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GPs Behind Closed Doors Season 9 Episode 3
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FunTranscript
00:00Good morning, surgery!
00:14I'm told that cobwebs are the best thing.
00:17That's not advice that I'm familiar with.
00:21That is my modern tablet for all day.
00:23You must feel like you're rattling sometimes.
00:25It's a lot, no.
00:26This foot is normal.
00:29Yes.
00:30This foot looks like a Cornish pasty.
00:35I got out of bed and all of a sudden,
00:37my nose poured with blood.
00:39My nightdress was full of blood.
00:46It's good, John.
00:47It's really good.
00:56Vernon?
01:11Hello!
01:13Vernon, hello, morning.
01:28We're in here today.
01:29It's a bit warm, but not too bad.
01:32Have a seat.
01:33Shall I sit here?
01:33No, you get this seat.
01:35I need to play on the computer sometimes.
01:36Sorry, sorry, sorry.
01:37No, no, no, don't be silly.
01:38What's happened?
01:39No, I've got a lot of complaint.
01:41Oh, dear.
01:42Um, I had some pain.
01:45Okay.
01:46I don't know if it was liver or whatever, but it was around here.
01:50It was very hard.
01:51Okay.
01:53And then it moved to here.
01:55Oh, so how long has all this been happening for then?
01:58Well.
01:59Weeks?
02:00Months, months.
02:02Okay.
02:02I think over half a year.
02:04But my stomach, I had some funny, as I got up in the morning,
02:11straight away, I got to the toilet, and that was not normal.
02:15So that was going to the toilet to open your bowels?
02:17Yes.
02:17It was a bit funny.
02:18I mean, I didn't mind it, but it wasn't usual.
02:22No, so it was a change for you.
02:23Yeah.
02:24I'll just show you something, doctor.
02:26Yeah.
02:27That is my amount of tablet for all day.
02:29So you line these up.
02:30Wow, that's a lot of tablets.
02:32I take all this in the morning.
02:33Yeah.
02:33That is the supplements that I take myself.
02:36So you've got these ones that we give you.
02:38These in the evening.
02:39These, yeah.
02:40And do you know why you're taking all these tablets, Vernon?
02:43Well, I know some of them when I had that heart attack and that stroke and thing.
02:47I know some of them is in that area.
02:49Yeah.
02:50But blimey.
02:51So the problem is that each one of these tablets is there for a reason,
02:55and it does seem like a lot.
02:56You must feel like you're rattling sometimes.
02:58It's a lot, man, really.
02:59Let's think about it.
03:00It's 14, 15 tummies.
03:03Yeah, but you're going to live to 100 with all of these,
03:05because we're going to keep you going, my friend.
03:06Oh, 100, really?
03:06So you've got to keep going with them.
03:08And then I think, I am slightly worried about the pain.
03:10Can I just have a feel of your tummy?
03:12Is that all right?
03:12Yes, yes.
03:12Come and pop up on here.
03:13Let me just, um, if you just...
03:15That's why I want to come and see you, Doc,
03:16because I've been seeing you.
03:18When I had my heart attack, it was you coming to my plant.
03:20When I had my stroke, it was you coming to my thing.
03:23Can I just have a feel of your tummy?
03:24Yes.
03:24Okay.
03:25Any pain in your tummy now?
03:27No.
03:28And if I just press at the back, any pain in the...
03:30The pain was up here, Doctor.
03:32So it's much higher, isn't it?
03:33Right there, the pain was.
03:34Stay sitting.
03:35I'm just going to have a listen to your heart for a minute.
03:38Strong as a horse.
03:41Oh.
03:43Not as a human?
03:44No, as a horse.
03:45But that's all your tablets that you're taking,
03:47keeping your heart good, so that's good.
03:48I'm a swingman.
03:49I'm a little bit more worried about your bowels and things.
03:51A slight change in bowel habit needs to be checked.
03:55Okay, so what I will do, sweetheart,
03:57is that do you think you can drop in a stool sample for me?
04:00Yes.
04:00And if this is negative, then I'm happy with that.
04:03Then we'll move on and work out what else we need to do, okay?
04:05And let me just get you a pot.
04:06There's one in here.
04:08Okay, so this is how we do it.
04:10It's called a fit test.
04:11This is how we do it.
04:13Yeah.
04:15There's a song.
04:16I know there's a song.
04:17You've got a lovely voice.
04:19This is the test we do.
04:20It's very easy to do.
04:21The instructions tell you what to do.
04:22And then drop it back around here.
04:23So I won't seal it, but I'll give you all of this.
04:26All right?
04:26Go and have your breakfast.
04:27Yes, I feel good that I came down.
04:29Good.
04:29Thank you, Doc.
04:30All right, you go and have your breakfast.
04:31Have a breakfast.
04:31And you take care, sweetheart.
04:33All the best.
04:33Bye-bye, Vernon.
04:34Bye-bye.
04:37Have a nice day, you friend.
04:39Yeah.
04:42Cosimo?
04:43Cosimo?
04:45Yeah, I'm going to be calling me.
04:47Okay.
04:47Bye.
04:49So take a seat.
04:50My name's Anna McHugh.
04:51I'm one of the doctors.
04:52It's nice to meet you.
04:53You too.
04:54Thanks for seeing us.
04:55No worries.
04:56So what's been going on?
04:57Do you want to show her?
04:59So he basically has got an infected thing.
05:02But it was massive yesterday.
05:03And I got it out.
05:05Can you see?
05:06But it's really painful for him.
05:08When did this all start?
05:10When did it happen?
05:11Yesterday morning.
05:13Oh, so quite quick.
05:14So you've been 24 hours.
05:15Yeah, he woke up with it, didn't you?
05:17And did you bang your finger off anything?
05:19I don't know.
05:21Okay.
05:21What did you do?
05:22I just woke up with it.
05:24You just woke up with it?
05:26Okay.
05:26You weren't digging in the ground or anything like that or biting your nails or anything?
