The Official Website for Carol Margaret Tetlow
In the good old days, the post natal examination at 6 weeks after delivery was a routine event. There was quite a lot to discuss, so much so that a whole ten minutes was allotted to this appointment, where as all other appointments were just 5 minutes (cripes -
As well as asking all the usual questions about the baby feeding, how was your experience of the delivery, what are you going to do about contraception, it was an opportunity to discuss weight and diet.
Not many women, six weeks after having a baby have losing weight high on their list of priorities (unless of course they are so called celebrities in this day and age who slip back to their usual twig like selves in a matter of hours and then make normal mortals feel like a lesser species -
One day, I was half way through a postnatal examination with a nice young woman, whose adorable baby was fast asleep in its pram in the corner of the room (=stroke of luck).
'Are you back into your normal clothes now?' I asked sympathetically.
'Oh yes,' she replied emphatically.
'Well done,' I applauded, 'even your jeans?'
'Yes,' she said, 'I'm sure they'd fit if I could just get them past my knees.'
The moral of this tale is that optimism is good. The glass is always half full etc.
The other trick is that that they come in, apparently wearing their skinny jeans but when they lift up their jumper, the jeans are held up by a selection of elastic bands, safety pins, pieces of string......
And a trick of the trade for all those aspiring docs amongst you -
Exercise, without a doubt is good for you and most of us should do more. Age is no criterion -
Mr and Mrs T (not really T but I am fed up with X) were a very very close couple in their eighties. Childless, they had no nearby family. She had defied medical science by living so long after a heart valve replacement years previously. But now the valve was starting to fail, she was becoming more breathless, filling up with fluid, developing fat, swollen ankles and a bloated abdomen. Despite the best juggling of her medication, she sadly died and one of my first thoughts was for Mr T and how he would cope alone.
He came to chat a few times and then was almost conspicuous by his absence. But in he came one day, looking very dapper in sports jacket, smart new hairstyle, shirt and tie, polished shoes, razor edge crease down his trousers.
'I'm ninety now,' he told me, after giving me a hug. 'I've started ballroom dancing and I've two new lady friends, who can't believe my age. They're only sixty.' He giggled mischievously.
He also told me that he had bought a computer and was emailing all his friends, researching his family history and shopping on line.
About a year later he came in and asked if I would listen to his heart, check his pulse and blood pressure.
'Are you worried about something?' I asked.
'No, not at all but I want to learn to jive. Do you think I can?'
Well, what would you have said? I said yes and he waltzed out smiling.
General practice -
How do you cope when, in the space of a day you are asked or told
1) I'm expecting quads after IVF, should I abort two of them to give the other two a better chance?
2) This is my new girlfriend, do you think we should get married?
3) They've told me my cancer's spread to my liver but offered me an operation to remove some of it. Should I have it done?
4) Can I have a letter for the council for a new washing machine?
5) Can I have a letter to help my child get into the school of my choice?
6) I've been reading 50 Shades of Grey and would like a check up before my husband and I try some new 'things'
7) Can I have some more methadone/valium/codeine -
8) I'm going to kill myself
9) My cat's had kittens -
10) While I'm here, would you also look at my baby, toddler and two small children?
11) I'm getting married next week -
All in a day's work...off for a lie down.
r and Mrs X were not blessed with a happy marriage. It can be very difficult when both halves of a couple come to consult with you independently to moan about the other one. Utmost tact is called for!
Mr X was registered blind but, contrary to all advice was still often seen driving around town, usually with one of his new girlfriends in the passenger seat. He had many.
Mrs X would come in and talk of her thirst for travel, to see South America, the Far East, the Antipodes.
One day, Mrs X came in and told me that they had split up. It was over. He would be living in the top floor of the house, she on the ground floor. Their paths were not to cross. She described to me the row that culminated in them taking the final step. Not only did she describe it to me but she acted it out for me, playing both roles, including the skirmish when they rolled around on the ground with their hands round each other's throats, shouting obscenities. I was spared no detail. Watching her roll around on the carpet with an imaginary foe in my consulting room was something that was unique -
In the end he moved away, with his new girlfriend. She moved into a small flat and indulged herself in her passion for travelling.
