To take Dd for a private scan

[ProbablyNotThisTime]

Dd has had head pain for 4 weeks, she's had a bout of viruses so we assumed it was that but it has persisted. She has described it as a sharp pain when she bends forward, moves, coughs etc. Shes been treated for sinus infection, sinus inflammation as a precaution as she didn't have all the symptoms but to rule it out. Ended up in A&E a couple of nights ago because the pain was so severe and they tried oxygen to see if it was a cluster headache and when that didn't work they just sent us home with nothing other than a vague mention of maybe referring to neurology. Shes not had a single hour without pain in almost a month. Gp isn’t being very helpful and A&E even less so. Thinking of maybe paying privately for a scan just to rule out anything sinister but Dh thinks we should go back to the gp again. We cant really afford the scan but I feel like we're playing a game of pass the hot potato woth the NHS not getting anywhere. Not even sure where to start with getting a private scan.

How old is she? Do you mean an MRI scan or something else?

Should have said she's 17.

How old is she? In a child, that would be enough to earn an MRI head on the NHS, but the GP wouldn't be able to order it, they'd have to refer via paediatrics.

Yes thinking of booking an MRI.

She's in that age where peads won't see her and waiting lists for adult neurology are too long given how much pain she's in currently and even trying to get a referral has been a nightmare.

I would.

I'd go back to your GP and request an mri. Just keep going back. Sorry your dd is going through this.

Hi this sounds awful for all of you. I would perhaps maybe go back to GP, Google Jess's law, may be helpful. tell them you want a second opinion. Your intuition is telling you something. Listen to it.
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I second @JustRubySnake. You are entitled to a second opinion, and going 3 times with no answers and getting worse they should refer you elsewhere

My SIL asked her GP if she should go for a private scan as waiting lists were 2 years and her problem was causing her problems at work (her employment was eventually terminated on capability grounds due to it).

The GP said to her there was no point getting private scan as what would she do with the results…. Regardless of the results they wouldn’t let her jump the NHS waiting lists for treatment/surgery. It would just mean she would perhaps know what it was, but unless she could afford to pay for private treatment it wouldn’t help her.

Perhaps speak to your GP to find out if they think a private scan is worth doing.

Just looked up Jess' law, thank you I will mention that when I call the GP tomorrow. This will be our 4th time (including A&E) contacting about the same concern this month so hopefully we may get somewhere. Poor Dd is exhausted and it's been so hard seeing her in constant pain.

I would go back to the gp and maybe explain that you’re so worried that you’re trying to access a private scan and see what they say.
That said , my teenager had chronic sinusitus after a virus that lasted the best part of a year. One thing I found very reassuring in the short term was to take her for an appointment at an optician, to assess if the optic nerve or anything was affected. I know maybe you don’t think it’s this, but I think any small bit of reassurance or knowledge can be helpful when you’re awaiting referrals etc.

I would push the NHS one more time. It can be helpful if they refuse to ask them to explain why, and what they think the risks might be of missing something v the risk of doing it unnecessarily.

If they still refuse, take their name and state that you are requesting them to write on her notes that you asked for the scan as you are concerned, and that they refused.

Often the idea that they're on the hook personally if they mess up starts to concentrate their minds.

Some GPs can refer a patient for a MRI without first referring them for an appointment with a neurologist. If the wait in your area to see a neurologist is very long then getting the GP to make the MRI referral may give you answers a bit quicker.

This is what Dh said, but I suppose I'm just wanting to rule out anything sinister quickly so that we can focus on treating the pain. I had assumed that if it was anything sinister the nhs would have to treat her even if the scan was done privately but I've never had private treatment before so unsure how that works.

Thank you, I was hoping the sinus treatment would clear it up as she was given a weeks worth of doxycycline and a steroid spray for her nose but it doesn't seem to have changed anything unfortunately.
We have been to the optician and had her eye pressure checked and the optician checked the back of her eyes and all looked fine which was a bit reassuring.
Will definitely call the gp again tomorrow and discuss our concerns/plans to have a private scan.

