What’s wrong with me, hospital clueless

[elm26]

Yesterday at 1pm, I put my 6 month old on the rug with his toys and went for a wee.

As I was walking back I had a sudden severe pain in my right side radiating into my lower back and up to my shoulder, I was in agony.

I called DH who was luckily only on a job 15 mins away, he came straight home and took one look at me and called ambulance, I was shouting out in pain they gave me gas and air and morphine.

I had an emergency CT when dye last night and also have a catheter as lost the ability to wee. Nothing showed on CT, they got me settled on morphine and today I’ve had a transvaginal scan which shows ovaries and womb look normal.

Gynae can’t find a reason so they’ve stopped painkillers and just giving me paracetamol but somethings wrong I feel like somebody’s twisting my insides. The gynae consultant was horrible and said the surgical team will come see me if they think it’s worth it?? So I’m waiting for that if they come.

I’m in so much pain and genuinely scared they’ll send me home not knowing what is wrong with me.

Has anyone has anything similar?

Could be ovarian torsion! Where the ovary twists on itself. It’s apparently agony but not very easy to spot. Push them on this and explicitly ask ‘how do you know for certain it is not ovarian torsion?’. I tend to find approaching things in that way ‘tell me how you know it is not x thing’ is usually really useful as it makes them wonder how they would defend their decision making if they got it wrong and they have to admit they don’t know for sure meaning they will keep looking.

yes, you have misunderstood. A negative d-dimer excludes a clot. A positive d-dimer could be due to a whole number of things, including clots, but also lots of other things (including inflammation, infection, pregnancy, cancer, post surgery, haematoma's outside the vascular system etc etc). If someone scores low on the risk predictors then doing a d-dimer may be useful in confirming that there isn't a clot. If they score highly they should have imaging. What happens in real life more often than not is that someone thinks they're being helpful by doing the test and actually make things more complicated when it comes back mildly positive for other reasons.

I think you’re misunderstanding me? Yes, a raised D-dimer may indicate other things, but it IS used as the first diagnostic test for a clot - if it is positive, THEN they will do more testing, like a CTPA or a Doppler test. If it is negative, then they are not going to perform any additional testing for a clot, which is why I asked OP about blood tests. I have been through this several times in my own life, unfortunately - D-dimer is not specific only to clots, that’s true, but if it is raised, only then would further testing be performed, according to my consultant (I had a tough time in hospital this past February). But! Maybe there’s something I’m missing? I know going through it as a patient is not going to make me as educated about it as a medical professional, so I’m fully aware maybe I’m still missing something here.

May have missed it but where does it say she has had a scan of gallbladder?

Hey sorry, we cross posted. I think we’re saying the same thing and wording it differently, or that I’m still misunderstanding? I’m sorry about that; normally I can understand these things. To me, that is a diagnostic test - if it’s positive, then they can consider a possible blood clot (and yes, possible other others). If it’s negative, then a blood clot isn’t possible. I think maybe this is the part I’m misunderstanding: so a blood clot is possible without a raised d-dimer? And yes, unfortunately, had a few “raised but okay” D-dimers, which is maybe why I’m confused (and sorry about this @elm26 - it wasn’t my intent to derail the thread and I really appreciate @Greybeardy and @JulietteHasAGun sharing their knowledge with me. ♥️

No worries! It can be tough on threads like these that have a lot of updates. OP posted her gallbladder scan was clear at 10:55 today.

If they want to discharge you without coming to a conclusion or say it was something that you don't feel is right, can you not invoke Martha's Rule to request an independent second opinion? I'm not sure how you do that, but there's supposed to be information about it in every NHS hospital now, isn't there?

@elm26 in my opinion, if they suggest discharge, simply say "I very much want to go home and will do so when the cause of the pain has been diagnosed and next steps have been agreed with an implementation plan." If they continue to be unhelpful, plump up your pillows and ask to discuss the next steps with the hospital's clinical director.

I hope it all gets sorted put quickly.

