Stuff You Should Know - The Appendix: No Respect
Episode Date: May 4, 2021The poor appendix. Despite findings that it serves a purpose, many people still cast it off as a second rate organ and the Rodney Dangerfield of organs. We aim to correct that notion. Learn more abou...t your ad-choices at https://www.iheartpodcastnetwork.comSee omnystudio.com/listener for privacy information.
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Hey, I'm Lance Bass, host of the new iHeart podcast Frosted Tips with Lance Bass.
Do you ever think to yourself, what advice would Lance Bass and my favorite boy bands
give me in this situation? If you do, you've come to the right place because I'm here to help.
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radio app, Apple podcast, or wherever you listen to podcasts.
I'm Munga Chauticular and it turns out astrology is way more widespread than any of us want to
believe. You can find in Major League Baseball, International Banks, K-pop groups, even the White
House. But just when I thought I had a handle on this subject, something completely unbelievable
happened to me and my whole view on astrology changed. Whether you're a skeptic or a believer,
give me a few minutes because I think your ideas are about to change too. Listen to
Skyline Drive on the iHeart radio app, Apple podcast, or wherever you get your podcasts.
Welcome to Stuff You Should Know, a production of iHeart Radio.
Hey and welcome to the podcast. I'm Josh Clark. There's Charles W. Chook Bryant's
swillin' away on some champagne. We're sorry, sparkling wine. Shandown, so it's from Napa.
And there's Jerry over there. Jerry's got her champagne too. We're all just hanging out. We're
going to talk to you guys while we wait for the shrimp cocktail to fall. Literally. Yep. And that
makes this Stuff You Should Know. That's right. We're back in the same room, everybody, for the
first time in about 14 months. And Jerry brought in champagne and frozen shrimp cocktail.
There's a story behind that. Go ahead and say it. You go ahead and say it.
I don't remember them. You were the shrimp. You first started it, I feel like, 12 years ago.
We were tracking to hit number one on iTunes in 2008. The beginning of 2008. No, nine maybe,
whatever. And I was like, I want a shrimp cocktail in the recording studio when we hit
number one. We hit number one, came and went, stayed number one, hit number one again. No
shrimp cocktail. This is the shrimp cocktail from 2009. That finally has made an appearance.
And it's frozen. It might literally be from 2009. It might be. It's turning, the veins are turning
kind of purple as it falls. So I can't wait to eat the shrimp cocktail. And yeah, we're having
champagne. Jerry classed it up, basically. I feel it was a nice homecoming. She did,
but the three of us are fully vaxed. We're in a room together. The microphones don't have
fake ears attached to them. Yeah. I mean, that joke won't make sense to you now, but we recorded
another episode before this one, but it was getting released later. So this technically
our second episode. Yeah, just put that in your button and smoke it in your hat.
What are you talking about? I have a weird urge to curse. I don't know why. I think you just did.
So Jerry beep, beep, beep, beep, beep, beep, beep, beep. But it's great to be back together and a
little weird, but not as weird as I thought it would be. That first one was weird because we're
in a different room. Yeah, we got all the weirdness out in a weird situation. It would have been
weird regardless. But now we're back in studio 1A. That was a really good move. Jerry, did you
plan it like that? To get the jitters out. Jerry said thumbs up. Yeah, she thumbs up. Yeah. Jerry's
real everybody. She chooses not to talk. Jerry's let her hair grow out. I know she got a ponytail
for the first time that I've ever seen. It's gotten even more peppery. No, salty in a salt and
pepper way. It doesn't get more peppery unless you make a move to make it so. And she looks
like a wealthy retiree who drives a Maserati and knows their way around the club. You know what
I mean? Okay. That's what Jerry looks like. She looks distinguished but also foxy. Yeah.
So I spent my last January of 2020 losing 25 pounds and then COVID hit and now I've gained back
25 pounds. Yeah. I'm exactly where I was. Is that right? Exactly to the pound and it makes me
really angry. Oh, no, just go with it. Oh, I know. But I just, you know, let me get back together. I
was like, man, I'm doing so good. I'm so good. Pandemic hit. That is good. Well, now I can
eat and drink all I want because it's sad. So you lost the weight before the pandemic hit?
Yeah. I hit it hard in January to March. January what? January 1st probably. Of 2020. Yeah. Okay.
And like I was working with a trainer like, you know, so I was having to go to her every
like three days a week and just, you know, I was making the right decisions and tracking and
the weight disappears and then COVID hit and I just started making all the wrong decisions and let
myself do that. Yeah. That happened to all of us. Myself included. I went through what you went
through where I lost a bunch of weight and I managed to keep it off and then COVID hit and I
was still doing okay. Doing okay. Maybe eating a little more than usual. Like I'm not going to let
it happen though. And I was, I wasn't and then our book hit and that's what got me. Oh, when we
were writing it. And working on it 20, 22 hours a day every day. I was eating so much. You gained
book weight. I gained book weight and I actually, I have not been this big since, I don't know when
man, but I still got it. So I'm, I'm doing what I can. You look the same. I, well then I, I,
what I started two weeks ago has kicked in, I guess, if I look the same. Well, you look great.
