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

Dr said I could give her cocodamol if paracetamol/ibuprofen not working. 3 weeks of codeine for a 13 year old does not sound like a good plan to me, at all

This is horrific.

A friend of mine had a twisted ovary or something in Y9, which required an op. I don't want to scare you but would looking up NICE guidelines round ovarian torsion be worth a try? Unless of course this has been ruled out (I hope so - and apologies if it's an unhelpful and stupid suggestion.)

Your poor daughter, this is barbaric. I had a ruptured ovarian cyst which made me vomit and was absoloute agony that came in waves and it floored me, I've had 3 miscarriages, a longgg Labour and 2 csections but the cyst pain was something else! I was scanned and told it had ruptured but they kept me there to see if my body reabsorbed the blood and fluid because I was told it was dangerous if not and could cause sepsis. How can they just leave her without telling you what it is. If she's in so much pain I'd be going elsewhere and wanting a second opinion. Hope you get her sorted x

She doesn't need constipation on top of this, that's for certain.

It's horrendous how women and girls are treated sometimes. Gynae pain shouldn't be seen as our birthright. I'm mad on your DD's behalf 🌺

it has not been ruled out, no! I'm very confused about how they are so unconcerned without knowing what is causing the pain

constipation is a really good point! I hadn't thought of that

would consider ovarian torsion + continue to ring GP surgery every day for emergency appointment x
Also, potentially book a private scan if an option x

OP l very rarely comment on threads but l just wanted to join the others in saying please push for an investigation into an ovarian torsion. I had one when l was 16 symptoms very similar to your daughters, started of with what felt like painful period pain increasing to agonising pain in waves. I was taken out of my GP’s in an ambulance as the pain progressed to screaming pain levels, initially the GP and the a&e doctors refused to believe it could be anything other than concealed pregnancy as l was a 16 year old wearing a school uniform 😠

After a scan showed l had an ovarion cyst likely a torsion l was whisked into emergency surgery as the surgeon said it was dangerous to leave me lying around as it could lead to sepsis. If they really won’t scan your DD then try local scanning clinics, usually set up for private pregnancy scans but they often run gynae scan clinics also, I’ve had one when l thought l had another cyst and didn’t want to wait on an NHS scan. Please don’t let this one go.

Ok.

So A and E have checked her out and they don't expect her to die imminently which is good.

A lot of the people waiting for a scan will be in equivalent or worse pain. Unfortunately a lot of the time all the GP can do if she or he does not control the scanning queue is prescribe painkillers.

I have endometriosis and have had since I started my periods age 13. I've also had various problems with cysts.

My GP refused to even refer me to gynae waiting list for 9 years. I spent 9 years of my life and all of my teenage years on pretty strong pain meds because I had extreme pain, vomiting and diarrhoea.

I only got diagnosed and operated on because my grandma gave me some money (it was actually supposed to be a rental deposit) and I spent it on a private operation.

If they have ruled out everything except gynae pain if I were you I'd hope it's a ruptured cyst because that will solve itself quite fast. If it's endo you have a longer path.

If you can possibly afford it I'd try to get a private scan as at least that way you will be able to see if there is a cyst.

And please don't rule out codeine because of constipation - if it is ruptured cyst the pain is horrendous.

i Paid for a private pelvic scan a few weeks ago! £130. I had an ultrasound and then an internal scan to check ovaries. Maybe search for local private clinics that do pelvic scans. My scan was clear and they told me there and then. worth a google search maybe?

All the doctors want is for you to leave.

If she is in agony like you say, then I would definitely bring her elsewhere. Good luck.

Someone mentioned upthread what I was wondering: could she have left a tampon in - not just from this period but from a previous one? I've scanned your responses OP and couldn't see a response, apologies if I overlooked.

update: children's hospital are lovely. the doctor here thinks it IS appendicitis probably, afterall. they have done blood tests which show just mild infection. they are keeping her over night for painkillers and to scan in the morning

Im shocked that the GP gave medication for severe bleeding when she wasnt even bleeding

Thats shocking

Glad you went to the childrens hospital and shes getting sorted
If they do find its appendix / another issue, please complain about the other hospital and the dr because your daughter has been treated so badly

I was thinking that I should do this. not even because I'm really cross etc but bloody hell....another parent might be more trusting and just take their kid home. things that he said that were bullshit 1) blood tests wouldn't be of any use 2) risks of scanning are too high in such a young person. idiot. actually I AM cross!

