Bloating/ascites/fat stomach. (?)

[ThisIsSimplyBeyond]

Hi

I have a problem with my belly atm. I am concerned it is ascites, yet I feel I am having my concerns minimised because I am also fat. To be clear though, bigger or smaller; my fat has always been on my arse (except for the apron left from post DC), whereas this is all on my abdomen.

So, I am also hardly eating because it makes me feel sick. I basically feel like I'm seven or eight months pregnant, it feels heavy, puts pressure on my bladder, and I can't lay on my front cause it's like lying on a ball. It is so uncomfortable, and it sometimes makes me need to catch my breath. My thyroid has been checked and is fine. Results are the top end of fine, but fine.

I spoke to the dr at the end of March about it and was sent for the bloods for my thyroid. They also checked if I am in menopause as my periods have pretty much stopped (some spotting, that's all). I have now had a second lot of bloods today to (apparently, I didn't see what they are testing) check for PCOS. By the time I actually see a doctor (i have an appt for the end of next week), it will be nearly a month since I first spoke to her. In this time, no one has examined me.

Am I right to be concerned? I feel that because my BMI is high they aren't taking me seriously when I say this "swelling" (or whatever it is) is new. They're just thinking I'm fat. Then with the eating, I know how common it is to assume the fat person is lying when they say they don't eat 🙄
I am worried that my weight is staying pretty stable, despite me not eating enough because of the increased swelling. Even allowing for meds affecting my metabolism, I eat less than one meal a day, and my BMR alone is near 2000 (I'm tall). It is this problem with non-weight-loss that makes me think it is not just bloating (as obviously air wouldn't weigh anything)

So I know it's covid-times and everything takes longer, but IABU to think it should be taken more seriously?

Has your face shape changed and become more ‘moon’ shaped? Could it be Cushing’s Disease? Often missed by GPS. My mum had it and putting on abdominal weight specifically is a key symptom.

Not as far as I can see Fay, but I have a friend with Cushing' so it is on my radar as a possibility

I would put all this in an email as a sort of recap/ have I understood the plan follow up to the appointment.
That way you have a copy/ audit trail of what you have told the gp.
Some GPs have been really poor over the last year.
A friend's child ended up having emergency, life saving surgery after weeks of trying to get an appointment and a telephone consult.
She wrote it all down, sent an email and was seen in hospital the following day.
I agree with pp. You need the scan asap.

I know end - I know more people who have died of what should be considered medical negligence in the last year, than I do who have died of covid. :(

Going to write an epic email today, including that I want a second opinion, all the things from my last appt that irked me, nice guidelines re OC screening, a list of my symptoms, umm a thing else...?

*anything

Otoh, plan b is that if it causes pain in my chest again, I'm gonna run with that and go to A&E.

This is the jist of the email, if anyone has any ideas of amendments before I send:

Firstly, the appointment was rushed due to others running behind, and we felt that dr X was not adequately attentive to the problems due to this rush. We felt the doctor was so focussed on solving the issue with beyond's menstrual cycle, that she failed to recognise how much trouble beyon is having from the swelling in her abdomen. While we are aware and understanding that delays happen due to circumstances beyond anyone's control, this should not affect the quality of care given by the HCP.

Following beyond's appointment, we were speaking to a friend who is a medical professional about the trouble she has been having. They failed to understand why dr X had not listened to beyond's chest when she explained the swelling is affecting her breathing, nor why dr X did not percuss beyond's abdomen to check for ascites during her physical exam (and when asked if she knew whether the distension was caused by fluid said she "didn't have x ray eyes"). They were also concerned that beyond was unaware of any potential - however small - that her symptoms could be a sign of ovarian cancer. In fact, as per The NICE pathway for detection of OC [ quote - "Carry out tests in primary care if a woman (especially if 50 or over) reports having any of the following symptoms on a persistent or frequent basis – particularly more than 12 times per month: persistent abdominal distension (women often refer to this as 'bloating'); feeling full (early satiety) and/or loss of appetite; pelvic or abdominal pain; increased urinary urgency and/or frequency"], beyond meets plenty of the criteria that would necessitate a ca125 test, purely to rule out a possibility of ovarian cancer, while also awaiting the referral of an ultrasound.

I think the urgent 2 week ref is based on a lump being felt, or a lump or fluid confirmed by scan.
I think you should be having an urgent scan and ca125 blood test. I think given your symptoms they should be the initial tests being offered.

