My Laparoscopic Appendectomy

A trip to the Emergency Room

Our last weekend started like any other: reading books, watching movies, and hanging out with friends. The nausea began Saturday afternoon while we were enjoying a good cup of tea and an interesting conversation at J-Tea. I chose to ignore it at first and attributed it to my overly abundant fresh fruit snack. But the nausea continued, eventually followed by sharp stabbing pains in my back. While my husband was driving me home, I threw up for the third time in my life; at this point I knew something was really wrong. I decided it was probably food poisoning and began self-medicating with mineral water, Swedish bitters, and probiotics. By 9pm I developed a 102.4 fever and chills. I took some Tylenol PM and went to bed thinking maybe I had the stomach flu.

On Sunday morning I woke up feeling much better; no fever, no nausea, only a slight dull pain in my lower abdomen. I decided I was well enough to go to work. I believed perhaps I simply had a 24 hour bug. However, by the end of the day, the pain centered in right side of my lower abdomen and began shooting painful stabs in my back and gut. I began to suspect appendicitis. After looking up the symptoms online and talking to my mother-in-law (an RN), Clayton rushed me to the emergency room. Unfortunately, our fears we confirmed after four hours of blood tests, urine tests, and ultra sounds.

I had many wonderful people visit me while I was in the hospital.
Thank you all for loving and caring about me.

The ultrasound confirmed that my appendix was inflamed - but not ruptured - on Monday about 1am. The doctor scheduled my surgery for the next morning as early as 8am. I was in complete shock at this point. I had never been cut open before. I didn't want them to take out my appendix. I was extremely healthy - even the doctor mentioned that when he saw my blood tests. I could fight this swelling on my own terms. Somehow I wanted to cling to the notion that if he would release me I could get the swelling of my appendix down via good diet and exercise. The doctor agreed with me that a very small percentage of people go home and their appendix gets better, but that in the majority of people however it ruptures. He explained that he was not willing to take that risk, and my husband agreed. Looking back, I am glad they were so adamant about it. They were both right and  I was not accepting the reality of what an acute appendicitis is.

Acute appendicitis is different from a ruptured appendix. The latter is a much more severe case; it requires multiple complicated surgeries and a recovery period of more than two weeks. Not going in soon enough after one's appendix ruptures can be lethal. Now looking back I am thankful that I am alive and that we went in before it became a matter of life and death. I am glad that my husband and the doctor had more sense than I and explained what would happen if the appendix ruptured at home.

Later that night I was given a room in the hospital and Clayton was allowed to stay with me overnight. I would like to say that I slept the rest of the night but between the routine check ups from the nurses, my own abdominal pains, and fears plus the IV in my arm caused me to just lay there watching the sunrise and imagining myself eating a grass fed steak (at this point I hadn't had a real meal in 24 hours).

Two days post surgery,
The nurses were impressed how quickly I was healing.

Laparoscopic Appendectomy

The surgery lasted only forty minutes. It was preformed via the innovative technique of laproscopy, wherein the operation is carried out through two or three tiny incisions, into which small video cameras are inserted to augment the surgeons vision. This surgery is less invasive, leaves less scarring, and shortens the recovery period. Unfortunately this procedure can be done only on patients whose appendix is not ruptured.

I was put under general anesthesia and I have to admit it is one of the oddest experiences I ever had. It as if I ceased to exist for forty minutes. When you fall asleep it is a gradual process and your brain continues to fire images and synapses, general anesthesia shuts down your body completely. Even the lungs can't function by themselves. Once I was awake, it took me a few minutes to comprehend that it was all over. I still thought I was going in for the surgery. They put a cell phone to my ear and I was able to hear my husband's soothing voice assuring me that everything went well. Being wheeled down the hallways in a post surgery bed made me thankful for the body that I have and reflect on the fragility of human existence. Less than twenty fours hours ago I was enjoying a cup of tea with my friends perfectly happy and healthy. This ordeal began as sudden as a thunderstorm on a clear, hot summer day.

Post Surgery Thoughts

Six days post surgery. Our body's ability to heal  is amazing!

I spent the first 24 hours post surgery in the hospital. The total recovery period in my case was five days. I am on day six today. While I was laying in bed I was given 3 rounds of antibiotics and offered more pain meds than I could imagine taking. One nurse mentioned between her teeth that I am given a lot of antibiotics which means that when I go home I should take a lot of probiotic supplements and vitamin C. No one else, including my doctor, mentioned anything about that, and I got the feeling that the nurse was "over-stepping" her boundaries. The first drink I was offered when I came back into my room after the surgery was Sierra Mist. I opted instead for the homemade broth my friend brought me.

It is not my purpose here to criticize the medical establishment. Indeed, I am very grateful for their efficiency, professionalism, and knowledge. If this happened even fifty years ago the chances of complications would have been much, much greater. However, it does amaze me how little emphasis the medical field continues to put on proper nutrition and its vital role in the human body. I could have eaten a burger from Carl's Junior three hours after the surgery and no one would have stopped me. I wont even mention the hospital food! Ok, just once: the first meal they brought me was spaghetti and bread sticks with a side of grey green beans, and conventional apple juice to drink.

