Jump to content

Menu

Paging Dr. Hive... (posting this from the children's hospital)


Veritaserum
 Share

Recommended Posts

Does she have a headache, followed by vomiting? Is that the cycle?

 

If you are already referred to neuro, please request a MRI. My son had prolonged vomiting due to neuro issues.

We've started writing things down over the past few days. She gets a headache and double vision, vomits, and then her head and vision return to normal. Her symptoms match what I'm seeing described for brain stem tumors, which, of course, worries me quite a lot.

 

I'll ask for a referral to a pediatric neurologist, but I know our regular doctor can order an MRI now so that its results are ready by the time we're actually at the specialist's appointment. We did that when my 14yo started getting migraines (at age 8). MRI was normal, so we created a migraine treatment plan (at the pediatric neurologist).

 

Dd10's situation doesn't really fit migraine, IME. I've only had visual disturbance twice out of hundreds of migraines. I never vomit with them. My 14yo doesn't get visual disturbance, but she does feel nauseated. Neither of us has ever had a migraine last 17 days.

  • Like 2
Link to comment
Share on other sites

We've started writing things down over the past few days. She gets a headache and double vision, vomits, and then her head and vision return to normal. Her symptoms match what I'm seeing described for brain stem tumors, which, of course, worries me quite a lot.

 

I'll ask for a referral to a pediatric neurologist, but I know our regular doctor can order an MRI now so that its results are ready by the time we're actually at the specialist's appointment. We did that when my 14yo started getting migraines (at age 8). MRI was normal, so we created a migraine treatment plan (at the pediatric neurologist).

 

Dd10's situation doesn't really fit migraine, IME. I've only had visual disturbance twice out of hundreds of migraines. I never vomit with them. My 14yo doesn't get visual disturbance, but she does feel nauseated. Neither of us has ever had a migraine last 17 days.

Yes, I'm sorry. That was my son's diagnosis. Of course it could be dozens of different things, so please don't assume the worst. DS was worse in the mornings and when he went from lying down to standing up, so perhaps add those sort of facts to your headache/vomit diary.

 

DS's pediatrician diagnosed him. We had been seen by dozens of doctors, but she ordered the MRI. I wouldn't wait for a referral to get the MRI in the works, if your pediatrician can make it happen.

 

Please do keep updating this thread. I will be thinking about you both!

  • Like 1
Link to comment
Share on other sites

We've started writing things down over the past few days. She gets a headache and double vision, vomits, and then her head and vision return to normal. Her symptoms match what I'm seeing described for brain stem tumors, which, of course, worries me quite a lot.

 

I'll ask for a referral to a pediatric neurologist, but I know our regular doctor can order an MRI now so that its results are ready by the time we're actually at the specialist's appointment. We did that when my 14yo started getting migraines (at age 8). MRI was normal, so we created a migraine treatment plan (at the pediatric neurologist).

 

Dd10's situation doesn't really fit migraine, IME. I've only had visual disturbance twice out of hundreds of migraines. I never vomit with them. My 14yo doesn't get visual disturbance, but she does feel nauseated. Neither of us has ever had a migraine last 17 days.

 

I have several friends that get the vision and vomiting with migraines, and you do have a family history of them, so in some ways, that's a good thing if that is it. That it is lasting so long, I can't explain. 

 

Hugs. 

  • Like 1
Link to comment
Share on other sites

It lines up with several brain stem complications, not just a tumor. Plus, there are other neuro complications that can mimic brain stem involvement. 

 

I'd ask for both the Ped's neuro referral and the MRI or at least a CT.

 

Kris

 

We've started writing things down over the past few days. She gets a headache and double vision, vomits, and then her head and vision return to normal. Her symptoms match what I'm seeing described for brain stem tumors, which, of course, worries me quite a lot.

I'll ask for a referral to a pediatric neurologist, but I know our regular doctor can order an MRI now so that its results are ready by the time we're actually at the specialist's appointment. We did that when my 14yo started getting migraines (at age 8). MRI was normal, so we created a migraine treatment plan (at the pediatric neurologist).

