I’m not aiming to annoy GPs, but the day after the “heart attack in the waiting room” I went to another case where the GP had been less than helpful.
It sounded like one of our ‘crap’ calls – “6 year old female, losing weight, tired”, not what you’d mark down as needing an emergency service.
The ill child did look very thin, and her concerned parents told us that she had been losing weight for the past couple of weeks. She was lethargic, wasn’t eating well (she was mainly drinking a lot of fizzy drinks) and had been having spells of dizziness. To my eye the child did look rather unwell.
The father had taken her to the GP earlier in the week, and the GP had told him that he was “wasting his time”, and that the child would soon put the weight back on. The father asked for the child to be sent to the hospital, and the GP refused this.
We got the child into the ambulance and starting running our tests.
Her pulse was normal, as was her blood pressure and oxygen levels.
Her blood sugar was not normal. It was above 33.0 mmols (which is, I think, around 660 dg/l). The normal value is around 5 mmols.
The child is (almost certainly) an undiagnosed diabetic.
In my ‘big book of how to tell what might be wrong with someone’ there are six probable causes for severe long-term weight loss. They are Malignancy,Depression,Thyrotoxicosis,Uncontrolled Diabetes,Infection and Addison’s disease. Within minutes of meeting this child for the first time, we had a provisional diagnosis.
It’s not hard to do a blood sugar test in a GP surgery, it takes about 30 seconds.
So why did the GP tell the parent to go away? Was it because the GP was so busy trying to fill the governments targets? Or was it the case that the GP considers severe weight loss in six year old girls a ‘phase’ that they will grow out of?
However now I realise why the ambulance service is doing diabetes screening.
This is the last moan I’ll have at GPs for a while now – I’ll see if I can balance it out with a tale of a heroic GP at some point in the near future.
