From the other side of the consulting table

Re: From the other side of the consulting table

Neil Wheadon — Tue, 10 Jul 2012 22:18:02 GMT

See you can spot the one with all the distinctions and prizes in this family.

Last attack 2 years ago - all better now

Re: From the other side of the consulting table

Sarah Wheadon — Tue, 10 Jul 2012 22:05:32 GMT

Idiopathic paroxysmal positional vertigo!!

Re: From the other side of the consulting table

Mark Hedberg — Tue, 10 Jul 2012 21:04:54 GMT

[quote user="Neil Wheadon"]

[quote user="Bob Russell"]I try to remember this and if I see a client is struggling will sympathise and let them know I understand it is not that easy being bombarded with questions. A good lesson to learn for any vet! [/quote]

Every vet should go and see a consultant in their formative years

My first visit was a seasonal allergy that I get every year on my elbow (very similar to a lick granuloma) I was left dazed and confused. It's something like lupus but isn't, all I know is it's a seasonal allergy, fuciderm works, scrubbing it hard with hibiscrub doesn't

My second was for ideopathic......... (I can't remember) It's where you spin and fall over as it affects the cochlea, you get nystagmus and vomit. I call it that spinning disease to anyone that asks. Fortunatel I had the wit in the consult to ask him to E mail a reference, so at least i've got something to refer too.

Bottom, line, if I can't remember, then what hope has a client when I wax lyrical about diabetic ketoacidos.

[/quote]

Was it Méniére's disease, by any chance?

Re: From the other side of the consulting table

Alet Engelbrecht — Tue, 10 Jul 2012 21:04:01 GMT

[quote user="Anthony Todd"]didn't touch me or my back[/quote]

Essentially - I had to go for mole monitoring (damn SA sun!) - which involved me stripping to my underwear and the consultant looking at me (or my moles )! Minimal touching, but creepy nontheless...

Re: From the other side of the consulting table

Anthony Todd — Tue, 10 Jul 2012 20:26:48 GMT

[quote user="Alet Engelbrecht"]Every vet should go and see a consultant in their formative years[/quote[/quote]

Yeah well just been to a consultant orthopod with a bad back [facet joint arthritis]

He had a look at the scans I had done in Australia told me Depomed injections plus radiotherapy would work for up to nine months, didn't touch me or my back, said he could do it that afternoon, would cost £2500.

I said I'd think about it [unusual, for me, steroid reluctance.]

Went to brilliant physio [and I've been to a few] loosened all the facet joints, said I was nowhere near bad enough for injections, and I've been totally pain free from then, now 3 weeks, for the first time in six months.

Got the consultant's bill for the consult [10mins] £250.00 Physio £76.00

Re: From the other side of the consulting table

Alet Engelbrecht — Tue, 10 Jul 2012 19:54:36 GMT

[quote user="Neil Wheadon"]Every vet should go and see a consultant in their formative years[/quote]

Very true! I had the misfortune of having to visit a consultant who's dogs were patients at the surgery (albeit one of the other branches). I clarified immediately my discomfort/fear of doctors and he tried to make conversation to make me more at ease. Part of that was about his dog - a nightmare of a Great Dane that ate a whole pot of rimadyl once, but some conkers the previous day - at the time I could not for the life of me remember anything and told him not to worry! Luckily, the dog proved quite indestructable.

Disclaimer: My experience with doctors had been extremely limited as back in the day I was indeed mostly treated by the vet (mummy dearest), rather than the doctor... (Luckily, I was quite healthy).

Re: From the other side of the consulting table

Neil Wheadon — Tue, 10 Jul 2012 19:14:32 GMT

Every vet should go and see a consultant in their formative years

Bottom, line, if I can't remember, then what hope has a client when I wax lyrical about diabetic ketoacidos.

Re: From the other side of the consulting table

Evelyn Barbour-Hill — Tue, 10 Jul 2012 18:45:14 GMT

P.S.

Why is the only means of obtaining veterinary examination of an animal, ever, exclusively, to "rush it to the vet" ?

O for the pen of Myles na cGopaleen

Re: From the other side of the consulting table

HMC — Tue, 10 Jul 2012 18:12:02 GMT

[quote user="Niall Taylor"]Well, no, even after watching an episode of Holby City the night before I don't say stuff like that [/quote]

Holby is brilliant... except last week's episode (bit over the top to have Mr. Hope working out a study schedule for a doctor who has failed exams- that's her job surely? And Mr. Hemmingway leaving so suddenly was a bit of a loss).

