Appendicitis/Ovarian Cysts

[Phoenix_girl]

Ok this thread is sort of about 2 topics that have both hit me at the same time....

 

On wednesday i was having sharp stabbing pains in my upper abdomen. I went to emerg. By the time I was seen the pain had lessened but moved to the right side of my abdomen.

They did blood work which showed an elevated white blood cell count and an ultra sound revealed an ovarian cyst on my right ovary.

The doctor said that the cyst did not account for the elevated white blood cell count. The ultrasound did not clearly show my appendix but what they could see did not appear inflammed at that point, but the doctor did caution it could be early stage.

 

So I have 2 questions:

 

Ovarian Cysts cause problems with the menstral cycle and to aleviate this, docs put you on birth control. I am already on birthcontrol, and I'm having problems with my mentral cycle (spotting, starting early/late). Is there anything i can do to fix this?

 

Appendicitis - since i was in emergency, the pain has localized down to my lower right part of my adbomen. Its become a rather constant dull ache/apain and sometimes when i push on it, i get a sharp pain that radiates to my back. I have little to no appetite, some bouts of nausea (no fever), and sometimes walking will make the pain worse. Problem is these symptoms come and go so i dont know if its just in me head (as i have become slightly paranoid). Is there anything that will tell me for sure if i should go back to emerg?

[jenny_mcs]

Wow, this would would worry me. I know that an elevated white blood cell count is one indication of a ruptured ovarian cyst. But it sounds like the ultrasound indicated the cyst was intact and had not ruptured?

 

What did the ER doc say when they sent you home?

[Phoenix_girl]

About the cyst, they say its intact and from what ive read many many women have them (and have them burst) without knowing it. The doc said if its gets bigger and causes more pain it might have to be surgically removed (right now its just 5 cm).

 

As for the possible appendicitis....they said "wait and see". If i develop fever, nausea, vomitting, etc or the pain gets worse, then im supposed to go back....

 

I just dont want it all to be in my head...

[15 Storeys High]

Acute appendicitis starts with pain in the centre of the abdomen and moves after hours or sometimes days to the right iliac fossa (lower right abdomen) as the peritoneum becomes involved.

Things to look out for....

Pain which wakes you or keeps you awake.

Movement and coughing aggravating pain.

Nausea, vomiting, anorexia.

Constipation or diarrhoea.

Temperature and pulse are normal at first but a slight temperature then develops.

An increasing heart rate indicates infection.

 

There are also a few tests you can do....

The Rebound Test (Press on the right lower abdomen and then let go. If pain increases once you let go that indicates an inflamed appendix.)

The Psoas test (Lie on your left side, extend your right leg behind you. If you get pain in the right lower abdo it's a positive Psoas and indicates inflammation)

The Obturator test (flex the right thigh and internally rotate the hip). If you get pain it's a positive test.

[pilotgirl]

I had an appendix rupture and nearly killed me. I had sharp stabbing pain that started to localize on the right. I was tested for everything from pregnancy to AIDS and also did an ultrasound. Nothing was seen on the ultrasound, even after making me drink 52 oz of fluid to "put pressure" on the area to make it more visible. Hurt like hell.

 

They considered doing a laproscopy to investigate, but since my white blood cell count was only slightly elevated, I was sent home with a probable cyst. This was already day 4 of the pain, and I'd been discharged from hospital A, and now sent home by the OBGYN. On day 5 I was readmitted after being stuck on the couch in fetal position, unable to answer the phone (which was my mom calling to check on me)

 

Now at hospital B, I went through all the damn tests all over again to find out that, whoops, looks like we may have had a perforated appendix on Monday, and now it's ruptured on Thursday. Emergency surgery followed, and a bad infection, high fever for days and a 2 week hospital stay.

 

Later found out that hospital A and B both delayed action because they had already done 2 surgeries that year where healthy tissue was removed, and it was only March. One more would mean trouble and a fine. So they had to be absolutely sure I was in fact dying to operate.

 

That was not the end of the story. The next two weeks were horrible and made me completely untrusting of hospitals, doctors and the health care system in general.

 

Bottom line: if it's on the right and you have an elevated white count, that points to infection. Nausea is not a symptom for everyone like they say. I never lost my appetite. The 3 days I was in hospital A I was not allowed to eat and I was ravenous. Day 4 I got to eat at home after the OBGYN, and day 5 I got my stomach pumped before surgery.

 

I know a cyst can exhibit many of the same symptoms, but if the white blood cell count is more than slightly elevated then you have an infection, and possibly a time bomb ready to go off. Seriously, I ended up with early gangrene in the abdominal cavity and possibly damage to my right ovary. The pain will be dull, deep and will get to the point where You Know That Something Is Really Wrong In There.