Jerry looks great. Everyone looks and feels great. Yeah. Let's talk about the appendix,
the Rodney Dangerfield of organs. This is one of my favorite articles that we've done in a while.
Agreed. This is a Dave Roos. Yeah. And you know how I often complain about science.
This is a kind of science I love. Yeah. Understandable. Yeah. Body science. Understandable. Super
cool. This factors into our hygiene hypothesis episode, our human microbiome episode.
Digestive system episode. Yeah. It all sort of fits together in that little worm like
organ. It's an organ, right? Yeah. It's an organ. Yeah. A lot of people thought it
was a vestigial organ. They're wrong. Right. But that weird little thing hanging out there.
Just going, just wiggling around like a little worm. Yeah. Is really kind of cool and fascinating.
And I love that it has a great story behind its lack of usefulness and then turns out usefulness.
Yeah. And it's just agreed. This is really good stuff. It's smash bang stuff you should know.
That's right. Let's talk about it. So like you said, the appendix is like this little worm-like
thing that dangles off the bottom of the ascending colon, large intestine. Colon,
colon, large intestine and large bowel are the one and the same. So when you hear people say
bowel, they're typically talking about that. Colon, large intestine. It's all the same thing,
which I found confusing until I looked it up and found, okay, that's all that.
Two to four inches long, the appendix. Right. Generally. Although the biggest one was pulled
out of a 72-year-old Croatian man named Sifranko August during his autopsy. And his was 10 inches
or 26 centimeters long. What do you think they were like in that autopsy? They're like, wow.
I think that the medical examiner's staff had a t-shirt made up that Sifranko August was buried
in that said, I've got the biggest appendix ever. Maybe. I mean, that's crazy because when you,
like I encourage you to look up a picture of the appendix, it is, it looks like a little worm.
And it's hanging there on this little bulbous pouch called the cecum. And the cecum is kind of like,
where it's the part in between the small intestine and large intestine where
there's an agreement that takes place, basically, where the small intestine is like, all right,
listen, I'll take all this food and I'll make it into thyme. But I am not going into the fecal zone.
Now you handle the fecal stuff, Colin. And the colon says, fine, here's my buddy, the cecum.
It goes forward. It'll service a little halfway house. You can pass everything along to me.
We'll broker it. You won't get any poop on you, small intestine. And I'll send it to the large
intestine. But off of that cecum is dangling this little dude. Yeah, which as far as anybody could
ever tell had nothing to do with digestion, which makes it really weird because everything else
around here has to do with digestion. That's just what they do. That's their trade. And the appendix
is just hanging out. And people just thought, okay, this thing doesn't make any sense. But the
fact that it's attached there and doesn't seem to have to do with digestion made people for a very
long time think that it was a vestigial organ. Right, which we'll get into the specifics of
one man who really championed that idea in a way that frankly made a lot of sense. And you can see
why it took that many years for anyone to really poke around further into it. Yeah, because you're
just like, yeah, he just explained this. Sure. But there are other mammals that have cecums.
And in some mammals, especially herbivores, they can be really big relative to their body size.
Because in herbivores, it acts as the pre digestion house for plants. And since they're
eating tons of plants, they have large cecums. Yeah, plant fiber is really, really good for you.
But it's also really hard to digest a lot of cellulose. And that's that large intestine
coming into play again. Because in the stomach and the small intestine, there's a microbiota,
a microbiome, which we talked about in that one episode, the human microbiome project.
There's some in the small intestine, I think there's far, far less even in the stomach. But
in the large intestine, that's where it really shines. Gotta make that poop. And those microbes,
the pathogens, the viruses, the fungi, all of the and the bacteria, most of all, they all kind of
work or fight or play and digest this stuff. They break it down so that we can absorb it. They turn
it into fiber. Dietary fiber keeps you from absorbing a lot of sugar or fats or whatever at once.
Insoluble fiber bulks your stool up. So it really kind of gets everything out of the colon,
really cleanses it when you finally poop. I've missed your hand gestures. Yeah. I've missed
you seeing my hand gestures now that I think about it. Because I do this even when we're recording
at home. Oh, I'm sure. I forgot what it's like to be seen. You're seen. Yeah. So the large intestine
has this microbiome that lives in there. And just remember that. That's a big important point.
Yeah, I put a pin in that, but not literally. Right. Because that would be dangerous. Out of
the 361 mammal species, only about 50 of us have an appendix or something like an appendix.
Obviously, the great apes do rabbits, possums, wombats, weirdly. Sure. They have square poop.
Do they really? Yeah. It comes out in cubes. Really? Yes. I can't tell if you're messing
with me right now. Wait, hold on. Keep talking. You're thinking of the square watermelons in
Japan. I may be thinking of all the bees. I'm pretty sure wombats have square poop. All right.
A rare in-show check, but dogs and cats don't have appendix. Cows don't. Orches don't. She
don't. Oh, yeah. Little poop. Poop cubes. Yeah. It looks like those ice cube chocolates.