Oh! Did I mention that he was 90 and she was 88? No, I don't think I did...…
I know you'd be worrying if I didn't drop you a line before my appointment tomorrow, so I'll be seeing you at 1040 in the morning and will bring that sample you asked me for. What did you say you were testing it for? I'll put it somewhere very safe as Mrs W is such a stickler for tidiness that if she finds it, it'll like as not be hoovered up in the shake of a lamb's tail.
Hope you're enjoying this fabulous weather we've had this weekend. I saw Mrs Britton on the tennis court and gave her a wave but she must have been concentrating very hard so I don't think she saw me. Give her my best anyway.
Good job the wind has dropped as it was a bit hairy wearing my kilt, though the fresh air does seem to have done the trick as far as the rash goes. But on the subject of wind -
Re the rash, we're hoping to do the lower dales charity bike ride on Thurs -
No letter would be complete without a snap, so here's a nice one. And no! It's not me and Mrs W doing synchronised swimming!
See you tomorrow.
Yours patiently (sorry, can't help it)
W Wottle Esq
The Teviotdale Medical centre is deliriously happy to announce that the second book in the series, Faith, Hope and Clarity has won a Pinnacle Book Achievement award. Entered with little hope (cos the author is a bit of a pessimist), this fabulous news arrived yesterday.
Thank you to you all and of course to Guy Boulianne,without whom none of this would have been possible.
And remember, book 3 is coming..............soon the title will be revealed!
10 September ·
Lovely sunshine, lovely day, so what could be more appropriate than to talk about a lovely lady. We were good chums and had many a good chat.
She was one of the first patients I came across in general practice. Well known to all the docs and the local psychiatrist because of her unstable bipolar illness and her frequent lapses, she was in need of a lot of care, which was often time-
Sighs of relief were audible when she decided to move into a local nursing home. Things must get better. Her medication would be supervised, surely a fine and helpful change. We had allocated nursing homes to specific partners, in an attempt to improve continuity of care and guess what? The nursing home she moved into was mine. I didn't have to visit very often as the staff were very good with her. She was definitely better off.
But suspicions started to be aroused when deliveries started to arrive at the nursing home. Several new suitcases, new clothes, shoes, jewellery, a handbag. Nobody rang the alarm bell.
One day I received a phone call from her requesting, in a very matter of fact way that I pop round and insert a urinary catheter into her bladder. When I asked why she told me she was planning a round the world trip and didn't want the inconvenience of having to go for a wee while on it!
I visited and spent much time with a manic patient, who had indeed, rung the travel agent and booked herself onto a cruise and her room was full of her new possessions.
Days worth of medication was stuffed down the side of her cushions.
I sent the psychiatrist in to see her. Her medication was restarted and as she was already in 24 hour care, admission was avoided, thank goodness. He did ring me after his visit, to talk about his advice.
'By the way,' he added, about to ring off, 'She's obviously manic and she kept going on about you having donkeys. You obviously don't, do you?'
'But I do,' I replied.
'But not three....'
'Called Poppy, Danny and Jack?'
Perhaps she wasn't quite as crazy as everyone thought
Another lovely photo of the town taken by the clever Mr Wosnian using his drone. This is an elevated view from the river.
20 September ·
She used to come and see me regularly -
We would always have a long, circuitous chat, come up eventually with a plan and then the next consultation would invariably start with me asking how she'd got on and her telling me she hadn't actually bothered to try. She always had a reason for why she couldn't do any of my suggestions. She was always too busy, had visitors, fell victim to flu, hadn't had time, had forgotten.
It was, not surprisingly, from my end, exasperating. Solutions to her concerns were as clear as day but for some reason she didn't want to take my advice.
Medical people reading this will recognise patients like this. They're hard work and it can end up with you either dreading their arrival when you see their name on your surgery list or tearing your hair out.
I felt I'd achieved absolutely nothing. I couldn't understand why she kept coming to see me as I obviously wasn't helping, or I didn't think I was. But she did, for several years and our rapport never quite clicked and no progress was made.
One day she came in and told me she was moving away. This would be her last visit to see me. Yes, I confess, I felt a frisson of relief. But then she shook my hand and thanked me for being the best doctor she'd ever had and how she'd miss me.
