How long before I should ring OOH (if at all)?

[doughnutty]

DS is constipated. He is screamimg in pain because he's holding it in. Started in earnest yesterday afternoon so by the time I realised it was too late to call gp/hv. But only then realised I couldn't remember the last poo. Might have been 3/4 days. He normally goes every day or twice in a day if he has one poo free day. He's 2.3 and has good vocab and understanding but he obviously doesn't understand the concept of "no pain - no gain"

He's passing liquid which soaks straight into his nappy, but what's left is like sand! Really gritty. DH and I have been trying to pull it out when we can but it's really difficult and we're scared of hurting him more.

He had a bout last week but he was ok in himself. This time he's lethargic, shivery and hot while he's straining/holding. Hasn't eaten much today and can't force him to drink much. I have got some orange juice in and a wee bottle of flavoured water (won't drink it straight).

If not doctor worthy, what else can I do. I'm almost as distraught as he is.

I would give him some pain relief and a nice warm bath while you decide. Sometimes a warm bath relaxes them and they poo too. Has anything triggered it - change in diet, trying a potty?

If he is distressed with it then by all means ring the OOH.

lethargic shivery and hot are clear doctor pdq flags to me.

I agree with Widow

Ok. My instinct is he'd be fine if he could get the damn poo out!!

Have tried to persuade into a bath a couple of times today but he's not for it. Might just dunk him anyway. His bum's so sore he just doesn't want to sit down at all.

Do you think a hot water bottle on his tummy would help?

He might have impaction and need some help to get it out, i'd ring them

He's already hot. Shivery is normally a way of the body trying to get very hot very quickly (i.e. creating a fever), and a sign of infection. I can't see a hot water bottle on a hot child helping.

It's exactly the kind of thing OOH are for. Really hope the poo comes out soon and he'll feel fine, but I wouldn't try to sit it out, especially if he's in so much distress.

He's not distressed all the time. Sorry, maybe I wasn't clear. The shivers come only when he's holding - so only when the urge comes which is regular but not constant.

He slept through last night. Only woke once and a shush wad enough. Had a nap today too but was shattered.

It's impaction I'm concerned about. When his nappy's off and we can see what's going on, the poo is half in, half out. But he's such a strong, determined boy and he just doesn't want to poo because it's sore.

He's perked up a wee bit in the last half hour. Ate some fruit and some more o.j. DH is suggesting reassessing in the morning if he doesn't sleep or it's not all out by morning. I'm just second guessing as he's my first and he's never really been ill/in pain before. Even when he had chicken pox he was neither up nor down with it.

was

Have you taken his temp? If its ok then I'd wait until tomorrow or possibly see if a pharmacist can help.

Has he eaten sand??

Think his temps ok. Thermometer battery has gone since I last used it but he feels ok except when he's struggling.

It's possible he's eaten sand - they play with it a lot at nursery. He was in all day Wednesday.

DH has just taken him up to bed. Much later than usual but at least he's so tired he might sleep.

Thanks for all your help and advice so far. If you have any quick fixes or suggestions please keep them coming.

Phone NHS 24 - that's what we do if we have anything at all we are worried about (not very often). They can be really re-assuring and you can talk to docs/nurses who can advise.

I would take him to OOH. He may need a glycerine suppository/lactulose/some numbing cream to help him pass it - my DS had something similar when he was 2.5, and it caused us problems for months as he got a tiny fissure when he eventually passed it, and it scared him so much he ended up chronically constipated.

I don't mean to scare you doughnutty, but it might be best to see someone. Hope he's all sorted soon.

Dh phoned this morning. We're at OOH now waiting for a paed to come and see him.

He barely slept from 2am this morning.

They'vr given us a movicol script and some glycerine suppositories.

We'll see how it goes.

How is the poor wee thing now?

fanjo , thanks for asking. Had an awful couple of days/nights.

He's been sleeping in with dh and been waking every 15 mins/half an hour fighting the urge to push.

Asked to go to bed at 5 o'clock last night but stayed in bed til 6 this morning. He's just knackered.

Still hasn't passed more than liquid but seems a bit happier this morning. We're on our third sachet of movicol so must be softening whats left in. But the glycerine suppositories haven't shifted what's needing to come out now.

Going to go to gp this morning, even though he seems chirpier, I need to know there's no more can be done now, and that I can avoid it becoming an ongoing thing.

I posted on that pain thread last night and almost put watching my wee boy in so much pain and being helpless.

Wish I'd listened to the first couple of posters. If we'd got him seen earlier maybe he wouldn't have suffered so much. I am a bad mummy, but I'll not be again.

You aren't a bad mummy, they had learned through experience as you have, you were doing what you thought was best!

Also have you tried putting loads and loads of Vaseline in and around his bum, can sometimes help a bit. Make sure he drinking loads with the Movical, hopefully he will go soon.

Don't feel bad, it's the first time it's happened to him so you wouldn't have known it would get so bad.

Morning.

If anyones still reading, have you any suggestions how to keep him clean now??

If I didn't have another baby who's just crawling and in to everything, I think i'd leave him nappyless and clean the mess as he went, but, I don't have the option.

What's coming out is still gritty liquid. Nigger bits, but obviously really sore to wipe. Using cotton wool and water now.

Main problem is he's never clean. It's just constant. I clean him, but by the time I've got the sudocreme, there's more bits.

Any suggestions????

OMG - BIGGER - BIGGER BITS!!!!!!

Damn phone.

Lol at phone.

Metanium is much better for sore bums

Got some of that somewhere. Thanks fanjo

As an update, he slept all night in his own cot, which meant a full nights sleep for everyone, though his bum was so sore, I wish he had woken in the night just so I could've changed him. I should've set an alarm - will do tonight. Even the baby gave us a night off. Dh has taken her to mil so just me and ds today which in normal circumstances would be a rare treat. As it is I'm watching toy story on a loop. Could be worse films to watch, I guess.

Has he still not really done a poo then? The watery gritty stuff sounds like overflow, maybe he is impacted higher up, I think I would bring him back to GP as they really should scan him to check.

No Fanny , nothing solid at all yet just constant gritty water.

Just put him down for a nap. Have changed him only 3/4 times this morning because I can't restrain him enough to do it more regularly. He's writhing today but has eaten a little - some grapes and half a slice of toast. A handful of yoghurt raisins. He asked for his usual breakfast this morning so thought he was at/near the end of it but, he couldn't sit long enough to eat it as his bum is so sore.

Probably not the best things but he's eaten very little the last 4 days so I'm giving him what he's asking for, which isn't much, while suggesting fruit and drinks v v often, which he's sometimes having. Not sure if that's right or not.

He is in so much pain I'm crying along with him. GP yesterday said the movicol will eventually leave him no choice but, I feel I'm now traumatising him with every nappy change .

Seriously, I'm devastated. He's gone to sleep and I'm lying in my bed sobbing.

I don't think I'm cut out for this mum lark

Doc felt his tummy yesterday and let me feel the lumps inside. They were just above his pelvic bone on his left side. Any idea how far up his gut that is??

I'm due back to work after ML in the next fortnight. I can't leave him like this. I can't leave him in nursery. Can't afford to not work. Haven't spent any time with dd for days.

I'll shut up now - feeling all sorry for myself.

doughnutty I would ask your gp to arrange for you to be seen at your local children's dept today.

It has gone on for too long now, for both of you. No wonder you are so upset, you're having to watch your little one in pain.

My son has had many health problems and it is awful to see them suffer. Maybe he needs to be being assessed by a paediatrician again.

You are doing a great job btw .