05:30No.
05:31And have you ever had it?
05:33Has he ever had anything like this before?
05:34No.
05:35I have.
05:36Have you?
05:36I remember I have.
05:37Did you?
05:38Well, we have a little look.
05:39So I just didn't want to leave it and it to get worse again.
05:42Yeah, so it looks like what's called a paronychia.
05:44It's quite sore, isn't it?
05:46I'm sorry.
05:47So there's definitely a collection of pus there and it looks like it's infected.
05:52We'll try four times a day an antibiotic cream.
05:56Okay.
05:56And if you've noticed that it's not improving, let's say, in 48 hours, then we can, yeah,
06:02we can give you an oral antibiotic.
06:04Yeah.
06:04Okay.
06:04Can I have a sticker?
06:06Okay.
06:06Oh, would you like a sticker?
06:08Yes.
06:09I think we do have one.
06:11I have some options for you.
06:13What do you say?
06:16What's your favourite animal?
06:17The lion.
06:19Yeah.
06:19Perfect.
06:20Do you see what it says?
06:22Awesome.
06:23Nice.
06:24Well done.
06:24Well done.
06:26Thank you so much.
06:27What do you say?
06:28What do you say?
06:29Say thank you.
06:40Jack, please.
06:42Jack.
06:42And here.
06:46Hello.
06:47How are you doing?
06:48Lovely to meet you.
06:49I've been reading all about you and I had a chat with Dr. Pearson as well.
06:52You poor thing.
06:53Yeah, no.
06:54It's crazy.
06:54It sounds like it's been a whirlwind of a few weeks for you.
06:56Yeah.
06:56How are you getting on?
06:57Actually, better than I thought I would.
07:00Okay.
07:00I think kind of after going through brain surgery, I thought I would need a bit more time to feel
07:05back to normal.
07:06But actually...
07:06What are the initial symptoms that you had that sort of prompted this whole...
07:09I honestly, I'd never had any symptoms prior to the seizure that I actually had that put
07:14me in hospital.
07:15So just a one-off seizure, went into hospital, did a scan, they found a benign brain tumour,
07:20thankfully.
07:21Thankfully, yeah.
07:21Thank goodness.
07:22And then you were into surgery straight away, cut it all out.
07:25Brilliant.
07:26So Jack is a young lad who presented initially to the hospital services having had a seizure.
07:32On investigation, it was found that he had meningioma, which is a type of brain cancer.
07:37So he was rushed into emergency surgery and it was removed.
07:41Thankfully, it was a benign tumour.
07:43Fine.
07:44Okay.
07:45And how's the recovery been?
07:46You say, I mean, I've had my sleepless nights for sure.
07:50God, you poor thing, you've been through the mill, haven't you?
07:52What are we doing today?
07:53How can we help today?
07:54So I've been feeling like some chest pain whilst lying down.
07:59And initially I thought it might be muscular.
08:03You know, it just felt muscular, but it's only on the right side.
08:07There are many complications after such major surgery.
08:11One thing that we do worry about a lot is something called a pulmonary embolism, which
08:14is a blood clot that affects the blood vessels around the lungs.
08:18And that can often present with sharpshooting, chest pain.
08:20And it's been now three or four nights where it's been quite painful and I've kind of had
08:27strained breathing, difficulty breathing.
08:50Is it that loud?
08:53I don't know if you do it on purpose.
08:55I'm not doing it on purpose.
08:55I swear to God, that's how I'm typing.
08:57Look, even on my phone, yeah, like, I'm like this as well, like, it's just the nails.
09:02No, you just want me to do this.
09:03Don't be a hater.
09:04Be a lover, yeah?
09:05I'm always a lover, baby.
09:07That's how I like it.
09:14Jennifer.
09:16Come on through.
09:18Tell me.
09:19Right.
09:20And what's been going on for you?
09:22We'll have a little look at this foot.
09:23Oh, yes.
09:25Right.
09:25There you go.
09:26So, excuse the toenails.
09:28You can pop the foot down and we'll get the story first.
09:30Okay, so I've been, I've just been on a fitness week.
09:33Okay.
09:33So before that, my navicular bone was really hurting.
09:38Are you medical?
09:39Navicular bone is very...
09:40No, I'm horsey.
09:41Oh, you're horsey.
09:42Okay.
09:42Sorry.
09:44When I was on my fitness week, this toe hurt like mad when I was pressing
09:50it down and since then, the side of this, the bone up the side here has been really
09:56hurting.
09:56Yep.
09:57And obviously you can see that it's hugely swollen.
09:59Quite swollen, yeah.
10:00Can I ask, did you have any trauma to it?
10:02Did you fall or go over on it or anything like that?
10:05Five bar gait.
10:07Okay.
10:07And I know it's really hot at the moment, so I know people's feet are likely to swell.
10:11Yes.
10:11But this foot is normal.
10:13Yes.
10:13This foot looks like a Cornish pasty.
10:15But we definitely have an injury on that foot.
10:18Okay.
10:18Well, we'll examine you here.
10:20I'm just going to move the foot, okay?
10:22It hurts on top of the toes.
10:25Top of the toes.
10:26Keep your leg where it is.
10:27Just move the ankle bone like this.
10:28Like that?
10:28Yeah, exactly.
10:29Hurts on the outside.
10:30Okay.
10:31And move your toes up and push down as if you're pressing on a pedal.
10:34Fantastic.
10:35Is that painful?
10:35Nope.
10:36Okay.
10:36So it's more than likely that you've done some musculoskeletal damage, so kind of a ligament
10:41or something like that.
10:42Great.
10:43So what I think we should do is the usual.
10:46Yeah, rest, ice, elevate and compress.
10:49Okay.
10:50Then I'll give you anti-inflammatories for a week and I'll give you a tummy tablet alongside
10:55that.
10:56That's kind.
10:56Yes.
10:56I think that once we get this injury rehabbed, I think physio is also a good idea.
