I’m an NHS GP – here’s when a ‘trivial’ headache can be an emergency you must get checked out

WHEN your children get sick, it can be difficult to decide when to take action.

Whether a baby or teenager, a sniffle or something more sinister, I see parents worried about their kids all the time – it’s completely normal.

Dr Zoe answers your health questions

The most important thing to remember is to trust your instincts.

No one knows your child and what’s normal for them better than you.

So if you think something is seriously wrong, don’t delay in getting help, particularly if it could be an emergency.

We were reminded of this when the parents of Martha Mills told their heartbreaking story.

Their 13-year-old daughter died in 2021 after doctors failed to admit her to intensive care for sepsis.

Now, the Government is considering bringing in “Martha’s rule”, in which parents have the right to ask for a second opinion while their child is in hospital.

Pushing back against doctors can be tough, so this move may help.

Here’s a selection of what readers have asked me this week . . . 

Q: MY daughter, 12, keeps having “episodes”.

She’ll feel sick and nauseous then she’ll eat or drink and feel OK for a bit, then dip again and feel ill.

She eats well, is hydrated and has no other symptoms. What could it be?

A: Hyperglycemia, the medical term for elevated blood sugar levels — or hypoglycemia, the medical term for low blood sugars — may cause nausea.

If this symptom in your daughter has been persisting for some time, then I’d advise speaking to the GP and arranging a blood test to rule out diabetes.

Probably not relevant here, but for anyone reading I want to highlight that severe nausea may be a sign of diabetic ketoacidosis.

This is a dangerous medical condition that must be treated to avoid coma or even death.

Symptoms include abdominal pain, excessive thirst, nausea, shortness of breath, frequent urination, weakness or fatigue, confusion and fruity-scented breath.

If you suspect diabetic ketoacidosis, seek medical attention immediately.

Other causes for your daughter’s condition include sensitivity to hormones — does this happen in the week before her period?

If so, it could be in response to the decline in hormones that happen at that time of the menstrual cycle.

Sexually active females should also consider pregnancy too.

Keeping a symptom diary to try to spot a pattern will really help in understanding what the cause could be and GPs find symptom diaries helpful, too.

Q: I SUFFER from abdominal adhesions which cause me a lot of pain after surgery 35 years ago.

The surgeon did a laparoscopic inspection and cut some adhesions.

They informed me in the ward that it was like a spider’s web in my abdominal cavity.

Pain meds help but do you know of any procedures that could help?

A: Typically, abdominal adhesions occur as a result of surgery.

They are scar tissue that becomes fibrotic and, as your surgeon describes, they can develop a bit like spider’s webs with fine strands that can end up sticking to organs or loops of the bowel.

In people who haven’t had surgery, adhesions can also sometimes form due to conditions such as endometriosis or following infections or inflammation within the abdomen or pelvis.

Possible symptoms include the pain which you mention but also bloating, cramping, nausea, vomiting and a change in stool habit — which can be altered frequency, consistency or both.

Adhesions are diagnosed by laparoscopic surgery as in your case or by an MRI or CT scan.

They can cause the chronic pain you describe in your letter and sometimes a partial or complete obstruction of the intestines.

Very rarely, adhesions can cause the gut to twist, cutting off its blood supply which is a medical emergency.

Did your surgeon indicate whether you might benefit from any further surgery in the future, or did they say they got rid of what they could and can’t do any more?

Surgery to cut the adhesions can be effective, but it comes with the risk of more adhesions forming from the surgery itself, so in theory can actually make things worse in the long run.

Research from a university in China found some patients have symptom relief with acupuncture.

Otherwise, the options include pain medication and dietary changes, with foods that are soft or low in fibre being most commonly advised.

Sometimes people will be referred to a pain clinic if the usual over-the-counter painkillers aren’t working, and depending on where you live, your GP surgery might be able to help you talk to a dietician, so do ask.

Fears over headaches

Q: I AM a 60-year-old woman and over the past couple of months I have been having shooting pains in the left side of my head.

Sometimes they are short and sharp and other times they are longer and more painful. They occur at any time, when I’m in bed as well as during the day.

I’ve had breast cancer twice, resulting in a lumpectomy, mastectomy and reconstruction.

I had a TIA [mini stroke] in 2022. I am reluctant to contact my GP over headaches.

A: I understand with everything you’ve been through you’re reluctant to talk to the GP about something that might seem trivial like headaches, but with the shooting pains you describe I’d advise you to get checked over.

Your GP will likely want to rule out a condition called giant cell arteritis (or temporal arteritis) where arteries at the side of the head – near the temples – become inflamed.

It’s a condition that we always consider in a person over the age of 50 with a new onset of headaches.

Symptoms include frequent headaches at the side of your head and up onto your scalp, jaw pain, problems with vision and sometimes flu-like symptoms, lethargy, depression and losing weight.

My advice is to call your GP today for an appointment and mention temporal arteritis.

They will likely arrange a blood test to look for signs of inflammation straight away.

If left untreated it can lead to stroke or blindness in one eye. So please do contact your GP and let me know how you get on.

   

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