Surgical question

I was wondering if any of you have heard of taking out someone’s appendix because “It is more elongated that it should be”. I don’t believe any blood tests showed an increase in white count. No fever, no vomiting. Only indications of anything were some adominal pain and back pain over the past year.
Case history: This women is quite obese (300 lbs) and has a history of constant problems with no true findings of anything medically wrong. The problems seem to go away after nothing is found by the docs, then new problems surface after a period of time. Delivered twins 2 years ago. Has a diet high in fat and sugar with little to no veggies and fiber, no exercise and gets others to watch her kids so she can sleep all day.
She was scheduled for a laparoscopy and after it was done, the doc came out and said they took her appendix out for the reason stated above.
Just curious. I know what I think, but I am not a doctor.

Well, I’m not a surgeon, but I know that we were taught on my surgery rotation that if you’re doing an open incision for presumed appendicitis and you discover a perfectly healthy appendix, you take it out anyway… because the incision is going to announce to any future surgeons who see the person’s abdomen that they’ve had their appendix removed!
Now, laparoscopically of course, those little buttonholes in various places could mean ANY sort of surgery, so the rationale doesn’t apply. But ya know, if they had gone to all the trouble to anesthetize me looking for a hot appendix, I’d just as soon they took it out of me, too. But I’d just like the truth rather than the curious statement that it wasn’t quite the right size.
Whose story are you hearing? Is this what the patient heard or what the surgeon really said?

Thanks Mary for your response.
I am hearing the patient’s feedback. Actually it is my crazy sister-in-law. I wish I could have heard what the surgeon said about it. I am really concerned because this lady is always having procedures done to herself, and personally I think it is a cry for attention. She was having troubles before Christmas and then mysterously the symptoms went away for the holidays and she flew arcross country to visit with her family and then spent Christmas with my husband’s family.
I commented to my husband that I wondered how long it would take after the holidays and after the attention for the holidays was gone, before she would have somethig wrong again. Sure enough a month and a half later she was having new symptoms and everyone was hyping attention on her again.
She rountinely goes for ultrasounds, MRIs, CAT scans, colonoscopys, etc. And it is always for something different. I mean, I would worry if the symptoms were the same, or if the doctors were the same, but new docs and new symptoms every time. I feel guilty thinking she is just doing all this for attention and if there is something wrong with her, I would feel really badly, but I know she likes attention and she doesn’t get it any other way. She got a huge amount of attention when her twins were born. She made the front page of the state paper because they were preemies weighing only 1 lb 4 ozs.
Depression also comes to mind. She rarely takes care of her kids. My husband’s brother works 3 jobs and still takes care of the kids when he is home and at night. During the day she dresses her kids and drops them off at aunts, mother, mother in law, or who ever will take them so she can sit on the couch all day. She is a very lazy person and won’t lift a finger to help anyone.
Ok, I have rambled on and on, but my husband’s family keeps asking me what I think is wrong with her. You know, it is the old my daughter in law is going to be a doctor so she must know everything now theory.

Hi there,
No surgeon is going to take out an appendix without an indication. (Having an extra-long appendix is not an indication for appendectomy). Since she was relating symptoms of abdominal pain, the appendix seemed to be a likely culprit for her symptoms. Many times we take out a healthy appendix because the patient presents with abdominal pain in RLQ with no other explanation. The appendix may have shown inflammatory changes on path report while it looked fairly normal. Mysteriously, her symptoms may be relieved even if the path comes back normal. About 20% of the appendices that we remove are normal but the patient feels better. It was fortunate indeed that the appendix was removed with a laparoscope thus avoiding an abdominal incision.

Amy, well, there IS something wrong with her - but it may be that its origin is psychiatric, and it manifests itself in somatic disorders. Unfortunately people with somatization disorder can undergo a lot of tests and procedures because they really do look like something is wrong.
In our psychopathology class, we were taught that people with somatization disorders should be treated by having regular, frequent scheduled appointments with their primary care doc. (the idea is that they get the attention they need without having to “ramp up” the symptoms) In the various places I’ve seen primary care, I have seen this practiced with exactly ONE patient, but I am quite sure I’ve seen any number of people with somatization disorders.
Folks with this problem aren’t doing it on purpose, not consciously. They are really hurting and somewhere the wiring has gotten screwed up so that psychic pain becomes physical affliction. She may very well be depressed or have some other mood disorder - but it sure sounds to me like the pain ends up coming out through her body.
Unfortunately families are notoriously reluctant to hear psychiatric diagnoses so I don’t advise that you answer the inevitable “What do you think is wrong with her?” by saying she’s a head case!