To be really worried there's something more sinister to this? Feel like I've failed DD

[karenaanna]

This could be long, sorry. Have NCed. Not sure this is the right place to post but more traffic and want to know if I'm worrying over nothing.

A bit of background- DD is almost 18 and is yet to start her period. I took her to the GP when she was 14 as I was concerned she wasn't showing any real signs of starting to hit puberty and they put it down to she being small for her age combined with the amount of intense exercise she does- at the time she was doing 20ish hours of semi-professional dance school a week and was planning on a dance career, she's now doing 18 hours but no longer wants to dance professionally, although she's still dancing at the same intensity. To this day she's never really had typical teenage mood swings.

Over the last few weeks, since the new year maybe she's put on a lot of weight, she's always been tiny, very ballerina esque and it's almost like she's suddenly gone into the pre puberty baby fat stage but at 17. Her level of physical activity and diet haven't changed. She hasn't said anything but is clearly aware. She's meant to be at a half term dance intensive this week starting today but came and woke me up in the middle of the night- which she hasn't done since she was about 6- in tears with what she described as stomach ache 'down there' (potential sign period is about to start?) and begged me not to make her go today. I sent her back to bed with neurofen and a hot water bottle and told her she'd probably feel better in the morning, but I'm getting an overwhelming vibe from her she doesn't want to go.

She hasn't been herself for the last few weeks, she's last year of Sixth form, so applications for further education. She's had offers from all of her chosen universities back but was inconsolable last week as she's also been rejected from all of the specialist drama schools she applied for- the Ucas application was for another subject and intended as a back up as the specialist drama schools are so competitive. When she sent off the applications she was intending to take up the university place if she didn't get a drama school place, but now it's actually happened she's decided she doesn't want to go to university and wants to reapply for drama school next year. She's at an academic school and so not getting any offers for a chosen course is very unusual, I don't think it's been easy for her seeing all her friends getting excited about university and place offers knowing she's going to be reapplying next year. She's been really low and unhappy since then, again she hasn't said as much, but she clearly hasn't been happy.

Since January she's had fainting episodes/dizzy/temporary lost vision spells, and episodes of what DD describes as severe pins and needles, she's had it a few times in dance classes and had to sit out because she can't physically put weight on her leg. Her dance teacher put it down to stress, I'm starting to wonder if it's all somehow connected and I should have pushed harder for a proper examination before. Do I take her to the walk in centre or is that overreacting?

Go and check on her and give her a huge cuddle.

Must be so scary and she's got so much to worry about.

If you need any help re college/uni applications, please PM me and I'm happy to take a look. I've been a sixth form tutor in the past and have seen a lot. I'm not an expert, but I'm happy to be another pair of eyes.

Can she sleep in your bed with you for the night?

Kick your partner out if you have one.

OP please do check on her. The fainting and blurred vision does worry me more than the weight gain. She really needs bloods and further tests and no more silly GP nonsense. This is clearly something a specialist should gap deal with.

kareneena

19lb since Christmas cannot be fat. Something else is going on (I am not a doctor btw).

Please remember that there may be lots of reasons that could make it difficult for a teen to tell her mother she has had sex. Your DD may be embarrassed, or in denial, or ashamed, or confused (some youngsters do not fully understand what counts as sex, or don't think the first time counts etc). Please keep an open mind - don't rule out an ectopic pregnancy - and do take DD to A & E if she gets a lot worse in the night. I am so glad you will be pitching up at the GPs tomorrow. I hope your DD feels better soon.

I would check on her.

I would check on her, with whatever comfort in hand I could muster (hot chocolate/chamomile tea?). Even if she is prickly and grumpy, at some level your concern will register and she will know that you're thinking about her.

Good luck - I hope you get some answers and that she feels better soon.

How worrying, hope you get answers soon as to what is wrong.

I'd be inclined to bring her to a and e if she gets any worse. Even if she was better tomorrow, I'd push for full tests.

The gp did a pregnancy test. At least I presume that's what the op meant when she said that the gp was able to rule out pregnancy.

An ectopic pregnancy, at the stage where it was causing fainting dizziness and abdominal pain would have a positive pregnancy test (although a previous poster is right that early on the test can be negative). So this is highly unlikely. And I am a doctor.

So while I agree you should check on her don't panic about an ectopic. And yes, take her to the gp in the morning or to a and e if things get worse. But try not to panic.

Please also make sure they test her thyroid.

When I was 21 I put on that amount of weight in a similar period of time and had a lot of similar symptoms. It took me a further two years to be diagnoses with a thyroid problem mainly because the thyroid normal levels are not consistent across the board. Please get all her thyroid hormones checked (ALL of them - insist on it as some labs will only do some even if requested) and double check the blood level results with a thyroid patient advocate website such as Mary Shomon's. Don't just accept it if they tell you her thyroid is 'normal'.

I'm maybe projecting my own experience here but the symptoms of fainting, blurred vision, extreme pins and needles and the tiredness really could point to a brain/nervous system (neurological) problem.

At her age it's unlikely she'd get a paediatric referral but I think you really need to kick arse at the GP (and I say that being married to one of them!) looking for general medicine, obstetric and neurology referrals. There are so many symptoms here they really need sorting.

Also wondering (in the nicest possible way) if psychiatric/psychological help might be needed. From all you've said, she sounds very unhappy and is there a chance she's depressed? It can cause rapid weight changes, both loss and gain..