 

I've also had minor ovarian cysts, and for me the pain felt more like an intense menstrual cramp. The appendix was different. Also the three classic tests: The Rebound Test, The Psoas test, The Obturator test were performed in hospital A on days 1-3, by doctors and puzzled medical students who actually came in to observe these tests being negative negative and negative. Fact is, I was so scared of surgery that I mentally blocked the pain while the doctors were in the room. They said if it was REALLY appendicitis, I would be jumping off the bed in pain when they pushed there. Well I wasn't, but I did had a ruptured appendix and now I've got the scar to prove it.

Good luck to you

[tiredofvampires]

pilotgirl, that sounds horrible!!

 

I have had this problem of "scares" about my appendix vs. ovarian cysts before (I went through a stint during severe emotional stress about a year and a half ago where I had a string of cysts, and there were a lot of "false alarms" about my appendix, but it sure was frightening and confusing.)

 

Storeys, I came to wonder after all that: is there a way you can "head off" a full-blown appendicitis that needs to be operated on? Can you start on a course of antibiotics if the pain is low-grade and early in the game and hope to cure the infection? Treat sort of prophyllactically/empirically if it's suspicious?

[15 Storeys High]

Not really. Appendicitis occurs, usually because of an obstruction, which causes invasion and inflammation of the appendix wall. Antibiotics alone won't remove an obstruction so surgery is usually needed too.

[Phoenix_girl]

I'm just worried that I've gotten myself so paranoid.

 

The pain is just a dull ache, which sometimes i notice and sometimes i dont.

Most of my symptoms (with the exception of my loss of appetite) come and go. I did the test where you pull your leg behind you and felt a slight twinge, but no stabbing pain.

Some things ive read said it can take days for appendicitis to develop, is this true?

 

As for the cyst - its only 5cm, but its gonna have to come out. I'm already on birth control but my menstral cycle is completely messed up (one month got it a week late, next month got it eary, this month getting it early again).

 

My body really likes to play the mind games.

[metrogirl]

My childrens doctor once told me years ago, the way he helps to rule out appendicitis is to have them jump up and down. If it feels almost like it is tearing inside, than more likely than not you have appendicitis.

 

Fortunately for me his advice came in very handy for me about 9 years ago. I had an ugly pain in the lower right side. I did the whole jumping thing and it hurt like crazy. I went to the doctor, was tested for everything and since my white count wasn't elevated they weren't exactly eager to do much. When I went back the next day because the pain was getting worse, only then did the doctor admit me for "observation". The surgeon came to see me in the morning and knew that I had appendicitis. He removed it later that day. I asked him, a day later if he was correct with his diaganosis, because my white cell count still was not indicating an infection. He said that it was in the beginning stage where it starts to become inflamed. He said most people wait until the pain is unbearable and usually by then it has already ruptured. I was lucky, they got mine early.

[Phoenix_girl]

jumping up and down doesnt seem to hurt it.....

[metrogirl]

jumping up and down doesnt seem to hurt it.....

 

That is a good sign.......When I did it, it literally felt like something was tearing in that area.

 

Hopefully what ever you are experiencing isn't serious. Feel better soon.

[Phoenix_girl]

well if i can find someone to go to emerg with me I'll go. I am not spending 8 hours in emerg alone again

[avman]

Appendicitus generally resolves within 24 hours. That is, the appendix ruptures. Then you've got much more serious problems because your abdomen is filled with infection.

 

If it's been much longer than 24 hours since you've had this pain I would hazard a guess that it's not your appendix. But if you still have significant pain I would call a doctor and get a medical opinion. The whole wait and see thing just doesn't sound right to me.

[Phoenix_girl]

it didnt sound right to me when the doc said it He kind of hinted that if it is early stages and my body is fighting theinfection then it could take a few days (i've read this in other places as well).

[avman]

I'd say get a second opinion from some other doctor. The pain you are having is not normal and in my opinion isn't something you should just try to ignore.

[Phoenix_girl]

Does anyone know anything about chronic appendicitis?

 

I was doing some reading to see if appendicitis symptoms can go away. By the looks of it, Chronic Appendicitis has milder pain that can come and go, and even sometimes no pain - nearly impossible to detect until the appendix bursts In a lot of cases it is treated with antibiotics but reoccurs....

 

The really weird thing is....a few months ago, I was having abdominal pain in the same spot - lower right - i went to a clinic. I was feeling generally unwell and fatigued. Doc did blood work, and urine test. Blood work came back with elevated white blood cell count. Urine analysis came back clean. Doc still suspected a bladder infection even though i didnt have the typical symptoms (burning when urinating, etc). 2nd urine analysis (week later) showed some "non specific" bacteria - so he gave me antibiotics and off i went. Bladder infection never really sat well with me

[pilotgirl]

After all was said and done in my case, I thought about the possibility that it has been chronic turned acute. For the 6 months prior to the event, I was very uncharacteristically run down and tired with on and off cramps and general malaise. I was an active, athletic 14 year old at the time and I chalked it up to general teen stress and puberty that was kicking in.

