In January, Amanda Buschelman began feeling jolts of pain on the right side of her abdomen. It felt so intense that the mom of three realized she needed to visit her family doctor. Immediately he understood what was wrong.
“He did a quick outer pelvic exam, pushing on my abdomen,” the 42-year-old from the Cincinnati, Ohio, area tells TODAY.com. “He was like, ‘Oh my gosh, I think you have appendicitis. He’s like, 'You need to go straight to the emergency room.’”
Buschelman went to the closest emergency room. The physician assistant examined her and ordered a scan to look at her appendix. The doctor arrived, and she felt stunned by his diagnosis.
“He’s like, ‘Well, I got the report back from the radiologist, and you have a cyst on your ovary.’ My mom looked at me in complete shock and awe because we both know I don’t have any ovaries,” Buschelman recalls. “I was like, ‘Well, that’s not possible because I had a complete hysterectomy 10 years ago.'”
Right-side pain leads to ER visits
Like many moms, Buschelman often ignores aches and discomfort and puts her health last. But the right-side pain she experienced felt too uncomfortable to neglect. When her primary care doctor sent her to the emergency room, she thought doctors there would diagnose her with appendicitis and offer surgery. Instead, she received a confusing diagnosis of a cyst on her ovary.
“He looked at me like I was a complete moron. He mansplained to me how, ‘Well, I’m sure if you had a hysterectomy, they don’t take your ovaries,’” she says.
She says she told the doctor that she may not have been using the correct terminology, but she knew her ovaries were removed at the same time as her uterus as part of her treatment for endometriosis. The doctor showed her the imaging and she saw a dot, which made her worry that her procedure wasn't effective and that she was still experiencing endometriosis symptoms. Still, the doctor seemed skeptical that her ovaries had been surgically removed.
“He still didn’t believe me until he looked it up himself (in my medical records),” she says. “I was so personally offended, I can’t even begin to tell you. ... I (was) scared because I (thought) my treatment (was) completely ineffective.”
The doctor consulted again with radiology and returned with a prescription for an antibiotic to treat what he said was diverticulitis, an inflamed bulge on the digestive track.
“In my heart, I (wanted) to trust that they know what they’re talking about,” she says. “But I didn’t have a lot of it.”
Buschelman went home, and over the weekend, she “cried and suffered” in pain. On Monday morning, she called her family doctor and asked if she should seek out a gastrointestinal doctor or her visit her OB-GYN.
The pain was getting worse, Buschelman recalls. “My doctor said ‘Go back to the hospital. You have appendicitis.’”
Buschelman says she “begrudgingly” returned to the emergency room and met with a different doctor. She explained her symptoms and her previous visit. The doctor ordered another scan.
“This time it came back ‘very clear’ that I had a mass or a tumor,” she says. “I’m thinking, ‘Oh my gosh, do I have cancer?’ Meanwhile, I’m in terrible pain.”
Doctors sent her home and urged her to follow up with her OB-GYN, who saw Buschelman as soon as she could.
“I explained the situation. I have this little tumor. I’m very concerned,” she says. “(My OB-GYN) said, ‘What do you mean they think you have ovaries and a cyst on them?'”
Her OB-GYN ordered a transvaginal ultrasound and did find something.
“She’s like, ‘I don’t think at all there’s even a small chance it’s gong to be cancer.’ She said, ‘I think more than anything, it’s probably just some leftover endometriosis that has been there the whole time and sometimes (the lesions) just grow,’” Buschelman recalls.
Her OB-GYN gave her an option: Wait and watch or schedule surgery. Buschelman opted for the surgery.
“I’m like, it hurts. I do not want it. I want my life back,” she says. “She goes, ‘I will remove it. We’ll sent it to pathology, just to make sure, and then while I’m in there, I’ll take a peek around and see what’s going on.’”
Buschelman waited two weeks for surgery, worrying the entire time. After surgery, she woke to a surprise.
