Table 2 Extract from transcript of audio-recording of IFR panel meeting about Jane’s case of breast reduction (site B)
Speaker | Spoken words |
|---|---|
Chair | Moving on to this case which is breast reduction, for back ache, we haven’t really… (inaudible) |
CPH | How old is she? (pause whilst members look through papers including a report from a physiotherapist and a letter from the patient in support of her application) |
ADPH | The physio report, doesn’t actually recommend, or what it says is that patient has responded partially [to |
Chair | partially] |
ADPH | the rehab programme and has been discharged. |
Chair | mmm |
ADPH | she needs a good bra |
GP | I mean I think her letter actually says very much more [than |
ADPH | yes] exactly |
GP | anything, now it’s a question of whether, you know, she’s not had a relationship, she feels embarrassed, there’s obviously a psychological= |
ADPH | hardly (inaudible) 38DD= |
GP | =well if she is 4 foot 11 and quite a petite [frame |
ADPH | what’s her] BMI? |
GP | then that could well be large. And the fact that she has had three children will make them much more pendulous anyway so I could accept that she says they hang to her stomach and all the rest of it. |
Chair: | I think the main thing here is that she hasn’t been referred, she doesn’t appear to have been referred to an orthopedic surgeon [or |
GP | breast] reduction, well |
Chair | to get a second clinical opinion. We’ve got the GP’s opinion but she hasn’t had any MRIs or anything like that. We don’t know what the other potential factors could be. |
GP | I don’t know that an MRI would help to be honest. I think there are much more psychological issues with this lady than (.) the backache is to be honest neither here nor there. I am actually more concerned about the fact that she is withdrawing, she can’t pick up her child, she feels embarrassed to have an intimate relationship, umm |
ADPH | She’s got a very young child, a 2 year old |
GP | She’s got very young children, and I think [that’s |
ADPH | yeah] |
GP | that’s making her exceptional personally and I would say, I would approve then |
Pharmacist | (inaudible) |
GP | I mean the only thing I could check is what her BMI is= |
ADPH | =I think that’s the only thing I wanted |
GP | whether there is a, you know, if she was a BMI of 40 then maybe losing= |
Pharmacist | weight |
GP | weight would actually make them less heavy but she might still need a procedure to make [them |
ADPH | I think] in principle we would agree but I mean I also want to know what her BMI is though |