I don't normally say this, as A and E are swamped but if you do not get anywhere with your GP I'd go to A and E. My mums GP over looked her condition. At diagnosis she was given weeks to live, she survived for over 7yrs. Had her GP sent her for a scan sooner she might still be here.

I'm sorry about your mum just I am a big avoider of A&E at all times - never mind covid times - so it's really a measure of how seriously I am taking this that I am considering it!

Sorry this is happening. I would add in that you felt your inability to eat was not believed as you were advised to lose weight. And that this is another potential symptom of ovarian cancer. Hope you get it sorted

Thanks super, yeah I'll add that in now :)

Is your surgery a one GP surgery?

I am a member of a surgery with 8 GPs. Some are more understanding than others. I know they must deal with time wasters etc but you need to be checked out.

Mums consultant said they hear the same story time and time again, ovarian cancer symptoms are put down to IBS or other hormone issues when all it takes is a 10 min scan.

It's quite a large surgery, multiple premises type. So seeing someone a bit more helpful should (in theory...) be fairly simple. Depending who is working from home cause covid.

I am mid fifties and was diagnosed with OC in December last year. My first symptom was indigestion and ascites and I have had 10 litres drained off in one go. As others have said, it really is simple to detect the difference between gas and air and I am horrified that your GP was so dismissive, especially with her unnecessary comment about X ray eyes, how rude and disrespectful. You need to lie down and place your hand at right angles over your tummy button, then get your wife to press quite firmly on one side - if it is ascites, the ripple effect will be seen on the other side. I could actually feel my fluid sloshing about I had so much. Do you feel it's getting worse? Mine increased quite rapidly and I became breathless with pains in my back. I really don't want to frighten you as I have been in your shoes but if it were me I would go to A&E and get examined properly. When I first started reading about OC when it became a likelihood for me, I read that many ladies are diagnosed in A&E and I can really see why.

I'm happy to answer any questions you may have.

Hi @FizzyOrange, I've seen you while I've been lurking on the support thread this morning
I can't see ripples, but DW said it's definitely slooshing from listening. And yes I have pains in my back, sort of above my kidneys-ish. Which already concerned me as it's close to where my ex had pain when diagnosed with pleural effusion. I've been measuring and afaik it's increased by an inch in the last week. So I'm keeping on top of measuring now too.
If I'm worse over the weekend while I wait for the GP to get back to me, don't worry I will go to A&E

@ThisIsSimplyBeyond my chest pain was in my back, below my bra strap. Bear in mind that some of the pain could be where your muscles are sore from supporting the extra weight on your front. As soon as mine was drained, this pain went away for me. I think you're sensible to go to A&E if you get worse, at least there you will see a doctor who will examine you properly.

In the nicest possible way, I really hope you won't be joining us on the support thread. Give me a shout if you're worried about anything .

Insist on an appointment OP , hope it's ok.

I mean hospital referral under 2 week wait.

Actually, having a picture in front of me, it's no-where near my kidneys! I have issues with proprioception
I know what you mean, fingers crossed I won't be joining you all

JSL, I'm just waiting to hear back from the doctors now, they have received my email.

Oops

@ThisIsSimplyBeyond how have you been feeling today? 💐

Still huge 😕 threw my dinner up last night - and I’d only eaten half of it - but at least my food has stayed in today. Was up at six cause I was so uncomfortable, so then had to have a nap mid-afternoon as I was exhausted.

I’m not in more pain, so no a&e for me yet - I will go if I feel I need to though. DW will make me! 😂

Started my provera that the gp prescribed today, will be interesting if that makes my swelling worse...

Doing my “way of dealing with the fact I may actually be quite ill” routine of making sure my hair is washed and my legs shaved. It’s ridiculous, I know, but makes me feel like I’m doing something. And I seriously don’t cope with being under-prepared, so win-win

@ThisIsSimplyBeyond I've been thinking of you today and wondering how you are feeling. Sorry to hear you are so uncomfortable.

Go to A&E and bypass all this waiting. I don't want to scare you but my wife had fatigue, nausea, vomitting, a lot of pain in her side and a very bloated belly, Dr Google suggested grumbling appendix. Couldn't get GP appt, only one with a nurse, so we went A&E and at the end of that visit she had been examined, had blood tests, a CT scan and a diagnosis of ovarian cancer. A&E asap OP.