Would this have happened to a boy?

Batman24 · Jan 14, 2009

It sounds like she has two things wrong...an inflamed appendix and a cyst. I would think her appendix needs to come out. If she is still in terrible pain I would take her to the ER immediately. You don't want her appendix to burst. Cyst can burst as well. Good luck with the gyno. Make sure to tell her about the inflamed appy as well.

Reigen · Jan 14, 2009

I had an ovarian cyst way back in 1976 the wait and see attitude that I was given -----well the cyst ruputred.

A second opinion is a good thing to get. I would have done that (had I known about that opition) and saved myself weeks of agonizing pain.

I hope your daughter is treated and gets better soon.

Reigen

BabyLady, BSN, RN · Jan 14, 2009

No blood work?

leslie :-D · Jan 14, 2009

your dtr DEFINITELY needs a 2nd opinion.

and after she's treated?

i would seriously consider finding a more sensitive pcp for her.

leslie

Medic09, BSN, RN, EMT-P · Jan 14, 2009

Caveat: I'm a guy.

Maybe your PCP is insensitive. I've seen both female and male docs who are.

Having said that, I consulted with a female Family Practice doc with a reputation for being very kind to her patients (my wife).

There has been a definite trend in some surgical circles not to remove an appendix so fast, like was once done. I thought I'd seen this in our hospital; and my wife concurs. If there is just slight inflammation, the docs may suggest a short 'wait and see' period (with or without Abx). I know our docs often are on the phone with the surgeons, but the surgeon may not come in and look unless they think the situation warrants it. The patient often doesn't see this. It may be the ED doc acted diligently and consulted, and the conclustion was wait it out for a while.

As for ovarian cysts, they often hurt like hell. Enough to make someone pass out. Depending on the individual situation, there may be nothing to do other than pain control. Or there may be more needed. Each patient, including your daughter, is an individual.

I tell almost every patient I discharge from the ED, 'follow up with your doctor'. It is just good advice. So, have your daughter see her Gyn, and see where it goes.

Good luck. I pray that your daughter has relief and healing soon!

CHATSDALE · Jan 14, 2009

i never had either but pain is a warning sign and should not be ignored...if the pain has not abated you need to take action

when something goes wrong the doctors say 'well that was a learning experience'

SCSTxRN · Jan 14, 2009

I don't think it would have happened with a female PCP - at least not one who has ever had an ovarian cyst. I've had 23 kidney stones, 2 nine pound babies, one epidural, and 3 ovarian cyst ruptures. I've also been shot. They're all (it was a complicated epidural - which is why the second baby happened without one) in about the same pain intensity - and my first ovarian cyst I was certain was a kidney stone, it hurt SO BADLY until it ruptured - which was like the feeling of a small atomic bomb in my lower abdomen, then relief mixed with a burning sensation.

What a jerk.

everthesame, LPN, LVN · Jan 14, 2009

Thanks for all of the replies.

I am sure labs were drawn but neither hubby nor daughter remembers any blood draws (probably with the IV start) and they both say the ER doc didn't mention any lab results other than the CT scan. Since the GYN is in the same health group as our PCP her nurse said she would have access to everything from the ER and the ultrasound.

I know of this GYN from my previous job and feel comfortable taking my daughter to see her. I always thought she was great with her patients and treated the nurses as valuable members of the health care team. I am just so glad there was a cancellation and I was able to get my daughter in to see her tomorrow.

Medic09, I appreciate the input from your wife. One of my daughter's best friends recently spent a week in an ICU after complications from a ruptured appendix. She, the friend, is fine now but we were all pretty shaken up by what happened to her. I guess the ER doc is up on the latest thinking on managing a possibly inflamed appendix.

Most of my work experience is in OB/GYN and I just can't get over my PCP's attitude about the whole thing. Again, hopefully after tomorrow's appointment we will have some sort of treatment plan and not just throwing pain med and nausea med at the problem. Those meds have their purpose but they really don't seem to be getting us anywhere except asleep a couple of hours after taking them.

rn/writer, RN · Jan 14, 2009

according to our male PCP it [an ovarian cyst] should not cause her so much discomfort. His advice was "Let's just take it day to day and see how she does."

Spoken like someone who has never had an ovarian cyst. Such cysts can cause excruciating pain whether they rupture or not. Either way, pain management is important.

When one of my daughters had one, serial ultrasounds were part of the diagnosis. Did your daughter have an ultrasound?

Glad you are following up on this.

lamazeteacher · Jan 14, 2009

Here's more input from a "strangulated" ovarian cyst sufferer.

When I was younger, without any pain from them, my GYN MD found ovarian cysts bilaterally. He said that they were the size of the grapefruit in his CA backyard. I had ovarian cystectomies bilat. with a preventive appendectomy.

On his post op visit, that superstar told me the "grapefruits" were the size of almonds upon their removal. Like all other cysts the fluid contained therein

will vary, but the potential to contain more fluid exists.

They need to be removed, as they have the potential (even if not painful) to block a ripened "egg" from leaving the ovary, thereby preventing conception when that is desired. So ignoring them is not beneficial, and pain is usually something that tells us we need to do something.....

30 years later, at 3 AM I had the painful one, and could only find slightly less pain assuming the knee-chest position. A stupid ED doc diagnosed diahrrea (without my saying that occurred) and prescribed imodium. I'm agreeing with you and adding the fact that some people graduate from medical school and lose IQ points rapidly, afterward.

It's extremely important to get a second opinion, even if you agreed with the first one. Then you're not left to wonder if you did the right thing afterward.

GadgetRN71, ASN, RN · Jan 14, 2009

OP, in answer to your primary question: No, this wouldn't have happened had she been a boy. I'm also not a big fan of the "wait and see" theory when it comes to an inflamed appendix. For the love of God, the stupid thing is pretty much useless. It's already inflamed and bound to get uglier-take the freakin' thing out!!

I feel very strongly about this because in my previous hospital, we had a notoriously bad ER, with some ER docs that were simpletons. I can't count the number of times we'd get a ruptured appendix in the OR and it would turn out they'd been seen in the ER previously, handed a script for Vicodin, and sent on their merry way. Often without a Cat scan. Many would have elevated WBC's too.

Get a second opinion..