How do they, how does that happen? How do they, yeah, how does that work?
I don't have time to read this, but it looks like there's a science alert from
January that says wombats are the only animals that poop cubes, and now we know how.
Okay. Well, that's a definite short stuff. Okay, we'll do it. Look for that soon.
So back to the vestigial organ aspect. Charles Darwin is the person who came out and said, hey,
I've been looking at these. And by the way, that was named officially by an anatomist named Felipe
Verhan in 1710, appendix vermiformis, which means worm-shaped attachment. And I think the first
appendix removal was in 1735. But Darwin was the one who said, hey, everybody, I've been looking at
these herbivores, and they've got these really big cecums. Yeah. Giant cecums. For this,
for this reason that Josh just described, future Josh. Right. And he said, so here's the deal is
is when we see a bunch of plants, we had humongous cecums as well. Yeah. And as our diet changed
and we got away from plants, you know, our body started to change along with it. And that
cecum just kind of shrank. And the appendix is just a little shriveled up piece of that formerly
large cecum. Yeah. And it's just dangling there doing nothing. Isn't that amazing? And everyone
until 2007 said, it sounds right to me. Yeah. Darwin's got it right. It does. I mean, it totally
makes sense and seems completely believable. Yes. But now that I know it was wrong, I question
every single thing he ever thought of or said. Yeah. Welcome to our world, Darwin.
You guys messed up that one thing. I just don't know if I can believe anything he said.
I mean, we hear that like every week too, don't we? It's fun. So, but yeah, we went for well over
150 years of just everyone believing that the appendix was a totally useless, vestigial organ
that had no function whatsoever any longer. And so, it was fine if you just took it out,
which as we'll see, like people do a lot actually. And it is fine for the most part.
Which we're lucky that it's fine. Right. But also, I think if it weren't fine, we would have figured
out very quickly, like, oh, wait, this is not supposed to do that. So, the fact that we were
able to remove the appendix later on without a problem just kind of lent to this or lent support
to the idea that it was a vestigial organ, right? But it turns out it does serve some function.
We'll start talking about that, I think, after a break. What do you think, Chuck?
That was so smooth. Thank you. So much smoother in person.
I'm here to help. This, I promise you. Oh, God. Seriously, I swear. And you won't have to send an
SOS because I'll be there for you. Oh, man. And so, my husband, Michael. Um, hey, that's me.
Yep, we know that, Michael. And a different hot, sexy teen crush boy bander each week to guide you
through life step by step. Oh, not another one. Kids, relationships, life in general can get
messy. You may be thinking, this is the story of my life. Oh, just stop now. If so, tell everybody
you everybody about my new podcast and make sure to listen so we'll never, ever have to say bye,
bye, bye. Listen to Frosted Tips with Lance Bass on the iHeart radio app, Apple podcast, or wherever
you listen to podcasts. I'm Mangesh Atikala. And to be honest, I don't believe in astrology.
But from the moment I was born, it's been a part of my life in India. It's like smoking.
You might not smoke, but you're going to get secondhand astrology. And lately, I've been
wondering if the universe has been trying to tell me to stop running and pay attention.
Because maybe there is magic in the stars, if you're willing to look for it. So I rounded
up some friends and we dove in and let me tell you, it got weird fast. Tantric curses, major league
baseball teams, canceled marriages, K-pop. But just when I thought I had to handle on this sweet
and curious show about astrology, my whole world came crashing down. Situation doesn't look good
there is a risk to father. And my whole view on astrology, it changed. Whether you're a skeptic
or a believer, I think your ideas are going to change too. Listen to Skyline Drive and the iHeart
Radio App, Apple Podcast or wherever you get your podcasts. All right, we're back from our break.
Who knows what amazing ads you guys just heard, but I'm envious of you because we didn't hear it.
We just have a moment of silence in between. That's right. And now we can talk about the
microbiome a little more. And if you want to look into our human microbiome project works show,
that was May 13th, 2014. There are 130 trillion cells in the body. About 30 trillion of those
are human cells with DNA. And the rest of those hundred trillion are the microbiome,
which is amazing. And it's really, there's something about the digestive system that just
frankly turns us both on a little bit. Yeah, there were these animations. I cannot remember
who made them. Many, many years ago. Yes, but the animator just understood us on a level that even
I'm like, oh, I didn't know myself like that. It just did little shorts for clips of our show.
They did one about a four and a half minute clip from how the digestive system works,
which is worth looking up on YouTube. It's there I watched it the other day. They were just gifted
and talented. It's one of my favorite little things that we ever, that someone ever did for us.
I want to say Nick. Nick sounds right. Okay. I think it was Nick. I hope it's Nick. Nick,
please like write in if you still listen. Nick moved on. Okay. Well, anyway, they were really
great. What Nick's work and if it wasn't Nick, Nick's new nickname is Nick. That's right.
