When to go to the docs

[Cl]

What's your benchmark/deciding factor in taking your babes to the doctors? My almost 6 month old has had a cough forever, but I'm loathe to go cos I know they won't do anything and I alwasy feel they look at you like you're a bit mad. I tok my first child most weeks it seemed, but am trying to hold back a bit with this one, without wanting to make him worse. Also what experience have you had of calling the doc out? A friend's child had a temperature of 40 and a massive nosebleed and after waiting 45 mins for the emergency doc to 'call her back' she panicked and went to casualty only to get a call from her hubby as she arrived to say the doc had finally called (an hour later) to say the child was fine, it was just the virus coming out - is this normal 'emergency' doc behaviour?

I usually wait until my childminder starts moaning about ds cough and saying 'hasn't he had it a long time'. I then take him to the doctors in order that I can reassure her he is OK and doesn't have asthma! Sorry, that's a bit flippant. Now ds is nearly 3 I have learnt that over the winter he generally tends to have one permanent cough. Having been to the doctors countless times I know there is nothing to do. He tends to cough mainly at night too. If he seems to be wheezing, or the cough gets worse during the day or the cough is stopping him sleeping then I'd probably take him to the doctors. I'll set myself a time span, something like if I don't feel happy this time next week then I'll take him. If it sounds croupy and he doesn't respond to steam, or the cool night air, then I'd probably whip him over to casualty.

With tummy upsets in a young baby I'd give it perhaps a couple of days. Now he's older I see how he goes, provided he's drinking, can eat a bit in a day or so and seems happy then I probably wouldn't take him now.

Any unexplained rashes, spots I'd take him as soon as possible - partly for my reassurance, but also to find out whether he is contagious and is a threat to other kids at his minders.

If he had a temperature, was hard to wake, floppy - really out of kilter, then I wouldn't hesitate to ring the doctor whatever time of day/night or even take him to hospital.

You shouldn't let a doctor's attitude put you off - if you are worried then get your child looked at. What I have found useful is that I will sometimes ring the surgery in the daytime to speak to a doctor and explain that I don't know whether to come in or not and what is his opinion. A two minute telephone conversation is very reassuring and doesn't waste anyone's time.

What's my benchmark for taking a baby to the doctor?

Light cough and runny nose, no doctor.
Chesty cough geting worse over a 24 hours, doctor.

Temperature, doctor.

Vomiting with no temperature, probably no doctor, if this happens just the once.

Vomiting with no temperature, but more than once, possibly doctor, but would cut out hard-to-digest food and drinks first.

Vomiting with temperature, doctor.

Extreme crying, obvious distress, suspected earache, lethargy or other unusual behavior, doctor.

Like you, Cl, I tried to take my second child less often than my first. I didn't want him dosed up with antibiotics all the time.

However, from six months he was being cared for by a childminder. I often found myself at the doctor's surgery to satisfy her worries more than mine, which is fair enough. She took her responsibilities very seriously and we never fell out over it, though dh and myself felt she could be a bit OTT. I think she wanted total reassurance that he was 100% OK every day. As his mother I took a slightly more relaxed attitude.

IME, our emergency doctor service is far, far superior to the service offered by the normal surgery, even though I frequently found the same doctors at each service.

For working mothers, our surgery set up is totally inconvenient. Most days you can't get an appointment after 6 o'clock, and if you plead, there is much tut-tutting from the receptionist. Even with a sick baby, you can wait days for an appointment, or you take pot luck and come at the end of a surgery session. This can involve hours of waiting.

After one awful experience I vowed never to do this again: My 10 month baby was very hot and had been a little sick. He was not really unhappy, but he was definitely not well. I phoned the surgery and said his high temperature was concerning me and was told I could turn up and wait for the doctor, but it would be a long wait. We were in a hot waiting room for about two hours, and I could see my son was getting increasingly ill. He was beginning to get quite lethargic. A few times I asked the receptionist if things could be hurried up - they could see my baby was not at all well, and I had no calpol or other temperature-reducing medicine on me. Nothing happened. When we eventually saw the doctor, he said my son's temperature was at a very serious level, and if he did not improve within an hour or two, he would have to go to hospital. I rushed home to administer calpol and cold flannels asap which bought his temperature down.

