Vetcetera Stethoscopic diversions in pet medicine and a petition for silence

February 1st, 2008  

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That's hilarious. I'm going to be so aware of this at the next visit? I wonder if I do it? (I'm sure I do, I'm a chatterbox with my Vet).

I have noticed with MY doctors and nurses that they always ask me a question just as they put the blood pressure cuff on and start listening. It always confuses me because I don't know if I should respond or not....aren't they counting and listening? It reminds me of the classic waiter/waitress that walks up to say "can I get you anythign else" just as I shove a bite of food in my mouth, "urf, hmph ust the eck"....lol...

Creature of Habit February 1st, 2008 08:38:00 AM

A reporters' trick for getting your interviewee to say more than he'd intended (or to just get something more out of a taciturn subject who isn't giving you enough for your human interest story) is to meet a response with silence. No "mmm hmm" or reassuring noises or acknowledgment, just quiet.

Almost everyone will respond with verbiage -- few people can hold out for more than ten seconds. It is hard-wired into people to be deeply uncomfortable with silences in conversation, especially at close quarters with a stranger or authority figure.

I had a professor in graduate school who used this quite a lot as a pedagogic device/dominance display (who can say?) -- it became quite a sport to see who could hold out the longest in the battle of the blank wall. I got kind of fond of our ten-word, twenty-minute meetings. Sort of zen.

As an EMT, I take the novel approach of asking for silence while listening to the patient's lungs. (Our elderly demographic and industrial/mining legacy means that most ambulance calls are for elderly patients with dyspnea.) The patient is typically no problem -- he has a job -- breath in, breath out, hold breath, release. The patient's family, if asked for silence, will not only stop talking, they tend to hold their breath and release at the same times. This has the incidental effect of calming them down. It's all good.

So -- just ask. It would be nice if we could get kitty-cats to breathe in/breathe out, etc., but since we can't get that, we can ask an owner for 30 seconds of silence. Try asking the cat for the breathing, and see if the owner does it?

H Houlahan February 1st, 2008 09:58:00 AM

Not sure whether I've done this (believe me I'll pay attention from now on!), but I did have a cat once who, the moment the stethoscope touched his body, would begin to purr very loudly and enthusiastically. Nothing would induce him to stop. It must have sounded like a Messerschmidt to the vet!

Judy February 1st, 2008 11:26:00 AM

I think the reason I've probably done it in the past is because I DESPERATELY want to relate all the VITAL information about my dogs life over the past 3 months that might have an impact on whatever is wrong with her. (last week she *almost* sniffed a dead bird before I caught her! and yesterday she chased her tail. She *never* does that!)

Ok, I admit I (we) give too much information. Buy 2 or 3 minutes to ask what is going on with your pet might prevent stethoscope chatter.

(barring that maybe you can dangle a piece of string in front if the cat owners)

Larry February 1st, 2008 12:41:00 PM

As Zora, my CRF kitty, also has HCM and once had Pulmonary effusion (that's how we discovered the heart issue) she gets to have the vet listen to her heart and lungs rather often.
She is usually ok with it- the vet takes off the top half of her carrier, pets her a little, and before she knows it he slides the stethoscope on her and listens. She starts to howl only when he takes blood or tries to measure her BP (yeah, she's hypertensive as well).

One time though, Zora was aggravated from the get go- she was howling on the top of her lungs from the moment I was a block away from the clinic...

Yet the vet still managed to listen to her with his stethoscope.
"How did you do that?" I asked.
"Good thing she needs to breath. I used the moments of quite when she took her breaths"

My ears hurts just trying to imagine what Zora sounded like through the stethoscope between breaths, when she was howling...
:-)

Xslf February 1st, 2008 01:14:00 PM

yup.. Happens to me all the time while taking blood pressures.. Putting the stethescope in the ears, is a signal for the patient to talk.. ughhh
barri

barri February 1st, 2008 05:03:00 PM

What do you do when the patient can't keep silent?? I'm thinking, of course, of my cats who can't help but stress-purr when they go to the vet...

Jeannie February 1st, 2008 07:31:00 PM

I agree with Larry. I think if the vet takes a couple of minutes to talk to the pet owner before seriously getting down to a physical exam, it helps. Some vets just pay you no mind period, refusing to believe you might have a clue that would help in the diagnosis.

Also, I had a vet once who explain what he was hearing. For example he'd comment on pulmonary sounds, move the stethoscope around to listen to the heart and comment each time. I always appreciated this instead of the defeaning silence most vets give you. He'd also comment when palpating lymph nodes, etc. I'd write this stuff all down.

Often too, you're already talking, they stick the earpieces in and start listening as if you were a noisy radio chattering in the background they didn't have to pay attention to. Sort of like someone sticking that Ipod earpiece in.

So, talk first while eyeball the pet. Then tell them you're going to listen with the stethoscope and that you'll explain what you hear while you're listening.

JMO

CathyA February 1st, 2008 07:35:00 PM

just like the waitress that always asks how your meal is right as you shove a forkful in your mouth, lol. I totally shut them out, don't even make eye contact and then nicely ask them to repeat when I'm done.

Jules February 3rd, 2008 02:31:00 PM

My vet often asks me a question as he is putting the stethoscope in his ears.. I feel rude not answering right away, but also feel rude for answerins as he's listening..

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