To take my 22year old dd to gp?

[SueDoeName]

My dd found a lump in her groin 18 months ago. She went to doctors and they said it was a swollen lymph node probably caused by infection.

She still has it 18 months later and it's got bigger.

She is always ill. Always got a cold or ulcers in her throat or throat infection. She loses weight despite eating really well. (More than me !)
She is always tired . Looks washed out . She is also anaemic . (Confirmed)
She's been back to the doctors twice - she is very sensible and grounded and has told me she's worried about lymphoma. The doctors dismissed her saying "google doesn't have a degree "
She is worried. I am now worried she has been referred for a scan but will take 4-6 weeks and then she has to await results before getting referred for biopsy.

I want to go to gp now with her and ask about a private referral and timescales. They aren't taking her seriously.

Aibu? I don't usually interfere but this seems like one time I need to. She needs someone a bit bolshy to fight her corner .

Try to see another doctor. My mother found a lump went to the doctor who told her it was nothing to be worried about. After some time she still wasn’t happy so went back and was told again it was fine. This time she wasn’t satisfied so paid to see a private doctor who immediately was concerned and order imaging. It was cancer and my mother died from it about 18 months later. Doctors do make misdiagnoses and it is worth getting a second opinion.

Go, go, go, and get it checked out. Be forceful and Ask for a referral. If they won’t do one, get a second option, or even change practises. Or complain to practice manager and get action that way. Lumps shouldn’t be ignored.

If you have the funds to pay for private treatment there is nothing wrong with going down that path - investigation and any treatment will be quicker.

You are her mum and obviously you will do anything to protect and help her. If she is happy for you to go with her, and private investigation treatment will help you both be less.worried - do it!

Sending best wishes and supportive thoughts to you both. X

Go with her. The weight loss is massive red flag.

Honestly, I advise any adult to take someone with them when they go to see a doctor if they feel they aren’t being taken seriously. I’ve had some amazing GPs where it would never be necessary, but I’ve had others who’ve spoken to me completely differently when there’s someone else in the room. Unfortunately young women are often dismissed completely (took ten years to get my endometriosis diagnosis because of this). My mum getting involved (I was 22) helped massively.

Of course it is fine to go with her. And fine to go again and push for swifter action.

Yes definitely go - my adult DDs notes describe me as 'difficult' but if that is what it takes! Also went down private route and as self-funding did not need GP referral.

My mum took me when I was 23 because my lymph nodes were swollen and resistant to antibiotics.
I was biopsied for non Hodgkin’s lymphoma. I’m glad she did interfere

Was it Lymphoma @Billie?

An initial consultation will be between £125 and £300. Blood tests can be really expensive, over £1k depending on what they are and a biopsy around £800ish depending on hospital costs as well as the consultant's fee. I'd recommend an initial consultation then get referred back to the NHS for tests and treatment.

If your daughter wants you then go with her. An advocate in the room, especially with a patronising sod, can really help. The weight loss would concern me.

That said, you don't have health insurance (and shouldn't need it!) and you are on limited funds. It might be worth pushing for another GP appt if you can get it quickly, before going private. Otherwise try to find a consultant who can refer you back to the NHS if necessary.

I agree that you can do initial consultation privately & then get tests done on nhs. Recent 1st appt with consultant in SW cost £200 but can be much more in London/SE. Good luck!

Ok thanks all I've looked at the bloodwise site and feel better prepared.

What she needs is a biopsy of the lump yet they have not referred her for this - only an ultrasound which in isolation will be useless. She then would need to wait for the results of that and only then did the doctor day they'd refer for biopsy. This seems bonkers.

It appears to me that the doctor she has seen does not think this warrants referral urgently under the 2 week wait system - so how do I get them to do it?

She is 5ft 8 and has gone from 9 stone to 8 stone 5 lb - not super rapidly but without trying.

She is ill again today with cold and fever

She is always ill . Always coughs or colds or sore throat , always has throat problems and gets ulcers in throat .

She doesn't know what the recent blood test showed , she was just told it was ok .

How do I get them to take this more seriously and refer under the 2 week wait ? I'm trying not to worry her and I know she is worried.

She can get a copy of the blood test results. If she is registered to book her appointments online, she will have direct access to them.
Otherwise, asking reception tomorrow and they will give her a copy.

This way you can have a look at what they mean by ‘OK’. (Eg her iron levels might be ok but very close to the lower limit etc....)

Be really clear, reference the 2 week urgent pathway and escalate to another doctor or practice manager if they dismiss you. ‘We are concerned about lymphoma and want her to be seen under the urgent referral pathway.’ It can also be useful to put the pressure back on them ‘We are concerned about lymphoma, can you tell us it definitely isn’t? How can you be 100% sure?’

Either go to a different GP and ask for urgent referral citing x,y,z symptoms. And don’t take no for an answer.

Or find a private specialist cancer centre (there are a number in London if you are there or nearby) or a local private oncologist who specialises in Lymphoma. Make an appt with them asap.

