Well after my son’s appendectomy Sunday, I learned a lot about symptoms of appendicitis that I thought others  might find helpful.  When we were trying to decide if we should go to the hospital, I searched the web for information and although I found some, I learned more in the process and so I thought adding that knowledge to the web for others searching would be helpful.

I will start with our story and then summarize the information I learned.

My son is 16.  He has some special needs.  He came to us around 4 pm and said his side hurt.  We looked and didn’t see anything visible so we told him to let us know if it got worse.  Around 7:00, he said it still hurt.  I had him lie down on the couch and point to where it hurt.  It was low and on the right side.  Way low and way to the right, not in an area associated with a usual tummy ache and his other side didn’t bother him at all.  We felt his head and it felt warm.  His temp was 99.5.  Due to the location of the pain, we looked up appendicitis, it said the symptoms were:  temperature under 101, nausea and vomiting, and of course pain in the lower right side.  Since he had pain and barely a fever, we continued to wait – but it wasn’t long before his temp rose to 100.6 and he said he felt sick to his stomach.  That was enough for us to decide we were going to go to the ER.

At the ER, the check in lady didn’t really take us seriously as she wrote “abdominal pain,” and then we had to wait.  He was feeling terrible.  By the time we finally got called into triage, the check in lady said she needed his weight but he could barely walk and couldn’t stand any longer.  She didn’t seem to care about that but I was firm, he needed to sit first.  He asked for a bucket and Joe was going to give him the waste basket but the check in lady wanted him to have one of those pink trays, however, she couldn’t find one.  She said, “wait a minute,” and left the room to find one.  Right, let me wait to puke… not going to happen, while she was away, we grabbed the wastepaper basket and he started throwing up.  She eventually came back with a pink tray and switched that out, it seemed stupid, he was already using the waste basket!

Afterwards, she realized she wasn’t going to get his weight and maybe he had an appendicitis!  She got help and people started moving now that they were taking this seriously.  She got him into a room while she took his history from me.  Here are the other things that I didn’t know were also things to look for in an appendicitis:  it hurts to walk.  She asked him that and we told her yes, it was obvious, he couldn’t even stand!  There is also supposed to be rebound pain, when you push, it  hurts the the releasing of it causes more pain the the pushing.  He didn’t show this but he isn’t really good at differentiating that sort of stuff.  They put in an iv and gave him anti-nausea meds, both those things helped a lot.  They took his blood and it showed an elevated white blood count of 1700.  They were going to do a ct scan that would require him drinking 2 liters of contrast, waiting 1.5 hours for the contrast to get where it needed to go, doing the scan, and then waiting for the doctor to read it and it could give a false negative.  So, the ER doctor, who was great, called his  buddy at the hospital (we were at stand alone ER) and told us that with all his symptoms:  the location of the pain, the fever, the vomiting, his age (this is a common age for this), and his white blood count, he felt fairly certain it was an appendicitis and that we should go have the surgery.  We agreed and they transported him to the other hospital.

We arrived and had to wait until the surgeon was ready.  My son had intermittent pain and they gave him pain meds.  Finally, they took him in at 4:00 am.  We had went to the ER at 10:00 pm.  The surgery was done in 1 hour.  It was laproscopic.  He had 3 small cuts.  He didn’t wake up (from sleeping, not cuz of the surgery) until 2:00 pm the next day and we went home about 1 hour after he woke up.  He has been in mild pain and only takes Norco every once in a while.  They do use CO2 gas to blow everything up to see the organs and his stomach is bloated and he feels pain from that (which pain pills don’t help with).  He will stay home from school for 1 week.

The surgeon said his appendix was inflamed but not ruptured.  We had caught it early which I am really glad about.  Strange enough, my neighbors son also had an appendectomy last week but his ruptured and he has been in the hospital for over a week now.  This just shows you that you should not wait, if you have the signs, check it  out or the recovery can be sooo much harder, never mind life threatening.

So – if you are wondering – do I (or my child) have appendicitis?  Should we go to the ER?  Here are the symptoms to look for:

1.  Fever of 99-101 (I guess it could be higher if you have ruptured and it is really serious but at that point, you won’t be reading here, you will know you need to go!  If it is pre-rupture, usually the temp is on the lower side – my son was 99.6 and then 100.6).

2.  Pain in the lower right abdomen – it is pretty low, well below belly button.  The doctors say it can move and start out higher and then end up lower.  I asked my son if he had pain before he told us about it and he did say yes.  Also, check the rebound test – if the pain is worse after you release, head out to the hospital – but if not, that doesn’t mean it isn’t an appendicitis as my son didn’t really feel  it was worse.

3.  Nausea and/or vomiting – it was when we hit 3 symptoms that I decided that it might not just be a virus.  Remember that most stomach viruses are not accompanied by fever.

4.  Hurts to walk – I didn’t find this anywhere online but the doctors in the ER all asked this.  My son found lying down helped him a lot but walking made things much worse.’

5.  Raised white blood cells – of course, this has to be done at the doctor / ER to find out.

Also don’t wait until it ruptures, if you think you have these signs, get it checked out.  Dealing with a ruptured appendix is not something you want to deal with.  So, I hope this helps if you are looking for symptoms of appendicitis.