She could of died another child might do next time
Im not normally for one that says complain about the NHS because they are so over stretched but what they done , or didnt do for your daughter could of been life threatening

Plus an Ultrasound has no effects on the body so what was the excuse for that ?!

I really would complain to PALS. I'd be very surprised if she was showing zero signs of infection earlier and suddenly is now. I'll bet anything she had raised markers earlier too, but the other doctor decided to disregard it. Or did they not do blood tests at all?

PP also makes a very good point that an ultrasound scan would be fine. I assumed they meant CT but an ultrasound would have ruled a lot of things out.

Not to mention the pain she's in, which clearly needs properly taking care of.

I really hope she's going to be ok. I'm shaking my head here at her poor treatment. Lucky she's got you looking out for her!

How is she?

I feel that I could have written this x I'm so glad that you are at the hospital. Similar happened with my daughter. They removed her appendix as a precautionary measure - they thought it was gynae and the removal would rule out any further complications of pain in the future being blamed on the appendix. When they did the surgery they found a burst cyst, her abdomen was full of blood and endometriosis.

you are thinking of mefenamic acid, which is NSAID. Tranexamic acid is to reduce bleeding

Your knowledge of the treatments for this condition is paramount and I feel you need to use this to advocate for your daughter... my daughter who has an official diagnosis has really helped me get my younger daughter treated effectively. My youngest has had issues with bleeding and pain for 18 months and it's been a process of elimination, working out what works well and what doesn't. We have found using the pill has sorted all of her symptoms and she's a lot happier. She takes the pill three months in a row then has a four day break and bleed and then back on it again. We were reluctant to use the pill but when she reached 15 we had no choice. Her 4 day bleed is horrendous though x she needs lots of medication to help with the pain. We are on the waiting list for gynae x her appointment has been cancelled three times.... it's been a year :(

Try and work out who is the best gynae doctor in your practice... and liaise with them.

Good luck x hope that she's ok xx Well done for going to the children's hospital xx

I hope your DD is alright this morning OP and she’s managed some rest. Good you went to the children’s hospital.

no, they didn't do blood tests at the first hospital. he said that blood test wouldn't be helpful because he had ruled out infection, based on her having normal vitals and a clear urine test. he said the blood test would show raised inflammatory markers for sure, but that wouldn't explain why they were raised.

I wish I had challenged him about the scan being dangerous. in my head I was thinking US scan doesn't use radiation, why is he saying that. I hadn't processed that he was talking about a CT scan. why would he use a CT scan for this, US makes much more sense

I have felt inclined to give him the benefit of the doubt because the nurse we saw in out of hours the night before also said it wasn't appendicitis...although she did caveat that with, need a scan/didn't have access to a scanner.

but the Dr we saw last night when we got to the children's hospital said that she is showing classic signs of appendicitis. she did a blood test straight away. she said sometimes on day 1 or 2 of symptoms, then a blood test isn't helpful because it takes a while to show in a blood test. but 4 days in, then it definitely would. and she DOES have low grade fever. temperature has been consistently high whilst we have been here. I find it hard to believe that it was normal when they took it in the previous hospital

I'm really struggling with why he thought it was ok to send a 13 year old away to wait 3 weeks to see the GP, with pain that was preventing her from standing/walking or even sitting up for long 🤷🏼‍♀️. I do remember a paediatrician telling me once about 'adultification' by professionals (we were discussing teachers at school at the time) because 1) she is very tall and 2) she is Black. And over the years since then I have read about experiences of Black women giving birth and how they aren't given pain killers so early because they are expected to have better pain tolerance. and I KNOW that women in general often have their pain overlooked in health care. I dunno, who could say really. I'm just so glad that I didn't just take her home and put her to bed!

yeah, I have been sat thinking...regardless of the outcome of this, I think birth control pill is probably a good idea isn't it, to control her awful period. she is chronically anaemic, as was I and it's horrible, so debilitating. she suffers with anxiety which is a whole other story but I'm wondering if it's related to her periods.

Well done op - you trusted your maternal instincts which proved you right. I hope your DD gets better soon 💐

thank you 🤞🤞

Well done for advocating for your daughter, I really hope they get to the bottom of things this morning for her and she's had a restful night