Okay. So yes, the digestive system does get us jazz and in particular the microbiome,
which we wouldn't have a digestive system or at least one that functions because again,
those bacteria help us break down stuff that we would normally have trouble breaking down,
help us form poop, all of that stuff. And there's a, it's a symbiotic relationship because in
breaking those, those things down like that plant fiber, for instance, they're eating,
they're happy, they're reproducing, but then the byproducts and the stuff that they break open,
make that stuff bioavailable for us so we can kind of get the nutrients and all that stuff
from it as well. It's a beautiful relationship. Not all bacteria is good though. No, there's
the bad stuff. And we should point out that most of this bacteria is in that large intestine,
in the stomach, in the small intestine, most of it's killed off by gastric acid. But
the bad bacteria is if you eat some bad chicken or if you... Have you ever done that? Yes.
Yeah. You know me, I've had all manner of stomach issues over the years.
Where did you get your bad chicken? I don't remember. I don't remember specifically,
but I know I've had bad food before that made me sick. Yeah. And in my case in Guatemala,
if you remember. Oh yeah, you and Jerry both. Well, it was... Not me. You know, we were even
closing our mouth in the shower. We were being so careful, but on that last night, it was the
ice from the mixed drinks. I know it. I forgot the ice is made from water. Yeah. And that water
was not good for Americans. And I stayed home that night, so I didn't get diarrhea.
It was worth it though. Jerry and I had such a good time. I'm so glad. So yeah, I got bad sick
after our guate trip. But that's the bad bacteria and that's how it can get into your body.
And your body's solution to this, as Jerry can affirm, is diarrhea. It's your body's
way of saying, we're just going to flush you out human being. Just get rid of everything. Get
rid of all the stuff, but that's going to take a lot of the good stuff with it. Right. And that's
no good because if you have all the good bacteria or a large amount of good bacteria leaving your
body, then that can leave you very vulnerable to nutritional deficiencies and other bad stuff.
Sure. Yeah. Because I mean, like a lot of the neurotransmitters that make your brain function
correctly are produced in your gut from the function of the bacteria. Like there's a lot
of bad things that can happen if you don't have a balanced microbiome in your gut. Right. So
interduke university in 2007, I guess someone was staring at a picture of the human body
from the inside out and locked in on that appendix. They said, oh no. And they're like,
it's just sitting there attached to the cecum. It's got to do something. Right. And they did
some studying and testing. The appendix went, I know exactly. You like me. And they figured out
this theory that this is a safe house essentially for that good bacteria. It's got a really rich
biofilm, which is we've talked about biofilm in a bunch of episodes, I feel like. Yeah. It's like
coating on the inside of the blindings of all kinds of things. Yeah. It keeps bacteria from
being destroyed. It's like a protective mucus. Yeah. Exactly. Which is, you know, that sounds
gross, but it's a really good thing. And the appendix is just lousy with this great biofilm.
And they said, I think, we think, the Duke University Blue Doubles think that this is a
safe house for that good bacteria. Because when the body's being flushed out with diarrhea from
its illness, the appendix is down there at the end of the cul-de-sac. It's not even getting
affected basically. Right. And so when that bacteria leaves and takes the good with it, the appendix
says, hi, I'm here. Look at all my good bacteria friends. Yeah. Go forth and do your work. Exactly.
It goes boop and pushes all like a big hunk of mucusy bacteria or bacteria ridden mucus into
your large intestine to recolonize. Which is amazing. And all of a sudden, the science world was
turned upside down. Yeah. Because they thought they, and it turns out they did find a use for
the appendix. Yeah. And not only is it a storehouse they found for bacteria, the good bacteria that
make up our microbiome, it's also a place where lymphocytes and other immune cells are produced.
Like it's called lymphoid tissue where like T cells, B cells, I think there's one called
T natural killer cells, which you don't want to mess with. That's the iced tea. Yeah. Or the Woody
Harrelson and Juliet Lewis of immune cells. They're produced in the appendix. Right. Right.
So when the recolonization process is going on, you could still have bad bugs in there,
but to prevent them from taking hold, those immune cells come in and just wipe them out
while the good stuff comes back in and recolonizes. So the appendix is a really,
apparently a very useful organ. It has a use after all. Yeah. But you can still live without it.
That's the weird thing. Why? Why? If it produces this really important function,
why would we still be able to live without it? I don't know. Oh, well, we'll talk about it later.
Well, no, what I didn't see anywhere was if you live in an adverse way because you don't have
your appendix, does that make you more susceptible to certain things if you have that foodborne
illness? Right. Okay. So here's the other thing. There was more support from the fact that you
can have your appendix removed. Right. So there's more support for the idea that the appendix plays
a role and isn't vestigial from the fact weirdly that if you remove it, at least in the developed
world, you're still going to be okay without it. Okay. It makes no sense as a paradox, but then
when they looked into the paradox, they're like, actually, this does make sense because of that
hygiene hypothesis that you mentioned earlier. Should we dive into that? Sure. All right.
Well, hygiene hypothesis in a nutshell, and I recommend you listen to that episode because
it was really good, but is sort of, it goes a little something like this.
