A&E visit with my daughter - still coming down

If everyone knew what their diagnosis was without input from professionals, then I wouldn’t have a job.

I don’t consider it a waste of my time to reassure people. In fact it can be one of the more rewarding aspects of my job.

God knows I spend enough time doing the reverse.

Nonsense - exactly the right course of action (except the speeding)

Ultimately, thats what A&E is for. You called 111 and they sent you in. Don't feel bad. Kids (even older ones) can't effectively elaborate on whats happening to them as they have no reference point, so ultimately it's always going to be a judgement call as to what you should do, there's no right or wrong.

You did the right thing by calling 111 - well done.

If you'd rocked up at A&E without first having called 111 then I'd still say that's OK. Not wasting their time at all IMO, given the symptoms.

You took the appropriate advice and she was safety netted, assessed and signposted to her GP. You'll be able to sleep well knowing she's safe and well.

Differential diagnosis is TIA. 111 will have followed the algorithm and recommended A&E. Triage did the same and rules it out. Sounds like the system worked perfectly. Much better than the alternative.

If you hadn't have taken her you'd be non the wiser. Migraines come in many forms...

Don't worry about wasting their time, It's why they're there. 

I had to go to A&E the other day. It was an eye opener! A brand new (6 months ) hospital, filled to the gunwhales with old folk on trolleys. Every bit of corridor occupied with trolleys, 6 ambulance crews waiting to offload.

And apparently that was a quiet day...

So we walked away with me feeling a little bit silly, wasting A&E time with that,

I wouldnt. Going there for a stubbed toe then yes but those do sound pretty serious symptoms and 111 obviously agreed.
That there was a less concerning reason doesnt make it any less sensible decision (depending on exactly how you speeded).

well said @kramer

Sounds like the system worked perfectly. Much better than the alternative.

Yes, that's what I was telling myself. And we all learned something new - even Migraine charity websites say that this particular form of migraine (that only effects 0.01% of the population) presents with symptoms like a stroke and that you should see a medical professional to rule it out. So it was pretty impressive that the triage nurse could identify it.

Differential diagnosis is TIA.

Yes, a good friend (not very old, fit and healthy) had one of those a couple of years ago and that was on my mind too.

Not for that I wouldn’t, I’d have gone for a migraine over a stroke but I’d still have had m daughter checked out.

I’d have gone for a migraine over a stroke

She's never had a migraine before so, although I initially wondered about that as a cause, I wasn't sure (especially with the numbness and loss of grip on her right hand which I have never heard of as symptoms of migraine). But apparently, they can start at this age because of all the puberty hormones.

Yeah they can. You did right though. 

Yeah they can. You did right though.

Yeah, reading up on migraines since, apparently so. I guess that's why I draw pictures for a living and not doctor.

As a father to two kids who have both had seizures from Anaphylalic shock at young ages you did the right thing.   Its ****ing scary not knowing what to do / what's going on, and its absolutely right to get them to professionals even if its only minor in the end.

I'm pleased to hear your daughter is OK.

Nonsense – exactly the right course of action (except the speeding)

If I was seriously concerned my child was having a stroke then hell yes I would speed on my way to A&E.

Safely and within reason, of course. I mean I post on STW so therefore am automatically a driving god 😉

Edit: When we were young one of my siblings had suspected septicaemia, meningitis or something (I don't remember exactly, I was smallish too). As there were no ambulances available immediately my mother sped there along the hard shoulder, through red lights and all, with hazards going and blowing the horn (no other kids were in the car!).

She told me afterwards that if the police had stopped her, they would've just given her an escort to continue to the hospital.

Anyway, um, cool story I guess.

I’m pleased to hear your daughter is OK.

Thank you 🙂 I just wanted to give her a hug, but she thinks she's too old for that rubbish now.

The one bit of advice that I give to all parents is to trust your instincts. If you’re worried get some advice.

Fortunately serious illness in children is relatively rare. However minor illness is very common. In practice this means that to spot the one sick child, it is inevitable that we will see thousands who don’t have much wrong with them. That’s just the numbers.

