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00:00skin A&E is back in business and our team of top dermatologists are back in Birmingham here we go
00:13here we go ready to tackle the nation's lumps and lesions no jobs too big maybe a slightly bigger
00:23pot yeah no treatment too messy I do have a habit of poking it and squeezing it very uncomfortable
00:30they'll bring relief Wow and results so happy restoring confidence thank you and changing lives
00:48doesn't want to come it's like a strawberry I've got eat my lunch this is skin A&E this week it's a
01:06testing time in the clinic scratching his head there's a brain on there isn't that far that requires focus
01:14I pry it free rather than cut it because I can see all your nerves there investigation hard to find
01:21the wall of this one and perseverance seriously it's like not stopping come on little friend the team are
01:31getting organized oh you've done everything just I was gonna come and help you oh yeah and sharing
01:37is caring do you have any sparidermid lids have two thanks ready for the first patient of the day
01:47hello I'm Lisa I'm 59 years of age I'm from Leicestershire and I work at a university have a seat for me I'll
01:57let you know in already I've got two events that are coming up so next year I'm turning 60 so big
02:04birthday and I'm hoping to have a really nice birthday party but the main thing is this summer
02:10my daughter's getting married and Lisa's hoping dr. Dev will get her skin ready for the celebrations
02:17hello Lisa come on in yes hello I'm through hello Lisa are you doing good thanks come and have a seat
02:28so tell us how how can we help today so I've got some lumps under my arms I'm not quite sure what
02:35they are I've had them for quite a while now probably about 10 to 15 years right they've gradually got
02:40bigger and they're quite uncomfortable they're quite large one's larger than the other on this side it's
02:45about the size of a satsuma okay it hangs down I'm conscious that they're there so I feel I know I'm
02:51not but I feel like I'm walking around like this rather than like that I do have real problems trying to
02:56find bras that fit properly because I get quite sore underneath and that restricts things that I
03:04can do like going to the gym you know because I can't get a good sports bra so it's really quite an
03:08effect on your life it has yes yeah when we go on holidays and swimsuits and things like that are very
03:16difficult I do feel very self-conscious and people often you know what's that that you've got there so
03:22yeah it's it's not a nice thing to live with what we're going to do is I'm going to have a little
03:27look at these areas okay are you able to take your top of it yeah yeah okay well done so you can see
03:35this is the larger one oh yeah okay feels quite restrictive it's quite you yeah and then this side I've got a
03:45smaller one it's your left and right yeah axilla really but your left one more than your right
03:50mmm let's have a little look my sister had the same really yeah so I don't know if it's a genetic and
03:56what did she have done um she did have hers removed privately okay it's really interesting I don't think
04:02I've ever seen anyone with something like this that runs in the family looking at it it's good news I
04:10think we can do this for you today brilliant okay but I think we'll restrict it to one and we'll do
04:16the bigger one for you yeah see how you go okay what the procedure would involve is local anesthetic
04:21yep we will take that off and give you a straight line scar in that area if I'm honest ideally I would
04:27have liked to have had both sides done but either way one's larger than the other so that's a little bit
04:33more troublesome looking at what you have I can't see that there's a defined lump under the skin like
04:42a lipoma but that would be the obvious cause of something like this it's just very rare to have
04:47them bilateral on both sides my feeling was let's make sure she has a good result with one and that
04:54she is able to use one arm after the procedure freely because she won't be able to use this arm properly
05:01all right here we go okay so sharp scratch coming up okay how are you doing I'm okay that's fine
05:10yeah daughter's getting married one of the reasons I wanted this done yeah I've got three outfits so
05:16far and I don't feel comfortable in any of them oh shame I want to look like the mother of the bride I
05:23want to feel like the mother of the bride and make her feel really proud of me it's gonna be interesting
05:28when we go in and see what we get out yeah okay here we go what I'm gonna do is just go over the top
05:37of it first just to see what it is yeah
05:39when we did the first incision I felt that I wasn't quite deep enough to get to what I felt was a
06:02lipoma it looked like normal fat to start with but as I went deeper I felt that I could see a
06:25different type of fat it's usually a slightly different color to the yellow fat is usually a