In developing, I'm sorry, in the developed world, our immune systems can be overactive,
and that's why we have things like allergies, especially foodborne allergies,
to like peanuts and shrimp that's sitting here in front of us, thawing out slowly.
Because our immune system really wants to do something. It is not good at Netflix and chill.
It likes to really be active, and if you've got clean water and really good fresh food,
and your body doesn't have to worry about that kind of stuff, it starts to attack your body
in other ways just because it wants something to do. Right. It's like one of those people at work
who like breaks something and then fixes it just to show they're working. Do people do that?
There's got to be some people out there. Okay. You mean like nudge a vase off their desk or what?
Right. At the vase putting back together plant. Okay. But there haven't been any breaks for a
while. Well, I'm just trying to see how that would happen at our office. Like how does somebody
break a podcast? You could break an RSS feed or something like that. Or maybe an IT person who
like screws up the system so everyone's like, you got to help us fix it. Right. Kind of like that.
What about this? What about somebody who organizes things when they're already a certain way,
but they just have too much idle time so they organize stuff and all of a sudden there's a
problem. That's kind of what I'm talking about. Right. So with the hygiene hypothesis, the idea
as far as it relates to the appendix is that because we live in this very sanitary version
of the world where we don't get hookworm because we don't wear bare feet and poop outside.
Our drinking water is clean. We don't have like giardia in it typically. Right. Because we're
not exposed to this stuff, our immune system is on high alert. So it attacks not just peanuts,
but also potentially the appendix too. Because it's just sitting there. It is just sitting there,
but also remember it's a storehouse of bacteria. Right. It's also a storehouse of the lymph system.
So it's producing immune cells and apparently if you're a kid and you get appendicitis,
which we'll talk about in a minute, all that whole thing, the number one cause of that is
overproduction of lymph cells. So it's possible that your immune system says this part of the body
is producing a lot of weird immune cells or way more than it should. There's a lot of bacteria
here I hadn't noticed before. Let's go attack it. That your immune system attacks your appendix
and causes inflammation. And then that creates the appendicitis that can be dangerous later.
That sounds very weird. Why would anybody say that? Well, Chuck, turns out that there's a paradox
that goes hand in hand with developing countries. Huh. Well, yeah. I mean, they've seen this kind
of proven out in developing countries is as they've become more developed and more industrialized,
their rate of appendicitis has gone way up. Yeah. And their body previous to that industrialization
is maybe getting water that's not great for them or food that might carry some sort of
foodborne illness. So their immune system is like, we love this person in this culture.
Because we're always busy flushing this system out with diarrhea and we're just hard at work
and we don't have time to create some fake peanut allergy or to go after the appendix
is not sitting around doing anything. Right. So this just, it's busy and they've seen as they
become more industrialized, appendicitis have gone up and sort of lockstep with that. Yeah,
it happened in the United States and Europe in the beginning of the 20th century. There was a big
spike. Like before that, there was no such thing as appendicitis basically. Right. There was,
but it was very, very rare and then huge and enormous spike and then it plateaus and stabilizes.
I think in both Western and Eastern Europe and the US were hovered around 100 cases per 100,000
people of appendicitis these days. Over in like, I think South Korea around that time,
no appendicitis. Later in the 20th century, early 21st century as the development just went
through the roof, huge cases, a huge increase of appendicitis and you can just kind of follow
it around the world as development comes, appendicitis goes up and they think that it's
this hygiene hypothesis that explains it. I love it. So you've got the safe house theory that the
appendix actually does have a purpose and a role and then you have the hygiene hypothesis that explains
why appendicitis is a thing in developed countries. Well, should we take a break
and dig into appendicitis? I think we should. It's going to be awfully painful and gross.
Hey, I'm Lance Bass, host of the new iHeart podcast Frosted Tips with Lance Bass.
The hardest thing can be knowing who to turn to when questions arise or times get tough
or you're at the end of the road. Okay, I see what you're doing. Do you ever think to yourself,
what advice would Lance Bass and my favorite boy bands give me in this situation? If you do,
you've come to the right place because I'm here to help. This I promise you. Oh god.
Seriously, I swear. And you won't have to send an SOS because I'll be there for you. Oh man.
And so my husband, Michael. Um, hey, that's me. Yeah, we know that Michael and a different hot,
sexy teen crush boy band are each week to guide you through life step by step. Oh, not another one.
Uh-huh. Kids, relationships, life in general can get messy. You may be thinking this is the
story of my life. Oh, just stop now. If so, tell everybody, yeah, everybody about my new podcast
and make sure to listen so we'll never, ever have to say bye, bye, bye. Listen to Frosted Tips with
Lance Bass on the iHeart radio app, Apple podcast or wherever you listen to podcasts.
I'm Mangesh Atikular and to be honest, I don't believe in astrology, but from the moment I was
born, it's been a part of my life. In India, it's like smoking. You might not smoke, but you're
going to get secondhand astrology. And lately, I've been wondering if the universe has been trying to
tell me to stop running and pay attention because maybe there is magic in the stars if you're willing
to look for it. So I rounded up some friends and we dove in and let me tell you, it got weird.
