What Happened to Appendectomies?

An appendectomy is the surgical removal of an appendix. But there's been a weird pattern in the incidence of appendectomies over the last few decades.
☠️NONE OF THE INFORMATION IN THIS VIDEO SHOULD BE USED AS MEDICAL ADVICE OR OPINION. IT IS FOR GENERAL EDUCATION AND ENTERTAINMENT☠️
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📜 S O U R C E S 📜
Fully annotated script here: / what-happened-to-99447631
Appendicitis (2024) www.ncbi.nlm.nih.gov/books/NB...
Appendectomy (2024) www.ncbi.nlm.nih.gov/books/NB...
Three Centuries of Appendicectomy (2023) www.ncbi.nlm.nih.gov/pmc/arti...
The Case Against Appendectomies (2018) www.nytimes.com/2018/11/19/we...
A Brief History of Appendicitis (2014) cbc.org.br/wp-content/uploads...
Historic Phases of Appendicitis (2011) www.ncbi.nlm.nih.gov/pmc/arti...
Berengario da Carpi (2019) www.frontiersin.org/articles/...
Da Carpi (1530?) www.google.com/books/edition/...
Heister (1754) upload.wikimedia.org/wikipedi...
Copland (1853) www.google.com/books/edition/...
Fitz 1886 Paper iiif.wellcomecollection.org/p...
Mcburney (1895) www.ncbi.nlm.nih.gov/pmc/arti...
NEJM Commentary on Fitz’s paper (1935) www.nejm.org/doi/full/10.1056...
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⌛T I M E S T A M P S ⌛
0:00 intro
0:40 Discovering the Appendix
7:37 Appendicitis Becomes Surgical
12:30 Is Appendectomy Worth It?
#historyofmedicine #medicalhistory

[@PatKellyTeaches]

I've got Patreon exclusives now! If you sign up at $2/mo or higher, you'll get to see my descent into madness as I try to figure out the history of Neosporin. It was way harder than expected. More exclusives coming soon.

[@typerightseesight]

How come all the s's are f's without the -

[@typerightseesight]

Ohhh, ty. @@deus_ex_machina_

[@bensantos3882]

I wrote a long reply to your video, if that will help get your story trending more for the algo.

[@Mike-xh7wb]

Galilean was not Roman, he was from today’s modern Turkey .

[@bobsmith6544]

Holy crap. Awesome video! My cousin's wife had her appendix removed in 2012, then almost immediately developed a still undiagnosed illness that keeps her from holding down food. I guess it's similar to lupus. She had very good health care and her father is a biochemist who develops drugs, so she got to see every specialist in the country. She is still alive and doing well; but has had a feeding tube in her stomach for years that will never come out. She can eat quite a bit of food normally though. Oh, and she was bulimic. So it's unsaid; but I'm sure most of us are blaming it on that.

[@duckiekraft6893]

My appendix exploded in the surgeon's hand. It was full of gangrene. That surgeon tried DESPERATELY to put me off until the next morning because he was insistent that since I was a girl, it couldn't be appendicitis and MUST be an ectopic pregnancy. I was TWELVE and a virgin. Thank God my mother was my greatest advocate. She basically told the hospital if they didn't get me in for surgery to remove what she was sure was appendicitis, she'd just have to do it herself. Had I been put off until morning, like the surgeon wanted, it wouldn't have mattered if it was ectopic pregnancy or an exploding appendix, I would probably be dead. Thanks Mom.

[@melissaharris3389]

An ectopic pregnancy is even more time sensitive them appendicitis. An appendix _might_ burst and _could_ cause death A ruptured ectopic pregnancy _would_ cause massive internal hemorrhaging and can be fatal. That surgeon was lazy and misogynistic. Good on your mom.

[@thisismyuniquestory]

Wonderful outcome, well done Mum UK

[@jamesmcinnis208]

You really need to take your mom to lunch!

[@leagarner3675]

I truly recognize your description of how you were treated by the doctor and hospital.

[@RaspberrySuprise]

ER dr's kept calling my wifes dieing and eventaully ruptured appendix round ligament pain from pregnancy. Because they didn't do anything until it ruptured she got to get cranked full of super strong anti biotics while pregnant.

[@danabryant3023]

My appendectomy in 2008 came with a carcinoid tumor as the cause. In my case, an angry appendix saved me from something potentially much worse. Thanks, little bud! RIP

[@PatKellyTeaches]

Glad you're around to tell the tale!

[@dianeshaw1145]

My appendectomy in 2008 revealed a case of pseudomyxoma peritonei (appendiceal cancer). I had HIPEC surgery which has kept it at bay, though it's still hanging around. So definitely there are times removal of the appendix is a good idea.

[@candinunya5211]

Oh cool I work where I have a lot of hipecs and I was really hoping they had good Stat survival rates but they dont share that kind of data w me as my role is more of the acute nature.

[@dianeshaw1145]

My HIPEC was in 2009; the 2nd of 3 surgeries for the condition. I get annual MRI's to see if any problems are redeveloping. So far, having a very normal life and quite grateful for it. I appreciate the work of all involved in taking care of these patients, and I thank you too for your work!@@candinunya5211

[@SeaforgedArtifacts]

Crazy, I had the same thing nearly 10 years later, I was told it was very rare

[@DavidKutzler]

I'm a retired nurse-midwife and have delivered >3600 babies. Interestingly enough, the incidence of appendicitis in pregnant women is identical to the incidence in non-pregnant women. But, the mortality and morbidity of appendicitis in pregnant women is double that for non-pregnant women. It is speculated that it's so easy to dismiss abdominal pain in pregnant women that the symptoms of appendicitis tend to be neglected until it unequivocally declares itself as overt peritonitis.

[@Beepinsqueekin]

My appendix started to rupture when i was 5 months pregnant with my daughter, I thought I pulled a muscle hanging wallpaper! Called my Dr, and I was in surgery within 2 hours! Good call, doctor !!

[@phillipsusi1791]

That happened to my wife with our first born, only instead of appendicitis, it was her gal-bladder. She tried to tell the doctors that she had massive family history of needing their gal-bladders removed, but they said she had HELP syndrome, and the cure was to induce delivery and when that failed, go to c-section. 6 weeks later she was back in the hospital having her gal-bladder removed. That interrupted lactation and so we had to switch to formula.

[@happyash6048]

My mom had appendicitis while pregnant in the 70s and they dismissed it as morning sickness even though she was in the 3rd trimester and hadn't had morning sickness previously. She lived, the baby did not.

[@Beepinsqueekin]

@@happyash6048 oh my goodness. I am so sorry! 😞

[@shadowmax889]

That's because obstetricians are very bad at diagnosing appendicitis, and because the symptoms do no present in the same way as a non-pregnant woman it often goes undiagnosed until it is too late

[@britty23]

My dad had his appendix removed in '95. However, they failed to realize he had been on narcotics for severe back pain. So, what they thought was appendicitis was actually just a severe case of constipation... 😮 Edit: the real horror story is when he finally got an enema and everything came out. He loves to tell the story of how he was sitting on the toilet throwing up because of the smell while also taking the most massive dump of his life.

[@erzsebetkovacs2527]

Was he on opiates?

[@britty23]

​@erzsebetkovacs2527 Yeah. And back then, the doctors were just handing them out like candy. My dad had no idea it could lead to that. He never took them again afterward.

[@thegoon1353]

from the stories I've heard opiates make you crap mountains

[@StepDub]

That was tough s***

[@Alexagrigorieff]

@@britty23 Elvis Presley died because of impacted megacolon, caused by opioids.

[@jessicahay9305]

I had mine taken out in high school. Id been hurting on and off for months until one day at school i started getting nauseous, started vomiting and the pain got so bad i couldnt stand and i had to crawl all the way up the hall to the school office, where the school "nurse" (not a nurse) called my mom and told her i was having cramps, so of course she wasnt in a hurry to get someone to come get me. My grandmother finally showed up, took one look at me and rushed me to the ER who took me into emergency surgery. It had ruptured.

[@AnnaVannieuwenhuyse]

Cheers, grandma!

[@user-uh4nh3yl2s]

Clearly not as bad as you, but I broke my foot goofing off during recess. Teacher didn't believe me, made me wait like 30 minutes before she let me hop on one foot to the nurses. Nurse didn't believe me, made me hop back to class. My hopping made her second guess herself, so she had me hop back to her office half way, and called my folks. Showed up the next day with a cast on my foot. People suck

[@laa4438]

I went to the hospital with a broken foot. Nurse scoffed that you dont get breaks in the side of your foot. So I went home and duct taped it. I looked it up later and you do get breaks there and they usually need pinning.

[@longiusaescius2537]

Chad meemaw

[@bickyboo7789]

​@@user-uh4nh3yl2s an old buddy shattered his wrist while drunk in public trying to steal booze. He was thrown in jail and no one believed him that he broke something, despite a shitload of swelling and him being unable to move his hand. His nurse mother finally picked him up and freaked out and rushed him to the hospital. He spent 4 days in jail as his mother wanted to teach him a lesson, thinking he was exaggerating his injury over the phone.

[@darriansea]

"dissections were considered kind of an icky thing" - wow we really do have so much in common with the past

[@squirlmy]

there were probably a lot of religious objections, to this day several religions prohibit dissections of human, it is considered disrespectful of the person. There's really some interesting stories of how this eventually changed in Europe. Michelangelo's "God touching Adam" is actually a good depiction of a cross-section of the human brain. Michelangelo had been in a lot of trouble for dissecting human corpses, but he secretly shared his knowledge, right on the ceiling of the Sistine Chapel!!!

