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.

@nether ideally I want them to do a scan of her stomach. Since the original hospital admission she has had recurrent debilitating stomach pains every few days. This then seems to lead to the other infections occurring. She has had her stomach felt many times by a dr but nothing other than that

^ This
Repeat UTIs need to be investigated in children

Then ask for that. You can say 'I want to speak to a doctor as I am very concerned there is something seriously wrong with my child - please can you tell me that you are refusing to allow me to see a doctor?'

I have had to be extremely pushy on two occasions and it was the right thing to do. The NHS is fucked at the moment so you have to push (many thanks to all those who vote Tory, really we should make Tory voters relinquish their place in the NHS queues, but that is another thread I guess).

OP get a kidney scan done. It won’t show reflux unless it’s happening at the time so it’s worth also getting a DMSA scan. As a PP said, repeat urine infections need checking. I’m always a repeat bore on these threads but DS2 nearly died from sepsis as a result of a UTI (underlying cause was reflux)

Stay strong!!! Say ‘I’m not happy’ if they try and find you off to go home.

that’s all you need to say ‘I’m not happy, no I will not be going home’

Definitely ask to see a paediatrician. Has she been referred for a kidney scan?

Agree with others stand firm and demand to speak to a doctor.

NICE guidelines state that child with more than I think 3 urine infections in a year must be referred to urology.

also from personal experience the urine must be sent to the lab so they can see what infection and therefore what antibiotics is required.

Agreed about the kidney investigations, my daughter was 2 when she had a urine infection and was admitted with an extremely high temp. She was immediately referred to a paediatrician and had various tests. She grew out of them.

Repeat urine infection can also lead to decreased kidney function. Urine infections can be complications of constipation. Repeat urine infections need to be investigated and it’s extremely poor they haven’t done bloods or more tests/scans to find out the root cause of these repeated episodes instead of treating them as isolated incidents each time. Sorry you’re having to go through this OP!

Did they just dip her urine? Repeated infections should really have a culture and sensitivity done too, otherwise they’re just throwing random antibiotics at it.

That's all very reassuring to read.....thank you! X

That poster wasn’t being a ‘gut therapist’ or a ‘nazi’ (JFC), and they’re correct that the gut micro biome is largely responsible for our overall health. Read around the subject before just being triggered because you read something about reducing sugar.

Here’s a fairly easy read for you.

amp.theguardian.com/lifeandstyle/2022/may/15/go-with-your-gut-tim-spector-power-of-microbiome

From what I can see from own experience A&E will treat acute situation & discharge back to GP, whereas in the past A&E would refer & often send you home with appointment for appropriate clinic.

Another one here saying get her tested for coeliac. I have a colleague who could have written almost exactly the same post as you about her daughter. Took her about 18 months of endless trips back and forth to the doctor and hospital before they diagnosed coeliac disease. She's a different child now

Thanks for all the support! Still waiting for a dr to come and see her but I will definitely be asking for a kidney scan as this is the 10 urine infection she's had in her life and the second one in a month

When my DD had recurrent UTI's (many years ago) she was referred for a micturating cystogram and a DMSA scan and then placed on a prophylactic dose of antibiotics.

A&E is so overrun at the moment that you do have to push to be examined properly. Stand your ground. If you get a good Doctor and can calmly recite rough dates and occurrences of illness, they will see immediately that the frequency is all wrong something is amiss.

Best of luck to you and DD

@ohnoohnoo
Hope you don't have to wait much longer and they really listen to you. 100% the right decision and I'd have done the same if it was my DC. Best of luck and hope everything improves asap x

If she only stopped antibiotics 10 days ago clearly they aren't clearing out what was there. I had the same with tonsillitis. 6 month cycle of 2 weeks on antibiotics, 2 weeks off. Same one, same dose (clarithromycin). I begged them to give me something else as clearly it wasn't working to come back so quick. On the 6th cycle they gave me another one in addition (metronidazole). After that I didn't get any reoccurrence, though the 6 infections had caused so much damage they were actually removed 6 months later.

Can you ask them about giving her a second, different type of antibiotic to see if it helps clear?

If you are still waiting to see Doctor now, jot down a list (if you haven't already) of the last few months so they can really understand how unusually frequent this is.

I wondered about the possibility she is coeliac too.

I hope you get some answers OP. It must be very worrying but you're right to hold your ground.

As you were booked into the hospital for blood tests today anyway, hopefully they'll realise this is a serious issue and isn't just a case of here's more ABs, off you go.

Echoing everyone else on the Vesicoureteral stuff. This runs in my family and we've all had little ops to sort it - they can do a little tweak to the urethra. Otherwise urine tracks back up to the kidney and you get recurring utis. It manifests as stomach pain. Lots of high temps, blood in urine - we were plagued by them as kids. Please push to see a kidney guy. Nephrologist.

If she only stopped antibiotics 10 days ago I’d say the antibiotics didn’t kill the infection- they need to send a sample to the lab and do cultures and give her a different type of antibiotics. As well as do actual tests into what’s going on.

others upthread are right though - antibiotics massively mess up gut microbes. I used to get horrendous thrush and stomach upsets after each round of antibiotics for repeat UTIs. Cutting back on refined sugar and getting live yogurts or the yakult type drinks would be a good idea, it helped me a lot. She still needs further investigation though.