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Posted: 2/20/2006 5:31:33 PM EDT
Have a 12.5 year old daughter who has had lower stomach pain going on 2 or 3 months now. Pain comes and goes, sometimes she is fine for a week & then it hits, sometimes it's 2 or 3 days or less.

Been to the Doc once & he had X rays of her lower abdomen. Pain was in both lower quadrants, but tonight it's in the upper quadrants as well & for the 1st time is a 9 on the 1-10 pain scale. Pain has been around a 4-5 but tonight she really hurts.

Has been eatting and drinking lots of water & normal stools and urine.

Dr did a kidney function test of some kind and she had a tiny ammount of protien in her urine, Dr wants to re do the test & we are going to do it tomorrow.

I want to see if they will do a ultrasound to see how things look, but don't know if this is a viable procedure. I'm also wondering if this has to do with puberty as she has not started yet.

Ideas?????????
Link Posted: 2/20/2006 5:37:43 PM EDT
Possibly ovarian cysts/follicles. An ultrasound would be very helpful
Link Posted: 2/20/2006 5:52:03 PM EDT
Thanks, will mention that to the Dr.

Our primary care Dr is a USAF clinic (tricare prime) & so far they have been pretty good to deal with. Hopefully this will not change things.
Link Posted: 2/20/2006 5:55:30 PM EDT
[Last Edit: 2/20/2006 5:56:00 PM EDT by KS_Physicist]

Originally Posted By ClayP:
Possibly ovarian cysts/follicles. An ultrasound would be very helpful



+100,000 on getting that ultrasound.

If the pain is that bad, she needs to be seen NOW, she could have a cyst/cysts rupturing, which can dump blood into the abdomen. I know someone who had to have emergency surgery to repair just such a problem at the age of about 22.

She's at an age where PCOS could be kicking in and making her life miserable. Thankfully, there's a simple treatment to help prevent cyst growth--hormone (birth control) pills. Her OBGYN might need to measure hormone levels for a few months to figure out the 'right' dosage.

My suggestion is to IM ARDOC or one of the other known doctors here to get his take on it, and then call your doc and discuss it.

Jim
Link Posted: 2/20/2006 5:57:30 PM EDT
Pain is @ 9, no fever? Tender to palpate? Swelling?

If you're seeing her doc tomorrow, just make sure you mention everything in your post. Keep an eye on her, and check the temp.

Hope things go well.
-otto
Link Posted: 2/20/2006 6:00:09 PM EDT

Originally Posted By KS_Physicist:

Originally Posted By ClayP:
Possibly ovarian cysts/follicles. An ultrasound would be very helpful



+100,000 on getting that ultrasound.

If the pain is that bad, she needs to be seen NOW, she could have a cyst/cysts rupturing, which can dump blood into the abdomen. I know someone who had to have emergency surgery to repair just such a problem at the age of about 22.

She's at an age where PCOS could be kicking in and making her life miserable. Thankfully, there's a simple treatment to help prevent cyst growth--hormone (birth control) pills. Her OBGYN might need to measure hormone levels for a few months to figure out the 'right' dosage.

My suggestion is to IM ARDOC or one of the other known doctors here to get his take on it, and then call your doc and discuss it.

Jim



+1 on ARDOC..i believe this is his area of work
Link Posted: 2/20/2006 6:07:37 PM EDT
ARDOC is good and seems to be an excellent resource, but understand that most physicians are under tremendous pressure when it comes to the liability of diagnosis of something for which they cannot be present. While he does us an excellent service, remember he can't always be the go to guy. Our ultra-litigous society has ruined the concept of community medicine that once existed.

This is not a knock on ARDOC, but a compliment, I hope you all understand.
Link Posted: 2/20/2006 6:12:08 PM EDT
Shrike,

Sadly, Otto is correct. Sounds like she has been to a PCP/Pediatrician. Might be worth a call to get an OB/GYN apt.

Good Luck.


AFARR
Link Posted: 2/20/2006 6:15:50 PM EDT
9/10 abdominal pain in a 12 y old needs to be evaluated and you should take her in.

If she has a fever as well, I would be VERY concerned about the possibility of appendicitis which might also present without fever. I have seen a couple of cases of appendicitis present in this fashion. Ovarian cysts are a reasonable possibility given the history. It would be interesting topin down the time frame.

A diagnosis of abdominal pain covers a whole lot of ground and would be difficult to ascertain over the internet. She needs an exam, and lab evalution not to mention a complete history.
Could be as simple as obstipation, a bladder or kidney infection, or a surgical problem.

You really need to take her in.
Link Posted: 2/20/2006 6:19:25 PM EDT
[Last Edit: 2/20/2006 6:24:25 PM EDT by DocH]
+1 on the possibility of ovarian cysts.

Also mention gluten enteropathy/ celiac disease/ sprue to your PCP. It is an unusual disease, but can present with waxing and waning vague abdominal symptoms. "Abdominal pain" covers a lot of ground, and will probably require a complete workup with labs and imaging.

