To take 16mo to A&E? In need of a hand hold …

[SingSweetNightingale]

Evening all,

I’m all over the place so forgive me for the the rush of information.
My 16mo has been ill since September, ever since beginning nursery. Virus after virus which I know is normal due to picking up lots of bugs from other children. She always has swollen glands which I’ve brought to the GPs attention each visit and have always been told they’re normal, not too big etc.

Last time DD was ill was beginning of December. Usual swollen glands and I was told to bring her back after Christmas if they don’t go down. She was given antibiotics for the first time at this appointment.

Fast forward to today and I realise the gland on the left side of her neck is visibly protruding. I’m an anxious person so I immediately called the doctor who asked me to go down this afternoon.
I honestly thought I would be told that yet again it was all normal but no… the GP seemed very concerned as the gland is about 1cm over what is regarded ‘normal’. DD is very small for her age so it appears huge to even look at.
Other than the gland, DD has very few other symptoms other than appearing tired and pale some of the time.

I was told by the GP that she needed an urgent referral and leukaemia and lymphoma can present in this way. Cue me having an absolute emotional breakdown in the doctors surgery.
I asked if anything can be done sooner than 2 weeks but apparently not unless she begins to show more symptoms.

AIBU to take her to A&E? I want a paediatrician to look at her NOW and tell me if anything is concerning. I don’t want to wait 2 weeks in absolute turmoil over the possibility something could be seriously wrong.

Any insights would be amazing or similar experiences. I’m an absolute wreck

@Piggyk2

I would definitely go to A&E. Dr's specialise in different areas.... GPS can be rusty!

While I completely understand and emphasise with OP's concern (and really hope she's reassured by the many PPs who've been in a similar situation due to much more benign/minor reasons, such as persistent infection)...

As the name suggests, A&E doctors are experts in accidents and medical emergencies. They are not pediatric oncologists, and do not have access to the diagnostic services available through referral. The "GPs can be rusty" comment smacks of stupidity at best. All a GP can do is identify symptoms and triage. Here, the relevant symptom require further investigation only available through referral. Hopefully (and very probably) that investigation will establish that's absolutely nothing for OP to worry about.

@Janesmom I'm not arguing with you and I don't want to offend you if you are a GP yourself. I've been to see SOME GPS and they honestly sit on their computer and don't seem to know much infact I've had to tell them what I need.... one GP was very lovely but suggested a drain be put in my groin! I've had this problem over the years.... so to suggest a drain be put in my groin is OTT it was a boil from shaving and I just needed a course of antibiotics on this occasion.

Anyway we can agree to disagree.

@Piggyk2 Totally my experience too. GPs were utterly useless any time I needed anything from them. Much better experience at hospitals when I went straight to A&E

Piggy Your GP was following the latest NHS advice. That is most certainly not "rusty".
See here:

"A GP can check if you need treatment.

You may need:

a small procedure to drain the boil to get rid of the pus"

www.nhs.uk/conditions/boils/

@scottishnames GPS make their own judgement. Also GPS cannot do the drain for me.... it would mean I would need a hospital referral. Mean while this was in the peak of covid where GPS were very reluctant to see face to face patients at the time.
Like I said... the boil is not unusual as I have a curly hair type and that adds to the issue.

The point is the boil would of burst by the time I would of got my referral through at the hospital.... I often get boils GPS cannot be sending all patients to hospital because they have shaved FFS. I know my own body! If that's the case I would be having my boils drained multiple times a year

[quote scottishnames]Piggy Your GP was following the latest NHS advice. That is most certainly not "rusty".
See here:

"A GP can check if you need treatment.

You may need:

a small procedure to drain the boil to get rid of the pus"

www.nhs.uk/conditions/boils/[/quote]
Also MAY is a possibility and that is NOT what I needed thanks V much for your concern about my groin though.

Thank you for all your comments - I appreciate all of the kind words and those who have been through similar experiences really do help me remain calm.

I didn’t go to A&E last night, my daughter was happily tucked up in bed and it would’ve been wrong to drag her there. Today she has been full of beans, seems completely happy. The only worrying symptom I suppose is the paleness to her skin - she always looks tired even if she isn’t.
I’m really trying to remain calm but I’m so so scared. I plan to call the surgery on Monday to ask if the referral has been done and if so I will then try to call the hospital to get a better idea of timescales

Sounds a good plan op, I hope you get seen quickly.

I’m so glad she’s been full of beans and happy today. Those are great signs. I’m crossing everything for you that she’s seen as quickly as possible and it’s nothing serious.

I would definitely take to A and E OP, I've taken all 3 of mine for various things (and always ended up being nothing serious, one time was a rash, another was a fall out of bed, and another time was croup but I thought the worst as a mum) but it gave me peace of mind and I would have been able to sleep if I hadn't got a professional opinion. I'm not sure about every hospital bit my local A and E department has a completely separate area for children so you will be seen quickly xx

Glad to hear your daughter is full of beans. Ringing on Monday sounds like a plan. Fingers crossed for you.