[@MegaVHF]

Bisect has a long "i" because there is only one "s." People want to pronounce dissect to rhyme, but it doesn't. "i's" are always short before a double-"s."

[@MichaelKingsfordGray]

They were considered "icky" because the Church lied to them that dissections were evil.

[@ShoutItFromTheHousetops]

🤣

[@Alden_Indoway]

@@MegaVHFI disagree. (Or should I say dissagree?)

[@whiskeytango9769]

My daughter suffered from a burst appendix when she was 14 years old. Her pain was severe, but for some odd reason, the doctor in emergency did not think it was appendicitis and sent her home. My wife took her to our family doctor the next day, who immediately referred her to Children's Hospital. Her fever, vomiting, and white count indicated a severe infection and the ultrasound of her appendix indicated that it was badly inflamed. Emergency Lapro surgery got rid of the burst appendix and the doctor said she had to suction out a lot of pus. A stay in the hospital and 5 days of intravenous antibiotics, and she ended up being fine. I always think how close we might have come to losing her then were it not for my wife's diligence. It was a lesson for me to always question the doctor if what they are telling you seems wrong. My daughter is now 35 years old with two kids of her own.

[@fancydeer]

she was a teenage girl with pain where her ovaries/uterus are. doctors/nurses don't take girls or women seriously when we tell them about pain but ESPECIALLY pain in our lower abdomen. it's always ""~cramps~"" like we don't know wtf cramps feel like.

[@whiskeytango9769]

@@fancydeer Her pain was so bad, at one point she sat up and asked us to kill her. The medical staff there were incompetent. I am happy we went to another hospital.

[@Hanna-se3vr]

Welcome to the reality of women’s healthcare. Whenever we are in pain it is dismissed as “lady issues”.

[@runawaytrain9794]

Same experience 2 months ago pretty much 'whiskytango' they sent me home TOO. I could have died. I just posted about it above in this thread.

[@hmeyers5114]

Crying and screaming on the floor pain for a month. It was either: Dr. A - cramps; Dr. B - constipation. The actual problem? Abscessed ovarian cyst bought me a week in the hospital on IV antibiotics after surgery for the infection. Women and girls are "just whiners", don't you know. I'm kind of amazed appendicitis is diagnosed at all in women as endometriosis takes an average of 10 years to get diagnosed. 🤷‍♀

[@missaeon]

Like quicksand, appendicitis is something I thought would be a much bigger danger to me in life. As a kid, I was afraid I would get sick out in the country and have to hope someone would believe me enough to take me to the hospital! This had happened to my dad. But I hadn’t thought about it in ages, and now I know that antibiotics are why.

[@ddegn]

My fear of quicksand has subsided with age but I still keep a watch out for lava.

[@chucklebutt4470]

There was a short story on a recent-ish episode of the podcast This American Life of a woman who was walking her dog on a beach near Boston I think and gets stuck in the sand and nearly died lol. She was talking about how often quicksand was shown in cartoons and movies for a while and how she was pissed she was gonna die that way, it was pretty funny. Also, there are these mudflats here in Anchorage, Alaska, people occasionally die from getting stuck way out during a low tide and then the tide comes back in and they drown.

[@ddegn]

@@chucklebutt4470 Dang it, now I have to watch out for lava and quicksand.

[@jerbear7952]

​@@ddegndude trust me the lava wont be a problem. If in the rare case you do come across some, throw some couch cushions down and just jump across. You'll be fine

[@ddegn]

@@jerbear7952 That's been my experience as well. I'm just worried I might not have a couch cushion ready when I need it. My wife won't let me carry one around anymore.

[@rickwrites2612]

Medievals called it "the side sickness". People would get intense increasing pain there, then itd burst infecting them with bacterium and theyd die of septic shock. Horrific death, could take weeks.

[@altruismfirst6489]

FYI Bread eating Peasants suffered while their Royal owners avoided grains. Rudolph Steiner proved septic shock is a cover up for GT (aka fictional Rockerfxxx foundation and Vaticanus sponsored "Germ theory") the samples extracted from victims by Dr Steiner found evolved Mold strains usually found in breads which naturally fight stomach bacteria and keep feeding on carbs in our digestive systems. These yeasts are often consumed in modern diets as "bakers yeast". The medical industry counters the Bakers Yeast, by administering more potent aka Lab weaponized Molds created as meta killing Penicillin strains to wipe out all other molds and also important bacteria that produce necessary enzymes and have been received from the mother since birth. The high carb diet that in most cases these issues is not identified or considered which leads to surgery as the end solution. Rockxxx Fondation controls 94% of the worlds Medical institutions for a good reason and as an investor you have to always back the worlds largest drug cartel.

[@jeffborders1146]

Bacterium is singular. Bacteria is plural.

[@tedundercarriage8183]

​@@jeffborders1146I've always wondered that. thank you for explaining

[@greendeane1]

I am here today because a great uncle had fatal appendicitis. In seeking treatment my grandfather met my grandmother.

[@one-sidedrationalization1091]

My grandmother got appendicitis on a college day trip to the beach where she met my grandfather. They went to the same school but didn’t know each other. He stepped up, carried her onto a bus, and took her to the hospital. So I am also here today because of appendicitis.

[@bellabear653]

@@one-sidedrationalization1091 You are also here because your grandfather is a nice fella.

[@g.k.1669]

The appendix turned out to be a reproductive organ.

[@fenrirgg]

Appendicitis was meant to make grandparent couples, faxts! 😂

[@erictaylor5462]

A friend of mine got into big trouble when we were kids when one morning, wanting to get out of going to school he did something rather foolish for a kid who's mother was a medical doctor. Because he knew his mother diagnosed sick people as part of her job he knew if he didn't really sell it, she would know right away if he was not telling the truth, so he decided "tummy ache" would be the safest lie. And so he set his plan in motion, and ended up getting an unnecessary appendectomy. He pretended it hurt when his mom poked his belly and the next thing he knew he was in the exam room of his mother's colleague (the hospital had a policy that doctors could not treat their own family members) and again reacting in the same way when the when this doctor performed the same way. He was horrified when the doctor said to his mother, "We'll prepare him for surgery right away." All he could think was, "Oh crap, what do I do now?" He knew the farther things went the more trouble he would be in when when he admitted he was only pretending to be sick. But things went so quickly he hadn't worked up the courage to admit to lying before they pushed the anesthesia. The last thing he thought as he went to sleep was, "I'm going to be grounded for years." His mother shared this part. When she realized he sone had appendicitis she went into panic mode. Because by his reaction to the exam she was sure it had already burst. When her friend came out with a tiny, fully intact, healthy looking appendix she knew exactly what he had done! As my friend revolvered from anesthesia he was surprised to find she wasn't angry. She told him, "I'm really disappointed." He would have preferred angry. "I really thought you were smarter than me." She pulled up her shirt to show him a small scar, bigger than his own new scar. Turns out she had done exactly the same thing when she was his age. She cried her eyes out years later as when watched him receive his medical degree. He really admired his mother, and he decided to follow her. I have to wonder, how many kids have ended up in surgery pretending to have a belly ache.

[@loydanderson-pak2586]

This is exactly how i lost my appendix 😂😂

[@jmarinotripp240]

Thats a really funny story. Had a laugh

[@SuLokify]

Great story and well written

[@mfmr200]

lmao, she is not angry because he is exactly her's. 😂😂😂😂😂😂

[@halonothing1]

That was a great story. I love anecdotes like this. I would read a whole book of little stories like this if I could. I'm sure they exist.

[@Anne_Onymous]

I tried waiting my appendicitis out and it ended up rupturing. Had to get emergency surgery, have all my organs washed, and get major doses of antibiotics to prevent further infection.

[@wholeNwon]

You were very lucky.

[@rodburket4582]

Just curious did you have episodes prior to the perforation? The symptoms started, but then resolved and stopped?

[@MostlyCloudy]

​@@rodburket4582 I did. Mine didn't burst, but the pain stopped "going away" so I couldn't ignore it anymore.

[@julienoe3702]

Same here but was on antibiotics trying to avoid surgery. Surgery was not avoided lol.

[@Anne_Onymous]

@@rodburket4582 It was the first episode I experienced and the pain never went away.

[@srelizabethmaryhermit6450]

I got violently ill on duty on the night shift. My colleagues kicked me into the ER and after blood work and a CT scan I was diagnosed with a hot appendix. The young pup resident told me I was too old to have a hot appy. Whereupon, I was taken back to my ward this time on a stretcher. It took my fine colleagues greater than 24 hours to get me on the table. I spent the next month in isolation on triple threat antibiotics, drains, peritonitis and a purfed cecum and hyperalimentation. Woo Hoo what fun.

[@tygerburning753]

Young pup apologized, right?

[@johnbauman4005]

Young pup was an unread ass. We knew appendicitis could happen at any age for decades. No substitution for applying oneself to the necessary study for patient care. Also, with CT evidence which is VERY strong, you have a case for malpractice or at least free care for all the complications due to delay in diagnosis and bad clinical judgment. If this was a physician in-training, supervision was inadequate.

