

#129
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...

Hands and feet are also very useful ... until they turn septic and need to be removed. Antibiotics can treat infections in the early stages if diagnosed well ahead of time. But once an organ is totally taken by infection it may be unrecoverable. Either you remove it or it becomes a lump of dead tissue spreading evil to the rest of the body. By the time someone is in the emergency room due to abdominal pain, by the time they are seen by a doctor and ultrasounded, it will need to come out.

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

#130
post #106

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…

I thought the stuff in your gut wasn't feces until it'd been through at least the small intestine?

The appendix is right after the transition between the small and large intestines.
Post reply on HN