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

It must be awful for u. I’m sorry x

I do agree that toddlers often look pale, get a lot of viruses, and have swollen glands. And a lot of mums are over anxious. BUT GP's also make mistakes and sometimes do not act quickly enough. Sometimes toddlers can be quite ill and act fine. Or it could be nothing at all. Absolutely A and E is not appropriate, but we aren't the parent here nor the GP so cannot second guess what the correct course of action is.

@lollipopsandrainbows - thanks so much for your story. It helps to know that it isn’t always the worst case.

A further update: DD had to come home from nursery with a temp of 38.5. She was really poorly from the minute she arrived at nursery even though she seemed fine when she was dropped off.
It’s so hard to know whether her glands are up due to another virus or if something else is going on.
I just keep hearing the doctor say “we don’t usually see glands this big in a child so small”

[quote SingSweetNightingale]@lollipopsandrainbows - thanks so much for your story. It helps to know that it isn’t always the worst case.

A further update: DD had to come home from nursery with a temp of 38.5. She was really poorly from the minute she arrived at nursery even though she seemed fine when she was dropped off.
It’s so hard to know whether her glands are up due to another virus or if something else is going on.
I just keep hearing the doctor say “we don’t usually see glands this big in a child so small”[/quote]
I'd call 111 for advice after she was sent home with a temperature.

I can't find a picture of the one under her chin, but this is one in her neck - they were of equal size in her groin so incredibly uncomfortable for her.

@lollipopsandrainbows - this is exactly what my daughters look like. It’s scary seeing them on a small child. She is small for her age so still looks like a little baby with these big golf balls on her neck.

I have a 16 month old. I would take her, especially as there's a paeds ED.

I'm also a HV and I'd advise anyone on my caseload to do the same.

Hope she's ok.

Please take your baby to A&E and don't listen to people online. Mumsnet is crazy when it comes to precious A&E. a baby suspected to have a serious illness is an emergency!

@XelaM it's really not. The child would be triaged as a minor as they're not presently seriously ill. Taking the child to A&E won't progress the pathway OP is already on. If the child turns very poorly then of course it's A&E, but presently that's not the case. It's how the NHS works.

But what's the harm in going to A&E especially as Op says her baby is now poorly with a high temperature? The worse they can do is tell her to go home.

My parents have always been of the school of thought that as long as you're conscious there's no need to go to A&E, which explains why as a child no one believed me that I had broken my arm and was in pain. Had to walk around with a broken arm for days before I was taken to the hospital for a scan and had to have a cast.

There's nothing wrong with going to A&E in the OP's circumstances. Better safe and all that

@XelaM

But what's the harm in going to A&E especially as Op says her baby is now poorly with a high temperature? The worse they can do is tell her to go home.

My parents have always been of the school of thought that as long as you're conscious there's no need to go to A&E, which explains why as a child no one believed me that I had broken my arm and was in pain. Had to walk around with a broken arm for days before I was taken to the hospital for a scan and had to have a cast.

There's nothing wrong with going to A&E in the OP's circumstances. Better safe and all that

The OPs little one could catch coronavirus or any other random virus and end up worse off for one thing. Did you manage to get through to the GP today OP?

OP I think if her glands are as big as the ones in the photo below I probably would want her seen quicker than two weeks. How long have they been that big for?

@WorriedGiraffe - yes I called them and they confirmed the referral has been emailed over however when I called the hospital they couldn’t find it. They said it may be a delay due to the weekend.
I am going to try again tomorrow but if I don’t get any joy I will be seriously voicing my concerns

@SingSweetNightingale We had similar with DS when he was around 3years old. He had swollen glands for a long time and a culmination of various different symptoms which ended up in him being sent home from nursery one day as he was lying star fished on the floor and lethargic.

GP said similar and gave us a 2 week referral for the same reasons - bloods were needed but they cant routinely do them.

We took him to our nearest childrens hospital with an A&E department the next day and they were great and seen him with no question or hesitation (even though it wasnt our most local hospital in our health region). We just explained the symptoms that he had and why we were concerned, they assessed him and took bloods that day. We had been worried about the bloods but or was actually a really straight forward and calm process but i can see its not something a GP could routinely do.

We got the results back in just a couple of hours and fortunately it wasnt any cancer as had been mentioned by the GP.

I havent read all the replies (just yours) and understand the general consensus is you shouldnt go - but in my experience it was the right choice for us and we trusted our gut instinct on it as we were so worried. Whats the worst case situation? They tell you they cant see you and send you home and if I was in that position again I would do it again.

