WWYD? dd1 unwell (potentially)

[NewBlueCoat]

on Monday night, dd1 came to me in tears (unheard of) and told me she was in pain.

she was able to accurately pinpoint (several times) the same spot. and answer some (quite extensive) questioning about what she may have done or not done (no bangs or bruises, it 'just hurted by itself' apparently). it was lower back/side, on her left.

dh has a history of kidney issues, so we were understandably concerned. dd1 is a reluctant drinker at the best of times, and so bladder/kidney infections are never far away anyway.

so, we took her to OUt of Hours, where she perked right up (doctors/hospitals are THE most reinforcing thing to her right now), and bounced around having a whale of a time. Doctor understandably couldn't do much when faced with a cheerful, active child.

Urine sample was required, so i dropped one down to the GP next day. Initial dip test showed positive for blood (sample was visibly clear, dd nowhere near menstruating/puberty), and so was sent off for further testing.

We havebeen keeping an eye on dd1 all week, and tried to up her drinking. She has intermittently mentioned that her back is still sore (and only once in a 'can we go back to that fun hospital place' kind of way). Today she has mentioned it more frequently.

I spoke to the surgery earlier, and her tests have come back as clear, therefore no further action to be taken.

I am not particularly happy with this - there certainly WAS an issue (maybe not a bladder one), as dd1 is not the type to be in tears over nothing. It would appear that the issue has continued, as dd1 has mentioned it occasionally (never as bad as Monday, but then she has confided, and may be trustingus to sort it out?). But I am not sure what else can be done? dd1 cannot answer any more questions than she has done (and she has done brilliantly at answering the many we had, and given us loads of info already).

So, what would you do? what next steps could we take?

dd1 has form for assimilating severe pain and not mentioning it, just acclimatising (she had to have 3 teeth out earlier this year as one was broken, and two others had huge holes in them - there is NO way she was not in pain, but never mentioned it at all), so if we leave it and there is something wrong, she could be in pain.

bloody, bloody autism. I sodding hate it at times like this!

Hiya, I've had my dd in hospital for pylonephritis last year, started off as a uti and because she wouldn't take the ab's, ended up in hospital with much more severe infection. There was no mistaking how ill she was, very high persistant fever, urine stinky etc.I was so paranoid when we came home that I bought some urine dipsticks from ebay and regularly dipped her urine for protein and leukocytes but then I am a nurse.
My dh gets terrible kidney pains when he is dehydrated or hungover, I'm not sure it is medically correct but I believe it to be the kidneys crying out for some fluid!
It's tricky with the altered pain sensation, I know I have been shown up in a@e once when I knew dd had really hurt her wrist, wouldn't use it all day then never complained once when the dr examined her, I got some sarcastic remarks! Just keep an eye on her, check for smelly cloudy urine, maybe press over her kidneys gently in her sleep see if she winces at all. Hope you get peace of mind soon.

There are some free apps about for eg where pain is etc here

I would keep taking her back to dr / A&E until you are happy

Drs generally say that when a Mum keeps bringing a child back then usually there is something wrong. Don't worry what they think of you, just keep going back.

Pain is just one indicator of infection, and the remaining indicators are all ones you can be observant for:

-Fever
-Malaise
-Strong smelling urine
-Frequent urination, especially small amounts
-cloudy urine
-discoloured urine
-blood
-loss of appetite

Is she still just taking one variety of drink? If not, cranberry juice is very good.

If she'll take it, you could see if giving her a dose of paracetamol changes her demeanour - if it does, you may well decide that she is in pain.

Is she dehydrated in general? How's her appetite?

Thanks.

Have been through the list all week, lougle, and it's a bit hit and miss.

Fever: on and off mild temperature (we've all been under the weather)
Malaise: she's certainly been off colour, and quite grey looking at times (see above)
Strong smelling urine: she hovers on the brink if dehydration, and generally resists going to the toilet. She has had strong smelling urine for most of her life! But it's not as strong smelling as it has been previously.
Frequent urination: not really. She has been going a little more often (maybe once or twice a day more) but not for small amounts. She has sometimes taken longer to actually have a wee than usual though.
Cloudy/discolured urine: no. Not cloudy, and the morning sample I obtained was very pale yellow - ok for a first morning sample. I have no idea how she remains hydrated. She certainly doesn't drink enough.
Blood: tested positive for this. Nothing visible though.
Loss of appetite: up and down, sometimes on, sometimes not. But then we've all been under the weather...

So, my conclusion is: inconclusive.

She is better at drinking a range of drinks now, but wouldn't drink cranberry, or not in enough quantity to make a difference. If she has more than 400ml in a day of fluids it's a red letter day.

I could try the paracetamol trick, but she can only take Calpol, and will react to the colourings/sweeteners/flavourings (usually have to peel her off the ceiling...) so again would be inconclusive.

Agnes: thanks, will take a look at apps for another time. Dd1 is being a star answering questions this time around, but that may not last.

Mckenngp1: thanks. I hope we can resolve this soon. I hate not being able to help her.

I think if it's all inconclusive, there wouldn't be enough to treat anyway. It's hard to cope with the thought of her being in pain and unable to communicate it though

Let us know how she is tomorrow.

I agree that if inconclusive hard to carry on - that's the problem. BUt not sure I agree there wouldn't be enough to treat (if found!).

Before she had her teeth out earlier this year, I'd have said I would have known if she was in pain/uncomfortable/unwell. It has always been clear before. But she had to have been in extremem pain (or unable to distinguish extreme pain) given the extent of the damage - the dentist was shocked. So that has left me quite wary.

She has mentioned it on and off all week, and not in a drama-llama kind of way (dd1 is quite the actress, and loves repeating and going over previous issues, and really hamming up the vocals and expressions. she is not doing this when mentioning her back pain), but in a resigned, ongoing kind of way. quite matter of fact.

she was very interested when I said I was going to speak to the doctor yesterday (for test results) - very keen to know what the doctor said (and not about what was for lunch, or what time they got up in the morning, etc - hr usual conversational topics). It seemed to signal to me 'at last! they're going to do something about this!' kind of interest (am aware I may be reading into it).

It's just so hard. She has such form for acclimatising and accepting things, including pain and discomfort. And now she has managed to tell us, and seemingly we are not doing anything about it (if she is still in pain). Nightmare.

You could ask if they would give a course of broad spectrum antibiotics, given her history and inability to communicate pain (citing the dental incident). They will (rightly) be reluctant to give antibiotics without evidence of infection, but may be swayed by the prospect of a short, lower dose course now versus more intense treatment if she does get a kidney infection as a result of an untreated UTI?