After this incident, unless I am faced with a dire emergency, I wait till 7O clock in the evening, then phone our emergency doctor service. I usually get to speak to a doctor on the phone within half an hour. They are always happy to see me or my sons. I simply put the phone down, travel to the surgery, a 10 minute drive away, and walk straight in to see the same doctor I have just been speaking to on the phone. A lot less hassle.

PS forgot to add, the emergency doctor service doesn't take calls during surgery hours, so I have to wait till our surgery closes before I can see a doctor. What a joke!

In effect, I am using the doctor's surgery only for dire emergencies that cannot wait till the evening - and the emergency out-of-hours surgery for the majority of my children's aches and pains. The reverse of their intended function.

Obviously, for the least serious problems, I make an appointment at the surgery.

Tigermoth I can see you would be really distressed by the incident when you has to wait for ages but I think it is really not fair of you to abuse your surgery in this way. What if everyone did this? You are taking up the out of hours time when there could be a genuine emergency for some other family. How would you feel if you or a family member was a doctor whose patients operated this little scam for getting seen straight away?
Doctors are people too, you know.They don't want to be dragged away from their families oin the evenings when they have been at work all day any more than you would . Please rethink your tactics which in my view are extremely selfish.
Have a word with your doctor if you think the reception staff do not prioritise well during normal hours.
I would love to hear the view of any GPs in this group regarding your out of hours visits.

These are my "guidelines" for when to call a doctor:
Fever over 40, call immediately
Fever between 38 and 40, call within 24 hrs if no improvement
Low grade fever with general flu or cold symptoms, make an appt if no improvement within 3 days.
IF the fever is also accompanied by any of the following: limpness, lethargy, convulsions, inconsolable crying for hours, crying, moaning, purple rash, severe headache, drooling, neck stiffness or severe dehydration - call immediately.
For a cough, if it is wheezy, around for more than 2 weeks, disturbs sleep or contains yellow or green phlegm (sorry!), go to the doctor during normal hours. If there is blood in the phlegm, or the child is having trouble breathing, call immediately.

I think as a mother we can sense when our child is really unwell, from their behaviour and manner, even if they don't have a fever, we know when something is "not quite right"...they are off their food, not sleeping, crying or restless...we can also (usually) tell when they are "faking it"! We also know how sensitive each child is, how one can be really sick and cope and the other is laid out for days.

So I say if all else fails, go with your instincts! The worst outcome is they think you are paranoid and send you home and you waste a morning/afternoon in a doctor's waiting room, but the worst outcome...well, let's not think about it!

Forgot to mention - when my dd was about 2 she had had a cough for months and we ended up at a specialists because the gp thought she might have asthma (my dh had it severely as a child); then after buying a nebuliser and torturing the poor child with it for a month or two, he decided it wasn't asthma at all but a "post-viral cough", which would eventually clear up by itself. Which it did - almost as soon as she stopped going to child care!

flox99, I hold my hands up. You are right and I am in the wrong here. If everyone did like me the local emergency service could come to a standstill. What I should be doing is looking for a new, less busy local surgery more able to meet my needs. I just havn't got round to it. Black mark for me.

In my defence, I'll say this:

RE dragging the doctors away from their families for an emergency call out:

I go to them, they don't come to me. They are doing a shift at the emergency surgery already, so they are not at leisure with their families.

RE Taking up time that could be used for a real emergency:

Yes, this could be so. It's could also be true if you go to the casualty department with a sick baby. Where do you draw the line? The emergency centre do prioritise. You can't just walk in whenever you feel like it. First you phone the receptionist. If she is convinced you need to speak to a doctor, she will get one to phone you back. When you speak to the doctor, they will tell you if they want to see you or not. So by the time you make the emergency surgery, you have gone through a checking process.

