Requiem for an Appendix: How to Turn Day Surgery into a Week in the Hospital

[Emmeileia]

I am not a happy camper right now, let me just say that upfront.

On June 19th I woke up at 2am with terrible stomach cramps, going all the way up to my ribcage. I did the 'grin and bear it' thing until 5am when I hauled myself to emergency.
I got in pretty quick, Dr looked me over, poked my abdomen, ordered some ultrasounds, blood tests and urine tests. Anyways, after 6 hours of waiting in the ER not allowed to drink or eat, the Dr told me that my tests showed nothing wrong, that it was probably viral or indigestion or heartburn, even though (to quote the Dr.) "appendicitis pain can present higher on women".
So home I went, I felt worse and worse till the afternoon when I started to get better.

The pain mostly went away over the next few days, though I had NO appetite and there was always some lingering soreness. But this past weekend I started feeling stomach pain again, lower down. No appetite at all, and dizzy when I stood up. But I kept putting off going to the ER, not wanting to waste time on what was not an emergency.
By Monday morning I was running a fever, and my mom finally convinced me to go in. New Dr, new ultrasound, new blood and urine tests and guess what???

I have a nice big abscess where my appendix used to be.

So the first Dr DID NOT CHECK MY DAMN APPENDIX. Seriously they did an ultrasound, all they would have had to do is move the scanner down a few inches to see it. And wouldn't you think they would want to check that, especially if they knew that the pain could show up differently in women?

So I get admitted, and given some hardcore antibiotics. The plan was to put a drain in my stomach to let the abscess drain for a few weeks then remove what was left of my poor appendix. Sadly, after my CT scan showed that the abscess was snuggled cozily in my bowel, that was no longer an option.

So now, here I sit in hospital. The hope is, with mega doses of antibiotics the abscess will shrink or reposition a bit and then they can put in the drain. If it does not, or if it manages to obstruct my bowel, it's going to be a big operation with them removing a nice chunk of my bowel too. The Dr told me I have plenty, but I am kind of attached to every bit, you know?

On the plus side today was my first day in three days being allowed anything other than clear fluids. So I get food again, though I have not much appetite. Plus, eating too much could cause the Dread Bowel Obstruction of Doom. The hope is in another few days they can send me home with pills until it is time to operate.

I know medicine is tough, but I *really* want to have words with that first Dr.

[BeeMused]

I know medicine is tough, but I *really* want to have words with that first Dr.

Oh, instead send him the bill... with some extra for the pain you were suffering thrown in

[Emmeileia]

No bill at least, I am in Canada and pretty much all of this is covered as long as I don't watch any pay-per-view TV or request a private room or anything. So at least I won't be losing money while I can't work.

[Kaylyn]

Even if it's covered by national healthcare, can you still go after the first doctor for malpractice? I'm unsure if it works exactly the same way, but it seems like you should be able to get something for lost time at work and for the unnecessary pain and suffering when he neglected to actually check the appendix the first time. You could have had it out and been well on your way to recovery by now if he had.

[Sapphire Silk]

Even if it's covered by national healthcare, can you still go after the first doctor for malpractice? I'm unsure if it works exactly the same way, but it seems like you should be able to get something for lost time at work and for the unnecessary pain and suffering when he neglected to actually check the appendix the first time. You could have had it out and been well on your way to recovery by now if he had.

Not necessarily. First of all, get a copy of the ultrasound report from the first ER visit. It's entirely possible there was no inflammation seen at that time. The report should say.

Sometimes things look normal on the first visit when they are not. That's not the doctor's fault. Even if something was missed, that doesn't necessarily mean malpractice. Medicine is not an exact science.

[Seshat]

Regardless of whether or not you decide to try for malpractice, please do ensure that the situation is reported to the first doctor's hospital. IMO, they should be given the chance to review the case and figure out whether they missed something they should have been able to see.

[Mikkel]

If it does not, or if it manages to obstruct my bowel, it's going to be a big operation with them removing a nice chunk of my bowel too. The Dr told me I have plenty, but I am kind of attached to every bit, you know?

I am missing half a meter of colon and doesn't have much trouble. The only thing is that if I have to go, I really have to NOW. I don't get as much warning as before, but even that is getting better.
I wish you luck and hope you keep as many bits as possible .

