Live data from Hacker News

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

arstechnica.com

181–190 of 212 posts

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

#181
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.

> If your appendix ruptures, it is life threatening and has to come out. It is life-threatening, but it most certainly doesn't have to come out for full recovery. In some cases, it's impossible to remove due to the infection (inflammation, abscess) obfuscating its location. The treatment is aggressive intravenous antibiotics for a period of time, then oral antibiotics. The statics for recurrence after recovery I've h…

Yes, this is exactly what happened to me. The only exception is that the nurse told me if they don't find pill antibiotics strong enough then I'd require daily intervenous antibiotics. However, I was glad they did find some.

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

#182

Finally a thread where I can contribute! I was part in the Finnish APPAC trial (published on JAMA/2015). In April 2012 I was in an out of the hospital for four or five times with intensive stomach pains, but as they weren't localised in the mcburney area and my white cell counts weren't elevated, I just got sent home with painkillers. The last time my white cell counts were slightly elevated (around 36 when under 14…

I'm surprised to hear you lost your job because of health issues in ... Finland?

That kind of wrongful termination sounds like something that would happen in the States not Europe. Correct me if I'm wrong.

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

#183

Earlier quoted context omitted.

A ruptured appendix would not likely be resolved with antibiotics, I'd think. But catching appendicitis before it ruptures would be a less critical issue.

It definitely can, mine fully ruptured and I didn't find out till 4 days later. It requires very strong antibiotics, but did work good. My appendix came out 3 months later in a normal way.

Wow, I find that quite amazing.

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

#184

Earlier quoted context omitted.

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

The appendix is a tricky organ, it's position varies a far bit so not all patients with appendicitis get the classical symptoms (pain that begins as dull around the belly button, then moves to the right lower quadrant add becomes sharp and worse on rebound). Digital (as in finger) rectal examination is meant to help detect some of the atypical cases. It was part of my teaching, although I haven't read up much on it.…

Yeah pressing on the area isn't so bad, but pull your fingers away quickly and oh Jesus! I had appendicitis when I was 8. It ruptured during the visit to my GP, literally shit blood, rushed off to the hospital for an emergency appendectomy. Fun times!

I was in there for a few days. The kid in the bed next to me was hard case. Nurse comes to check on him and he goes "yeah I managed to get all the grass out of my cut, and now it's heaps better"

He'd pulled all his stitches out.

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

#185
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!

Tells you a thing or two about the social nature of applied sciences.

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

#186

Earlier quoted context omitted.

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

Heh, yeah. It is traditional. And ineffective (of course). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071072/ I was kind of out of it. Maybe there was a lot of pain, but my memory of it was just so much discomfort, what is something minor like that?

That's an excellent article you link - to paraphrase the conclusion: digital rectal examination should not be performed routinely for abdominal pain, but should be considered an investigation to consider when diagnosis is unclear.

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

#187

Earlier quoted context omitted.

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 ti…

Pretty sure the whole point of this article is that often enough patients arrive in the emergency room at a point where it's NOT too late to treat successfully with antibiotics.

Look at the people in the thread who ruptured. They certainly did not make it in time.

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

#188

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…

do we know how non 'modern' cultures deal with that ? different diet/lifestyle makes the condition rare if not more ?

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

#189
I had a cousin who delayed being seen for their stomach ache and the appendix burst. They ended up hospitalized for like 6 weeks with one end of the surgical opening left open so the wound could be drained or repeatedly cleaned out or something.

I'm glad they are doing studies here. Please note the phrasing in the article concerning "uncomplicated" cases. I have plenty of criticisms of modern medicine, but let's not throw the baby out with the bathwater here.

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

#190
post #171

Earlier quoted context omitted.

I had/have a few issues now. My kidneys were damaged and there have been slight memory issues. Both eased over time. The weirdest thing was, I started craving BBQ ribs. I was indifferent to them before.

Glad you are feeling better...but after reading your comment I too am craving bbq ribs. I was indifferent to them before.

After his comment I was curious, but still indifferent to bbq ribs. After yours, I too am craving bbq ribs. Some sort of ripple effect?
Post reply on HN