The shifting feasts of consulting
This was my third outing of the week after church on
Sunday and the office on Tuesday. I had a rescheduled appointment from December
that I attended yesterday. It was my usual biannual checkup, which has shifted
from the April/October cycle to a January/July cycle in three years.
Once I realised, I would not be able to attend the early
December appointment because I would be out of the country, I called to
postpone the appointment and reschedule it to mid-January. I ensure I never
miss my hospital appointments or consultations as it deprives others of time
and audience with scarce medical personnel.
A miscommunication between us some 18 months ago meant I
never received my expected scheduling for May, and we fell into a June/December
cycle that only happened once. Besides rescheduling, I was promptly given a
prescription to make up for the additional time.
Let’s keep to what we discussed
For this consultation, I had a few issues to discuss, the
main one being the unfortunate mismanagement of information that I should not
have received until I had met the consultant involved in that area of
investigation and diagnosis. The computerisation of personal medical records
meant that a certain diagnosis ended up in my clinic notes that the person I
met should have redacted before forwarding to my doctor and I.
Blog - The note
that crept in
The sinking feeling of reading a diagnosis of
adenocarcinoma of prostate over a week before my scheduled appointment with the
consultant urologist was as earth-shattering as it was a humbling reminder of
one’s mortality. When I remonstrated with the doctor, he offered to redact the
diagnosis, but what good was bolting the doors after the horses had bolted?
Meeting with the chief consultant of the team that had
assumed my care for over a decade and she for about 8 years, she immediately
understood the issue.
She said she would raise an incident with the
multidisciplinary teams to ensure that they are aware of what information gets
passed to the patient; that it is centred on their particular consultations;
and that the more interested patients can assess seemingly hidden
interdepartmental communications to read the chatter pertaining to them.
A malignant test of the benign
For me, what I learnt was the difference between the
definition of malignant to the layperson and the medical establishment. When I
read malignant adenocarcinoma of the prostate in interdepartmental
communications, I read it as a qualifier of the type of cancer, something
rampaging and very likely to cause death.
To the medical eye, malignant always means cancer
regardless of stage or metastasis. The absence of cancer in the presence of a
growth or tumour will be considered benign. [Medical
News Today: What are the different types of tumour?]
My consultant patiently explained the terms fully to
enhance my understanding. Other issues in my notes were from the perspective of
the person I saw. Any similarities would suggest a lazy engagement, as
situations and circumstances do change between visits.
All good and nice
We discussed the readings of my blood tests, and the need
for new assays, though this time without a urine sample and at the end of my
allotted time with a medical student present, I was handed on to the
phlebotomist who had no problem drawing three vials of blood before I was sent
on my way to collect my renewed prescription and I made my way home.
In all, the consultation was pleasant, and the typical
readings were within normal range, it is likely I have lost a centimetre in
height, and the physiotherapy to address issues in my spine will not commence
until all the other medical issues are resolved.