[Emmeileia]

I've not really thought of suing the Dr. or anything like that, it seemed a waste of time and as Sapphire Silk said diagnosis is not an exact science.
I did check the ultrasound report though, the nice thing about the hospital here is they always send you home with a copy of reports on all the testing they did on you during your visit. (For reference or for your family Dr.) They definitely did not check the appendix.
It's just frustrating really. I get that people make mistakes, and it can be a tricky diagnosis but it is hard to keep zen about it when it happens to you. Though now that I am back on solid food, it is getting easier.
I did discuss it with my mom, who's been a nurse for more than 30 years now. She said it is likely because since the pain was high up, and I wasn't on the floor crying and asking for painkillers the Dr. the misdiagnosis happened. I guess I have a high pain tolerance? Honestly I was more nauseous than in pain, even when it burst.

[Sapphire Silk]

I've not really thought of suing the Dr. or anything like that, it seemed a waste of time and as Sapphire Silk said diagnosis is not an exact science.
I did check the ultrasound report though, the nice thing about the hospital here is they always send you home with a copy of reports on all the testing they did on you during your visit. (For reference or for your family Dr.) They definitely did not check the appendix.
It's just frustrating really. I get that people make mistakes, and it can be a tricky diagnosis but it is hard to keep zen about it when it happens to you. Though now that I am back on solid food, it is getting easier.
I did discuss it with my mom, who's been a nurse for more than 30 years now. She said it is likely because since the pain was high up, and I wasn't on the floor crying and asking for painkillers the Dr. the misdiagnosis happened. I guess I have a high pain tolerance? Honestly I was more nauseous than in pain, even when it burst.

I'm glad they gave you a copy of the report. Most places (here in the US anyway) you have to ask for it.

The doc may have been thinking the problem was gallbladder initially. Some people do have a high pain tolerance; people interpret pain differently. What's a 10/10 to me may be a 4/10 to you. I can't explain how the appendix wasn't scanned, but usually the WBC count goes sky high with acute appendicitis, so that may be why the doc went down the garden path. And some people live with chronic appendicitis for years.

I'm sorry you're going through all that. I hope you are starting to feel better, and that you won't need any more surgery. Do keep us updated.

[MoonCat]

And some people live with chronic appendicitis for years.

And some don't. You'd think they would want to check that out, since they know the pain can show up higher in a woman.

[Emmeileia]

Well, they let me out Friday. I am on some horse-sized antibiotic pills for now, and the surgeon is hoping we can put off any surgery for a long while to allow things to get rather less inflamed in there.

In fact, he says if I have actually gone and blown my appendix to smithereens rather than just rupturing it I may not need surgery at all. So, let's hope I went all out?

[MoonCat]

Well, they let me out Friday. I am on some horse-sized antibiotic pills for now, and the surgeon is hoping we can put off any surgery for a long while to allow things to get rather less inflamed in there.

In fact, he says if I have actually gone and blown my appendix to smithereens rather than just rupturing it I may not need surgery at all. So, let's hope I went all out?

This is confusing to me. I thought a ruptured or otherwise "blow" appendix meant mandatory emergency surgery because it could kill you.

No?

[Sapphire Silk]

And some don't. You'd think they would want to check that out, since they know the pain can show up higher in a woman.

Actually, I don't know that's true. I know the OP says the doctor told her that, but I've never heard it before, and I can't find any reference that supports it.

Not saying the OP didn't hear what she said she heard. I'm saying I question what she was told.

This is confusing to me. I thought a ruptured or otherwise "blow" appendix meant mandatory emergency surgery because it could kill you.

No?

Ruptured means it opens and spills pus into the peritoneum, where the infection spreads rapidly (peritonitis). "Blown" means the organ no longer exists, but you still have the issue of peritonitis. The OP had this issue either way; it's why she was in the hospital. It could have killed her. Luckily it didn't.

I suppose the surgeon is saying that if the organ ruptured so completely that there is no original tissue is left, this means there is nothing to adhere to the bowel and cause scar tissue that could obstruct the bowel.

[Emmeileia]

I believe that is what the surgeon meant, is that if the appendix was destroyed so thoroughly there is no tissue left I may not need the surgery. But if there is any remnant of it left I definately will.

I certainly could have misheard the Dr. about where pain can show up, I was not exactly in the best state at that time!

[AccountingDrone]

I know that when Rob's appendix blew when he was 12 he spent almost a month in hospital, and caused his surgeon to vomit when they opened his abdomen [he went a week between his appendix bursting and getting admitted to the hospital, it has plenty of time to sit and fester.] He has a seriously huge - wide and long - scar remaining from that dance.