View Full Version : Re: TK's HCM checkup at Tufts...Phil P

October 28th 06, 07:24 PM
On Sat, 28 Oct 2006 08:50:10 +0200, Nomen Nescio wrote:

> TK went for his yearly Echo, etc., at Tufts this week.
> Some good news, and, as I see it, a disturbing development.
> The Good:
> TK has turned out to be the one in a thousand cats that has
> seen MAJOR reversal in his HCM. Reversal to the point where
> it is almost nonexistent.
> Mitral regurge.....undetectable in all but his most excited state.
> Wall thicknesses......damn near normal
> Atrium.......near normal
> I don't have the full report, yet, or I'd post the numbers.
> But his overall condition is excellent.
> Dr Rush said that if this was the first time he'd seen TK, he would
> tell me that I could discontinue the (twice a week) aspirin, but under
> the circumstances he was reluctant to suggest changing anything.
> So since his kidney values are all good, we're continuing the aspirin
> and monitoring kidney function regularly.
> Overall, the news couldn't be much better.
> Now the disturbing development (and it may keep me from going
> back to Tufts):
> Dr. Rush and another cardiologist were looking at the echo. Pointing,
> running playbacks, and talking VERY quietly among themselves.
> This was before I knew the results and it was making me VERY
> uptight. As my wife later described it, there was a "feeling of urgency
> in the room". Looking back, I would describe it as a "feeling of excitement".
> You kinda had to be there, but it was very unnerving for me.
> So Dr. Rush told us how well TK was doing......and then:
> He wanted to sedate TK to take some readings when he was in
> a less excited state (TK was very excited about the whole event.
> squirming, bitching, etc.....He was not a happy cat)
> I was reluctant to sedate him.
> Then came the offer that really disturbed me.
> "We'd like to use him in a couple of studies we're doing. We want
> to sedate him for some more tests, do some x-rays, and draw some
> blood for (someone else) who is doing a genetic study of HCM. If
> you consent to this, there will be no charge for today's visit or any
> follow-up care" Uh-Oh. .......Houston, we have a problem.
> TK has just gone from "patient" to "data point".
> While I would like to help in research that might do some good
> for other cats, I have several reservations.
> a) TK is NOT a good subject for a study. He may live in a
> house, but he is not a "housecat". He's still at least 75% wild
> and is very distrusting of humans (especially men, which may
> say something about his life before we found him). He trusts
> me, he trusts my wife, but nobody else.
> b) I don't want to subject him to "tests" that he does not need
> and that increase his risks (ex. X-rays)
> c) "Safe" anesthetics have almost killed me twice. (Do you know
> anyone who has been on the edge of cardiac arrest from a drop
> of Novocaine in the eye?....You do now!)
> d) TK can't give his "consent" for the tests.
> e) He may be an important "data point" to Dr Rush, but to me
> he's my "buddy".
> (This kinda goes back to Philosophy 101. Would you kill one
> person if it would cure cancer for all mankind?... What if that person
> were someone you loved?)
> Anyway, I thought about it for a VERY short time and then declined.
> Dr Rush was visibly "displeased" with my decision.I think he thought
> I would jump at saving $300 on the day's visit since most of the time
> (as my wife describes it) I "look like I should be standing on the street
> corner with a tin cup in my hand". (A bit of advice, guys. You may want
> to think twice about marrying a fashion model if you're really fond
> of your 10 y.o. jeans)
> But anyway, the mood in the room REALLY went downhill from there.
> I stood firm. TK was NOT going to be part of their study. I did finally
> agree to let them draw a small blood sample for genetic testing.
> That turned out to be a big mistake even though it seemed like a fairly
> benign proceedure.
> An assistant prepared the needle and Dr Rush grabbed TK and held
> him in position to draw blood from his jugular. TK struggled, Dr Rush
> held him tighter, assistant poked, Tk struggled, assistant poked again.....
> Four times and no blood sample. Then TK pulled back, shook his
> head, and missed the point of the needle with his eye by what looked
> like millimeters. That was enough! So I said "I don't think this is working
> very well".
> Dr Rush snapped at me: "If your going to say things like that when
> TRAINED PROFESSIONALS are doing their job, you'll have to
> "No, were done", I said in as non-belligerent a tone as I could muster.
> "He's just too excitable today"
> "You want to stop?"......"Yes"
> So that was it for the blood draw.
> Admittedly, I might have been a little more diplomatic about stopping
> things, especially since two students were in the room. But I wanted it
> stopped, immediately, and didn't have the time to choose my words
> as carefully as I would have liked.
> The visit was wrapped up with a level of tension that was so thick
> you could cut it with a knife.
> Went out to the counter to pay the bill and get the basic report. Written
> on the bottom under "follow up visit" we were "advised that TK will
> need to be sedated" for the next echo.
> Dammit!
> If TK continues to do well, I've got a year to decide how to handle
> this. But my gut feeling says DON'T take him back to Tufts now that
> he is considered an important data point in a research project.
> This turned into a longer rant than I intended, but I'm really torn as
> to how I should handle this. Obviously, my concern is to get TK
> to best care possible for TK.
> I see two choices:
> Don't go back to Tufts.
> (Where do I take him?)
> or
> Go back to Tufts and make it real clear that I am here for TK's
> benefit and I don't give a flying f**k about his research.
> (That should go over real big)
> Version: N/A
> PkCduL7H4aTZ5swp+WVi0ocrqqY+lDCCW6vRd9t9tgqHYD12th 70+5/WbpW96MBy
> f8fvA0mQjLz1+vlN/1wrgx8uUdPWPyggqXfKWQPV1xnHNM0S1s9PCXK2DNSprb3N
> /1Xve4ld0gg=
> =7OJ3

If he seems to be doing well in a year, why take him back at all? I
don't remember reading your original posts so I don't have all the facts.
Sometimes you have to go with your gut feelings. Best wishes. MLB