This isn't a blog about what a fabulous doctor I was, it's a message that no matter what, you keep trying, even when you think there's no point. Never give up.
21 September ·
Not feeling so good this weekend. I had a nasty fall at the weekend (see photo) and my leg is still very painful, despite Mrs Wottle's best ministrations. We went to the seaside again and I was trying to get into a good position for some bird shots (see other photo) but only got this one which is any use before I was knocked over by two black labradors(see photo). The others are all blurred as I was falling over as I took them. Good job there's no attached sound as you might have been offended by my language. Even Mrs Wottle told me off, plus I got my trousers damp and looked as though I'd wet myself.
I'd be grateful if you'd have a look at the aforementioned limb and give me some advice. I can't actually put any weight on it and the pain has kept me awake all night but didn't like to go to Casualty as they're always telling us not to in the newspapers and on TV because they're so busy. So I thought I'd wait for you. It'll take me a bit of time to get from the front door of the surgery to your room, so please be patient. Hang on -
Mrs Wottle isn't overly pleased. She'd entered her famous apple pie in the local baking contest and came last. I think that might be because hers was gooseberry.
See you tomorrow doc, can't wait, if I'm honest. This b****** leg is giving me some gip.
Yours patiently (ho ho)
W Wottle Esq
22 September ·
A little while ago, on television, there was a short film, promoting awareness of having a stroke and imploring people to act quickly. It would appear in between adverts for cars, washing up liquid and cat food. In it, the warning signs were given, while we watched the effects on a person's face -
Mr Y came to see me one day, a routine appointment. He told me that he had seen this advert (for want of a better word) and that a few days previously, he had noticed one side of his face drooping and had had difficulty speaking.
I expressed concern and he sought to reassure me. Completely seriously he commented,
'It's okay doc, I knew it wasn't a stroke though because there were no flames on the side of my head.'
A worrying case of taking things literally. He had in fact had a mini-
24 September ·
Message from Elliott Douglas to be displayed in all areas of the surgery building, Lambdale Town Hall, Delicious -
Some shameless self promotion today now that the award stickers have arrived and can be displayed on all copies of Faith, Hope and Clarity!
25 September ·
In times gone by ( ie when I was a junior doc, hell bent on a career in surgery) the fashion was to move around the country, every 6-
So, I'd been back at Nottingham for a year (not counting the 2 months off with chickenpox) doing obstetrics and gynaecology but there was still a little voice inside me reminding me that the love of my life was in fact the large bowel and perhaps I should look for a job in general/bowel surgery next. My colleagues in O&G all tried to dissuade me, they wanted me to stay in their speciality but (whether it was the effect of the chickenpox on the brain) I wanted a bit of an adventure.
I saw the advert for a 6 month post on Orkney in the British Medical Journal, reminded myself just where this was and, much to the hilarity of the other members of the department, sent in my application.
We were coming to the end of a particularly difficult antenatal clinic, as usual Stevie Wonder's song, 'Isn't she lovely?' was playing on a loop all afternoon, to set the maternal scene. I had just been doing a postnatal examination and found a fungating cancer on a woman's cervix (think cauliflower) and everyone was feeling morose at the implications for this new mother.
My bleep went off. 'Ha ha, that'll be Orkney calling,' said the registrar glibly. I shot him a look and went to answer the call, only to find that it was and the job was mine if I wanted it. I accepted and was to start in February.
A few weeks later at Christmas, one of the consultants came round with presents for all the junior doctors (as was her annual wont. She was extremely scary and best avoided if possible). No surprise that the presents were all bottle shaped, wrapped in holly covered paper. She distributed one of them to each of us with a cursory festive greeting and then when she reached me, delved into her bag and produced a soft, square parcel, which clearly was in no way alcoholic. The appearance of her teeth informed me that she was smiling, a facial expression rarely seen.
'You'll need these,' she commented.
I unwrapped my gift to find a pair of thick, green striped socks.
'Don't forget to come back,' she said and walked off as I shouted my thanks.
I feel a bit guilty that I didn't go back but I think she'd be pleased to know that I went on delivering babies for as long as I possibly could..…
Another of the kind Mr Wosnian’s photos of the town taking a birds eye view