06:30bit more orangey there we go you okay there yeah I'm fine
06:40sort of just tears back in doesn't want to come out okay let's just do that then see if we can tease
06:57him out it's okay no sir oh yeah stubborn as hell it's got to be a bloke there are lots of nerves in the
07:05armpit and if you delve too deep you can damage nerves and vessels that go down the arm you always
07:11have to be wary of how deep you're going in one's armpit coming up oh my god it's not gonna pop
07:22I've made our job far harder by doing it that way around
07:29I've just left the hand cream there I don't know if you need any oh I will actually don't
07:47keep washing them don't they it's 11 o'clock and while dr emma and donna wait for their next patient
07:54doctor Magnus's has already arrived hi my name is John I'm 73 I live in Hertfordshire and I'm a retired
08:04chartered quantity surveyor have a seat for me I'll let you know when we're ready for you I've played
08:10table tennis badminton and tennis basically all my life so I am a racket player and I now play pickleball
08:19okay John the doctor's ready for you it could sound competitive but not very competitive I'm a good
08:27loser put it that way
08:28come in hello how are you come on in okay hi there come through nice to meet you I'm Dr Magnus have a seat
08:37for me thank you very much this is Angela hello Angela so how can we help you today well let's hope you
08:44can okay I have a sis here yeah and I have a sis there yeah on the back I hope they're not joined
08:51okay okay they've been there many years and I find them embarrassing when I'm actually swimming and
08:57my dear grandson who's only seven Thomas yeah he's a lot points it and goes oh they've got bigger
09:05which is always a worry when anything like that gets bigger I just find them uncomfortable and
09:12unsightly do you mind if we take a look at the areas please do sitting on a chair like this quite
09:17hard chair you need to get into a certain position to get comfortable and that's that's one of the
09:23main problems I have with it I'm going to touch your skin okay so it's fair size isn't it it's about
09:31a good three centimeters that one certainly looks like a cyst all right let's have a look at your back
09:36as well then so this looks similar again it's about a good three or four centimeters does feel
09:43like a cyst you cover up and have a seat for me okay it's perhaps unusual to have them in the same
09:49location on the back and the front but it's very common to have more than one cyst on on a patient
09:54it's a tendency that some people do have I think it is reasonable to remove them okay you think you can
10:01do that for you fantastic I'd have no bumps there nothing for my grandson to point at I think I feel
10:08a bit more confident actually in the swimming pool so if you'd like to just lie up onto the bed for me
10:13now thank you great now have a sit down then you can lie down great right so I'm just going to put
10:19some injections into numb the area for you be as gentle as I can here we go am I doing anything
10:31wrong in my life no not very clear why it happens in some people with others just basically it's bad
10:38luck basically okay I've heard that before that I'm unlucky okay doing really well
10:46a little pop there there you go so you've done all the difficult bit now well done okay
10:55ready
11:03all right good so what kind of work do you do then retired yeah how do you keep yourself busy what
11:16do you do what you like to do grandchildren yeah sport tennis pickleball so pickleball is quite a new
11:23one isn't it it's not one that very popular isn't it plus it's grand sport in the uk oh really
11:29yeah so it is a little bit scarred so that means that rather than just popping out as a
11:38nice sort of round cyst where you just have to free it up a little bit more why why is it scarred
11:43often you might have had some infection without realizing it oh I see yeah okay I wasn't expecting
11:49to hear that I wasn't aware at all of any scarring or any infection previously on these cysts and
11:57that surprised me the back is an area where you are going to be pressing on it so if little bits
12:07of the cysts are getting sort of leaking into the tissue that can cause a lot of scar tissue
12:11there we go right so that's the back so I've got the um sort of cyst out all the scar tissue okay
12:39that's the back done hopefully the the one on the front is going to come out a little bit more
12:44easily we'll just get your positions so we'll see whether this is a similar type of cyst or whether
12:58it's a bit more of a mobile one
13:02so this one's a bit more typical type of cyst really I'd say it's it is more enjoyable when the
13:27cyst just pops out nice and easily and you don't have to work your way through a lot of scar tissue
13:32you to release it using it all out there
13:34okay that's good
13:43now I just need to make sure we get all the lining out
13:47perfect okay there we go great well I didn't see any mess come out certainly in my mind
