Are GPs trained to “sniff out” underlying issues based on symptoms?

[Judystilldreamsofhorses]

Sorry this is a long boring post.

I’ve been suffering from an un-lovely combination of sinus/allergy issues (long term thing) and acid reflux (last six months) which are causing me to have a lot of mucus in my throat, cough, and sore throat. I “saw” a GP in the summer and tested positive for h Pylori, which I was treated for. I didn’t feel much better, although the stomach pain definitely improved, and at the next appointment he switched my nasal spray for a steroid one, and (not sure why?) took me off the reflux meds. I’m better in my nose, but still there with the reflux and all the symptoms.

Today I had an appointment with a different doctor who I felt was really thorough and really listened. She has repeated the nasal spray, and put me back on the reflux stuff. I said I was very anxious about it all, and she said based on my symptoms she felt no need for further investigations.

Google tells me these are all symptoms of both throat cancer, and of lung cancer. If the GP was concerned, she would have asked me in, right? All of this has been on the phone. I did have a dental checkup a few weeks back with no issues, so presumably she would have picked up on throat problems.

I have no breathlessness, the mucus is clear, and my oxygen sats (based on a pulse finger thing from Boots) are fine, heart rate is 63ish resting based on that device and my Fitbit. My DP has high BP so has a very fancy monitor thing for that and I am in the “optimum range”.

I am peri-menopausal and feeling very anxious in general. My DP says I need to just lay off Dr Google, and trust the actual doctor. If you can hear hooves, it’s probably not a zebra, right?

I VERY rarely see a doctor - not for the first five years we lived here other than smear tests - so just feel a bit weird about it all being on the phone. I have a facial neuralgia thing which means I have a dental checkup every three months, and I feel like I have a good, trusting relationship with my dentist which obviously I don’t have with any GP.

(Absolutely not knocking the doctors in any way, just in a bit of a rabbit hole!)

@HorseGallopingOnATomato funnily enough I took a probiotic when I did the triple therapy, and just started one last week again. I really need to go and have a chat with someone at the independent health food shop to make sure I have the right one actually.

Trouble is with many symptoms. 100 people can have them but only one might have cancer. We can't refer everybody and the skill is to sort through the wood to find the trees.

We are all aware of the "red flag" signs. It's often very obvious when people have cancer but sometimes not. My colleague picked up an ovarian cancer just today. I've picked up loads over the last 34 years but I've also had people who I thought must have cancer but they don't.
Diagnostic skills take years to learn and perfect. Or do we ever perfect them? I don't think so. The human body is very complex.

It took me a very long time to settle down after being treated for h pylori. Loads of investigations and eventually the symptoms just stopped. I developed oesophagitis and so my oesophagus was very sensitive for an awful long time after the initial infection.

Years later I still have to be careful with what I eat and drink otherwise it flares up.

So your GP may well be right. It’s frustrating that sometimes symptoms just persist and there isn’t much they can do. I really pushed for investigations as I was worried about cancer. Ultimately I had a lot of investigations and associated stress but no impact on Tyne outcome!

As a long term sufferer the things that help immensely are drinking enough water, cutting down significantly one caffeine and alcohol (boo!)

@Musicaltheatremum I take it you are a GP? Based on my symptoms, would you think “red flag, cancer”? I felt like the doctor was very reassuring on Friday and would have hauled me in to the surgery if she had had concerns!

@Gumboots29 I really need to up my water. I started drinking a glass every time I boiled the kettle but have forgotten again so will do that right now. I am a real tea Jenny which doesn’t seem to impact it, or alcohol, funnily enough - whereas chocolate is a total killer!