[@alleecmo]

"too old"?!? If you still *have* an appendix, even at age 120 years, you are still "young enough" to have it get ill. Ditto for tonsils. (Nearly 60 and still have both)

[@doccock100]

@@alleecmo @johnbauman4005 non-surgical management for appendicitis (antibiotics and fluids) and are used in many courtries as first line treatment. In America (where I am assuming you guys are from) an expensive surgical proceedure always will be touted as the best and first option for everyone. In cases of proven perforation or abscess then surgery often cannot be avoided. In cases of straight appendicitis, sugery vs non-surgery is near equivelent. As far as having your tonsils out.. the MASSIVE increased risk of COPD, bronchiectasis and pneumonia should not be understated. It is easy when you are not appropriately educated to believe that there are body parts that are superfluous to requirements, but just because you don't know what they do, it doesn't mean that they don't do anything at all. Just because you have been led to believe that surgery is the only option, it doesn't mean it is (do some research on sham surgery) 'Young Pup' doesn't need to apologise. Young pup used his / her / their best judgement, and as with everything that requires judgement, the situation doesn't always go as you would wish. 'Young pup' would discuss all cases with senior team, and they would have underwritten and agreed with risk assessment. Basis of my opinion, 30y as doctor, lecturer in postgraduate medicine, chief of medicine for large hosptial.

[@thomashockman4972]

Yawn. Your use of cutesy slang and extraneous adjectives made this tedious to read. You should either read a book on writing, or stop writing with the intention of boring the reader.

[@robertsandberg2246]

I read a book about bush flying in Alaska when I was in junior high. One of the stories was about a man who was staying by himself in a hunting lodge way out in the wilderness. He had some medical training and one day realized the abdominal pain he was experiencing was appendicitis. He had some equipment he repurposed for surgery; a hunting knife, some hemostats from a fishing tackle box, some fishing line to sew himself up, (with some needles from a sewing kit, presumably) and a Coleman lantern for light. He performed the surgery on himself as best he could with the improvised medical tools he had. He survived and said something along the lines of "wanting to live is a great motivator to get through the pain." I've always thought that was a harrowing story! I've been trying to find that book for years. I'd like to read it again. Also, in the 1960s, there was a Soviet expedition to Antarctica in which their medic performed an appendectomy on himself. That one at least had localized anesthesia to work with though! Still harrowing though. I think that one is on KZbin.

[@Jones4Leather]

It is currently a requirement to have your appendix removed before staying in the research station in Antarctica. There are several months during the winter when rescue flights are impossible due to the cold.

[@robertsandberg2246]

​@@Jones4LeatherInteresting. Thanks for sharing. I've wondered if appendectomies could be done as a preventative measure.

[@williambowling8211]

There was a published case series of "auto-appendectomies". People who, in similar circumstances to your tale, took out their own appendix. I think there were 18 cases in the paper.

[@SciShow]

Amazing! Loved this, and thanks for writing that SciShow!!

[@PatKellyTeaches]

My pleasure! And thank /you/ for allowing me to work with one of the finest content teams around. Every editor and fact-checker was delightful to work with!

[@oaktadopbok665]

After about 8 hours of appendicitis I was hoping I could die and get it over with. You have no idea- it's not just pain, it's pain and nausea and the most excruciating backache and fever/chills it's a 7th circle of hell.

[@cobramcjingleballs]

Weirdly as a kid I read my mom's 1000 page medical book. My brother got appendicitis and parents just thought it was stomach flu and put him bed and did the normal thing back then: chicken soup, crackers and gingerale. I poked in right abdomen and say oh yeah you need to take him to hospital. Probably saved his life.

[@lonniewhitten813]

I had sudden onset of constant throwing up and great pain in my gut. I also had pain that ran from my right shoulder diagonally to my lower left side. I was admitted to the hospital, put through countless tests and totally drugged up trying to stop the pain. During the first night in the hospital, I felt a “pop”. I told nurse after nurse, and gave the “yes, dear” statement. After one week, the doctors decided to do exploratory surgery because they couldn’t figure out what was wrong. I was turning yellow and laying on deaths door. When I woke up, I had 16 different meds dripping into me (I’m allergic to penicillin). I was in the hospital for 3 weeks. Turned out my appendix did burst and I had peritonitis (yellow as an Easter egg) and my appendix was located in my back, thus the reason they couldn’t diagnose me. Took me 6 more weeks to recover. It was a horrible time in my life, but I lived. It’s been 42 years and I’m still kicking.

[@susiemitchell1198]

The real reason appendectomies are down is because insurance doesn't reimburse the doctor for the procedure if they don't deem it necessary. Insurance companies are running health care now.

[@user-eg4dx6zt9l]

Not where I live thank goodness.

[@robinharwood5044]

Are appendectomies down in civilised countries as well as the US? If so, it isn’t the insurance companies.

[@SeattlePioneer]

Do you have EVIDENCE to support your claim, or is this merely your personal prejudice?

[@SeattlePioneer]

As you suggest, I'd guess that there are a variety of ways to determine whether insurance reimbursement is interfering with patient care. In the absence of such documentation, this sounds like the political supposition. Just guessing, but if there WAS such documentation I'd imagine that we would be hearing lurid complaints about it from surgeons and others.

[@vivianloney]

Absolutely no way doctors are performing emergency surgery less because of health insurance. Legally insurance cannot deny coverage if a patient reasonably believes they are in an emergency. If it gets to the point that a doctor thinks emergency surgery is needed insurance cannot claim the patient should have known it wasn't an emergency and left AMA. That's a bullshit excuse an insurance company might try to use but that's a winnable appeal.

[@EvilDransChannel]

This guy should be way bigger, one of the best new educational KZbinrs

[@user-vr5cb8ye8t]

I want him and the mortician chick to get together, it would be so satisfying to the yenta in me.

[@user-vr5cb8ye8t]

@@user-pl4pz2xn2c WOW disagree

[@weplaytowin]

He just needs better lighting..

[@nastybastardatlive]

I was thinking exactly the same thing. But the way it goes is "the higher the subscriptions, the lower the intellect of the viewers". That's what I see anyway.

[@bluesideup007]

When I did my surgical training (mostly rural hospitals) in 1978-80, one of the well respected, and large statured general surgeons with a deep voice said two things that stuck in my brain my whole career (primary care). First was, "If 25% of the appendixes you're taking out are not normal, then you're not aggressive enough, and one of YOUR patients is going to DIE!" (of course, this all changed in the late 90's and 2000's when high resolution CTs became more widespread. Now it's relatively uncommon to take out a normal appendix) The second thing he said early one morning walking down the hospital corridor after I had done pre-rounds and was to present the surgical cases for the day: I said, "well we have a light day; only two minor cases." He stopped dead in his tracks, and looked down sternly at me, "There ARE NO minor cases, only minor surgeons!" Never truer words that served me well my whole career.

[@williambowling8211]

CT has not improved the diagnosis of appendicitis. The definition of minor surgery is someone else's operation.

[@baxterwilliams2170]

You wrote scripts for SciShow videos?! No wonder you are so good at making quality videos on this channel. You have experience with some of the best!

[@fluffysheap]

Considering that there is a major error - if not outright dishonesty - in virtually every scishow video I'm not sure writing for them is much of an achievement

[@jooleebilly]

@@fluffysheap ::Citation needed::

[@josiee0874]

​@@fluffysheapIf you don't trust the same source what are you doing here 😂??

[@unvergebeneid]

​@@fluffysheaphaha I came here to say this. I hope his research is better than that of Scishow. I never spotted any deliberate dishonesty. Just shoddy research, a poor understanding of science and nobody to look through the comments for people pointing those errors out.

[@barcodenosebleed5485]

I wonder if that's why he started his own channel. Every day at my job I grumble at the shortsighted decision management makes and the hundreds of thousands of dollars being left on the table and fantasize about what I'd do differently. I obviously don't have all of the information; I'm not delusional to think I could wave a magic wand and fix things. But I definitely think the values, the culture starts at the top and some different perspectives could help. Anyway, perhaps he got fed up with the oversimplification, lowest common denominator targeting that seems to infect a lot of media companies and figured he could build something better.

[@666toysoldier]

As a scrub tech, the worst case I saw was a 20-year-old man whose mother "was quite capable of taking care of her son, thank you very much!" By the time she finally brought him to the hospital, his appendix had long since ruptured. He got a midline incision, navel to pubis. His belly was full of infection, and we washed him out with 5 liters of saline. He left surgery with 4 drains in his belly. I don't know if he survived. This would have been between 1977 and 1980.

[@Adri_Unsung]

That’s HORRIFIC, no wonder it’s stuck with you for so long

[@smbrannon]

My wife was diagnosed with appendicitis. I had read about Eriksson and Granström's paper, and my wife and I discussed it, and she decided to go the antibiotic route. We had to be pretty firm with the ER doctor. He acquiesced, prescribed IV antibiotics, she improved overnight and was released. This was more than 21 years ago, and she still has her appendix, and hasn't had a recurrence. I'm just a layman, but I believe we evolved the organs we have as they provide a survival advantage, and therefore we should keep them if possible.

[@ADBBuild]

The alternative argument is that we have evolved to not need it and it is just a leftover of whatever it used to be/do.

[@briandbeaudin9166]

.​@@ADBBuildMaybe it never had a purpose.

[@lenitaa7938]

Or her appendicitis could have recurred or burst! She got very lucky, that’s all! Mine had a carcinoid tumour inside the appendix that was spreading! That is how these tumours get diagnosed! If not removed, a death sentence! Often, these tumours are slow-growing and produce no pain until it’s way too late! A famous Hollywood Indian actor died of it!

[@ImperialFool]

​@@ADBBuildit's sorta useful to the immune system. At least people who get it removed have slightly worse immune systems.