A private doctor cannot directly refer for NHS treatment but they can refer you over to their NHS practice if they have one, or they can write to you GP advising them to make an immediate referral to rule out Lymphoma if necessary.

I would definitely see a different GP in the practice. All of these symptoms could be other things or not related at all but they should only reach that conclusion after ruling out serious causes. Unintentional weight loss ( although I think it depends over what time frame)and an unexplained lump are enough I would think to warrant tests. I see they are doing an ultrasound but surely a biopsy should have been ordered too and all under the 2 week urgent referral system.

Has she had any night sweats Sue? If she has that is another symptom they will listen to. My husband had Hodgkin's. He was referred under 2 week wait but I think his bloods were wrong in conjunction with the lump so it was quite straight forward, I know it's.not as easy every time. The B symptoms of weight loss, sweats and itching don't always happen but are another indicator. I think like you say, you need to tell them what you suspect and ask for the referral. We are on a Hodgkin's Facebook group, I've seen many people join who sound like they have classic symptoms and then it turns out they haven't got it. So fingers crossed that the doctors are not referring her for a reason. If it does turn out to be lymphoma then please join one of the Hodgkin's/ non Hodgkin's groups, they've been life savers for us x

www.nice.org.uk/guidance/ng12/resources/recognising-investigating-and-referring-people-with-symptoms-of-suspected-cancer-pdf-96095824837

Go with her an ask her GP why he or she is not following the NICE guidelines. @SueDoeName

@SueDoeName my dd was red flagged for lymphoma and she was first given an ultrasound, she was given a fine needle biopsy at the same time. They inserted a fine needle into the lump and drew some cells.
The ultrasound can tell if the lump is something to be concerned about, whether it is reactive or non reactive.
If there is concern they will refer further.

My dd then after CT scans had the excisional biopsy where they removed part of the lump under general anaesthetic to confirm the type of lymphoma she had as there are about 70 different subtypes.

So the ultrasound is the right way to go and it will tell you if further tests are needed.

undomesticated she has ONLY been referred for the ultrasound not a biopsy , and not on the 2 week pathway so she's been told to chase it with hospital who told her it's a 6 - 8 week wait and that's just for a
Scan not a biopsy - simply not good enough.
We have an appointment this afternoon. I asked to see a different gp and the go I spoke to seemed more concerned. Dd remembered that when she went for her review for some other meds the nurse asked her if she had an eating disorder because she'd lost over a stone in 6 months. She didn't even realise and certainly hadn't been dieting or trying to lose weight . She laughed it off at the time but put together with the lump, the constant infections and illnesses, the fatigue I think she ticks the 2 week wait pathway at least .

I'll see how we get on this afternoon.

Well what a battle that was. Elderly locum male gp who wouldn't even feel for the lump except through clothing so he couldn't feel it . Tried to fob us off again , spent around 10 mins asking him why she can't just have the biopsy to which he gave every reason not to "fuel her anxiety " before in the end I quoted the NICE guidelines at him - he then begrudgingly referred but said they might refuse the referral (which to me reads he will put his spin on it and ignore the cold hard facts ) he agreed her nodes in neck are also swollen, she has a temperature, she's got her second cold since 16th December, she's lost a stone in less than 6 months without trying and he still just wanted her to wait for the ultrasound 6-8 weeks away and wanted to do a chest X-ray ! Also kept
Telling me her bloods were fine - and I replied that bloods don't show lymphoma. He was yet another condescending twit. I've rung practice manager and complained- I actually used to work there so I sought out the one remaining receptionist I knew and asked her to help.

I'm not confident that some spin won't be put on the referral- I know I'm my job (law) I can often get the result I wa t from the way I present the case . Not
Hopeful.
I rang the bloodwise helpline and they agree she needs the biopsy. And yes I realise it's highly likely to be nothing but why can't we get that information and reassurance!
Bloodwise have said if all else fails go to A&E so if the referral gets rejected I'll do that next .
Why is this so bloody difficult! He wouldn't even hear of us going private saying he would not help get a private referral for something available on the nhs ! Well bloody let us go with nhs then . He was omnipotent and I'm feeling very frustrated and dd is now just so browbeaten she wants to leave it as she thinks we've done all we can .

Well done on getting your referral. Be on the case. If you don’t hear within a couple of weeks, then ring the surgery and/or med sec of the department you have been referred to. Basically, be proactive, and be a nuisance.

It’s so hard isn’t it. On the one hand you’re slightly relieved when GPs don’t look worried but it’s you that has the underlying worry until proven otherwise, not them. Well done though, she’s a lucky daughter.

Well done for standing your ground.
I fought for years to try and get something done about debilitating tonsillitis and ear infections.
I was constantly fobbed off.
Eventually I visited every week for a month. (The receptionist was furious) I cried, I begged.
In the end a Registrar referred me thinking I had some symptoms of lymphoma.
My mum came to the specialist appointment and spoke up for me.
My tonsils were gone within a month.
It was life changing. (No lymphoma thank goodness, but I've had just one mild throat infection in a year)
I was 39
Mum's are great at sticking up for you.