A&E or wait to see the Gp??

[ohnoohnoo]

Have posted a few times about this issue, I should probably change my username as my details are now probably quite outing but I've kept it the same so people can see the previous issues!

Short version of backstory is that DD (5) has been poorly every few days since Feb which was when she got admitted in to hospital with stomach pains and vomiting. Eventually needed a drip and was told it was some sort of gastroenteritis. Since then she has been on antibiotics almost constantly for different things, tonsillitis, urine infections etc. She can't seem to go more than 5ish days without coming down with something else.

Things ramped up 3 weeks ago when she got another urine infection. Temp went to the highest it had ever been (41+), got put on antibiotics and after a couple of days seemed to be getting better. However she then developed severe diarrhoea, going up to 15 times a day and it was just fluid, sometimes had blood in it. That has continued and is still going on.

Gp agreed to do a stool sample and also referred for bloods to see if there is a reason she keeps getting poorly. Stool sample has come back negative for c diff, gastroenteritis and anything else they tested for. She is booked in to the hospital for bloods tomorrow.

Here's where I'm not sure what to do. I picked her up from school yesterday and as soon as we got home she started screaming and crying saying her stomach hurt again, she was literally lying in the foetal position and said she couldn't move. Gave her some calpol and rang Gp to let them know it was happening again. They have booked us in for a face to face appt this morning. Since then she has developed a really high fever and is still crying with stomach pain.

Should I wait and take her to the Gp this morning or should I just take her up to A&E so they can see how bad she is getting and hopefully find the cause quicker? I don't want to waste anybody's time but I'm also at the end of my tether and just want somebody to help her.

Poor little bugger, I hope you can get the right help for her.

My son had similar turned out to be acid reflux he was 5 and put on gaviscon haven't really had as many issues since

Yes, I’m with appendicitis- it was painful like hell, I was rolling on the floor with pain and then it stopped - it perforated by then.

I had temperature, generally felt unwell but no other symptoms. Been to A&e but got told it’s kidney infection. Eventually got blood test done and my white blood cells were through the roof, the finally done an ultrasound to find my abdomen is filled with bowel contents and I was borderline septic.
(It wasn’t in the UK btw)

it’s no joke, if you can please push for an ultrasound! All the best for your daughter

Nurse has just come out to say that she definitely has another urine infection. They said they will probably just treat that and send us home. I know it's good that they are going to treat it but I honestly just feel so stressed about it all. She only just finished anti biotics for the last urine infection 10 days ago and that's what started the bloody diarrhoea (which is still happening). Just feel like we are going in constant circles but not getting an answer as to why it's all happening

Glad you took her in, it’s gone on too long, I’d be insisting on her staying there until they’ve done some investigations into what’s causing all this. Poor little mite

Since then she has been on antibiotics almost constantly

@ohnoohnoo nearly half a year on antibiotics? This isn’t good at all. The antibiotics are wreaking havoc inside her. I struggle to finish one course of antibiotics because I end up severely nauseous, feverish and can’t stay too far away from the toilet due to diarrhoea. I understand I probably have severe reactions compared to most. She needs plenty of probiotics and gut loving food.

Your GP should be referring your Dd to a specialist so they can treat whatever she has rather than handing antibiotics to her like sweets.

Perhaps try to insist that they do more investigations as it’s been going on so long.
If not joy with that route you can still go to the gp appointment later today and work on them doing other tests.

That doesn't sound like an adequate response at all, OP. Will you get to see a doctor to give the full history to?

@ohnoohnoo I think her GP should test for Crohn’s. Some symptoms include bloody stool, diarrhoea, stomach pain and weight loss. She needs an ultrasound and CT scan. I can’t believe the GP hasn’t done a blood test yet!!

The bloods are the next step - did you say tomorrow?

I expect they'll include a full blood count - do you know what else is being checked?

I'm hoping that we will get to see a dr before we leave. I'm planning on trying to stand my ground and insisting that more is done before we leave because I honestly feel like we can't keep going on this way. The dr said she weighs less now than she did last summer so she hasn't put any weight on in over a year. Or has lost so much recently. I just really want some answers

I'm not sure what other investigations you expect?

