Recently, I had two patients / cases that reminded me of the important role that we play in CLIENT SUPPORT.
This was the little old dog of a long-time client. The dog was wobbly, needing support to stand, and would chose to turn to the left most of the time. Her regular vet had seen the dog and, ‘didn’t really tell her what she thought it was’. The owner was told to monitor. A neighbour wondered if it was a vestibular episode. So, she called the clinic. The receptionist thought it could be vestibular and made her an appointment to come in.
I saw the dog. The body looked vestibular, but not the eyes.
We tried the Dix Hallpike – the test for benign paroxysmal positional vertigo. However, it did not set off any nystagmus. I did a little lasering at the base of the skull – to help with healing of the brain, should that be the root of the issue. I advised the owner that it didn’t appear to be vestibular, but that it could be something in the brain. The laser might help or might do nothing. It might make her sleepy for a day or two, should it stimulate ‘brain healing’ (according to an anecdote in the book The Brain’s Way of Healing’). She had a follow-up appointment at the clinic a few days later.
She came into the clinic at the next appointment. She said that the dog was sleeping in the car. She said she was doing a lot of sleeping and was needing a lot of help to stand. So, I went out to her car to see the dog. She was sleeping. The owner said she had even taken the dog to emerge over the past couple of days and was given the “Quality of Life Lecture”. She was distraught. She just needed some conversation.
So we chatted. I told her, “You have bred and owned dogs for a long time. You understand quality of life. You didn’t need that lecture. I’m sorry you had to go through that.”
We talked about what medications her dog was on. She said, “Gabapentin and Medicam, as the vet had prescribed.” I said, “I don’t think she’s in pain, and Gabapentin can make her sleepy on top of the laser that I did. Maybe that’s what’s going on.” She replied, “She’ll eat and drink a little if I bring it to her. I know she doesn’t have quality of life like this, but I don’t think she’s in pain.”
I could tell that she didn’t need another quality of life lecture, and the little dog did not appear to be in pain. I could also tell that she wasn’t ready to ‘let go’ of her little dog, at least not yet. So, I added, “You know, you could take her off the medications and see how she does. Monitor her. You don’t need to make any decisions today, because she does appears to be very comfortable. She’s just sleeping a lot. Maybe stopping the gabapentin will wake her up a bit.”
The owner said, “Okay. That sounds like a good plan. We have a plan. Can I have a hug?”
I gave her a hug. She thanked me.
I emailed her a couple of days later to check in. This was the reply,
Thank you for thinking about us.
Sxxxx is still sleeping beauty. She is calm and does a good amount of twitching. Her eyes look good.
Sometimes now she can hold her head up. Also she can hold a stand with help - a lot of help.
I still think a bit more time, but also prepared for more time not getting us anywhere.
Because she is calm and napping almost 24/7 I don’t think there is pain.
Your support means so much.
So, this is not a case about me knowing more than any of the other practitioners involved. It’s not a case about patient care. It’s not even a rehab case.
It’s a case about understanding and ‘reading’ people. Maybe more human healthcare practitioners possess this skill, but not all of them. Some veterinarians and veterinary technicians/nurses possess this skill, but not all of them.
So, this week, I challenge you to ask yourself, “What does this owner need today?” Do they need hope? Do they need options? Do they need a firm warning about adverse events if they don’t adhere to post-op confinement advice (as an example)? Do they need a hug? Do they need a ‘check in’? Do they need a plan?
That’s your challenge for the week. I’d love to hear your feedback.