14:04I know they have gone brilliant looks very neat it makes me feel very good that they have gone
14:11there's no question about that anything else you wanted to ask I think so yeah as soon as I go home
14:17the first person I will see is my grandson Tommy Thomas will love it he will he will thank you
14:23thank you thank you no doubt he will ask to view the the stitches so I look forward to showing him
14:31bye-bye that's one happy customer meanwhile back in dr. dev surgery here we go okay he's still searching for 59 year old Lisa's lipoma but the lump in her underarm isn't what it seemed on the surface
14:52this was turning into a much bigger procedure than I thought can you pull on that there we go yeah that's it
15:02essentially this was not a lipoma you're having fun in there trying to turn you inside out now
15:10oh okay the lump of skin that was on the armpit was just due to extra skin had I fully known and appreciated that I would have just cut it out like you would a normal lump of skin
15:27any pain no
15:31okay
15:37so I made the procedure twice as hard by trying to get the fat out first which is not something you do
15:49if you're removing skin you just take out the skin with the fat and close it up
15:54I was thinking maybe if we take this off yeah I'll get your pen and you start drawing
16:02you're gonna sign it for me yeah that's right
16:04so I had to use a pen so that I got just the right amount of skin in order to not create a lump when her arm is down
16:14but also not to take too much away so she's still able to stretch her arm up
16:19I think we just need to cut it okay
16:23if I could get you to do that
16:47okay what I was doing is closing from the middle of the wound to the end
16:54closing it up seeing how much skin is bunching up taking a bit more
16:59so we're sewing and cutting sewing and cutting sewing and cutting
17:04little nip and tuck
17:06it was a little bit uncomfortable trying to keep in the same position and try to keep still for so long
17:21I didn't realize how long I'd actually been in there
17:24I can't wait to see what it looks like
17:27neither can we
17:28Dev is a real perfectionist when it comes to skin closure
17:37and how the wound will actually look for the patient further down the line
17:43and often you just have to really really take your time
17:47front looks good good good
17:50you're going to go onto your side
17:52yeah just gently roll you're fine
17:54I needed that line the scar to fit in the fold so no one could see it
18:01I'm glad we didn't do two
18:03okay great well that was longer than expected
18:13Dr. Dev wanted to make sure that it was as neat as possible
18:20so I really appreciated the extra time that he took
18:23putting me all back together again afterwards
18:25I could have been quicker I just didn't realize how long it had taken
18:37wow okay so do you want to see your result
18:42yes please
18:43so that's what the scar looks like
18:46wow
18:46okay
18:47yeah amazing
18:48okay
18:49that's brilliant
18:50are you ready to have a look
18:51I am yes
18:52okay
18:52all right
18:53so oh wow
18:56this is the bit of skin
19:00that we took off
19:02okay
19:03I was quite surprised how large it was
19:06it's one thing when it's attached to your body
19:09but when it's removed and it's lying out flat in front of you
19:12it's like wow
19:13and then underneath it was sort of
19:16like jelly
19:17it doesn't quite feel like a lipoma
19:19so we'll wait to see
19:20we will send it off to the lab
19:22and see what it feels like
19:23yeah
19:23thank you so much
19:24so you can say bye to that
19:26bye bye
19:30okay
19:30I was just so delighted
19:32I'm really looking forward to telling my daughter that I finally had this procedure done
19:37she knows how much this has bothered me
19:40thanks very much
19:41nice to meet you
19:42all right
19:43all right
19:43and you look after yourself
19:44this is going to be not only a weight off my armpit but it's going to be a weight off my mind as well
19:51coming up
19:56it's a greasy one
19:58this is in a sensitive location I need to make sure that I don't damage any other structures
20:02after a hectic morning
20:14it's time for a restock
20:16Dr. Shraza I'm just going to go and get some paper towels
20:19sure
20:20and refresh
20:21ready for the afternoon session
20:23my name's Avril
20:26I'm 58 years of age
20:29I'm a civil servant
20:31working with young people and their families in the community
20:34take a seat for me
20:36I'll let you know when the doctor's ready for you
20:37I'm a people person
20:39I can be a bit loud
20:41my friends and I used to go to all the club places
20:44Ibiza
20:45Magaloo
20:47party animal
20:48not now though
20:50ready to show off his groovy moves
20:54is Dr. Adil Shraz
20:55come in
20:57hello
20:58hi there
20:59hello
21:00hi
21:00come through and take a seat Avril
21:02yes
21:02I'm Dr. Shraz
21:05nice to meet you Avril
21:06and this is Vilma
21:07how are you Vilma
21:08right
21:08how can we help you
21:09what are we doing