Let’s start off from the beginning.  I started having VERY (and I won’t be graphic but I mean VERY) heavy periods and bad cramping.  I went to a local GYN doctor and he examined me, did a pap and ordered an ultrasound and endometrial biopsy.  From the exam he said my uterus seemed a bit enlarged.  The ultrasound showed 1 small fibroid (probably not the cause of my bleeding) and a thickened endometrial lining.  After much reading on the internet, I was told by MANY women that an in-office (with just Motrin for pain) endometrial biopsy was EXCRUTIATING.  I told the doctor that I just couldn’t do it awake.  He told me that my pap had come back abnormal so he would refer me to a GYN Oncologist anyway.

At GYN Oncology, I was examined again and got conflicting information from the 2 doctors – but she did agree to do a cervical biopsy (for the abnormal pap), a D&C (and get my endometrial biopsy that way), and a hysteroscopy (looking inside the uterus with a camera) under general anesthesia and then we would proceed from there.

I  went to same day surgery for that and tolerated things very well.  The worst was that the anesthesia guy couldn’t do an IV to save his life.  It took 4 attempts with Lidocane that was quite painful.  Post surgery, I woke up nicely, bleeding was minimal, and I went home.  I was up and about within a couple days, just taking it easy.

The pathology results came in and all was clear of cancer!  Thank God!  So, the doctor referred me back to a regular (but different – I wasn’t going back to doctor #1 as he was terrible) GYN doctor.  I chose to cancel that and go see my GYN doctor from 12 years ago because she is the most amazing person and doctor.  She had delivered my 12 year old son back when she was doing both OB and GYN.

She told me all of my options:  Birth control pills, Depo Provera shots, IUD, ablation, and hysterectomy.  I gave it a lot of thought and decided that the hysterectomy was the best choice for me as it was a guarantee to fix my problems, the other solutions may or may not have worked and I did not want to be back dealing with all of this again in a year.

We scheduled the surgery quickly.  Two days prior to surgery I had to do a bowel prep.  I drank Magnesium Citrate (Cherry).  The dose said 6.5-10 oz for an adult.  I went with the 6.5 oz.  The stuff was nasty and one more sip would have made it all come up.  It took 7 hours to work and I went about 15 times (didn’t get sore but did use baby wipes).  I was on an all liquid diet at this point too.  The next morning I had 2 more episodes of diarrhea.  I didn’t eat much that day just 1 milkshake and  a bowl of cream of chicken soup broth.  I took 2 days of antibiotics and 4 days of acidophilus.

We got up at 4:30 am to leave at 5:00 so we would be at the hospital at 5:30am.  We then waited without much interaction from the hospital staff for 2 hours.  I did get an IV (one stick, yeah) during that time.  I had a terrible headache from not eating so they let me take 2 Tylenol with a sip of water.  It helped a lot.

Finally they came in at 7:30 and gave me a dose of “happy meds” in my IV.  I don’t remember anything after that until I woke up.  Waking up was HARD.  My incision site was VERY painful.  I remember asking for pain meds and going back to sleep.  Apparently they want you to breathe while sleeping though – which apparently I was not doing.  The nurse said no more IV pain meds until I could remember to breathe!  I tried and was somewhat more successful.

Once I got stabilized with pain meds, I was still very sore but better.  I had to go to the bathroom (the cath was taken out before I woke).  The first bathroom trip was in a wheel chair, painful, and not too rewarding (just a small amount that burned when it came out.)  I felt very weak and sore after the trip.

I got back and bed and kept dozing off.  My throat was very sore from being intubated.  I asked for a popsicle and felt much better after having one.  The sugar and the cold was helpful.  That was when things started getting better for me.  It was slow but now that I was on top of the pain meds, the sharp pains in my incisions weren’t as bad.  I had one bout of feeling like I would throw up but that quickly passed once I was lying down in my bed.  I had to use the bathroom again and  had a nice “normal” event and “passed” my tests including walking to the bathroom.

The nurse wanted to start me on oral pain meds but wanted me to eat a cracker or two first.  She gave me a package of Graham Crackers.  The problem was that my mouth was SOOOOO dry (I had a patch of med behind my ear to also help with nausea and it makes your mouth turn into Cotton Mouth) that I couldn’t eat the cracker with a sip of liquid for each bite.  I finally got the cracker down and she gave me liquid Lortab (ughhh, nasty tasting stuff!).    Once that kicked in, I felt really good, only mildly sore.  I walked to the bathroom a third time (they used up 3 liters of IV solution!) and did well.  I told them I was ready to go home.

My doctor came and talked to me.  She said my uterus was quite large and she thought I was going to feel so much better once I healed.

At 1:30 pm (6 hours from start to discharge) we went home.  I was comfortable on the way home but did have to stop once to use a bathroom AGAIN!!!  They told me to stay on top of the pain pills (taking Percocet) and the nausea meds.  We got home at 2 pm, I took 1 nausea pill and by 3 pm I was in a lot of pain from the incision site again – I was supposed to wait until 4:30 for the pain pills but couldn’t do it and took it early.  I have been doing great since.  I haven’t even had to nap.  Just typing on the computer, talking to my kids, and still going to the bathroom a TON.  There is no bleeding (a tiny bit of brown discharge sometimes).  I have 3 incisions.  One is in my belly button and one on either side.  The left side is the one that hurts, it is bigger (about 2 inches) and is where they had to take the uterus out from.  She did my LEEP, removing a cone of tissue from my cervix and stitched it up.  I weigh 6 pounds more than I did this morning when I weighed myself, all water weight.  I am hungry, awake, and in no pain as long a I don’t move a lot and stay on the pain pills.  My doctor said that Thursday and Friday will be harder days as my insides “wake up” from the anesthesia.