Dd10's situation doesn't really fit migraine, IME. I've only had visual disturbance twice out of hundreds of migraines. I never vomit with them. My 14yo doesn't get visual disturbance, but she does feel nauseated. Neither of us has ever had a migraine last 17 days.

 

  • Like 1
Link to comment
Share on other sites

We are waiting to be seen at the children's hospital. This morning she says it hurts to see. She also can't squeeze my fingers. And, of course, she vomited during the night.

 

I'm praying hard for your daughter and you. And for the medical team to be insightful and compassionate and very very thorough. 

 

While you are waiting, can you write down a timeline of what has happened, and then a list of her symptoms, not just the ones right now but all of them in on place? Include how often for those that frequency would be meaningful. 

 

So  - vomits 3-5 times a day, blurred vision,headache, weakness in extremities, painful vision, etc etc 

  • Like 1
Link to comment
Share on other sites

I gave the timeline history to the ER doc. He agrees we need to see her brain, but he can't order MRI because they're completely booked. Those patients won't get bumped without a trauma emergency. He ordered a CT scan. He will also write a prescription for MRI and refer us to neurology.

 

I'm so frustrated.

  • Like 1
Link to comment
Share on other sites

I hope he can advocate for you - that is so frustrating about the MRI schedule but at least a CT will be better than nothing and a good first step to see what is flowing and where. Praying for her here!

Link to comment
Share on other sites

Waiting for CT results now. The tech was going to take us back to ER without contrast. I had to argue with her that we needed contrast and that the doctor approved it. The tech checked with the doctor. They did the contrast.

 

I want to smash things because of how difficult it is to get the care she needs. She has been ill for 18 days!

  • Like 3
Link to comment
Share on other sites

Dd is upset. She wants to go home. She doesn't feel well. :(

 

CT came back normal. ER doc is going to see if he can get her admitted so we can get faster answers. He may or may not be successful. We're going to draw more labs and do IV fluids.

 

I'm praying they admit her. Hugs mama. 

SaveSave

Link to comment
Share on other sites

The doc just popped in to say neurologist thinks really bad migraine (I disagree--18 days? Didn't respond to Maxalt). The GI doc is still thinking. Both were phone consults with the ER doc.

 

They just swabbed her nose and drew blood. She is utterly miserable (screaming, crying, shaking). They did a basic neuro exam (squeezing hands, walking across the room, following light, etc.). They also did an eye test (reading letters). She collapsed during the eye test (shaky legs).

Link to comment
Share on other sites

I gave the timeline history to the ER doc. He agrees we need to see her brain, but he can't order MRI because they're completely booked. Those patients won't get bumped without a trauma emergency. He ordered a CT scan. He will also write a prescription for MRI and refer us to neurology.

 

I'm so frustrated.

 

is there another hospital/clinic that would have a slot for a MRI?  I would push for something.

 

my friend kept getting the run around while sitting in the ER waiting for a MRI. (oh, we have all these trauma cases . . . . ) they finally found somewhere they could get one. of all the "trauma cases"/people who came through the ER that day . . . her dd was the only one admitted to ICU.  (as soon as they saw her results.)

Link to comment
Share on other sites

I'm so sorry your daughter has been struggling for so long.  I hope you get some answers soon.

 

A few more thoughts:

*Sadly, she really does need a MRI of the Brain. Unfortunately it can be hard to visualize all of the posterior fossa in children with a CT and statistically their brain tumors are more likely to hide there.  While headache, visual changes, and vomiting can certainly be other things they all fit with a tumor and this needs to be ruled out. I can understand that they may not be able to get the MRI from the ED (I'm an EM physician if I want an MRI I need to have an emergent this MRI will change my management over the next hour kind of reason) but they can admit her overnight and get the MRI sometime in the next 24 hours. (Perhaps even overnight because often inpatients are brought down for outpatient scheduled cancellations or no shows.

*I won't say this couldn't be some atypical migraine (perhaps with some superimposed cyclic vomiting syndrome) with this presentation but I think other things need to be excluded before that is the decided diagnosis.

