appendectomy recovery

[lollie010]

My 8 yo ds had an open appendectomy almost 3 weeks ago. The surgeon could not do the laparoscopic procedure, so he has about a four inch incision. At 10 days post op the surgeon released him to do "whatever he feels like doing." The problem is he feels like doing absolutely nothing. After being released, he returned to school for a half day and it went horribly. He left in extreme pain and tears after 2 hours. I was not too concerned because that started a week long fall break and I assumed surely after an additional week off he would be up to returning.

 

Unfortunately, he is still not feeling well and Monday the break is over. He does ok for about an hour and then is completely wiped out and in tears.

 

Ive never dealt with absences and stuff because we've always homeschooled, but this year I am teaching at and he is attending a small classical school. I called the pediatrician about his lack of stamina and asked for further clarification. I was told by the nurse that, I didn't need to come into the office (or talk to the doctor) and that there was no reason whatsoever for him to miss any additional school over the issue and therefore no excused absences.

 

I am completely at a loss. We tried getting out yesterday and he lasted a few minutes before he was aching all over with a headache and chest pain from asthma. He could barely get back to the car, pale and shaking. His surgical sight was still hurting. He's a very healthy, fit athletic child, other than asthma and allergies (which are at their worse).

 

I just don't know how to proceed. He certainly doesn't seem like he can make it through an 8 hour school day which is extended by 2 hours because he is a teacher's kid. :(

 

Is this in the realm of a normal recovery? If I compare it to my only abdominal surgery (a c section) he would be due a little more time. He really doesn't seem to be "milking it." Any thoughts? What he describes sounds just like the flu, but no fever.

 

Thanks for listening.

[JudoMom]

We've never had an appendectomy, but it sounds like something isn't right. I'd get him back in to the doctor.

[Starr]

I am completely at a loss. We tried getting out yesterday and he lasted a few minutes before he was aching all over with a headache and chest pain from asthma. He could barely get back to the car, pale and shaking. His surgical sight was still hurting. He's a very healthy, fit athletic child, other than asthma and allergies (which are at their worse).

 

I would take him to the doctor. It is hard to imagine the doctor  won't see him with those symptoms. If the pediatrician won't see him I would be looking for a new doctor. Have you called the surgeon ? Did he get a post op check?  :grouphug:

 

[Carrie12345]

It's been over 30 years since mine (I was 7 or 8) but it doesn't sound right to me.

 

I'd take him in, but I'd also consider what things may be going on in his head. I was terrified through my whole recovery because I didn't fully understand everything. I went into complete hysterics when it was time to get my staples removed. No one explained it to me, and I was picturing the bent ends of paper staples being yanked through my skin! He could have fears that are causing physical symptoms.

[lollie010]

My husband took him to the post op with the surgeon and was told he could "do what he felt like doing." I guess to us that meant he was ready to start getting back to normal activities. Being a man of few words, hubby just took that and didn't ask any questions. We knew he was getting an additional week because of fall break, so didn't really have any concerns at that time. On Wednesday, I started realizing that he wasn't improving steadily after we went for a walk and he was miserable. On Friday, I thought it would be easier and quicker to go see the pediatrician but was intercepted by the nurse. :) But, after how things went last night, I will call back and insist. :( it's so hard to get off from work!!!! Makes me really miss homeschooling!!!

[bethben]

My ds had this when he was about 8 (he's 12 now).  That does not sound normal.  He didn't have the surgical scar (they were able to do it laparoscopically), but his appendix did burst and he had infection all throughout his abdomen.  After about a week, he was almost back to normal.  The antibiotics were worse than the actual surgery.   Same thing with dh.  After he stopped taking the antibiotics, he was pretty good to go.  

 

We've had a lot of surgeries in this house with kids.  We've never had what you are describing three weeks post op.  I would see your pediatrician or follow up with the surgeon. 

[displace]

Follow up with the surgeon. The person taking him needs to describe: he can't sit for X min/hours without pain, he has pain doing Y, he can't eat/drink Z, he has this other symptom, he goes to the bathroom ...

 

It could be he's a slow healer, has nerve pain, or other problems. I assume you are giving him pain meds?

[lollie010]

This really helps. That's not been his experience at all, so must be something else going on. I was expecting a "no big deal" recovery so what he's going through has really thrown me off.

 

My ds had this when he was about 8 (he's 12 now). That does not sound normal. He didn't have the surgical scar (they were able to do it laparoscopically), but his appendix did burst and he had infection all throughout his abdomen. After about a week, he was almost back to normal. The antibiotics were worse than the actual surgery. Same thing with dh. After he stopped taking the antibiotics, he was pretty good to go.

 

We've had a lot of surgeries in this house with kids. We've never had what you are describing three weeks post op. I would see your pediatrician or follow up with the surgeon.

[lollie010]

I think you are right. In the past three months he's had a major respiratory infection that flared his asthma, a concussion and appendicitis. As well as a new school and routine. So maybe he's just going to be a slow recovery.

 

Follow up with the surgeon. The person taking him needs to describe: he can't sit for X min/hours without pain, he has pain doing Y, he can't eat/drink Z, he has this other symptom, he goes to the bathroom ...

