Another A&E thread

[MyOtherCarIsAPorsche]

AIBU to take granddaughter to hospital this evening or will it wait?

She's been having headaches regularly this year. She describes pounding and pain in eye. GP said eye test - optician immediately said that she could see a large prescription. DG had glasses then three months later had another checkup and a stronger pair prescribed. She's due back in December. So I'm assuming that they're increasing the strength of the glasses in increments.

Her headaches have persisted. This current one she's had since last Friday. I picked her up from school on Monday and could tell that each footstep was making her wince with pain. She couldn't sleep Monday night because of pain and feeling sick. We've been alternating paracetamol and ibuprofen for pain relief. Saw GP on Tuesday who said it was nothing sinister but was referring her to paediatrician. This evening she was complaining of eye and nose pain and appeared to be light sensitive. She's woken in pain a couple of hours after she went to bed and her eyelid is drooping.

Is this worth a trip to A&E?

We're very worried.

DGD can use Fitovers over her prescription glasses. https://www.i-sunglasses.com/prescription/fit-over-glasses/non-polarised-fit-overs I wear yellow and copper ones unpolarised indoors to stop the blue from modern LED lights from triggering my migraines and use the copper in polarised for driving and grey in polarised for outdoors not-driving. They do different sizes, measure her glasses and get the smallest ones that will take her frames.

If you can only afford one set, get copper unpolarised: maximum blue light removal, decent overall light intensity reduction, won't interfere with screen use.

@VitoCorleoneOfMNMafia

If I had been with them today at the optician I would have got the sunglasses. Normally I would have been with them.

She wore sunglasses from the children's range at Boots before she had glasses. She's always asked to wear them since she had a peppa pig pair as a present.

I'll be picking the new glasses up in the week with her because mum will be at work. I will get sunglasses then.

Has your daughter spoken to 111 with the new symptoms. Has hard as it is, your granddaughter needs to be the focus at the moment?

I had an MRI spine and hips and it took 45 min - I was not far from panic when it finished.

I'm thinking that DGD will not cope with this - her brother had one recently and was sedated. I'm not sure these scan places do that?

DGD's condition sounds like status migrainosus.

A&E can give "Oramorph" morphine for severe migraine pain, they did when I was crying uncontrollably and begging my mum to kill me just to end the pain and throwing up. They can also offer triptans and other second-line treatments.

You mentioned precocious puberty: DGD can be given lupron short-term to delay that until she's taller.

Divorce the husband, you don't need his negativity and he is BVU dragging you off to fucking sheep shows when DD and DGD need you.

@BarbDwyerHair

No - when we rang 111 Thursday evening they immediately sent an ambulance from the description of the symptoms.

My daughter has no one to look after her other children.

My husband had to come and look after them also, while I went to pick them up early Friday morning. So it involved more than one additional person.

"My daughter has no one to look after her other children."

Take them in too then!! The poor little girl who's in pain needs to be the priority. The lack of action between you and your daughter is honestly really upsetting, fucking step up and help this poor child

@VitoCorleoneOfMNMafia

I've thought about divorce - then I think that it's not his fault that he was on bypass during his op longer than planned.

Seriously, I fight against my feelings with regards to his personality change all the time. I married in sickness and in health. He was not like this before his op. He was so laid back he was horizontal. Now he is 'up like a rocket at the slightest thing'.

He knows how horrid he is - and it's not just with me. He's had to apologise to just about everyone he knows because he knows how awful he can be. He doesn't know why he acts like he does and he says he tries to stop while he's in mid strop - but he can't.

He had his heart set on this sheep thing ages ago and insisted I go because I've not been in our extortionately expensive holiday home for such a long time. He threatens to sell it because I've not made use of it for the last two years because of one thing and another - it's just that we seem to bounce from one crisis to the next recently.

I couldn't not come. Daughter insisted I come. I really didn't want to but felt I had to. It wasn't that crap today - the sun shone, the resident hare, and the resident pheasant came to see us. We've laughed and held hands and judged some yellow sheep (among other breeds). Not officially judged, just trying to justify the rosettes awarded. I'm just so frustrated that I'm here and not at home at this particular moment in time.

Do you know that I don't drink alcohol since my first grandchild was born in case of emergencies like this? My husband says that this is a stupid thing to do - but I do it.

My husband is assured that DGD has migraine because all of my family have it and he isn't surprised that DGD has it. He's satisfied with the diagnosis. I'm not so sure - neither is mum.

I suggest Fitovers or other over-the-glasses types because

• they allow DGD to try out different lens colours cheaply
• they don't need to be replaced every time DGD's refractive prescription changes
• they are robust enough to withstand being shoved in a pocket, whereas prescription sunglasses need to be carried in a case
• they are cheap enough to have a spare pair on standby in case of loss
• DGD isn't functionally blind whilst switching between sunglasses and clear glasses

I write as someone autistic, with migraines, and a corrective prescription including cylinder and prism (so no contact lenses for me) that means that my glasses go on when I wake up and are removed again at bedtime. I got sick of carrying multiple glasses cases everywhere. Fitovers also mean that I push them up into my head when I drive into the Mersey tunnel and pull them down when I emerge, without any period of being without the sight correction that I need to drive legally because without glasses I cannot read a licence plate at 30 feet.

We did this - my daughter and granddaughter were in A&E approximately 48 hrs ago.

I couldn't believe they didn't scan.

