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Life-limiting illness

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16 months old - Fear of lung cancer.

148 replies

mimmlw · 22/02/2021 18:49

My son was born October 2019. No problems at birth, born at 37 weeks gestation at 7lb 13 so a good strong healthy weight - if he'd gone to full term he could have been 10lb.

He was breastfed almost exclusively until August 2020 when I began to wean him off - I wanted to give his immune system the best chance.

In September 2020 he developed a severe infection that was suspected as some kind of blood infection. Some strong antibiotics and in a couple of weeks he seemed completely fine. Then between September and November he had a number of smaller infections, rashes, high temps etc but nothing requiring admission.

Then in November 2020 he became very ill, and this was the beginning of my 'bad feeling'. He was admitted for a week on IV antibiotics and his temperature was near impossible to bring below 40 celsius. No particular chest type symptoms although they did a Chest X-Ray as he was having mucusy nosebleeds which showed evidence of 'chest infection'. One doctor in A&E could hear a noise on his lower right lung, although no other doctor seemed to be able to find it. They did viral swabs and found evidence of Adenovirus and Rhinovirus - althought they said to us that they have no idea why he was so poorly from just this. I queried whether he is possibly immunocompromised, but it was shrugged off and told to 'see how he gets on'. He recovered from this illness completely and we had almost a week where he was the picture of health - as far as we were concerned considering his state since September.

At the end of November 2020 he started with a cough and I could hear his breathing be quite wheezy. No temperature. Took him back to the GP who diagnosed chest infection as she could hear a noise on his lower right lung (same place as A&E doctor - but seemingly more significant). A course of antibiotics but no improvement. Continued to take him back to the GP, but they just kept fobbing me off with 'well kids get ill, and he has no temperature and is generally well so be grateful' in a nutshell.

We then get a call from the Pediatric Consultant from the hospital at the very beginning of January 2021 as a follow up to his November admission. I say he isn't well and quite frankly I'd like something done about it as I've been ignored since it started in November. While he is generally 'well' in that he plays and laughs, compared to other children his age, he is simply not the same. He doesn't eat anywhere near enough, he can be incredibly lethargic and has a lot of 'off' days where he seems to be in pain we can't locate and he just wants to lay on the sofa, as well as his communicative development being slow. He was put on a 2 week course of Co-Amoxiclav (strong antibiotics), weighed and measured (he has gained since last measurements, although has dropped a full centile and needs monitoring), ordered an X-Ray and given a follow up consultation. The X-Ray shows shadows on his right lung - which was said to be a 'bacterial infection' despite antibiotics making no difference whatsoever. No improvement so he was referred to a specialist children's hospital but was told it may be 4-6 weeks until he was seen. I raised a concern that I had started to see blood on his cot sheets when I woke him up in a morning - but was told it was most likely nosebleeds so 'not to worry'.

I started noticing watery blood on his sheets and comforter more often, but there was no blood on him and it was just a couple of spots. Then last week he had a large coughing fit and coughed a large amount of bloody mucus. He has since coughed blood every day since, and regularly cries out in pain. I took him to A&E at the specialist children's hospital who were shocked he has been left this long. They said they don't believe it is an infection at all but 'wouldn't like to make guesses at this point' and was given an urgent referral to outpatients that they said should have given us an appointment within 48 hours. I phoned up as I hadn't heard anything and they forgot to make the referral. We now have a video appointment for the 1st March, which I said wasn't good enough, although they have nothing sooner.

I'm honestly terrified. I think any parent's logical conclusion would be to assume cancer when there are undiagnosed shadows on their lung, a noise and coughing blood. Although I still feel stupid for even considering this is an option and I hate jumping to conclusions - I just can't seem to find any viable alternatives and I feel so let down by his healthcare providers.

Is it normal that the appointments when it is suspected aren't extremely quick? Is there anything I can do to get him seen sooner? Am I being completely paranoid? How did you cope waiting for assessments and tests? Every hour feels like a year and the not knowing is unbearable.

OP posts:
needadvice54321 · 14/03/2021 20:42

Good luck to you all tomorrow x

Borderterrierpuppy · 14/03/2021 22:13

Good luck tomorrow hope that you manage to get some answers.

Maidofdishonour · 14/03/2021 22:20

Good luck for this week. Take a notebook with you and keep notes of what tests he has, results etc. It helps, especially when tests are varied and you can end up talking to several different doctors, consultants etc.

Wondermule · 14/03/2021 22:47

Good luck OP, you’re both in my thoughts x

itsgettingwierd · 15/03/2021 17:15

Hope everything is going well today Thanks

Stressedmummyof4 · 18/03/2021 22:32

Hi op,

Hope everything's been going ok this week

X

kate288 · 18/03/2021 22:46

I hope they get to the bottom of it soon op. You must be so worried. Welldone for persisting and advocating for your child

mimmlw · 20/03/2021 10:55

UPDATE

Sadly we don't have any more concrete answers, however some more serious infections such as TB have been ruled out which is a good thing! They weren't able to get down very far with the bronchoscopy (I think he said branch 2 or 3) but in general the lungs don't look majorly unhealthy, there's no obvious signs of bleeding and no excess mucus or fluids.

