Playing With Pain: Baltimore’s Anderson and His Appendicitis

When Baltimore Orioles’ star Brady Anderson recently announced he had appendicitis, but was not going to have surgery so he could keep on playing, the question that popped into many people’s mind was “Can he do that?�

Putting on a brave face and pushing through pain for the sake of sport may sometimes be possible, even admirable. But physicians are perplexed by the all-star centerfielder’s decision, because the only reliable treatment for appendicitis, they said, is still surgical eviction: getting the offender out of the neighborhood as quickly as possible.

“He should not be sitting around,� said Alexander Balan, a surgeon at the Medical Center of Delaware in Wilmington. “It’s the worst thing he can do.�

The appendix is a small tube that juts off the large intestine. If it becomes infected and is left untreated, it can rupture, spreading its infection throughout the abdomen. Balan said about 5,000 Americans die each year from undiagnosed or untreated appendicitis.

Moreover, excavating the appendix these days is simpler and less painful than ever before because of a surgical revolution set off by laparoscopy, or what might be called surgery-by-video. Recuperation from the procedure is much quicker than with general surgery, with many patients leaving the hospital within 24 hours and often the same day as the operation.

The procedure involves lowering a miniature camera into the abdomen through a small slit. This permits the surgeon to view the entire abdominal cavity on a television monitor. Then, working with tiny instruments through several other dime-sized slits, the surgeon performs any number of tasks, including removal of a diseased appendix, as he watches his movements on the monitor. Romanian gymnast Gina Gogean, who won the silver medal in the Olympic women’s all-around gymnastics competition last week, had an emergency laparoscopic appendectomy several weeks before the competition began in Atlanta.

Because the cuts made in laparoscopic surgery are small and the tearing of muscles is minimized, it reduces trauma and pain to a patient and therefore the need for post-operative pain medication. “It’s just a puncture wound,� surgeon Balan said. “It will heal by itself; many times it doesn’t even need stitches.�

In Anderson’s case, the classic symptoms of appendicitis -- tenderness and pain in he lower right abdomen -- flared on July 19. They abated and Anderson, a leading American League home-run hitter, was on the field again five days later.

Still, William Meyers, chief of surgery at the University of Massachusetts, who examined Anderson July 21, said on July 25 that if Anderson had undergone an immediate laparoscopy to remove his appendix then “he’d probably be back (at work) close to now.