[@smbrannon]

@@lenitaa7938 It wouldn't have reoccurred and burst unless we ignored it. You have to be infected for a while before it gets to bursting. This isn't TV.... And it wasn't luck. It was an informed decision.

[@ahobimo732]

I had appendicitis for a week and probably nearly died because the *multiple* doctors that I saw failed to properly identify what was happening to me. When they finally did an MRI, they had me on the operating table about 10 minutes later. I asked one of the nurses prepping me if I could get my appendix in a jar after they removed it. She said no. Because my appendix was so messed up, they couldn't do the laparoscopy method. They had to actually cut me open to "clean up".

[@mariekatherine5238]

My nephew, aged 13, asked the same thing, for his appendix in a jar to show his friends! They also said no although his was successfully removed laparoscopically.

[@gavincross2902]

Me too. Wasn't until an older doctor saw me. Within 30 minutes I was under the knife. Healing up sucked as well!

[@amando96]

Same here! Seems like it happens often enough for junior physicians to catch it@@gavincross2902

[@terencejay8845]

I had an emergency Appendicectomy (which is the correct name for it) and they found mine was gangrenous. This was after two doc visits where I was doubled up in pain. I was opened up, too. The lasting effect, apart from a purple 5" scar, even 30 years later, is the abdominal adhesions that resulted and have multiplied since, strangling my large intestine.

[@HangtownTactical]

Dude I went through the same thing expect I had it for nearly 3 weeks!! It took three trips to the emergency room before finally a competent dr realized I need emergency surgery. They literally just kept telling my parents I was just constipated and told them to give me an enema

[@emom358]

I used to hear this on Dr. Demento and WFMT Midnight Special. Can't find a good sung version. Wash your hands and get them dry, Keep them clean and keep them high, When you’re sure that you are able, Promenade up to the table, And get that appendix, lay it bare, We’re doing the McBurney Square. Now drape that patient neat and tight, Bare the quadrant of the lower right, Do si do and careful all, While you make an incision in that wall. Right hand under, if you dare, Doing the McBurney Square. Swing that knife blade, with a toss, Along the muscles, not across, With your fingers then induce The peritoneum to work loose. You mustn’t rip and you mustn’t tear, Doing the McBurney Square. When that cavity’s been breached, The secum and appendix reached, Put a purse string suture on the base, And sprinkle gauze pads round the place. Duck for oyster, I declare, Doing the McBurney Square. With a peritoneal cuff inside, Crush, ligate and then divide, Swing your partner, I’ll swing mine, Paint the stump with iodine. Now force it back again with care, Doing that McBurney Square. Tie the purse string very tight, Suture the peritoneum right, Let those muscles settle in, Then count the pads and close the skin. Salute the patient, collect your fee, You’ve done the appendectomy

[@Pallasathena-hv4kp]

Dr. Demento! A blast from the past!

[@prototropo]

Very impressed and happy to find this channel, and particularly this topic. I had an open appy at age 12 in 1964. The pain that alarmed my dad enough to drive to an ER at midnight was truly awful--I was utterly immobilized and writhing on the floor in agony. The surgeon came to my room afterward with my appendix in a jar--it was bulging fat, sickly white, very vermiform indeed. He said it had nearly ruptured, so I guess I'm still here thanks to presumptive surgical Tx. Almost no-one I know, of any age, has had an appendectomy, or even rule-out appendicitis. But most people my age--born before 1960--have had a tonsillectomy with adenoidectomy. All my spare parts now are gone but one--and I'd happily donate my spare kidney if they'd take a 72-y-o specimen. Unruptured.

[@Mercmad]

Tery FB market place. people will buy anything on there.

[@raysitzes2455]

They took My right kidney out in 08 I had colan cancer and they found the kidney cancer on a cat scan said if I hadn't of had colan cancer the kidney cancer would have killed Me because it don't have any symptoms untill its to late so colan cancer actually saved My life

[@nikevisor54]

Can we get a follow up video on how to remove our own appendixes using standard camping gear? Seems like a useful party trick to learn

[@TheDaniel366Cobra]

There was a Soviet surgeon who had performed an appendectomy on himself at an Antarctic research station. He was the only one capable of doing that.

[@dee5298]

​@@shannankane6487 Y not?

[@nancymcnafferson3192]

A party trick you can only use once

[@loopshackr]

@@TheDaniel366CobraThat's why researchers who spend the winter in Antarctica must now undergo an appendectomy before they go down there. Medical evacuation during the antarctic winter is extremely hazardous.

[@andrewrossy]

Whoa. That’d be some party !!! 😂

[@infamouspineapple2175]

I went on a whole side quest learning about the use of “f” as the letter “s” after you showed old writings 😭

[@PatKellyTeaches]

You probably already found this, but it's the long S. en.wikipedia.org/wiki/Long_s

[@JonBrase]

Life, liberty, and the perfuit of happineff...

[@gelelied]

Still in use in modern German as "ß". The Swiss got rid of it by changing it to "ss".

[@alquinn8576]

I still don't understand the long s even after reading wikipedia on it. It seems like it had always been utterly useless, and reading the rules for when it should be used gave me a migraine. as far as I can tell, it was used to make things look fancier by some strange measure.

[@teh-maxh]

@@JonBraseLong S wasn't used at the end of a word, so it'd be happineſs.

[@rickradix7464]

I sent this to my son he just had to make a decision to remove my 10 year old granddaughter's appendix. I have worked in the medical field for 35 years. As shown, the research was developing for some time. Because of recurrence, he decided to have it done, and this gave him concise information. You made this just in time for him. Thanks.

[@maggierose2386]

Retired operating theatre nurse here. During my time - before laparoscopies became common - appendectomies were often left for the junior surgeons for the experience, I suppose. It seemed to me that a lot of pink, plump and healthy appendixes were excised. It wasn't my place to comment, but I couldn't help wondering 🤔 Thank you for this video. It was very interesting and educational.

[@mrjohnyt2932]

Junior surgeon. Not all are sent off for histology. But they can be. And you can have early appendicitis that looks normal grossly. However, the risk is it appearing normal, bailing and the patient becoming severely ill with perforated appendicitis after and you have a lawsuit as well as looking not very smart.

[@miguelservetus9534]

@@mrjohnyt2932Thanks for your addition. Visual appearance does not correlate enough for ruling out appendicitis. Pathological examination is the gold standard but not a good use of health care dollars. The symptoms start at the midline due to the obstructive pathology then migrate to the R Lowe quadrant when the peritonitis begins. So the best diagnosticians get them pink. I never understand the second guessing by those without the knowledge or training.

[@mrjohnyt2932]

@@miguelservetus9534Exactly. There are some meta analyses to suggest you can leave a “pink” appendix in-situ. However, long term follow up is lacking, and I don’t think you would be able to persuade any decent general surgeon otherwise. If you’re in that spot, it’s always out than in.

[@thomaxtube]

@@miguelservetus9534I think it’s good to leave room for second guessing / questioning when we are removing natural parts from a living human body - the treatmet options and opinions need to be able to be questioned and will change and evolve, as we do, just assuming it’s there to be cut out with no other reason to be there, feels short sighted. Although helpful/ life saving in many modern emergency cases.

[@geodkyt]

Addressed in the video itself.. When the appendix was viewed as a vestigial organ with *no current use* , removing it whenever you were in the area anyway wouldn't cause any problems and *would* automatically prevent the possibility of future appendicitis and a potential emergency appendectomy or burst appendix. Given the accepted medical knowledge of the time, prophylactic removal of an appendix when you were doing abdominal surgery *anyway* just made sense. I remember when the medical community was still debating the "apoendix as a gut bacteria reservoir" hypothesis. Before surgeons accepted that a still healthy appendix actually *did* something useful, as far as they were considered there was no downside to removing it whenever you already had the abdomen open.

[@BrianStanleyEsq]

My mother, born in 1925, developed abdominal symptoms ca. 1937. Living in rural SW Oregon, she likely didn't get to well-informed physicians until she was very ill. Anyway, the family oral history is that the surgeons at the principal hospital in Medford acted quickly, performed peritoneal lavage and immediately concluded that the appendix had ruptured. They performed an appendectomy at once but noted that the necrotic appendix and its burst contents seemed to have affected the surrounding tissue. This was well before antibiotics, and she was in a touch-and-go condition for days after the surgery. When recovered, she reported having had a near-death experience, but that's another story.

[@Gemini_Mama]

I would love to hear the near-death story - I find them fascinating!

[@joywebster2678]

In the 1980s surgeons were removing appendixes any time they were in the open abdomen for other purposes. As a Nursing student observing in ORs this was oft-repeated. Remove so theres no future problem, while doing a gall bladder removal etc.

[@Jkstolz]

Because taking more organs means a quicker death.. population control via medical mistakes.. was the leading cause of death, before 2019

[@badAtPickingUsernames1988]

I heard they used to do that with tonsils and abnoids too. I had a teacher in middle school who recounted how the doctor visited their house and took out everyone's tonsils and abnoids on the same day. They weren't even sick. It was preventative. I also remember Roald Dahl mentions getting his abnoids taken out as a kid without him even being told they were going to do that until the doctor took them out in his autobiography. They never did that with appendices only because that's a much more major surgery than just going into the back of someone's mouth.

[@user-gl5dq2dg1j]

Isn't the gall bladder high and to the left and the appendix low and on the right? I guess back in the day before laparoscopic procedures this was probably not that far apart when you had to get your hands in there.

[@joywebster2678]

@@user-gl5dq2dg1j correct wide open often to see if any other complications cancers in the older patients.

