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GPs Behind Closed Doors Season 9 Episode 2
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00:000 is feeling completely normal, 10 is feeling like a death's a door. How do you feel?
00:10About 9.
00:17And there's all these bloody hallucinations around me.
00:19There's one that's always sitting in my place.
00:21That's horrible.
00:24How long has it been there for?
00:26A long time.
00:27What, more than a month?
00:28Oh, yes.
00:29You can't leave that, that's a long time for it to be there.
00:35I was up a ladder, I was fitting a window, and the expanding foam tin exploded in my face.
00:41It just went off.
00:46I want to change my life.
00:47Okay.
00:48Because I'm 20 years old.
00:49I want to stop, like, the drugs and everything.
00:52The main thing is you're motivated to change.
00:59To be continued...
01:00To be continued...
01:14I'm getting greedy.
01:30Morning surgery.
01:35Hello.
01:36Hi.
01:36All right, how's it?
01:37Yeah.
01:37Hello.
01:38All right, then.
01:39Come on in.
01:40Come and have a seat.
01:44How are you doing?
01:45Well, look, I'm at the moment, I'm a bus driver.
01:49All right.
01:50And I'm just getting this pain on my feet.
01:53Okay.
01:53I don't understand.
01:54It's not swollen or anything.
01:56No, but it hurts.
01:57It hurts, yeah.
01:58And how long has it been doing that for?
01:59The last couple of days.
02:01Okay.
02:02Now, my foot pedal, because I'm driving a different bus now, it's higher.
02:07Okay.
02:07So I've got to push a bit more pressure on it.
02:09Okay.
02:10And how long have you been driving the different bus?
02:12Since the 24th.
02:13Okay, so just a few weeks.
02:15And did you, have you banged your foot or any trauma to your foot?
02:17Anything that you can think of?
02:18Anyone trodden on your foot at a party or something?
02:21No, no.
02:21Well, I'm too old to go to a party.
02:23Oh, I don't believe that.
02:23Yeah.
02:24I'm too old to go to one of them now.
02:26Let's have a look at it.
02:27Let's have a look at it.
02:28Amy, where exactly does it hurt?
02:29When I put pressure on it.
02:31Okay.
02:33So when you're taking a step and sort of bending it.
02:35Yeah.
02:35Okay.
02:36And I'm going to press along the bones here.
02:37Nothing there.
02:38No.
02:39Nothing.
02:40No.
02:40But when you try and take a step and bend, then it starts.
02:43And it's across here?
02:44Yeah.
02:45Okay.
02:46Have you done any massive walking or anything like that?
02:48I walked from Fulham to Clapham Junction.
02:51I've been doing it for the last few nights.
02:54I'm trying to get, because I've got diabetes as well.
02:56Okay.
02:57So I'm trying to get, you know what I mean?
02:58Lose the stomach and all that.
02:59Lose a bit of tummy.
03:00Yes.
03:01Do you normally walk quite a bit?
03:02Not really.
03:03Not really.
03:03Not that distance, no.
03:04Not that distance.
03:05Because there is a condition called a march fracture, because it's what soldiers used
03:09to get when they marched.
03:10Because if you march a long way and use your bone, because you bend your foot every step
03:14you take, sometimes you can inflame.
03:16It's not necessarily fractured, like we have to go to fracture clinic or have operations
03:19or anything, but you can damage the bone inside.
03:22Yes.
03:23And are you wearing these shoes, sort of trainers?
03:24No, I'm wearing shoes, but my shoes is not, you know, flat.
03:28It's kind of a bit of...
03:29Okay.
03:29It's a bit worn.
03:30There.
03:31Yeah.
03:31The heels.
03:31You know what I mean?
03:32So I wonder, actually, if that's what's causing it to be really important, what shoes we
03:37walk in.
03:38We need the best supportive shoes you can wear.
03:41Best thing to do when a muscle and joint and things like this get inflamed is a little
03:44bit to rest it and try not to walk quite so much on it.
03:48Well, I'm working tomorrow, but I'm not working Saturday.
03:50I can give you some anti-inflammatory medicine just for a short time that will really help
03:54take away the inflammation and make it feel so much better.
03:57But I'll rest it on Saturday.
03:58So Saturday, I'm going to stay at home.
04:01There must be some sport on.
04:03No, I just watch a bit of D.
04:04You're not a big sport fan.
04:05No, I am.
04:06I'm a Tottenham fan, so I love me Tottenham and that.
04:09Do you know what I mean?
04:09They won the Europe.
04:11They did.
04:11They did amazing.
04:12Yeah.
04:12Didn't they?
04:13I know my son's an Arsenal fan, so I'm afraid he must have been able to do that.
04:15Me and him wouldn't get on then.
04:16No, you wouldn't.
04:17No, you wouldn't.
04:18He was most cross about that.
04:20I'll bet he was.
04:22Well, look, let's do that.
04:23I'm going to send both prescriptions just through.
04:25Yeah, thank you very much.
04:25All right.
04:28Hello.
04:29Hi.
04:29Hi, Hopi.
04:36Hi, Hopi.
04:53Hi, Hopi.
04:53Nice to meet you.
04:56Great.
04:57Yeah, how can I help?
04:57Obviously, Hopi's got a bit of a complex background with her epilepsy and her autism,
05:04but she's had a cough and cold for the last six days.
