to wonder if NHS doctors overdo it a bit when they write off almost every childhood illness as a "self-limiting virus" which needs nothing more than Calpol, rest and fluids? (long, sorry)(39 Posts)
Genuinely not having a go at the NHS of which I am a supporter, but starting to feel really frustrated at the difficulty of getting my daughter's condition taken seriously and wondering if anyone else -- from a medical background or otherwise -- has any useful perspective on this.
I feel like almost every time my dd has gone to see a GP with any condition at all since she was born this diagnosis has been waved under my face within seconds without any proper attempt at investigation. My dd has had a chronic cough for over 3 weeks (and the background to this is that she has asthma symptoms), I've seen 3 GPs about it and they keep pulling this one out of the hat. I've read recently that whooping cough has come back and is being misdiagnosed -- or under diagnosed -- because a lot of GPs assume that all children are immune because of vaccinations.
I also realize that GPs are very busy people and have to deal with a lot of neurotic mums whose kids probably don't need to go to the doctor in the first place. But at no time has any of the GPs I've seen suggested any further investigation, taken a swab, done an x-ray or anything. Its just "virus, calpol, off you go..."
My DH and all of my dd's childminders (all of whom are from relatively poor countries where you wouldn't expect the health service to be better than ours) have all said they are shocked by how quick GPs here are to put everything down to viruses and wave you off.
Any GPs out there who have a view on this? Anyone had this experience? Are they generally right to assume that most childhood illnesses will clear themselves up? Or are they under so much pressure to hit targets etc that they are just desperate to get patients out of the door? Because its starting to feel like they avoid any further investigation because they don't want the surgery/health authority to get charged for something which may turn out to be a false alarm and that scares me...
I just heard that in it's first year an average child will get 12 bugs. One a month. Lots of those parents will be wasting the GPs time and demanding treatment for those normal bugs. Better, most of the time, maybe not in your case, to limit treatment.
Frankly, I'm worried about antibiotics not working, we should all be wary of that.
I totally agree about the antibiotics and I've heard that statistic about the sheer number of bugs kids get, particularly in daycare. I have an open mind about this, don't have an anti GP agenda. I just can't help worrying about it....
Well has it ever been more than a virus in the end?
Yes when DDs were little we had alot of viruses, sadly once it wasn't, it was serious but even hospital said virus.
Most of the time it is. There are warning signs for more serious conditions and a seriously ill child presents very differently than a child with a virus IMO?
" I've read recently that whooping cough has come back and is being misdiagnosed -- or under diagnosed -- because a lot of GPs assume that all children are immune because of vaccinations."
Even if it is being missed, after the first few days, there are no treatments and you just need to ride it out.
"(all of whom are from relatively poor countries where you wouldn't expect the health service to be better than ours) have all said they are shocked by how quick GPs here are to put everything down to viruses and wave you off. "
In areas where doctors are paid by test etc, they do a lot more unnecessary investigations to get more money.
90% of the diagnosis is in the history.
Also, in poorer countries they would be less likely to wave off every parent with a virus explanation because it would be much more likely to be something worse. I speak as someone who got a nasty tropical disease in Cambodia. My 'flu' or 'sunstroke' turned out to Dengue Fever, not something i would have caught in Croydon.
I'm a GP.
Children do get lots of viral infections in the first few years. It's not unusual few the first few winters to feel like they're never well because one runs in to another. They're immune systems are coming in to contact with lots of bugs that they've never been exposed to before, so they do tend to pick up everything going.
GPs tend to investigate children less readily than adults because investigations can be very scary and unpleasant for children, particularly young children who don't understand what's happening to them. Blood tests are painful, throat swabs are uncomfortable, Xrays are often of poor quality in children because they can't stay still enough and there's the radiation exposure which isn't ideal. Chest xrays won't show anything abnormal in the vast majority of children with a cough (it would show a pneumonia or a swallowed object, but not asthma or whooping cough for example). A 3 week cough is very normal after a viral infection, but on a background of asthma symptoms you might think about a trial of an inhaler in a young child, or some breathing tests in an older child.
Most GPs would recognise a child who's experience is different from the normal run of the mill infections, but you can always ask for a second opinion from a second GP if you are not satisfied. On occasions I've referred to a paediatrition when parents are worried about frequent viral infections, as much for reassurance as anything else. Referral is based on need not money.
My GP dh has said he wants to put a sign up in his waiting room that says "if you've not had your cough for at least a month, GO HOME!"
He wouldn't, because he's a nice doctor, but I know the constant "it's a virus" consultations do get a bit monotonous!
I know children are notoriously difficult to investigate - after 12 years in GP he wouldn't attempt a paediatric blood test as it's hard to do, and potentially very painful for the child!, he'd refer to local paediatricians, who are even less likely to do it if they think it's a virus!
Almost always it is a virus, he's never missed a serious diagnosis, and only one child patient has died (and that was a difficult and rare cancer) in 17 years of being a doctor.
