Never pass up a chance to sit down or relieve yourself. -old Apache saying

Wednesday, June 17, 2015


Recovery continues with mandatory naps in the afternoon.  This is hard work!!

Once he learned that my white blood cell (WBC) count was off the charts, the first thing the on-call doctor at the River Oaks Emergency Center did was to give me a mega-dose of antibiotics.

Apparently it was one of those newer super-antibiotics that is being used for those bugs that are showing immunity from antibiotics. It seemed a little rash.

I can't fault him. You are confronted with a bacterial infection, you take a standard course. 

But once the CT scan results came in revealing acute appendicitis, it was off to the hospital. 

During my recovery, I ran across this story about treating appendicitis with antibiotics instead of removing it surgically.  Too late for me, but it might save you an expensive and painful experience.

Antibiotics Resurface as Alternative to Removing Appendix

NY Times - May 18, 2015
Every year, 300,000 Americans with appendicitis are rushed into emergency surgery. Most think that if the appendix is not immediately removed, it will burst — with potentially fatal consequences.

But now some doctors say there may another option: antibiotics.

Five small studies from Europe, involving a total of 1,000 patients, indicate that antibiotics can cure some patients with appendicitis; about 70 percent of those who took the pills did not require surgery.

Patients who wound up having an appendectomy after trying antibiotics first did not face any more complications that those who had surgery immediately.

“These studies seem to indicate that antibiotics can cure appendicitis in many patients,” said Dr. David Talan, a specialist in emergency medicine and infectious diseases at the University of California, Los Angeles. “You at least have the chance of avoiding surgery altogether.”

Dr. Talan and other researchers are planning a large clinical trial to compare people with appendicitis who receive antibiotics or surgery.

By suggesting an antibiotic alternative, the researchers are bucking longstanding medical tradition.

Surgical treatment for appendicitis began in the 1880s, when surgery itself was something of a new idea. Doctors struggled to figure out which patients to operate on, because the procedure was dangerous and they knew some patients would get better without it.

As surgery and anesthesia improved, however, the appendectomy became the treatment of choice. According to the medical thinking of the day, it made sense.

For years, doctors thought the appendix — a tiny worm-shaped tube that hangs off the right side of the colon — became inflamed because it was blocked by a small piece of hardened feces. As it turns out, though, the vast majority of people with appendicitis do not have such a blockage.

“No one knows what causes appendicitis,” said Dr. James Barone, a retired chairman of surgery at Stamford Hospital in Connecticut and Lincoln Hospital in the Bronx.

And an inflamed appendix is not, as most people think, a ticking time bomb. While perforation occurs in 15 percent to 25 percent of patients, researchers hypothesize that those who get perforations may have a predisposing immune response or infection with certain kinds of bacteria. In others, appendicitis goes away on its own.

Nor is the length of time that an appendix is inflamed necessarily linked to the risk of perforation. Most people with a ruptured appendix already have it when they show up in the emergency room.

The planned clinical trial pitting antibiotics against surgery will attempt to answer important questions. Are antibiotics as good as surgery in curing appendicitis? Could they do so at less cost, avoiding a hospitalization afterward?

How often does appendicitis recur after a person is treated with antibiotics? Will patients successfully treated with antibiotics later rush to the emergency room every time they feel abdominal pain?

It’s even not clear how the drugs should be administered.

More at the original.

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