Would you be annoyed with school pastoral person over this?

[PikachuSayBoo]

Dd is in year 11 and has been unwell for a couple of months. She's been diagnosed with severe anaemia and very low Vit d levels.

I rang school up yesterday and told the pastoral lead for her year. I wanted to give her a heads up that dd is very tired, she's worrying that it's going to affect her at school, she has brain fog, is depressed and has chest pains and shortness of breath.

So this afternoon dd is in a lot of pain and starts crying in class. Lesson finishes and dd is sat in the school cloisters crying. She has a late lesson on a Tuesday so should stay after school has technically finished. This is a compulsary lesson not an optional one. One of dds teachers told her she should go home. Pastoral person comes along sees dd and according to dd shouts at her, tells her that crying isn't going to help and that she needs to get to her next lesson. Dd told her she was crying because she was in so much pain and says she was just shouted at.

Dh wants to ring up and complain. Dd had 100% attendance last year so isn't the sort of kid to try and skive off a lesson. Dd doesn't want us to ring up school as she says the HOY and pastoral person hate her enough already.

[ImBackOnHereAgain]

frequent periods and vit D deficiency can be part of PCOS- I am guessing thyat has been ruled out in your daughter;s case? Fatigue and being overemotional are also symptoms of it.

[ImBackOnHereAgain]

As someone who battled ME/CFS for years a s a teenager and young adult and now has to take Vit D for a deficiency I feel for your daughter. I had a nightmare getting understanding at school for my ME although to be fair, the issue wasn't so much teachers but thre other students. I would like to think things in schools have moved on regarding hidden disabilities/chronic illness but sadly it seems they haven't . :(

[ChameleonCircuit]

Knitting, you'd be much better off starting your own thread with an appropriate title, you'll get better answers.

[knittingwithnettles]

I'm bumping this thread to see if anyone knows whether a 16/17 year old (year 12) with a Vit D level of 25 nmol would be considered deficient or insufficient. Because the GP has just prescribed (without talking to me, or knowing ds's weight, which is that of a fullgrown man) a kick start dose of 25,000 IU a month. The instructions on the packet and on those paediatric guidelines state that deficiency is treated with an ampoule of 25,000 IU a week. Whereas insufficiency is just a question of 1000 a day. Don't know what to think or do, or whether to question, or just increase the dose myself.

Any experts? (I will ring the dr on Monday, just wanted to be forewarned and know whether I am making unnecessary fuss over standard dosage) Ds is quite lowspirited atm, and sleeps too much, always tired etc. His iron is fine as is his B12 and thyroid.

[PikachuSayBoo]

Don't think so. They only started her on the contraception a few weeks ago to try and make her cycle more regular as they thought frequent periods might be one of the reasons behind the anaemia.

[MsJudgemental]

Could her contraception have something to do with it?

[RhodaBorrocks]

If she's still feeling so unwell after being on the tablets for 6 weeks I'd be taking her back to the GP.

You should stick to the dose, for no other reason than if you don't then you'll be skewing the repeat bloods at the end of October.

If you overmedicate her and she starts to feel better, and the bloods come back better, and you say nothing, then the GP will think that 1600iu is the correct dose for her. Not knowing you've doubled it. They'll continue to under medicated and you'll continue to overmedicate and nothing will be learned. In fact, if there are other issues they may not be uncovered.

I say this as someone who's DM is currently under medicated on thyroxine (doctors orders until more tests are done) and feeling awful, but sticking to it, as continuing over medicating may be masking other problems.

At your DDs age I also felt awful all the time, lots of pain, anaemic etc. I was eventually diagnosed with Fibromyalgia and Ehlers-Danlos Syndrome. I'm just saying that as I want you to know that it could be other things if the vitamin D isn't helping much, so keep pushing with the GP to get to the bottom of things.

(And as to what others have said about weights and medicines - DS is tiny, so I always give him the dose recommended for one age group lower than he is, as listed on the packaging. When we got the new NICE dose guidelines at work I saw I was doing exactly the right thing and if I'd dosed him by age rather than weight I would have been overdosing him.)

[Discobabe]

I don't know about vit d deficiency but she shouldn't still be feeling ill with the anaemia. It's normally rectified reasonably quickly with iron tabs. I'd be concerned if she was still having symptoms of that after 7wks? of meds. Definitely take her back as you said.

[PikachuSayBoo]

passthewine thanks for that link. I've read it a few weeks ago and it states that the dose should be Higher than what the GP prescribed.

I can't ring the GP, they don't communicate with people like that. They don't want her to have her bloods redone until the end of Oct when she's been taking meds for three months.