11:02We need to definitely give this some time to heal and hopefully we'll be on to a winner.
11:08That would be really good.
11:09That's really kind.
11:11Lovely to meet you.
11:11Where are you from an island?
11:13Cork.
11:13Oh, are you?
11:14Yeah.
11:14Oh, yeah.
11:14My husband got divorced in Cork.
11:16Oh, God.
11:17Great place.
11:17Everyone has a story from Cork, I think.
11:19They do.
11:20Thank you very much.
11:21Take care.
11:21Can I listen to your breathing?
11:29Is that okay?
11:30Yes.
11:31Great.
11:32Can you take a few deep breaths in and out for me?
11:35Lovely.
11:36Take a very deep breath in and then force out as quick, as hard as you can.
11:40And then you breathe deeply in and out through your mouth.
11:54Nice deep breaths for me.
11:56Lovely.
12:04Yeah, that sounds pretty good.
12:05That sounds pretty good, which is good news.
12:07Any shortness of breath when you're up and about?
12:13No.
12:13Sort of walking around and stuff?
12:14No.
12:15Good.
12:15Any wheezing sounds coming from the chest that you've noticed?
12:18Not.
12:19Well, I mean, forced wheezing, yeah, but like trying to loosen the chest up.
12:25And have you managed to bring anything up?
12:27No.
12:27It's been really dry, right?
12:29And you mentioned it's only been sort of three or four nights, maybe?
12:32Yeah.
12:32So since Saturday afternoon, I've been feeling this.
12:34Yeah.
12:34We did like a big day.
12:36Yeah.
12:36Out, which he hasn't done a lot of exercise in a while.
12:39Yeah, of course.
12:40So when he came home, that's when it started to hurt.
12:43Are you able to lie on the couch?
12:46Yeah, sure.
12:46Is that okay?
12:48Grand.
12:48Lovely.
12:49Really, really good.
12:50And it's all on this side?
12:51Yeah.
12:51All on that right side, yeah.
12:53When I can pinpoint the pain when it's really bad, it's kind of in behind here.
12:57Back there.
12:58Yeah.
12:58Kind of there.
12:59Yeah.
12:59Yeah.
12:59Fine.
13:00Can I get you to take a deep breath in and out for me?
13:03Good.
13:06Really good.
13:06Are you able to sit up for me?
13:14Brilliant.
13:14That's really good.
13:15Thank you so much.
13:16So there's good air entry throughout.
13:17Normal sounds.
13:18So no crackles, no wheeze.
13:19The thing that I was thinking of as well is that could there be a bit of crepita, so air
13:23in the wrong bit?
13:24Right.
13:24I'm not feeling that or sort of getting a sense of that.
13:27So I'm really reassured it's nothing serious.
13:29It most likely is muscular.
13:31Now what you could do is use a bit of ibuprofen gel, a topical therapy, just to rub into the
13:36air you're wearing.
13:36Exactly.
13:37Voltrol, whichever one.
13:38If there's any other symptoms, so the shortness of breath is getting worse on exertion or when
13:43you're upright and stuff, then come and let us know.
13:46If the chest pain is happening not just on lying down and not in certain positions, again,
13:51it's something to let us know about.
13:52Do you have time now for a quick blood test?
13:55Yeah, sure.
13:55Yeah.
13:56Sharp scratch.
13:57Three, two, one.
14:00There we go.
14:04So these results should be back by tomorrow, actually.
14:07And then our policy is that if they're really abnormal, we'll contact you.
14:10If you don't hear from us, you can assume they're fine.
14:12But of course, you're welcome to call for the results.
14:14All right.
14:15Perfect.
14:15Thank you very much.
14:16Great.
14:16My pleasure.
14:16You're very welcome.
14:17Amazing.
14:18Nice to meet you.
14:19Thank you very much.
14:19Likewise.
14:19All the best.
14:28All right.
14:29Shane, come on to you, sweetheart.
14:33Hello.
14:34Come on in.
14:35Come and have a seat.
14:36How are you doing?
14:37No, 50-50.
14:39You poor thing.
14:39So tell me what's happened.
14:42I think since we started this journey, I've lost, I was at my biggest 24 stone.
14:46I'm now 13 and a half stone.
14:48Wow.
14:48I mean, you do look fantastic to tell you.
14:50You look really good.
14:50And obviously, I can tell you're really pleased with yourself.
14:52I don't know.
14:53It's just, I got discharged.
14:55I was doing really well.
14:55I feel like my ADHD at the time, because of the severity of it, it was masking quite a
15:01lot of my borderline and how much I was actually really struggling with that.
15:04Okay.
15:05Yeah.
15:05So I thought I was doing all right.
15:07Things weren't terrible at the time.
15:08They weren't great.
15:08But I thought I could deal with everything that was on my plate.
15:11Yeah.
15:11I thought I'd process stuff.
15:12I clearly hadn't processed.
15:13Okay.
15:14And then I got to stop the aeroproprazole, but I was only ever on five.
15:18So I've known Sheyenne since she was a child, and she's been struggling with her weight and
15:22her mental health for most of her life.
15:24And we've been trying to help support her through both of these challenging journeys.
15:27She's managed to drop her weight and her BMI considerably, and it will hopefully help
15:32with some of her musculoskeletal problems.
15:34Her mental health has often been a challenge, and that often comes in combination with being
15:39overweight.
15:39And she's currently under the crisis team who are there to help us when things are really
15:43very difficult.
15:44So are you on anything then at the moment?
15:45Nothing at all?
15:47And do you think you can manage without anything?
15:51If the support is there, yeah.
15:54But what support do you think would help?
15:57I don't, I have no neighbour, I have no one to speak to.
16:00And friends and stuff from Fulham, are they able to come?
16:02I don't have many friends.
16:04And it's difficult, isn't it?
16:05Yeah, and it's hard to let people in.
16:07My mental health is always, just everything, I don't know, something about, I don't know.
16:12If I'm happy, I'm manic.