I've gone about 4 times a year for two years. Usually because my baby/toddler is ill, occasionaly because my more robust 7 year old is ill - mostly he has normal surgery appointment s. Never, so far, on my own behalf.

On the times I have gone, the waiting room has had two other patients at the most, and everyone has been seen within 10 minutes. I get the impression that there is more than one doctor on duty.

The botttom line is, yes, I should change my daytime doctor surgery to make me less dependent on this service.

As it stands, I won't put what's morally correct before the health of my sons. So if they are ill, I take the most immediate route to their recovery.

sue W, I have phoned NHS Direct twice now in the past year, both in the dead of night; once because of a really high temperature, the second -really high temperature and spots. On reflection the advice I recieved was all the standard stuff that I knew anyway, cool flannel, water, and make an appointment to see GP in the morning, unless of course, the temperature got worse and then straight to casualty. However, it was so reassuring to talk to a professional, especially with the high temperature and spots occasion (turned out to be hands, foot and mouth)I think that it calmed me down, like talking to another more experienced mother. I did, however, find the endless questions such as "sorry can you just repeat your postcode, ... and your telephone number was it 638 or 628 ..... very long winded as all you want to do is scream "is my baby gonna be ok or what" Has anyone else called them?

flox99, I am so glad you did not seem to take offnce to my message, which I almost regretted posting!
Yes, I had forgotten many surgeries now operate that system where there is an on call doctor in a surgery somewhere anyway.
My brother is a GP in a rural practice and their on call rota is the more old fashioned sort where a group of local doctors just take turns to be the one with the pager and he gets called out at all times of the night, which he accepts as a necessary part of the job. He does really hate however being called within two or three hours of the surgey closing for a problem that has clearly not just emerged in the last couple of hours, as he feels the patient is just deliberately trying to circumvent the receptionist, avoid queueing, not take time off work or whatever.
Also he feels that because the vast majority of calls are for trivial things ( not to knock the patients here, many of whom are genuinely worried and do not know their complaint is not serious) it creates mindset among doctors where they are really not expecting anything serious.
I must be very fortunate in my surgery as they do seem to prioritise children and pregnant women during the day! I have always been squeezed in the same day(not that I have needed to go too often )and the reception staff really could not be more helpful and pleasant.
Good luck in your search if you do decide to find another surgery

I've used NHS direct several times since my 2 1/2 year dd was born. Found them very useful especially for reassurance. The first time I used them was when dd was 7 weeks old and it felt good to have someone to talk to as I was at the end of my tether with a non-stop crying baby - we've all been there. Also found that if I try to get an appt with the GP and say that I have called NHS then I don't feel like a "time-waster".

im a mumsnet virgin - so here goes!
In response to cl before i go to the dr i stop and take a step back. a dr once told me to treat the child and not the symptom and so if my child had a persistant cough but was generally otherwise well i would do nothing.I generally feel that with perhaps the aid of some targeted homeopathy or added vitamins kids get over things in time. (well that was good for me)

message withdrawn

I use NetDoctor (www.netdoctor.co.uk) a fair bit on the internet. Every so often they have an 'Ask Dr Hilary' session where you email questions and he emails you back. At one particular time, question time coincided with ds having a goey ear infection. I wasn't sure whether to let it runs its course or take ds to the docs, as it wasn't causing him any distress. Anyway, I asked Dr Hilary and got a nice response which suggested I should take him along to my docs. The next day I made an appointment and ds needed some antibiotics.

I called the emergency doctor out-of-hours service which was very good. He's based in a cottage hospital 5 minutes drive from us..we took our baby with a high temperature over to see him and he was delighted to examine her & make sure she was ok. A bonus - the cold night air brought her temperature down a treat and she gurgled away at him. Other than that - NHS direct are pretty good.