Concerned about daughter *in A&E*

[Unsure1899]

Really worried about daughter.

She’s 15 for context. Woke me up about 2am- excruciating pain in middle of chest- really tearful saying her chest hurts more when she lays down or tries to take a deep breath. Gave OTC painkillers- tried distraction etc. Sat downstairs to see if painkillers helped. They didn’t. At 4am I brought her to A&E as she was beside herself in pain.
Triaged in Peads V quickly, ECG fine. Obs normal. Awaiting X-ray but I’ve asked if this could be linked to starting contraceptive pill a month ago (progesterone only). Doctor has pulled a face and he’s said it’s unlikely. No blood tests at this point, I’m worried that she potentially has a blood clot due to pain and where it is. I’m not great at being strong and firm but feel like this X-ray will come back clear and we will be sent home with muscular pain!l

Should I push further?

Anxiety? Low bgms due to poor diet? Acid?

Hi,

I'm ND and have all sorts of gastric chaos, but mint chewing gum helps me very very much when things are tricky. It might be worth trying to just to get a sense of whether it is a stomach acid thing. Might not solve the problem but might give you a data point.

The coating on Wrigleys extra white is calcium carbonate, so it's basically an antacid.

My dd her friend has arfid and has just had a micky installed does she have a ng feed

Omeprazole.

How is she now? My daughter is also autistic and won't take gaviscon but she will chew on Morrisons orange flavoured antacid tablets and the spearmint Rennies. It could be one of many issues that are not necessarily the heart or lungs. Many referred pains can cause severe chest pain, such as Gallbladder stones, costochondral inflammation, and stomach issues, etc. It's great you're keeping an eye on her. I hope she feels better soon.

Sounds like Tietze's syndrome. Unlikely to be a PE with normal obs.

Progesterone pill only does not raise clot risk. If it's a PE they would have likely heard changes on the stethoscope

I have ARFID.and really struggle with gaviscon. Rennies worked well for me. Not the peppermint (it was way too strong) but the spearmint and fruit ones were ok.

I still struggled to chew them because of the chalky texture but I had success putting one in the side of my mouth between my cheek and teeth and just letting it dissolve. Sometimes I'd also cut one up into small pieces and swallow them like tablets.

Eventually I started lansoprazole and stopped needing the rennies.

Google costochondritis. I getvtgis occasionally and it's benign.

I got diagnosed with Costo 6 months ago and still get very severe daily pain. I’ve seen some people who have struggled with the pain for 18 months, and most people find it returns once they’ve had it. It’s not the chest lining either, it’s inflammation of the connective tissue. Mine is much, much worse when I don’t wear a bra because the added weight on the chest aggravates it.

The pain would be in the breast plate itself and would also be painful to touch/press down on.

How much is she eating? How much weight has she lost?

She could have slipped into anorexia territory and chest pain with abnormal bloods would be a red flag.

Gosh yeah. That's it. It's awful isn't it. Sorry I wasn't sure the exact part but it affects the chest area really badly doesn't it. And feels bruised when you touch it.
I'm so sorry you're still suffering after so long.

At one point I had it really badly for 8 weeks about four times a year, for ten years!
The first time you think you're having a bloody heart attack. 🙁

That has an element of truth as I was suffering from ED when I had it. I'm not sure why, immune weakened? I'm in recovery now and take loads of vitamins and it's gone. I didn't know they were linked actually. Thank you.

Please stop worrying about being OTT! This is your child. You have to do better at being strong and advocating for her. If doctors don't like it, tough. You know your child.

I haven't read past this yet and I hope she is okay.

That’s exactly it!! Apparently most people get diagnosed after going to a&e thinking it’s a heart attack! It’s just awful.

To be honest I'm concerned now that if I did have genuine heart symptoms I'd just put it down to costo!
There was a bloke I knew from work and he always had it, just like me. Then one day he had a heart attack and needed a stent. I think he initially tried to claim it was costo and wouldn't call an ambulance till he collapsed outside work!
I hope you're not suffering from it now x

My husband had costochondritis and was in agony for months. Could barely lie down in bed, definitely couldn't lie on his side etc They initially thought heart attack.

Calm yourself.

A diagnosis I did not make, merely a suggestion to maybe help.

I said I work in CAMHS and we see this a lot, that is a fact not a diagnosis.

Just wanted to arm OP with questions for ED staff should she require it.

Try to stay in the spirit of the thread and don't be openly mean.

@poppettypop you are speaking to whom precisely? I don't believe my tone was as ill mannered as yours but if yiu work for CAMHS, in whatever capacity, I would expect little to no courtesy.

But also completely unecessary to be combatitive when the doctors are doing the necessary tests

I've had costochondritis. I was so painful, even breathing hurt. I had to sleep in a chair because I couldn't lie down for the visit. Luckily it lasted a few days at most

@Unsure1899 you said your daughter is autistic and has ARFID - is she double jointed by any chance? A lot of autistic people are hypermobile. There's also a crossover between hypermobility and costochondritis. I'm hypermobile and have had costochondritis on a few occasions and it is agonising, every time I've thought I was having a heart attack.

If she isn't hypermobile / double jointed then ignore this obviously. I hope you get some answers soon.

We weren't aware they were at the time and I have been in situations when they have refused. For example when they disbelieved I had a broken back.

I found your tone ill mannered. Why is everything i said in inverted commas?

I was merely trying to help having had experience of dealing with this type of pain in patients with ARFID.

Of course I would not make a diagnosis either in person and especially over the internet I am not a Dr.

It was an alternative suggestion to hopefully ease the OP.

Inverted commas are used when quoting. A basic SPAG rule.