16:14I'm not just having a good day or anything, there's something wrong with me.
16:17If I'm sad, I'm depressed.
16:18There's always something wrong with me.
16:19I always am mentally ill to a lot of the extended friendship group, and it feels like no one
16:25ever trusts me.
16:26And what I'm saying, they don't check in on me.
16:29They've never...
16:29The ignorance around mental health, that we people are frightened of it, they don't know
16:33how to do it, so they often don't pick up the phone because they're not quite sure what
16:36to ask and what to say and things.
16:37So it's not so much that they don't like, necessarily, as a person, they just don't know how to approach
16:41it.
16:42I can understand I'm not the easiest.
16:44And the fact you're engaging with the crisis team now is great, and I think if they do want
16:47you to start on medicine, obviously we'll help support that.
16:49You know what it's like for me, I've been in and out of hospital, being stabbed and
16:53poked and scanned since the age of 11, and it doesn't look like it's going to stop.
16:58ADHD higher team have been amazing, so far, so good.
17:02So I don't think we've got a shared care.
17:04No, no, no, I'm still dose deciding.
17:06So of course, as you know, we're happy to support that, so once you're stable, we'll take
17:09over that, and I think we'll try and just keep things moving.
17:13The only other question I had was, I have a plastic surgery appointment on the 10th of July
17:16at Chelsea and West.
17:17You have it?
17:18What are we asking them for?
17:19Tummy tuck, arms, boobs.
17:21Okay, because if you've lost all that weight and you've got all this excess skin, it is
17:23horrible.
17:24They will want to know that your weight has been stable for at least two years.
17:27It's been coming down.
17:28Because they'll be nervous to operate if your weight is fluctuating.
17:31The problem is, when you have a weight of that weight, it will have impacts on your
17:35body.
17:35You did the right thing, you've dealt with that, but now we've got all the other bits and
17:38pieces that we'll try and deal with.
17:39Thank you, thank you.
17:39All right, well done, sweetheart.
17:40Well, some good luck with things.
17:41You take care.
17:42Thank you so much.
17:43Bye-bye.
17:43Bye-bye.
17:48Martin.
17:53Yes.
17:54Hello, doctor.
17:55Hi there.
17:57Hi there.
17:58Come on in.
18:00Hi, I'm Dr. Presswitch.
18:06Nice to meet you.
18:06How are you doing?
18:08I've got this backache.
18:10I don't know what you can do about that.
18:11Backache?
18:12Well, I've got this curvature of the spine.
18:14Yes.
18:14How long have you had this abnormal curvature of your spine?
18:18Well, it's gradually got worse over a number of years, really.
18:22Right.
18:22I suppose for a couple of years or so.
18:25Okay, so it's not something that you had all throughout your life.
18:28No.
18:28Oh, no, no, no.
18:29No, I think, yeah.
18:30Okay.
18:31And any idea what's led to that?
18:33I think I've got in the post office and I think I've always carried things on one side.
18:39I don't know, really.
18:40Okay.
18:41I mean, I can only assume that that has something to do with it, really.
18:45It's all right when I'm sitting down a line, though.
18:47Right.
18:47But when I'm walking, I find it's getting worse, really.
18:52And where is the pain?
18:54Um, I mean, the bones are sticking out a bit there, really.
18:58So, so, down in the lower back area?
19:00Yes.
19:01Have you ever seen a bone specialist about this?
19:03No, I haven't, no.
19:04I did, I did have an x-ray a year or two ago.
19:08It's okay if I examine your back?
19:09Yes, yeah.
19:10Yeah.
19:10Can you come and come behind here for me, please?
19:19And are you standing as straight as you can right now?
19:22Yeah, almost, yeah.
19:24This is where it's hurting you the most?
19:26Yes, yeah, I mean, it's sort of painful I lean against anything.
19:31Just trying to feel where your hips are as well.
19:33Yeah.
19:34Okay.
19:36And this is getting worse than when Dr. McNabb was last saw it?
19:40Yes.
19:41Okay.
19:41So, July last year, we did an x-ray.
19:49I'm inclined to repeat x-rays, okay, if it's getting worse.
19:56And I'm referring you not to physiotherapy, to an orthopaedic specialist.
20:01Yeah, yeah.
20:01I'm trying to find it.
20:02It is a significant deformity, isn't it?
20:06Yeah, yeah.
20:07And it's really impacting you day to day as well, limiting your functioning, causing you pain.
20:14That being said, Martin, I'll refer you to them.
20:17I don't know what the treatment options are.
20:20No, no.
20:21So, I don't know what your expectations should be in regards to what they can do.
20:25Well, yes, it would just be nice to know what the options are, really.
20:30Do you live on your own, Martin?
20:31No, it's with me, my brother.
20:33Your brother?
20:34It's always here.
20:34Okay.
20:35Is he in good health?
20:36Yes, yes.
20:37Okay.
20:38But he is 80.
20:40Okay, so he's a bit older than you.
20:41Yeah.
20:42And so you're living in a house together, but you have no one else coming in with help at all?
20:48No, no.
20:48And do you feel like there's anything you do need extra help with at the moment?
20:53Not particularly.
20:55Okay, that's good.
20:57Yeah, so what I'm going to do now is I'm going to request x-rays of the thoracic and lumbar spine.
21:02Right.
21:03And then once we've got those back, I'm going to put them in a referral or send them to the orthopedic team.
21:06Okay.
21:07Okay.
21:07I think that the most pressing thing is getting that x-ray done.
21:11Yes, yeah, yeah.
21:12Great.
21:12Okay.
21:15Do the hand.
21:17There it is.
21:17There it is.
21:18Yeah.
21:19Okay.
21:20I like it.
21:21Okay, thank you, Doctor.
21:22Nice to meet you.
21:22Thanks.
21:28Gemma.
21:29Hiya.
21:31I want one of those scams.
21:34Oh, they're so good.
21:36Come on in.
21:37Have a seat.