Good luck.


Doc H.

ETA: If the pain is now 9/10, especially w/ fever/chills; then that is suspicious for a more serious problem and she should be seen in the ER tonight.
Link Posted: 2/20/2006 6:24:13 PM EDT
Pain has droped to a 6 & she is doing better along with eating, drinking and moving around.

BP/resp/temp and pulse are all normal for her, & upon palpatation pain is in the lower left quadrant with a little radatating to the lower right, but not nearly as much. Nothing abnormal felt when palpation except the pain it caused & she was giggling as it tickled.

Pain seems to drop down to the area of the pubic synthesis
Link Posted: 2/20/2006 6:37:21 PM EDT
Thanks everybody,

Trust me when I say I'm ready to take her to the ER if needed, but want to make sure she is a ER case and not just a over reacating parent. Heck, I know several people who work in the ER and would have no qualm about taking her in as we would get right in

I'd never ask a Dr to diagnosis anything over the net, just looking for some off the record advice so I can ask about it when we sit down with the Dr & have a good idea of what I want and expect to see happen.

From watching her reacations and signs/symptoms I'm judging the pain was less than what she says it was when she said it was at a 9, but it still hurt quite a bit due to how she was moving around and playing.

Appendicitis was my 1st concern and am watching her signs/symptoms close.

No fever, that was one of the 1st things I checked along with her BP.

We have to see the primary care provider before she can see a OB/GYN or get a ultrasound, but that's one thing I'm going to ask about when we see the Dr.
Link Posted: 2/20/2006 6:42:31 PM EDT
At the least have her sit on the toilet UNTIL she has a good BM.
Does it burn when she pees?

Keep an eye on her and take her if necessary. I would have a low threshold for doing so.

If she has a surgical problem they won't want her eating anything for sure.

If she was playing I doubt 9/10 pain
Link Posted: 2/20/2006 7:12:13 PM EDT
PS, see sigline below
Link Posted: 2/20/2006 7:14:47 PM EDT

Originally Posted By drjarhead:
At the least have her sit on the toilet UNTIL she has a good BM.
Does it burn when she pees?

Keep an eye on her and take her if necessary. I would have a low threshold for doing so.

If she has a surgical problem they won't want her eating anything for sure.

If she was playing I doubt 9/10 pain



Last BM was last night, none today & she could not go tonight & thoough I was "strange" for wanting her to try Made her sit there for 20 min and no joy so she has gone to bed.

No pain or burning sensation when peeing.

She seems to be feeling even better, more mobile and happier, she said pain was down to a 5.

She does not eat a lot, but tonight she was hungry and ate more than usual.

Will check i on her every now and again & she has been instructed if she wakes up hurting like earlier or even if it just hurts & that the pain wakes her up to come in and wake me up.

If that happens we will more than likely be making a ED visit.
Link Posted: 2/20/2006 7:19:58 PM EDT

Originally Posted By ClayP:
PS, see sigline below



Not bad, just wanting some info to enlighten my dumb azz so I don't look like a total tool when we go in to talk to the Dr tomorow.

I just like to have a general idea about things so I can ask good questions and request valid procedures like asking for a ultrasound to rule out cysts/follicles

Ain't I smart
Link Posted: 2/20/2006 8:24:12 PM EDT

Originally Posted By Shrike9:

Originally Posted By ClayP:
PS, see sigline below



Not bad, just wanting some info to enlighten my dumb azz so I don't look like a total tool when we go in to talk to the Dr tomorow.

I just like to have a general idea about things so I can ask good questions and request valid procedures like asking for a ultrasound to rule out cysts/follicles

Ain't I smart



You are, and a good dad for doing so. Just remember to articulate the everything you mentioned here. One of the things I have seen is that patients tend to "play down" symptoms when in the presence of their physician.

I "shadowed" a radiation oncologist at Harvard in December.. everytime the patient brought their wife with them, the spouse quickly corrected certain concerns:

How many alcoholic bevs. per day?

Husband: 1, maybe 2.....
Wife: Damnit (insert name here) you know you have a least 6-8 per night.

People are frightened when confronted with illness, it takes some psych evaluation to understand the truth.

Keep us posted, hope your daughter does well.
Link Posted: 2/21/2006 5:16:56 AM EDT
Thanks for the ideas everybody, taking her to the Dr this AM!!
Link Posted: 2/21/2006 11:21:58 AM EDT
Doc did not really want to do a ultrasound as she thinks it's just hormones and puberty kicking in, but thanks to the advice here she relented and the Ultrasound is scheduled for tomorrow

I also asked if we could see a OB/GYN depending on the ultrasound results & she did not really want to refer us to one right now, but said she will think about it and see what the results of the ultrasound are.
Link Posted: 2/21/2006 11:28:59 AM EDT

Originally Posted By Shrike9:
Thanks for the ideas everybody, taking her to the Dr this AM!!




Hope everything goes well, can't wait for the updates!
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