Some pangs -- you are not my doctor

November 26, 2024 4:35 PM

Nor am I asking anyone on the net for medical advice -- but would take ideas and opinions. Today at 11ish I began to get a pang about once a minute just about where I figure my appendix is

(Not quite sure, I asked my paramedic niece, who sent me a diagram, but still not sure. She also mentioned "excruciating pain", nausea and vomiting, and this is nowhere near any of that, but annoyingly often.)
The last thing I want is to go to an ER on Thanksgiving Eve, not to mention the thousands of dollars I already owe the medical world for other things.
I have diverticulitis, well-managed with colestipol (off-label) and the occasional Imodium.
What symptoms have you had before you were dx'd with appendicitis?
Now it's been quiet while I typed this -- about 5 minutes. (Is this like taking the car to the mechanic where all the symptoms stop?)

posted by intrepid_simpleton to Health & Fitness (17 answers total)

Last time my partner went to the ER for something like this, the doctor ruled out appendicitis and said if the pain returned, try jumping up and down--if that doesn't make it way worse, it's not appendicitis. Here's an NPR article referring to this "jump test" for children. It has not been scientifically validated in adults, but it was the clinical recommendation of at least one ER doctor for an adult. Here's an article discussing some signs/tests specific to adults.
posted by brook horse at 4:56 PM on November 26 [6 favorites]

My appendix pain was on the front of my abdomen, about halfway between my bellybutton & my right hip. It started as occasional aching, then off-and-on sharper pains for a couple days. It was enough that I thought I should probably go to the same day clinic/urgent care later that day, once I was done with work.

Then I tried to go up the stairs & nearly passed out & it hurt a lot more. (I did not have excruciating pain & don't remember any nausea.) I went to the ER, told them I was pretty sure there was something wrong with my appendix, and was in surgery less than an hour later.

It is better to get checked out, just in case. It's much easier to deal with before it bursts.
posted by belladonna at 4:57 PM on November 26 [3 favorites]

When I had appendicitis the 'tell' was when pressing deep into my abdomen, and then letting go, removing the pressure -- well, that's when it really hurt.
posted by Rash at 4:58 PM on November 26 [5 favorites]

I have diverticulitis, well-managed with colestipol (off-label)

There are also diverticulitis emergencies, if you aren't already you would want to familiarize yourself with those symptoms.

Keep in mind you can contact your doctor's office and ask them about your symptoms

The last thing I want is to go to an ER on Thanksgiving Eve, not to mention the thousands of dollars I already owe the medical world for other things.

Assuming you are being honest about that being the last thing you want to do, I suppose dying at home instead of going to the ER is always an option. So you have choices there.

Not really so sure about what is so terrible about Thanksgiving eve in particular, I don't think it is known for being especially busy. And lots of offices are operating as normal on Wednesday.
posted by yohko at 5:20 PM on November 26 [2 favorites]

Response by poster: very funny, yohko, but you made your point :).
posted by intrepid_simpleton at 5:29 PM on November 26 [1 favorite]

I'm glad you found it funny -- Sadly with the medical system in the US it is an option many people choose so as not to use up an inheritance they hope to leave for their heirs. So there is a lot of seriousness there as well.
posted by yohko at 6:17 PM on November 26 [2 favorites]

Response by poster: My pain has all but stopped. I added a hot pad after reading up on diverticulosis. I will check in with the doc tomorrow (unless it gets worse). I know all about the crappy health system, as my HealthCare.gov seems to pay rather capriciously and arbitrarily!
posted by intrepid_simpleton at 6:35 PM on November 26 [2 favorites]

Money is just money and I don't mean that lightly. But if you're at all enough worried at the point where you're thinking you should go to the ER. just go. I went to the ER twice last year for what turned out to be nothing significant both times but I have zero regrets about doing so (one actually involved an ambulance ride).
posted by edencosmic at 6:40 PM on November 26

Do you ovulate?
posted by ponie at 6:47 PM on November 26 [4 favorites]

Eric Strong, MD is a Hospitalist at Stanford University that offers training videos for doctors on diagnosis and treatment of various medical conditions. I have given you his video on Acute Abdominal Pain He identifies areas of the abdomen and symptoms and recommended treatments. There are other short clips on his site, Strong Medicine, if your symptoms don't fit. I hope you find some useful information among his offerings. I hope you feel better.
posted by effluvia at 7:50 PM on November 26 [3 favorites]