21:37I'm Dr. Dad, Jim, we've met before.
21:38Hiya.
21:41Coming on nearly four years ago, I ended up having a big accident in my home, which caused my
21:47jaw to be crushed.
21:48It was left inoperable because of the nerve that's in the way.
21:52But the last couple of weeks, I've had changes.
21:54Like, I've got constant tingling sensation.
21:56Like, I'm getting headaches.
21:57So, all around the back of my ear, like, under my eye and around the back of my neck.
22:03But now, even when I'm talking to you, it's like the tingling sensation is just constantly
22:08in the side of my face.
22:10Okay.
22:10And I've noticed, like, even in the way that I chew my food and the way that I'm talking,
22:13I'm very conscious and aware that there's a change.
22:16Yeah.
22:17And have you ever had the tingling before?
22:19Is that completely new?
22:20I've had tingling before, but not all the time.
22:24Okay.
22:24But you would say you've had this tingling?
22:26Yeah.
22:26So, it's been aggravated before, but it's not been long-lasting.
22:30Yeah.
22:30Okay.
22:31And what did the surgeon say when they kind of last saw you?
22:34So, they said that they had to leave it.
22:37Yeah.
22:37Left inoperable because the nerve said it caused me to be paralyzed if they touched it.
22:42Right.
22:56Right.
22:57Oh, yes.
22:58When was this?
22:59I met him on...
23:00Saturday.
23:01Saturday.
23:01See, you know better than me.
23:02Yes.
23:03So, he came around 7.30.
23:06So, he came...
23:06All right, a bit later.
23:08A bit later.
23:10So, we drove.
23:11It was a nice drive.
23:11He even had his hand on my leg like this while he was driving.
23:14I'm like, oh, I feel like a princess.
23:16Okay.
23:17He bought all the food.
23:19So, and then we're talking, talking.
23:21And then, obviously, he started kissing me.
23:23All right.
23:23And then, obviously, I'm eating as well.
23:28One minute, one minute.
23:30You're kissing him while you've got chicken in your mouth.
23:33I was hungry.
23:36Okay.
23:37Diet, you man.
23:38Hello, surgery.
23:39When they'd done the 3D x-ray, it was described as my jaw was crushed.
23:47Ever tried any painkillers for the nerve pain?
23:49I have tried, but nothing is helping at the moment.
23:53And what have you tried?
23:54I've tried naproxen.
23:55I've tried cocodomols.
23:57I've tried normal paracetamol.
23:59I've tried hot and cold compressions on it.
24:02And nothing seems to be making a difference.
24:04Okay.
24:05Let's have a little look in the mouth.
24:07When was the last time you saw a dentist?
24:10About a year ago.
24:11Okay.
24:12But they even struggled because I can't open my mouth as wide as what I used to either.
24:16And any pain kind of internally at the moment?
24:19Or is it just this tingling?
24:20Not internally, no.
24:21It's just a constant.
24:22And it's more of an ache, like a fuzzy ache, like something's constantly on the nerve.
24:28That's what it feels like now.
24:30And if you were to kind of get the exact path where it goes in your cheek, where would you say it is?
24:34So it's all here.
24:35Yeah.
24:36It goes around the back here.
24:37Around the back.
24:37Around, like, to the back of my neck there.
24:39And sometimes I get the thingy under the eye.
24:42You know, it feels like it's twitching.
24:45But let me have a quick look in your mouth first.
24:48So I'm just going to feel around the teeth.
24:49Any pain there?
24:51Uh-uh.
24:52And on the upper?
24:53Uh-uh.
24:53No?
24:54There?
24:55Yeah.
24:56Where does that pain?
24:57Right into the cheek?
24:58Yeah.
24:58Okay.
25:00Okay, and this side's okay?
25:01Mm-hmm.
25:02When I press there, is that the same pain?
25:04Yeah.
25:04I'm just going to fill up your neck.
25:15Any pain up in here?
25:17Mm-mm.
25:19Any pain when I press along there?
25:21Yeah, it's...
25:23It just feels like I said more than eight.
25:27Okay, and you just smile.
25:28Show me your teeth.
25:30Good.
25:30Puff your cheeks out.
25:32That's okay.
25:33Yeah, and just open your jaw.
25:36Good.
25:37Okay.
25:38So I think it could be the nerve pain.
25:41It could all be from the injury in the past.
25:44But I think you're quite tender over your teeth.
25:48So in those kind of molars.
25:50So I think probably the first thing to do would be to go and see a dentist.
25:53And just check it's not a dental problem.
25:56Okay.
25:56If we then link it back to the injury before and we think it's, you know, nerve pain.
26:01So you have a nerve that kind of goes like this.
26:04So if we think it is a nerve kind of shooting through, then we can give nerve painkillers
26:09rather than your simple paracetamol, ipofen, those kind of things.
26:12Yeah.
26:12So that definitely would be an option that we could consider.
26:14But I think at the moment with it being new and with you being really, really tender when
26:18I, you know, press over the teeth, I think you need to see a dentist initially.
26:22So I would try and get even an emergency appointment and try and get in there.
26:25And at least then they can be like whether there's any infection.
26:28And then once you've seen a dentist, obviously if they can't refer you or they want you to
26:32see us about the pain or, you know, we need to get in touch with all surgeons again, we
26:35can definitely do that.
26:36Is that all right?
26:36That's fine.
26:37All right.
26:38Thank you so much.
26:38Not at all.
26:39Oh, it's like lava out there today as well, isn't it?
27:05Oh, God, yeah.
27:06I sweat a lot.
27:07It just runs down my face.
27:10Are you not hot in that?
27:11Yeah, I don't wear t-shirts.
27:13I don't care about my fat arms.
27:14It's too hot.
27:17It's hot.
27:19Do you know when it was hitting like 38, 40?
27:21Yeah.
27:22I was sat there with a jumper on.
27:24Were you?
27:27Is it really hot outside now?
27:29It is.
27:31Enjoy the sunshine.
