Please help! DD missing GCSEs due to nausea - Stemetil not working - what else can we do?

[Fretfulagain]

Did post earlier but didn't put GCSEs in the title and the fact she is missing her exams is what makes this urgent. we are at wits end.
started Monday pm, quite suddenly.
nausea - tiredness - lightheaded - some stomach pain but doesn't seem severe
Period arrived Tuesday - it is irregular
GP prescribed Stemetil (2nd appointment of week) but not doing much and she's flat, feeling sick and exhausted this morning.
Missed a week of GCSEs.

we are trying to get liquid into her but even that is an effort and she is taking tiny sips. yesterday she had some ritz crackers, a few bites of ham sandwich (after Stemetil seemed to be working) and half an avocado all day. Nothing so far today.

My worry is that there is no sign of improvement and looking at previous threads there are a lot of examples of unexplained nausea in teens lasting weeks or even months.

what else can/should/shouldn't we do?

Thanks for the understanding - it clearly is horrible for her.
I will look at other OTC anti nausea options, thanks for tips.
she did do a urine test when she saw GP first time so dropped off Tuesday but results not there when we had appointment yesterday and I’d expect GP to ring if they got results back with anything worth looking at.
a covid test is the one thing we haven’t done but will do one so we can rule it out - none of typical symptoms.

It sounds like exam nerves I used to get this and actually was physically sick before my final professional exams, I never ate before any of them. I'd send her in I'm much calmer by the end of the exam.

OP - current Covid symptoms (they have been rather hidden from view) are typically gastric. Please test!

She has done a covid test - negative

but she has just eaten a boiled egg with a bit of toast.

I don’t want to count any chickens but hope is stirring. Wish us luck!

Eating is a good sign. Fingers crossed.

Dear OP,
I am concerned that the focus on anxiety related to GCSEs is a red herring. You say that she managed to sit two weeks of her exams, presumably without any significant issues related to stress or anxiety? If she wasn’t sitting her GCSEs now and she had these symptoms would you even be considering that all this might be anxiety related?
If it is at all possible to get private face to face review by a GP, I think that would be really helpful. A private GP will have more time to undertake a more thorough examination/assessment which is just as, if not more, important than any subsequent blood tests.
If that is not a possibility then I would take her today to your nearest walk in centre for an assessment. I give this advice both as someone whose DD is also sitting her GCSEs right now and as a healthcare professional.

Chewing on harsh fresh ginger helps me with nausea.

Sounds like she's really anxious, nausea meds won't help that.

My DD was given Diazepam for very frayed nerves/severe exam anxiety that meant she couldn't perform as she is capable, we trialed it during her 2nd mocks & thankfully it worked well without affecting her memory/thinking too much. After failing most of her mocks. She passed everything with flying colours, bar the one exam she forgot to take it for

Sorry but what on earth do you mean by "it would irritate my GP...". Why on earth would that irritate your GP. And if it does you need a new GP, that would be very unprofessional. Don't not seek medical advice in the way you feel is appropriate, because it might irritate another doctor. That's ridiculous.

Hiya,

Is there anyway she could be dehydrated? Dehydration can lead to nausea and vomiting even more so than the original cause, especially if she's not keeping down water. I would try to get a urine sample and see if any markers are raised. In the meantime I would try a different antisickness too, they don't all work the same for each person. You can even be on a concoction of them. Only know this as I dealt severely with hyperemesis, but obviously try get to the bottom of the problem, though not sure how to advise you there 🥺

Good luck OP x

It really just sounds like she's got a bug of some sort, and if she's eating a bit more, it's starting to pass.

See how she goes, I personally wouldn't rush to do anything else & try myriad cures. And the private appointment / bloods is pointless at this time

It's very tough but hopefully she will feel better for the rest.

You can deal with the consequences afterwards, there are always solutions.

Best of luck to her. 💐

Thanks - you make a good point about the anxiety and it is true that she had no issues doing language oral, which was earlier than the others and her weakest subject, or subsequent two weeks of back-to-back exams.
I agree a proper consultation with time to talk to her and go through everything would be very helpful - and also what we are missing. We've had a urine test and a prescription to treat the symptoms so far - not much talk of investigating cause although I also acknowledge that if it wasn't for exams there would not be so much pressure on getting her upright and into school pdq. So exams are skewing everything.

Could this have been a hormonal triggered stomach/abdominal migraine? Stress also a possible trigger?

@Fretfulagain - sorry to bump an old post but did you get to the bottom of your daughter's nausea? I really hope she's OK now and managed to sit the rest of her exams.

My DS is in his GCSE year and is currently off for the fourth day with severe nausea. Our GP saw him yesterday and suspects migraine, but wants to do a load of blood tests to rule out anaemia, vitamin deficiencies etc. before she'll treat him and there's a four-week wait for the phlebotomist. He has buccastem (after I rang and begged for it this morning) but he's taken the first dose this afternoon and says it's made him feel worse. The school attendance officer is nagging me to send him in but he clearly feels dreadful. He says he's not stressed about the exams and we have a while yet, but we need to get him sorted.