The trouble is you don't just need a scan, you need to see a consultant to refer you and help you understand the results. You are right though that if e.g. god forbid a tumour was identified, the NHS would treat.

Look up red flag neurological symptoms. If she has these go to A&E and explicitly list them. They can do a CT scan then and there to rule out anything immediately concerning if warranted.

If not keep going back to the GP.

Is the pain constant or just upon activation? Ribs? Any accidents or falls? Any tingling or numbness in extremities (hands, legs)? A few physios run ultrasound scans which is cheaper than an MRI. May reveal some evidence or discount other issues. Had she had an Xray done? Bloods done?

The pain is somewhat constant in that if she bends forwards, moves her head too quickly or coughs, laughs, sneezes etc she gets the pain quite intensely and she has been experiencing pain more typical of a headache at times too but the pain is always there with movement. No tingling or accidents recently. Got an appointment to have bloods done in a week.

My DD was off school for a month with chronic migraine and shoulder pain at age 13. Three visits to GP and two to A&E. We tried physio, acupuncture, chiropractor. Her MRI was scheduled six months away but I had one done privately - which still needed a referral from the doctor. Anyway £650 and they thought it looked ok, prescribed quite strong drugs but they didn’t help and I think she eventually just learned to live with a certain amount of pain. We did have the NHS scan too, plus a host of other tests. Nothing conclusive. Anyway a few years of getting nowhere and a move back to London and suddenly the symptoms became more acute and 111 sent her to A&E. She was able to get an MRI next day and they told her it was likely to be MS (confirmed a few weeks later after further tests). It all fell into place then.
So if you get the private scan, it may only rule out things like a tumour. My DD’s current doctor says there wasn’t anything on her first NhS scan but they didn’t do a high contrast scan then. At 17 she’s in between - my DD was admitted to paediatric ward but was seen by an adult neurologist too (a 17 year old is nearer and adult physiologically than a toddler)! You need to keep pushing.

I had a private MRI scan recently, albeit for my pelvis not my head. It cost £440 and this included a scan report and a phone call from a doctor to explain the results.

I don't know if an MRI scan or CT scan would be be best at showing the relevant detail in this situation. However, I'd be wary of having a CT scan on my head unless I knew it was medically indicated, as these aren't completely risk-free due to the radiation involved.

The pain pattern does suggest an acute sinus infection that can take up to 3 months to clear. Covid classically causes sinus pain without the normal discharge. It can be very painful and difficult to treat since it appears to be inflammatory rather than build up of fluid in the sinuses.

Would you suspect drug use? Cocaine can cause inflammation in the sinuses. It’s a popular drug in young people and although we are often confident that our children don’t use drugs it should always be considered. Same goes for smoking and vaping.

I started with sinus problems in my late teens and it was excruciating. I’m now in my 60s and rarely have problems but I have learned how to deal with it. Ibuprofen can make it worse but paracetamol eases it temporarily. I found that decongestants help but often dry the mucosa so it becomes more inflamed. I prefer good old fashioned steam with either menthol crystals or eucalyptus oil is most effective.

An MRI or CT may show congestion and nasal polyps that can block drainage from the sinuses. I would think a private consult with ENT consultant would be more productive and they will be able to request further investigations if necessary. There is an extensive system of sinuses through the skull and inflammation/infection can spread through them leading to pain in the cheeks up through the eyes and across the eyebrow area. Basically the whole of your middle face is painful.

Definitely pay if you don’t get anywhere with the GP.

Is the pain fleeting or does it linger? Lhermitte’s sign may be worth reading up on.

If there is anything that needs treatment the NHS will treat this even if diagnosed through a private scan. I recently had a private MRI on my brain for unexplained pain. I have a cyst that the hospital NHS CT scan did not pick up. NHS urgent referral to a Neurosurgeon was put in place when I went to the GP with my private scan results.