[@joywebster2678]

@badAtPickingUsernames1988 my 2 older, and one younger sister had T& As for having yearly tonsillitis. I had it 3x a year, and I still have mine. Why, I was born in a period of time between my older siblings and way younger siblings when there was a thought that the tonsils actually had a role to play in the body. So my friends and I kept ours. Only greatly swollen cases were removed. This period lasted about 5 yrs. Then it was remove them. One thing I noticed is my 3 sisters have issues with runny noses, more colds, and allergies. I still get occasional tonsillitis, but rare colds and no seasonal allergies.

[@chesthoIe]

I woke up in the hospital after drinking peppermint tea and pepto for two weeks, septic and appendixless. The doctor tells me, "I ran my finger all the way up and down your colon and small intestine, and I didn't find a single thing." Jeez, doc. You can't like, buy me dinner?

[@EMILY_RACHEL_]

why would there be nothing to feel?

[@chesthoIe]

@@EMILY_RACHEL_ My appendix ruptured completely.

[@EMILY_RACHEL_]

@@chesthoIe i need an anatomy lesson lol i’m guessing they’re usually connected. that’s crazy glad you’re okay

[@dirtpounder]

As long as he was a gentleman about it :D

[@mspicer3262]

When I was 18 (in the mid-80's), I had appendicitis, and my appendix burst while it was being removed. My heart also stopped twice during the surgery, I got a shot of adrenaline, I think. I did have one more episode in the recovery room, and wound up getting defibrillated. Finally, I came down with peritonitis (a result of the ruptured appendix). My temperature peaked at 107 degrees, and I was essentially out for about four days. I spent a total of 20 days in the hospital for a procedure that most people were in and out in about 3-4 days. Fun times.

[@cameronschyuder9034]

107?! Holy heck, you are very lucky to survive through that. Good work on the doctors’ parts too in helping you out

[@mspicer3262]

@@cameronschyuder9034 I was very lucky that day... my surgeon was the Head of the General Surgical unit in the city's main hospital. There were a lot of good doctors at work, and nurses too. The 'fever-dream' memories are fun... surrealism on levels I've not experienced before or since.

[@anynimus1617]

3-4 days? My daughter was kicked out 12 hours after surgery.

[@mspicer3262]

@@anynimus1617 that may be what the stay is NOW... my surgery was done in 1986, the average stay was 3 days, if there were minor complications, up to 5 days, a rare few got out in 2 days. Things have changed in the past 30 years.

[@patriciasmith7074]

Wow I didn’t know a human being could withstand a temperature of 107 degrees. You are very lucky to be alive. I am so sorry you had to go through all of that. God must have something for you to do in life. My husband was in high school and out of town at some tournaments and he started getting sick and he said he was doubled over in pain and he put up with it for 3 days before he got taken home. Finally home they realized he was really sick and needed to go to the hospital. They lived in a very small town with no doctor or hospital so they had to drive to a city that had one. They checked his white count and it was sky high and that was the only way of determining plus the localized pain and fever. Then they decided they had to operate, luckily it hadn’t ruptured and he had a big incision because the laparoscopic method hadn’t been invented yet. His cousin had the same illness hit but they put off doing anything and his ruptured and he almost died and was in the hospital for a month. My daughter had the symptoms and we took her to the hospital and the doctor didn’t take her to surgery, he put her on antibiotics and the symptoms got better. But a few years later she had to have gall bladder surgery and they took her appendix out then because they had her cut open and the pathology came back that it had been chronically infected and diseased and the first doctor should have removed it.

[@jamesmitchell6925]

I insisted on taking antibiotics. My doctor reluctantly obliged. Cleared up in 24 hours.

[@julienoe3702]

Same here but mine ruptured and I nearly died. Glad you had a better outcome!

[@phillipsusi1791]

@@julienoe3702 I'm curious as to how bad it was when the decision was made? In 2000 I had what I thought was indigestion from eating an onion and pepper filled cheese steak sandwich. I took a warm bath and it subsided so I went to bed. I woke up with the pain back at 6 am and went to the ER. By 9 or 10 am I felt fine and said I was hungry. They said I couldn't eat until they figured out what it was. After numerous tests, several more hours, and saying it couldn't be appendicitis ( or otherwise I'd still be in pain and throwing up ), they gave me a CT scan and said that my appendix WAS inflamed, and they had to take it out. I said if it seems to be getting better, why not give me some antibiotics, and another CT scan in 6 or 8 or 10 hours to see if it looks better or worse, then decide. They said no, we're just going to take it out now. I wish they hadn't been so hasty. It seemed like it was getting better on its own and some antibiotics would have only helped it get better faster.

[@nemesis91101]

​@@julienoe3702id rather get rid of it. You don't need it. Just one more thing to get infected.

[@melissacondon1791]

Are you afraid of reoccurence? I'm so thankful I'll never have to go through that pain again

[@blahmanliutenant]

​@@melissacondon1791I've had my appendix act up twice, both times cleared up with whatever I was given in the hospital and since my late teens never did it again

[@lizabethcraig9341]

I was a surgical nurse for 43 years, starting in the mid-1980's. Gynecologists had been doing laparoscopies for years by then, but mainly for diagnostic purposes. Then came laparoscopic gallbladder removal, and it wasn't long before laparoscopic techniques were developed for all kinds of abdominal and pelvic issues, including colectomy, nephrectomy, and bariatric (weight loss) procedures. Surgical and anesthetic techniques and methods have evolved so much over that time span and are now so much safer that if I were to develop appendicitis today, I'd opt for surgery. I've seen what peritonitis and sepsis can do, and no way and I risking that!

[@patriciadoyle7032]

my daughter, at 27 weeks pregnant, had her appendix burst. ER did not figure it out for 3 days. Baby came at 30 weeks. He is almost out of the hospital now. He is great and my daughter is better.

[@arandomvan]

Happened to me at 26 weeks - they couldn’t figure it out for a few days either…something about being pregnant moving organs around and camouflaging typical symptoms. Scary times. Glad your daughter and grandson are fine!

[@oliverhawthorne3434]

In 2020 I had what I believe was salmonella poisoning (after eating some improperly cooked chicken schnitzel) which morphed into an appendicitis three weeks later. Long story short, my appendix had ruptured and I had an abscess - diagnosed with CT. Surgery was considered but was considered too dangerous because of the inflammation. I was treated with antibiotics and released 3-4 days later ... 2-3 months later I was completely fine, no residual pain. I still have my appendix now, almost four years later. I think antibiotics should be the first line of treatment and surgery only as a last resort.

[@lenitaa7938]

Raptured appendix requires a lifesaving surgery! Antibiotics alone would not cure it!

[@lenitaa7938]

If u had a ruptured appendix, then a surgery would have been only lifesaving recourse! The ‘Antibiotics only’ treatment would not be likely to save u! Perhaps, it did not rupture yet?

[@oliverhawthorne3434]

@@lenitaa7938 Oh no, it had raptured, but my body had contained it in an abscess ... I had gone to the ER three times over two weeks and only on the last occasion did they do a cat scan. They decided not to operate because there was so much inflammation, they would likely have had to remove part of my bowels along with the appendix. I'm glad they did not operate.

[@MartinMCade]

I had my appendix removed in 1984, when I was 19. I had a history of illnesses when I was younger where I would get sick, feel no appetite and a "hot" feeling in my gut, and occasionally vomit. But it would resolve in a day or two. In 1984 I was away from home during my first year of college, and I got sick again. I thought to myself it was the same thing I had had before, so I just waited it out. After a week I went to the campus clinic, they did some tests and sent me to the local hospital where I was in surgery the same evening. It turned out that my appendix was retrocecal and retroperitoneal, which means it was outside the normal stomach lining and behind where it was supposed to be. As a result the surgery was more complicated than average and I have a larger-than-normal appendectomy scar. The surgeon who removed it later told my parents that he had not believed in such as thing as "chronic appendicitis," until he saw mine. It had clearly been infected before. After this video I wonder if an antibiotic treatment earlier in life might have resulted in my keeping my appendix.

[@CatMom-uw9jl]

Chronic appendicitis is definitely real. My husband had recurrent abdominal pain when we were first dating in college in the 90s. We never put two and two together. He’d chug Pepto for a few days and it would go away. Then, while visiting his cousin, who’d fortunately just finished nursing school, he got extremely sick. She recognized appendicitis and took him to the hospital, where they got it out just in time. Years later, we were bingeing on MASH episodes, and there’s one where Margaret mentions having chronic appendicitis that flares up from time to time, and if it does, she wants Hawkeye to do the surgery even though Frank is the senior surgeon. Sure enough, it went acute. I immediately said, “That must have been what you had! It would flare up and fade, then finally turned acute!” The show had a medical advisor, so he must have seen that happen for it to stay in a storyline.

[@James_T_Quirk]

In 1967, I went to hospital when I was 8, for Bronchitis, while I was there, they also removed my Appendix, I remember the Doctor telling mum, "it was better, in the long term" ...

