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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

Original poster

To think I'm right and the doctors are wrong?

360 replies

Rabbitpoop · 15/03/2022 15:40

DD is 13yo and has had really bad nausea and stomach ache for 10 days. Shes been off school the whole time and very little appetite. GP thought it was appendix related so sent us to hospital. First surgeon admitted us and said seems like appendix as she only has pain in the exact area of the appendix. Put us on the list for surgery.

Saw another surgeon who said he wanted an ultrasound first. Fair enough. They couldn't see her appendix during the scan but no obvious signs of anything else wrong so surgeon passed us to paeds.

Paediatrician came in and said it is constipation before he even examined her. She isn't constipated at all and the pain is only on the bottom right side in a specific area. I questioned him and pushed back quite a lot as I'm 100% sure this is not constipation. She's had no change in her bowel movements. Paeds said there's no sign of appendicitis in her blood tests so it's unlikely to be appendicitis.

I looked up the NICE guidelines and it says that you can't rule out appendicitis by blood test or ultrasound and that it can present differently in different people. It seems the only real way of telling is laparoscopy/surgery but the surgeons won't do it as she's not writhing in pain.

I don't know what to do. I'm sure it's not constipation and that it's something to do with her appendix. They said they wouldn't give antibiotics either as there's no sign of infection.

I'm worried they're just going to tell us to go home and she'll continue to be off school, feeling sick, barely eating and with a stomach ache.

Any advice?

OP posts:
SirenSays · 15/03/2022 17:11

Anyway, took her to the GP again as we were due to go on holiday the following day abroad. Again told tummy bug. We went home. Within minutes of being home she screamed in absolute agony

Very very lucky that you didn't go on the holiday. We had a patient, a young boy, whose appendix burst while on holiday. By the time he was flown back and in our hospital he was in critical condition.

I needed my appendix out but no one would believe me. I was told I had a urine infection by a nurse who glanced at my sample. Then another doctor told to go home and try a light diet, whatever that means. Ultrasound showed nothing wrong. I was back by ambulance for emergency surgery the next day.

Lucifersleeps · 15/03/2022 17:25

I also had a huge ovarian cyst at 15. Took the doctor nearly a week to diagnose it.
I’ve also had a burst appendix and I have to say the cyst was much more painful than the appendix! I walked into the dr and he did the press & release thing and sent me to hospital who thought it was just inflamed as I wasn’t crying in pain and sent me for a laparoscopy at 7pm. “You’ll be out in less than an hour” they said… At 2am I got out of surgery with a huge scar (as well as the 3 little laparoscopy ones)!

nex18 · 15/03/2022 17:38

My dd had the same at a similar age. I was convinced it was appendicitis, as was the GP. I’m also a paediatric nurse with around 10 years experience working in paediatric surgery so my self diagnosis was from experience not Google although i was in a different role by then. Dd says I must have believed it was her appendix or I’d have sent her to school not the doctors. However she had no signs of infection. So her appendix stayed put and the pain eventually subsided. We never got a diagnosis but she clearly didn’t need surgery. So maybe the doctors are right!

SnapAndFartAllDayLong · 15/03/2022 17:44

I had the exact pain and Dr said it was constipation... turned out to be a huge 11 cm ovarian cyst!!! Go with your gut!

olympicsrock · 15/03/2022 17:51

I am a surgeon. If at 10 days into her Illness her blood tests ( WCC abs CrP) are normal this is not acute appendicitis.
Ultrasound scans are often really useful in young people particularly if slim . They do not just show gynae problems but will often pick up an enlarged appendix or appendix mass/ abscess.

The appendices they do not see are the small normal ones…

Sounds like the surgeon has made a comprehensive clinical assessment.

Original poster
Rabbitpoop · 15/03/2022 18:13

I don't want her to have surgery either unless it's necessary but I also have no faith in a paediatrician who diagnoses constipation based on absolutely nothing.

So far we've seen a different doctor each time, no one is monitoring progress or pain scores. Obs are completely normal, no change at all.

OP posts:
Original poster
Rabbitpoop · 15/03/2022 18:16

@olympicsrock

I am a surgeon. If at 10 days into her Illness her blood tests ( WCC abs CrP) are normal this is not acute appendicitis. Ultrasound scans are often really useful in young people particularly if slim . They do not just show gynae problems but will often pick up an enlarged appendix or appendix mass/ abscess.

The appendices they do not see are the small normal ones…

Sounds like the surgeon has made a comprehensive clinical assessment.

So what would you suggest? Should she just go home and stay off school and see how it goes? How long to continue in pain and nausea and no appetite? What if nothing changes? There has been no change in 10 days and there's still acute pain over the appendix area.

I'm happy to be told to go home and see if it changes and bring her back. I'm not happy to be told its constipation when I know it isn't!

OP posts:
Original poster
Rabbitpoop · 15/03/2022 18:20

Would mesenteric adenitis cause pain only in the appendix area (can't remember the fancy word they used, sounds like someone's name)?

OP posts:
BigYellowTaxiT · 15/03/2022 18:22

I was left with a grumbling appendix for 4.5 years between the ages of 13-17. Flares ups every 6-8 weeks of abdominal pain, nausea and vomiting lasting 48-72 hours every time, until they finally removed it just before my 18th birthday. Various doctors told us it was period pain, growing pains, psychological, all the usual rubbish. Push them with the NICE guidelines so she doesn’t end up like I did.