He had a really bad turn after the procedure (Tuesday) and ended up with a temp of 40.5, heart rate peaking at 235BPM and oxygen struggling to get above 92%, unresponsive and paracetamol didn't help at all. He was in a critical condition for a long time, and was having constant rigors which they said were warning signs he was going to start with seizures if we couldn't get him under control. Luckily after a few hours, his temp started coming down into the 39s and his heart rate started to come below 200. They ended up doing a lumbar puncture and more blood work all of which were clear apart from a very small increase in infection markers. They also did another x-ray which showed an increase in 'fluffiness' as they called it - which could have been caused by the saline used in the procedure (in which case I said well why did you bother putting him through the x-ray if abnormalities were going to be explained anyway 🙄). They said they don't really understand why that happened, as post-op temperatures can happen but not to that extent, and he didn't even have proper surgery. It's possible that they stirred up the organisms in his lungs which caused his body to react - but even so the severity of the reaction was extreme, and they have never once seen anything like it. They kept him in until Friday to continue observations and get a few more teams to see him and he's doing much better now, despite his usual symptoms. In a way it was a good thing that he had this episode in hospital, because they have seen how he can get at home. He's never usually this poorly, and it was a good thing we were where we were so the oxygen was administered as fast as it was. It all started happening in his sleep too, so if we were at home we could have completely missed it as he was barely conscious and not making noise, and it all happened so quickly - his numbers were done 10 minutes before and he was fine, it was only picked up on as I just looked at him and his breathing seemed 'off' and I had a feeling. It doesn't bare thinking about.

The only findings they have are some adenovirus and bacterial influenza samples from his lungs, although he had adenovirus in November so it could just be left over DNA rather than an active infection. It's both unlikely that he would catch it twice, as well as having symptoms in between, as well as unlikely that a child with a functioning immune system would still have the infection months later. He also has some raised inflammation markers in his blood, but not the ones they'd expect to see accompanying an infection - so it could be inflammation they're seeing on the x-rays rather than infection that they're assuming.

They also found something called a Type 1 Laryngeal Cleft, which is an extremely mild birth defect above the voice box. It can cause recurrent chest infections, as well as coughing and choking after eating/drinking as it can prevent the valve separating the food pipes and wind pipes from working effectively. Though they said if that was an issue, he would have had a lot more problems with choking on milk as a newborn etc, so basically it isn't a problem and they don't need to do anything about it - most people don't even know they have it.

He's got to have some immunology tests done in a few weeks after he's had a vaccination to see how him immune response is, 4 weeks of strong antibiotics just incase this flu bacteria is causing any problems and then repeating the chest x-ray. If the x-rays still show shadowing he'll have a CT but they can't do that until his lungs have had chance to recover from the bronc anyway.

Any time he has a temperature we have to take him to A&E to be tested for infection. If he has temps without infection then he'll have to be referred for a bone marrow biopsy with a higher specialist - which could mean being transferred to GOSH or similar very specialist hospitals. They also want to test for CF but the labs currently don't have capacity due to coronavirus testing and his newborn screening was negative which picks up 98% of cases.

The doctor also said that if he was a betting man, he would say this isn't likely to be lung cancer or bronchiectasis as his lungs don't look angry enough, which is really reassuring. He's said to just try and take things one day at a time, and the CT would give us a solid answer if he doesn't improve from the antibiotics (although he's had 2 two week courses of this antibiotic since November so honestly I'm not holding my breath), but that this shouldn't be my main concern.

It's been a long long week but very glad to be home and have some kind of plan in place x

OP posts:
notapizzaeater · 20/03/2021 11:51

Thank god you where in hospital when it happened.

Fingers crossed they
start getting some answers x

HarrietLong · 20/03/2021 12:38

Thank you for the update OP. I’m glad to hear that nothing sinister has been found, and that you are being taken seriously. Still a worrying time for you of course.

needadvice54321 · 20/03/2021 12:41

Goodness what a week you've had Sad

sconenotscon · 20/03/2021 15:16

Sending hugs your way and hope you get some answers soon

Wondermule · 20/03/2021 15:23

How stressful OP, but it sounds like they’re being very thorough and it’s good news the main worries have pretty much been ruled out. The human body can be odd, sometimes you can never quite get to the bottom of things then it clears up, which is frustrating but at least not serious. Hoping you get answers soon as I bet you’re mentally exhausted! Flowers