Gosh it sounds like your DD & of course you are going through a grim time. I have a DD the same age. Just wanted to offer a hand to hold.

If she is short and has no periods it could be Turner Syndrome possibly too. I think you need to ask for a referral to an endocrinologist, insist on one.

I've just spoken to my dh (on call GP tonight in his area - it's quiet for now!!).

Clearly you don't know me or him and I could easily be hairy of hand ( :) ) but he really thinks you need to go back tomorrow (ooh won't be helpful tonight) and request neuro and gynae referrals. If GP won't, go to A&E.

I really hope it's nothing. He says MS, other rarer neuro stuff, ovarian cysts and potential ectopic come to mind. If her pain becomes acute or she faints again, straight to casualty.

I'm not interfering but it is worrying. Hoping it's all ok x

Are you able to help her manage the pain tonight? I hope you are both ok and have a better result with the GP tomorrow, it's exhausting trying to fight someone who supposedly knows best, but she is your daughter and you will be the best judge of any deterioration.

Thinking of you both.

have you checked on her, OP ?

Your poor dd xx

Op please ignore all the many and varied 'you must insist on....' comments on this thread from non medics. Go back to your gp. Explain your concerns. Insist that they take your concerns seriously and refer her to whomever they think most appropriate. But honestly going in and asking for a referral to 5 or 6 specialities is pointless. Be firm that you are not happy and want more to be done, but let them do their job and assess her and decide what is most appropriate. Because they are a qualified medical professional, who is actually seeing your dd, and actually will have her best interests at heart.

They are not either a doctor who hasn't seen her (like me or weegie's dh) or a random stranger with no medical qualifications who had never met your dd like most others on this thread.

Some of them might be right about what is wrong but what you want is your gp to look at her with an open mind. Good luck x

Hope your DD is ok

I would be worried about Turners, a mosaic form if she has no 'typical' characteristics and I would have her seen tomorrow (or now if she is in pain). I would be concerned about germ cell tumours (more common in girls with Turners).

It's probably not, it's very rare, but given the lack of periods it is a possibility.

I have been wondering about turner syndrome too. Sometimes this is how it is diagnosed, when puberty doesn't quite arrive. Hand holding here too op. I have pcos and endometriosis and the pain is excruciating. I often faint from it. So do be open minded to the fact that the pain may be so much worse than you think.

She's asleep, I've given her a cuddle. Honestly I just don't think she wants a massive fuss made about this, I think she's ashamed. ProfPlum that's exactly what I think, there's no way 19lbs in 6 weeks can be just fat. But alas, she's a teenager. Obviously I don't know for sure but I really don't think she's lying to me about not being sexually active. That's just my gut feeling though.

LittleTurkish thanks so much for your kind offer, she has offers from all her universities [insert proud mummy emotion] :)

Turner syndrome is unlikely I would have thought, I know she's short but I'm not quite 5'' and none of either side of the family is tall. I will ask about it though.

DH is working away this week but having been filled in he reckons she's under too much stress and that's part of the problem (which is what we told her school when they piled more responsibility on her this year but that's another issue!)

Is it a bit obsessive to keep checking in on her?

You check on her as much as you like x

Hi

Sorry that I didn't see this thread earlier - she has 'primary amenorrhea' and there are a few causes of this, all of which must be investigated thoroughly with some reasonably simple tests

The most common cause of this is constitutional delay, ie
delayed start to puberty - has she met all the other stages of puberty (look up tanner staging) eg does she have breasts, body hair. Do you have a family history of delayed puberty?

She may have a hypothalamic or pituitary disorder - leading to decreased synthesis of the hormones FSH and LH ;and hypogonadotrophic hypogonadism. Exampes of such a disorder would be hypopituitarism, or a prolactinoma

Anorexia Nervosa will also have this same effect

She may have an ovarian disorder, resulting I decreased synthesis of oestrogena nd progesterone, this will cause increased FSH and LH and hypergonadotrophic hypogonadism. This would happen in a condition such as Turner syndrome, or with an ovarian malformation

She may have imperforate hymen - this is actually v common, and is where the blood is unable to escape from her vagina and backs up behind the hymen. Here all FSH LH oestrogen and progesterone levels are normal. It is easy to fix, and the fact she hasn't had sex means this really is a strong possibility.

Something as well, but much rarer, is RKH syndrome /MRKH syndrome, a problem with the structure of her uterus ovaries or vagina

• and before you dismiss the anorexia, I am afraid that being a low body weight and exercising excessively will actually induce the same amenorrhea - symptoms, this would also account for a sudden weight gain if her eating or anything changed as it can lead to residual problems with thyroid function etc. It would also account for her fainting and visual disturbances.

Another worry re the visual field issues is whether there is a pituitary adenoma or similar compressing, but it would usually start differently to this.

I think imperforate hymen or a lifestyle/ body weight and structure related delay are actually quite likely here to account for a delay.

If that is the case then it's easily treatable. wish you well OP and yes you do need a gynae referral absolutely

But agree with upthread, your GP will want to help her so don't go guns blazing -

19lbs is actually only a stone and a bit it sounds a lot but I easily gain that much in that time frame - also be wary of a teenager's confessions re sex/ definitions thereof

Hope you get to the bottom of it soon but try not to panic there are all sorts of things it could be and it may I feel just be a delayed puberty because of exercising and low body weight

Check on her as much as you liked op. Sleep on her floor or in her bed if you want. I have a slightly unsettled toddler tonight and intend to do the same