None of us want to miss the sick child. From experience it is devastating. No matter how busy we are, we all want to find them.

I'm currently in hospital (visiting my dad) and showed your post to the nurse who's in here checking him over and she says you absolutely did the right thing. She says that they would much rather deal with a case that turns out to be a best-case scenario rather than you stay at home and it go horribly wrong. Glad your daughter's fine after the stress of a quick dash to A&E.

She also says that they prefer to see mountain bikers in her A&E (Prince Charles in Merthyr) than the local druggies as we tend to apologise and comply rather than punch, kick and be gobby little shites 🤣

You absolutely did the right thing.

I get occasional ocular migraines - one of the symptoms is disrupted vision (like looking through cracked glass) first time it happened i was driving home from work, and absolutely terrified i was having a stroke.

Hope this is a one-off, but definitely follow-up with your GP.

we walked away with me feeling a little bit silly, wasting A&E time with that,

Well, stop it. I swear, the sole purpose of 111 must be to tell people "you're a nob, stop being British and go to the hospital."

I had to go to A&E the other day. It was an eye opener!

What you see on TV isn't the half of it. The corridor spaces are numbered now (at Blackburn at least) so this isn't a fleeting problem. I had to blue-light my mum earlier this year. The ambulance station (actually "Resus") was great, the ward was great, the gap between the two was in a corridor next to a Reception area for eighteen hours.

She’s never had a migraine before so

Anecdotally, they can be weird like that. I've had a couple of bouts over the years, came out of nowhere, came and went over a few weeks, then went away as abruptly as it started. Scared the absolute piss out of me when the first one hit, I genuinely thought I was dying. (Something your daughter may not have communicated...)

Thank you 🙂 I just wanted to give her a hug, but she thinks she’s too old for that rubbish now.

"You might be but I'm not, and I need a hug so come here."

Nothing to add other than you did the right thing and I hope your daughter gets some good treatment and improves.

Hope this is a one-off, but definitely follow-up with your GP.

Yeah, the nurse said she would be sending a letter to them and we definitely will do - apparently with this particular type of migraine (if it turns out to be that) benefits from having a good meds plan in place. Interesting I did read that head injuries can trigger an attack and she did take a couple of knocks to her head in netball on Sunday.

I genuinely thought I was dying. (Something your daughter may not have communicated…)

She did ask 'Am I dying' on the way to hospital. I reassured her she was not (whilst secretly praying to myself). TBF, I don't *think* she was being serious.

Nothing to add, except to say that A&E was definitely the right call with those kinds of symptoms. No-one's time was wasted.

My sister is a theater nurse.

When younger my niece was complaining of a sore arm after she fell over,  Wouldn't let anyone at it to check. Called 111, popped along to A&E with a distraught child. Called in to see the A&E bod only for my niece to push herself up and walk in as if nothing had happened

even Migraine charity websites say that this particular form of migraine (that only effects 0.01% of the population) presents with symptoms like a stroke

I am surprised that it is as rare as that. I suffered migraines with stroke-like symptoms when I was a teenager. Complete numbness would travel up one arm starting with my thumb, then across my face and even my tongue. It did affect my hearing and speech to a degree.

But in my case the stroke-like symptoms only lasted minutes and I was then left with severe headaches and maybe vomiting. It must be scary stuff to have it last for a prolonged period and as everyone else says you undoubtedly did the right thing. In fact you did what you were told to do.

Hopefully if it happens again, as is more than likely, it won't be as scary, even though it will never be pleasant. In my case I eventually grew out of them and any later migraines tended to be bog standard ones. I suspect that it is linked with teenager hormonal issues, I believe there is a connection between migraines and hormones.

I believe there is a connection between migraines and hormones.

Yes, the nurse did say that. Thankfully it wasn't anything more serious and we now know more about what it is. Thankfully she has a very high pain threshold and can, for the most part, work through this sort of stuff.

@johndoh  You did absolutely the right thing, hemiplegic migraine are not to be messed with as they can/do present as stroke like symptoms. 