 

After the surgery, recovery and gaining the 20 lbs back that I lost in the hospital, I felt really good...better than I had felt in recent memory. I suspect that I had a slow onset that became acute after a long while.

 

My uncle had a similar situation when he was 15, only he nearly died because his pain was on the left. Apparently, his appendix was on the left and the doctors had never seen that before and went in to do liver surgery when they found the ruptures appendix.

 

Even in this day and age with the technology that we have, it is still hard to definitively diagnose appendicitis in its early stages.

 

p.s. I could jump up and down, press on the spot, walk etc until it burst. Then I was doubled over in pain like I had a knife in my side. By then in was too late.

[Phoenix_girl]

I've been feeling really really run down for a long while....and even when i was in the clinic that was one of the things I had. I take vitamins sometimes and that helps a bit, but i always chalk up my fatigue to being stressed out (lots of other things going on).

 

A lot of things I have read though indicate that many doctors don't believe that chronic appendicitis exists. I dont want to leave this until it bursts, but i dont want a doc to just wave it away either and I dont have a family doctor.

 

My gut says something is wrong........am i just paranoid?

[avman]

My gut says something is wrong........am i just paranoid?

 

Best to trust your gut in such circumstances. I'd say go get yourself looked at to be certain.

[15 Storeys High]

Chronic appendicitis can go on for years....intermittant pain every so often with or without nausea and vomiting. It eventually leads to acute appendicitis but length of time varies. I know someone that had chronic appendicitis for four years (flared up every five weeks or so) until they finally removed it, hours before it would have ruptured. I would get yourself checked every single time pain occurs just so it's on record.

[tiredofvampires]

I had no idea there was any such thing as "chronic appendicitis". Learn something new every day.

 

About a year and a half ago, without much warning, I developed a goring pain in my left lower abdomen that was so bad, within hours I couldn't sit up with it, I was writhing too much. It didn't feel like anything ordinary (gas bubble, cramps). I was not aware of the Psoas or Obturator tests (ah, so that's what they were doing with my leg when I went in!), but I did do the Rebound test on myself and it seemed ambiguous. My friend had to drive me to the ER, since I couldn't drive. Once there, they did a CT on me, and told me the results were consistent with a ruptured ovarian cyst, since there was fluid in my abdominal cavity in the area.

 

They told me that the results of the CT also showed that I did NOT have an appendicitis. So I wonder if getting a CT (or even MRI? I don't know if they can do an MRI though of the intestine because it moves too much) of the abdomen would bring a definitive result? I didn't get the feeling that there was much question left about it from what they said, looking at the CT. Now, I don't know whether they were just assuming it was the ovarian cyst based on their exam and the free fluid they saw, but I would think it would be terribly irresponsible to tell me in clear terms that they were ruling out an appendicitis if the CT was at all indeterminate.

 

They did tell me that there are atypical cases of appendicitis which involve none of the classic symptoms -- and pain on the left side. They said some people are entirely asymptomatic, too. (I had to wonder if all these people were treated then post-rupture of the appendix. Must be.)

 

I was told that the fluid would be reabsorbed within 24-48 hours. And whether it's because of my body's slow healing time or the fact that each month for the next 4 months, a version of this occurred (only not so dramatically), that pain continued for those months. I had various ultrasounds and as long as the pain persisted, there was still fluid in my abdomen. So I don't know if your ob/gyn can determine if there is any fluid in there, but that is highly irritating. It was nearly incapacitating a number of times until it finally resolved.

 

As for treating chronic appendicitis, is there any way of dealing with that other than just waiting for the inevitable? Sounds like, Storeys, if you took antibiotics it could still drag on for 4 years (!) and really you'd get nowhere. I am just wondering why if they know a person has a chronically inflamed appendix, why they take a "watch and see" stance if it's not going to resolve on its own.

 

OP, I don't know if this is your bag at all, but my personal experience is that modern medicine is superb for a few things: emergencies and acute conditions, and diagnostic technology. However, it is fairly poor at dealing with chronic conditions. I have a few chronic diagnoses, and have found significant benefit from certain types of alternative medicine, most notably Chinese medicine -- which is most effective I've found for gastrointestinal and female disorders. The Chinese medical model rests on the idea that "stangation" of "energy" occurs in an area of the body that becomes chronically inflamed or diseased. "Energy" sounds like a fairly hokey word, but it is a loose translation for circulation, bloodflow and delivery of nutrients. Apparently, appendicitis is caused by an obstruction which leads to the infection, according to Storeys and this fits perfectly with a classic "stagnation" condition.

