...to change my GP?

[wb]

I've been with my GP for 4 years now and have always found her supportive and helpful. She is also the GP for ds1, and has always been great with him too.

This week I took ds2 for his post-natal check up with her (he is 6 weeks). She examined him and said everything was fine but mentioned in passing that his skull sutures were fusing, which was unusual on a baby so young. I asked if this was a problem, and she said no.

Fast forward to yesterday when I end up in A&E at the local childrens hospital w. ds2 on an un-related matter. They gave him a general examination during which they also noted the apparent fusion of his skull sutures - ONLY they didn't think it was unimportant at all. Cue immediate CT scan, checks for certain genetic conditions etc.

Anyway, as it turns out only one suture is actually fused and he has been referred to the neurosurgery team on an outpatient basis. Depending on how he develops he may need nothing at all, but the worst case scenario is major cranial surgery.

OK, not great but at least we know now there might be a problem.

Thing is, this has really shaken my confidence in my GP. On the one hand she made the right diagnosis (fused sutures) but her interpretation of what it meant is very different from the doctors at the hospital. Did she make a mistake, or is this one of those things that can be interpreted differently? Should I talk to her about it, or just change GP or just forget it. Like I say, I've always found her great before but now I just don't know. Opinions please.

I agree Riven. But is it reasonable to expect a GP to recognise that your child might have a condition?

I think if you have lost confidence in her then you should change. Similar thing happened with ds2. When he was born, the Dr doing the check-up before discharging us said that the sutures might have fused prematurely and wrote a letter to GP. It is a group practice and one of the GPs is also a friend of ours. Anyway, we took ds2 to GP and it happened to be friend. She didn't think it was anything to worry about but nevertheless called in other GPs to check (not sure if non-friend GP would have done this). They all said we should have his head measured every couple of weeks. I think your GP probably should have, at the least, suggested this.

tell her what happened and ask why the opinions differed so much. don't get personal - just ask it as an open question as, if she's made a mistake, she needs to know so that she doesn't do the same in future. if she gets defensive, agressive or doesn't appear to care, change GPs. it could well be one of those things that isn't black and white.

i have to say i never really trust GPs - they really are 'general' and it's always, always worth pushing them when they say stuff - so, personally, i would have pushed her on the initial diagnosis, gone home and done research then come back with more questions. that's not to say you did anything wrong AT ALL, just i've had lots of crap experiences with GPs in the past, who seem more concerned with getting rid of you than seriously treating you/your kids.

hope your DS IS ok

She did spot it though. I don't know what I'd do in these circs.

One of my friends changed GPs (we had the same one) as he 'missed' her son needing a circumcision but later on she told me she regretted changing surgeries as the new ones weren't as sympathetic as her old one (plus it was further to go).

My GP is pretty good so I'd be loathe to change but try to go with your gut instinct.

Is it possible that she said it wasn't a problem immediately because she didn't want to alarm you at that moment? Maybe she going to check up on the condition afterwards and get in touch with you if she found out it was more serious.

It could be a possibility, but I don't know if that's how GPs do things.

"Depending on how he develops he may need nothing at all"

I think you said it all there, she spotted it and if it became a problem she would note it and look for it next time. It has not become a problem yet so nothing to look for yet.

I do think it is a hard balance to get between maybe seeing something and maybe not in a patient.

However, if you feel that it has shaken your confidence then change if you want but also bear in mind you might feel shaken at the moment and that this may wear off.

if it were me I would be telling the GP how you feel and see if she is defensive or glad that it is brought to her attention - it is supposed to be a partnership between you and her with the child's interests at heart .

She may appreciate the feedback.

As an aside, it's shit changing, I did (cos he was various sorts of tosser) and it is now recorded in my medical notes that he "found it difficult to communicate with me" My current doctor is very nice and approachable and communicates better with me.

I wouldn't change my gp but would change receptionist if I could. Once told gp that I didn't know why he'd gone to medical school for years and years as his receptionist could diagnose over the phone without even seeing my ds2. She had refused an appointment as they didn't give out emergency appointments for sore throats even though I explained that mt son suffered from recurrent tonsilitus so I knew symptoms, that he had a high temp and puss on his tonsils and I would be reassured if a doctor could take a look. Ended up at a&e instead. He DID have tonsilitus. I know they do get plenty of time wasters but shold err on side of caution with babies and young children.