“The first thing my husband said was, ‘Did they tell you what happened?’ and I said, ‘Oh my gosh, no, what happened?’” she says. “He said, ‘They took your appendix. You had appendicitis.’”
What is appendicitis?
Appendicitis, an inflamed appendix, is incredibly common. The National Institute of Diabetes and Digestive and Kidney Diseases says anywhere from five to nine of every 100 Americans gets it. It’s something that emergency room doctors see often, says Dr. Anjali Bharati, an emergency medicine doctor at Lenox Health Greenwich Village, who was not involved in Buschelman’s care.
“Suspected appendicitis is considered an emergency,” Bharati tells TODAY.com. “Most physicians will tell patients to go to the ER to get examined and possibly get some imaging.”
She says symptoms of appendicitis include:
- Right side, lower abdominal pain
- Fever
- Loss of appetite
- Nausea
- Vomiting
Doctors might use an ultrasound or CT scan to take an image of the appendix.
“Appendicitis is a clinical diagnosis, but there are also organs in that area that can cause pain that can sometimes confuse the signs and symptoms of appendicitis,” she explains. “Imagining makes it a little bit easier to tell the difference between a pain coming from the appendix versus a pain coming from another structure.”
Other organs on the right side that could contribute to pain in some cases include, a kidney, the ureter, “the tube that delivers urine to the bladder,” and, in women, an ovary or fallopian tube. Imaging works well, but Bharati says “nothing is 100%.”
“What radiologists look for is inflammation in that right side area. Inflammation coming from the appendix is usually limited to that right side area,” she says. “The appendix itself usually has signs that it’s inflamed. For example, it’s enlarged.”
The appendix is a “vestigial structure,” meaning it once was needed for digestion, but humans no longer need it, Bharati says. That means it’s smaller and blood doesn’t flow to it properly, making it difficult for antibiotics to reach it to treat an infection. Surgery is the go-to treatment for appendicitis.
“It’s very difficult to get treatment to that area,” she says. “Most people just have their appendix taken out. Also, it’s not an organ that you need.”
If it’s not removed, it can rupture, which “can cause a really terrible infection and sepsis.”
Bharati said it’s important for physicians to “take a collaborative approach” to diagnose appendicitis because the symptoms can overlap with other conditions.
“Not every right-side abdominal pain is appendicitis,” she says. “We do have to take things into account, like the history of the patient and their age and their prior illnesses, in interpreting the imaging to making sure we have the right diagnosis.”
Bharati encourages people who have persistent pain that doesn’t resolve to continue following up with doctors to find the reason.
“In the emergency room, our evaluation is a snapshot in time,” she says. “If you feel that your existing condition progresses or gets worse, definitely return to the emergency room.”
Speaking up for others
Buschelman’s doctor also removed the mass identified in the emergency room scans, which was endometriosis. When the OB-GYN saw the appendix, she called a general surgeon to for a consult and that doctor recognized the appendicitis and removed it.
After Buschelman recovered, she felt unsettled by her experience and made a TikTok about it. She felt stunned by the number of messages she received — many from women recounting similar experiences.
“It’s really important that we not just focus on my story and that we talk about all of these other women in my comments that are just being ignored,” she says. “I want these other women’s stories to matter. I want them told.”
After being dismissed by the doctors, Buschelman second-guessed herself and wondered if the pain was imagined. She saw in her chart that the doctor noted she was “anxious.”
“I doubted myself for a hot minute. (I thought), 'Maybe this isn’t anything, maybe this is me being anxious,'” she says. “I’m like, ‘No way. I know myself. I’m doubled over in pain. I’m crying.’”
Receiving the diagnosis of appendicitis felt validating, and Buschelman is glad she persisted in getting medical care. But she’s worried that being dismissed might stop another woman from getting the help she needs.
“What if the next woman leaves the doctor and doesn’t trust their own body? she says. “Or doesn’t follow up because they don’t know to?"