 

It could be he's a slow healer, has nerve pain, or other problems. I assume you are giving him pain meds?

[trulycrabby]

A four-inch incision is big, especially for a child. I am hoping the pediatrician did not realize that this was an open, not laparoscopic procedure.

 

I would take him back to the surgeon who did the procedure to make sure there is no infection and to get a school excuse.

 

:grouphug:

[nixpix5]

I would take him back in to check for infection. My son at 14 yo had a ruptured appendix and after spending 3 weeks in the hospital they released him. About 10 days after he was exhausted, in pain, sick...I came home from the store one day to find him passed out on the floor. He had an infection so we got him back in. I always wish I would have taken him back sooner and not waited as he ended up on strong medication from an IV at home due to sepsis. I would say it doesn't hurt to be cautious.

[Plateau Mama]

I would go back to the surgeon for the pain. Not the pediatrician. My son had the lapriscopic procedure, but had complications. He was hospitalized for 8 days. The next week he started school with 2 hours and worked his way back to full days. He would call when he was tired. By the next week he was back at school full time but he could do nothing else. He would come home and sleep for hours.

 

A friend who was a dr told me that because of the complication it would take 3+ months for my son to be back to normal and not to schedule anything extra. No sleep overs, no hikes, no walks, nothing. He needed rest. And sure enough at around the three month mark he bounced back.

 

That being said, when he was released from the hospital he had no pain. He was just tired.

[aaplank]

My husband recently had a complicated appendectomy that was unable to be done laparoscopically. He also had some issues with bleeding and had to be restitched. His surgeon told him to not work for 3 weeks and limited his lifting to 10 pounds for 6 weeks.

 

10 days seems way too fast. I would definitely take him back to the surgeon to find out the source of the pain. Also, some have difficulty clearing anesthesia from their system. I would say that your son needs several more weeks of recovery even if all is well.

[Alessandra]

I would take him back in to check for infection. My son at 14 yo had a ruptured appendix and after spending 3 weeks in the hospital they released him. About 10 days after he was exhausted, in pain, sick...I came home from the store one day to find him passed out on the floor. He had an infection so we got him back in. I always wish I would have taken him back sooner and not waited as he ended up on strong medication from an IV at home due to sepsis. I would say it doesn't hurt to be cautious.

This. Peritonitis can be a post surgical complication, if there was leakage prior to or during surgery. Also, if the antibiotics were not effective, infection could develop. Often instructions tell you not to take certain antibiotics with milk, because something in the medicine could bond with calcium, but they do not mention avoiding other foods, such as leafy green veggies, that also have calcium.

T

I agree with pp that the surgeon is the person to see.

 

Nixpix, sorry about your ds. That is serious! Some kids may go home with a PICC line. Nothing fun there.

Edited October 21, 2017 by Alessandra

[nixpix5]

This. Peritonitis can be a post surgical complication, if there was leakage prior to or during surgery. Also, if the antibiotics were not effective, infection could develop. Often instructions tell you not to take certain antibiotics with milk, because something in the medicine could bond with calcium, but they do not mention avoiding other foods, such as leafy green veggies, that also have calcium.

T

I agree with pp that the surgeon is the person to see.

 

Nixpix, sorry about your ds. That is serious! Some kids may go home with a PICC line. Nothing fun there.

Yep, they put a PICC line in and I remember sleeping in the room with him and getting up every couple hours to switch out various bags. I was pregnant with my DD at the time too. It was rough. It took him years to recover fully from that experience. To this day when my kids have abdominal pain I feel a slight panic wave. I never want anyone else I love to experience that again.

[Liz CA]

I was back in school after one week. The scar twinged a little if I bent sideways. As more time went by it was like it never happened.

 

Take him back. Something does not seem quite right...especially the paleness and shaking. Pain should be fairly minimal by now but pain perception is a very subjective thing and his pain level sounds way too high.

[JFSinIL]

I would take him back in and go all Mom on the medical folk until son is thoroughly examined and possibly scanned to make sure all is healing as it should. Could there be any adhesions pulling on things, or a hernia at the site,etc.?   I have had too many (9) abdominal surgeries to rule out anything.  Adhesions/scar tissue can hurt like the dickens if it is pulling on something. I had a few inches of small intestine removed this summer for just that reason - doc went in thinking she would patch a small hernia at the site of an earlier surgery and found part of my innards mangled up by adhesions. My "same day" minor repair work turned into a five day stay before I was released...and I ended up readmitted for another four days when after a few days my innards went on strike and stopped working.

 

Kidlet has been through a lot, and is not going to be 100% back to normal activity for a couple months, probably.   A full day of school two weeks after surgery is asking a lot of a little kid.

Edited October 22, 2017 by JFSinIL

[Annie G]

I'm disappointed that the nurse treated you that way. Either something is physically wrong with your boy (infection, adhesion, or something) or he's having a tough time dealing with everything that he's been going through.  Whatever it is he deserves to have his complaints taken seriously by the medical staff! 

