Mom, To have a really good understanding of what doctors do to determine what is causing the problem, it’s helpful to understand the concept of “differential diagnosis,” which essentially means that based upon the symptoms that are present, there are a number of possible causes for the symptoms. If the symptom is something quite general, say like abdominal pain, then the differential diagnosis could include all sorts of things, from things that are not serious at all (minor intestinal virus) to those which are life-threatening (appendicitis, pancreatitis, etc.). The more information the doctor receives, based upon medical history, examination, lab results, etc., the more refined the list of possible causes becomes. A doctor will first eliminate the possibility of it being a life-threatening condition. If that happens, usually by negative test results–they may not try much else–because neither you or your insurance company want to have to pay for unnecessary tests or hospitalizations, and if it isn’t life-threatening, then why go to the trouble? Really, it’s only a more elaborate form of the same decision-making process any parent goes through before taking their child to the doctor. First obviously your child is in pain, so, is it time to take them to the doctor? Well, that depends. Where are they hurting? Did they experience any type of fall or other trauma to the affected area? Are they throwing up? Feeling like throwing up? A fever? As parents with three children who have had their appendices removed (as well as my having 4 siblings who have had the operation) , we recognized the symptoms of appendicitis quite quickly:
Abdominal pain–usually starting in the middle of the stomach around the belly button, then later moving on to the lower right quadrant.
Nausea.
Walking/lying on their sides hunched over. Kids are usually more easy to read by their physical actions (when they don’t know you’re watching) than by what they tell you. Depending upon age, they may not have the vocabulary to tell you exactly what you need to know. Also, for younger children, the desire to please a parent ranks higher than providing accurate information. A well-meaning parent can inadvertently “lead” the child to say what the parent starts to think is happening, because what the parent asks, and the way she asks it may lead the child to believe that the parent wants a specific answer: “honey, does it hurt here?” rather than “honey, where does it hurt?”
Fever. Usually the fever for us was not very high–101-102, definitely not in the 104 range (but again, some kids naturally have consistently higher fevers than others (my second child was that way with the chicken pox, with urinary tract infections, and with the flu).
Basically, these symptoms for us were the indicators that we used to definitely take our kids to the emergency room, not the clinic.

Other things that the doctor might use to eliminate life-threatening conditions from the differential diagnosis is one of various illness-specific tests. With appendicitis the doctor will often check for “rebound tenderness.” This test is performed by pushing in on the area over where the appendix is located and then quickly releasing the pressure–which if appendicitis is present is more painful than the pushing (though the pressure is uncomfortable, too). Other appendicitis-specific tests include having the child hop or jump in place. The doctor will also be observing to see if there is “guarding” which is an involuntary tension in the muscles over the area in reaction to pressure.
Of course, there are the lab tests. The doctor will first do a urine test–checking for the evidence of white-blood cells and protein in the urine. If white cells are indicated, the doctor will usually follow that with a blood test. An elevated White Blood Count (WBC) is an indication of infection.
If these tests do not reassure the doctor that nothing life-threatening is happening, he may order tests from radiology, which will usually involve some kind of contrast to show what’s going on inside. That was the only way with our youngest appy victim that they were certain it was appendicitis.
(An explanation here–young children may or may not respond to all of the other clinical tests in the classic manner–they may not experience, for example, as much localized pain in the lower-right quadrant. Our daughter was able to hop, endure the rebound tenderness test, and so forth without much reaction–it took an experienced doctor (with the aid of two sets of blood tests) to finally realize that she was a pretty tough kid. He decided to perform the other tests when she was distracted, and it was a little wince while she was in deep conversation with someone else–and no more–that led him to conduct the radiography contrast test which confirmed that she had a perforated appendix.
One thing to note is that usually appendicitis is an acute illness (meaning that the onset and progression of the disease is quick (over the course of hours-not days or weeks)) and not a chronic condition. One of the explanations I’ve heard for why appendicitis happens is that the opening of the appendix into the colon becomes blocked, not allowing the body to expel matter that is in the appendix, which in turn results in the swelling (then later, if not caught the “perforation” or bursting of the appendix). With symptoms that span over weeks and even up to a month, a doctor would likely eliminate acute appendicitis from the differential diagnosis.

It’s nice to see you back blogging. I was beginning to wonder what was going on. By the way, thanks for commenting on April’s comment on how to study the scriptures. I missed that post and went back to read her comment. It was awesome and I intend to use many of her suggestions.

“Very many wish to be vouchsafed the Kingdom without labors, without struggles, without sweat; but this is impossible. –St. Macarius of Egypt

“Repudiate the world and all that is in it; close the innermost part of your soul to everyone; crucify your flesh together with passions and lust and, finding yourself in incessant prayer, select a narrow path wich leads to eternal life.” –St. Theophil of the Kiev Caves

I’m struggling with the same thing.. how do we conform our will to God’s?

It’s definatley something to keep praying about! Maybe using the words of the Great Doxology?

“…Blessed are you, O Lord, teach me your commandments. Blessed are you, O Master, teach me your commandments. Blessed are you, O Holy One, enlighten me in your commandments.”

+God bless!