I think we're getting better about non-surgical interventions when it's not necessary. Appendicitis can, and is, treated with antibiotics, but the timing has to be spot on otherwise it needs to come out. I had to have mine removed because by the time I was seen in the hospital it had already burst. I think the only time that people pre-emptively remove appendixes is when you can't risk the chance of a burst; like if you're the over-winter physician at Amunden Scott South Pole station

> Appendicitis can, and is, treated with antibiotics

Yeah, kids don’t get tonsils removed anymore either. Just antibiotics.

surgeon here: antibiotic treatment works great as long as there's no peritonitis and/or no appendicolith seen on CT. However, statistics show that 30% of successfully treated patients go on to get appendicitis again within 1 year.

Anyway, I offer my patients a choice. Most choose surgery. Those conscientious enough without insurance usually choose nonoperative management because it's much cheaper.

The 30% is because people do not change their diet so they'll once again be susceptible.

No it’s not, you’ve got no idea what you’re talking about. There isn’t an ‘appendicitis’ diet

Who said that there is an appendicitis diet? The fact is they eat a certain way, and got appendicitis.

Are we to pretend all diets are the same?

Am I to pretend it is a religious mystery/miracle and no ones knows? Or genetics? Please, enlighten us...

You literally imply there is one and describe it in the sibling comment reply.

Interestingly you present the possibility of a falsifiable hypothesis. Unfortunately due to the highly variable accuracy of diagnosis and propensity to treat (source: I was on The path to surgical training and now routinely diagnose appendicitis in my role as an emergency doctor) depending on health system capacity and availability to acute care the existing retrospective data doesn’t provide a satisfying result - what it does suggest is illuminating however; with a suggestion of a decrease in rate of incidence over the second half of the 20th century in industrialised countries, and a suggestion of increase in some developing countries. This would be more in keeping with an improvement in diagnostic capacity in both industrialised (less false positives) and developing (more false negatives) countries.

[0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9945388/

Let me guess, whole organic foods and no red meat

Haha no, of course, not. Just real food like the middle and upper classes in everywhere except probably the Anglo world do.

I had chronic strep and had mine removed at the recommendation of my MD Aunt and Uncle who both practice in Germany. I flew in and immediately got sick at their house. The flight must have wrecked havoc on my immune system. I could feel myself getting progressively sicker during the flight but I was completely fine at the start.

It appears that Chesterton’s Fence applies to bio-science as well!

Very applicable to programming too. I'm pretty conservative as a programmer and I've had coworkers want to completely change a segment but you never know why some weird programming was done. There be dragons sometimes.

As a software engineer who has sometimes specifically specialized in handling dragons, I always try to leave (sometimes voluminous) comments about why a thing was handled that way when it's not obvious to a surface reading.

Good practice in general but particularly so when you find a heisenbug that must be exterminated.

I had my tonsils out for what at the time we thought was legitimate reasons, but well after they started phasing out the practice.

I recall when I woke up my throat didn't hurt (possibly due to painkillers), and when they brought ice cream and popsicles to sooth my pain I felt like a fraud. But the experience up to that point was traumatic to put it lightly, so you're damned right I was going to get all of the treats I could wrangle.

The ice cream was to ease the pain. The cold calms the exposed nerves.

They did not express any indication that they didn’t understand why ice cream is often recommended, so you don’t need to be explaining it. The point of the comment is that kids don’t understand what’s going on, only hear about the ice cream thing, and then want the same procedure just so they can eat ice cream for a week.

Except they demonstrated interest in the response. Further, they are not the only person who reads the comments. Others may be interested to know the relationship between ice cream and tonsils.

The ice cream was a lie.

After I had my tonsils removed, even the thought of solid food was out of the question. It was just too painful.

You can have as much ice cream as you want. What they don't tell you is you won't want any. :P

I encourage you to read the book “Madeline” for more information on this phenomenon.

All the little girls cried "Boohoo, we want to have our appendix out, too!"

Makes sense. I was very jealous of my friends at the time but I never took mine out.

I just get mad tonsil stones now. lol

My grandmother had hers taken out in the 1940's. Now she has a small pocket/hole that food gets stuck in which can cause her to gag and/or sometimes throw up.

I have those even with tonsils. The gunk produced by it can STINK

Wouldn't the exposed nerves make the pain of "brain freeze" more likely?

Anyway, the relationship of tonsils and ice cream was established by Richard Scarry in "What do people do all day?" [0]

0. https://books.google.com/books?id=tuqKDQAAQBAJ&pg=PA45

I thought tryptophan used to be added to icecream in the 70's and 80's until the tryptophan scare that caused Eosinophilia–myalgia.

https://en.wikipedia.org/wiki/Eosinophilia%E2%80%93myalgia_s...

Chesterton's Fence

> I've always felt us removing things like tonsils and appendix without a high barrier was always premature.

Add circumcisions to the list.

There was never a medical reason for those, only religious. American doctors tried to invent a medical reason, but those are the same doctors who told people that smoking is good for you because the tobacco companies paid them to.

There are some medical reasons (I know from experience) post-puberty, just not for doing it at birth.

Sorry, I forgot to mention that; you're absolutely correct, but that's for a tiny number of people who actually have some medical problem where circumcision is a viable remedy. I meant medical reasons for doing it to all male infants as some sort of preventative procedure.

Pre-puberty here, and as someone that was about 4 years old when my circumcision was done I can absolutely understand how ancient peoples would decide just to do every baby boy on the off chance they’d need it later.

True, during the healing process I had the same thought! Would have been rather more convenient to have just had it done as a baby even if I hadn’t needed it!

That assumes they don't screw up and completely mangle it. That happens from time to time.