27:32Thank you very much.
27:33It's hot out there today.
27:39I ain't been out for over a week because I've had this bug.
27:42Really?
27:43Yeah.
27:43You did call the other day and said, I'm really unwell.
27:45I took everything.
27:46I've been very unwell.
27:48It's getting on me wick now.
27:50Do you need me?
27:51Come through.
27:52Lovely to see you.
27:53Yeah.
27:54I'm not well.
27:54Looking very summery.
27:55You're not well.
27:56I'm sorry to hear that.
27:56I don't know how much it's bug up.
27:59Take a seat.
28:00Make yourself comfortable.
28:03Lovely to see you.
28:04So tell me what's been going on.
28:05How can I help?
28:05I got up on Monday morning.
28:07I'm still a bit dizzy because I've been getting dizzy.
28:09You know, I lost my brother and sister in the same week.
28:13Got out of bed and all of a sudden, I felt something come down.
28:17And my nose poured with blood.
28:19My nightdress was full of blood.
28:20And then I sat down for a little while.
28:23And I started getting the shakes.
28:25And then I started burning up.
28:27And all my throat and everything.
28:29I'm not well.
28:30Any other symptoms?
28:31Any difficulty swallowing, food not going down, getting stuck?
28:34To tell you the truth, this week, because I don't do any pick.
28:37This week, all I've had is toast.
28:39Yeah.
28:39And cold water.
28:41Lots of appetite.
28:41And hot lemon.
28:43Yeah.
28:43And honey.
28:44Yeah.
28:44And I just want to get better.
28:46So I'll get out and about.
28:47But just from a safety point of view, I just need to know, have you been struggling with swallowing?
28:52Is food still going down?
28:54Is it getting stuck?
28:54Is it coming back?
28:55No, no.
28:56But you can still swallow?
28:57Yeah.
28:57You can still swallow.
28:58Brilliant.
28:59And any drooling?
29:00Any excessive saliva production and drooling not able to swallow your own saliva?
29:04No, I spit that out anyway.
29:06That's absolutely fine.
29:07Any rashes on your skin?
29:08No.
29:09Good.
29:09Any headaches?
29:10Yeah, I've had headaches.
29:12Yeah.
29:13All on top.
29:13Yeah.
29:14And what do they feel like?
29:15How do you have to describe them?
29:16Well, on Sunday, I was washing up and all of a sudden I had this pain here.
29:20Okay.
29:21And I had to stop.
29:22And did you have any visual changes associated with that?
29:25Yeah, I get goody.
29:26No, sorry, visual changes where you can't see.
29:28Yeah, I've just had the cataract done.
29:29No, sorry.
29:30With that headache that you had on that one side, when that headache happened, was there
29:35any change in your vision?
29:36Any blurred vision, loss of vision, zigzag lines?
29:39No, just like dizzy.
29:40You know what?
29:41You're going like that.
29:42Yeah.
29:42Okay.
29:43So dizziness.
29:44Drinking water, keeping hydrated.
29:45Yeah, I've got to get some today.
29:46That's fine.
29:47And are you passing urine okay?
29:49I've got an infection, I think, again.
29:51Well, but...
29:52Because you know when I go away, it sort of burns worse and it comes up.
29:56Does it?
29:57And it sort of comes up and I've got red in the face.
30:00What comes up, sorry?
30:01But I do suffer with, like...
30:02You get flushes?
30:03Yeah, flushes, yeah.
30:04Like a hot flush when you're urinating?
30:06Yeah.
30:06Okay.
30:07And how long has that been going on for?
30:08Well, up and down, up and down.
30:10Because you know I've been in hospital and had the prolapse.
30:12Yes, I know, I know.
30:14Yeah, yeah.
30:14Okay.
30:15I'm just trying to ascertain acutely in the last week or so what the main issues are.
30:20Today, my job is to make sure...
30:22Get rid of this.
30:23Absolutely.
30:23Patients often come to see the doctor with a vast array of different symptoms.
30:30It's really important at the onset to try and establish exactly why the patient is there to see you.
30:37We don't want to risk missing something serious.
30:40It's perfectly fine to have a list, but maybe tell your doctor what the list is before the consultation starts or at the start of the consultation,
30:48so that we can prioritise and work through the main issues.
30:51Are you able to open your mouth really wide for me?
30:54Stick your tongue out and say, ah, lovely.
30:55Ah.
30:56Yeah.
30:56Say, ah, again.
30:57Ah.
30:58Lovely.
30:58So, yeah, I think you've got a little stone in that tonsil on the right-hand side.
31:03A tonsil of stone.
31:04So they can happen, you know, very commonly.
31:06It's just a build-up of sort of calcium and things like that.
31:08It will go, absolutely.
31:09But we can help with the discomfort and the symptoms of it for you.
31:12Not a problem at all.
31:13Yeah, because, you know, it annoys me.
31:15That's why I'm...
31:16Of course, yeah.
31:17So what's caused that?
31:18The infection?
31:18It could be a bit of an infection, most likely viral, and then sometimes you can get a sort of a stone forming as well.
31:24What are you going to give me?
31:25So I'm going to use a bit of Dithlam spray, which will help numb the back of the throat.
31:28It'll be really, really good for that.
31:29And then the stone will just work its way out.
31:31If you eat sort of more citrusy fruits and things like that, it will encourage it to work its way out.
31:36It might be a bit painful.
31:37I'll tell you what, I do eat strawberries, grapes.
31:39Yeah, that's fine.
31:39Brilliant, absolutely fine.
31:41Yeah, really, really good.
31:42And then in terms of sort of bereavement support, there's an amazing organisation called Cruise.
31:45I know, that's it.
31:46Do you remember I told you about it last time?
31:48Yeah, I asked the same.
31:48Yeah.
31:49Have you contacted them or have you thought...
31:50No, I don't have the internet or anything.
31:52Well, that's fine.
31:53I'll give you their phone number.
31:54You don't need the internet.