[@bensantos3882]

I had mine removed, after that I could always belch on command, for hours on command. My poop began to stink terribly but I was 14 when this surgery happened. I also always have a delicate spot where the scar tissue is. I remember it took me almost a year to stop feeling sharp internal pain when running for the track team too there(the part of where it was connected to my abdominal/intestine). After I had it, I was the only one to have ever gotten it from either side of my family. To give you reference my family is very conservative Catholic, my father alone had 12 siblings and countless cousins. Oh boy, this is where the pain never ended! Our family was cheap, so grandparents, uncles, aunts, cousins on either side of the family would come to me or call up my house asking all the stages and how did it feel to get appendectomy. This was so bizarre I would get a random call from cousins I barely spoke with unless it was holidays. I remember the most annoying thing was this is pre 2008- smartphones so people instead of looking it up always called me regardless. These stories they told me were so random, like hey I've had this pain down there for 2 months is it my appendix!? I said no you would be dead by 2 weeks if that were the case. Another one was I feel pain but it's from the back, is it my appendix!? I said no that's probably your kidneys or spleen? The most common one was oh I have the worst pain in my life and going to die here, it must be my appendix!? I always asked what side is the pain from, right or left? They would reply its the left, the pain is so unbearable and I'm going to the hospital! I said hang on, the appendix is on your right side, it's nowhere near your left hip. The next week I call to see if they're ok, how as the hospital visit? Oh that I just slept it off and I'm fine now. I realized I must by my Catholic family's appendix doctor, even now my cousin's have teen children and now my cousin Sabrina's son called me and asked 'Hey Ben I heard you had an appendectomy, do I have an appendicitis too?' I suppose I will live with this curse for the rest of my life now. I also will admit when I get this random question call, I suddenly get a phantom pain in that spot with the scars, almost as if it's not because of the surgery but no one wants to spend time or money to see a real doctor or look up medical MD. On average this I get 3-5 calls every year, my sisters every year keep asking me if their kids have an appendicitis too. We found out one is lactose sensitive and the other had Celiac Disease but both got it from their father's side of the family so let that be a good case example of my misery.

[@cc_snipergirl]

The pain could be abdominal adhesions. Basically, scar tissue from the surgery forming where it shouldn't. You can have that corrected if it bothers you enough

[@bensantos3882]

@@cc_snipergirl I never knew that, I'll talk to my doctor during my next physical then. Thanks.

[@barcodenosebleed5485]

As the tech guy in my family and that being a common trope I find it amusing that this can translate to appendixes. It sucks that you had to deal with that pain after. I can imagine a scenario where someone is gaslit like, 'we took out your appendix, there's nothing there to cause pain, you're all better now, it's all in your head'. And then you have family members constantly reminding you of a horrible, traumatic experience lol. I don't want to project my experience onto yours, mine was completely different anyway, but it took me a good 30 years to understand how the health stuff that happened to me as a kid had influenced and was still affecting me as an adult. So I'll just say I hope you're doing okay.

[@Bitterrootbackroads]

My favorite Evolutionary Biologist is Bret Weinstein from the Darkhorse podcast. He has a way of thinking that makes sense out of many things, including why the appendix may have a good reason for existing. The symptoms you experienced after removal might suggest a loss of the permanent gut flora, which is possibly something that gets inherited and may contain some combination of microbes that make digestion work better, and are exactly what his ideas predict. His hypothesis is that a severe case of intestinal diarrhea may wipe out those microbes, but the appendix may preserve enough of them to allow for repopulation after things normalize. If one believes that metaphorical truths may exist for a reason, the metaphor here is “Chesterton’s Fence”. If routine appendectomies are declining maybe the medical community is coming to the conclusion that it’s not wise to remove something until you understand why it’s there.

[@bensantos3882]

@@Bitterrootbackroads I'll look into that, I got a few suggestions from other replies for my next physical. Also this is still going on as I am the appendix expert. At work someone asked 'has anyone ever had an appendicitis!?' I said yes where do you feel the pain? They pointed at their left side and were thankful when I told them that isn't where your appendix is.

[@aallan16]

My brother nearly died when he had stomach pain diagnosed as 'malingering' in '71. When collapsed screaming they took it out. 12 months later I mentioned some tummy discomfort. My mum dragged me to the ER and they cut me open. My scar is three times as long as my brothers because they had a good look around in there to see what was wrong with me. They took the appendix out anyway just in case😅

[@th8257]

Here in the UK, surgery for appendicitis is now considered a last resort. The first treatment is antibiotics. My dad had appendicitis recently and was given a course of antibiotics. He's fine now. The USA is fairly notorious for unnecessary surgery though - largely because theres so much $$$ in it.

[@Jabberwockybird]

The U.S. medical field doing unecessary surgeries, and overprescribing of pills is the reason people in the U.S. are cynical of big medicine. And racist events like the Tuskegee Study shows that people are right to be cynical.

[@wholeNwon]

Actually there isn't. Peritonitis is so dangerous and appendectomy so safe that most want to proceed with surgery, if there isn't prompt relief from antibiotics alone. More often they are a prelude to surgery to reduce the very low complication rate. Now, too, surgical staffs are often salaried and employed by hospitals. They are usually paid the same regardless of whether they operate.

[@vickyc2573]

Really? That wasn't my experience having an appendectomy in the UK in 2020. They confirmed it had some inflammation but wasn't yet perforated, and gave me the choice of surgery or antibiotics. They said if I took the antibiotics it was kind of a 50/50 that it would be remedied now AND I could get appendicitis again in the future. I clarified that if they took my appendix out that that would be the end of it, and they said yes, so I said why would anyone choose the antibiotics then? It was definitely not given to me as a "last resort" option. I went in to hospital late on Thursday night and had the surgery Friday evening.

[@wholeNwon]

@@vickyc2573 That is certainly the choice I would have made, too. Appendectomy is never a "last resort" anywhere in the world that I'm aware of.

[@evelynmahoney3569]

@th8257 You just nailed EVERY aspect of "Sick Care" in the U.S. It can't be called Health Care when the goal is to keep everyone sick while the HMOs, pharmaceutical industry, politicians, and many, many others rake in the profits. The more appointments, tests, lab work, Xrays, MRIs, CT Scans, prescriptions, procedures, surgeries, therapies & treatments that they can sell to you & your insurance company, means more profits for them. Of course you're going to be given a prescription (or a ☆VACCINE) that has horrible side effects! Gotta keep you sick & comin' back for more.

[@philmann3476]

In 1980, I "wintered over" at Palmer Station Antarctica with 6 other men, one of whom was a Navy Chief Hospital Corpsman who served as our medic. A common question was what he would do for a case of appendicitis. His answer was that he would first load us up with antibiotics and wait it out. If the appendix burst anyway, he would then make a small slit in the abdomen and insert a drain tube. He would NOT attempt to take it out surgically. That was 40 years ago and it seemed to make sense. He seemed to know his stuff and we had confidence in him.

[@c138599]

The surgeon who recently removed my gall bladder (much to my relief) here in Australia told me he regularly performs an appendectomy on people prior to their service in Antarctica. He said it is currently a prerequisite due to the forced isolation which would make medical help unavailable?

[@philmann3476]

@@c138599 Could be. Although we were all young and healthy, it was a concern and something to think about. That was 40 years ago and basically you took your chances with appendicitis. Funny thing is, they did make me get my wisdom teeth removed before going. Never gave me any trouble before, but they said the teeth needed to come out before they'd send me. Makes you wonder if they really know what they're doing after all. In any event, it all worked out and none of us faced any serious problems. Master Chief Saul Rosenberg (RIP) took good care of us. Rosie, well done and many thanks.

[@72Saeth]

Great watch, I myself had a laparoscopic appendectomy in 2015, diagnosed by CT like you mention. They performed the operation in the early morning and I went home that afternoon. After what it put me through, I'm glad to have it out honestly. I'm not sure how necessary it is but because of the supposed function of the appendix, I am pretty diligent about taking a probiotic.

[@jett8193]

I had mine out around 12, in the early 80's! It hurt so bad I could NOT stand upright. I remember the poke test, nearly blacking out from the pain! The surgeon got to it as it was ready to burst~ eek! Thanks for this video, with the most helpful info on this subject I've ever found!

[@diegovelosa8519]

I LOVEEE YOUR VIDEOOSS SOO MUCH, currently senior year of hs and your videos are some of the reason I am going into health sciences

[@PatKellyTeaches]

That's amazing to hear! Best of luck in college

[@herbertfawcett7213]

When my sons appendis was removed at age twelve, it was, as described by the surgeon, "Detached, encapsulated, and slightly gangrenous."

[@AngelOneiros]

I literally just had appendicitis last month, and generally after something like this happens to me I love learning as much as possible about whatever I just went through (root canal, c-section, so on) so thank you very much for this video! I found out my dad also had his appendix out in the ‘70s, I had no idea until I told him about mine. I honestly barely had any pain, it was just so localized in such a specific spot that I was suspicious. After spending several hours in the ER waiting room with only a mild twinge of pain in my side I was a little worried I was being dramatic, but next thing I knew they were sending me for a CT scan then prepping me for surgery in the dead of the night 😂

[@marcfruchtman9473]

This was very helpful. I dare say, better than a lecture in medical school because it covers the history so well. Thanks for making it.

[@julietcunningham852]

There have been four cases of appendicitis in my family. Back in the 1890s, my grandfather's nine-year-old brother died from it. It seems (as my mother told me), that standard practice at the time was to give the inflamation time to calm down, but it didn't work in this case. The next was his younger brother, my grandfather. He was operated on right away, as later was my mother. It seems that the family appendicitis progressed rapidly, more than was usual in most cases.When my turn came, I was in fourth grade. My doctor knew all about the family history, and booked me for surgery that day. It was only five hours from first symptom to the start of the operation. The verdict: "We got it in time".(!!!!!) None of my three siblings got appendicitis, and, as I have no children, it looks like that family problem may be over with.

