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.

Honestly, I'd let her sleep for a while and then go back early evening.

@antelopevalley I know you mean well, but the NHS is in a dire state. Yes, the OP may get a referral BUT it could be weeks away.

For the cost of £250 she could get an appt with a private specialist in possibly days.

No one is disputing what is 'right' but there are times when you do what's best, for yourself or family, not what is 'owed' to you by the NHS.

@ohnoohnoo Have they not said what bacteria is in the urine?
If it's e. coli that is from poo.

I agree the other symptoms need investigating, especially possibly coeliac. This can be a blood test but to be sure it's sometimes a biopsy of the intestines.

In the meantime, keep your DD well hydrated to flush out any bacteria and keep her bottom and vulva very clean after she's had a poo.

@JinglingHellsBells I am not arguing on principles. A one-off appointment with a private specialist will itself achieve nothing except referrals for further tests to explore the different options. So it would cost more than that.

My first port of call would be insisting on an urgent GP referral and then finding out how long that referral will take. In some cases, referrals take a long time, but I also personally know people who have been seen quickly. So it makes sense to find out first how long it would take before committing potentially a lot of money to going private.

How long referrals take vary depending on where you live and what speciality you are referred to. My dad was seen incredibly quickly, my mum waited much longer. It is always much quicker if you say you will accept short-notice cancellations. My dad was seen within a week by a consultant because he took a next-day cancellation appointment. It would not have been any quicker private.

And exploring the different options may take some time anyway. If the initial obvious tests show nothing, it can be a case of trying things and seeing if it works e.g. tackling constipation or dietary exclusions under a nutritionist. The best-case scenario is that blood tests point to an obvious cause. But I have been done this road with a family member where the diagnosis was something not serious but rare.

Could it be Pseudomonas? This needs iv antibiotics to shift it. My daughter had this and kidney reflux too.

keep going you are on the right track.

Thanks for the continued support, really means a lot! She is back to screaming in pain and her temp has gone up to 40.7 so I'm waiting for my hubby to finish work so he can have our youngest and I can take her back in.
Forgot to mention earlier that they also thinks she has the start of tonsillitis again (4th time in two months) and she is not crying saying her mouth hurts when she breaths.
Her whole body just seems to be suffering bless her

*now

Can’t you take honest to hospital with you and DH picks her on his way?

Poor thing, I had a frequent flyer at hospital and it’s a nightmare, full sympathies.

Really hope they get to the bottom of it too

have they mentioned mésentéric adenitis? If the coeliac screen is negative it could be a possibility.

Don’t forget to pack for you to stay over too

@ohnoohnoo , oh my goodness your poor daughter and poor you.

My daughter had similar experiences over 9 months including the diarrhoea, writhing and crying in agony etc. and it was all to do with her being constipated. As soon as we got seen by a paediatrician they knew what it could be, got her scanned to check everything was okay and got her on meds. Not had a urine infection or antibiotics since!

Really hope you get seen by someone soon and she gets scans etc to check body is functioning properly to rule things out.

Definitely don't change her diet before all coeliac tests are done. You risk getting a false negative

If her temp is really 40,7 (and only you know how reliable your thermometer is) I would take her immediately and take the youngest dc with you. That really is high.

Oh your poor DD, I'm sorry your GP has been useless. Glad you're taking her back in, I'd maybe just go straight in and your husband can pick youngest up from hospital later.

@antelopevalley Have you used private medical cover?

An appt with a private consultant often speeds up the process. You can mix private and NHS. They could contact the GP and suggest which route to go down, for a start, and which is the best consultant to see in the NHS.

Most consultants also work in the NHS so they usually know where to direct patients like this child faster than a GP.

The OP would also get a long appt- up to an hour- to discuss all the myriad of symptoms, and get EXPERT advice on what happens next.

The NHS usually works at a snail's pace, with appts being sent via paper letters, never emails, and the whole process can be tediously long.

@antelopevalley I agree with you that the OP ought to pressurise the GP first but her experience doing that doesn't instil any confidence.

Too often, people are pushed from pillar to post, waiting to see one specialist after another until they are sent to the right one.

This poor child's needs are not clear as there are so many things that need sorting.

@antelopevalley I hope you get some answers but just bare in mind the coeliac antibody test isn't always accurate, she really needs duodenal biopsies if it's negative to rule it out.

Do make sure that they do not overlook that your DD has had a whole series of back to back infections (not just GI and UTI), and is losing weight. Is her pain related solely to current infection, or does she mention other types of pain eg joint or bone? What are her energy level like between infections? Are her lymph nodes frequently up? Is her tummy protruding? Does she get bleeding gums or nosebleeds? Night sweats?

Sorry, I know that's a barrage of questions, but is any of then apply to DD you need to mention them to the doctors, so they get a full picture of all her symptoms.

Back in A&E again now and waiting to see the dr again

Glad you've taken her back. I hope you get more help this time!

That makes sense about awaiting blood test results first!
Oh no, poor love, I’ve just seen your update and I hope you get somewhere soon 🤞🏼

Don't let them turn you away. Also please don't let her temperature spike like this give paracetomol and Iboprufen together if absolutely necessary. I feel for you and hope your little one feels better soon! Sorry I posted earlier thinking you didn't take her to the hospital somehow my phone didnt show any other posts except for your original OP. Having sick children is the worst and I hope they get to the bottom of it! All the best x

Hi OP. It sounds like no one is putting these things together and just treating the different illnesses as totally separate occurrences. Some one needs to look at the bigger picture. You have recognised that as her parent. I feel like people on this thread are giving out better ideas and suggestions than the treatment in A and E. Good Luck and remember the squeaky wheel gets the oil. Keep complaining.

The advice on here is great so thank you all again! She has been seen by the A&e dr. This morning they said her throat was a bit red so they thought tonsillitis as well as the urine infection. Now they've checked her again and said since this morning she has grown massive puss filled spots on her tonsils. So this will be about the 4th episode of tonsillitis in the recent months. They have prescribed her two sets of antibiotics and the dr just asked if I'm happy for her to go home but I've said no, I would rather get her seen by paediatrics and get an answer because she honestly can't keep going on like this. She's feeling so poorly bless her

I’m not a doctor but it’s extremely concerning how many infections she has been developing

You are absolutely right. She needs a proper examination that looks deeper instead of just treating these immediate infections that reoccur. They can see how any time she was diagnosed with them already! Poor child