
Im Glad I Got Appendicitis in the UK (Not the US)
Since I was a child, I've been terrified of appendicitis. There was no horseplay with my cousins and siblings after a meal. I suspect that myth was helpful to parents who wanted their children well-behaved in spite of post-dessert sugar highs. Still, everyone is born with an appendix and so we are all at risk one way or another. There are enough horror stories to make us wary. Most famously: Harry Houdini, the legendary magician and escape artist, who couldn't escape from a belatedly attended, ruptured appendix. He died of peritonitis — the bacterial infection of the abdominal cavity caused by pus from the burst appendix — on Halloween 1926, the 11th day after he'd noticed symptoms and about a week after surgery.
All that said, appendicitis — and the appendectomies performed to rid people of the acute infections — is routinely dealt with nowadays, with some 280,000 cases in the US and about 50,000 in the UK every year. The procedures are mostly done laparoscopically with three small incisions that allow a small, lighted camera to guide surgeons toward the inflamed organ to remove it. There are few complications, though soreness and tenderness can last for a few weeks after. It is, despite the small incisions, major surgery. Most cases involve people 30 or younger, perhaps — as some studies surmise — because hormonal activity may lead to the blockage of the appendix's opening to the large intestine, the condition that leads to the inflammation of the finger-like, 2- to 4-inch-long tendril-like pouch. Tennis legend Rafael Nadal underwent an appendectomy in 2015 when he was 28; he went on to win seven more grand-slam titles.
That doesn't mean that older people don't get appendicitis, but it's much less prevalent. Houdini was 52, and I was 65 when I came down with it two weeks ago.
I'm recovering fine from the surgery. But, as a dual US-UK citizen, it has led me to think about the cost of the operation if I had come down with appendicitis in the US and not the UK. There is constant talk among Americans of the unexpected deductibles that come with insurance. Even with Medicare — which I qualify for and am enrolled in — the 2025 deductible for inpatient hospital care is $1,676. That's what's Medicare Part A requires you to pay before it starts covering for the remainder of your treatment. One estimate has the uninsured cost of an appendectomy to be about $7,000. There may be more costs. All procedures, not just appendectomies, can be broken down into distinct categories of medication, treatment and rehabilitation. Those may be covered by Medicare Parts B, C, D. There are other parts of the Medicare alphabet — and variations on it sold by the big health insurance companies — but I'm afraid to find out why I might need them.
For those under 65, a comprehensive private medical insurance policy — either paid by you or your employer — will cover most of the costs of an appendectomy. The big if is if the emergency — which is what acute appendicitis is, meaning it might strike at the most unexpected moments — lands when you are inconveniently away from the health providers in your insurance company's medical network . There are excruciating stories online about people who are rushed into hospitals on the verge of peritonitis, only to be hit by out-of-pocket bills of tens of thousands of dollars that insurance refuses to cover due to a variety of technicalities. Oh, and there are still deductibles even if you have 'good' insurance. You can always get a separate policy that covers potential deductibles, but that'll be extra. The paperwork in the US that comes with an appendectomy — or any other major procedure — can be overwhelming. The threat is enough to make you work to stay as healthy as you can. No horsing around. Forever.
In the UK, the National Health Service estimates that an emergency appendectomy will cost it as much as £2,200-plus for an adult, though that can reduce by almost half depending on location. You can also opt for private medical care if you don't want to go through the long NHS waits for consultation or the crowded emergency rooms . It was late Friday night when I realized I was most likely suffering from appendicitis . If so, I knew not to tough it out like Houdini. But my NHS doctor's office in the neighborhood was closed. I didn't know of a private service to call. So I headed for the nearest open A&E: Royal London Hospital in Whitechapel, a district best known as the haunt for Jack the Ripper.
When I got to Royal London at midnight, there must have been 40 people ahead of me, but every hour saw a little bit of progress moving up the queue. I was given pain medication early on, then moved to the 'same-day emergency care' section where I got a CT scan to confirm my and the attending physicians' suspicions. By the time I was walked — gingerly and in bright-red non-slip socks — to the surgical theatre , it was 12 hours since I'd got to the A&E. There were no rooms for me post-surgery, so they kept me in the very ample recovery ward overnight. I was sent home by Sunday afternoon with two weeks' worth of painkillers.
My monetary cost for all this? £0.00 — and barely any paperwork except on surgical consent forms and the post-op recommendations for getting better and follow-ups.
The full name of the troublesome little extension in our intestinal tract is 'vermiform appendix' — vermiform coming from the Latin for worm-like. The ancient Egyptians may have noticed it in the mummification process because they described something as the 'worm of the bowels.' But it wasn't 'vermiform appendix' until Italian anatomists described it as such in the 16th century. The first successful operation to remove an inflamed appendix was performed in London in 1735, though it wouldn't be until 1886 that appendicitis was scientifically defined. How many human beings have died of peritonitis caused by the worm we were all born with? It's impossible to guess.
To avoid emergencies, astronauts and polar explorers got their appendixes removed as a rule before going on their far-ranging expeditions. Famously, a Soviet surgeon assigned to Antarctica had to perform his own appendectomy in 1961 — without general anesthesia — because he was the only medic on the base.
For an older patient, appendicitis may indicate other conditions, potentially serious. I'll deal with them if they turn up. Right now, I'm glad I hurried to the hospital that Friday night. On Sunday morning in Royal London, as I was waiting to be discharged, I overheard a doctor telling a fellow patient in the recovery ward: 'You have very bad appendicitis. We can't operate. We will have to give you antibiotics for a week here and then we will reassess.' The patient was in so much pain, a moan was the only response I could make out. I shuffled off in my bright-red, non-slip socks, a survivor of appendicitis but still terrified.
More From Bloomberg Opinion:
A foreigner who falls ill in the UK and requires treatment from the NHS is usually charged 150% of the what the procedure would normally cost.
You may argue that I've paid for it via the UK's higher taxes. Well, I'm glad I paid my taxes then.
This column reflects the personal views of the author and does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.
Howard Chua-Eoan is a columnist for Bloomberg Opinion covering culture and business. He previously served as Bloomberg Opinion's international editor and is a former news director at Time magazine.
This article was generated from an automated news agency feed without modifications to text.

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