[@rodburket4582]

The medical community claim there is not a genetic relationship to appendicitis. However about 90% of my family members including 1st cousins have had their appendix removed. About a third of them had perforated appendix before it was removed.

[@cartwrightworm1317]

My dad had his appendix out the old fashioned way in 1994. I had mine removed in 1997, but by laparoscopy. We were amazed at the difference in just three years.

[@timstorey7915]

My buddy got it in the late 90’s but he didn’t realize and by the time he got to the doctor it burst and he almost died. They had to take out all of his organs and wash them and put them back inside because he went septic. He was a skinny guy but looked huge after that was done. It took maybe a year or so for the swelling to go down and for the organs to settle back into proper position. He has a number of medical conditions that he is still living with, but he is generally fine now.

[@runningfromabear8354]

I had my appendix taken out during lock down. I was fine, no pain and then during a movie, I started getting gut pain. It came on really fast but I've had much worse pain, so I didn't think it was that bad. 3 natural births, gallstones, burn unit survivor as a child, multiple accidents. My husband disagreed and said if it's painful enough for me to be controlling my breathing, it was time for the ER. Waited in the ER with social distancing in the ambulance bay and i was sweating and fever and pale and then i collapsed. Woke up post-op hooked up to monitors and air, to find out my appendix was taken out. First time I've collapsed. Thstaff were so apologetic and sweet but I was thrilled that I got away with a medical event with very little pain! For me that's a win in my books. Burns and gallstones are much worse. Would rather have appendicitis. Felt sick and a bit painful but really not that bad.

[@julienoe3702]

I opted for antibiotics for appendicitis in 2022 against the surgeon's advice. It ruptured anyway and thanks to atypical symptoms I walked around for 3 days with it ruptured. Came closer to death than I care to admit. Hospitalized 10 days after surgery. Months of severe anemia following that. All thanks to my intense fear of surgery.

[@phillipsusi1791]

I had mine out in 2000 even though it seemed to be getting better on its own and took them 12 hours of testing to change their mind from it wasn't the appendix to it was. I still think it didn't really need taken out, but then again, I recovered from the surgery no problem in 2-3 days without even taking the narcotics they gave me ( they sent me home like 10 hours after the surgery ), so I don't know...

[@skyhawk61]

Had abdominal pain for about a week before going to emergency to have it looked at. Doctor examined me and sent me to get a CT scan asap. From there I was admitted to surgery. Before that I was informed that I had a possible perforated appendix. After the laparoscopic surgery, I was discharged 2days after and sent home. Post surgery analysis was that I had a perforated appendix and they had caught it before it burst. Several days later I started experiencing pain in my abdomen again which worsened a couple days later. Went back to emergency again and was admitted for abdominal abscess surgery. Had the tube in me for 3 weeks(inflamed fluids finally drained out). What a process that involved over a month of medical procedures. Never in my wildest moments had I ever thought that I would have an appendectomy. Never forget the one in the WWII movie where a medic performed it at the bottom of Tokyo Bay in a submarine. NIMBY(I thought) after watching the movie but years later, it happened ! BTW was 80 yrs old when it all occurred. 86 now and enjoying the hell out of life. But an appendectomy at my age? Go figgah!!

[@johncgibson4720]

I am a 3rd-year premed. I loved the antibiotic episodes. And this episode is also epic. Just outstanding.

[@notthesimi]

My mom had appendectomy. She felt horrible for months until the doctors finally believed her. This was in the 80s. I had a different experience. The first time I was in pain I went to the doctor and they gave me antibiotics for the stomach flu. Took it for five days, felt fine. Two days later the pain came and it was way more painful then the week before. Called my aunt to take to the doctor because I was sleep deprived and in too much pain to drive safely. My doctor sent us to get a mri. I ate lunch after the mri because hadn’t eaten anything all day. After eating lunch I got a message from my doctor saying that I had appendicitis and needed to go in for surgery. Went to the hospital. Eight to nine hours later I went in for surgery. Thankfully I had a doctor that believed me.

[@phillipsusi1791]

The flu is a virus. Antibiotics don't work on a virus. If they think you have a virus, they don't prescribe antibiotics.

[@OdysseusIthaca]

Fantastic description, great content! Anybody who can make the appendix so interesting deserves a sub.

[@glen6258]

How is it possible for you to not have over a million subscribers? I love all your videos. They are all out together so well and are very informative. Keep up the awesome work Patrick.

[@Dubyel]

Thanks very much for this most informative video. 20 years ago, I had been having periodic abdominal pain and heartburn for years, so when my appendix ruptured, I didn't realize what had happened, and I didn't go to the ER until if was almost too late. Had open surgery and a week in the hospital. Then, when they went back with CT to check for adhesions, they found my gall bladder was in terrible shape. They did second laparoscopic surgery to fix the adhesions and remove the GB. Turned out the GB was what had been causing all the abdominal pain for 20 years. It was such a life changer that I told people it was worth the appendectomy to get rid of the gall bladder.

[@joeolejar]

In 1993, in Ohio, our pre teen son developed abdominal pain that was excruciating. I took him to the local hospital where they found an elevated white count and appeared to fit the profile for an inflamed, if not perforated appendix. A surgeon found a pink appendix, but also discovered a Meckles diverticulum. An aborted appendectomy probably saved his life. The surgeon had not seen a Meckles diverticulum in 30 years of practice.

[@Conundrum191]

I had to have mine removed back in 2010 (was done laparoscopically). Had went to bed in some discomfort, and then woke up around 4am in extreme pain where I could not lay on either side for more than 30 seconds. Went to the local hospital, and had both bloodwork and a CT which showed appendicitis and that it had to come out. Given it was done laparoscopically, I actually ended up only spending a night in the hospital and was released the next day.

[@mrnice4434]

I'ts funny what you all can take out of a human body and it still works (kinda): appendix, tonsils, one kidney, testicles, uterus,.... It's like a game of Jenga how many stuff can you pull out before the person dies :)

[@crisptomato9495]

You can even “disable” half of the brain with a hemispherectomy and the patient can be functional afterwards if they’re young enough. Bodies are so weird and horrifying and awesome!

[@owlbyovrprepared1128]

A significant (not necessarily majority) portion of the intestines, liver, and lungs can also be eliminated without ending life (though the liver trends toward regrowing rather than simply adapting as-is).

[@MetsterAnn]

⁠​⁠@@owlbyovrprepared1128I had half my liver removed (cancer). I felt no difference, aside from a relatively long recovery complicated by nosocomial c-diff. Seems to now be same size according to scans but they can see the removal scarring. I also had an appendectomy a few years before that, and was worried about a scar. Told the doc my fear and he did a beautiful laparoscopic job with no visible scar. A couple years later, I had a mastectomy and liver resection and my worry about scarring became ironic. My appendicitis pain was in the center of abdomen rather than side. Very interesting video. I’m glad that the gold standard is still surgery because I could not have withstood the pain long enough for antibiotics to take hold. I don’t know if it was ruptured or not though.

[@arrowhead8856]

i recently got my gallbladder removed and i was shocked that it’s not going to impact my life much, if at all. kinda feels wrong that you can just get rid of some organs and be completely fine

[@maryel5398]

@@owlbyovrprepared1128I have 10 inches of colon left (officially that’s the rectum). My colon had pretty much shredded from diverticulitis. The surgeon attached that 10 inches to the small intestine, and I’m here living fine. Incidentally, they removed my appendix during the surgery, because why not - I was already cut wide open!

[@larrylawson5172]

You might talk about the Chinese technique of going in through the rectum to remove the appendix. I understand it is less scar tissue, no cuts to the skin, no abdomen muscle cuts, less painful and heals faster with less complications. Other surgeries can be done this way as well. They also do some surgery endoscopically as well. Same reasons. Heals faster, less pain, less scaring. Then you get into the psychology of we don't do it that way. I heard about this 15 years ago, right after I had my appendix out.

[@SteveRichfield]

You didn't mention mock appendicitis - similar symptoms from bowel stasis near the appendix. This is recognized by having a normal white count. I once had this back in the 1980s. Two doctors were ready to remove my appendix, but they couldn't explain the normal white count, so I refused surgery. Walking cleared the problem later that day.

[@BaalFridge]

I know literally nothing about medicine beyond first aid, and your videos are incredible! You're an excellent medical science communicator!

[@MoonJarGirl1]

Hi Patrick!!! Saying Hi from Orange County, Ca! Im excited for this new vid! I loved the bacteriophage vid and your other work too! Please keep it up. The world needs educators like you. Thank you!!

[@PatKellyTeaches]

Thanks for the kind words! And I love Orange County - I did undergrad at Chapman!

[@erictaylor5462]

"Dissection was considered a icky thing." Dissection is an icky thing. The smell is amazing. Not a doctor, but if I had to guess, I think some of the smell comes from the feces in the gut. But there is more to it than just a poop smell. Likely it wasn't performed because at the time, without anesthesia it was hard to get the person to lay still. And without antibiotics, or an understanding of germ theory, it may as well be murder to cut as person open. There were also religiose reasons for the taboo that had nothing to do with "Thou shall not commit murder"

[@kbuzard6]

Got my appendix out when I was 14 in the mid-2000s. The symptoms progressed really quickly for me. Woke up one day feeling nauseous, started vomiting every hour, then the pain migrated to my right side. Went to the ER at 10pm that day. After an interminable wait in the waiting room, the doctor determined it was appendicitis but decided to keep me overnight and operate in the morning. By the time they operated, it had perforated. I had to stay in the hospital for a week and have a draining tube from my abdomen for a few weeks. Was out of school for the better part of a month. Had they operated sooner, my recovery would’ve been a lot quicker. So, I’m not a huge advocate for waiting and seeing…

[@prince_8bit]

so glad for more videos from you !!

