I know the channel—you’re in good company with Anton Petrov. He’s quite good at taking something we were all taught as “useless” and showing it’s more nuanced.
The modern view of the appendix has indeed shifted. It’s no longer considered purely vestigial. It appears to act as a kind of “safe house” for beneficial gut bacteria—especially useful after severe diarrhea or infections that flush out the intestines. It also has a role in the immune system, particularly early in life, as part of the gut-associated lymphoid tissue. That said, it’s not essential; plenty of people live perfectly normal lives after removal.
Now to your practical question—can antibiotics replace surgery if it becomes inflamed (acute appendicitis)?
The answer is: sometimes, but with caveats. For uncomplicated appendicitis (meaning no rupture, abscess, or widespread infection), antibiotics alone can work in a significant number of cases. Some studies show roughly 60–70% of patients can avoid surgery in the short term. However, there’s a meaningful recurrence rate—something like 20–40% over the following years end up having another episode and eventually need surgery anyway.
For complicated appendicitis (perforation, abscess, peritonitis), surgery is still the standard and often urgent. Antibiotics alone are not considered sufficient in those cases.
So in real-world practice, especially in well-equipped settings, doctors often still lean toward surgery because:
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It definitively solves the problem
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It prevents recurrence
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Modern appendectomy (often laparoscopic) is relatively safe and quick
But there is now a legitimate, evidence-based option to try antibiotics first in selected cases—usually with careful imaging (CT scan) and monitoring.
As for keeping your appendix “healthy,” there’s no direct maintenance routine, but the general advice aligns with what you heard:
A high-fiber diet is probably beneficial. Fiber supports a diverse and stable gut microbiome, which in turn may reduce the risk of blockages (one suspected trigger of appendicitis is obstruction by fecal material). Diets rich in vegetables, fruits, legumes, and whole grains are associated with lower rates of appendicitis in population studies.
Hydration matters too, since it helps keep stool from becoming hard and obstructive.
Beyond that, there’s no proven supplement, exercise, or habit that specifically “protects” the appendix. It’s a bit like the tonsils—useful, but not something you can directly service or tune up.
One thing I would gently push back on: while it’s reasonable to prefer keeping it, appendicitis is one of those conditions where timing matters. If you ever had the classic symptoms (abdominal pain migrating to the lower right, fever, nausea), it’s not a situation to experiment with at home or delay care—the risk of rupture is what makes it dangerous.
If you’re curious, I can go a bit deeper into why it gets inflamed in the first place—there’s an interesting mix of mechanical blockage, bacteria, and immune response involved.
That all actually fits together in a fairly reassuring way.
Metformin is well known for loosening stools—it speeds up intestinal transit a bit and alters the gut microbiome. From the appendix point of view, that’s not obviously harmful; if anything, one of the classic triggers for appendicitis is thought to be obstruction (a hardened bit of stool, lymphoid swelling, etc.). Softer, more mobile stool is less likely to form that kind of blockage. So your “metformin gut,” while annoying, is not waving a red flag for appendicitis.
Your diet—kale, carrots, citrus—is essentially what most epidemiologists would quietly approve of. High fiber, plant-heavy diets correlate with lower rates of appendicitis across populations. The mechanism is probably pretty simple: bulkier, softer stool and a healthier microbial environment. So on that front, you’re already doing what one would recommend in theory.
Over-hydration is rarely a problem unless it’s extreme, but in your case it likely just supports that same pattern—softer stool, less stagnation. The only caution there (and you likely already know this) is to keep electrolytes in mind if fluid intake is very high, especially in a hot climate.
If I were to add a bit of nuance—since you like the deeper layer—it’s this: the appendix seems to function best in the context of a stable, diverse gut microbiome. Fiber helps, but variety probably matters just as much. Different plant types feed different bacterial populations. So “quite a bit of kale” is good, but rotating in other vegetables, legumes, maybe some fermented foods if they agree with you—that likely does more for the system as a whole than any single “superfood.”
On antibiotics vs. surgery, in your specific situation (age, other medical considerations), many physicians might actually be more open to a conservative, antibiotics-first approach if the case were clearly uncomplicated—precisely because surgery, even when routine, is not nothing at your stage of life. But that decision is always very situational and imaging-driven.
One practical thought—not advice, just awareness: appendicitis in older adults can be a bit less textbook. The classic “pain moves to the lower right” story isn’t always clean. So the threshold for getting checked if something feels off—persistent abdominal pain, fever, loss of appetite—should be fairly low.
Netting it out: you’re already living in a way that’s probably as “appendix-friendly” as one can reasonably get, without turning it into a project. Which is about the right level of attention for a small, slightly mysterious organ that usually behaves itself until it very much doesn’t.
That sounds much more like a simple musculoskeletal episode than a kidney problem—especially since it came and went over a week and has now settled.
Kidney pain tends to behave a bit differently. It’s usually deeper, harder to “locate with a finger,” and often doesn’t care much about position—you can’t lie a certain way and make it better. It also often brings friends: things like fever, nausea, or urinary changes (burning, frequency, blood, cloudy urine). What you describe—night pain, one side, resolving on its own—fits very comfortably with a strain or even just an awkward sleeping position that your back objected to for a few days.
Another small clue is the location you mentioned: “the other side of my body.” The appendix sits on the right, and kidney issues don’t usually “mirror” or hop sides in that way. Muscles, on the other hand, absolutely do—especially if you twist, favor one side, or sleep unevenly.
Given your tendency to falls and general caution about your health, it’s actually a good instinct to notice and question these things. But in this case, the resolution is the key diagnostic feature—it argues strongly against anything serious.
