Appendix Better out than in?

[brianhumber]

My Appendix was fished out rotten and in pieces in early July as a consequence I had some faffing about in High Dependency Unit, high temp of 40C, catheter hassles and a drain for couple of weeks afterwards. Those purveyors of comfort and joy, my doctors, have told me I was quite ill and kidneys, liver etc will take 6 - 9 months to get back on song.

So it was good to toddle off to Littlehampton on Ronhilda this weekend with four other yachts from our club and enjoy just being on the water even if the winds were a little absent. Managed to test sail my new lightweight geny flown from a small bowsprit which worked very well ( I was in the middle of installing this when my Appendix struck overnight), saw the shiny new MIxon South Cardinal mark and came back into Chichester via the target barges and Winner sands.

However I had half planned to have been in the Channel Islands or Midway across the Channel on the day this happened and as it was just 16 hours from first feeling any twinge to a temp of 40C, agony and even Morphine not working, the thought has occurred what would I have done had this happened mid channel.

Guess the learning lesson is if you suffer a grumbling appendix like I did last year insist the NHS take it out then and do not accept " we will think about removing it if it grumbles next time" .

Brian

 

[ProDave]

I was always told there is no such thing as a grumbling appendix

Years ago I used to get a pain in about that area from time to time and that's when i was told about the no such thing as a grumbling appendix and it must just be a stitch.

It hasn't happened for years.....

 

[pvb]

I had mild aches/pains and an upset tum one day, which I'd put down to a dodgy petrol station sandwich. Next morning, no better, my wife took me to hospital where I was immediately admitted and appendix removed. By the time they got to it, it had burst, so a messy procedure. At no time had I had severe pain. Before the op, the surgeon had said he thought it was the appendix, but there was no real test, so he'd have to operate and take a look. When I asked what would happen if it looked OK, he just said they'd take it out anyway as it didn't do anything much and would prevent future problems.

If it had burst while I was on an extended trip on the boat, I'd probably have died from peritonitis.

 

[Sybarite]

My Appendix was fished out rotten and in pieces in early July as a consequence I had some faffing about in High Dependency Unit, high temp of 40C, catheter hassles and a drain for couple of weeks afterwards. Those purveyors of comfort and joy, my doctors, have told me I was quite ill and kidneys, liver etc will take 6 - 9 months to get back on song.

So it was good to toddle off to Littlehampton on Ronhilda this weekend with four other yachts from our club and enjoy just being on the water even if the winds were a little absent. Managed to test sail my new lightweight geny flown from a small bowsprit which worked very well ( I was in the middle of installing this when my Appendix struck overnight), saw the shiny new MIxon South Cardinal mark and came back into Chichester via the target barges and Winner sands.

However I had half planned to have been in the Channel Islands or Midway across the Channel on the day this happened and as it was just 16 hours from first feeling any twinge to a temp of 40C, agony and even Morphine not working, the thought has occurred what would I have done had this happened mid channel.

Guess the learning lesson is if you suffer a grumbling appendix like I did last year insist the NHS take it out then and do not accept " we will think about removing it if it grumbles next time" .

Brian

Francis Chichester asked for instructions on how to do diy under a local if the occasion arose.

 

[prv]

Francis Chichester asked for instructions on how to do diy under a local if the occasion arose.

There was a Russian in an arctic research station who actually did it, I believe.

Pete

 

[Daydream believer]

However I had half planned to have been in the Channel Islands or Midway across the Channel on the day this happened and as it was just 16 hours from first feeling any twinge to a temp of 40C, agony and even Morphine not working, the thought has occurred what would I have done had this happened mid channel.

Brian

Difficult one this. Definately a good cause for a Maday.
However, from the point of view of rescue i think i would rather be this side of the half way line. I would rather be rescued by the RNLI than Sybarite's mob any day.
But from the point of view on treatment perhaps nearer the other side might be better esp if you have travel insurance

Glad it turned out OK though

 

[Sybarite]

. I would rather be rescued by the RNLI than Sybarite's mob any day.

Apart from knowing nothing about the French, any particular reason?

 

[Minchsailor]

Out. Many, many years ago I had a grumbling appendix - then one day it flared it and, although it was not exactly a flashing blue light emergency job - it did have to come out in a hurry and was great inconvenience. In those days it was a full blown op, 10 days in hospital

My partner had his out a few years ago. Keyhole surgery. Home in 3-4 days.

