to report this GP? and if so how best to address it?

[nellieloula]

I took my otherwise healthy DD (11 months) to see a locum GP yesterday cause she has had what seems like a permanent cold for months (probably picked up from her big brother I know, but it has gone on for ever) I was concerned that we were over medicating cause she needs nurofen/medised to settle at night and I'm reluctant to keep pouring it down her throat!

Anyway, the upshot of this was that he explained she would always have this problem due to her 'flat nose' - it is slightly flat at the bridge, but then so was DS's until he grew up a bit. Wasn't worried about that until he went on to clarify that 'this is one of her mongoloid features'

I was pretty stunned. Mostly at his choice of expression, quickly followed with a massive array of 'oh my god, have I totally missed something here' doubts. I haven't - and I'm sure if she was on the down's spectrum it would been picked up anyway. that however isn't my concern to be honest - it was his statement of fact.

I left, really not knowing what to say, and am now absolutely furious. But not sure how to further it - or indeed if there is any point???? I was thinking of going to see my GP so at least they know what kind of rubbish he's coming out with......any thoughts? AIBU???

marina

My DD was on long term medication, and the GP made a comment about the toxic effects this would be having on the water/sewerage systems.

Bit of an exageration I think, and hardly my biggest concern at the time

I have heard it described as a spectrum quite a bit monkey. Even without mosaicism it presents as a spectrum, from those with severe LDs who remain unable to talk and needing a lot of care, to those who are able to hold down jobs and get married.

Marina - I think yours is worse. Awful and very upsetting. The "girls can't get it" was just laughable. (At that stage I told him what I wanted, didn't quite trust him to decide what I needed )

To answer your question about what to to, write to the practice manager and/or your local Primary Care Trust.
You could also write to the General Medical Council who may take an interest as he is a locum (they could write to his agency and ask if he has had any other complaints)and your complaint would be registered against his file as well.
Most likely outcome though would be a letter of apology from the practice on behalf of your GP on behalf of the locum (IYKWIM). I think the most they would do to the locum, unless they were lots of serious complaints against him, would be to advise he has more training and looks at how he deals with patients, the language he uses etc

completely gobsmacked.
whatever the explanation (ignorance/wrong notes) it should be addressed, esp as imo, 'mongoloid' is racist AND offensive to people with DS.
And while I aggree that DS may vary in how it affects people, you either have it or not- you can't have it 'a bit'

'At 11 months, you almost certainly would have been told if your DD has Down's Syndrome!

you'd hasve spent days worth of hours in hospital check up rooms, completing forms etc

report! shameful gp!

and no, mongoloid is not OK- offensive beyond belief

'you either have it or not- you can't have it 'a bit' '

actually thats called mosaicim isn't it?

only wsy it ca be dx'd though is by genetic tests- not some arse ifnormant GP!

marina, sorry for your bad experience, that was awful. Lost a dd myself at 20 weeks and was shown letter in hospital, before the stillbirth was induced, asking for "foetus and placenta" to be sent to london for testing. That was our daughter, we had a diagnosis already via amnio so did not need PM to benefit us or others in future. Thankfully the Dr there was much more sympathetic than the one you encountered, the hospital did a lot in helping organise a funeral for dd. hugs for your anniversary, know how tough they can be (I am almost 5 yrs on)

Would you have been more comfortable if he had said 'flat mid face' or 'hypertolorism' or a more clinical phrase? These are just the more usual terms (nowadays) for the same thing. I'm sure he was using the word discriptively not for diagnostic purposes.

Madlentileater if you have mosacism, yes you can have DS 'a bit'.

a bit off track from OP, but i lost a dd myself to mosaic chromosome abnormality (not downs), at 20 weeks pg, so am very aware there can be a huge differnce between those who do not even make it till birth, those who are born and die young/have huge problems, and those who can have a relatively normal and fulfilling life in the community (often with hidden addition health problems such as diabetes, heart probs, but life expectancy for downs etc is rising )

OP, that GP you saw was out of order, if only for not recognising your shock reaction and explaining themselves

if your other DC had the same nose features at same age and is ok now, don't worry. if you cant help worrying, ask for tests (esp if considering future pg as it is poss tho unlikely that you or DP could be carring a dodgy chromosome - sorry that sounds awful, I can't remember what it is called, trans-something i think)

However, I do actually KNOW someone whose childs Downs (full, not mosaic) was not picked up till the child was 10 months (and that was because he was being used as a case study in a GSCE childcare group and the teacher thought there was something not quite right). this is 15 yrs ago though and I am sure incredibly rare due to better monitoring by Hvs etc, so yes, it does get missed sometimes till there are obvious developmental delays if physical signs are not marked and no mother serious health issues present

other not mother, sorry!

also, have you considered allergies to explain constant cold-like symptoms? dairy/dustmite would be my first guesses

DD2 went dairy free for eczema and dreadful diarrhoea, and hey presto, no more colds and catarrah (sp?) either!!

