The MDT Letter

In the last 5 years or so a new TLA has appeared (apologies for those who aren't Yes Minister fans - a TLA is a TLA in that its a Three Letter Acronym) that can strike fear in the hearts of those awaiting their test results...

The MDT!!!!

The what?

The MDT... The Multi-Disciplinary Team meeting...

In the old days, our cardiologists would get out test results, have a think, possibly a large drink and try and work out what to do with us... The good ones would ask for colleagues to have a look over their shoulder.

As a process this stank, and as a scientist it is so short of best practice that it always bemused me - I'm used to peer review, review committees, "blinded" review...

So, over time the informal look over the shoulder has changed, developed in the right way, so that we're not looked at as one offs, by one person.  But looked at by the team that looks after us (even if we only see our cardiologists and cardiac liaison nurses) and they review the results with their collective knowledge and experience.

Think of it as the medical equivalent of the Council of Elrond...

This isn't a patient information leaflet on MDT's, but if it reassures people from my experience then I'll run through it...

My cardiologist has had the jitters about my pulmonary valve for years, all of my cardiologists have... And on the face of it I should be too.  However, something freaky seems to be happening, I'm stable... I have an exercise tolerance that most of my non-dicky ticker friends can't match and again I'm stable.

So doing his job, I've been thrown through the MRI machine, and the exercise bike test, along with the normal echo and ECGs... And then the MDT met and discussed me.

When I've seen these on the TV they've been like a classic "show and tell" session - a series of pictures, data points, results from the tests would be put up.  Each of those around the table can, and should, say something about the case, comparing me to reference values, norms of my age and condition (though the concept of norms and me should raise a laugh), and then have a discussion about the best course of action.

Who is in on these discussions?  Well, my cardiologist, another consultant, a locum and a specialist registrar, the surgeon, a radiographer (to explain the pretty pictures) and the cardiac liaison nurses.

They chew the fat, go through the options and then come to a conclusion... These can range from life as normal, which for us is come back in six month or longer... then drugs options, then surgical and for those who are unlucky how to maintain things as long as possible with no other options to improve things.

Which they get written up and send to your GP - copying you in, so you know what it going on.

So, back to me.... They've met, the letter has been sent.  And yes, there's a bit of stress as you scan the first line... and then I read and I start smiling... they're using phrases like "asymptomatic" and "excellent exercise tolerance" so I'm in the life as normal category - back in 6 months, run me through the tests again - the exercise test and the MRI.

So life as normal, but I'm allowing myself a little celebration... probably a curry!

So, that's my MDT story - and it looks like its working how its meant to...




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