WeakAsIAm · 15/03/2022 18:41

@bluesky45

Tell them what the nice guidelines are, in relation to this, then ask them if they will do it. My bil is a paed and he told me to do this when at hospital with my dc for something different because I wasn't happy with what they were saying and felt fobbed off. I asked him, he said they weren't right and they should be doing the test I wanted them to do and that it's in the nice guidelines. If you tell them this, they will know you know what they should be doing, that you won't be fobbed off. This did the trick for us! Good luck!
Asking a health professional if they know the NICE guideline is the equivalent to asking the computer repairer if they know about the power cable. Please be reassured that we do not recoil in horror at the mention of NICE guidance and that not only has the health professional heard of it; they have also read it, understood it and applied it in clinical context. Which is more than can be said of Dr Google and his clinical fellow Mumsnet.
TillyTopper · 15/03/2022 18:44

I think if you've exhausted the options in the hospital she is currently in then you need to go private and use your health insurance and then push for answers. It's all very well for doctors to say it's not things - but clearly you have to push for an answer on what it is!

Sapphireskies · 15/03/2022 18:57

Keep fighting for what you believe in. You are her mother and you know your daughter best. Sounds like appendicitis.

Theluggage15 · 15/03/2022 19:04

Keep pushing if you think something’s wrong. Go private to get a second opinion. Doctors are certainly not infallible. My ectopic pregnancy was diagnosed as depression, I knew something was wrong, it was horrible being ignored and patronised. I ended up having emergency surgery because of the doctor knows best attitude.

CaptainCallisto · 15/03/2022 19:08

DS2 had this when he was only 4. They kept insisting it couldn't be appendicitis, couldn't see his appendix on an ultrasound, and thought it was constipation. Luckily, as he was in a lot of pain, they kept him in. Six days later, when they couldn't work out what was going on and none of the constipation treatment had eased his pain or temperature, they took him down for exploratory surgery. Turned out it was his appendix, which had partially ruptured, and he spent another week in hospital recovering from sepsis.

TheyWentToSeaInASieve · 15/03/2022 19:10

Ahh, our delightful NHS again. They usually have a reason to put things off.

You say you have private medical insurance. I'd say go for it and urgently. Trust your gut. They won't necessarily get to the bottom of it, but neither will they put you to the end of the queue or dismiss your concerns.

user19888891 · 15/03/2022 19:15

‘but I also have no faith in a paediatrician who diagnoses constipation based on absolutely nothing’

YABU
I’m pretty sure the paediatrician will have reviewed her clinical history, observations, blood work and scans before entering the room to speak to you.
If she still has pain the GP can review again and potentially refer to paeds outpatients for further review.
It really does not sound like appendicitis and surgery is not indicated to further investigate this

beddygu · 15/03/2022 19:15

My brother had a few years on & off with nausea, vomiting, cramps in his teens. He stopped eating as food made it worse & got very thin. Turned out it was gall stones.

Hairyfairy01 · 15/03/2022 19:34

What is it you actually expect the doctor to do? It sounds like they have ruled out an awful lot of things to me. Please don't quote Nice guidelines at them, they are well aware of them.

drivepot · 15/03/2022 19:52

I was told my appendicitis was constipation
12 hours later I was in emergency surgery
It wasn't..
hope your DD is okay op

Hairyfairy01 · 15/03/2022 19:58

@drivepot

I was told my appendicitis was constipation 12 hours later I was in emergency surgery It wasn't.. hope your DD is okay op
But in this case it has been going on for 10 days. They have obviously kept her in to keep an eye on her incase something like this happened, but it hasn't with no signs saying that it will.
Legalconundrums · 15/03/2022 20:27

Something clearly isn't right if she has been like this for 10 days. Trust your instinct here and go for the private referral. Poor kid, must be rotten for her

AliceS1994 · 15/03/2022 20:31

I am a paeds nurse. Watch and wait approach seems entirely typical and very reasonable given her presentation (e.g. no infection markers, 10/7 day history with no progression, negative ultrasound).

You don't believe it is constipation- have you discussed these concerns with your doctor's? As long as you are polite there is absolutely no danger of you causing offensive by asking the doctors for their rationale and asking your questions. (I'm sure they would prefer that to speculation!) If you suspect the doctor is going to be difficult to discuss this with as you seems to have concerns then feel free to ask your bedside nurse or the nurse in charge to initiate the discussion for you.

springbreak22 · 15/03/2022 20:33

I would be using the private healthcare!

Original poster
Rabbitpoop · 15/03/2022 20:48

@user19888891

‘but I also have no faith in a paediatrician who diagnoses constipation based on absolutely nothing’

YABU
I’m pretty sure the paediatrician will have reviewed her clinical history, observations, blood work and scans before entering the room to speak to you.
If she still has pain the GP can review again and potentially refer to paeds outpatients for further review.
It really does not sound like appendicitis and surgery is not indicated to further investigate this

I assure you there was absolutely no reason to suspect constipation in her history, notes or scan. It just felt like we were being fobbed off and not listened to.
OP posts:
NeverChange · 15/03/2022 21:02

My appendix burst because 15 year old me didn't know the difference at the time between that pain & my period pain, until I was screaming in A &E.

If she's not showing sign of infection, what are her periods like, if really heavy she could have endometriosis which presents similarly but doesn't show on a scan.

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