Hello - sorry to hear about your son. DD did manage to sit a few more exams and in the end did enough to be graded on all subjects and passed them all. But the nausea turned out to be anxiety related and was the start of a long journey. We aren't at the end yet, and she's not really had any treatment but she's better than she was and has been assessed for neurodiversity (she is ND but not autistic) and is on meds for anxiety (which have helped). It has been very tough.
If your DS's symptoms are anxiety related (and I'm not suggesting they are, of course) then it can be important to understand if there is any neurodiversity there as the treatment for anxiety differs depending on whether you are ND or NT. I wish you all the best and hope you get some answers. Please DM me if I can be of any more help.
Good luck.

Thank you so much. I'm glad your DD got through her GCSEs but sorry you're still on an anxiety journey. I do wonder whether this is partly anxiety with DS, but today he's a bit bunged up and looking more as if it's a bug (I started a thread and a few people seem to think it's Covid, although LFTs when it started were negative). He's not ND and isn't generally an anxious kid, but some level of anxiety is inevitable in the run-up to GCSEs. I just want him back to his normal bouncy self :(

@Fretfulagain Hi, I hope you don't mind me asking this. But when you say your dd was assessed as neurodiverse but not autistic, was this following an ados assessment? We're waiting on the results of my ds ados, in the hope that he will be diagnosed autistic. But I'm wondering now whether he may get a diagnosis similar to your dd. He struggles with intrusive thoughts, making friends and cannot do small talk. Along with his obsessive interests, he is 16 btw, we believe he ticks quite a few boxes for autism but you never know do you? If you feel comfortable to explain a bit more, I'd appreciate the info. Thank you.

Yes, she had an assessment and scores highly in two out of the three categories but does not tick the 'special interest' box (in a nutshell). The reason it is important to know if the anxiety is related to ND is that it's being ND in an NT world which is causing the anxiety so that needs to be recognised and addressed via environmental changes and/or things like working on interoception (that is, recognising and understanding your feelings, DD scores low on this which means she doesn't know she is getting stressed/anxious/hot/thirsty so her body throws everything at it and she is suddenly - from her pov - hit by a wall of nausea). NB no-one is talking about 'treating' the ND, which is just how they are wired, but rather addressing the issues that can cause around anxiety etc. Does that make sense?

Having said that, there is a bit of a gap when it comes to treatment and you have to present with pretty severe issues to get it addressed. We are still waiting for actual treatment after many many assessments, false starts and cancellations.
I hope that helps. Good luck to you and your DS. Please also understand I am not an expert and can only talk about our experience - and we are all different!

In a supportive way, I hope it is a bug! I wouldn't wish what we went through on anyone. If he is open to talking about what makes him anxious it might be worth doing a few exercises with him about handling it before the stress really kicks in. Anxiety is a fact of life so if you can help him handle it, it's a great life-skill. Good luck!

Thanks - I hope it's a bug too. He's perked up a bit this afternoon, although he's been brighter in the afternoons most days so I'm trying not to get too optimistic! I'll have a chat with him about anxiety and exercises tomorrow (when the teachers are on strike, handily, so there's no pressure to get him in). I'm a walking anxiety disorder myself so I have a few tricks I can pass on, although I'm fully expecting an eye-roll and 'I'm not anxious, mum...' He's seen his best mate hospitalised with anxiety due to undiagnosed autism in Y7, so he knows it's something to be taken seriously. He's generally very laid-back - on the surface, at least - but there's bound to be exam stress at some level. I've messaged his form tutor as well to ask him to keep an eye on things once he's back in.

@Fretfulagain sorry to jump in here, but my ND child has been feeling nauseous for nearly 3 months to the point they can't leave the house. I suspect anxiety but the GPs aren't offering any help and are steadfastly refusing to medicate in any way. Can I ask how you got anti-anxiety meds? Through the GP or CAMHS?

Sounds like you are on top of it. If you think he’d open up to a counsellor (ie not his mum!) it might help if you’ve got the funds (GCSEs will be over if you wait for Camhs) but you are the best judge.

We got it through a team at hospital which took an interest via another health condition DD has. They did the assessment and suggested meds as her mood was too low to engage with therapy by that point (this was in late October and she’d had no help since June/July). The Camhs waiting list is months long and in my experience they only muster some interest when the child needs a crisis team (because they’ve been abandoned and start to lose hope). Not criticising those who work there, I know they are overwhelmed but the system is failing our children. Having said that, a child who doesn’t leave the house is in crisis and in need of help so get on the waiting list and go to the GP and do all you can. Hunt out the treatment protocol of your health authority and quote it. Sometimes you need to be the advocate and it’s not always comfortable and it’s a tight rope and it’s time consuming and draining and no-one will thank you but it’s all you can do. And/or go private if that’s an option.

This is just my experience - it’s hard hard hard. The individuals are good and nice but the system is brutal and broken. I dread to think where we’d be without Prozac as it’s the only help we’ve actually been given thus far.

@Fretfulagain thank you. I think I need to
find some time (when?) to come up with a proper plan. The trouble is when there’s a crisis, you have no headspace to think long term.

Yes, that is so true. Sometimes the best you can do - and probably the best thing to do - is take it day by day. Our GP never really engaged. Is your child willing/able to talk to you about how they are feeling (if they know and can verbalise it)? Would the school offer any pathway?
if all else fails there’s always therapy with a private practitioner. It’s not ideal as they aren’t linked into GP etc but better than nothing. Do you know anyone who has a therapist for their child? You can often get a recommendation via someone else’s therapist.
good luck. It’s the toughest parenting we’ve ever done and doubly hard when the health service abandons you, I know.