GP won’t see 4yo for 2 weeks [Title edit by MNHQ - Please read beyond the OP before responding]

[trombolese]

Hi, just need to get an opinion on what people would do in my situation.

Some background on my 4yo - severe silent reflux from birth which meant awful awful sleep and feeding. This went undiagnosed for 7 months which then led mega tonsil problems, golf ball size which then caused severe obstructive sleep apnea. Tonsils out at 2.5. Grew back 5 months later to full size, if not bigger (didn’t think possible, consultant at Evelina said she’d never seen it happen that quickly) - constantly infected, had them out again at 3.5. Never weaned properly due to feeding issues, always bad with food. Quality of life crap due to tonsil problems. Since having them out it has only very mildly improved to be honest. He has also suffered with constipation the past year due to poor diet.

Since beginning of October he has had a fever at least once a week, sometimes explained, sometimes completely unexplained. The longest he has had fever for is 8 days with no other symptoms. GP not interested and said these things happen (we have 2 other kids…it doesn’t happen). So many lots of antibiotics, a couple of long lasting chest infections and since November an ear ache that hasn’t gone and he is still suffering with today. Yesterday he spiked another fever of 39, no other symptoms but sent home from nursery. He barely eats a thing, some days he will only eat 2 squares of toast. The rest of the day he drinks like a fish, just water other than 1 x cup of milk before bed and sometimes 1 x in the morning. He’s lost about 3kg so far. He’s so so unbelievably pale, puffy eyes and big bags under his eyes too. He’s recently taken to crying a lot. A lot, a lot. Over things very trivial to the average person but these crying episodes can last up to an hour. He’s extremely irritable and sad. He seemingly can’t walk longer than about 15 minutes without complaining his legs are hurting loads (to the point where he will just crawl along the floor instead if we let him!) and more recently he is waking in the night complaining of itching. His tiredness and lethargy some days is another level.

Seeing as this is his 10th fever in as many weeks (I am keeping a diary now) I contacted the GP with a massive list of his symptoms as I am now actually really concerned. They can’t see him for 2 weeks and have told me to “contact the HV” for advice in the meantime. What advice can they possibly give?! I am really concerned he is lacking something important in his diet or god forbid, something even worse.

AIBU to call 111? Do I take him to a&e?! This just seems crazy now. He has missed so much nursery and it just breaks my heart that his QOL is so shit.

Go to A&E. Take warm clothes, snacks and drinks but do not leave until you have seen a doctor. Be insistent. Unfortunately with medical professionals the squeaky wheel gets the grease. Strongly emphasise the length and severity of your child's symptoms.

When you have the time, write to your practice manager and explain why not seeing your son as a priority is unacceptable. Copy in your local MP. I've done this before (sadly have had to more than once) and they fell over themselves to provide a better service.

I really hope you get seen quickly xxx

Every time I’ve been unable to get an appointment for something I consider urgent I’ve spoken to the practice manager. They then speak to a GP and I’ve always been seen the same day. I would give this a try before going to A&E.

Vote for A and E here.

I think you need to queue jump routine tests at this point. Best of luck.

Thanks so much all, in the queue on the phone to the surgery now again, if no luck with practice manager I’m going to contact 111 as I completely agree with you all, I just couldn’t tell if I was being dramatic as this has been going on for what feels like forever now.

@Doteycat his poo is very pale which concerns me and where he’s constipated it causes him so much pain despite pooing now fairly regularly. Weeing fine thankfully.

I would actually suggest to avoid the GP and go to A&E. Although the GP can assess him, he really needs a full set of bloods which can only be done at the hospital so I would just take him there, preferably somewhere with a paediatric unit so he can be seen by a specialist. Don’t be fobbed off, at the very least he needs blood tests so please insist that these get done.

Take him to A&E

What colour is his wee?
Pale poo, v strong wee and itching along with the tired is a sign of poss gall bladder/liver issues.
I ask because he sounds like me and I'm currently recovering from a liver infection. I'm fine and i will be fine but I was shattered and off my food for 2 weeks. Then i stattwd itching. wentg doc and and asked what colour my poo was. When I said pale, he took bloods and sent me to a and e.
I will stress, I AM FINE now. But I needed steroids. Tell them he's itching and his poo is pale and if they don't see him , take him to and e.

