Is there such a thing as minor appendicitis surgery o

October 4, 2012 7:38 PM

Is there such a thing as minor appendicitis surgery or am I going to be calling 911 for a student in the middle of a midterm tomorrow?

I have a student who emailed me an assignment they said they couldn't hand in in person because they were in hospital with appendicitis. They had surgery, were released this morning and claim they will have no problem turning up for the midterm for the class tomorrow. As far as I am aware this is a bad, bad, bad idea of badness which will probably result in me calling 911 as they slump to the floor in agony. I told them not to come, but they insist that they'll be fine as it was only minor surgery with a tiny incision. Is this possible? If it's not, how on earth can I convince them not to show up? I'm phoning the advising office for undergraduates tomorrow to see what they might be able to do, but other than emailing to them that this is a terrible idea and they should not do this because it will harm their health (as I've done) I don't know what else to do. (There would be no consequences for them not showing up other than they'd have to take the exam at another time; it they had to be out for a long chunk of time, I'd waive that and have them just take the final.)

(It's, I guess, possible they're lying, but they'd gain so little by the lie - emailing an assignment rather than handing it in - and it's such an obviously difficult surgery and they'd need to give me documentation that I find it hard to believe it's a lie.)

posted by lesbiassparrow to health & fitness (25 answers total)

Appendicitis is a bad, bad bad scene if the appendix bursts. This happened to me recently. It sucked. Took months out of my life.

Appendicitis before it bursts is a minor laparoscopic surgery with a day or two recovery time.
posted by slateyness at 7:49 PM on October 4, 2012

Actually, it's an outpatient thing now. Friend of mine's brother had to have an emergency appendectomy and all told was in the hospital for about 18 hours. Laproscopric is the term i think. Tiny incision. If the appendix has not ruptured that's how they do it these days.
posted by sio42 at 7:49 PM on October 4, 2012 [2 favorites]

There's laparoscopic appendectomy, which is outpatient.
posted by Blazecock Pileon at 7:50 PM on October 4, 2012

Anecdote: My sister had the small-incision version while on vacation and 48 hours later spent an entire day walking around Colonial Williamsburg.
posted by BlahLaLa at 7:50 PM on October 4, 2012

In the sense that it's an abdominal surgery, it is a significant surgery. But I would not call it necessarily a difficult surgery - it just depends on the case. Some are very easy to do, and the small incision is because he probably had it done laparoscopically, which means with a camera. The incisions are literally like 1-2cm across.

There are still potential complications after an appendectomy, even if it's done laparoscopically (constipation or obstruction from narcotics and bowel slowing, for example, or intra-abdominal infection), but nothing that would be caused by walking around or sitting and writing a midterm.
posted by treehorn+bunny at 7:52 PM on October 4, 2012

I'm not saying that it's a good idea for them to come to the exam (if for no other reason than they're on pain meds and are likely a bit loopy), but I offer this anecdote: at thanksgiving dinner a couple of years ago, my massive, generally indestructible brother got up from the table and said "my stomach hurts. I'm going to the hospital." and walks out the door and drives himself there. He's got a freshly burst appendix and undergoes arthroscopic surgery. Next morning he's got a 1" scar and has to be talked out of driving home.

Not impossible. But I think you're right...if it's real, tell them to rest a couple of days.
posted by kjs3 at 7:53 PM on October 4, 2012 [5 favorites]

Yes, there is only a tiny incision. If the person feels up to coming in, then they should.
posted by wandering_not_lost at 7:54 PM on October 4, 2012

One of my coworkers recently had an emergency appendectomy and he recovered within three days. Another friend had preventative surgery and was able to be well again in a day and a half. I think you're overreacting.

I would email the student back and say that given the circumstances you would like to insist that they take a make-up exam instead.
posted by These Birds of a Feather at 7:55 PM on October 4, 2012 [1 favorite]

I think your student may have over-optimistic expectations of what they'll be capable of tomorrow, but it's not going to be a crisis or emergency.

I had my appendix taken out in June. I was out of the hospital just over 36 hours after I walked into the emergency room (and the surgeon considered releasing me at 24 hours). I was tired and sore, but managed a couple of hours of activity the day I was released (e.g., went to the pharmacy, though I wasn't able or supposed to drive myself). I was back to my normal, desk job work schedule by the end of the week (and I could probably have resumed my schedule a day earlier). It's real surgery, but recovery is astonishingly quick.
posted by ddbeck at 7:56 PM on October 4, 2012 [1 favorite]

An appendectomy, is usually done laprascopicaly and insurance and HMO's being what they are these days, they try to kick you out of the hospital the next day. But you still have been cut up inside and there are sutures inside of you which won't heal for weeks. IMHO (and I am not a doctor of course) you should spend a day or two at home at the very least. I don;t think you should go out into the world 48 hrs after general anesthesia and march around. You get bounced around, maybe you take a fall because of anesthesia aftereffects and your internal sutures aren;t going to like it.

Your student should not be at school - he should be at home resting for a couple days at the very least.
posted by Podkayne of Pasadena at 7:57 PM on October 4, 2012 [2 favorites]

I am somewhat relieved (thanks!), but they were in hospital for 2 days. Would they be in that long for laproscopric? (I am worried mainly because 20 year olds tend to think they're indestructible and can bounce back from everything...leading to this sort of situation.)
posted by lesbiassparrow at 7:58 PM on October 4, 2012

I had the non-laprascopic kind of appendectomy and was in the hospital for definitely more than two days. Maybe three or four at least? I had REALLY good insurance and healthcare at the time. My appendix did not burst. I wasn't supposed to exert myself in any way for at least two weeks. Within a month after surgery, I'd lost about 15 lbs (I only weighed 120 lbs to start with). I felt exhausted all the time and kept losing my voice and having other minor ailments for at least that long. Basically, appendicitis is an infection of an organ followed by a surgery to remove that organ. No matter how you slice it (no pun intended), it is (or at least can be!) a big deal.