Im not sure if you would get the same experience at a normal A&E as there are less peadeatric doctors available usually but if you have a childrens hospital nearby I would definitely go there.

I have an operation myself tomorrow under general anaesthetic so feel really upset at the timing of it all.

My partner could take DD to a&e but it’s a crucial time in his working month where he’s under a lot of pressure with deadlines and so wouldn’t be able to take her until later on in the afternoon when I feel it’s a big upheaval for her with teatime/bedtime etc if we’re just going to get sent home anyway.
My parents would also take her if I asked them to but again the mum in me just wants to be with her myself.

I will call everyone I can in the morning tomorrow before my op and hopefully will get some answers. If not I will take her to a&e myself on Wednesday if I can’t get answers and try to get her assessed.

would go to a&e. My son had this when he was 2, he had a couple of back to back virus’, and then his right gland went down and his left gland grew rapidly over the course of two weeks.

I went to the GP who referred him to a&e immediately - essentially the virus had caused a blockage in his gland which had itself become infected. The dr we saw at hospital said it can cause sepsis if not treated - he had IV antibiotics and he was fine in the end

The harm in going to A&E at the moment is the waiting times and the pressures (yes, I work for the NHS). Current waiting times at my trust are 8-10 hours, this includes paediatrics. Other local trusts are reporting the same timescales. If you really want to go, which I understand, current guidance is to call 111 in the first instance. If they advise A&E all your paperwork will be there on arrival with a summary of your daughters history, which should speed up the triage process. I hope you get her sorted OP, it brings it all back for me.

Sorry to hear that shes feeling poorly again.

If you really think she needs to see A&E, then you/someone else should take her tonight or first thing.

If its something that can wait a day or two because of work commitments then by definition it's not an emergency. Equally, whilst I understand you wanting to take her, if its worth delaying until you are around, then again, its not an emergency.

If you can get it sped up tomorrow because of her being ill, then that's probably a good idea, and obviously a covid test in the meantime, as your don't want there to be delays because of anyone suspecting that.

I will call everyone I can in the morning tomorrow before my op and hopefully will get some answers. If not I will take her to a&e myself on Wednesday if I can’t get answers and try to get her assessed.

That seems like a sensible plan. Concentrate on your op for now and if you've heard nothing after chasing them up by weds then take her.

op if she's ill again I'd go back to the GP and they will expedite the referral of they need to, including getting her seen by a paediatric Dr that day. It would mean they have her history and would be quicker than a and e. Without being too blunt a and e are mutually there to determine if someone is in danger of serious illness/death at that moment, if the answer is no then they will just put her back into the system again.

There should be an on call ward Dr that your GP can access which may mean you can bypass A&E entirely, which for many reasons would be preferable.

Good luck for your op today

A further update for anyone still here:
I called the clinic she is supposed to have been referred to. They have no record of the referral. It seems the GP has made a mistake when sending it through.
I called the GP surgery and spoke to a receptionist who said she would ask the secretary to call me tomorrow when she’s back at work. I said that’s unacceptable as the words leukaemia and lymphoma were bandied about on Friday and I have almost waited a week as it is.
She said she would ask the GP to call me but she can’t guarantee when as she is in clinic at the moment.
I’m honestly beside myself. I have an op at 2pm this afternoon but just feel like cancelling it so I can concentrate on DD.

But how is she today? Unless she is really ill today and needs seen all you can do is wait for the GP and have your op. You need to be well for her.

And please do something about you're own anxiety (I say this as someone who was trying to navigate suspected leukaemia in DD recently, during lockdown 1 by phone).

Don’t cancel your op- you need to keep busy and as hard as it is don’t obsess over this.

Chase the doctors and call them again. You can ask to speak to the practise manager and explain to them how upsetting and distressed you are and how you’d like this matter to be resolved as a matter of urgency.

As hard as it is- stay calm and polite and factual when you’re on the phone.

How is DD today?

@SingSweetNightingale

A further update for anyone still here: I called the clinic she is supposed to have been referred to. They have no record of the referral. It seems the GP has made a mistake when sending it through. I called the GP surgery and spoke to a receptionist who said she would ask the secretary to call me tomorrow when she’s back at work. I said that’s unacceptable as the words leukaemia and lymphoma were bandied about on Friday and I have almost waited a week as it is. She said she would ask the GP to call me but she can’t guarantee when as she is in clinic at the moment. I’m honestly beside myself. I have an op at 2pm this afternoon but just feel like cancelling it so I can concentrate on DD.

Unacceptable. They should be sorting this out immediately. Hope you're okay, OP.

• and agree that cancelling your op will not be productive. Hope it all goes well.