Editor’s note: Alice Paul Tapper, 15, is a sophomore in Washington, DC. She is the daughter of CNN’s Jake Tapper. The opinions expressed in this comment are his own. See more opinions on CNN.
I almost died around Thanksgiving last year, and it was completely preventable.
It started on a weekend in November 2021 with stomach cramps, low fever, chills and vomiting. Soon it became clear that I had to go to the emergency room. By the time I arrived I had low blood pressure, high heart rate, severe abdominal pain, and a high white blood cell count.
I was given IV fluids to combat my dehydration, but I was no better. The doctor and nurses didn’t know what was wrong and stood around me confused, like they were waiting for me to tell them what to do. The sharp cramps and throbbing feeling in my stomach got worse, so they transferred me to another hospital.
With advice from my pediatrician, my parents told the doctors to check for appendicitis. But since I was tender all over my abdomen – not just my right side – the doctors ruled it out. My parents kept pressing, so a doctor told me to get up and jump. I could barely lift an inch off the ground. The doctors concluded that what I had must be a viral infection and would eventually go away.
This was not the case. I got sicker and my skin started to turn pale green. As Monday became Tuesday, I was only given Tylenol for my pain. My mother asked the doctors why I couldn’t have an ultrasound to see what was going on in my abdomen; they said it was not necessary. My dad asked me why I couldn’t get antibiotics; doctors said for a viral infection they could do more harm than good. My parents kept pushing for a gastroenterologist to have more information about my condition to assess me, but he never came.
I felt helpless. My condition wasn’t the only thing that alarmed me; just like the lack of recognition I received from the hospital. I was not heard; when i described to the doctors how much pain i was in, they responded with condescending looks.
Tuesday night my dad came home to be with my brother, but it wasn’t long before my mom called him in tears. I was in agony and only treated with a heating pad. My dad got the hospital administrator’s phone number and asked for a gastroenterologist, for imaging – for anything. The phone call worked, and on the orders of the hospital administrator, I was finally taken in for an abdominal x-ray. Imaging showed it was not a viral infection.
In the middle of the night I was rushed for an ultrasound which revealed that I had a perforated appendix that was leaking a toxic stream of bacteria into my internal organs. When I learned of my diagnosis, I was almost relieved. At least the doctors now had a plan.
Eventually, the surgical team took over. The next two hours were a blur. A CT scan was followed by emergency surgery; two laparoscopic drains were inserted into my body to get rid of the toxic leak. I had sepsis and we later learned that I was in hypovolemic shock, which can stop organs from working. Last night was the scariest night of my life.
Once I was well enough to leave the intensive care unit, I stayed in the hospital for another week, bedridden with uncomfortable drains in my body and horribly sharp cramps, for which I was given morphine. I could barely walk. I didn’t recognize the helpless, hunchbacked, green, exhausted girl I saw in the hospital mirror.
Why did it all go so horribly wrong?
My mother soon heard about the research conducted by Dr. Prashant Mahajan, Vice President of Emergency Medicine and Division Chief of Pediatric Emergency Medicine. at CS Mott Children’s Hospital at the University of Michigan. Mahajan’s research notes that although it is the most common surgical emergency in children, appendicitis can be missed in up to 15% of children at initial presentation. Up to 15%!
This is because there are so many possible reasons for abdominal pain. Appendicitis can mimic several common conditions, including constipation and acute gastroenteritis, which pediatricians at my hospital mistakenly thought I had. According to Mahajan, up to half of patients with appendicitis may not have the classic signs of right lower quadrant pain, fever and vomiting.
Mahajan’s research also shows that misdiagnoses of appendicitis are more likely in children under age 5 — and in girls. I was disappointed but not surprised to learn that girls can be listened to and taken seriously less often.
Hospitals need to change the way they assess and diagnose appendicitis because it can often present atypically. Anupam Kharbanda, a pediatric emergency physician at Children’s Minnesota, came up with something called the pediatric Appendicitis Risk Calculator (pARC) score to help assess a child’s likelihood of appendicitis, using variables such as gender, age, age, pain duration, pain migration, white blood cell count and more.
The pARC score could be an important element in changing diagnostic practices and saving lives.
In 2018, a 5-year-old girl in England, Elspeth Moore, was sent home by a pediatrician even though she complained that her stomach “felt like it was on fire”. The doctor diagnosed a viral infection. She died of peritonitis, sepsis, and acute appendicitis two days later.
My story has a less tragic ending. Luckily, I wasn’t sent home unattended like Elspeth was, and I finally got the care I needed. A few months after my first hospitalization, I had an appendectomy at a new hospital, Children’s Hospital of Philadelphia. My health is back to normal. But I have a new mission to raise awareness of appendicitis misdiagnoses – because what happened to Elspeth could have happened to me too.
The x-ray machine was down the hall, the CT machine just one floor below, the ultrasound machine a few steps away, and the antibiotics I needed were only a phone call away. But the doctors didn’t use these tools to diagnose and treat me quickly, and as a result, I almost died. It breaks my heart to think of the boys and girls who don’t have parents who can get the hospital administrator’s phone number — who can’t make their voices heard.
I still can’t believe this happened to me – and I don’t want this to happen to anyone else.
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