Hi OP, I'm a GP and just wanted to offer some reassurance. We have a very low threshold to refer people especially kids. The fact that she is well (by this I mean eating, drinking,not feverish,lethargic or losing weight) is really positive.
We only need a tiny index of suspicion to refer someone for further tests. And we see lots of raised lymph nodes so this is common (but needs checking)
The reason we mention the 'c word' is that it is best practice as scary as that sounds. If a person arrives at the hospital with no clue what we are referring for, it can lead to them being shocked and losing trust in medical professionals as they can feel overwhelmed. It also makes it hard for our secondary care colleagues to start investigations. You will likely be seen quicker than 2w- most kids referrals are seen within a few working days.
Sorry you're going through this, it must be so worrying but it's all part of the process and I hope this brings you some reassurance while you're waiting x

When the drs were concerned about those sort of illnesses you mentioned with my dd, we were sent to hospital straight away. This has happened twice. Thankfully she was ok, but it was a dreadfully worrying time. The last time this happened we last July, so during covid. If the dr was really worried, I think they’d send your dc in straight away.
Call another dr on Monday and say how worried you are & hopefully they’ll refer you straight away.

@ThirstyMeeples - thank you for this, it helps to have a bit more understanding of the process. I think my mind switched off and didn’t hear much the doctor said after she mentioned leukaemia and lymphoma. It doesn’t help that I suffer quite badly with anxiety and things like this just send me into a state of pure panic. I hope she’s seen soon as 2 weeks seems such a long time.

@Happymum12345 - yes the GP said if she appeared unwell in herself together with the symptoms she was worried about she would’ve sent her straight in. As it happens she hasn’t lost weight and seems overall quite happy in herself so she didn’t think it warranted immediate action.
Glad your DD was well x

Ah OP I really feel for you, but you should know enlarged lymph nodes are extremely common I small children. I mean extreeeeemely common. The doctor did right to refer to be on the safe side, but even on the most urgent referral pathways, the vast majority of children have nothing wrong, just reactive nodes. It is especially reassuring that she is gaining weight and is lively and active. Pale skin in mid Jan after colds etc ain't too surprising. Worrying things are persistent lethargy, easy bruising, pinpoint rashes.

Just an update: I called my doctors surgery to check the referral has been made which it has.
I then called the hospital she has been referred to but she isn’t even in their system yet.
I know I’m probably being unreasonable but I hate the waiting. It all adds to my stress

I would be going to a&e and I would not be happy they can’t do bloods for two weeks I would want it done now. Even if they can’t do anything at least you tried, I’m so sorry you must be in bits with worry.

Lots of people here don’t want anyone going to a&e unless your heads hanging off. If you want to take her then go.

Thank you, I’m fighting with everything in me not to take her to a&e. She is at nursery today and was happy as Larry this morning so I know she isn’t probably unwell enough to warrant a trip to a&e.
I just can’t bear the 2 week wait. I know it’s supposed to be the quickest pathway but it’s awful in terms of anxiety and not knowing.

I was told that a normal phlebotomist wouldn’t be able to draw blood from a 16mo. It needs to be a consultant apparently or someone specially trained. I don’t know if that type of person exists in childrens a&e.

I can tell when I call and say a referral was made on Friday the receptionists think I’m cuckoo and impatient for calling so soon to chase. I think they forget sometimes that a real parent is sat at home waiting for news on whether their child is seriously ill or not.

As much as I see that you are desperately worried, I can't see that A&E is an be appropriate place to take her at all.

Its not an accident, and 'emergency' doesn't mean 'the standard route is too slow' but for sudden health crisis that aren't appropriate to go via the GPs. Its not a shortcut, or a second opinion centre.

I imagine you'd be sent home, and even if they did examine your daughter, the most they would do is make a 2w referral themselves. Unless she was presenting as very unwell, I think they are unlikely to do any tests themselves.

Waiting is torture, but hopefully you will get an appointment soon with the experts and they will be able to fully investigate what is going on.

Lots of people here don’t want anyone going to a&e unless your heads hanging off.

yes you shouldn't go unless you're dead

@Aaaa1167336

I know not realistic for all (or even many) but worth building up an emergency fund for private consultants - the fact is the NHS is a joke and keeping a few hundred in reserve is much cheaper than private health insurance. You can build up a fund little by little.

Or take out insurance. I only pay £49 a month for me and my child. This is with BUPA.

Could you and maybe your parents scrape together a few hundred pounds to take her for a private consultation? I have insurance, but if I didn’t this is what I would do. In your situation, I wouldn’t want to wait, but I’m a worrier as well.

Overdraft? Credit card? Bank loan? It wouldn’t cost much for them to see her, at least you’ll know faster and having a small debt will be worth it.

Nah I’d take her to a&e and see if you can get a scan. GPs can be crap

Op:
I really feel for you.
My eldest son had to have multiple blood tests when a baby/toddler and these were all done via the childrens ward on an outpatient basis.
If your child was acutely unwell then the Dr would have sent you to the paediatric ward straight away (this happened with my son a few times)
So I hope you can be reassured that this process is normal.
You may get lucky and get a cancellation.
You may also need to ask if you need an emla prescription to apply to your dds skin prior to the appointment.
Good luck x