It got weird fast. Tantric curses, Major League Baseball teams, canceled marriages, K-pop.
But just when I thought I had a handle on this sweet and curious show about astrology,
my whole world can crash down. Situation doesn't look good. There is risk to father.
And my whole view on astrology, it changed. Whether you're a skeptic or a believer,
I think your ideas are going to change too. Listen to Skyline Drive and the iHeart Radio app,
Apple Podcast, or wherever you get your podcasts.
I'll bet the ads everyone heard were just astounding.
So we've been dancing around the appendicitis kind of this whole episode. It was identified for
the first time in 1886 by Reginald Fitz. And before that, they just said, if you've got an
abdominal illness and you die because of it, it's just you had a bad stomach ache that killed you.
Sorry. Dave wrote one of my favorite lines in the history of stuff you should know,
articles. He said, Fitz was the first to finger the appendix. It's the culprit. I was like, man,
finger the appendix. That's a spinal tap record.
That's gross, but you actually probably could finger the appendix because it's like a little
pouch. Just like to just box it. Think about finger sized. You could fit your whole forearm into
a Sifranco August appendix. Oh man. That's an incher. So appendix, everyone. The appendix.
Everybody grew up. Calm down. So the appendicitis happens because basically I mentioned it was
a cul-de-sac. It's the end of the road situation once you get to the far end of the appendix.
But that other end that connects to the cecum is very narrow and the opening is not that big.
And it can get clogged up with bacteria. It can get clogged up with certain
kinds of seeds that go through your body undigested. Hey seeds.
Hey seeds, sure. This is really gross, but it can get clogged with fecaliths,
which are stone-like pieces of petrified feces.
My friend, I saw that that is the number one reason for appendicitis in adults.
Is fecaliths. That's a hard word to say, but that's what happened. The opening blocks,
bacteria builds up. It gets inflamed and inflammation is the sort of enemy of all
the human body. Right. And you start to get fever and nausea. You got pain. You might get a
pain in your sort of lower right side of your gut. Yeah, because that's where your appendix is.
Like if you make an L shape with your thumb and forefinger. Like the loser. Exactly. I didn't
want to say it, but okay. Sure. We're going to get some email about that.
If you take the thumb and put it in your navel and point your finger to your hip,
that is like in the little V is where your appendix is. Oh, okay. Where your thumb and
yeah, the little webbing. Yeah. All right. Well, that's if you get a pain there
and you are nauseous and you might have a fever, then get lead to a hospital emergency room
because you might have advanced appendicitis at that point.
Yeah, it can be a problem. You might have an appendectomy quick like they can do them super
fast. If you get it really, really early, they might concur with just antibiotics, which is great.
But I think 1887, the very year after Fitz identified the disease in 1886 is when they
had their first appendectomy. Yeah. Which means they had been happening the whole time.
They finally just said, oh, wait a minute. I think it's the appendix is why all these people are
dying from the stomach pains. Right. So maybe we can start removing this little useless dangle.
Yeah. I think it was a guy named Thomas Morton, maybe? Yeah. Thomas Morton was the surgeon who
looks like he lost his brother and son. Yeah. It was from mysterious stomach ailments,
but it was probably ruptured appendixes. And that's what happens. It ruptures
and then leaks bad stuff into your intestines and your toast. Yeah. So when the appendix is
infected and it leaks that stuff, it perforates is what they call burst is another way to put it,
depending I think on how bad it is. All of the infected pus, if there's fecalists in there,
whatever bacteria they have with them. Yeah. All that stuff gets for that watermelon.
It spills right. Yeah. It spills into your abdomen. And your abdomen has an
inner, it has an abdominal wall and it has an inner coating called the peritoneum. The peritoneum
is not to be infected with anything. It's very delicate. It doesn't like gross stuff. No, no.
Keep all that and the appendix and the intestines and all that. Yeah. Large intestine. But when
your appendix bursts and releases all that stuff, it gets your peritoneum infected and your peritoneum
is like a highway straight to your blood vessels, straight into your organs. And so all of a sudden
your infection goes from your appendix, which you can deal with, to your peritoneum being
infected, which means your blood and then your organs are infected, which means you can go into
shock and you have a cascading system failure. That's why it's an emergency when you have appendicitis
because it may rupture and that can be problematic. Yeah. And you can still die from that. I think the
surgery itself in 1925, the mortality rate from an appendectomy was 14%. Now it's down to point,
well, it's one-tenth of 1%, whatever that is. That's pretty low. And that was since the mid-50s.
But that's the mortality rate for the appendectomy, right? The surgery. For appendicitis, I think
overall, maybe worldwide, it's I think 0.2 to 0.8%, which means two between two and eight of every
two and eight people who get appendicitis out of every thousand people who get appendicitis.
There's gotta be an easier way to say this. They die from it. They buy the farm. Not many,
but that's significant if you're eight people out of a thousand. That's not for sure. I wanted
that to be 0.8. And I think the mortality rate is lowest in young people, obviously, although
young people between 10 and 30 are the most likely to have an appendectomy, I think, right?