I’d like to be a fly on the wall for that speech

Have they done a D-Dimer blood test? That would help to investigate blood clot

Another vote for gallbladder or gallstones, especially given that you have recently had a baby. Gallbladder problems are very common following pregnancy.

if someone scores as being high risk for a DVT/PE then they should be having imaging, not a d-dimer. If they don't score highly then a d-dimer may be helpful - if it's negative that's reassuring and if it's not that needs more thought. Many of the things that can cause slightly low sats will also cause a raised d-dimer in the absence of PE. Unfortunately when a d-dimer's done for the wrong reasons and comes back mildly positive (because for example they have an infection, or a ruptured cyst) it then often commits you to exposing that person to a chunk of radiation/the risk of a reaction to contrast/therapeutic anticoagulation that they don't need while they're waiting for the scan, so doing it inappropriately comes with some risk. Quite a lot of the possible diagnoses that could be behind OPs symptoms could cause a raised d-dimer in the absence of PE/DVT so it's probably not a helpful suggestion here.

Yes. I guess it’s maybe how you worded it. 😀. I think most HCPs wouldn’t term it a diagnostic test because it doesn’t diagnose. It’s an investigation. Sorry, don’t mean to sound snarky at all. 👍🏻

Oh no, it doesn’t sound snarky at all! And thanks to you and @Greybeardy (I saw your response too) and it makes a lot of sense because I have chronic illness and often have a slightly raised D-dimer (only high enough that they did further investigations for a clot once). Yes, I suspect I’m using the term diagnostic incorrectly based on what it means to me as a layperson, which sounds like it’s incorrect in medical terminology. Sorry about any confusion and thanks for the knowledge!!!

I have no idea OP but wanted to say well done for fighting your corner.

Keep it up!! Get PALS involved if you need to.

Be strong. Take care xx

Kidney stones , if it wasn’t for the wee thing I would say gallbladder as the pain of an attack is excruciating

Agree with this as a possibility. Any signs of jaundice - yellowish skin & eyes? Just saying, as I had terrible pains (rolling on the floor pains) totally out of the blue, (which nothing at all would relieve) - felt like a belt made of barbed wire was squashing my entire ribcage area + back & neck - it was diagnosed as a gallstone stuck in the bile duct causing acute pancreatitis. This did pass by the time I had a full MRI 2 days later, after intravenous fluids & antibiotics, & some morphine which did eventually help, but I had a CT scan first that showed there was something there. My bloods were OK .Good luck 💐

OP hold on in there, sure your kiddies are missing you too but you need to stay where you are & get this pain under control & a reason for it so you are in best shape for them.

fingers crossed you get some answers in the morning!

Same with my DH. He was on the floor literally screaming with pain. I've never seen him like that before.

I had a scan on my gallbladder on a Thurs evening, just an ordinary pregnancy type scan. Was told that everything was clear no sign of any gallstones. The following Thursday evening I ended up in a+e with horrendous pain. Told doctors about scan, my GP was convinced I had gallbladder issues hence the scan. I was sent for a MRI on Friday morning which showed my gallbladder was " chock a block full of stones". I was told the original type of scan didn't show up enough details to determine if there were stones present

Have you had an MRI? I also wondered if it was spinal - slipped disc / pinched nerve. I have low grade slipped disk and it’s been a rollercoaster.. I could see bending down for baby and loo etc might bring it on..

Tell all that to Merope Mills.

I feel for you op but keep pushing or get a friend/family member to push for you!

Martha was rapidly deteriorating and all the evidence showed that she needed critical care. Her death was a preventable tragedy.

@elm26 has said that she's improving. All of her observations could be the result of morphine. Or they might be something else. But taking this thread as her advice, she's either got a PE, gallstones, pancreatitis, cauda equina syndrome, an aortic dissection, a slipped disc, an ectopic pregnancy, or a burst fallopian cyst.

The team that is treating her will have all of her history, her observations, her blood tests, and her scan results.

That may all be so, but it seems a great poty that findings and plan are not being clearly shared with the op. As.so often, it's about communication and in my experience patient /carers questions are papered over and not clearly answered until the patient or carer is very firm and digs in their heels. Too often in hospitals every person on shift has a different version of the "facts" or what next.