CheekyCrow · 21/03/2021 16:03

I hope everything turns out well for you OP. Has anyone investigated PCD, primary ciliary dyskinesia? My daughter had a very similar experience although she was much older when it started, 15. Constant respiratory tract infections, weird immune markers (including evidence of a fungus that causes farmers lung), the mild laryngeal cleft, wheezing, tightness in chest. The Royal Brompton investigated PCD and she showed some changes in her cilia but not entirely consistent with PCD. The best thing for her has been daily nebuliser during the winter months (hers only came on between October to March) and fortunately she has been well for a year now. But it started every October with a very distinctive wet sounding cough. I realise the nebuliser treatment might be virtually impossible with a 16 month old but worth an ask. I suspect in our case DD might have a very mild case of PCD (it's controlled by many genes, she might just have minor changes to the cilia where their beat pattern is slightly disorganised). I hope you get answers soon. I remember the trauma of it clearly so my thoughts are with you. Thanks

mimmlw · 21/03/2021 19:28

@cheekycrow nobody has investigated it specifically that I'm aware of, however from a quick google it seems unlikely as PCD involves a large build up of mucus and his bronchoscopy showed that that isn't a big problem for him as far as they can tell. I'll jot it down in my notes though to check with his consultant! Thank you. I'm glad that your daughter has managed to get her symptoms under control!

OP posts:
CatToddlerUprising · 15/04/2021 07:28

My DD has laryngomalacia, dysphagia and one of her lungs doesn’t inflate properly. The journey you’ve had so far is pretty identical to us. To diagnose she had 2 x bronchoscopies, CT scan and a whole range of bloods.

mimmlw · 19/04/2021 21:44

UPDATE -

So he's been on co-amoxiclav for 4 weeks and his chest x-ray today has shown no improvement at all. Respiratory team have said they're out of their depth now and so have passed his primary care over to the Infectious Diseases and Immunology team. They've ordered a sweat test to rule out although they doubt it is CF. They're pushing the ID&I team to see him as soon as possible. He had his 1 year vaccinations 2 weeks ago and he got really poorly from those with temps in the 40s for a good few days and not controlled with paracetamol/ibuprofen, so I think I'm in agreement that there is something more going on than just a lung issue. He's also got a nasty rash at the moment and a fluctuating temperature and they've done a blood test for chicken pox (but said it doesn't quite look like chicken pox and he isn't scratching it) - although I have no idea how this could have been caught as we've been shielding and he's been isolated, especially from children.

It likely that ID&I are going to do a bone marrow biopsy and potentially a CT which means another general anaesthetic.

It broke my heart today as soon as we walked into the blood room he started crying because he knew where he was and what was happening. And he sobbed through his xray but didn't move. I hate how this is his normal :'(

OP posts:
HarrietLong · 19/04/2021 22:02

This just sounds gruelling, I'm so sorry it is taking so long to find answers. Thank you for updating us, I have been wondering how you are all getting on. It is so difficult for you to have to put your son through all this, knowing that it is necessary to help him, but being unable to explain it all to him. Hugs to you Flowers

Cheesybiscuitsmineallmine · 20/04/2021 16:01

Didn't want to read and run. Thinking of you and hope you get some answers very soon, the waiting must be agony.

WhiskyIrnBru · 20/04/2021 16:08

I initially thought CF so it's worth pushing them.

As a side note, my friends DD has recurring lung infections and has been quite unwell and she was found to be a carrier. I don't know the ins and outs but my friend was told that being a carrier can make you more susceptible to infections etc. Good luck opFlowers

tigerbread20 · 20/04/2021 16:11

Haven't read all the thread but this was very similar to my daughter from 14 months to age 2.
Mumtiole hospital stays, over 20 courses of antibiotics and then long term prophylactic antibiotics, constant lung shadows, constant wheeze, I knew something was wrong. It took 6 months before we were referred to the lead consultant and that was after a stay in PICU. I was convinced it was something terrible.
They started her on montelukast and a brown inhaler she has just gone 8 months without symptoms. The road to get here was awful but nothing sinister in our case, which I really though was impossible.

I hope you get some answers soon Flowers

marauder1994 · 20/04/2021 16:18

I didn't want to read and run. I so hope you get answers soon. Xxx

Harvey3 · 20/04/2021 19:41

I didn't want to read and run, I hope that you're ok. My son has had respiratory issues and been put on the same antibiotics and had a CF test and bloods scheduled. It is very worrying so I do feel for you - and hope you get answers soon.

AvaCallanach · 21/04/2021 13:43

Neutropenia of some sort? Or another immune system issue? My friend's daughter had recurrent infections as a toddler and was found to have neutropenia, which is a lack of a certain blood cell that fights infections. She had to take antibiotics every day and go to hospital if she got a fever.
She grew out of it and is a normal young woman now.

Cheesybiscuitsmineallmine · 08/05/2021 12:09

How are things with you now, hope you've managed to get some answers.