YANBU I feel exactly the same. Having been fobbed off on many occasions when i knew something was wrong i am now quite insistent on further investigations if i think it necessary. I have also pretty much demanded a referral <with good reason> on more than one occasion. Have also bypassed GP's completely and taken ds straight to the local children's hospital where the staff are brilliant.
I do however think it's down to luck as far as your gp goes. I've seen gp's i thought were great and others not so much.
Just want to point out i am not some crazy/neurotic mother, my son has had genuine medical conditions. I do have a medical background of sorts myself (veterinary!)
And to be fair, the one time dh was convinced one of our children did have a genuine problem needing intervention, he went straight to the local paediatric A&E where they rolled their eyes at him, did an x-ray and discovered a serious hip problem in our then 4yo dd2, that we've just got the all clear on 5 years later!!
your Dr will know if they have had a whooping cough vaccine, it tells them on their computers.
mind I only know this because they had a pc issue with me and I got quizzed why'd didn't have everlasting when she did
Yes I think YABU. Common things happen commonly - it's usually a virus, not always but usually.
My 20 month old has a cough and a runny nose, he's had it for about 3 weeks. I haven't taken him to the GP because there is nothing that can be done. He is fine in himself, plays, eats some meals, sleeps as well as he ever does.
What do you want your GP to do? It is so, so common for kids to have these kinds of symptoms for a couple of winters when they are young while their immune systems build up.
Use Calpol when you feel she really needs it, try and make sure her diet is ok, wrap up warm when you go out, and keep her hydrated.
I don't think a persistent normal-sounding cough is a symptom of whooping cough anyway is it? Is that not...erm....more of a whooping sound?
Fair enough, you may all be right -- I just wanted to get some other opinions on it.
Actually, what drives me mad is when your DC has been coughing for a week, you're 99.9% sure it's completely normal, then some old biddy in the Post Office goes "Ooh, what a nasty cough" in a hushed and fearful tone, and you feel guilt-tripped into taking him to the doctor.
Where they tell you it's just another virus. Again.
You don't need to have a "whoop" to have whooping cough and the OP's description of her DD's cough could well be whooping cough however with a 3 week history even if it is there is nothing that can be done as antibiotics would now have no effect.
And your Post Office comment - so true!!!
DD1 had numerous viral infections and a pretty solid 5 months of coughs.
Only when she got stridor breath sounds did I go to the gp
my sil and got antibiotics and an inhaler eventually. The viruses are just constant it's only when they get a secondary bacterial infection you need to do anything really.
SIL basically said keep an eye on her and only on rash/droopiness/wheezing or a temp that calpol can't bring down should you seek intervention.
Her history would point to asthma but we held off testing until 3 and she did, as the gps had said, grow out of it so YABU
I think most of the time it is just viral. I do take my youngest in at the drop of a hat because he's prone to chest infections and has other disabilities that are worsened when he's ill too.
The only time our GP's 'viral' diagnosis was very, scarily, wrong my eldest ended up in hospital for days with paediatricians scratching their heads too. It was only the consultant that was able to diagnose him correctly in the end.
That said, our GP's is not great. My worry is that nearly all the GPs, bar the main one whose name is on the practice, are very, very young and inexperienced. I'd be far happier seeing older more experienced doctors.
My favourite is the 'viral rash' - I'm sure when I was a kid, a rash actually meant something and could have a name/treatment attributed to it. Now it's just a virus. I don't bother going to the GP now.
My son has asthma (as do I) and we were being fobbed off with 'virus' by his drs when I knew it was more than that. They said that guidelines said that he had to have three documented episodes before they started calling it asthma (we are in the US by the way, not the UK). I insisted they test him because it was not a regular cough and was more serious and needed appropriate treatment. Lo and behold, he has asthma. Quelle surprise.
Now saying that, the year he was ?3? he did get every cold and virus in existence and seemed to be constantly run down or sick, but it was also when he started preschool.
Softly, I don't wheeze when I have asthma symptoms. Ever. I am a cougher. And sometimes I need interventions, occasionally heavy duty ones.
Oh and also our wonderful doctor was 99% sure that DS had grown out of his asthma because regular tests don't show it. He had to have a fancy test to prove it one way or another for a sport he was in and apparently his asthma is quite bad, he just has a very large lung capacity for his size so it is hidden.
I've found the opposite. I've been a bit laissez faire about something just being a mild virus but the GP has taken it much more seriously.
My son is prone to dry skin and used to get rashes / eczema-like symptoms on this legs and arms. Once when my nanny took him to the docs with a sore throat, the doctor saw the rash and sent him straight to A&E with to be checked out for meningitis. I was so convinced it wasn't, I nearly stayed at work. As I suspected it wasn't meningitis (he was running around A&E cheerfully for the whole 4 hours we were there) though the serious way it was treated did give me a scare and I have become more cautious.
As others have said, kids get loads of viruses and you really should ring NHS Direct before taking them into a GPs to make sure they don't pass it to a vulnerable or immune-suppressed patient.
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