31:55You can just call them.
31:57She had a big funeral.
31:58Yeah.
31:59I miss her.
32:00Of course you do.
32:01Of course you do.
32:01It's, you know, when these things happen so suddenly, it's really difficult.
32:04At least if it's...
32:06Because they used to phone me every day.
32:07Oh, I'm so sorry, Jacqueline.
32:09I'm really sorry.
32:10Give that number a call.
32:11They're fantastic.
32:12Only when you're ready, though.
32:13You know, it's a process.
32:13Yeah, I will.
32:14And remember, you will get through this.
32:15It's just a matter of time.
32:16It will get, you know, you'll learn how to deal with it in slightly different ways.
32:19I lost all my sisters now.
32:21Oh, I'm sorry to hear that.
32:22You know, we're always here.
32:23If you need anything, do let us know.
32:24Yeah.
32:25Good.
32:25Thank you, Doctor.
32:25Brilliant.
32:26All the best.
32:26Take care.
32:27Look after yourself, all right?
32:28Thank you very much.
32:29Pleasure.
32:29No, you're very welcome.
32:38How are you?
32:39That's okay.
32:40You're welcome.
32:41Take care.
32:42John?
32:43There's the time.
32:44I'm watching.
32:44How are you?
32:45Bring that with you.
32:46Bring that with you.
32:46Come on.
32:47How are we?
32:49Oh, more...
32:50Hopefully I'm improving.
32:52You feel better?
32:55No, much the same.
32:57Getting pain.
32:58Where?
32:58In your foot?
32:59From down there, yeah.
33:00Right.
33:00But anyway, you're going to tell me that it's improving.
33:03That is wonderful.
33:03I don't know yet.
33:04It might be falling off.
33:05I hope not.
33:06How are you feeling?
33:08Are you feeling better in yourself?
33:10Can't say I am, no.
33:11I'm still failing big time and trying to get my life organized.
33:16Yeah.
33:17Ready?
33:20Now, what does that look like?
33:23Looks like pretty awful.
33:24No, that's just the cover.
33:26Oh, it is getting smaller, isn't it?
33:29Yeah.
33:30Oh, is it?
33:30Oh, wait a minute.
33:31Of course it is.
33:33Well, it's looking more than pink to me.
33:34That's looking a bit raw.
33:36It's not raw.
33:37This is healthy.
33:38Okay.
33:39I promise you, this is a new skin.
33:44It is called epiphyls, and epiphyls is the final stage of healing.
33:51So this is really, really good.
33:54No, but we said a minimum of six weeks, didn't I?
33:57Well, we know now that we're in about the eighth week now.
34:00Yeah.
34:01So not too bad.
34:02I bungled the beginning of it.
34:03Could you pull it on here for me?
34:05Yeah.
34:07That's it.
34:10It's good, John.
34:12It's really good.
34:14I mean, look at that.
34:16Can you see that?
34:18Yeah, yeah, yeah.
34:19And look at this.
34:20It's still right there, but it's receding.
34:23This is impressive.
34:25So another six weeks?
34:27Now you've got new skin coming through.
34:30I would say probably by next Friday, we'll have a nice pink covering over that.
34:35I think we're getting there.
34:36I really, really do, considering what it was when you first come in.
34:40So now.
34:41The bit that's white now, is that dead skin?
34:44It's just dried skin.
34:46So that will regenerate.
34:48Like sunburn, when you burn yourself, and then after a while, the skin peels, and then
34:54you get the new layers of skin coming through.
34:57If it starts coming away, put a meepaw plaster over the top.
35:01One of the ones you gave me?
35:03Yes.
35:03No, it's still putting the night stalks on with the...
35:06But make sure they're loose, remember, not tight.
35:09And I want you to offload that ankle as much as possible.
35:14Okay.
35:15Okay?
35:16We are getting there, sir.
35:19Good.
35:20Take care, John.
35:21Yeah.
35:30Catherine?
35:31The doctor's ready for you.
35:32Room four.
35:35Hi.
35:36Hi.
35:37How are things?
35:38Fine, actually, yeah.
35:39They're all good.
35:39Yeah, they're all good.
35:40How are you?
35:41What's happening?
35:41I'm so...
35:42I've developed this thing on my head.
35:44Don't know what it is.
35:45It just came out as a blue.
35:47Wow.
35:47It was very obvious yesterday and today, obviously, and the day before I could see something coming
35:52up.
35:52Yeah.
35:52Don't know what it is.
35:53I don't know if I've got any other kind of marks on my body.
35:56I haven't noticed any, but I'm a little bit brown, so it might be a little more difficult.
36:00But, yeah.
36:01You're at home.
36:02When you woke up, it was like this.
36:04Yes.
36:05I've been traveling for work, but I just noticed it.
36:09Yeah.
36:10So...
36:10And no way you could have banged it or anything without noticing...
36:14No.
36:15No.
36:15Okay.
36:16Yeah.
36:16Well, it's a bruise.
36:19And as with bruising, it's to do with clotting, which is to do with red, white cells, platelets,
36:26liver, all those sorts of things.
36:27I know I have had problems in the past with blood clotting.
36:32I know that was picked up in pregnancy and I had hemorrhaging, kind of severe hemorrhaging
36:39for my...
36:40for births.
36:42Yeah.
36:43There was some underlying thing, but I don't think it was ever followed up on.
36:46Okay.
36:47Some people can get spontaneous bruising for no reason.
36:50However, we need to rule out more pathological causes, so to speak.
36:57Do you feel well?
37:15Um, fatigued a lot, I would say, generally.
37:19So virally in any way?
37:21No, not really.
37:22No sore throats, nothing like that?
37:24No, no, no, no, no, no, no.
37:25Yeah, apart from the sort of general low-level fatigue, I just did an MRI because I've got
37:32pancreatic cysts, which are being monitored.
37:37Yeah.
37:38And that was when?
37:39I saw, I had the scan done two weeks ago.
37:42Two weeks ago.