Yes. Which is interesting. That's weird. The reason that it's lowest in very young people
is the common knowledge among doctors and in the medical field is that the appendix has played
a role for a long time, but it's just part of your immune system when you're very young.
I have the impression that that is old-school thinking, that is pre-bacteria safe house
thinking. What? That young kids don't get it because they just have killer immune systems?
Yeah. And that the appendix is just on fire and it's just happily working. And that it can become
problematic after it stops providing its function. Okay. The idea is that the younger you are,
the more vulnerable you are to dying from diarrheal diseases or infections. And so you would have a
healthier immune system. And kids do have just this hopped up immune system. But I think the
medical understanding up until recently is that the appendix plays a part of that, right? Gotcha.
But that it stops functioning as you get older and then you're vulnerable to appendicitis. And
then after you make it out of the danger zone, you can just basically coast and get fecal lifts
all day long, blocking up your appendix and it doesn't matter. The new thinking is that no,
it's the storehouse for stuff. We just don't need it anymore because we don't really get
diarrheal infections here in the developed world. Right. Yeah. Okay. That makes sense.
But appendicitis is a thing and if you do go to, or if you do have symptoms that seems weird,
generalized pain around your navel or where your appendix is, you should go to the doctor.
The thing is, is this new idea that the appendix actually does serve a function
has at least in some quarters created this call for doctors to stop doing what are called negative
appendectomies, where it's like, oh, you got stomach pain. Let's take your appendix out.
And just see if that fixes it. Right. Yeah. Yeah. Because supposedly a non-perforated appendix may
actually resolve itself. Right. Like it may go and like spit that seed out and like go back to
normal or whatever. Right. And you don't want to just lose your appendix willy-nilly. For one,
you're undergoing surgery. There's always complications in rest of the surgery. The point
is though, don't just stay home. This one paper I read was like, you're better off for the physician
to wait and see in the hospital. Keep you in the hospital under observation so that if you do need
emergency surgery, you're there. Yeah. And that it may resolve itself on its own if it hasn't
perforated already or that that's preferable to just removing the appendix and negative
appendectomy. Don't be like, I can still play my street hockey game later, right? Yeah. I think
they were saying like, it's not up to you, the patient, like just go to the hospital. I'm talking
to the doctors right now. The paper was saying, you know, don't remove the appendix if it doesn't
need removing. Are we at Harry Houdini? I think so. Yeah. So this is a little addendum. I kind of
think, oh, it's like an appendix. I kind of think we should do a Harry Houdini episode at some point.
You bet. Don't you think? Yeah. Should we talk about this now at all? I think we should do Houdini
around Halloweeny. Okay. Okay. That sounds fantastic. I tried to think of something to rhyme with,
weenie. That's an approval. No, it's like a thumbs up, like a magnifini. Oh, that's great.
Right. That was, yeah, that was good. I'm going to stop it right there by using good.
People really don't know that I just left the room for like 15 minutes trying to think of
something and came back with the magic of editing. Jerry didn't do like the star wipes out.
So there have been a few people who have died from a ruptured appendix. They believe that Brigham
Young, the Mormon prophet did, Charles Floyd, the only person in the Lewis and Clark journey
expedition to die. I didn't remember that. Did you? I think I remember just mentioning
I do remember that one person died. Yeah. Yeah. And we're like, what was his problem?
Why did he screw everything up? And it was his appendix. So Harry Houdini did die of
an appendicitis. And I don't think we even said perianitis. Yeah, we did. Did we say that was
the actual word? That's the, oh, I don't know, but that's the infection of the peritoneum. Yeah,
that's the name of it though. Yeah. And that's what you do. Like you don't die from your appendix
bursting because again, like, yeah, it provides a function, but it's not, it doesn't keep you alive.
It's not like your heart bursting. Right. It's the peritoneum getting infected that kills you.
So Houdini did die of that, but you know, the old story is that he had come off stage. He was
backstage in his green room and presumably having smart food and beef jerky. If you're
at a stuff you should now show. Stilling club soda everywhere from opening the bottle. Oh man,
I can't wait to do that again. Yeah. But I can't wait because I'm not doing that anytime soon
still. I don't want to get on a plane yet. No, not quite yet, but we're looking forward to that,
for sure. But you know, there were these college students who came backstage and one of them was
like, I heard that anyone can punch you in the stomach and that you, you can make your stomach
strong and it won't even hurt you. And I'm a pretty good stomach puncher. He goes, well, that is
sort of, and the guy punches him before he even has a chance to really prepare and say, sure,
bring it. Right. And that sucker, a sucker punch and that burst his appendix. And that's how he
died. And that story is just a little blurry around the edges is how that went down exactly.
Right. Yeah. So there, there were eyewitnesses and they did say that this guy did punch Houdini.
That it's conflicting whether or not Houdini gave the guy permission to punch him or not,
or if the guy just started punching. But there was a young man named Jocelyn Gordon.
Whitehead. Whitehead. Houdini's last words were done in by a guy named Jocelyn.