But tell the doctor there is a history of repeated infections, frequent fever, weight loss and ask if there should be a full blood count before leaving. Especially if she also has night sweats, bleeding gums, bruising or significantly increased fatigue.

I'm not sure what other investigations you expect

Maybe that's because you are not a medical doctor? Im not either but I can think of several. I'd start with a set if bloods first though.

My son, 7 at the time, experienced symptoms of diarrhoea, weight loss and recurrent fevers for a year. Was referred to a so called paediatrician who was useless and I used to leave the appointments in tears as she was adamant he was fine in her opinion. One day he got another fever so I took him to an A&E dept with a specialist children's hospital and refused to leave until we'd been seen by the Gastro team as I highly suspected by this point that he had Crohn's disease. They came and saw us and agreed with me and started him on strong combination of antibiotics and booked him in for scopes and he was diagnosed within a week. He'd had an anal abscess which had caused fistula's which were the cause of the fevers and he was borderline for sepsis! The paediatrician we were under prior to this agreed very reluctantly to refer us to a Gastroenterologist at ours local hospital and that appt actually came 6 months later.....if I'd have waited he could have died. ALWAYS trust your gut instinct and I really hope you get seen by a Urologist very soon x

@ohnoohnoo please do not leave A&E without speaking to a doctor and preferably getting a referral to a hospital paediatric consultant. Be stroppy (but polite) if you need to. Do the broken record. Insist on talking to whoever is in charge. Be steely. You are her advocate and need to be strong for a bit longer.

This is not normal or acceptable and as a PP said you need to get her in the system. Weight loss of this nature on its own should not be ignored.

Your poor little one. I hope they get to the bottom of it soon.

The GP should do the tests, then they refer to the relevant speciality if required. A&E will treat the emergency and generally request that your GP refer on their behalf because it requires tracking and loading with them.

@BearPomBear I'm so sorry to hear this. I hope your son is feeling better now and that it's under control. It makes me so angry that people don't listen to kids sometimes.

I've got crohns and know how bad it can be. ☹️

@itsjustnotok if there is an acute issue then admitting directly is the normal course of action. It's clear from what the OP says that the condition is still acute and needs immediate treatment and further investigation/referral without fannying around (again) with a GP who has clearly exhausted his/her expertise.

Echo what others have said about about insisting you see a doctor before you leave.

He's doing OK thank you, he's 12 now and on Aza and Biologics but we're in for more scopes on Monday as he's having a few issues. Crohn's is an awful disease x

It was actually Mumsnet that helped me get the courage to push for further investigation. I posted 4 years ago for advice and was inundated with replies, support and advice, I even had private messages from paediatric doctors and nurses who gave great advice and I'll always be grateful for that. Really hope you can get into the system quickly OP x

Sounds like she needs to be admitted for a few days and have some proper testing done! Hope she’s ok x

I would ask for a scan to get her for vesicoureteral reflux - it’s a cause of repeat urine infections and girls are more prone than girls.

*than boys

no, it's because I know A&E generally doesn't provide a GP/diagnostic service.

They fix the acute problem, and then send to for admitting or back to GP.

A&E tests are generally for establishing nature and extent of acute issue, so they can stabilise and decide whether its admission or GP

I say 'generally' because I know that on MN someone will always have a counter-example or quibble with how I've out it.

(And I had included what to say to a doctor to increase chances of bloods (at least FBC) being done on the spot)

OP: if you have further ideas about what investigations, are you prepared to post them? Because I can try to help with 'bing bong' wording for those too. But the likeliest upshot, whatever you say, is that it will be back to GP for investigation, and referral depending on what their tests reveal (starting with the bloods already scheduled)

@BearPomBear I think I remember that. I certainly recognise your username

Glad your boy is being managed well. One of my friends has a son with colitis (v similar) who was ill throughout his teens, but aced his exams and is now studying medicine. His seemed to get better with age so maybe there is hope. My gastro consultant does research and says they are getting tantalisingly close to a cure. Fingers crossed for that!