DS1 and ongoing infection.

[CouthyMowWearingOrange]

DS1 has been ill and off school since 21st September. He started off with a cough and a temperature. Took him to the GP that day, as he was meant to be sitting his 11+ the next day, and needed a medical note to be able to sit the alternative sitting.

He was dxd with a viral respiratory infection. No antibiotics given.

He then had such a sore throat, to the point of not eating or drinking without painkillers that I took him back to the GP on Monday 25th September. The GP said he now had viral tonsillitis as well. He refused to give antibiotics as DS1 is allergic to penicillin and amoxicillin, and he didn't think it was bacterial.

I disagreed, and asked him to take a swab for testing.

By Friday 28th September, DS1 was no better, and still not eating, drinking properly, or sleeping properly, I took him back.

The GP apologised to me, told me the swab had come back saying DS1 had a streptococcal throat infection, and he gave him antibiotics. He put him on 250mg erythromycin tablets 4 times a day.

DS1's throat has got worse, not better. He has been surviving off a maximum of half a meal a day, after painkillers.

DS1 hasn't eaten ANYTHING since dinner time on Monday. He is hardly drinking either, except half a small cup of water when he takes his antibiotics.

I have booked YET ANOTHER appointment with the GP.

What else can the GP do for DS1? He is losing weight, looks awful, is shattered, he is hungry but can't eat because his throat hurts too much, the antibiotics don't seem to have done anything. I'm worried.

I've also got the school on my case, as he last attended school on the 20th September. DS1's dad, my Ex-H, is getting mardy with the school about DS1 not being there (we don't talk at present, long story).

Probably will have the EWO out in the very near future too, I'm sure his attendance must have dropped below 85%, as this is so early in the school year.

What do I say or do at the GP's to get this taken more seriously? DS1 is not well. At all. I have tried tempting him with every sort of food known to man. He is 10yo, and even turning down doughnuts FFS!

I forgot to say, DS1 is 10y6mo, and in Y6. Can't scroll up to add that at the start as am posting on my phone.

Not sure if this is viable but could you speak to the children's ward at your local hospital - if they would see him you would get specialist advice.

Our local hospital had a sort if day clinic thing. We were able to go as dd had been in patient at one point and I was able to phone them direct.

Forget school.

I'm no expert but I believe it's trickier with fewer anti-bs to choose from because of his allergy.

The ones he has been given are clearly not working, so they need to try another. In fairness to you, you didn't know this but I wouldn't have hung around so long before taking him back to GP. Get in there today and get them to do something else. It's not fair for them to let him suffer like this.

I may try that after GP visit.

What else do you think the GP could do? I am thinking that the next step is probably inpatient treatment with IV antibiotics given his penicillin/amoxicillin allergy. I hope not. But I just want him better. He is so bloody miserable, and is sick and tired of being ill for so long.

Is there anything I could ask the GP? Any sensible questions? I'm unsure what will be their next move.

The GP told me to give it 5 days of the 7 day course before coming back. This afternoon will be the 5th full day. I was only doing what the GP advised, as he told me that erythromycin takes slightly longer to see an effect. Which seemed plausible to me.

Ok I'm a complete ignoramus really but my mum was recently v poorly with a kidney infection and was given various courses of anti-bs, the first THREE of which did nothing. She was really unwell and I was so cross that it was strung out over weeks.

On asking my DB who is a doc, he said that he has stopped prescribing some of them as they are only effective around half the time, but are cheaper. So docs prescribe in the hope that (a) they will work, (b) even if they don't work it was viral anyway and clears up in the meantime with the result that (c) they've saved money. At least this helped my DM to know to get back to the doctor's rather than suffering on for even longer.

So with the added complication of the allergy, I think you need to push for the GP to keep trying other things - ask about the known efficacy of what is being prescribed.

Thank you. These are the things I need to know about.

Just tried to work out attendance percentages, and I am fully expecting to hear from the EWO in the next day or two. His attendance is either 59% or 64%, depending in how they look at the Authorised absence for his alternate sitting of the 11+. Which he had to sit on the 1st, despite still being poorly.

Thing is, due to the throat swab I insisted on, they KNOW it isn't viral, and that he has a streptococcal throat infection.

Yes, bloody good job you insisted on it.

Honestly, sod the school. Get GP to write letter while you're there and then make photocopies to hand to any school bods or EWOs that come and bother you.

It's the least the bloody GP could do after sending you home insisting it was cheap viral. Grr

I have just been doing a bit of online research, and apparently there is a strain of strep throat that is erythromycin resistant.

They usually advise penicillin/amoxicillin as a first line treatment. That was discounted due to allergy. Erythromycin is the second line treatment. That hasn't worked, so DS1 must have the erythromycin resistant strain.

From what I've read, there are very few other AB's that they can treat strep throat with in children.

And it looks like the next line will be tonsillectomy. Crap. Hope they can try some other antibiotic before they look at tonsillectomy.

Try not to worry there may well be something else.

You're trying to walk that fine line of being assertive so gathering all the facts, while at the same time not basing everything on snippets of google. It's impossible really.

You have to trust the doctor but be very pushy if your bullshit radar goes off.

I tell you what though, if the GP is not more helpful and dynamic this time, no harm in turning up to A&E (imho - I know many on here feel strongly about not wasting precious resources ) when your DS is feeling so sorry for himself and is eating/drinking so little.

What about the cephalexins?
I am allergic to penecillin and can't take erythromycin either.
I have to take either doxycycline or one of the cephalexins.
Can't beleive they have left the poor thing this ill for so long :(

Yep, def a and e if gp is shit.

Cephalexin. Didn't think of that. I have to take that when I get a chest infection as I'm allergic to erythromycin as well as penicillin and amoxicillin.

Can DC's take cephalexin though?

Not sure.
Pretty sure they can take the tetracyclines though....

Yes, I guess tetracyclines might be good too.

Roll on 3.30pm when I can take him back to the GP.

I managed to get him to have a yoghurt after his last painkiller. Just a yoghurt.

Oh the poor thing.
And poor you :(
I like doxycycline because its only 1 a day :)

I am not surprised he doesn't want to eat. Many people respond badly to the bad side effects of erithromycin. Clarithromycin is the much newer, more effective, fewer side effects (and more expensive) drug which only needs to be taken twice every 24 hours rather than 4 times which is the case with Erithromycin. Erithromycin can make you feel very nauseous/cause tummy upsets. It made me feel like wanting to die when I had it prescribed. I then found out about clarithromycin, switched, and had no side effects and got better very quickly.

Your GP does not sound great. So if it is an option I would see another GP. Also, if he found out that it wasn't viral tonsillitis (and I HATE WITH A PASSION how some GPs label everything as viral without testing - can they smell something is viral or are they plain ignorant (my dd almost died because an incompetent GP), but was bacterial, I hope he contacted you and asked you to pick up a prescription rather than waiting for you to contact him again.

If no luck with GP take him to A&E at least there are proper paediatricians. Don't worry about the school at the moment, that is something to sort out once your son is better. Concentrate all your efforts on getting him better, streptococcal tonsillitis needs to be taken seriously, normally after 24-48 hours antibiotics you need to see an improvement, otherwise you may need different treatment. Be assertive, seek help, don't wait because you don't want to hassle people, it is too important!

I hope he gets better soon.