14 DD Mottled Skin, ice cold hands and feet

[BarrysT]

My DD is 14 has been mottled for a few days, has had lots of gastric problems and a recent UTI last week after urodynamics. We have already taken her to a&e they said it's nothing to worry about but something just feels off. I am going to try get an appointment with the GP tomorrow. She has just been sleeping so much. Her antibiotics for uti finished yesterday and her blood results dont show an infection.

What worries me is the mottling is everywhere hands, legs, feet, tummy, chest. Her tummy takes 6 seconds to return to normal after pressing it, her hands and feet are around 5 seconds and her chest also about 6 seconds. The doctor in a&e yesterday said her bloods are fine so it's fine. It just cant be normal something has got to be wrong! Her feet are ice cold, even with fluffy socks on, room temp set to 22C and thick fluffy jim jams. The only place she feels warm is in the bath or shower. After that she will feel cold and cant get warm

Since Wednesday she has been exhausted out of school, sleeping from 7pm to maybe 12 noon or 1pm 18 or so hours will wake for a few hours, be thrown on the sofa. She is not going for a wee much, her normal is 15 times a day she is down to 4-5 at best. Rightly or wrongly we have put the baby cam in her bedroom to keep an eye on her. When she is awake she finds it so much hard to breathe after going up or down the stairs. Again totally not like her she plays football so is fit and mostly healthy

I just dont know anymore! I dont know what is wrong

Sorry you're going through this - you must be worried.

I know it's probably not what you want to hear, but I would take her back to A&E tonight, and ask for the bloods to be rerun, and for a second opinion. I get that the bloods show no infection, but that's an awful lot of red-flag symptoms.

I hope she takes a turn for the better soon.

I'd be taking her back to A&E now and ask for a Martha's rule second opinion if you don't get anywhere.

Unfortunately I agree re getting a second opinion.. cold hands and feet combined with UTI and mottling is worrying

In medical terms, her central capillary refill is 6 seconds. That is a significant red flag. She needs to be seen in A&E tonight. I am seriously concerned that she has sepsis. Please DO NOT leave it to the morning.

(A passing paediatrician)

You need to go back. Take a list of symptoms and ask that they document them in her notes. Is she drinking? If she's sleeping 18 hours per day, I wouldn't think she's getting enough fluids, which would at least in part explain the dizziness, poor urine output and poor circulation.

I agree with pp saying take her back to A and E. I don't like the sound of this at all. (Retired nurse).

Just to add that in sepsis, temperature isn't always high. High or low temperature can both be red flags for sepsis and people often have a false sense of reassurance that someone doesn't have a fever.

I am not A medic but it sounds like sepsis to me and when you get to a and e tonight please say sepsis and show them the message froM the dr on this thread.

Go back and ask “could this be sepsis?”

A&E please - don’t delay

Take her back to A&E tonight - remember Martha’s Rule to ask for a second opinion if you feel you need one. You can do this, advocate for your girl, she sounds really unwell. Let us know how you get on, I’ll be thinking about you.

Absolutely. Low temperature can be a more worrying sign than fever.

Oh no! Like others say, please get a second opinion at A&E under Martha's rule

You're such a great mum! Definitely right to go back - one of the main things to look out for in paediatrics is the parents having a gut feeling that something is off, so don't ignore that.

Not to scare you but important to always keep in mind the sepsis symptoms. It's really positive that her bloods were fine yesterday, but things can change quickly so tbh I would go back and get checked again. The reason I say this is that you mentioned decreased urine output, recent infection and being really cold - have you taken her temp? These are all possible signs, hopefully it's not sepsis and don't want to worry you but would always err on the side of caution.

Does she have a rash? When you say mottled skin, is it mottled or a rash? Does it go when you put a glass on it/apply pressure?

So sorry you're both going through this worrying time, sending hugs and hope she improves, please update us if you can x

Go back OP.

It is better to get sent home again for "nothing" than to miss a problem.

If your gut is that something is wrong, LISTEN.

None of us think you are being silly going back.

Oh gosh thank you so much we have woken her up and will take her back, sadly we dont have a choice of hospitals the next one is 2 hours away. I did forget to mention, which worried me so much yesterday, that she had a headache with pain down her neck. The hospital again told us if she was sleeping so muhc it was just a tension headache but I did question the doctor on this but they said she was fine

Please make sure you use the word sepsis with every person you speak to, and if they say it's not, ask them to explain to you why they're discounting it.

Agree. Say you're worried about sepsis. It tends to concentrate minds. Good luck.

I’m very glad you’re going back, OP. Sorry if you’re in for an unpleasant night!

Great to hear you're going back @BarrysT ! Completely agree with previous posters about Martha's Rule - if you aren't satisfied with the advice from the Dr's you see and are still worried please use this. An independent team would need to come and review her. There should be contact information for this displayed in the hospital or you can ask for it - I believe it's been rolled out across the NHS now so they are required to provide it.

Excellent advice 👏🏼

Ex nurse here. You are doing the right thing by bringing her back to A n E. Hopefully you won’t be waiting too long.

Just a thought if its a two hour drive. Could you ring 111 on the way and tell them that you are on your way to A and E and these are the symptoms and what people have said on here. Ask them to pass this on to A and E.. and then they will be hearing it from you and from 111. Best of luck for your DD x

Hope she ok

I think @BarrysT is saying that the hospital that is next nearest after their normal hospital is 2 hours away.

@BarrysT I'm not stalking you, but a few days ago you posted about your younger child of the opposite sex with the UTI - I'm only saying because UTIs in boys tend to be more significant than UTIs in girls, so if this is in fact your DS, you'll need to emphasise that he was treated for a UTI recently and has finished antibiotics. You still need to tell them if it is your DD, but it might be more significant to highlight if it's your DS, because UTIs in boys are more likely to become severe.