Didn't see that kind. One account was that he was still laying on the couch and the guy started
wailing on his stomach. Well, yeah, because he had injured his ankle the night before,
a couple days before, so he was reclining on the couch. I guess somebody was sketching him.
It was basically like that scene in Titanic. Oh, really? Yeah. Or he's like, draw me like
one of your French girls. And the guy started drawing him. Right. And then the guy punches
him while he's down. That happened. The question, the thing that's sketchy is whether or not that
guy punched Houdini in the appendix and Houdini's appendix ruptured where it otherwise wouldn't have.
They think that that happens very, very rarely. A appendicitis brought on by blunt trauma.
They think that he probably had appendicitis already. This guy punched Harry Houdini in his
inflamed appendix and that that created problems. So the guy definitely killed Houdini one way
or the other. Did Houdini already have appendicitis or not? Right. And he probably did. Most scholars
say, yes, there's just no way this little guy from McGill University, I mean, come on, the Canadian
Harvard, give me a break. Jocelyn? Yeah. That he burst Houdini's appendix. Yeah. I had a weird
brief Houdini obsession when I was a little kid. Oh, yeah? I think I did some sort of visual
report when you would just do a, not even, maybe it was a book report. An interpretive dance,
is that what you're saying? Yeah, that's what it was. But yeah, it was on Houdini and I was just,
for a little while, I just was really Houdini obsessed and then kind of magic obsessed. Oh,
yeah. Did you have one of those kits? I had a magic phase. Did you have a kit? I may have had a kit.
Did you go to the trick shops, magic shops? Yeah, there was one called Eddie's Trick Shop here
in Stone Mountain that I went to. That's awesome. Those places were great. Deca fake cards or some
nice fake vomit or poo. Yeah. Yeah. You always looked up to the person behind the counter and then
you grew up and you're like, oh, that's how you used to work there, kind of thing. Yeah, it was the
magic shop and then the place that sold or sold the old mad magazines. Those were the two greatest
places on the planet when you're a certain age, you know? Yeah. You got anything else about appendix,
appendicitis, Houdini? Uh-uh. This is good. I quite enjoyed this experience. I did too. Thanks to
you guys for listening and since we don't have anything else about the appendix, that means
it's time for listener mail. I'm going to call this great idea from a 10-year-old listener
and this one is genuinely going in the to-do file. Okay. Dear, and this is short and sweet,
dear Chuck Bryant and Josh Clark. Hi, my name is Jack and I'm 10 years old and from
High Watha, Iowa, and I listened to your podcast while I mow. My dad introduced me to your podcast
and they've been great. My favorite one so far was probably Titanic. It's really interesting.
Before I listened to that one, I wasn't really interested in the Titanic, but when I listened,
I got more interested. I was wondering if you ever thought doing one on child labor,
it was after you mowed the grass, so. Oh, okay. Yeah. I learned about it in school and want to
know more about it. Thank you for all your great podcasts and that is from Jack and that is
as on brand of stuff you can know episode as I've ever heard. Yeah, but also coming from a child
laborer, it really kind of has a certain like glow to it, you know? Yeah. I think that's a great
idea. I wonder if this kid is just like, I'm going to get my parents back for this. Maybe.
Because do you remember wanting to mow the grass when you were 10? Totally. And then you started
to in about the third or fourth time, you're like, I've made a terrible mistake. Well, it all
depended that, but it also depended on the kind of mower that your parents stuck you with. Yeah.
We did have a rider for a short time. Oh, wow. That was kind of pre go-kart car driving. Yeah,
yeah. Yeah, it's like driving. Yeah. But with a blade spinning at thousands of RPMs right beneath
the. Exactly. Sure. Just put that nine-year-old in the seat. All right. Who is that again? That was
Jack. Jack, thank you. Great name, great idea, great person all around. Yeah. Coming soon,
like you can count on that one, Jack. If you want to get in touch with us like Jack did with the
great idea, we are always open for those. Take your idea, wrap it up, spank it lightly on the
bottom and send it off to StuffPodcast at iHeartRadio.com. Stuff you should know is a production
of iHeartRadio. For more podcasts, my heart radio, visit the iHeartRadio app, Apple podcasts,
or wherever you listen to your favorite shows. Hey, I'm Lance Bass, host of the new iHeart podcast,
Frosted Tips with Lance Bass. Do you ever think to yourself, what advice would Lance
Bass and my favorite boy bands give me in this situation? If you do, you've come to the right
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you through life, tell everybody about my new podcast and make sure to listen so we'll never
ever have to say bye bye bye. Listen to Frosted Tips with Lance Bass on the iHeart Radio app,
Apple podcast, or wherever you listen to podcasts. I'm Munga Chauticular and it turns out astrology
is way more widespread than any of us want to believe. You can find in Major League Baseball,
International Banks, K-pop groups, even the White House. But just when I thought I had a handle on
this subject, something completely unbelievable happened to me and my whole view on astrology
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are about to change too. Listen to Skyline Drive on the iHeart Radio app, Apple podcasts, or wherever
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