*If this has been going on for almost three weeks I would be really surprised if she wasn't at least mildly dehydrated. Sometimes dehydration can make it impossible to break the vomiting cycle (even if the underlying diagnosis really is viral (and usually self limited) gastritis/gastroenteritis.

*It sounds like she has had three ED visits (or were there more) and a few outpatient PCP visits, you can make a pretty strong case for a "failed outpatient treatment" admission. (If it matters with your insurance whether it is a full admit or observation these words will usually make the full admit case.)

*I presume they did a comprehensive metabolic panel at some point or are doing one now? Because looking for electrolyte derangements (either due to the vomiting or in a few cases causing the vomiting) and liver enzymes would be key. You could also add an amylase and lipase if that hasn't been done (and, yes, that is a rare zoloft association when the ED doctor asks again if you're a physician).

 

Good Luck! I hope she feels better soon.

  • Like 10
Link to comment
Share on other sites

Push for admission and a neurology consult. Stress to neurology that they need to consider all possibilities. I've found that you can answers more quickly when you're inpatient ... my son has been inpatient for more than 200 days in his mere 4 years. Sometimes you have to tell the doctors what to do -- you're paying them, and you're the only one who has the full picture of your child's situation.

 

 

Sent from my iPhone using Tapatalk

  • Like 2
Link to comment
Share on other sites

I'm so sorry your daughter has been struggling for so long. I hope you get some answers soon.

 

A few more thoughts:

*Sadly, she really does need a MRI of the Brain. Unfortunately it can be hard to visualize all of the posterior fossa in children with a CT and statistically their brain tumors are more likely to hide there. While headache, visual changes, and vomiting can certainly be other things they all fit with a tumor and this needs to be ruled out. I can understand that they may not be able to get the MRI from the ED (I'm an EM physician if I want an MRI I need to have an emergent this MRI will change my management over the next hour kind of reason) but they can admit her overnight and get the MRI sometime in the next 24 hours. (Perhaps even overnight because often inpatients are brought down for outpatient scheduled cancellations or no shows.

*I won't say this couldn't be some atypical migraine (perhaps with some superimposed cyclic vomiting syndrome) with this presentation but I think other things need to be excluded before that is the decided diagnosis.

*If this has been going on for almost three weeks I would be really surprised if she wasn't at least mildly dehydrated. Sometimes dehydration can make it impossible to break the vomiting cycle (even if the underlying diagnosis really is viral (and usually self limited) gastritis/gastroenteritis.

*It sounds like she has had three ED visits (or were there more) and a few outpatient PCP visits, you can make a pretty strong case for a "failed outpatient treatment" admission. (If it matters with your insurance whether it is a full admit or observation these words will usually make the full admit case.)

*I presume they did a comprehensive metabolic panel at some point or are doing one now? Because looking for electrolyte derangements (either due to the vomiting or in a few cases causing the vomiting) and liver enzymes would be key. You could also add an amylase and lipase if that hasn't been done (and, yes, that is a rare zoloft association when the ED doctor asks again if you're a physician).

 

Good Luck! I hope she feels better soon.

Thanks. We ran a metabolic panel on Monday. I had my husband call for the results today. He texted on his way out the door that the only abnormal things were low vitamin B and elevated CBC (no idea which levels or how high).

 

This is our third trip to the ED. We've also visited her primary care provider three times. Failed outpatient treatment is so very accurate. This has been awful.

  • Like 1
Link to comment
Share on other sites

Thanks. We ran a metabolic panel on Monday. I had my husband call for the results today. He texted on his way out the door that the only abnormal things were low vitamin B and elevated CBC (no idea which levels or how high).

 

This is our third trip to the ED. We've also visited her primary care provider three times. Failed outpatient treatment is so very accurate. This has been awful.

 

Hmm wonder how low. Low thiamine can cause vomiting. Low B vitamins can also cause other issues...I'll look them up for you. 

Link to comment
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

 Share

×
×
  • Create New...