I myself have had migraine since I was 14, going on 40 years of the little blighters, sadly mine are just your common migraine, lots of intense pain, brain fog, light and sound sensitivities, nausea and vomiting to name a few of the fun things.

While hemiplegic migraine are scary, there are lots and lots of new treatments available now.

If you'd like any help please do feel free to PM me, I can give you a lot of info regarding triggers and coping strategies etc.

TGG

This is what the system is set up to do, you call 111, they advise, when it comes to children they err on the side of caution, so almost always 'go direct to A&E' if symptoms line up against anything serious, 111 is part of a triage service, and it's there to reduce pressures on A&E where it can.

If only more folk used it, and minor injuries before setting off to A&E it would make life easier for most, same as doctor appointments and pharmacies.

Like yourself, visiting A&E is not pleasant, last visit earlier this year with the daughter was via minor injuries and due to her temp, it was a straight to A&E job, thankfully BRI has a children's A&E, so easier to deal with, but the mess around a hospital is horrible these days, blue badge holders thinking it's a permit to abandon a vehicle anywhere, so turning the drop off area into a parking area for them, meaning blockages for people and ambulances, same around the area when then trying to park, if there weren't two of us taking her i haven't a clue how i'd have gotten her to A&E without abandoning the car on the road!

Agree with Kramer..

I'm forever telling people that "just because I haven't given you a terrible diagnosis, it doesn't mean a visit to the Dr was a waste of time"..

She had symptoms that warranted urgent inout, ergo you did the right thing. It's grand the outcome was a 'non-severe' illness, but you still did the right thing.

About 90% of my consults end with me giving the patient reassurance they'll revert back to the mean..

DrP

Another vote for 100% the right thing. I once took a phonecall from my wife who was, it turned out, in the middle of a hemiplegic migraine. It was terrifying. Like you I thought she was having a stroke, as she had pretty much all of the symptoms that we're told to look out for. Making no sense, slurring speech, numb in half her body
She'd never had one before, never had one since(but she had always suffered hormonal migraines with more common symptoms). It was almost certainly due to a change in contraceptive pill, which ironically had been done to try and prevent migraine!

I'm no medical person, but have had a lifetime of migraines which are possibly finally under better control, and my wife has hers much better managed. Please feel free to drop me a message or post here and I can happily share some of the stuff I've found out over the years. It's a huge area and some of the medical professionals I've seen were incredibly dismissive, but there are some good solutions out there.

You did the right thing, and how your daughter is doing ok. Sometimes the 'hangover'/postdrome is almost as bad as the main attack.

I just wanted to give her a hug, but she thinks she’s too old for that rubbish now.

Tell her hugs have no age limit😉
After what the lot of you have been through these last few weeks, I would like a lorry load of hugs to turn up at your door.
Hope you all have a calm and uneventful patch for a wee while.
You are doing a top job,take care.

I might just add, there’s a world of difference between presenting the first time your daughter has a hemiplegic migraine, and every time she has one (once it has been suitably investigated).

Sounds like the system worked perfectly.

Aside from the prospect of a 10hr wait, it's quite nice to hear a good news story of a system that worked well.

Triage (111 then the triage nurse) did the sifting and sorting just as it should. I'm sure a hard pressed triage nurse will blast me for this, but you didn't 'consume' the most in demand, most pressed and most expensive A&E services.

Well, stop it. I swear, the sole purpose of 111 must be to tell people “you’re a nob, stop being British and go to the hospital.”

I think it’s a mix of this and the opposite!  “No you don’t need a Dr to come out at 3 in the morning, because you are feeling tired but can’t sleep”

FWIW id probably have missed the 111 step and gone straight to A&E given those symptoms as I’d never heard of migraines causing loss of grip etc.

FWIW id probably have missed the 111 step and gone straight to A&E given those symptoms as I’d never heard of migraines causing loss of grip etc.

I was starting to consider that as the wait time on 111 was quite long and I was getting a running commentary from her 'my arm has gone numb now', 'my other foot is tingling', 'my eyes are starting to hurt'.