But I'll try and get her seen next week if I can get an appt. and will also try and make sure it's not with the same VTS trainee Dr as last time because not only do I think he didn't prescribe enough Vit d he totally messed her contraception and mefanemic acid prescriptions up. So no I don't have much faith in him.

[JudyCoolibar]

I really don't understand why you would rather make decisions about dosage based on Google than phone your GP.

However, putting that aside, I would suggest writing to the school without referring to this specific incident and spelling out what the known symptoms of your DD's condition are, with specific reference to it causing hr a great deal of pain. If you can back it up with a medical report, so much the better. Emphasise that she is a child who tries to keep going and does not skive, so if anything they may need to make her go home or go and lie down, rather than shouting at her to stop her.

[passthewineplz]

Sorry forgot to say. In the first instance please always follow your GP's recommendations. However if you'd like to carry out your own research, please refer to the evidence based research which is used by/followed by health professionals - which is available at the NICE, and the Royal college of pediatrics and child healths website sites. The journals and articles are often valid, however until evidenced based research is completed health professionals are unable to recommended the findings from the analysis.

[passthewineplz]

If your GP has prescribed a dosage of 1,600 it looks like they may have slightly increased it based on the recommended daily dosage which is 1,000 max. According to national guidelines this can be increased upto 10,000 for 4-8 weeks, however rather than increasing the dosage yourself, please speak to your DD's GP.

[passthewineplz]

The recommended daily dose, and dosage for children who are deficient in vitamin d are here.

www.rcpch.ac.uk/system/files/protected/page/vitdguidancedraftspreads%20FINAL%20for%20website.pdf

OP please have your DD vitamin D levels rechecked so the GP can adjust the dosage appropriately.

[PikachuSayBoo]

That ties in with a 2011 study which showed that 4000 iu a day was the most effective dose. Much more effective than lower doses.

[dodobookends]

The NHS website I looked at recently said that you shouldn't take more than 100mcg a day as it will be harmful.

100mcg = 4,000iu

[PikachuSayBoo]

I've face booked my paediatric consultant friend now to see what he thinks.

[PikachuSayBoo]

Yes and if 10,000 iu is a guideline and dd is having 3000 then I doubt im overdosing her. The nhs website says a 6 month old baby can have 3000 units a day and dd (who is adult size) weighs more than a 6 month old baby.

But I promise dd will go back to what the gP (who never weighed her) prescribed until I get her back in at the doctors. And then I will ask if she should actually be on 10,000 never mind 3000 a day.

[StarryIllusion]

They're judging a snapshot, nothing more. I highly doubt you go round feeding them entire bottles of pills normally. Don't take it to heart. wonders if that would make DS go to bloody sleep

No, that is just a general number, a guideline like when paracetamol packaging says that you can have x doses per day but actually that is only for over 12s of a healthy weight. Under 12 year olds is much less and not as often and a very underweight adult would not be able to safely take a normal dosage either. You will find if you go to A&E and they prescribe your child painkillers and you go back and say they aren't working they will weigh the child to determine the exact maximum safe dosage. Her GP will have set the dosage based on her and any excess won't be absorbed anyway so it won't actually help and she will get ill from trying to purge it, as I found out when trying to raise my magnesium levels. God that was a level of Hell only previously associated with Norovirus. I've never been so sick in my life.

[PikachuSayBoo]

Even this nhs website says that 12-18yos with symptoms of Vit d deficiency should take 10,000 iu a day for three months.

www.rnoh.nhs.uk/clinical-services/paediatric-adolescents/vitamin-d-children

[PikachuSayBoo]

No, am quite happy for people to,point it out and as I said over half an hour ago I will tell her to go back to what the gP said. But people still want to happily point out that where they work theyd be reporting me to SS, etc. I would say that's judging my parenting.

I would have thought that journal article would state that 10,000 iu a day is safe if it is safe for everyone. There's no caveat that you must weigh over x pounds.

[StarryIllusion]

You don't know how much those people weighed, their height, levels or even their general constitution though OP. My GP regularly marvels at my magnesium levels. They are often so low that normal people would be in hospital but for me they are baseline normal. Same with sedatives, I can hold enough sedative to floor a man twice my size and still walk a straight line. It's just my constitution. No need to get defensive, we're not judging your parenting, you're just doing your best for your DD and clearly very worried about her but ODing on prescription vitamins can and has killed people. Would you rather no one had told you about the toxic effects of overdosing on this stuff?

[PikachuSayBoo]

Thanks Dixie. Will ask the gP about that when I take dd back.

[PikachuSayBoo]

Maybe you'd like to read that journal article.

[msgrinch]

Its a hell of alot better than giving your kid an overdose!