21:10I'm here
21:12because I've got a big lump in my head
21:15ok that you covered
21:16yeah I cover it all the time
21:18I hate it
21:19I really hate it
21:20erm
21:21I've had it about 23 plus years
21:24it was tiny
21:25yeah
21:25and then it's grown over the years
21:27probably the last year it's had a bit of a spurt
21:29ok
21:30and that's kind of giving me worry
21:32what sort of symptoms does it cause itself
21:35erm
21:36the only symptoms what I really get of it
21:39is if I get like a tension headache it really hurts
21:42and I don't know whether it's on a nerve or something like that
21:45but that hurts
21:47it is unusual for lumps at the forehead to be involved or be causing headaches
21:53erm unless there's possibly direct pressure on them which then may cause a bit of pain
21:57I'm really conscious of it
22:00before I started hiding it now it's got bigger
22:03people say what's that what's that
22:05first of all what I'd like to do is examine
22:08have a feel
22:09and then I can decide whether it's something we can do for you today or not
22:13ok
22:14alright
22:15I'm praying
22:16let's have a feel of this
22:18I'm going to pull your head back a little bit further back is that ok
22:21yeah
22:22ok
22:23so it's quite soft it does move around a little bit
22:26if the dermatologist can treat me today I will be absolutely delighted
22:33a weight off my shoulders or I should say a weight off my head
22:37so the most likely diagnosis is that it's a lipoma
22:41but it's something that we can definitely do for you today
22:44and hopefully we can get rid of it
22:46I've called it the Malteser
22:48I've called it a unicorn
22:50Mr. Bump
22:53Mrs. Bump
22:54erm
22:55the thing
22:56I'm laughing now but it is a big thing for me
22:59it moves down to about here
23:01a couple of things we need to be cautious of
23:03so this is roughly where one of the nerves will be running
23:06along here
23:07it's called the supratrochlear nerve
23:10then you have another nerve that will be running roughly
23:13probably around here
23:15so that's your supraorbital nerve
23:17the forehead can be quite a sensitive area
23:19particularly above the eyes
23:22these locations contain nerves
23:24so damaging them can then cause problems with sensation in the area
23:28ok so step one will be the anaesthetic
23:31ok and then this will sting unfortunately
23:33can it grow back?
23:34it can but it's unlikely
23:35if we get the whole thing out it will be unlikely
23:37yep
23:38coming up now I'm sorry
23:39mhm
23:40mhm
23:41well done
23:42bit sharp
23:44that erm
23:45going in but I just
23:46what I just thought about
23:48it's a small sacrifice
23:49ok anything sharp there?
23:52no
23:53I'm just trying to loosen the skin so I can get to the actual lump
24:08uh huh
24:09can you see it yet?
24:11yeah it's just sitting underneath
24:14I can feel it just there
24:15ok
24:16because this is in a sensitive location I need to make sure that I don't damage any other structures
24:27that's why it just takes a bit longer
24:29mhm
24:30because it's stuck down
24:31the main thing is that I don't really want to cut it
24:36I need to
24:37you've got to get it out
24:38pry it
24:39yeah I need to pry it free rather than cut it because I can see all your nerves there
24:42and I don't want to really be damaging any of those
24:45he did it raw she took his time erm and as he was doing it explaining it very professional
25:02so you can clearly see a nerve there
25:05what did he look like the nerve?
25:07just like a little thread
25:09yeah
25:10mhm
25:11I don't get to see the facial nerve quite often so there was a great opportunity
25:15to see how the facial nerve looks
25:21ok
25:22that's it now we're done
25:24it's out
25:25it's out
25:26hey
25:27are you gluing or stitching?
25:28stitching
25:29always stitch
25:30why do some other people get things cut erm glued?
25:35I mean if you had a just a little cut you can
25:38superficial cut then you can often glue it but not this type of thing
25:42books my husband could ask too many questions but it's just me, my daughters are safe
25:51I actually really enjoy answering patients questions I think it shows that they're involved in their care
25:56it's also nice for me to be able to talk to patients in something that they're interested in
26:00glad it's out
26:02fantastic
26:03I'm quite keen to see what it looks like
26:05ok this is essentially what's
26:07it's a little thing isn't it?
26:10yeah so you can see that it's not that big but sitting on over lined bone it sort of protrudes
26:17oh my gosh
26:19it's a tiny thing
26:21it's embarrassing really
26:24that's what I've been moaned about
26:26oh my gosh
26:28come out, I'm grinning like a Cheshik
26:34yay
26:35but I couldn't help it
26:37it was brilliant both of you
26:39I'd do a jeep book I said
26:41thanks very much
26:42you're welcome
26:43you're welcome
26:44bye bye
26:45take care Adel
26:46bye
26:47Dr Adel Wilma
26:48thank you
26:49you change my world
26:51ok
26:52yeah
26:53what's your plans for the rest of your days?