I might just add, there’s a world of difference between presenting the first time your daughter has a hemiplegic migraine, and every time she has one (once it has been suitably investigated).

Absolutely - now we have witnessed it and know what it is, I won't be so quick to go into PANIC! mode.

@drp  She had symptoms that warranted urgent , ergo you did the right thing. It’s grand the outcome was a ‘non-severe’ illness, but you still did the right thing.

I would consider migraine to be severe IMHO, it is after all a serious neurological disorder along similar lines to epilepsy, theres even migra-lepsy which gives you both migraine and epileptic symptoms.

She did ask ‘Am I dying’ on the way to hospital. I reassured her she was not (whilst secretly praying to myself). TBF, I don’t *think* she was being serious.

Yeah, "probably not" is likely not a great answer. 😁

I suffered migraines with stroke-like symptoms when I was a teenager.

Mate, that sounds horrific.

Anyone who thinks a migraine is "a bad headache" has never had a migraine. After my brush with them I've spoken with other sufferers and frankly, there but for the grace of dog I got off very lightly.

The first bout I'm pretty sure was situationally induced. It's a long story and not really relevant to anything.

The second time around it just... happened. I was sat playing World of Warcraft and got a weird visual disturbance, a zig-zag pattern at the edge of my vision. Over a period of, idk, 20 minutes maybe it drifted to the centre of my vision and I had to say "sorry guys, I need to stop playing, I've slightly gone blind a bit." (I make light of it now of course, but it was terrifying.) Then it went away. And I thought, "Phew. That was weird." Then it felt like someone had taken a cricket bat to the base of my skull, I've never known pain like it. Then I went for a lie down in a dark room for a bit of a cry, suddenly understanding why sensory depravation chambers are a thing. Tell the cat to stop stamping its feet.

They did me in for about four weeks and then just stopped. Horrendous bloody things. I have the deepest of sympathies for chronic sufferers.

She’s never had a migraine before so, although I initially wondered about that as a cause, I wasn’t sure (especially with the numbness and loss of grip on her right hand which I have never heard of as symptoms of migraine). But apparently, they can start at this age because of all the puberty hormones.

I had my first hemiplegic migraine when I was a young teenager as well. It happened when I was having a bath after a mountain bike race and scared the living daylights out of me. My parents, being typical boomers, told me to take a couple of paracetamol and man up.

I think I’ve had only one other since, but plenty of other migraines. Aura ones are the most common for me.

And I’m comfortable with appropriate speed on the way to A&E as well, having three points and a fine to show for it, along with a parent who is still alive.

Never feel bad about using A&E. Especially for your kids.

Twice I've treated one of our kids as if "just ill" and wanted to just keep them in bed, to be overruled but their wiser mother to immediately take them first to the GP (back when this was an option and before 111 replaced just dropping into your GP) and then ordered straight to A&E... in both examples the "illness" required immediate action... one an appendix whipping out within hours... the other the administration of insulin and the start of a life long journey of treatment.

The "don't bother the medical professionals" seems drummed into some of us, well definitely me, by our parents. Sod that, seek help. Don't be like me.

[ I'm not moaning about 111 calls by the way, the service has been proven to be damn good recently ]

I would consider migraine to be severe IMHO, it is after all a serious neurological disorder along similar lines to epilepsy, theres even migra-lepsy which gives you both migraine and epileptic symptoms.

In terms of medical severity, it's not a severe/life threatening illness.

Yes it's a debilitating illness..many conditions are, but it's not a threat to life or limb.

DrP - (severe migraine sufferer since a kid)

we tend to apologise and comply rather than punch, kick and be gobby little shites 🤣

so better behaviour displayed than on here then?? 😂😂

OP - right thing done. Glad all OK.

OP – right thing done. Glad all OK.

Thank you - I've just spoken to her, she feels okay now but hasn't got full strength back in her hand yet. I wonder if she'll have the presence of mind to say she's tired and wants to rest tonight, rather than have her usual Tuesday night maths tutor 🤣🤣🤣

It's been said loads, but just to add that you absolutely did the right thing and the system worked as it should.