Q & A

I will now answer a few questions that came up through this process for both me and my friends. I am posting the answers here in an attempt to bring clarity to certain issues surrounding the appendix that seem to be universally confusing. If you disagree with any of my statements, or would like to share your own experience/thoughts, please feel free to comment. This blog is a platform for learning and sharing information.

What is the Appendix?
The appendix is a small, closed tube the size of you pinky finger. It attaches to the beginning of your large intestine. It is open at the end that connects to the large intestine and closed at the other end. Material can move in and out of the appendix, but it has nowhere to go.

What Causes Appendicitis?
Some of you have asked me if I know what might have caused my appendix to become inflamed.

A major factor for me was constipation. As a teenager as well as in my early 20's, I didn't eat a very healthy diet. I consumed a lot of processed flour, sugar, and sodas. It was not until two years ago that I began improving my diet; but the damage had been done.

Another factor is holding it in when you really need to go to the bathroom. I have refused to have a bowel movement when I am working many times. I considered it to be unprofessional and awkward. The result is the inflamed, gassy, bloated intestine, leaking fecal matter into the appendix. I am sorry if this is a rather unflattering exposé .

For some people, bacterial and viral infections in the digestive tract can lead to swelling of the lymph nodes, which squeeze the appendix and cause obstruction. Traumatic injury to the abdomen may also lead to the appendicitis. In some cases it can also be the result of a genetic predisposition.

I believe I have been the victim of at least three of the factors that may have caused my acute appendicitis. Looking back, I wish someone would have told me that the consequences of my behavior would result in having an organ yanked out of my body. But I was young and believed I was indestructible.

Is the Appendix Entirely Useless?
Most of us are routinely told by the medical establishment that the appendix is a vestigial, a.k.a. useless, organ, a remnant from our evolutionary past. In fact, a lot of people have it removed before they take off for extensive traveling and visits to foreign countries just to avoid possible complications. Before this surgery, I, like many others, had no idea if the appendix served any function or not. But, after having it removed, I got curious and did some research. I found this article from the Scientific American that explores the important role that the appendix plays in the body.

For years, the appendix was credited with very little physiological function. We now know, however, that the appendix serves an important role in the fetus and in young adults. Endocrine cells appear in the appendix of the human fetus at around the 11th week of development. These endocrine cells of the fetal appendix have been shown to produce various biogenic amines and peptide hormones, compounds that assist with various biological control (homeostatic) mechanisms. There had been little prior evidence of this or any other role of the appendix in animal research, because the appendix does not exist in domestic mammals. 

Doctor Loren Martin Professor of Physiology at the Oklahoma State University

Dr. Loren Martin argues that appendix removal ought to be done on less of a precautionary basis because the appendix can be successfully transplanted into the urinary tract to rebuild the sphincter muscle and reconstruct a functional bladder.

Recent studies are also confirming that the appendix encourages and supports healthy bacteria in the gut. In fact a healthy appendix is populated by a lot of probiotics that guard the gut, ready to jump in to help at any signs of bacterial infection, diarrhea, or an intense treatment with antibiotics says William Parker PhD, assistant professor of experimental surgery at Duke University Medical Center.

The appendix does not only support the gut flora it is also rich in infection fighting lymphoid cells which helps support the immune system.

In this context, the function of the appendix appears to be to expose white blood cells to the wide variety of antigens, or foreign substances, present in the gastrointestinal tract. Thus, the appendix probably helps suppress potentially destructive humoral (blood- and lymph-borne) antibody responses while promoting local immunity. The appendix - like tiny structures called Peyer's patches in other areas of the gastrointestinal tract - rakes up antigenes from the contents of the intestines and reacts to the contents. This local immune system plays a vital role in the physiological immune response and in the control of food, drug, microbial, or viral antigens.  Doctor Loren Martin Professor of Physiology at the Oklahoma University

The appendix doesn't seem to be as useless as some medical experts might lead us to believe. Yet when it is inflamed and infected the appendix ceases to play the important role that it was designed for and it begins instead to leech infection into your body. I am not speaking against having you appendix removed when it is infected. However I am speaking against having your appendix removed for prophylactic reasons. Some doctors will remove it for precautionary measures while they are preforming other surgical procedures. When a doctor asks you if you would prefer to have your healthy appendix removed be informed and know what you are choosing to live without.

Even if you are like me and you don't have an appendix anymore it is important to know what roles it played in your body and how to aid your body in compensating for the loss. In my case I will be supplementing with a lot more lacto-fermeted foods and probiotics. I will also try to keep up with some of the research on this particular topic to find out if there are new discoveries related to the loss of the appendix I should know about.

Closing Thoughts
Now at twenty six I feel more vulnerable than ever. This surgery was a good reminder that the human body is highly sensitive and needs to be handled with a lot of care. It is an incredibly humbling experience when your body  is communicating  that one of your organs is in distress and the only thing you can do is to have it removed. I am grateful the surgery went so well and we got the inflamed appendicitis before it ruptured but I am also aware of the huge physical and emotional stress I put my body through. Part of me feels extremely overwhelmed with the task of recovery and readjustment my body is going through. For this reason I am trying to take one day at a time and really listen to what my body needs. It is one of the most valuable and fragile assets we, human beings, have.

To read part II, an update a year later with more questions answered go here.