26:54I'd like to do a road trip
26:56a road trip?
26:57yes
27:01oh I love a road trip
27:03but what about the rest of the team?
27:05my favourite holidays are wildlife holidays
27:07so somewhere we can go bird spotting
27:10I'm happy to try anything new
27:12we've gone from being beach and pool to now moving around in a car and Airbnb-ing it
27:18and it's so much more fun
27:19I don't mind the city but as long as at some point I get to swim in the sea
27:27the next patient has crossed the Irish Sea to get here
27:31my name is Craig, I'm 36, I'm from Northern Ireland and I'm an NHS manager
27:36have a seat for me and I'll let you know when you're ready
27:39home is very busy
27:41very intense
27:42four children
27:43they're all under 10
27:45three boys and a girl
27:46and they keep me and my wife on my toes
27:49there isn't a lot of time for hobbies
27:51but I still manage to squeeze my bagpipes in
27:54and my son is actually learning the bagpipes as well
27:57the doctor is ready for you now
27:59it's down the hall on your left
28:01Craig's appointment is with Dr Emma McBullen
28:08Hello
28:09Hi, how was it Craig?
28:10Hi Craig, come on in, have a seat
28:12How are you?
28:13Not too bad, thank you
28:14Good, a fellow countryman
28:16Oh well, yeah, yeah, yeah
28:18Are you from Northern Ireland?
28:19Yeah, yeah
28:20Very good
28:21So what can we do for you today?
28:23I have a lump on the head
28:26It's not painful
28:28I've had it for a number of years
28:30and I suppose recently it has gotten bigger
28:32It's starting to get more noticeable
28:34so it makes me a bit more self-conscious
28:36Have you ever had any cysts anywhere else?
28:39So I actually had one in the same place
28:41and my previous GP had actually removed it
28:45They had put it down as a pilar cyst
28:47Pilar cyst, yeah
28:48And the GP did say initially
28:50look, this could come back again
28:52you know, and sure enough it did
28:54It did
28:55It's really common for this to happen
28:57Do you mind if I have a little look at it?
28:58Oh, I have a look at it
28:59Sometimes people just stick a scalpel in them
29:02and squeeze them and sew it up again
29:04and think they've removed the cyst
29:06Yeah, it does move around quite easily
29:08Yeah
29:09It's quite hard
29:10It's a cyst
29:11It's a cyst
29:12That is a cyst
29:13There's no scar in this area
29:15Is there not?
29:16I can see
29:17Scalps heal very well
29:18Yeah
29:19It's a really common place for cysts to occur
29:22because there's so many hair follicles
29:24so it could have been a new one as well
29:27Craig, I think we're going to be able to remove that for you
29:29Oh great, yes, that'll be good
29:30All right
29:31Yes, yes, yeah
29:32So we'll put some local anaesthetic in
29:34make a little incision through it
29:35and then hopefully get the whole shell of the cyst out
29:37so it doesn't regrow
29:38Yeah, yeah, yeah
29:39Maybe they've left a little bit behind last time
29:40Yeah
29:41And that's why it's grown
29:42But can we get started then?
29:43All right, yes, yes
29:44I was a wee bit apprehensive that they might say
29:46we can't do this
29:47I was elated when they said
29:49yes, we can
29:50Get yourself as comfortable as you can
29:51Get yourself as comfortable as you can
29:53Yeah
29:54Right, let's get you local
29:56Are you okay there?
29:58Aye, yes
29:59Let me know if it's too sore
30:01I'll give it a rest
30:02I'll give it a rest
30:03Put a bit in the surface there
30:12Is that starting to feel like it's settling
30:14It's not stinging anymore?
30:15It's not stinging, no
30:16Right, good
30:18I'll let Donna clean it up
30:19Yeah
30:20Maybe just trim a wee bit of hair from over the top of it
30:22Is that hair?
30:23Aye, I work away
30:24Are you okay with that just over the top of it?
30:27It can be a wee bit nerve-racking
30:29And especially you're kind of thinking
30:31How much hair are they going to have to remove?
30:33But I think overall the positives outweigh the negatives
30:37Okay, so just um
30:40Just going to trim a bit off here
30:48Just have a seed there, see if that's enough
30:50Yeah
30:51Yeah, that'll be fine
30:53Is that okay?
