Be Your Pet's Medical Advocate

Posted by Aaron

Sunday, November 22, 2009

I recently went through a spell of severe back pain and finally broke down and visited my physician. They were kind, listened to my concerns, prescribed some different pain management options, and then recommended that I go and have by back radiographed (x-ray).

Once I left the office, however, communication totally broke down. The doctor's office called the next day and said, "The X-rays are abnormal you need a MRI." I called the radiologist and was informed that the MRI was listed at $2,000.

I nearly pooped myself.

So I called back the doctor and I tried to get them to tell me what we were looking for, what was abnormal about the x-ray, and what kind of treatments we were going to consider. This was a lot of money. They were, unfortunately, totally unable to explain what they hoped to accomplish with this diagnostic, only to say that it was important and they needed to look at the "tissues." Seriously. $2000 and all I get from you is you want to look at the "tissues?" I was a bit upset.

I had the MRI (As it turns out, it was only $500 due to insurance negotiated discounts - who says our medical system of insurance ain't screwed up?). Afterwards my doctor's office called back to tell me that the MRI was abnormal and that I could be sent for injections for the bad disk if I wanted to. Seriously, that was the extent of the discussion. This left me even more frustrated.

I had to call back and insist that I talk to my RNP and discuss what the goals of thearpy were, what the expectations are for treatment, and what the actual diagnosis was. Point was, I had to GO AND SEEK OUT this information. I nearly had to drag it out of them.

I had to be my own medical advocate.

I have never had problems with this office, in fact I really like this group. I still like them, but they dropped the ball on this one.

I had seen the x-rays. I had a copy of the MRI made before I left the office so I was able to look through them and see what was up. I also had enough knowledge to know what we were looking for. What I did not know what how this would be handled in a human. I needed my physician's office to actually take the time to explain the plan. Why the recommendation for steroid injections? Surgery now? At what point do we consider it? Physical therapy?

Gee, Aaron, Why are you boring us with this long sob story about your back?

Because this experience was a reminder for me to NOT do this when I am working with my clients. I know this kind of thing happens every day both in human and veterinary medicine. It is easy to loose touch when the patient is not sitting in the room in front of you. I try very hard to keep up communication and take the time to explain, and I think I'm better than most. But I am sure that I have dropped the ball from time to time and have probably left some clients confused or with a feeling of being "out of the loop."

Your medical care and your pet's medical care is a TWO WAY STREET! It involves both the medical staff and you! I don't believe for a second that my doctor's office was trying to be lazy. But I do think that they did a terrible job this time communicating diagnostic findings, assesment of those findings, and a coherant plan with the patient. I had to take the responsibility to get the information.

You should handle your pet's medical care the same way. Hold your veterinarian and their staff responsible for giving you the information you require to make informed decisions. Make sure you are comfortable with the direction your pet's care is taking. If you don't understand something, call them back. Make for darned sure you have been given the information you need. We're all on the same team.


A Quick Influenza Update

Posted by Aaron

Thursday, November 19, 2009

I received an e-mail not long ago about a cat being diagnosed with H1N1 influenza. You will all remember that H1N1 is the "swine" flu as opposed to the H3N8 dog/horse influenza. I've checked into it and there have been a couple of cases of cats and a couple of ferrets with confirmed H1N1.

At risk of sounding redundant: DON'T PANIC!

We know that influenza virus can jump species. It's why we have the H1N1 epidemic to begin with, right? So it stands to reason that there would be instances where the virus jumps from people to cats.

Is it scary? Yes. It is. We always pay close attention when something like this happens. When there are inter-species jumps we always investigate and see if there is any difference in the virus, type of infection, or incidence.

Is it common? No, It's considered rare. I'm sure there are cases out there we don't know about, but if you consider there are two cat cases compared to many thousands of human cases, it's rare.

Has the virus mutated? NO. Genetic analysis says the virus has not changed, it just happened to infect a different species than we would have expected.

I assume we are going to see more of these. The cats and ferrets infected have all recovered from the infection and it is essentially the same story for them as it is in us or dogs.