"Depending on how he develops he may need nothing at all"

My niece was born with a suture already fused. You can't just leave this condition to see if it develops as fused sutures mean the skull cant grow properly. At its mildest may not be noticeable or cause problems, at worst can cause eyesight and nasal probs, pressure on the growing brain, and a skewed look to the face. Which my niece has
There is only a short optimum time for any surgery if its needed, before about 18m old while the bones are still soft. SIL has declined the surgery that was recommended and now the child is well outside the short optimum age range.

So no, the gp should not have said 'see how it develops' as if you had not been in a&e the next day it might not have been picked up on till its too late.

MIL and I found a ton of stuff incl support groups on the internet plus the procedures for dealing with it are posted by the hospitals that deal with it routinely, if thats any help?

However I would mention it to your gp about how disappointed you are at her wrong diagnosis. She can't be expected to be an expert on every single field of medical care so may appreciate the feedback. If she is funny with you or doesn't apologise then yes I would consider moving.

Hmmm, dh had a similar thing. His gp told him his headaches were 'absolutely not a brain tumour', and guess what? 1st tumour removed 4 years ago, 2nd one due to be removed in May. The Ambulance crew we called to dh 1st time round insisted he had no brain injury, despite him being semi conscious and non responsive, we had a nightmare trying to be taken seriously and get him to hospital.

We didn't do anything about it at the time, bigger fish to fry and all that, but now I really wish I'd followed it up, mainly because I think the hcps involved need to know they made a mistake so they can learn from it and avoid similar situations in future.

fwiw I agree with earlier advice to discuss it with the gp in a non confrontational way and see what she says.

profyaffle!
Hope every thing goes well for you in May.

Thanks all for your advice. I think I'll talk to my GP and see how I feel then.

Flibbertyjibbet, thanks. My husband and his mum both have quite strangely shaped skulls (not noticeable under their hair) so I'm hoping that it is some mild, directly inherited thing. But I'll look on the net cause I would like to know more, even if it alarms me.

Profyaffle -esp. about he ambulance crew. Good luck for May.

Thanks - prognosis is good, all should be well

Hope your ds is OK too wb.

ProfYaffle - & , can't believe that!!

Well, actually, I believe they can mess up anything thinking about it. My sister has had 2 experiences of Drs/Hospital mess ups. First one was some years ago when she was getting terrible headaches and kept being sent away. Drs said go to opticians, opticians said go to Drs. Even when her sight pretty much went they were useless. Then one Dr phoned her on her mobile after she'd gone (had looked in her eye and said saw something that optician needs to look at) and said that they actually thought she needed to be seen at an eye specialist so was immediately referred. Once there they did whatever and then sent her by ambulance to another specialist hospital and eventually discovered she had Intercranial Hypertension (too much fluid surrounding her brain) and had to have a spinal tap. If left untreated she would have eventually slipped into a coma or had a brain aneurysm (according to what I've seen on the net). My dad was furious and complained big time to the surgery! (there's a much longer story behind it i.e. how etc. but I won't go into that). Then last year after being sterilised, she became pregnant shortly after which ended up in ectopic pg. She was having tests done to look out for this but was never told to watch out for shoulder pain. When she got this she was convinced it was unrelated to EP as they hadn't said this to her. Even though I'd said to watch out for it (thanks to info from MN!). It was only when I lost it with her on the phone and demanded she went to A&E right away when she got it really bad that she actually went and was rushed into surgery and had both tubes removed. They said she was in extreme danger by the time she arrived and was very lucky. I was so . Yet another mess up!!!

Sorry went on there a bit didn't I!! can you tell I have no faith!

As far as your op.....I personally think that yes, GP's can't know everything as they don't specialise in these things HOWEVER if they said what was wrong but then made out it's nothing to worry about, that IS wrong and needs addressing. I wouldn't necessarily move Drs but would do what others suggested and see how they react.

Hope everything is ok with ds.