30:54Yeah
30:55It's kind of bald in any way, you know
30:57It is not indeed
30:58You've got a great head of hair
31:00I'm just going to check to see if it's gone numb
31:02Do you feel anything sharp here?
31:04No
31:05So I might just remove like a little ellipse there
31:08Yeah
31:11Oh, scalps do like to bleed
31:17Yeah, so if we remove a little bit of skin
31:19It looks less like there's a bald patch there
31:21Aye
31:22Well, do whatever you have to do
31:23Don't be saying that
31:24You just want to be gone, don't you?
31:29Oh
31:31Get one side out first
31:32I hope I'm pressing very hard on your scalp here
31:34I know
31:35You can't feel that
31:36No, I can't
31:37I just feel pressure
31:38Just feel pressure, yeah
31:39But it's not sore
31:40It's not sore
31:42It was just basically them rummaging around
31:45In my head
31:46There maybe was a few squelches and things, but nothing too disconcertain
31:53It's cheesy
31:54It's alright, I just haven't really loosened it up this side, I think
31:56There we go
31:57There we go
31:58One, two, three
31:59It's not going to pop, Donna
32:00Sorry
32:01No, I meant to pop it out
32:02No, I meant to pop it out
32:03No, I meant to pop it out
32:04There we go
32:05There we go
32:06One, two, three
32:07It's not going to pop, Donna
32:08Sorry
32:09No, I meant to pop it out
32:11Yeah
32:15Oh, I need to see this
32:17I'm just trying to keep this hair out of the way for you
32:21I know
32:22Thank you
32:23It's been great
32:25It's going
32:26I don't wanna leave
32:27No, I want to leave
32:35Oh, oh
32:36It's great to hear that
32:37I did
32:38Yeah. Looks like a turnip.
32:41Oh, yeah.
32:47It's gone very well-behaved, coming out.
32:54So I'm just putting the stitches in now, Craig.
32:57OK.
32:58Cool.
32:59There's a brain in there, isn't there?
33:01Oh, we've not gone that far.
33:03It'll still be a mystery when you leave.
33:05That would be a shock.
33:09So there was quite a big hole there.
33:11Thankfully, the skull was still in the way
33:13and I was nowhere near the brain.
33:15I'd ask, did I have a brain in there to begin with?
33:19Sometimes, I'm not sure.
33:24You made me laugh then, and my glasses steamed up.
33:27Obviously, we can't put a dressing on.
33:29Yes.
33:30So we put, like, a spray dressing on.
33:32Yes, OK, fair enough.
33:35So this might feel a bit cold.
33:36OK.
33:39So a spray dressing, it's almost like a glue.
33:42Just gives that protection amongst the hair
33:45while that wound starts to heal
33:47and hopefully prevent infection.
33:49Would you like to have a look?
33:50Yes, please.
33:51Yes.
33:53Like a bean.
33:55That's a funny little thing, isn't it?
33:57It was quite big, actually.
33:58It is.
33:59I didn't think it.
34:00I wasn't.
34:01It must have went sort of down in.
34:02Yeah.
34:04It looked like a shallot, to be honest.
34:06You know, a small onion.
34:09Hopefully, it's fully gone now.
34:11No, well, I'm glad you took it.
34:12Do you want a picture?
34:13Do you want a one?
34:14Oh, yeah.
34:15I will.
34:16One for the family, I'll think.
34:19I'll be able to go home and show everybody.
34:23There you go.
34:24It's a going, little bean.
34:25Yeah.
34:27We could maybe blow it up and put it up in the living room, you know.
34:32Big as we can get it.
34:34Lovely to meet you.
34:35Nice to meet you.
34:36As a memento of my time in Birmingham.
34:41Lovely little bean.
34:42Yeah.
34:46Coming up.
34:47This is one of the poem I just keeps on giving.
34:49It just feels really weird.
34:56It's been a whirlwind of a day at Skin A&E.
35:05Today is a blur.
35:06We've seen that many patients.
35:09And it might be late, but the action never stops.
35:13My name's Jackie.
35:14I'm 53.
35:16I know I don't look up, but thanks.
35:19I'm from Rotherham, South Yorkshire.
35:21Let's check you in here, Jackie.
35:24Jokes.
35:25I like jokes.
35:26That's me.
35:27And I also like to sing.
35:29What everybody knows me for is Dolly Part.
