Unhappy with treatment my mom got from Dr T Viljoen

Instead of prescribing medication every time, Dr Viljoen should have referred my mom to a gastroenterologist.

https://www.mountsinai.org/health-library/diseases-conditions/appendicitis

Your pain may be worse when you walk, cough, or make sudden movements. Later symptoms include:

Chills and shaking
Hard stools
Diarrhea
Fever
Nausea and vomiting

If the appendix is not removed, it can leak bacteria and infect your entire belly, which can be very life threatening.

Usually, the first symptom is pain around your belly button. The pain might be mild at first, but then it gets sharp and severe before not too long. The pain may then move into your right lower abdomen. You may also have diarrhea, fever, nausea, and a reduced appetite. 

Sometimes, people think that they might be having food poisoning. 

Your doctor will make a diagnosis based on your symptoms. You may also have blood tests and a CT scan or ultrasound. 

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You can get appendicitis if your appendix becomes blocked. That blockage could be from feces, a foreign object, or, in rare cases, a tumor. When your appendix is blocked up, bacteria that normally live inside it start multiplying like crazy, and cause an infection. If you've got appendicitis you'll usually have pain that's centered around the area of your belly button. 

At first the pain may be minor, but it can get very severe and will usually drift downward to the bottom right part of your abdomen. You may also have nausea, vomiting, diarrhea or constipation, and a low fever. Your pain may let up for a time. 
This relief can be misleading, though. Just when you think you're getting better, your appendix may have actually burst.
If that's the case, the pain will get start to get more and more intense. 

To diagnose appendicitis, your doctor will ask about your symptoms and press on your abdomen, which will feel very tender. You may need imaging tests, such as a CT scan or ultrasound of your abdomen, so the doctor can see if the problem is with your appendix. If you have appendicitis, the number one way to treat it is with surgery to remove your appendix. In fact, appendicitis is the number one cause of emergency abdominal surgery in the U.S. You may be treated for an infection first, before your surgery. It's important to treat the appendicitis quickly because you can develop a collection of pus called an abscess in your abdomen once your appendix bursts.

...

Outlook (Prognosis)
Most people recover quickly after surgery if the appendix is removed before it ruptures.

If your appendix ruptures before surgery, recovery may take longer. You are also more likely to develop problems, such as:

An abscess

Blockage of the intestine
Infection inside the abdomen (peritonitis)

Infection of the wound after surgery

Gastroparesis means paralysis of the stomach. It’s a functional disorder affecting your stomach nerves and muscles. It makes your stomach muscle contractions weaker and slower than they need to be to digest your food and pass it on to your intestines. This leads to food sitting too long in your stomach.

https://my.clevelandclinic.org/health/diseases/15522-gastroparesis

Gastroparesis

Interferes with the muscle activity (peristalsis) that moves food through your stomach and into your small intestine. When your stomach muscles and nerves can’t activate correctly, your stomach can’t process food or empty itself as it should. This holds up your whole digestive process.

Bezoar and gastric outlet obstruction

A bezoar is a compacted, hardened mass of food stuck in your stomach. It forms out of pieces that were left behind when your stomach emptied. A bezoar may become too big to pass through the outlet at the bottom of your stomach. It can also block it and make it hard for any other food to pass through. Healthcare providers treat bezoars with medication to dissolve it, or if necessary, surgery to remove it.

Gastroparesis

Food that doesn't digest that hardens and stays in the stomach. This food can harden into a solid mass called a bezoar. Bezoars can cause nausea and vomiting. They may be life-threatening if they keep food from passing into the small intestine.

https://www.mayoclinic.org/diseases-conditions/gastroparesis/symptoms-causes/syc-20355787

https://badgut.org/information-centre/ostomies/bowel-blockage-or-obstruction/

Urgent care is required if you are vomiting, have severe/constant pain, or if there has been no output from your stoma for 12 hours. In these circumstances, you should go to your closest emergency department for assessment and treatment. 

You will be monitored for any signs of ongoing problems. Sometimes, depending on the severity of the obstruction or if it fails to resolve with the conservative medical management, you may require surgery to correct the problem.

UTI Complications

The main danger associated with untreated UTIs is that the infection may  spread from the bladder to one or both kidneys. When bacteria attack the  kidneys, they can cause damage that will permanently reduce kidney function. In  people who already have kidney problems, this can raise the risk of kidney  failure. There's also a small chance that the infection may enter the  bloodstream and spread to other organs.

Symptoms:
Pain on either side of the lower back.
Fever and chills.
Nausea and vomiting.

When you have UTI/bladder infection, to reduce chance of kidney infection, take AUGMENTIN BD 875mg. 
*** Wish the doctors and surgeons in SA would take note of it ***

The cardiovascular adverse effects of the selective COX-2 inhibitors like myocardial infarction, hypertension, fluid retention and congestive heart failure, among others, have led to a revoking of Merck’s Vioxx (rofecoxib) and the unavailability of Arcoxia (etoricoxib) in the USA. 

They are widely prescribed in Europe, South America and Asia for musculoskeletal pain.

***
Specific COX-2 inhibition may induce renal ischemia, electrolyte imbalance and increased blood pressure. 
The common outcome of renal ischemia is renal fibrosis followed by atrophy and chronic renal failure.
(Kidney ischemia is a disease with a high morbidity and mortality rate. Blood vessels shrink and undergo apoptosis which results in poor blood flow in the kidneys).

https://pmc.ncbi.nlm.nih.gov/articles/PMC3047866/

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Etoricoxib - Black Box Warning

Gastrointestinal Bleeding: 
While less common than with traditional NSAIDs, serious gastrointestinal bleeding, ulcers, or *perforation* can occur.

Liver problems: 
Such as elevated liver enzymes or liver damage.

Increased Risk of Heart Attack and Stroke: Etoricoxib, like other NSAIDs, can increase the risk of serious cardiovascular thrombotic events, including heart attack and stroke, especially with long-term use.

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Celebrex / Celecoxib - Black Box Warning

https://www.webmd.com/drugs/2/drug-16849/celebrex-oral/details#sideeffects

Heart Attack and Stroke:
Trouble breathing.
Sweating, upset stomach, vomiting, or dizziness.
Sudden weakness on one side of your body.

Stomach Bleeding:
Celecoxib can increase your risk of bleeding, ulcers, and tears (*perforation*) in your gut.

Liver Damage:
Nausea or vomiting.
Stomach or belly pain.
Fever.

Kidney Damage:
Reduced need to pee.
Difficulty catching your breath or chest pain/pressure.
Nausea.
Seizures.
Confusion.