Prolonged malnutrition is linked to liver/bile disorders. He’s vulnerable and needs assessing asap. He has no fat or muscle reserves. Malnutrition in children is not simply reversed by eating more food it needs to be medically managed carefully.

I agree that you need to avoid the GP. Even if they’ll see you today and refer you for blood tests that will take 1-2 weeks whereas if you go to A&E then they very well may take the bloods today. This is potentially serious and I wouldn’t be hanging around.

Oh my goodness how worrying. Hoping you managed to get through on the call you were making to be seen.

This would align with my thinking too.
My bilirubin (sp?) Was off the scale but also fixable. He needs seeing.

Is definitely go to a&e as I'd be worried the doc will fob you off again with a wait and see. The symptoms of itching, lethargy, random temp combined with how little he's eating and everything else would worry me. In your gut so you think he's ok or something amiss compared to how he usually is ill?

Itching = liver (also with the pale stools). Are the whites of his eyes yellowish at all?

Agree A&E best option. Has he been tested for diabetes?

His wee is pale too as he drinks so frequently, I’m talking a bottle of water (one of the tommee tippee sportee beakers) every hour if we let him even sometimes through the night (sometimes we try and eek it out as we don’t want him to be drinking too much). He has been wee tested for diabetes and they’ve said he’s fine in that department thankfully on the drinking but yes the itching concerns me too. Thank you!

Rang the surgery and she said they have absolutely not a single minute to see him but she “understand my concerns” and said to call 111. A GP has dismissed his symptoms btw as our e-consult things are triaged by a GP first. I am feeling very cross and whoever dismissed me next is going to feel my wrath.

Go to a and e.
Just go.

I'm absolutely aghast that your GP won't prioritise a clearly very poorly small child. Hopefully 111 can get you an appt very quickly whether A&E or elsewhere. If they don't answer so, I'd probably just go especially if you have a children's A&E anywhere close.

I would contact the health visitor as she/he can refer you to the children's ward/assessment unit for tests.

I wouldn’t bother with 111 either, I’d take him to A&E. be very clear in outlining what you’re concerned about - as much as I wouldn’t normally encourage googling in this case I would reel of a list of worse case scenarios and expect to be reassured properly about each of them.

I would take him to A&E, especially if your local hospital has a children's emergency department. GPs here are not trained in paediatrics and often are unable to give the correct advice. At children's ED, you'll see an actual paediatrician who will be best placed to advise you AND advise your GP.

The itching worries me (can be a sign of liver issues) and the weight loss and persistent fever needs to be evaluated - as does him being pale (could indicate iron deficiency - but note I AM NOT A DOCTOR)

At very least I'd call 111, but in my experience (frequent visitor over the last 2.5 years to our local children's emergency department) you will get better advice and care at a children's emergency department, and it does sound like your little one needs to be seen and evaluated. Just prepare for a wait, take snacks and water and books / toys.

He needs faster intervention than this.
Go to a and e..

I wouldn’t be bothering with 111 tbh, you’ll likely wait ages for triage and then for Dr to call back so might as well have gone to the hospital to start with. Take food, drinks, iPad/book, charge pack, warm clothes and expect to be there for a while. Maybe take another adult with you who can save you a seat (if there’s one to start with) whilst you’re in and out of triage.

Poor thing. He needs to see a specialist for tests and to get a handle on what’s going on with him.

He doesn’t have mouth ulcers does he? Just with you saying how little he eats I wondered if his mouth was sore.

Also, as a mum with a young child with frequent health issues (in our case, breathing issues and ear issues), just want to send you much solidarity. It is SO HARD at the moment to get toddlers seen by any medical professionals. I had a fight this week to have my 3yo with a chest infection and significant wheeze and difficulty breathing seen at our children's ED. But it was well worth it to actually see someone who understands paediatric medicine