Emergency departments are not designed to admit everyone that attends. Your daughter presented with symptoms that to any lay person are serious and the medical professional did their job.

You did the right thing, 100%, well done. <br /><br />

I had a hemiplegic migraine aged 41, it was terrifying. It was exactly like the stroke ads on the telly, I couldn’t form sentences and my arm went all weird. I was admitted to the stroke ward via A&E. The long and lonely night before an MRI will never be forgotten. I could have hugged the consultant who told me it was a migraine, not a stroke. Everyone told me I’d done exactly the right thing going to A&E and I fully agree with them. 

The second time around it just… happened. I was sat playing World of Warcraft and got a weird visual disturbance, a zig-zag pattern at the edge of my vision. Over a period of, idk, 20 minutes maybe it drifted to the centre of my vision and I had to say “sorry guys, I need to stop playing, I’ve slightly gone blind a bit.”

I get those, sometimes just one, sometimes I’ll get a spate of them over several days. Fortunately, apart from the occasional follow-on headache I don’t have any real problems. Which is good, because I’ve had one come on while doing 70 on the M5.

When Jo, my late partner came to live with me, she told me she’d suffered a sub-arachnoid haemorrhage when she was living in Southern Ireland, about fifteen years previously and as a result she’d get seizures, mostly minor ones, but occasionally she’d have a major one, but she’d learned how to deal with them and not to worry and to not call an ambulance.

Predictably, she had one, and I panicked, having never seen anyone have one before. I called an ambulance, and she got rushed down to Bath and put through a scanner, because of her medical history. I went down to see her, and she signed herself out, but the atmosphere was somewhat frosty, shall we say. The people I spoke to at the hospital said I did exactly the right thing, with her history n’all.  Bless her, she’d thawed out by the time we got home, and I said sorry, but I’d do it again, just to be on the safe side.
I did, but she never came home that time.

Thank you – I’ve just spoken to her, she feels okay now but hasn’t got full strength back in her hand yet. I wonder if she’ll have the presence of mind to say she’s tired and wants to rest tonight, rather than have her usual Tuesday night maths tutor 🤣🤣🤣

Just in case you might be tempted to think she’s trying it on (kids, eh!?), she may very well not be.

If I have a bad migraine attack, it can take me out for a week. The attack will come on, and then I’ll normally try and sleep through it. So that takes a day. The following day, I’ll still have a headache. It’ll be like the mother of all hangovers, and that can last a couple of days. If I’m lucky, it’ll be gone after that. If not, then it’ll be a ‘normal’ headache for a couple of days.

I just wanted to give her a hug, but she thinks she’s too old for that rubbish now.

Depending on how 'spiky' she is on the teenage spectrum the @cougar and @fasthaggis suggestions may work. You'll know best though (sandwich, a recovering teenaged daughter sufferer).

Thank you - I have got over the 'wanting to hold her tight' thing now. She needs her own space and she's welcome to a hug anytime she wants one. She did try the grip test with me again last night though - and nearly broke my fingers LOL!

FFS - she was at a Halloween party tonight and it’s happened again. I’d had a couple of beers so my wife went to get her. All the same symptoms but didn’t last as long . Grumpy as hell when she got home 🙁

No one gets a migraine just once, at least I have never heard of that, so I guess it was inevitable. And expect more to come.

Hopefully though although never pleasant they won't cause the same level of anxiety as the first one did.

Sorry to hear your lass has suffered another one - I don’t know for sure, but I’m certain I’ve read that migraines can start to appear in teenagers, so these might be an indication, DrP will be able to confirm I’m sure. If so then sadly it’s something she’s going to have to learn to cope with in future. Good though that she’s surrounded by family who can help her to get appropriate treatment and help in the future. A g/f of mine from years ago used to suffer from them starting in her late teens, early twenties, which is when I first met her, and they would knock her for six; being sick, terrible headaches and having to go to bed in a dark room for a whole day. It left me feeling so helpless, because there was nothing at all that I could do for her. 🙁

I’m always so relieved that mine are so minor by comparison that I can work through them, maybe sitting quietly for a few minutes with a *bad* one, until my vision clears.

