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

[Rabbitpoop]

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?

I'm not sure I can face a long drive and then a long wait in A&E somewhere else. We were referred straight to paeds by the GP so didn't have to wait in A&E at all originally, we were seen straight away. So feels like we've taken a step backwards now! She's missing so much school as well.

I would ask gp for referral - we have Bupa and they also offer us zoom dr appts we can use for referrals.

If she's in a lot of pain, enough to be missing school then keep going until she gets a scan at least.

DD2 had an ovarian cyst at age 11 by the way, just as her periods started, so it isn't unheard of. They can go away by themselves (DD2's did) or require keyhole surgery. Some cysts can cause torsion which is very painful.

I understand. Although it sounds like you could have a long wait in a and e. My friend went to a regional hospital with a paeds A and E. It wasn't far away.

Don't worry about school. Nothing you can do about that now. Just reassure her. They'll help her catch up.

@Rosehugger

If she's in a lot of pain, enough to be missing school then keep going until she gets a scan at least.

DD2 had an ovarian cyst at age 11 by the way, just as her periods started, so it isn't unheard of. They can go away by themselves (DD2's did) or require keyhole surgery. Some cysts can cause torsion which is very painful.

She's had a scan. Everything was normal but they couldn't see the appendix.

OP, always go private if you have the insurance. Standard NHS has a general approach to dismiss people or 'wait and see'.

This is weird - has she not had a CT with contrast? That's the gold standard for appendicitis diagnosis, particularly when it's a chronic case rather than acute.

No they've not mentioned a CT scan at all.

I'm placemarking to come back later, but I've been through this with my DD. Trust your instinct OP. I proved the doctors wrong and got an apology in the end. You know your child

Just noticed that she also has really bad breath that wasn't there yesterday, although I suppose could be due to not eating or drinking.

If she's not had a contrast CT then ask for that as a priority rather than jumping straight to surgery. Most hospitals would do one before going down the surgical route, I can't think why they haven't done one yet.

They don't normally do a ct with contrast to diagnosis appendicitis in paeds. I've been a paeds nurse for 13 years and they get an ultrasound and bloods. Maybe an xray to rule out constipation but not a ct.

I had appendicitis not long ago. I was in so much agony and couldn't move. My CRP was through the roof and I had very low blood pressure. It really doesn't sound like this for your DD. I can't understand why you've been sent to wait in A&E. I'd be kicking up a huge fuss, especially as you say she was supposed to be having surgery.

OMG what a frustrating nightmare! Obviously something is causing the pain and nausea and as appendix until proven otherwise (in spite of normal crp and wbcs) it feels like having a look is entirely warranted. Being bumped off the list for something urgent is one thing, no one expecting you is quite another! Hope someone comes to the rescue soon.

@fairgame84

They don't normally do a ct with contrast to diagnosis appendicitis in paeds. I've been a paeds nurse for 13 years and they get an ultrasound and bloods. Maybe an xray to rule out constipation but not a ct.

Yup this. The patients I’ve looked after have bloods and an ultra sound scan. I’ve been a Paeds nurse for 20 years.

My daughter had exactly these symptoms at age of 11. Several doctors missed it, but she was diagnosed with an abscess on her appendix and was very poorly by time a marvellous GP finally took it seriously. She ended up having a week in hospital to have abscess drained and then appendix removed a few months later. She made full recovery but I would keep pushing for it to be taken seriously just in case.

I had an infection and and abscess around the appendix area when I got chickenpox when I was 7. I still remember at the time that I knew I was really ill and it seemed to take ages for anyone to take me seriously. I was in absolute agony - stabbing pains in the stomach, really painful just travelling in the car, then the GP said something like "jump up onto the table" and I just couldn't. Eventually I ended up in A&E - three hour wait which is forever when you are seven. By the time I was treated I was delirious- probably had sepsis by then, I am lucky to be alive. Had emergency surgery- as they suspected appendicitis - and was in a hospital for a week on antibiotics which at that time were injected into my bum every 4 hours. Then I went home from hospital and ended up back in for another week after I was in agony again having my stitches out. That's when I had the abscess drained so further surgery and antibiotics. I was ill/recuperating for the entire school holidays and missed the first half term of school.

If someone is in pain and can't eat it is something that needs urgent care.

Just had a nurse come and tell us we can go home. WTF? I said we came in having been told she would have surgery. Nurse looks confused. Has gone away again.

Presumably she has gone to find out what is going on and why no one knows anything ?

Yes I hope so.

It does sound like the surgeons haven’t told anyone anything. 🙄

OK we've been told to stay in overnight now and they'll do the surgery in the morning. There's been no change in the pain/nausea and its been 11 days now.

Have you got the surgeon’s name? Can you ring his secretary? Or contact PALs (tomorrow) and let them know what’s been happening, see if they can get to the bottom of things for you?

Oh my gosh! I’m so appalled on your behalf that they’ve flipped from “just go home” to surgery in the morning. Has your DD been able to eat something?

Bloody awful OP, well done for advocating for your daughter. Hope you both get some answers soon x