Appendicitis: One Patient’s Atypical Experience

Appendicitis is the inflammation of the appendix, which is a finger-shaped pouch with no known purpose that projects out from the large intestine on the lower right side of the abdomen. This inflammation causes abdominal pain of varying degrees and is usually treated by surgical removal of the appendix. If the inflammation is left untreated, the appendix can rupture, which can then release pus or infection into the abdominal cavity that can lead to a life-threatening infection called sepsis.

According to the Mayo Clinic, the most common symptoms of appendicitis include sudden pain that begins on the right side of the abdomen; sudden pain that begins around the navel and often shifts to the lower right abdomen; pain that worsens with coughing, walking, or with other jarring movements; nausea and vomiting; loss of appetite; low-grade fever that may worsen; constipation or diarrhea; abdominal bloating; and flatulence. The Mayo Clinic goes on to report that most often appendicitis occurs in people between the ages of 10 and 30 and that the site of pain may vary, depending on age and location of the appendix.

As a recent appendectomy patient, I would like to point out that the above is the perfect textbook scenario that emergency room doctors hope to encounter. I, like my life, am anything but perfect or predictable. I went to bed on Monday with a touch of GI upset, which is my normal since I battle with an autoimmune disorder that tends to upset my stomach quite a bit. I woke up on Tuesday with the same light GI upset accompanied by a mild pain in a perfect circle around my belly button. I thought this new sensation would pass so I went to work.

The perfect circle of pain in my navel was still with me on Wednesday and still mild. I could eat and use the bathroom, so I went to work. The mild belly button pain lingered into Thursday, which is when the bloating began. I had to unbutton my jeans just to stay seated on my yoga ball at work. Every now and then the mild pain would spasm into something like a love tap in the abdomen from Muhammad Ali or a Pillsbury Doughboy poke in the belly by Andre the Giant.

After a few hours of mild navel pain accompanied by spasms of stronger pain, I finished my work day and headed to an urgent care clinic, which was lacking the CT scanner necessary to accurately diagnose appendicitis. I was told if the pain did not go away in three hours to go to the emergency room. Well, three hours later, the navel pain was still there, just dulled, so I went to bed and slept for a few hours before falling out of bed after experiencing a tremendous pop of pain that was just under my bloated Venus of Willendorf belly curve. The perfect circle of belly button pain was still present as well.

My love Dutch drove me to the emergency room where I was quickly admitted and subsequently treated to an IV placed in my forearm less than two inches from my small wrist and to a copious amount of dripping fluids. The emergency room doctor tapped on a few areas of my abdomen and “hmmm”ed his way around my circle of belly button pain. He stated he could not identify the source of my pain and was leaning towards a ruptured ovarian cyst. I declined pain medications because, if I stayed still, the pain continued to be mild.

To help with making a diagnosis, I was sent off for a CT scan with contrast dye. Within 45 minutes, the emergency room doctor came in and explained I really did have appendicitis, the slowest moving one he had ever seen. My appendix was twice its normal size. I was given IV antibiotics as I waited for the surgical team to swing by to schedule our imminent date. Being a complete geek, I asked to see my CT scan and a surgical resident walked me through what we were seeing: inflammation around the appendix, dark spots of air in the abdominal cavity, and all the organs that reside in the abdomen.

I was admitted to the hospital at 4 a.m. on Friday and went into surgery around 1 p.m. later that day. By the time surgery commenced, my appendix had increased to three times its normal size without any change in pain and without the appearance of pain on the right side of my abdomen. My laparoscopy procedure involved a half-inch incision near the top of my panty line, an inch-long incision on my right side directly across from my belly button, and a star-shaped incision inside my belly button.

I was told two weeks later at my surgery follow-up appointment that the appendix had developed a tiny hole in it and was on its way to rupturing. My surgeon was able to bag the appendix while it was still in my body so that if it ruptured during surgery I would be at less risk of developing an infection. The appendix was removed through the incision on my right side, which explains the extreme tenderness present in that area during recovery. He said the incision on my large intestine was stapled shut using surgical grade staples that can remain in my body for the rest of my life.

While I was not the patient with the textbook symptoms of an appendicitis, I was thankfully the patient with the textbook recovery from surgery, with little to no pain and a winning attitude. Unless you count the moment when I was being wheeled from recovery back to my hospital room while cursing like a sailor, which really was not socially acceptable since I was being cared for in a Catholic hospital. Dutch said the nurse escorting me tried to not laugh out loud, so I am hoping she overlooked my potty mouth or at least told her family I was the highlight of her work day.

I was ahead of the recovery curve and wanted to go for a walk and to eat pudding for breakfast before it was officially time to do either. I gave myself sink baths, changed my own hospital gown afterwards, and changed the dressings covering my belly button. After laparoscopy surgery, it is normal for the belly button area to ooze a frothy pinkish substance. My nurses speculated my recovery went so well because I am generally healthy on a normal day.

The takeaway from my journey through the onset of mild belly button pain to my release from the hospital with three surgical incisions and a now absent belly ring from freshman year of college is that I need to listen to my body more. I was very lucky my appendix did not burst and that I did not have an ongoing infection in my abdomen because I ignored my pain, even though it was mild.

Unusual pain needs immediate medical attention. Be safe and don’t wait to go to the ER for evaluation if you are experiencing unusual pain, especially around your belly button.