Should I get this checked out?

There are many times that you get a cramp or discomfort, and especially for women, it is easy to pass off and think that it isn't a big deal.  Even if it lasts a couple of days....sometimes it really is nothing more than horrible menstrual cramps (ladies) or a pulled/strained muscle, but it can be something much more serious, like appendicitis.

Why is appendicitis a big deal?
Your appendix, when infected, can easily rupture when it is infected which can cause the infection to spill into your abdominal cavity and cause a very serious infection that can lead to death if it isn't treated quickly.  If the appendix does not rupture, but stays infected, the infection can cause an abscess in the abdomen that also runs the risk of rupturing.  This rupture causes severe, excruciating pain and a  form of infection that is overwhelming to your body...basically, its NOT GOOD!!

What are the signs and symptoms of appendicitis?
-Aching pain and tenderness from your belly button usually down the right side of your abdomen
-The aching pain can become more intense over time
-Rebound tenderness: if you push in on the lower right abdomen, then release, the sharp pain occurs upon release.
-Nausea and vomiting
-Loss of appetite
-Low-grade fever
-Abdominal bloating
-Diarrhea

Is there a cause?
Truly, what causes appendicitis is unknown but it is occurs many times after people have had a GI virus and the virus is thought to get trapped in the appendix, also if some food particles from the small intestines get trapped in the appendix, it can fester and cause an infectious process.

What will happen when I go to see my HCP?
The will draw blood looking for an increased white blood count (WBC) which shows that an infection is present, check a urine sample to rule out a urinary tract infection/bladder infection/kidney stone, and possibly perform a CT Scan to look for actual appendicitis through imaging your abdomen.  Most importantly HCP's will do an abdominal assessment to look for a specific area of pain.  Also, ladies, please be aware that you will most likely have a pelvic exam to rule out that the pain is from an STD or PID (Pelvic inflammatory disease).  Depending on your symptoms, some HCP's will not perform any or of imaging and send you directly for surgery.

What is the treatment?
Surgery!  If you have straight uncomplicated appendicitis, you can have laparoscopic surgery where 5 small holes are poked into your abdomen, the surgeon inserts a video camera and small surgical tools into your abdomen, and you can usually leave the day of surgery or stay overnight.  The benefit is faster healing.  But, due to other situations (like past abdominal surgeries or ruptured appendix) you may need to have open surgery in which the abdomen is opened through a 2-4in incision and it allows for full visualization of the abdominal cavity and allows the surgeon to wash out your belly when infection is present.  You usually are required to stay 2 days after surgery to ensure that you are passing gas and can eat without nausea, then you are free to go home.  At home, with either surgery, you need to assess incision sites for signs of infection (pus oozing from incision, redness, swelling, fever greater than 100.3, or trouble with nausea and vomiting/keeping food down) and call your HCP if you have any of these symptoms.
*If you have an abscess, you may have a drain placed and put on oral antibiotics, then come back in a week for your surgery.

What happens after I get home?
As stated above, look for signs of infection and call your HCP if you have them.  Also, limit exercise and heaving lifting for the first 10-14 days, but get up out of bed and walk around as much as you can.  When you feel tired, sleep- your body is healing from a major infection and surgery, and the best thing you can do is sleep and allow it to heal.  To prevent a pneumonia after surgery, getting up and walking around helps, but if you feel like you need to cough, do it!  It will be uncomfortable, but hold a pillow over your belly with both hands (pretty tightly as a splint) and cough; it will decrease the pain and allow you to clear your airways.  And talk to your HCP before returning to school/work/working out to make sure that they think it is OK too.

Pain:
You will have pain after your surgery and will be prescribed pain medication.  Try to take it as ordered, and if your pain is still present, even with the medication taken as prescribed, call your HCP to write you or something else. Also, the use of music can help to decrease your pain symptoms and guided imagery; basically distract yourself by meditating or thinking of things that make you feel happiest and best (for example, I think of being really warm on a beautiful beach in Bali, and I imagine everything down to the smells that I remember.)  It helps distract your brain from the pain that you are feeling, and it won't take care of all of your pain, but can help you between doses of pain medication.

Appendicitis is something that can be easily missed by the patient, and it can make you very sick.  So please go to your HCP or ED if you have any of these signs and symptoms.  As stated on earlier blogs, sometimes women will actually have PID (pelvic inflammatory disease) or another STD that will present like appendicitis, so be ready for some questions that you might think are not appropriate, but trust me, they are!!  Get any pain in your abdomen checked out, but especially if it gets worse!

Yours in Good Health
B