Guest post by Erin Henrici
[Healthcare context: Erin is based in the US]
We have all had that paranoia, whether from binge-watching too much Grey’s Anatomy or self-diagnosing after an anatomy lecture, about the ticking time bomb growing in our bodies: the appendix. How can something so small, and arguably useless, create such an urgent and terrifying situation in the case of rupture? How do we know if our appendixes will stick with us to the end, or jump ship as soon as it acknowledges the state of the world?
The often televised or reported form of appendicitis is technically acute appendicitis. Acute appendicitis may be caused by a bacterial infection or a small obstruction in the opening of the appendix (commonly referred to as the size of a popcorn kernel). Often the symptoms that accompany this form of appendicitis are sharp pain, fever, sweating, nausea and vomiting, and difficulty walking. If the abdominal pain abruptly ends, it could be a sign that the appendix has burst, which leads to fecal material being spread through the abdominal cavity and could lead to peritonitis. Like I said: ticking time bomb.
The other type of appendicitis, which is less commonly discussed, is chronic appendicitis. This occurs when the appendix becomes chronically inflamed for weeks, months, or even years, and the symptoms may come and go. Because this only occurs in about 1.5% of appendicitis cases, it is often difficult to diagnose. While patients with this condition may not be experiencing the full blockage that results in rupture, they still experience continuous pain and discomfort that can last for years, so the appendix is still taken out as a result.
In 2012, what I initially thought was a bad bout of food poisoning from Thai food ended up being an agonizing three months of severe pain and stomach issues, which had me in and out of the campus health center and hospital multiple times a week. My vitals were normal, so I was continuously prescribed drugs to help with stomach acid and gastrointestinal issues. Further testing was inconclusive, and I was provided the “garbage can” diagnosis of Irritable Bowel Syndrome. I was placed on anti-depressants and referred to mental health counselling as I was probably just stressed from being a college student and I couldn’t manage my anxiety.
Nevertheless, the pain persisted. A sharp pain would stab me in the lower abdomen, to the point that it would feel like a slap in the face in its suddenness. Each time, I would start to sweat and my heart would race; is this the day that I finally die? I would be too afraid to go to sleep, and often would stay up all night telling myself that I could go to the hospital in the morning if it was still bad. I could sense something was wrong, but every time I went to the health center it felt like they were diminishing my concerns and continuously became less helpful over time. This initial flare up severely negatively impacted my academics and mental health at the time.
I went off my anti-depressants and my birth control and changed my eating patterns, and the symptoms slowly decreased. But then, FLARE UP: Junior year, the stabbing returned, and the health center urged me to seek out counseling again. FLARE UP: My semester abroad in Italy, I was referred to the E.R., where they ultimately decided to refer me to gynecology since it seemed like a “female issue,” and one of the counselors insisted I see a therapist there since it seemed like I was just homesick and anxious. In total, I experienced these flare ups for FOUR YEARS.
During 2016, my first semester in grad school, I embarked on my favorite past time of getting some Indian food, clumsily ramming my body into a table returning from the buffet, and then heading out to a concert for the night. Mid-concert, the familiar stab returned. As a continuous bargain that I had with myself, I waited up all night and decided to go to the health center the next day. As my university was connected to a lot of teaching hospitals, they had a tendency to refer students out to E.R.s for anything that had symptoms that could potentially be related to a dire health concern (i.e. $$). After sitting in the E.R. waiting room for 11 HOURS (thanks America), I was finally seen by a doctor. I gave him the story, even throwing in being-jabbed-by-a-table-corner as a symptom, and expected the usual. He laughed regarding the table aspect, but said that they would let me get a CT scan anyways since I had been dealing with chronic pain. One hour later, he returned saying: “Well, congrats on being the first person to get appendicitis from running into a table”, and confirmed that my appendix was quite inflamed and needed to be removed. 24 hours later, and with three new battle scars on my belly, my appendix had finally left the chat.
Having my appendix removed felt like a pressure was lifted off my chest (well, in this case, my abdomen), but the experience of having to go through those issues for four years still lingered. Was it out of pure benevolence that this doctor decided I finally earned the right to a CT scan? Why was it so easy to dismiss my symptoms and pain before, and write them off as being hormonal or psychological? Regardless of the fact that it did not present the imminent danger of acute appendicitis, I was still clearly communicating to the health professionals that I was in a great amount of discomfort and my situation was not being validated. It got to the point where I would experience overwhelming anxiety when I went to the doctor’s, which didn’t help the case that it wasn’t “all in my head,” and I still have to shake that feeling off today when trying to get help for other chronic issues.
My story can resonate with a lot of women who have sought help for medical issues and were turned away or defeated by the assertion that their symptoms are related to their biological structure or mental health. I am grateful that my condition was not fatal, and that I have one less body part to worry about now, but that is not always the case. The medical community needs to acknowledge the biases and assumptions that exist regarding a woman’s pain, and provide further investigative health services before writing off her concerns.