The Season for Sorrows and Joys

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Why is it that the scariest and toughest illnesses occur at the festive time of year? Instead of family gatherings at home with music and merriment, for some people the holidays involve hushed tones at the bedside in a hospital.

It may have started as nothing serious. An ache. Maybe stomach flu. But when symptoms turn serious, getting to an emergency room is not to be delayed.

One common cause of trouble is the appendix. This odd, little finger-shaped organ was poorly understood in medical history until more recent times. The fact that a ruptured appendix could be removed without apparent implications for the patient had doctors convinced it was an evolutionary leftover. More recent research suggests it functions as a “saferoom” for good bacteria – ready to replenish the gut as part of the immune response to heal infections.

But when the appendix itself gets infected by bacteria, viruses, parasites or fungi, the tube that normally is about 4 inches long can become acutely inflamed. Pain can come on quickly and be severe.

For the doctor, sometimes the diagnosis can be as easy as rolling off a log. But at other times, it takes the wisdom of Solomon. Every surgeon knows the abdomen can offer astounding surprises. The pain of an infected abdomen can be similar to a perforated hernia in the large bowl. Or to cancer. Or, in a woman, a twisted ovarian cyst.

Claudius Amyand removed the first appendix at St. Georges Hospital in London, England, in 1736. But confusion reigned for many years on how to treat this disease.

For instance, records show that one New York surgeon just stitched up the small hole in the appendix. Another surgeon merely straightened out the kinks in the organ. If these patients survived, it was with the help of the Almighty!

In our family, it was the Christmas of 1946 when a long trip home from Europe by a much-loved father involved the terrible pain of a ruptured appendix. The delay in getting to the hospital resulted in peritonitis and the terrifying possibility of death. New availability of penicillin made the difference, and after a few harrowing days, the near tragedy was averted.

Today, somewhere between 5 to 9 people out of every 100 will develop appendicitis at some point in their lives. It’s more common in males and usually occurs in people in their teens or early adulthood. But it can happen in people of any age.

How do you know if that pain in your gut is a serious case of appendicitis or the other common problem of abdominal gas? First, mind the location. Appendicitis involves dull pain near the navel and upper or lower abdomen that can shift to sudden pain in the lower right side of the abdomen. The pain will worsen with coughing, walking, or other jarring movements. Abdominal gas will not normally leave the patient doubled over in pain, curled up on the floor, and unable to move.

Call for medical help and get to the emergency room if you suspect the appendix.

The good news is that when diagnosed correctly and treated promptly, the patient is likely to be mended and back home soon.

Not all people who fall ill are as lucky. During this year’s holiday season, we’ll be thinking of those who are spending time in hospital fighting an illness and unsure of the prognosis. To them and their families, and with thanks to the people caring for them, we wish all the best for recovery and a healthy year ahead.

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