Dd still ill, over six months and no diagnosis.

[PikachuSayBoo]

I'm at the end of my tether with it all. She's sitting her GCSEs this year and is crying in pain most days.

Until last Feb/March she was generally fit and well (apart from a case of shingles a year previously)

She started complaining of acute episodes of chest pain and breathlessness. Would be doubled over and crying. Generally worse in the evenings/night and worse when lying down.

I took her to out of hours one evening and they couldn't find anything wrong with her and said it could be stress. They recommended a blood test but dd refused.

These attacks continued and I was dubious about the stress diagnosis. She would go to bed quite happy and then an hour later come down crying. One night in a hotel she spent all night propped up in a sitting position as she couldn't lie down.

She finally agreed to a blood test mid/end July and her Vit d was a bit low (52) and although her Hb was ok her ferritin was low at 7. So she was put on vit d tablets, iron tablets, contraceptive pill to regulate her periods and mefanmic acid for pain relief.

So she's been taking these tablets for two months. She's to go back for a repeat blood test next month.

But she's no better. I would say she's worse. She says she's been crying at school all day as she's in so much pain. Still mainly chest pain and breathlessness but also stomach pains at times. She says she gets hot flushes, bad headaches and feels weak/dizzy/faint at times. Surely the tablets should have sorted out the anaemia/Vit d issue by now?

Ive also tried her on gavviscon as I read that lying down can make heartburn worse but that doesn't seem to have helped.

I'm worried this is really going to affect her exams. Not sure whether to wait another month for her blood test or go back to the Dr now. Won't they just say we need to give the medicstion longer to see if it works?

It's 111.

I had suspected gallstones which turned out to be an infection called gastritis. It's an inflammation of stomach lining and can be caused by acid production being too high which can originally be caused by stress.

I took omeprezole and that solved it.

OP does she ever complain of itchy hands or feet?

Never complained of itchy hands or feet.

We went to out of hours once when she was bad one evening and the nurse asked her if she was worried about school or anything and dd started crying so the nurse put it down to stress. All her obs were ok.

Have you considered lactose intolerance, DDs started with severe heartburn especially after eating cheese.

Hadn't thought about lactose intolerance. She does eat a lot of cheese.

I will make a list of possible diagnosis for the GP, who is going to love me isn't he!

Op you need to go back to your GP or out of hours GP. It isn't normal and you need an answer. Even if she is stressed I would be worried about the pain.

My first thought was anxiety as mine can just come and go BUT my DGM has a hiatus hernia (I think that's how it's spelt) and that causes quick bouts of pain in chest and also black outs especially after drinking or eating. It also lends it's self to severe indigestion. My DGM had her gall bladder taken out a short while ago so maybe they are all connected.

Also the MA tablets she is having for period pain are actually just for blood flow they offer no pain relief. I know this from experience and another doctor telling me.

I would start digging in now and asking for second opinions or going to differnt hospital. My friend has just has to do this and her dd was actually quite bad when her GP and health visitor had accused her of being a neurotic new mother,

Tranxamic acid is for blood flow but mefanmic acid is a NSAID so very similar to ibuprofen.

Yes, GP should have properly investigated!

It sounds like they found the 'easy' answer - stress - but normally this diagnosis is reached by ruling everything else out.

Even if it's 'just stress' Hyperventilation Syndrome is painful (gasses in the body all wrong) and can be solved.

I had HVS and read a book by Dinah Bradley, Breathing Pattern Disorders and how to overcome them - a brilliant book, those exercises helped immediately and I finally knew what was going on. It was diagnosed by a consultant tbough, after ruling out heart problems.
The pain was quite instant, it takes only a few minutes of disordered breathing to get the body into a state. I thought I was having a heart attack. Scary.
Good luck with the GP.

Helicobacter Pylori?

Has she had an ECG? I wonder if you could ask the GP whether he can arrange tests to rule out pericarditis or viral myocarditis? I'm sure she will probably have had an ECG at some point if she has presented with those symptoms but I wasn't clear from your post (sorry if I've missed it). Chest pain and breathlessness can of course be down to anxiety but the tests to rule out underlying cardiac causes are best done at the time she is actually having the symptoms and the pain.

Mefanmic acid or any nsaid should never be prescribed without a stomach protector. They can cause severe stomach issues!

I hope you get to the bottom of it for her.You are absolutely right to push

Six months of suffering and they have done so little? Shocking.

7 is really low for ferritin. Did she have very heavy periods? Did she eat meat?

She needs some scans and more tests. Ask them why they are not running them.

No, she's never had an ecg.

She has to take some responsibility for where she is as she refused a blood test for months. If she'd had the blood test straight away she would have been in the Vit d and iron tablets sooner and if they hadn't worked I guess we'd be further down the line with tests.

So I'm going to ask about ultrasound for gallstones, ecg, chest x ray, omeprazole, stomach protector for the nsaid (she has only been taking it when she has her period and with food). Coeliac.

Just hope gP doesn't thnk ive got munchausens by proxy!

She had heavy periods and an irregular but frequent cycle before going on the pill. She's not much of a red meat eater at all but she has been on a multi vitamin with iron for a year as I was worried about her lack of meat and fruit.

Only tests she's had are blood tests, listening in to her heart with a stethoscope and lots of abdomen prodding.

That ferritin level is extremely low for a woman. Ferritin is supposed to be 50 minimum with it ideally being around 70/80. I would get a full thyroid panel done as low ferritin can be a symptom of underactive thyroid.

OP mefenamic acid can cause severe stomach pain and acid reflux (as can taking ibuprofen regularly, or indeed any NSAID). I would suggest she stop taking the mefenamic acid and you could try acid inhibitors for acid reflux - you can buy short courses of ranitidine over the counter iirc.

Ok, will stop the mefanmic acid and get some ranitidine.

Is the refusal of blood tests because she is afraid of needles?

I would second the recommendation to get cardiac causes ruled out. It's probably nothing at all like this but best to know that.

Alternatively does PoTS ring any bells? see here is worth investigating?

Afraid of needles.

The POTS symptoms would fit as well. Will take her pulse next times she's having an episode.

Wheat set off my indigestion every time I had it while a teen and also when pregnant. No idea why. Bloody painful so had to avoid wheat

I had awful gastric/chest pain before being diagnosed with coeliac disease. Would come and go but s pizza would certainly do it.