To be worried about ill teen?

[LlamaDrama99]

She's been ill for months, bloods were all clear but we're waiting on more blood tests to be done. So far this term she has 50% attendance as she just can't manage it. The extra bloods weren't booked in until late next week but I've I managed to get an appt for this tomorrow now but then we still have to wait yet another week for them to come back.

She's pale, lethargic, loss of appetite, dizzy, she fainted yesterday (GP rang and said it was because she hadn't eaten breakfast, yet she never does). I'm really worried. Drs seem to think it might be stress but she said she's only stressed because she feels unwell and I'm not convinced being stressed would make you pale?

It would be unreasonable to go to a&e wouldn't it? :( I'm so worried.

@Floralnomad 🙈🤩

[quote GrimDamnFanjo]@Saladovercrispsanyday

Sorry I was really unclear. I did mean Eating Disorder.
Blood tests would show up blood sugar levels etc
[/quote]
Yes but 100% would not diagnose on basis of this.

Anorexia nervous in nhs is BMI. Simple as that.

Sadly this is something I’m slowly acquainted with

The blood impact of anorexia is substantial BUt NOT definitive, far from it.

Closely acquainted

do NOT go to A&E this is neither an accident nor an emergency. You will get nothing done there. Go to your GP and ask for further assessment

Is she suffering from mental health issues? When I went through my lowest period in my 20s I had all these symptoms including fainting episodes. It did turn out to be severe anxiety

INSIST that bloods include a full screen for Coeliac Disease. All the symptoms are the same and can even mimic what people think is an eating disorder. Coeliac is very common in UK, 1 in 100 people.

Refer to paed
Coeliac?
Migraines?

LEA officer for children missing school due to illness to record she is sick and access tutor etc

I'm not sure why people are advising OP to take her DD to A&E. It doesn't sound like either an accident or an emergency, although clearly needs sorting so just make yourself a nuisance of the GP and insist on a face to face appointment ASAP. Exaggerate her symptoms if you really need to when you speak on the phone, just to get her seen by the GP.

We had to make an actual emergency late night dash to A&E with my DS last week. Was the result in not seeing a GP face to face for months, just telephone consultations and antibiotics prescribed after urine tests. It was one of the most stressful experiences of my life. Not helped by the waiting room being full of kids the majority of whom looked like they could have waited till the next morning to attend the walk-in centre or minor injuries - things like a teenager who had injured the back of his heel, he had a dressing over it but was walking ok on it and not bleeding or anything, or kids who were running round looking fine. My son had to wait an hour and a half despite being at the highest priority (other than immediate life or death), and the wait for non-urgent kids was 5 hours. It's not a solution for not being able to see your GP, it just affects the kids who really need to see someone urgently, like my son who needed an emergency operation.

It's the GP face to face consultation issue which needs pushing. It's NOT a solution to put more burden on A&E staff just because you're finding it difficult to get a GP appointment. TAke her to a walk-in centre if you really need to, but not to A&E unless she is doing something like vomiting constantly and getting dehydrated, or can't stand up in front of you. If you have the money, go private to get her seen more quickly. Put in an official complaint to the practice manager if you get no joy with them. Emphasise that you're getting investigated by the educational welfare officer for school absence and you're worried you'll get fined through no fault of your own.

No, it's not right, but there are ways round these things without causing issues elsewhere in the healtcare system, it's just pushing the problem onto somewhere else.

For what it's worth, my first thought was an eating disorder too And the coeliac possibility is worth a thought.

@CurlyhairedAssassin

What did a&e do for you son?

I will second that I think it’s celiacs disease. I was severely unwell at 16 and was diagnosed with a stomach ulcer, which was a result of celiacs. It took 12 further years to get a diagnosis though. Very similar symptoms to what you’ve described. I was also being very sick after eating anything containing gluten. Not sure how they missed it tbh but back then it wasn’t very well known.

@DunderMifflinSalesRep

Is Long Covid a possibility?

That was my thinking too. Sounds very similar to my DS (except he eats breakfast) who's been referred to the Long Covid clinic after months of problems. All his bloods came back normal too, even coeliac despite ongoing issues with gluten.

The one sure test for coeliac is bowel biopsy. However, you could just take DD off all gluten for four weeks or so and see how she feels. She doesn't eat breakfast; is this because of discomfort? Does she have "growly guts" and a gnawing anxiety in the morning? This can be a coeliac symptom. Anxiety will go hand in hand with this, as the gut produces 90 per cent of our serotonin. Deal with the coeliac and the anxiety will sometimes resolve itself.

Coeliac disease is becoming more common because of the commercial cereal strains that have been developed in the past 25 years. People who might have once had a bit of gluten-related bloating are now developing the full-blown disease.

[quote Saladovercrispsanyday]@CurlyhairedAssassin

What did a&e do for you son?[/quote]
He had acute urinary retention because of some structural issues so had an emergency procedure under general anaesthetic with the surgical team. It is a medical emergency (obviously - apart from the severe discomfort, there is a risk of kidney damage unless dealt with quickly). he was discharged after a day and a half and went back for further day surgery on Monday and will be reviewed by the consultant in 8 weeks time.

If only the GP had given him a physical examination that traumatic emergency dash to A and E could have been avoided. Our GPS are actually quite good, it was just the lockdown procedure at the time that was at fault I think. They just should never have stopped the face to face consultations. Too easy to miss things like thst.

Coeliac
Glandular fever
Eating disorder or other mental health
Lyme disease
Long covid
PoTS
CFS

I think these are all the suggestions made so far and they all seem like possibilities. There’s a lot of crossover eg glandular fever could trigger both PoTS and CFS. Lots of other viruses can also do this.

Some other questions because you never know. Does your DD happen to be very bendy? Has she had any skin rashes during this? Wondering if it could be fatigue as part of a hypermobility disorder, which often also goes with PoTS, or there could be another autoimmune issue like lupus.

The one sure test for coeliac is bowel biopsy...not bowel

Intestinal not bowel.

www.coeliac.org.uk/information-and-support/coeliac-disease/getting-diagnosed/?&&type=rfst&set=true#cookie-widget

If the blood test is positive or there is clinical suspicion of coeliac disease your GP will then refer you to a gut specialist (a gastroenterologist). In adults, agut biopsyis usually carried out to confirm the diagnosis. However, new guidelines published as a result of the Covid-19 pandemic recommend that for some adults who have very high antibody levels, a further blood test can confirm the diagnosis without the need for a biopsy. Do not remove gluten from your diet until all tests are complete or until recommended by your gastroenterologist.

I second what @Embracelife says - DON'T cut out or cut down on gluten before getting tests!
You might get a false negative for Coeliac disease if you do as you won't produce enough antibodies to register a positive.