My seven-year-old daughter has been very sick for almost two years and is getting worse. Initially, we thought she had appendicitis. She became extremely tired and said her stomach hurt so bad she just wanted to sleep. She vomited a lot. We took her to two hospitals. Both did CAT scans. The first one couldn’t get a good reading and sent us home. Less than one week later, she was still in pain so we went to the other hospital. They were able to get a good reading and said her appendix needed surgery right away because it was inflamed. The surgeon came and said he just thought it was a virus and treated her with antibiotics and an I.V. for a couple of days.

However, she continues to vomit once or twice a month. Out of the blue, she could be feeling fine then, at night, she gets pale vomits and feels better after one or two hours. She has been on antibiotics eight times in the past two years. She is tired a lot, drinks a lot and loves to eat but, after a few bites, is full. She is skinny. She has lost 4 pounds in the past two weeks. She also has chronic sinusitis and a chronic cough. She also was bitten by a friend’s dog over Mother’s Day weekend and it got infected right away. She was in the hospital for four days. The first course of antibiotics didn’t work so they had to go to something stronger. It takes her a long time to heal, even if it’s a scratched mosquito bite.

Last week, she woke up warm to the touch, looked horrible and had a 4 inch by 4 inch raised welt on her neck near her glands. It scared me so much but, it went away after about four hours.

We think she may have symptoms of type 1 diabetes. She hasn’t been tested for that yet. The ENT says he thinks she needs tubes in her ears and maybe he will remove her adenoids and maybe tonsils. Her allergist agrees but wants her tested for cystic fibrosis. All that information is fine, but I’m concerned about the vomiting and no one can give me a cause. We have also noticed that if she eats really sugary stuff like a slushy or Twizzlers, she vomits in less then an hour. Should we test her for diabetes? I know that there are other symptoms, but I’m afraid they are just treating the obvious and not the underlying problem that seems to be getting worse. What is it going to take? I don’t want to wait until she’s in a coma.

Your daughter certainly does sound ill! Having these persistent (and I presume not “constant”) symptoms for nearly two years would be a worry.

Based on your accounting of the events, I would be optimistic that this is NOT type 1 diabetes. I think the main reason I want to conclude this is that I would hope that after two years of going to the doctors, getting evaluations and scans, etc., that a serum glucose and urinalysis were done! If her symptoms were attributed to diabetes at those times, the glucose levels should have been elevated and the diagnosis made. Furthermore, the main symptom with diabetes mellitus typically is increased urination during the day and usually the night, and you didn’t describe that.

You didn’t indicate what type of doctor typically cares for your daughter. I hope she has a primary care physician and that you aren’t just taking her to emergency rooms or walk-in clinics. I think your daughter needs a careful, thorough evaluation by a pediatrician who will take you seriously. Make an appointment for a complete evaluation: If you show up as a walk-in or a follow up visit, the doctors may not have set aside enough time for this long array of worrisome sounding symptoms. If recurrent vomiting, weight loss, and early satiety (getting filled up quickly) are the main symptoms, I think you may need to seek a referral to a pediatric gastroenterologist.

Typically, appendicitis is not so chronic to last two years, but other intestinal diseases such as inflammatory bowel disease (e.g., Crohn’s disease, eosinophilic enteritis, celiac disease, etc.) are chronic. I’d look for those before considering more rare conditions such as porphyria, for example.

The recurrent courses of antibiotics is also a bit of mystery to me. Antibiotics DON’T treat “viruses,” so I don’t know why any antibiotics were prescribed. Also, dog bites commonly don’t need to be treated with antibiotics either (cat bites do). So, I am uncertain what was going on. Nevertheless, if your daughter were truly having recurring bacterial or other serious infections, her immune system functions would also need to be screened.

Near your city would be the Children’s Hospital of Philadelphia and the children’s hospital in Manmouth. There may be others. Request a referral from your pediatrician or family doctor and take the results and records of all prior evaluations with you!

Good luck and please let us know what is learned.

DS