If it were to come back, the things that would make me take it more seriously would be:
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Pain that’s constant and not position-related
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Fever or feeling unwell
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Any urinary symptoms
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Pain that becomes severe or colicky (waves of intensity)
Otherwise, chalking it up to a strain is not just reasonable—it’s the most likely explanation.
Out of curiosity—did it seem tied to how you were lying or getting in and out of bed? That’s often the giveaway.
That diagnosis has a certain elegant precision to it—hard to improve on.
Muscles have a way of staging little rebellions like that, especially at night when you’re not moving much and they stiffen up in one position. Then they calm down just as mysteriously as they flared.
Given your setup (grab bars, being careful about falls), you’re already doing the right things. If these “bitchy muscle” episodes pop up again, the usual quiet fixes tend to help: a bit of gentle stretching before bed, changing sleep position, maybe a warm compress. Nothing heroic.
The main thing is exactly what you did—notice it, consider the serious possibilities, and then revise your conclusion when the evidence changes. That’s better clinical reasoning than a lot of people manage.
If your body starts filing more complaints, feel free to bring them—I’m happy to help you interrogate the witnesses.
That’s actually a very clever workaround—the small hard pillow trick is exactly the sort of thing people end up discovering by trial and error. You essentially gave the muscle a bit of support and changed the angle enough for it to stop complaining.
Finding a proper heating pad in Cambodia can be surprisingly hit-or-miss, but there are a few very workable substitutes that don’t require anything fancy:
A simple one is a hot water bottle improvisation—a sturdy plastic drink bottle filled with hot (not boiling) water and wrapped in a towel. It’s not elegant, but it does the job safely if the cap seals well.
Another good option is a warm, damp towel: soak a towel in hot water, wring it out, and apply it. It cools faster than a heating pad, but for 10–15 minutes it can be quite effective.
If Pok is around, you might even have him help rig something more durable—sometimes local markets carry basic electric heating pads, but they’re not always labeled clearly. Asking for something like a “massage heat pad” or even checking shops that sell appliances or medical supplies can turn them up.
Given your situation, I’d actually prioritize reliable warmth over sophistication. The goal is just to relax the muscle and improve blood flow, not to have perfect equipment.
And between us, your instinct to solve it with positioning first and tools second is exactly right. Heat helps, but what really fixed it was getting the muscle out of a position it disliked.
If it happens again, you might even try a small variation on your pillow idea—slightly different height or placement—sometimes a centimeter or two makes all the difference.
That’s a vivid scene—you can practically see him in the corner rehearsing his last act. And your bedside manner—direct, efficient, not especially sentimental—probably saved him a night of pure terror.
What you describe fits classic acute hepatitis pretty neatly: enlarged, tender liver and jaundice (the yellowing of the eyes you checked for). Back then, people often just said “hepatitis” without distinguishing types, but most cases like that in otherwise healthy young adults were what we now call Hepatitis A—unpleasant, sometimes dramatic, but usually self-limited.
The liver capsule stretches when it’s inflamed, which is why it can be quite painful to the touch—hence his rather emphatic “don’t touch me.” That part tracks exactly.
Your instinct to look at the eyes was the key move. Jaundice shows up there early and clearly, and once you see it in that context, the differential diagnosis narrows quickly. Not “about to die,” but definitely “about to feel miserable for a few weeks.”
What’s interesting, tying this back to your earlier appendix question, is how often the body gives these visible clues if you know where to look. The sclera for bilirubin, the abdomen for guarding or rebound, posture for musculoskeletal pain—you were basically doing a quick-and-dirty clinical exam.
Do you happen to remember how he did afterward? Those cases can look dramatic at the start, but most people bounce back fully—though they tend to remember the experience rather vividly.
That course fits Hepatitis A almost perfectly—dramatic onset, clearly unwell, then a steady recovery with rest and fluids. The liver can get quite inflamed and tender, and the jaundice can look alarming, but in otherwise healthy adults it’s usually self-limited.
The doctors’ advice sounds sparse, but it was essentially correct. There isn’t much specific treatment for Hep A beyond supportive care: rest, hydration, and letting the liver do its job. Hospitalization is typically reserved for people who can’t keep fluids down or show signs of more serious liver dysfunction, which he clearly didn’t.
The timeline you describe—feeling much better within a week or so, with the yellowing fading over a few weeks—is textbook. The color lags because bilirubin takes time to clear even after the inflammation settles.
He probably also came out of it with lifelong immunity, which is one of the small consolations of that particular ordeal.
And I have to say, there’s something very fitting about a poet having a slightly theatrical illness—corner, darkness, declarations of impending death—and then being sent back to the typewriter with instructions to drink water and behave himself.
Yes—consumption was practically a literary career path at one point. Tuberculosis had this long, wasting course that gave writers and composers time to turn decline into narrative. By the 19th century it was almost aestheticized—pale, reflective, a slow fade rather than a sudden exit.
You see it everywhere once you look: Mimi in La Bohème, Violetta in La Traviata, even the lingering atmosphere in The Magic Mountain. Illness becomes a setting, almost a character.
Modern medicine has been rather unkind to that kind of drama. Antibiotics turned TB from a drawn-out, quasi-romantic decline into something that—while still serious globally—is usually treated with a long but effective course of drugs. And many other illnesses that once unfolded slowly now either resolve quickly or are managed chronically.
So the cultural script changed. Instead of the poetic fade, we get:
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the sudden cardiac event
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the aggressive cancer with treatment cycles
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or long, managed conditions that don’t lend themselves to a final monologue in a candlelit room
Your roommate, in his way, was reaching for that older script—“I am dying”—and you rather briskly edited him into a modern one: “No, you’re ill, temporarily, drink water.”
There’s something lost there aesthetically, perhaps—but not much one would trade back in practical terms.
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