@MyOtherCarIsAPorsche But symptoms have worsened since then and she's still in pain, she needs adequate pain relief if nothing else!

Her symptoms do sound most like migraine.

Edit I take it back, hadn't read the full thread but just saw she has also started falling.. her symptoms sound like brain tumour. She needs to be in hospital until she has a scan to exclude brain tumour. An MRI will not happen fast enough so likely a CT. If I saw her with these new symptoms I would admit and do a CT overnight.

(Return to post pre-edit...) she also has vomiting, vision changes and persistent/ escalating pain related to her latest acute ongoing episode. These are red flags. I'd suggest you look at some of the resources the children's brain tumour charity headsmart has produced. You can also find professionals guidelines on their website which you can share with HCPs. Nocturnal symptoms and hypertension are concerning. She needs an urgent (quite possibly inpatient) scan to be safe imo. I don't want to alarm you unnecessarily as it is much more likely this is migraine, but undiagnosed brain tumours causing raised pressure in the brain can kill suddenly (and avoidably). If she has new symptoms since last being seen go back via GP same-day or go to AE.

You married him in sickness and in health, not in kindness and in asshole. It's not your fault either that he was under too long.

He could try CBT or some other kind of therapy for managing his thoughts and behaviour better. CBT is now available as self-directed online courses.

Migraines and seizures and ASD are all very linked genetically and inheritable. My ds started getting migraines that we could recognize as that around the age of 6 or 7. He probably had them from birth. He also has cyclical vomiting. And was eventually diagnosed with mitochondrial disease (migraines are often present in mitochondrial patients). Your DGD should get an urgent referral to a neurologist (and maybe a geneticist too).
We found that taking the "mito-cocktail" of supplements helped enormously with preventing many of the symptoms including the migraines. Dr. Richard Boles is one of the experts on this. molecularmitomd.com. My ds took large doses of CoQ10, Vitamin D, B2, Levo-Carnitine, Omega 3's among other things and they all helped enormously with his migraines and general health.

I know - I'm stuck!

I've suggested that my daughter go to the local walk in as soon as possible in the morning.

My younger daughter may be able to help (she has three young children and lives an hour away) at a push. We can leave tomorrow if need be.

DGD is asleep for now.

I don't understand why the hospital didn't give her a migraine medication if that's what they diagnosed.

They said to wait until she sees the paediatrician that she was referred to for confirmation.

DGD had quite a serious bout of vomiting with headache this time last year. She was back and forth between GP and A&E for two weeks and became very dehydrated and weak. She lost a lot of weight. It took three doses of ondansetron to break the cycle of vomiting. But I'm not sure that was connected to this. But now you've reminded me of this episode I'm not sure.

@KidsDr

Yes - she looked up at a shelf in a shop and fell backwards.

She also said she was dizzy this evening.

She's been waking frequently all week because of pain.

She never usually wakes in the night - always slept well.

She's woken twice this evening and asked for painkillers. She usually detests painkillers and avoids them. She has them in school (prescribed because of headaches on Tuesday) and hasn't asked for them once. She didn't tell the teacher she couldn't see what was on the whiteboard.

GP and paediatrician said keep on alternating calpol and ibuprofen.

This may be really obvious but we have a family history of migraine down through the generations. My mother, grandmother and one of my children had them. One of the triggers for my family was chocolate. My son cut out all chocolate for a while at about 9 and the migraines went away. He can eat smallish amounts of chocolate now and we haven't had any recurrences and he seems "to have grown out of it". Of course, I realise you may have investigated all these sorts of things. I do hope your GD's situation gets resolved.

My Mum had awful migraine attacks - she would be very ill for at least a day and couldn't see properly. I had them too when I was younger. They were awful but at least I could see - though my vision was disturbed. But isn't it unusual for migraine to last for such a prolonged period?

In later years I had to call an ambulance for my Mum because she had the most horrendous headache and was crying with pain. Despite many tests and a brain scan, the hospital could find nothing untoward. Eventually, she was felt a bit better but very shortly afterwards the terrible headache returned and she was diagnosed with shingles in her head and face. I had to stay with her for a week until she began to feel better. She then developed Bell's palsy and one side of her face dropped. Fortunately, she recovered. I wondered if there was a chance that your granddaughter has shingles?

As someone else has said, if it is definitely migraine, surely there is medication to help alleviate the pain and distress? But I agree with SofiaAmes that further specialist investigation should be sought.

A&E gave me oramorph before the duty neurologist showed up. Given that I waited several hours for said neurologist and was vomiting and crying from the pain, that was a very necessary act of compassion.

I'll concede that they might not want to give triptans or ergot, but they can give a child a dose of opiates so that she can at least sleep.

Having said that, trying triptans and noting whether they worked would be useful diagnostic data, as long as it posed negligible risk to the chil

Yeh I think your D needs to make a real big concerted effort to present at A&E with DGD no later than tomorrow morning and explain symptoms have worsened since the child was last seen and Calpol and Ibuprofen aren't touching the pain. A&E can and will give more effective pain relief but you do actually have to go there. This poor child

I would take her back to A and E and insist on a referral to neurology.
Ask to be assessed for Horner's syndrome or third nerve palsy.
At the very least she should have had a field of vision test at the opticians to rule out neurological causes.

I'm more worried that the double vision is due to a 6th cranial nerve palsy, which would urgently mandate a scan.

https://www.mayoclinic.org/diseases-conditions/horner-syndrome/symptoms-causes/syc-20373547