 

If I were you (and since your first posting, it seems this problem is NOT an acute appendicitis needing emergency care), since you have a little leverage here, I would try to find a reputable Chinese medical practitioner who is skilled in prescribing herbs. There are powerful herbal blends that you can boil (literally, sticks, bark, roots, etc.), or powdered mixtures that you take daily that work to address the "stagnation", and if you combine this with acupuncture, the pain reduction can be dramatic. (Acupuncture is so effective, it is used in China during C-Sections without need for aneasthesia or epidurals.) It's not just for reduction in pain, but in situations like yours, it increases circulation, which is vital to fighting infection.

 

So I don't know about the CT?....that might diagnose it better?....

 

And then, if it appears there is no immanent danger/emergency, to a Chinese doc pronto and see what happens there. I've had things turn course almost overnight with herbs alone. A few days of acupunture treatments close together would be ideal as well. It might be resolved with a course of this type of treatment, but first try to get a sound conventional medical diagnosis.

[Phoenix_girl]

Hi All

 

Well i was back in emerg last night as i fainted at work - first time fainting, dont want to do it again.

They have confirmed that I do have a bladder infection, but the doctor seems to think there may be an underlying cause.

For now Im on antibiotics and if i'm not improving after 2 or 3 days I have to go back to emergency for most tests (I've already spent 22 hours in a week in emerg).

I'm a little frustrated that they arent doing more imaging tests to rule out problems with my organs (like my appendix). This is my 2nd bladder infection in a year and the last one i had was the first one i have ever had.

My gut says theres still something they arent finding.....hopefully they dont find it the hard way.

[tamara01]

Phoenix_girl, is everything alright now? What was the doctors advice? Was it really link removed?

[Tickles]

On the early hours of Dec 19th 2010, I walked towards my Husband as I felt ill and collapsed after feeling an excrutiating pain shoot accross my lower belly. We had a few guests over the evening before but, I hardly drank anything as felt a bit 'weird'. I had been feeling 'off' for a few weeks but, had to idea there was anything wrong. My periods had become more painful and heavier and I felt aggitated a lot of the time. I was also gaining weight and feeling bloated.

 

My Husband said I was semi-unconscious for nearly 2 hours and groaning in pain. We waited 2 hours for the ambulance as were snowed in and live quite high up on a mountain. He and my 13 year old son were amazing in keeping things calm until they arrived. The next couple of days were a blur of xrays, scans, blood tests etc and they could find nothing wrong ](*,) . They were giving me Morphine and Tramadol as I was in such bad pain. I couldnt eat or drink in case I needed surgery and had vomitted a few times so they had me on a drip.

 

Monday evening (20th) I started getting quite severe pain on the right side of my abdomen which was very sensitive to touch and movement. The consultant came to see me on Tuesday (21st) and said they suspected Appendicitis and would perform a laparoscopy later that day as the pain was increasing and I had developed a temperature and faster heart rate. Surgery was at 7pm due to waiting for a few emergency cases to be dealt with first. It wa a 2 hour surgery and they removed a swollen, infected appendix and also found that I had several small infected cysts burst on my left ovary and a very large one had burst on my right. They cleaned up the pus and gave me a check over for any other problems. I had 3 small incisions, one slightly below my belly button, one on the left side of my abdomen (strange as my appendix is on my right lol) and one just above the pubic hairline. Christmas was a big struggle as I was on multiple antibiotics which made me constantly nauseus but, at least I was home with my family.

 

I am a mother of 3 children who has always had painful periods but, never any diagnosis of ovarian cysts. I was shocked that everything had happened so quickly. It has been 2 weeks since the surgery and I am still quite sore as I developed a bad couch when I got home which pulled on my tummy a lot. My belly button would is quite sore and has a hard lump underneath it. The side wounds is healing very well and the bottom one is slightly sore but, still terribly bruised. My tummy is still a bit swollen even though I have lost nearly a stone in 2 weeks. I started my period yesterday which nearly crippled me but, my consultant and local nurse did warn me that the first one would be more painful then usual due to all the 'messing around' inside.

 

There you go!! One minute I was planning for a stress free christmas, catching up with coursework and celebrating the weekend with friends, the next, I had collapsed and needed surgery. You can't always predict these things but, if you get any warnings and really do not feel right then don't take no for an answer from the medical professionals and its your body on the line. Hope everyone is heathy and happy now

[Chanie Smiley]

I've been have this sharp stabbing ache on my right side, sometimes it moves just below my belly button and goes all the way to my left lower abdomen. But mainly the pain in in my lower right abdomen. The ordered me to to a pelvic scan but thats two weekns from now.... they did a blood test and my white blood cells and slightly elevated. The pain comes and goes but when it comes it's so sharp. walking makes it worse. sometimes if i breath too hard i feel it. Sometimes i have the nausea feeling, but the urge to vomit is not there. I really wanna know whats bothering me.