Good luck to her, and very best wishes. 

That's crap news johndoh, at least she was somewhere where people were able to look out for her.

Really sorry to hear this. The mass of hormones released in puberty can start to trigger them unfortunately.
Obviously not a topic for us middle aged men on here, but suggest you keep a note of the incidences vs her hormonal pattern.
My wife's are linked to this, and it's glaringly obvious when you look at the data she collects!
GP has tried various different contraceptive pills which has varying effects. There's also a triptan(I believe it's Frovatriptan) which can be taken at a small dose proactively for a certain number of days every month which helps a lot of women.

Really hope she finds something that works for her. It's a really crappy thing to live with. Do not let the GPp just brush it off as headaches!

That’s crap news johndoh, at least she was somewhere where people were able to look out for her.

Yeah, she was there with her twin sister so she just called and my wife went to get her. We were always going to take her to the doctors' this week (it's half-term here) but we've called this morning and taking her this afternoon now.

And yeah – I understand that migraines can be triggered by teenage hormones and be linked to periods so yeah – I think she will have to learn to live with them, But two in six days - ouch!

Sorry to hear you're going through this.  Makes it even worse when its your own child.

I went through this last year, exact same symptoms except I couldn't talk or breathe, very scary for my other half who found me upstairs.  Mine was brought on my stress and lack of sleep but I've also heard in teens they can be brought on my hormones, my other half was the same.

The docs at NNN didn't have a clue what was wrong with me and couldn't decide whether it was a stroke or a brain bleed - one tried to prescribe some aspirin but if it was the latter would have most likely killed me.  Luckily my sister in law was a nurse in A&E that night who had heard I'd come in and made them see sense (took a further 4 weeks however to get a proper diagnosis thanks to my GP pushing hard for it), spent the night in A&E, CT scan, MRI scan found nothing eventually so was discharged, felt awful taking up an entire bed for 24 hours with what felt like a huge hangover after the initial seizure/symptoms.

I'd spent almost 18 months on the lowest dose of Amitriptyline (1omg I think), this was mainly to quell the constant headaches I had afterwards and to help sleep.  Cold turkey'd those around 2 months ago now and feel fine.

One thing to note, afterwards I found I had a huge brain fog, short term memory was buggered and just took a lot longer doing things, felt like my brain had been fried and just needed to catch up.  The neurosurgeon who I spoke to in A&E essentially said it was like my brain shut down and re-wired incorrectly, hence forgetting how to breathe and talk and not being able to dial 999 myself, mixing it up with 911 and 199...

So - doctor's appointment done. For some reason they don't think it is hemiplegic migraines (which is a surprise as all the symptoms suggests that is exactly what it is), so the next steps are a whole load of blood tests.

TBH, even if they do think it's a hemi-whatsit, blood tests can't hurt.

not being able to dial 999 myself, mixing it up with 911

I know it's not the point you were making, but when dialling from a mobile phone either number should work (along with other standard numbers like 112). The GSM logic is "contact the local emergency services," not "dial this specific number."

TBH, even if they do think it’s a hemi-whatsit, blood tests can’t hurt.

I guess not – I was just surprised they quickly discounted them as a diagnosis (although they are pretty rare compared to 'normal' migraines) given the symptoms. Still, at least something is being done, that's the important thing.

I know it’s not the point you were making, but when dialling from a mobile phone either number should work (along with other standard numbers like 112). The GSM logic is “contact the local emergency services,” not “dial this specific number"

I totally get your point, I wasn't hitting "call" as I visually could see it was wrong but my fingers were just typing the wrong thing.

a bad headache, some loss of vision, tingling and numbness in her lips/cheeks and down the right side of her body. 

And

checked her grip – she could barely squeeze her right hand.

Straight to A&E, everytime