cascadian telegrams: the story of the appendix

Some people explode fireworks for 4th of July, I decided to explode my appendix.

My appendix was removed on Monday July 6th. I’ve posted some details on FaceBook and elsewhere about what happened, but for posterity, here’s w’appened….

July 4th was normal with a bike ride over to Wallingford to watch fireworks over Lake Union, but by July 5th I could tell something was wrong: I was weak and a bit nauseous and had pressure in my abdomen. I was listless all day.

When symptoms hadn’t abated by Monday 6th I checked online and my symptoms matched those of appendicitis: The abdominal pressure had moved over to the right side of my abdomen, and when I visited my doctor he poked and prodded a few places before diagnosing appendicitis and lining me up for a CT scan later that day to verify. He told me not to eat or drink anything except for clear liquids so as to not affect the scan.

I had the scan late afternoon, and the scan technician told me they’d get back to me Tuesday (next day) or maybe Wednesday, so as I was hungry I grabbed a sandwich at the clinic cafeteria. But as I was driving home from the clinic, the doctor’s office phoned and told me to turn around and head straight to a nearby hospital as my appendix was “perforated” (‘perforated’ is apparently the same as ‘ruptured’) and had to come out.

I drove to the hospital and – after some confusion about where to go and whom to see – they were ready for surgery. Until I told them about the sandwich.

“What? You had a sandwich? He ate a sandwich!” After a few minutes of conversation between doctors, anesthesiologists and others the sandwich had become a “huge sandwich” (“He ate a huge sandwich!”). While I sat there, confused and bemused. I tried to explain that the CT tech told me they’d call me Tuesday or Wednesday, so I assumed no surgery this evening, but after they explained the risk of ‘aspiration’ (food coming up the tube down my throat and into my lungs, causing infection) versus the risk of waiting on the appendectomy we decided to go ahead.

“Do we have contact info for your wife? Is she here?”

“I told her not to bother as I thought it would be outpatient surgery…”

The nurses and anesthesiologists around my trundle bed rolled their eyes at that… now giving me the how could you be so stupid look, but finally they wheeled me on my cot out to the operating theater where they gave me the happy gas, and I went off to the land of nod.

A few hours later I woke up and Susan and Malcolm were there. The surgeon (Doctor Chebli… “like the wine”, he said) said everything went fine, except that there was ‘no way’ the appendix had just ruptured as it was ‘like cement’ and took him a long time to scrape off appendix tissue from the pelvic bone where it had settled. This was weird as I’d only had limited symptoms beforehand… how could it have ruptured without me noticing it?

The other thing that was weird was that my left eye hurt, like some grit or an eyelash was stuck in it. Susan and I flushed it out but couldn’t make the irritation stop, so I kept bugging the nurses who in turn bugged the opthamology department who wouldn’t come until Dr. Chebli insisted they come. They finally showed up the next day (Tuesday 7th) around 5pm and as it turned out the anesthesiologist didn’t tape my left eye all the way shut (they tape your eyes shut for surgery, apparently) so there was a scratch on my left cornea just where the eyelids meet. My eye must’ve scratched against the gauze pad during surgery. Thanks for that guys, and thanks to the hospital for waiting 24 hours before they’d even diagnose the thing and give me some pain relief. Between my guts and my eye, I was in pretty good pain, and I looked a real fright with my eye patch, hobbled gait and IV tree attached, shuffling around the ward in the middle of the night just to keep my metabolism going. Thanks to the eye I couldn’t read, use a computer or watch television, just lie there and contemplate the many flavors of jello I enjoyed for 2-3 days (there’s lime, raspberry and what-I-think-is-lemon) along with the crappiest broth you’ve ever eaten. Trying to read with one eye gave me a headache.

So by Wednesday 8th my “plumbing” was mostly working again (the constant question: “Did you pass gas?” Eventually to this I could answer “yes”, and as there was nobody else in my room, I couldn’t say “it was him!” and point the finger) so they gave me the option of returning home Wednesday evening. More correctly, they kept asking me if I wanted to go home until the answer was “yes”, not unlike how Malcolm will browbeat me until I relent.

So home I went with my pirate eye patch and plastic drain bottle sticking out of my side. I had a fever for a few days as the infection in my abdomen worked itself out, but thankfully they send you home with a handful of Percocet (which make you hallucinate a little) as well as antibiotics so that made it possible to sleep.

After a few days though I was nearly my old self again, albeit with very limited energy. I had to warn Malcolm not to jump on me and roughhouse as we normally do. He was very respectful and even discovered that he needed a bandage (for a bug bite) on his leg which coincidentally needed changing whenever my bandage needed changing… a “sympathy injury”. He was a good little chap during the whole thing though, even if he did take advantage of the fact that I was laid up in the guest bed to curl up with mum in my usual spot in our bed.

Due to my surgery we missed as planned camping trip (to Jarrell Cove) so Susan and Malcolm had to settle for roasting marshmallows over the stove, while I watched some of the milk carton derby on Green Lake from my attic window and scanned pictures all weekend for my parents’ 50th wedding anniversary album… a good, not-physically-taxing thing to do while recovering.

Finally on Monday 13th I got the drain removed. That was very weird… I could feel the tube being pulled across my abdomen on the inside as he removed it and the staples over the other two holes. “I’ll try not to pull out too many organs” he said as he yanked my liver through the tiny hole. Now I’m drain-less and nearly normal again – Yay.

So the obvious question is: How could I have walked around for so long (maybe even months or years, according to the doctor) with a ruptured appendix?

His opinion is that I had chronic rather than acute appendicitis:

Judging by its gravity and rate of development, appendicitis can be either chronic or acute. Acute appendicitis is very common and it is characterized through intense symptoms and fast rate of progression. Chronic appendicitis has a very low incidence in people and it is characterized through milder, almost unperceivable symptoms and a slow rate of progression. The general symptoms of appendicitis have an unspecific character. While acute appendicitis is considered to be difficult to detect, chronic appendicitis is almost impossible to detect relying only on the patients’ reports of symptoms. For instance, while patients with acute appendicitis experience abdominal pain, high fever and nausea, people with chronic appendicitis may only experience a generalized state of fatigue and illness. The only effective means of diagnosing chronic appendicitis are blood analysis, endoscopy and abdominal computerized tomography.

so there you go. Apparently when my appendix ruptured it settled down into a pelvic bone and stayed there, and didn’t spread infection into the rest of my abdomen until the weekend of the 4th, when something must have aggravated things.

Today I’m happy for modern medicine as 100 years ago I would have most certainly died from this.