 

:grouphug: To you and your son. Hope he feels better soon. 

[Sandwalker]

Some of his symptoms could point to low hemoglobin/hematocrit. Did he have much blood loss? Is his pulse rapid?

 

I would make an appointment with the surgeon's or pediatrician's office for Monday. If he runs a fever, to the ER.

Edited October 21, 2017 by Sandwalker

[lollie010]

Thank you all so much for the info and ideas. Our plan is to hang out around the house until Monday morning and call the surgeon's office at 8:00am, unless things get worse. It's been a real mess. He still looks really pale, but has not been as miserable this afternoon.

 

In a strange twist, we realized that the surgeon is the same surgeon who recently did a lumpectomy on my mom. He told her she could go back to cross fit training 3 days later. She ended up having the procedure done multiple times with a drain placed in weeks later. Her recovery ended up taking 8 weeks. 😱 So I'm thinking although he is a surgeon, perhaps he has never actually had surgery. :)

[lollie010]

My goodness--how scary. I will keep watching closely!

 

I would take him back in to check for infection. My son at 14 yo had a ruptured appendix and after spending 3 weeks in the hospital they released him. About 10 days after he was exhausted, in pain, sick...I came home from the store one day to find him passed out on the floor. He had an infection so we got him back in. I always wish I would have taken him back sooner and not waited as he ended up on strong medication from an IV at home due to sepsis. I would say it doesn't hurt to be cautious.

[lollie010]

Wow! If my guy makes it to school this week, I am sure he will be doing absolutely nothing else--he will be too wiped out. And the make up work!!!! I can't even imagine.

 

I would go back to the surgeon for the pain. Not the pediatrician. My son had the lapriscopic procedure, but had complications. He was hospitalized for 8 days. The next week he started school with 2 hours and worked his way back to full days. He would call when he was tired. By the next week he was back at school full time but he could do nothing else. He would come home and sleep for hours.

 

A friend who was a dr told me that because of the complication it would take 3+ months for my son to be back to normal and not to schedule anything extra. No sleep overs, no hikes, no walks, nothing. He needed rest. And sure enough at around the three month mark he bounced back.

 

That being said, when he was released from the hospital he had no pain. He was just tired.

[bethben]

If it’s an consolation, I have called surgeons plenty of times with things that turned out to be nothing. They send people home so soon after surgery and we’re supposed to know what’s normal recovery vs. abnormal? I’ve even sent pictures of things that didn’t look quite right. Even if it’s just knowing that recovery will take longer, calling/being seen can set your mind t ease.

 

 

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[Annie G]

If it’s an consolation, I have called surgeons plenty of times with things that turned out to be nothing. They send people home so soon after surgery and we’re supposed to know what’s normal recovery vs. abnormal? I’ve even sent pictures of things that didn’t look quite right. Even if it’s just knowing that recovery will take longer, calling/being seen can set your mind t ease.

 

 

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This. :iagree:   However, last year dh had bypass surgery and his incision became infected inside. The surgeon told us to go to the ER and the ER said it looked fine and sent us home. (It was a weekend and the surgeon was 50+ miles from home) The next day we saw the surgeon and he was like no, that is NOT ok.  Yeah, they almost had to open that sucker back up.  Better safe than sorry. 

[Tap]

I had an open appendectomy a few years ago.  I also think that something sounds wrong.  I would suspect an infection, but it could just be inflammation.  I would also wonder if he could need a bump up in his asthma meds right now.  (surgery and Inflammation making it worse)

 

I had a lot of pain afterwards but the surgeon warned me that he had to 'dig my appendix out".  It ruptured and the appendix itself was in a higher than normal place and imbedded in my other organs/muscle.  He told me to expect a lot of pain.....and yep, it hurt pretty bad for a couple of weeks. I had a huge lump under the wound that I was concerned about but he said was normal.  It all faded in a few weeks and I recovered. 

 

In the hospital, I had lung/breathing issues because no one gave me breathing exercises to do.  It really slowed my recovery to be dealing with lung issues on top of the surgery. 

[Plateau Mama]

Wow! If my guy makes it to school this week, I am sure he will be doing absolutely nothing else--he will be too wiped out. And the make up work!!!! I can't even imagine.

 

 

We got "Lucky" in that he was hospitalized during spring break so he didn't miss any school while hospitalized. The teachers were very flexible in what they made him make up the next couple of weeks. It would have been really hard had he missed 2 weeks of school. He was in 7th grade. Worst part was the surgery was on his 13th birthday. But we remind him that he will never forget that birthday and wins the award for worst birthday ever.

[PinkyandtheBrains.]

Checking in, how is kiddo doing?

[lollie010]

Checking in, how is kiddo doing?

Aww! Thanks for checking. He went to school for 3 hours this morning and needed to head home. I spoke with the school and they said no worries at all. We could do whatever we need to in order to get him feeling better. I was offered a leave of absence if necessary. So we are going to get him back in to see the surgeon, who only sees patients on Thursday and then make some decisions. Im hoping his is just one of those little bodies that takes a little more time to heal.

[PinkyandtheBrains.]

Hope your appointment goes well today!