MY HEALTH EXPERIENCE:Having your appendix out in your mid-40s is a bit unusual, writes SYLVIA THOMPSON
I FEEL like a bit of a fraud writing a health experience on my minor surgery compared with the traumatic conditions that often feature in this slot. Yet, minor surgery is a common health experience for many people, and if you’ve never been in an operating theatre before, it’s a shock to the system and, in my case, an out-of-the-blue, unexpected event. So here goes.
It all started with a general feeling of discomfort after dinner, similar to indigestion. As the pain got stronger, I took mild analgesics and headed for bed for an early night. But, as with most pain, it got worse during the night. Now extending right across my abdomen, it began to feel more like early labour pains.
I took more painkillers and tried to sleep, but found I was up and down all night, feeling nauseous. As daylight broke, I found myself dry-retching in the bathroom and taking more pain killers.
The next morning, I went to my GP who examined me and said that she needed a second opinion on what she thought was either gallbladder or appendix pain. Within half an hour, I was in the reception of the emergency department in St Columcille’s Hospital in Loughlinstown, Dublin. At this stage, I was bent over in pain and hoping I would be called soon. The pain itself had become much more focused on the right-hand side of my body below my ribcage.
I was first seen by a nurse and soon after by an emergency doctor. I was thanking my lucky stars I was in a small hospital with an emergency department that was busy but not chaotic. The doctor examined me and also said she wasn’t sure if the pain was coming from my gallbladder or my appendix.
I was given stronger pain killers and asked to wait to see the surgeon who would then decide whether I would be sent for a scan. Now exhausted from a poor night’s sleep and no food, I dozed on and off, waiting for the surgeon to come.
And then finally, the surgeon – in fact two different surgeons – came to examine me. One diagnosed the pain as coming from the gallbladder and the other said it seemed like the appendix. And so, one realises the value of scans to pinpoint the exact site of the pain: the problem was the ultrasound scanning was completed for the day, so I had to wait until the morning.
I was put on intravenous fluids. I asked for more pain relief, lay on my trolley and tried to rest as much as possible, filtering in and out nearby conversations of kidney stones, colonoscopy investigations and personal stories of life and death.
The next morning, I was sent for a scan at about 10am and a nurse scanned my entire abdominal area. Together with the consultant doctor, they diagnosed the appendix as the source of the pain. The appendix is a tubular extension of the large intestine. No longer deemed to have any specific function, it is usually removed when it becomes painful and inflamed.
I was returned to my trolley in the emergency department where I was asked to sign a consent form for surgery. Within what seemed like minutes, I had a bed and I was lined up for surgery. No sooner was I in my designated bed that I was asked to change for theatre.
Just at this point, I felt a little panicked, wondering whether this was entirely necessary (never having had a general anaesthetic before, I now put that down to nerves). I was wheeled down to surgery. Within minutes, I was meeting the anaesthetist again and was out for the count.
I came to in the recovery area and was wheeled back to my ward. It all happened so quickly. But, although I had some wound pain from the keyhole surgery, I knew instantly the previous pain had gone.
The surgeon came to tell me that I had acute appendicitis from an appendix that was in a bad state for some time. Acute appendicitis is the result of inflammation of the appendix when bacteria or other waste materials get lodged in it. I was given intravenous antibiotics and was in hospital for two more nights. By then, I was feeling stronger, but spent about another 10 days at home recovering, each day feeling better and better.
Having your appendix out in your mid-40s is a bit unusual, so once you tell your story, you hear of how many people had their appendix out as children. You also hear horror stories of gangrenous and burst appendix whose poison spread into the whole body, occasionally resulting in death. I felt lucky – lucky that my pain was manageable, lucky that my GP sent me to hospital straight away, lucky that I had surgery within 24 hours of arriving there.
I was impressed with the communication between doctors, nurses and patients in a small public hospital. The idea of moving minor surgical operations for the likes of appendix from these small units seems completely unjustified.
Laparoscopic surgery: the facts
Once considered a tremendous technological breakthrough, laparoscopic surgery is now the most common way to investigate and remove the appendix. Two small cuts are made in the skin (to the left and under the navel) and another larger one in the navel itself. The latter is used to insert the laparoscope, which is attached to a monitor to view the internal organs. Carbon dioxide gas is passed into the abdomen through a small needle to inflate the abdominal cavity and move the intestines out of the way. The surgical instruments are then inserted just under the skin through the small incisions and guided across to the appendix which is clamped, tied off and cut away. Laparoscopy is done under general anaesthesia. One of the biggest advantages is that it is not necessary to cut through abdominal muscle to get to the appendix, which results in much faster recovery time. If the surgeon can't access the appendix with this method, he/she will revert to an open incision instead.