 

[Daydream believer]

Apart from knowing nothing about the French, any particular reason?

Well for a start they are French!!

 

[nigelmercier]

... Years ago I used to get a pain in about that area ...

Note that an inflamed appendix normally starts with pain in the centre of the abdomen, and not everyone has it on the right. Removal can lead to issues with C. Difficile, so make a note of the symptoms if you don't have one anymore, especially following a course of antibiotics.

 

[tudorsailor]

Two things to note.
1) Pain starts centrally but then moves to lower right side - usually after vomiting
2) Appendicitis becomes less common in middle age. So for most forumites not likely to be a problem!

NHS site is quite good

Appendicectomy used to be a good training operation for juniors, I did a fair few in my time. I would not like to do my next one on the ARC, but that is one of my fears.

Tudorsailor

 

[[70521]]

Years ago I was told that the British Antarctic Survey (BAS) insisted that everybody over wintering had their appendix removed (I was interested in working with them). On finding out that a chap at work had worked for the BAS and over wintered with them he advised me that his appendix was still inside. Another unban myth destroyed.

 

[Sybarite]

Well for a start they are French!!

I thought it might be something as profound as that.

 

[Seajet]

I had my appendix go bang - quite suddenly - over a Friday night, when I went to the Doctor's the next morning the pain had me crippled up over the car roof ( I wasn't driving ).

I believe it was common practice on long 1970's sailing trips to have your appendix removed first as a precatioun, I'd definitely go for this !

 

[Angele]

Two things to note.
1) Pain starts centrally but then moves to lower right side - usually after vomiting
2) Appendicitis becomes less common in middle age. So for most forumites not likely to be a problem!

Yep. That is exactly how it was for me - just before my 1st year exams at university.

Started with feeling a bit poorly (like indigestion), followed by inability to focus my eyesight, then vomitting. Pain so unpleasant that I was, apparently, pulling my hair out (no wonder I am so thin on top). Within 6 hours I was admitted to hospital. I remember the doctor pressing on my abdomen. When he removed his hand I nearly hit the roof in pain. "Yep, that is your appendix" he said. The next thing I knew I was being anaesthetised.

Better out I say.

 

[Daydream believer]

Years ago I used to get a pain in about that area from time to time

Yes mid channel can be difficult some times

 

[tudorsailor]

When he removed his hand I nearly hit the roof in pain.

That's classic "rebound tenderness" . I suspect young surgeons now simply order a scan and have lost the art of examination

Better out I say.

I for one would not volunteer for an operation when I had no symptoms, even if going off shore. Where would you stop? Take out the gall bladder too? How about all your teeth? Maybe have a prostatectomy while you are on the table!

TS

 

[Angele]

I for one would not volunteer for an operation when I had no symptoms, even if going off shore. Where would you stop? Take out the gall bladder too? How about all your teeth? Maybe have a prostatectomy while you are on the table!

TS

I say "better out than in" purely from a selfish perspective. Having had mine done (out of necessity) I no longer have a fear of having problems with it when hundreds of miles from help.

 

[tudorsailor]

I would fascinated to see a analysis of medical problems suffered by ARC participants over the years. It might focus the mind as to what to plan for.

The other consideration is the trend to try antibiotics if surgery is not imperative

There was a study showing surgery acutely is not always necessary:
The study's findings were published in the Journal of the American Medical Association.

For the study, Salminen and colleagues randomly assigned 530 patients with acute appendicitis to appendectomy or a 10-day course of antibiotics.

The researchers found that appendectomies were 99.6 percent successful. Among patients treated with antibiotics and followed for a year, 73 percent did not need surgery. However, 27 percent of the patients treated with antibiotics had to have their appendix removed within a year after treatment.

So carry the appropriate antiobitics and maybe have the surgery if necessary, later.

TS

 

[bikedaft]

i believe that in the distant past the BAS did insist on an elective appendicectomy (and maybe astronauts?)

however if 1 in 10000 people haing a general anaesthetic die, then fairly quickly you start killing more folk than saving.

and, as tudorsailor has pointed out, there is a fair chance you can delay things until you get shoreside, even on ARC, with antibiotics

some russian scientist did do his own about 3 years ago with a mirror and live phone link to a surgeon, in the southern winter (they would be dosed up with antibiotics and flown out at other times of year)