37:43One always gets worried about bruising, spontaneous bruising.
37:46We investigate for every possible cause.
37:50It can be due to a more worrying pathological cause, such as leukaemia, or it can just be
37:56a symptom that can run in the family, or there can be no cause found.
38:00Pancreatic cysts are very close to the liver, and the liver is where clotting is processed.
38:06So we need to do a blood profile to rule out any more sinister pathological causes.
38:13I can feel a little gland there.
38:18I don't know if that's painful at all.
38:20Is it like a bruise tender, is it, in any way?
38:23Yeah, I can feel it.
38:23I can feel it.
38:23You can feel it, as though there is something.
38:26Something, yeah.
38:27So you can't really feel a bump, but you can feel it more tender than the rest of it.
38:31Yeah, yeah.
38:31And it's the only place, there's no others.
38:32Yeah, I haven't noticed anything else, and I've seen these things, but they're not
38:35nothing, not that I'm aware of, in any way.
38:38Yeah.
38:40So I think you do need to go for some blood tests.
38:42I think the sooner you go, the better.
38:44Okay, okay.
38:45And if you go today, I'll have the results tomorrow, basically.
38:48So we'll look out for them, but do call anyway.
38:51Brilliant, thank you.
38:52And we'll just have a look at those.
38:54Thanks a lot, thanks a lot.
38:55Nice to see you anyway.
38:55Yeah, take care.
38:56Bye.
38:56So, tell me what's been going on for you.
39:08So I've noticed some, basically some red patches around my skin.
39:12Okay.
39:13It's a little bump, but it itches.
39:15That eats a lot, burns a lot.
39:17And it's really itchy and uncomfortable.
39:20Some on my torso, some on my arms, some on my legs.
39:22It itches mildly, not so horribly.
39:27So they're slightly raised and a bit scaly, aren't they?
39:30Yeah.
39:31So it's on the skin, under here, here, in the back.
39:36And on my scalp as well.
39:38Okay, so pretty diffuse.
39:39Oh, it's annoying.
39:45Jennifer?
39:46Oh, yes.
39:47As my records probably show, I had a new hip about eight or nine weeks ago.
39:55Looks to be working well.
39:56It's working well.
39:58You pleased with us?
39:58Yes, very.
40:00All I came in for, really, was a prescription for this ointment.
40:06Okay.
40:06Which you said I hadn't had since 1960 or something.
40:11Me?
40:11Somebody did.
40:12Somebody did.
40:12I couldn't believe it.
40:14Because it was first given to me for something on my leg, which was pretty well healed.
40:19But that's cured it.
40:22So this is fucidic acid cream.
40:25What do you understand about this cream in terms of what it does?
40:29It seems to help.
40:31Yeah.
40:31This isn't a balm for all conditions, really.
40:34It's actually quite specifically just a cream for, like, mild bits of infection.
40:39So, yeah, looking at your skin, can I have a look at that bit there?
40:45Yeah, I do.
40:45Yeah.
40:45So you've had a surgery there, haven't you?
40:47You've got some scarring.
40:49And there's some scale and thickening there.
40:51Does that get a bit itchy?
40:52It gets itchy.
40:53Yeah.
40:54Okay.
40:54It gets a bit sore from time to time.
40:57So it looks like you've got, you know, a few kind of sun-related and maybe age-related bits on the arm, on the face.
41:06Yes, exactly.
41:07And down here, you know, on the ankle as well.
41:11This isn't the cream that I would normally give for those.
41:14Oh, really?
41:14For dry skin, I would be using something else.
41:17A dry, itchy skin.
41:18I would just be using, you know, an emollient moisturising cream.
41:23Yeah.
41:23I don't think you need something that's got antibacterial properties in it.
41:26No.
41:27If you ever did get something that looked like a, you know, a skin infection, an early skin infection.
41:32What can I do about this?
41:33Because this does worry me.
41:35There's some letters here from dermatology.
41:37I can quickly just have a look.
41:38Yeah.
41:40Yeah, some actinic keratoses on your nose, behind the shoulder, the right side of your forehead.
41:45That's the other thing.
41:46Yeah.
41:47But I put it down to that cream, having made it better.
41:51But you say it didn't.
41:53You know.
41:55So these skin changes are not cancer, but some of them can progress to squamous cell carcinoma,
42:03which is a slowly, locally spreading skin cancer, which can cause, you know, nasty skin breakdown.
42:11It can go into surrounding tissues and, you know, cause bleeding and things like that.
42:15But there's no sort of cream I can put on to ease it, because I really felt that that made it better.
42:21So I suspect that what all it's doing is just softening this a little bit for you, so I can give you something that will do that for sure.
42:27Okay.
42:27I'm told that cobwebs are the best thing.
42:31That's not advice that I'm familiar with.
42:34Okay.
42:34I must have put cobwebs on burns and things.
42:39Okay.
42:40Yes, my knowledge isn't very up to date.
42:43I think it's only if you've got very thick ones.
42:46You're going to give me a prescription, or can I buy it over the counter?
42:50No, a prescription for you.
42:51Right.
42:51Absolutely.
42:53Okay.
42:53We'll sort you out.
42:54Okay.
42:55Right.
42:55Thank you very much.
42:57All right.
42:58Thank you so much.
42:58Not at all.
42:59Have a great afternoon.
43:03Just let us know how you're doing.
43:04Thanks, Doctor.
43:04See you all.
43:05All right.
43:05Take care.
43:05Bye-bye.
43:06Bye.
43:08Okay.
43:08Thanks a lot.
43:09Okay.
43:09Good to see you.
43:10And you too.
43:11Thank you so much.
43:12Appreciate it.
43:12All right.
43:12Pleasure.
43:12You're very welcome.
43:13Take care.
43:13All the best.
43:14Bye now.
43:14Bye-bye.
43:14See you later.
43:24Bye-bye.
43:40See you later.
43:44See you later.
43:44See you later.
43:44See you later.
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