I had appendicitis (and an emergency appendectomy) around this same time last year, oddly enough. My symptoms sound similar to yours and also didn’t seem to be “that bad” comparatively until it very rapidly got bad. It started in the late afternoon, and felt a lot like ovulation pain (weird pangs like someone plucking a string inside you) + general stomach upset. I get heartburn and other less specific tummy aches a lot so I didn’t think much of it. Had a kind of fatty comfort food dinner and it just got worse throughout the night, like waves of increasing discomfort in between periods where I felt ok. I thought it was probably something I ate and convinced myself to wait until the morning when the walk-in clinics opened and went to the earliest available clinic. I even stopped along the way to run an errand. By the time I checked into the clinic and learned they were probably going to refer me to the ER anyway, I was feeling pretty awful. I drove myself to the hospital, puked in the ER bathroom, and was quickly admitted. 😂

I was honestly surprised to find out it was appendicitis because I legitimately thought I was overreacting. I’ve had heartburn more painful than that! Also what sucks is that if it’s not something serious you WILL be treated like you’re overreacting bc that happened to me when I went back to the ER after surgery (beside the point but I digress). Being in the ER sucks. My advice is that if you’re feeling worse now than when you wrote the post, go to the ER anyway.
posted by a.steele at 8:11 PM on November 26 [2 favorites]

Do you ovulate?

Or, do you have ovaries in general? Funky shit can go on with ovaries too. (Like, this, for instance, which happened to me.)

Honestly, even if it were the day before Thanksgiving - or even if it WAS Thanksgiving - if it hurts bad enough in the morning, I'd go, just to rule things out. Could be appendicitis; could be ovarian torsion - it could also just be a massive gas cramp and the doctor just kindly gives you some gas-x and leaves the room for 20 minutes. Abdominal pain is not something you want to screw around with.

(Odds are that it isn't ovarian torsion, because you wouldn't be typing an AskMe in that state, you'd be writhing in intense pain and screaming "OH GOD WHY HAST THOU FORSAKEN ME" by now.)
posted by EmpressCallipygos at 8:27 PM on November 26 [5 favorites]

I had a ruptured appendix resulting from appendicitis that was misdiagnosed as gastritis, and that was hell, but I was in much more intense pain at the start of it than you sound like you are.

Having said that, I wanted to chime in this thread because one of the things I learned through my experience is that relying on palpating / rebound pain and matching symptoms to area of abdomen can easily result in a misdiagnosis. Not all appendicitis has rebound pain (that's what the "removing the pressure" comment is talking about, it's commonly considered to be a reliable diagnostic tool, but it's not 100% reliable), and, weirder even, the appendix is not even always in the same place in every body. I am mentioning this in just in case your symptoms return/worsen, and you use these ideas to figure out if it's likely you have appendicitis or not.

There is also chronic appendicitis which can come on slowly and be more dull than sharp, so just FYI.
posted by virve at 9:17 PM on November 26

I am reluctant to comment here since I am a GI doc and obviously cannot provide medical advice here but just as a general point

The location of the appendix can be highly variable. Since it is long(ish), soft and floppy, the tip of the appendix can move behind the bowel, or upwards, or towards the umbilicus.

For this and other reasons, appendicitis can be difficult to diagnose and especially difficult to rule out without imaging and labs.

In some cases, there's the classic right lower quadrant abdominal pain, and rebound tenderness (where it hurts more when abdominal pressure is removed suddenly) but the symptoms might not be quite as obvious as that and certainly there does not need to be "excruciating pain" for the patient to later be diagnosed with a ruptured appendix.

I guess what I mean is that new onset abdominal pain can never be evaluated without putting your eyes (and hands) on a patient.
posted by M. at 11:32 PM on November 26 [2 favorites]

Response by poster: Do you ovulate?

Thank G*d I'm past all that.
posted by intrepid_simpleton at 5:13 AM on November 27

Response by poster: Follow-up: I have now been many hours (since 11 pm last night) with no pain. I think it may have been a lack of fiber, to put it delicately. I will definitely mention it to my doc next time I see her I do thank each of you for your thoughts and input.
posted by intrepid_simpleton at 12:53 PM on November 27 [1 favorite]

My two cents: I had appendicitis which turned into a ruptured appendix. I never had a fever or nausea -- just an ache that would change in intensity throughout the course of a couple days. It hurt worse when I lifted up one knee. But the press-test did nothing.

I ended up going to the ER when I got very light-headed and faint. I ended up being in the hospital for five days.

Go get it checked out.
posted by egeanin at 2:42 PM on November 27 [1 favorite]