It would not have occurred to me that he meant Downs Syndrome. DH has a problem with ear wax which is compounded by being what used to be termed mongoloid. This 'mongoloid feature' has a medical significance as does your dds nose. Pointing it out wouldn't have made me furious even if the terminology is outdated. Part of the problem is there is no longer an acceptable word to describe what used to be Mongoloid. Ethnic group forms usually use Chinese to describe the whole of east asia, pacific islanders and native Americans which is hardly satisfactory. It would be like all white europeans having to tick a box labeled 'German' due to having similar features to a stereotypical german person.

The term 'mongoloid' was mentioned in Bad Science in the Guardian last Sat. Apparently a study was carried out where some scientists deemed it was OK to use this term!! It was cited in the article as a useless study...I'll have a look for the link.

here is the column. Ben Goldacre's usual rant is about the media misinterpretation of the MMR/autism link based on a seriously flawed study...

I am so [shocked] and

I was at the hospital with my 2 year old for an eye check up and I mentioned previous problems. I had concerns he had DS and wanted to find out to give him what he needed. I mused that surely we would know by now, the doctor replied "that's not for me to say." I went home worried about something completely different to what we had gone in with and when I mentioned it yesterday to the lady eye doctor she said doctor's bedside manners are awful.

Would see the proper gp - what does this doc mean - will always have procs with nose? why use term monogoloid? I'd call them & get an emerg appt.

Well - thanks for all the messages. Just got back from seeing our GP who was shocked (to the point of laughing, which if you saw my DD you would too, such is the misuse of the adjective). And absolutely mortified.

It was an emergency locum (he was in his 50's - to be honest I should have known there was something strange from the outset cause when I told him she was very distressed at night, he asked how do you know she is? How do you know she is in pain? )they have never used before - she is lodging a formal complaint and assured me they won't use him again.

So I do feel a lot better. And I agree with other posters that it is just one of those words which regardless of whether they correctly describe a certain look or not, is just not used in today's society. Wholly inappropriate and has too many connotations (rightly or wrongly) to be employed medically without causing parental concern.

Thank you for you support. Feel happy that I took it further. Although not at all happy that my DD has a double ear infection and pus covered throat, neither of which he picked up less than 24 hours ago

As others have said 'Mongoloid' is a technical term. God help us if someone decides appendix is a bad word because surgeons will have to start saying "I'm now removing the 'dipsy do' or some such thing.

Hmmm, very technical in this paper..."two Italian doctors argued that "mongoloid" really was an appropriate term for people with Down's syndrome, because such people shared many characteristics with oriental populations (including sitting cross-legged, eating different types of food containing MSG [monosodium glutamate], and enjoying handicrafts)".

Laundry lover - sorry but PMSL at the quote - "enjoying handicrafts" lol - i did have a chinese friend who would do cross stitch in her tea break .

Nellie - i am pleased that your doctor took you seriously. I was honestly unsure if this was a frowned upon medical word or not - clearly the locum has had a common sense and tact bypass. I'm sure your little girl is just gorgeous - silly old codger.

Sorry she is so poorly though - hope she feels better soon xx

Nellieloula......glad you got the issue with locum sorted via your regular GP. However, just wanted to add my experience regarding the constant colds etc. My DS2 suffered with constant colds and coughs from around 2 months of age until 11 months. What stopped it for us was taking him for cranial osteopathy. Now, most people would never say that DS2 looked remotely like a child with Downs - neither physically nor developmentally. And in fact he doesn't have Downs but I had noticed that the bridge of his nose wasn't particularly high or pronounced. The osteopath took one look and said his facial bones were compressed (prob due to birth - natural but he was big and I am tiny ). He worked on his face for about 10 minutes - very gentle - DS sat on my knee and didn't get at all upset. By the time he turned him around, his face looked significantly different and he hasn't had any problems since. If there is any subtle compression of the facial bones, the mucous etc present in her system will not drain away properly and therefore prolong coughs and colds.

Sorry.........very long response but hope it helps!

DD permanantly had a cold for the first year, but I had a bad cold with a temperature the days she was born and she caught it off me within 2 days.
She constantly was getting colds with a stuffy nose for the next year, this coincided with her big brother starting nursery, so he may have been bringing bugs home.
After that she has been fine and now is very rarely ill.

Downs Syndrome does have varying degrees of disability. There are very high functioning scenarios and completely none functioning scenarios.
There are certain characteristics of DS of which a flat nose is one. However, so is having only 1 Palmer crease on your hand, my dd1 only has 1 (and the implications were pointed out i.e. its a DS characteristic), she doesn't have DS and is infact well above her chronological age in several developmental areas.
The point is that the term is purely descriptive and is only offensive because of people using it in an unpleasant way.

It is fact that people with that shape of nose will suffer from more sinus problems than someone with a Roman nose.