Re: From the other side of the consulting table

Bob Russell — Tue, 10 Jul 2012 17:56:26 GMT

I took two of my dogs to see Andy Moores (a few years ago) - a lame young GSD and a lame Staffie (pain in the ar*e) and was surprised just how much pressure I felt under as the questions were (very nicely) thrown at me. It even got to the stage where I had to admit the lameness was in the 'other' right leg!!

I try to remember this and if I see a client is struggling will sympathise and let them know I understand it is not that easy being bombarded with questions. A good lesson to learn for any vet!

Re: From the other side of the consulting table

Dagmar Steele — Tue, 10 Jul 2012 17:09:55 GMT

I thought it was nice to read a story where despite of the sad outcome there was no vet-slagging going on. And I am very sure that many things we say are received very differently and if repeated sound even more different from what we actually said. Owners are lay persons and they make things we say fit into their minds, worlds, knowledge. (In fact, if I remember right, there is a study that owners remember about ten percent of what we've just told them once they're out of the door). I didn't agree with all the things said, I would not FNA mammary lumps due to their nature of having both malignant and benign parts, plus I'd never say there is no chance to operate because he'd bleed to death. It may be arguable if it makes sense to operate on hemangiosarcomas, but it is possible without the patient bleeding to death. But then, this might be clients interpretation as well. I always find it very helpful to hear how clients view and receive what we say and do - it helps us doing even better the next time....

Re: From the other side of the consulting table

Niall Taylor — Tue, 10 Jul 2012 16:44:39 GMT

[quote user="Evelyn Barbour-Hill"]Do veterinary surgeons really say things to the client like "the bloodwork is all good", or "she'd bleed out on the table'" ? [/quote]

Well, no, even after watching an episode of Holby City the night before I don't say stuff like that - there is a certain amount of artistic license going on here. I do find this person's interpretations of events interesting, though it's the general sentimentthat I appreciate. As vets we all have our stories of apparently awkward clients who seem (from our perspective) to go out of their way to "be difficult" - it's nice to hear someone with a more positive story to tell (about her veterinary experience I mean, not necessarily with regards to the outcome per se). I also think though this tale can also give an insight into why people might get the wrong end of the stick about certain things so help us to understand the "difficult" client a bit better too.

Just sayin'

Niall

Re: From the other side of the consulting table

Richard Fox — Tue, 10 Jul 2012 16:30:45 GMT

[quote user="Julie Innes"]

It is a sad story. Re the pathologist- I think sometimes clients hear the bits they want to.... At least Misty had a good life, and sounds like she was well loved and cared for. Always happens to the nice clients, doesn't it?

[/quote]

Yes I expect your right - As an aside however I personally do not recommend cytology for suspected mammary neoplasia :)

Re: From the other side of the consulting table

Gillian Mostyn — Tue, 10 Jul 2012 16:29:45 GMT

yeah - I read a couple of things that puzzled me. Did you find it to be an accurate account or not? It is always interesting wondering if the owner is taking in what you say and do.

Lovely story though.

Re: From the other side of the consulting table

Evelyn Barbour-Hill — Tue, 10 Jul 2012 16:24:24 GMT

Do veterinary surgeons really say things to the client like "the bloodwork is all good", or "she'd bleed out on the table'" ?

Re: From the other side of the consulting table

Julie Innes — Tue, 10 Jul 2012 16:16:11 GMT

Re: From the other side of the consulting table

Richard Fox — Tue, 10 Jul 2012 16:05:30 GMT

Whilst it is a sad story, and thanks for the post Niall, I am shocked about the cytologic diagnosis? of a benign mammary tumour on Cytology!

Anyway, I rushed her to the vet, and he immediately did a fine-needle aspirate of the tiny lump, and the happy news was that it was "benign". Nothing to be done, no surgery, no problems. A second tiny lump was discovered, that was tested too, and was also benign.

I would have to say the pathologist, in my opinion, was a lot braver than I

EDIT: The NHS guidelines now state that a diagnosis cannot be made on the basis an FNA of breast masses BTW :) A core biopsy is the minimum.