Tell your student to get some rest.
posted by lalalana at 8:15 PM on October 4, 2012

Yeah, make him stay home. Like kjs3's brother, I fancied myself indestructible and also drove myself to the hospital with a burst appendix. Then stubbornly persisted in trying to resume normal life ASAP. In retrospect, it was dumb. Painkillers also make you dumb. My surgery was way worse though- 2 weeks cumulatively in the hospital.
posted by slateyness at 8:17 PM on October 4, 2012

Make him stay home. Please, please make him stay home. Surgery is surgery, and he was under general anesthesia, which can make your brain foggy for some time. Plus, yeah, painkillers. He won't be able to perform to his potential, and it's not like he faked appendicitis in hopes that you'd give him an extension.

My last roommate had appendicitis during his pediatrics block during third year of medical school. He was admitted on Thursday, had surgery on Friday morning was back at work and on call on Monday night. He's a smart, hard-working guy, but pushing himself that hard so soon after surgery easily delayed his full recovery for a couple of weeks.
posted by honeybee413 at 8:27 PM on October 4, 2012 [1 favorite]

but they were in hospital for 2 days. Would they be in that long for laproscopric?

I was in the hospital for 2 or 3 days after my laproscopic appendectomy. The only thing I'd worry about with your student is if s/he is a little spacey from pain-killers during the exam. I was back at work (well, telecommuting from home) by the end of the week.
posted by belladonna at 8:29 PM on October 4, 2012

Something to consider - if he's on the dumb-making pain killers and takes the exam and unexpectedly bombs it (because, yeah, dumb-making pain killers), can he re-take/make up for it? If not, *strongly* encourage him to stay home. If so, consider letting Mr. Indestructible (aren't we all at 20-something?) take the exam, provided he can leave early if pain/pain killers prove stronger than he predicted.
posted by MuChao at 8:33 PM on October 4, 2012 [2 favorites]

Does your university or college have a dean system for advising students? I discovered I had mono (weeks after it started) my freshman year and despite being unable to sit up straight or actually swallow at all, still tried to go to class. My dean actually told all of my professors to refuse to let me into class, helped with extensions on papers and finals, and made sure I was on track academically, which is to say: made me take a few days off. It was the right call. Your student could be totally fine, or they could bomb it because of pain medication and be horrified by their scores two weeks from now. Their dean might know more, and be able to set up a solution and timescale that works for both of you for this midterm.
posted by jetlagaddict at 8:40 PM on October 4, 2012

Laparoscopic would be a 2-3 day recovery in the hospital. That is what they told me I would have. Once they stuck the camera in, they found a mess and think it had been burst for about a week, complete with gangrene. Like slateyness, it took a few weeks out of my life.

Your student should be just fine. He will not slump over.
posted by Tanizaki at 10:22 PM on October 4, 2012

I was in the hospital for six days, but that was with a burst appendix, when they didn't do laparoscopy.

If they've sent him home, he can't be in any danger of collapse.
posted by tel3path at 2:58 AM on October 5, 2012

He will probably not be hurt by your midterm, but I would have him wait a day or two to avoid the hassle in case he feels less good mid-test, requiring you to make up a new one.
posted by a robot made out of meat at 3:29 AM on October 5, 2012

As somebody with an unfortunate amount of experience in this, I can tell you that it all depends on how much toxin has leaked out of the ruptured appendix. Worst case scenarios involve life support while you have pumps inside you to get all the toxins out. Even in the best case scenario, your student will be hurting. I can't imagine him being well enough to concentrate to the degree where he could do well on a test.
posted by wolfdreams01 at 5:33 AM on October 5, 2012

I have a 2.5 inch scar from when I had my appendix removed so not the laparoscopic version. It wasn't actually my appendix that was the issue but they got that too so I imagine this would be a normal routine for an unburst appendix.

Had surgery Wednesday night
Discharged from hospital Friday afternoon
Returned to school Monday morning (but I absolutely could have taken a test on Saturday or Sunday if I had too, I was just tired and sore and walking funny)
Returned to dance (albeit a bit restricted) on Thursday
posted by magnetsphere at 8:29 AM on October 5, 2012

My appendix burst while they were removing it. They thought they had cleaned out the incision, but not enough. Still I was in back to school in 2 days, then when they removed the staples the incision split wide open. They cleaned it, packed it with gauze and said change it everyday. No reason he should miss school. I was bummed. I mean really whadaya got to do to miss school!
posted by Max Power at 12:10 PM on October 5, 2012

Your student is an adult. It doesn't sound like he's in grave danger of dying in the middle of your exam, so I think you should leave the choice of whether to show up or not to him. If he bombs it...well, that's a valuable life lesson, and it's not as if a poor score on an exam is going to ruin his entire life. Also, you don't know what else is going on in this student's life. It may be he doesn't want to reschedule the exam to a different time because he has other things going on that are more of a priority, and he would like to just get your exam out of the way. As teachers, it is really easy to feel like doing their best in our classes should be the most important thing for students, but that's not always the case. I know when I was in college and had an illness during finals, I turned in a couple of papers that were subpar instead of taking a totally justified extension because I just needed to get things finished and move on from the semester. That was the right choice for me at that time. And that is a choice that your student has the right to make providing he's not endangering others (i.e. arriving at class with a contagious disease) or seriously endangering his health (which it sounds like he's not).
posted by rainbowbrite at 5:24 PM on October 5, 2012 [1 favorite]

Well, did they slump over OR WHAT?
posted by liketitanic at 5:12 PM on October 10, 2012 [1 favorite]