35:32I did embarrass my husband not so long back,
35:35and I got up on a karaoke in a pub full of strangers.
35:40And sang Jolene.
35:42OK, Jackie, the doctor's ready for you down the hall on your right.
35:46OK, thank you very much.
35:47No problem.
35:48Waiting to see Jackie is Dr Natalia Spearings.
35:55Come in.
35:57Hi.
35:58Hello.
35:59Come on through, welcome.
36:01Hi, you must be Jackie.
36:02I am.
36:03Hi Natalia, nice to meet you, welcome.
36:04Nice to meet you.
36:06Mrs Dutta, she'll be assisting me.
36:07Lovely to meet you.
36:09Come and have a seat on the little white stool here.
36:11OK.
36:12So how can I help you today?
36:13I've got a fat lump on my bottom.
36:16Oh, right.
36:17Ew.
36:18I've had it moved once before, which is probably about 19 years ago.
36:21Oh, right.
36:22That's quite a while.
36:23Yeah.
36:24And it's grown back, obviously much bigger.
36:25It's bigger than it was?
36:26Yeah.
36:27And I'm conscious that people can see it when I'm behind me.
36:32So I cover it up as much as I can.
36:37And I can feel it when I walk now.
36:39Oh, God, really?
36:40Yeah.
36:41You don't feel it when you sit down?
36:44No, because obviously it's squishy.
36:45It's squishy.
36:46It's squishing into my bottom.
36:47Yeah.
36:48So I do think we can remove this, but of course we have to have a look.
36:51Yes, that's fine.
36:52So let's position you on the couch in a way that you're comfortable.
36:55Try not to wear anything too tight.
36:58Big baggy clothes I wear.
37:00I want to be able to wear something figure-looking sometimes, but I don't.
37:05So let's just have a look before anything.
37:08So I've moved underwear to that side.
37:14It does move over quite prominently, doesn't it?
37:19Sorry, this is going to be a lot uncomfortable for you.
37:21Just because I'm...
37:23Okay.
37:24She doesn't know how far down it goes down here.
37:28Sorry.
37:31I've positioned the scar well.
37:33I had to mark out the margins of it, and one of the margins was going very close to her midline of her bum.
37:41I was hoping it wasn't going to go too far down because that would have been really uncomfortable for her.
37:45I'm going to do a little sharp scratch and a sting.
37:47You're going to feel that now.
37:48Ready?
37:49Okay.
37:50I'm going to pinch the skin, and you're going to feel it sharp.
37:51Good.
37:52Well done.
37:53Well done.
37:54And a sting now.
37:57You okay?
37:58Yeah.
37:59Fine.
38:00I can hardly feel it, to be fair.
38:01Oh, very good.
38:05All right.
38:06Do you feel any pain?
38:07You let me know.
38:08I can feel that.
38:32Oh, as in pain?
38:34Just sharp, stinging.
38:35Sharp.
38:36Okay, yeah.
38:37I knew it was because I was going around the lipoma to try to get the edge of it.
38:43And the anesthetic doesn't always move that far, so I had to go back and put anesthetic inside the area of the lipoma
38:50to make sure that whole area was going to be numb so she wouldn't have that again.
38:54Not necessarily uncomfortable, as in really painful.
38:58It's just like, ooh, kind of.
39:02Jackie, have you got any hobbies or interests?
39:05Been going lots of music concerts recently.
39:08Oh, what did you go see?
39:10The other week I saw Bruce Springsteen.
39:13Oh, no way!
39:14Yeah.
39:15Yeah, I'm trying to do more fun stuff like go to concerts and things.
39:18We did try to get tickets to see you.
39:20Justin Bieber?
39:21Oh, no.
39:22No.
39:23Definitely not.
39:24I really want to see Justin Bieber.
39:25Oh, no.
39:26Really?
39:27Yeah.
39:28Okay.
39:29Love the Biebs.
39:30She likes Justin Bieber.
39:31Not my cup of tea, that one.
39:33I've seen Whitney Houston.
39:34Oh, my God.
39:35Epic.
39:36Wow.
39:37Do you feel anything now?
39:38Because you might start feeling it again.
39:40Just tell me.
39:41I'm all right.
39:42I can feel you tugging, but...
39:44Yeah, you're going to have to feel that, yes.
39:45Yeah, that's fine.
39:46It doesn't hurt.
39:47We're getting there.
39:48Good.
39:49It's coming out.
39:50It feels really weird.
39:51Yeah.
