urgent gynae advise needed for teenager please

[Crackalac]

life's been a bit chaotic and I just can't think straight, so this might be obvious

dd13 started with what we thought was severe menstrual cramps on Saturday. this is normal for her but this was more extreme.... vomiting and fainted. but me and other dd experience bad periods so horrid but didn't worry too much

it has improved since but she is still getting waves of pain where she can't walk, peeing hurts, keeping her awake etc etc

it occurred to us that she has not long finished a period and so we went to OOH last night. they ruled out appendicitis and urine infection, and do think it's gynae. they didn't have access to a CT scanner and told us to see GP today.

I have been trying to contact GP anyway since yesterday and have received a text message saying phone lines are down, should get a response in 2 days

I think she needs a scan. I don't think she should wait 6 months for GP to refer her to gynae. but currently she isn't in extreme pain so I don't feel like we can go to AnE. she fell asleep about 6am so is currently settled

How about calling an ambulance?
Definitely AE,
but also, bowel obstruction, rather than gynecologic character?
Good luck.

Gosh poor poor girl, so young to be dealing with this sort of thing :(

Call an ambulance and she'll likely still be waiting tomorrow. Waiting times are insane.

Yeah don't bother with an ambulance quicker to get there yourself,

Hope it is nothing too serious OP

Good luck op.

Ruptured ovarian cyst is a possibility, it can resolve on it's own, it's worth getting it checked out anyway to rule out torsion. It's very painful and most likely to occur in the time between period ending and ovulation.

Hope it's not a hideous wait for you

Hope she's ok x

I'm a bit gobsmacked tbh. urine test normal, all vital signs normal including normal temperature now. doctor happy that there is no infection...urine/kidney, bowels ok, no appendicitis. he wouldn't scan, said that they ruled out life threatening conditions and the radiation risk of scanning wasn't justified in someone of her age. she should see her GP for the appointment in 3 weeks. she can't stand or walk for very long or very far and was crying out in pain when we went over potholes in the car. I asked about ovarian cyst, he said maybe but they wouldn't treat it anyway. so she is expected to lie in bed and wait for GP appointment 🤷🏼‍♀️ take paracetamol and ibuprofen (she has been since Saturday)...WTH??

do you think I should take her to the children's hospital to see if they will scan her?

I don't think there's any point. I have endometriosis cysts on my ovaries, and they just said they leave them
As an example I'm on every painkiller possible and have had to ring an ambulance for pain relief because I was on all fours screaming in pain
Gynae wait is still a year

If it's a cyst it may ease, mine seemed to flare then settle down and I get pain before my period too

If you are worried then yes. My girls were scanned in their teens. Is it really such a big deal?

Until someone is 18 they are entitled to paediatric care

You could take her to the children’s hospital, but don’t go in with the agenda of having a scan - explain the situation, the severity of the pain, etc and accept that if a third clinician (likely a paediatrician or a fully qualified paediatric ACP) comes to the same conclusion as all of the others that you may well need to go home and follow the advice of analgesia and watchful waiting for a few days. The pain may settle down if its own accord in which case that’s fabulous, but it may also worsen (or other symptoms such as fever/vomiting etc may return or worsen), in which case you go back.

A scan may not show anything, and then what? An exploratory surgery, just in case? Or would it have been better to go home and rest for a few days with regular analgesia and see how things pan out, knowing that you can return at any time night or day if things get worse?

Trust your instincts as her mum, paediatrics likely to trust your instincts too, but do be mindful of managing your own distress and anxieties in front of your daughter too, as that’s likely to make her anxious and her capacity to manage pain will be reduced.

I mean, she HAS rested for 4 days with analgesia and still has debilitating pain 🤷🏼‍♀️. it's all very well not treating it....but we don't even know what 'it' is. if it is a ruptured cyst shouldn't that be established and in her records even if it clears up on its own?? surely that informs the treatment of her painful heavy periods going forward?

the doctor today said that if she was a 50 year old women, then he would have scanned her. but surely it's more important to know if a young girl is ALREADY suffering from painful cysts etc?

(it's my dad's funeral on Friday, so some of my stress about not having a diagnosis/plan is related to how we are going to manage to attend that. I recognise this!)

She dd has to put up with extreme pain and passing out. That's unbelievable

@itFeelsLikeSummer yes

My gynae wait has been a year and every month I faint, throw up, take morphine, I can't move off all fours and take 1-2 days off work. It's been trying to manage the symptoms while I wait to see the consultant

Oh no, what a nightmare. It does sound like she's in a significant pain.

I wouldn't think you were unreasonable for getting another opinion. I would think at the very least they'd have discharged her with some decent painkillers.

It sounds odd to leave someone in pain with a cyst too. I've also had one of those removed on the NHS because it was causing me pain. I don't know if it was because it was over a certain size, but no one told me to just deal with it.

A ruptured cyst may not show in a scan.

I knew I had one because I'd just had surgery which spotted it (big one) and then when they scanned again after I was in pain it wasn't there.

He's right that the only things they can do for it (if that is what it is) are painkillers.

You should be able to contact your GP and get better pain relief though.

Try mefenamic acid or possibly naproxen sodium (NSAIDs) or co-codamol (codeine and paracetamol mix, also available at pharmacies).

I believe they're a lot stricter in opioids these days so you probably won't get codeine.

Was this recently?

I had mine removed as an emergency operation in 2009. If they've stopped doing it on the NHS, it must be for financial reasons.

If you’re concerned about PID ask her GP to do a vaginal swab whilst you wait for gynae referral

@Crackalac Poor kid. I'd definitely take her to the children's hospital.

I'm surprised they wouldn't scan her when she was in that much pain.

I was sent to a&e by my gp a few years ago for abdominal pain. They scaned me, it was a cyst. They put me on the waiting list to have it removed. They where going to leave me in pain for months. Luckily we had private insurance through my husbands work and I had it removed within weeks.

Oh and a&e said if it had been a twisted cyst they would have removed it ASAP as that is an emergency. So how could they have possibly ruled these things out without a scan?

I had mine removed as an emergency operation in 2009. If they've stopped doing it on the NHS, it must be for financial reasons.

They'll remove large cysts if they're causing issues, but often they don't cause issues (pain) until they rupture and generally once ruptured they self resolve. Not sure whether it's because of age, but I was given morphine in hospital and sent home with co codamol.

but presumably you are an adult. it's not that unusual for grown women to have gyny issues is it. and we are better equipped to deal with chronic pain. it isn't usual for a young teenagers to have this type of gyny pain