[@JonyRotten]

30yrs in surgery (I miss it) and I couldn't even fathom a guess as to how many (open and lap) Unhappy Appies I've seen. As to why it's a surgical case: I couldn't even fathom a guess as to how many (open and lap) Burst Unhappy Appies I've seen.😉 Great video, Great job. Thank you.

[@joelb8653]

Great video as usual.

[@chrisfromsouthaus2735]

My appendix ruptured while I was being prepared for surgery, and it was the biggest sense of relief I have ever felt. I was in an absolutely excruciating amount of pain one second, and the next it just evaporates.

[@error.418]

So glad I found this channel, Bedside Rounds podcast vibes with a very clean, welcoming, and informative vibe

[@PatKellyTeaches]

Such kind words, thank you! Dr. Rodman is S-tier medical history content, he's so good

[@Skaldewolf]

What baffles me more is the 'waviness' of the graph before the 90s. There were years were appendectomies were performed on a much higher rate than usual.

[@aloysiusdevadanderabercrombie8]

Perhaps there was just years where there was more or less appendicitis than usual?

[@nothanks9503]

@@aloysiusdevadanderabercrombie8 That’s what we call clinically significant

[@Woodman-Spare-that-tree]

What was the scale on the vertical axis of the graph? You can make anything look dramatic if you stretch out the scale.

[@aquariTerrible]

Yisssss a new video! Excited to learn about the history of appendectomies o: I almost had no visible scars from mine but the dilly dallied too long and I ended up getting that big ol' incision vs the laproscopic working. So I now have 1 big visible scar and 3 almost invisible ones from just one Itty bitty (partially popped) appendix! lol

[@pasdpasse439]

Love your channel! Keep up the good work!

[@teresaforsyth3221]

Well done! Perfectly edited, too!

[@erzsebetkovacs2527]

Thank you for this video essay, this was extremely interesting. Now I know that the Hungarian equivalents of the appendix and appendicitis are actually a misnomer and an archaism, because similar to how Dupuytren thought, these Hungarian terms etymologically mean the caecum and the inflammation of the caecum (sic), respectively, even though Hungarian medical language uses them to refer to the appendix and appendicitis, respectively.

[@PatKellyTeaches]

Ohh woah, that's a super interesting parallel

[@Joiner113]

The colorectal surgeons I've been placed with recently have hypothesised that current lower rates of appendectomy might end up resulting in higher rates of carcinoid tumors and pseudomyxoma peritonei in the long run. Would be interesting to see if that bears out, and the same for other procedures which are becoming less popular, e.g. whether reduced rates of oophorectomy result in higher long term rates of ovarian cancers.

[@boblossie3192]

Love this kind of teaching! I came back to listen to it a second time.

[@juliuscheng5788]

The issue with just relying on CT scanning for diagnosis: radiation. There is a non-zero lymphoma risk for every CT scan you do, so we tend to avoid getting CT scans on children if at all possible.

[@BoraHorzaGobuchul]

Somehow people often do not understand that a CT scan involves ionizing radiation - most likely they confuse it with an MRI. When they're told that the radiation exposure is much higher with a CT scan then with a "usual" X-ray most are surprised.

[@BoraHorzaGobuchul]

Somehow people often do not understand that a CT scan involves ionizing radiation - most likely they confuse it with an MRI. When they're told that the radiation exposure is much higher with a CT scan then with a "usual" X-ray most are surprised.

[@briant8]

There is also a non-zero chance of lymphoma for, doing lots of things, like living. So what?

[@briant8]

What’s riskier, the chance of lymphoma from a CT or sitting on a hot-appy? Risk-reward, dude. Risk-reward…

[@briant8]

And what about those scans that save people FROM needing the risk of surgery?

[@DylanBretzJr]

Captivating and informative as always, Patrick! I didn’t know you were a writer for SciShow - so cool! Curious if you’ve written for any other science/medical YT channels. Looking forward to the next video 👍

[@PatKellyTeaches]

I have! I'm working on a Patreon exclusive about my freelance career, but I wrote / hosted a show for Seeker, which is a local San Francisco-based channel. But the career highlight was script editing for the American Public Health Association's channel

[@sylviaelse5086]

I got appendicitis in my early teens, and was admitted to hospital. Since it seemed to be resolving by itself, and surgery would have kept me in hospital over Christmas, I was discharged. But a couple of years later, I got it again, and this time surgery was performed. Appendicitis is unpleasant, and getting it twice was not a plus.

[@kaelhooten8468]

My appendix is a little house for some very stinky bacteria that help me poop* really nicely, thanks. I’ll keep it, it’s my buddy.

[@polyvg]

Around 1980, I went on holiday far away and with somewhat less than ideal healthcare. Of course, I had an appendicitis. They gave me high dose antibiotics - can’t now remember whether it was Ampicillin or Amoxycillin. And tried to persuade me to have an appendectomy. However, I improved and after a while was discharged. Had to stay a few extra days as the airline was unwilling to let me fly until a doctor signed me off as fit. One thing I did get, advice that I had a degree of intolerance to penicillin. Tablets were likely OK but injections should not be given. I also found the smell of the antibiotic dreadful. To me, my sweat stank of it for many months - long after I had finished taking them. I did ask, but no-one else could detect anything. Also had some discomfort which was put down to minor adhesions from the infection. Doctors ever since have found it difficult to know what to make of that. However, a couple were aware of the possibility and agreed I should not have penicillin injections - think they had been trained outside the UK. (Not naming the country because they were fine and I don’t want to smear a country for its reputation all those years ago.)

[@mattsonn]

I had an appendicitis scare in November ‘23, it turned out to be something benign and unrelated to my appendix. Until the CT scan and bloodwork came back normal, they were getting me ready for surgery. This was in a well equipped US hospital.

[@Sodier402]

Well if the CT scan came back positive they’d want to be ready to operate.

[@th8257]

The USA is notorious for unnecessary surgery. Largely because there is so much profit in it. Things like wisdom teeth removal is off the scale in the USA compared to most other countries and the USA is pretty much the only country in the western world that does routine infant circumcision.

[@garak55]

I mean, since europe will become a caliphate in like 30 years, the US will stop being the only ones with routine male circumcision.

[@Beepinsqueekin]

My ex-husband ignored bad right sided pain until....it suddenly quit. A week later, that pain returned so bad he got extremely sick and rushed to the emergency room. Urgent surgery was done, he lost part of his intestines and colon from the widespread infection from the ruptured appendix.

[@tony9146]

Very interesting video, thank you! I had ileal surgery for my Crohn’s disease and my surgeon was kind enough to remove my appendix while he was in there. I didn’t even realize it until my brother pointed it out in the surgical notes a day later.

[@patrickd8770]

Great video. I would add we are better at diagnosing appendicitis too via CT scans and lab tests like CRP as well. In the 80’s / 90’s it was common to do an appy on anyone who had lower right quadrant pain (especially young men); now we can diagnose it much better and rule it out if so. It’s also seen relatively as a free lunch in surgery- meaning the risk-benefit of it largely favors surgery (vs. watchful waiting or antibiotics as discussed). Treating a ruptured appendix is horrible and will make you much more proactive once you’ve dealt with one.

[@TheRunningLeopard]

A tendency towards appendicitis is unfortunately something that runs in my family, not looking forward to likely having to deal with mine as well.

[@shawnpurcell5424]

@patkellyteaches Thank you for starting your appendectomy graph from y=0 (as opposed to say, y=6 to make it look more dramatic). [by y I mean the appendectomy rate on the y axis]. The way you did it, I can glance at the graph an immediately tell, as a percentage, how much it is dropping, which in the end, for me, is pretty dramatic :).

[@deus_ex_machina_]

For examples of graphs deliberately intended to mislead, see r/nvidiagraphs. For sound examples of data visualization, I recommend r/dataisbeautiful.

[@PatKellyTeaches]

Thank you! As the other commenter mentioned, it’s good data vis policy, but it was also necessary for the second graph. To show laparoscopic appendectomies on the same axes, I needed to have a 0 since my source started laparoscopic surgery tracking at 2-ish

[@BonesyTucson]

Excellent video! Always wondered about appendectomies.

[@bojo88]

Thank you, I found this really interesting as someone whose appendix ruptured at the age of 2 years old. It's subsequent removal led to complications later on, with the development of gangrene and further, emergency surgery. I still live with the results of that to this day.

[@caragarcia2307]

There did seem to be a spate of apendix problems in the 90s. The people I knew who had surgery either had a rupture and needed emergency surgery or had reoccurring issues and decided to have the surgery rather than keep suffering. They would probably have needed an emergency surgery eventually, so it was probably safer to do it without massive infection. I think it was probably the change in dietary habits.

[@josephpadula2283]

My father had a burst appendix at 12 in the 1930’s . The scar was enormous and scared me the time I saw it . I didn’t from 1975 to 2012 in the navy or on U.S. civilian merchant ships and only had a doctor on any of the ships for one month on a cruise to Brazil . I never had one rupture but may have gotten an ulcer from worrying when we were 7 days from any port with a hospital many times ! Merchant ships have no hospital corps man that were able to do the operation in wwii.

[@NickHammer99]

I get so pumped to see a new video from you

[@pafeso1659]

Same lol