39:52It's a greasy one.
39:53It's a greasy one.
39:54Really stuck down.
39:56Because Jackie had had it removed a few years ago, that may have made it more difficult
40:14for me to remove because of the scar tissue and how it was adherent to kind of the surrounding
40:21tissue.
40:22This is one of those, like, pull ones that just keeps on giving.
40:25Yeah.
40:26Yeah.
40:27It's like...
40:28More.
40:29More.
40:30Oh, pulling.
40:31You felt that sick.
40:32It just feels really weird.
40:34It's pulling right now.
40:35Now I'm not cutting anything.
40:36I'm just pulling it out.
40:37Yeah.
40:38Yeah.
40:39It's going to feel weird.
40:40I like to use my fingers for blunt dissection.
40:43If I can get into the cavity.
40:45Because it gives me a much better feel of what's happening around.
40:48Also, I know I can't traumatize anything because I can't cut anything.
40:52Yeah.
40:53Seriously, it's like not stopping.
40:55Come on, little friend.
41:08Jackie's lipoma wasn't just one perfect ball.
41:10It had kind of roots to it in the cavity where the lipoma was sitting.
41:15So that does make it a lot more tricky to get it out because I want to make sure I get everything out so it won't recur again.
41:20I'm not quite done, but I'm going to start to suture it because I think once I suture it, then kind of this...
41:28The excess skin, which is causing a bit of lumpiness here, I can suture that out.
41:33I had to remove some excess skin from Jackie's lipoma area when I was closing it because if I hadn't done that, she would have had kind of saggy skin there.
41:41And that would have not been very cosmetically elegant.
41:45I appreciated that Natalia did that. Quite impressed, to be fair. I wasn't expecting that at all.
41:52Okay, so this is going to be a funky looking lumpy scar, right?
41:56Okay.
41:57But it will settle down.
41:58Right, thank you.
41:59So I'm going to put a dry dressing on, okay?
42:04Okay.
42:05I can't remember how long ago it was when I last wore a swimsuit.
42:10Yeah, I avoided swimming for quite some time.
42:15So I'm looking forward to that bit.
42:18How are you feeling?
42:19I'm feeling fine.
42:21Yeah, because I can't actually feel anything at the moment.
42:24You'll certainly feel it in a few hours.
42:26Yes, I can imagine.
42:27I can imagine.
42:28Do you want to see it?
42:29Yes, please.
42:30Yes.
42:31It's a wheel that won't die over.
42:36It's so fat.
42:37The little balls.
42:38Ooh, yeah.
42:39Ooh.
42:40Looks a bit like sweet corn.
42:4279 grams.
42:43No, sorry, 76 grams.
42:45I'd like to say thank you ever so much.
42:47I am so impressed with how you've handled me.
42:51Natalia were wonderful.
42:52Yeah, I can't fault her.
42:54She made me laugh while she was cutting away at me.
42:57Well, thank you for coming today.
42:59No, thank you.
43:01Natalia was really lovely.
43:03Bye.
43:04Bye, bye.
43:05And you.
43:06Bye.
43:0779 grams.
43:11That's like a serving of couscous.
43:16Yummy.
43:24I'm a lot more confident and a lot more comfortable as well.
43:29Anne bought the dress of my dreams.
43:31So really looking forward to a daughter's wedding in a couple of weeks.
43:41I'm delighted with the results.
43:43And so is my grandson, Tommy.
43:50I'm enjoying going for walks more now as the life home has gone.
43:54I'd just like to say a big thank you to everyone at Skin A&E.
44:08I feel a lot more confident.
44:11I like walking on cloud nine.
44:13Next time on Skin A&E.
44:17Funny looking fan here.
44:20The ultrasound scan report, it did mention one large vessel running over the top of it.
44:25I was quite worried about going through that.
44:28I could just hear a crack and then just a whole load of squelching.
44:33Squish.
44:34I'm loving this.
44:35This is how we want them.
45:04I'm loving this.
45:05Let me know again and you can get back up.
45:08I'm good.
45:10I'm I'm good.
45:11I'm smoking away.
45:12I'm smoking.
45:14The sound of Ken C poblaciĂłn.
45:16eking.
45:20I'm very 대한.
45:22I'm kind of a sad sentence.
45:23I'm a demon.
45:24If you think he's got to and hear it, thanks.
45:26I'm so happy about people's just a cooker.
45:28I know.
45:29Thereas salvar,endarizist,
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