05:07She's had fevers reaching 39.8, and she's just overall said that she feels funny.
05:15She's now complaining again of headaches.
05:17I want to be a doctor and I will work.
05:20You want to be a doctor when you grow up, do you?
05:22Awesome.
05:22That's good.
05:23That's really good.
05:24Do you want to show the doctor where it hurts?
05:26Yeah.
05:27Yeah.
05:27My neck is...
05:29Just there?
05:30Yeah.
05:31And headache?
05:31Where's your headache?
05:34Where's your headache?
05:35You said it's at the back, isn't it?
05:36Like before.
05:37Temi pain?
05:38No.
05:39It makes me nervous about her when she's then complaining about her headaches and stuff and
05:43saying she feels funny because I know obviously illness lowers her seizure threshold.
05:47Yeah, exactly.
05:48How are her seizures generally controlled at the moment?
05:52Okay.
05:53Yeah.
05:54She'll have three in May.
05:56So whatever it is at the moment, it hasn't triggered anything?
05:59Yeah.
05:59But we do want to keep it at home.
06:00Yeah.
06:01Right.
06:01So, Hope, are you okay just to come and sit down whilst I do things like check your temperature?
06:06This goes in your ear.
06:07Is that okay?
06:08Yeah.
06:11So temperature is normal at the moment.
06:13Perfect.
06:13It's nice to see.
06:15Okay.
06:16I feel good.
06:17That's perfect.
06:18Yeah.
06:20So good oxygen levels.
06:22There's the heartbeat.
06:25Yay!
06:26Yeah.
06:27Now, it's helpful to see you breathing.
06:29Shall we go do that behind the curtain so I can actually see the chest?
06:32Sure.
06:32Okay.
06:33Yeah.
06:33Do you want me to lift your arm?
06:35Good job.
06:36There you go.
06:36You won't be alone.
06:38Dabu's with you.
06:42You're a pro.
06:43Okay.
06:44Can you do a big, big cough?
06:45Big one.
06:46Really good.
06:48Okay.
06:49Okay.
06:50Her chest is clear.
06:50Okay.
06:51Perfect.
06:51I asked her to cough because there were some sounds.
06:53Rattling.
06:54Yeah.
06:54Cleared.
06:55Okay.
06:56And then last but not least, I just want to have a little peek in your ears if that's okay.
07:00Which one should we do for us?
07:02Ready?
07:03One, two, three.
07:04Lie on mummy.
07:05Hopi.
07:05Lie on mummy, baby.
07:07Chew.
07:08Oh, okay.
07:08Okay, okay.
07:09Hope, hope.
07:10It's okay.
07:10All right.
07:10We're going to stop.
07:11We're going to stop.
07:12All done.
07:13What's your favourite colour?
07:14Well, or do you want to go for the animal?
07:18That's a very good choice.
07:19Please?
07:19Please.
07:20Good girlie.
07:21Based on what I'm seeing, I think that we don't need to give any antibiotics at the moment.
07:26Okay.
07:27The weekend is coming up, and you've got valid concerns about if she deteriorates and the
07:31risk of that inducing a seizure for her.
07:33So, I'm happy to send a prescription to the pharmacy so that if anything happens over the
07:39weekend, is there a change in how she looks?
07:41Is she no longer well enough to go and place new symptoms like vomiting, drowsiness, rash?
07:47You can start taking it.
07:49Okay.
07:49Brilliant.
07:50Wonderful.
07:50Okay, perfect.
07:51Thank you so much.
07:52Can you say thank you to the doctor?
07:54Thank you, doctor.
07:55High five.
07:56Go on.
07:58Thanks very much.
08:00Bye.
08:00Thanks for seeing us.
08:01Bye.
08:02Bye.
08:02Lisa.
08:03Hello.
08:04Hi.
08:04Come on through.
08:05Nice to see you.
08:06Nice to see you.
08:07I haven't seen you for ages.
08:08You're looking really well.
08:09Right.
08:10Let me, do you want to, are you coming in?
08:11Do you want me to wheel this in?
08:13Right.
08:13We're in room four, so we've not got very far to go.
08:16Okay.
08:16It's slightly cooler the further this way down the corridor as well, which makes it a little
08:20bit easier.
08:21So, how have you been?
08:23Well, I've not been brilliant, really.
08:25Okay.
08:26Oh, I fell, didn't I?
08:27That was the first thing that happened.
08:29Yeah.
08:29So, you had the fall, and we've had the urine infections, haven't we?
08:32Yeah.
08:32That's been the big problem.
08:33And how's your mood?
08:35How are you feeling?
08:35Not just too good.
08:37It's been better than it was, though.
08:40It's been very bad because of all the fact that I, you know, don't want to be sort of
08:44like, don't want to give in to the whole thing.
08:48I know.
08:49And that's the problem with Parkinson's.
08:51It's such a horrible disease, isn't it?
08:53And it sort of progresses a bit.
08:55And you've been so good.
08:56I mean, how many years ago have you had it?
08:57I can't even remember now.
08:58Well, I was in 2012.
09:002005 from the frozen shoulder.
09:01Yeah.
09:022012, officially.
09:03Parkinson's is a tricky one because there's not, you don't wake up one morning and suddenly
09:06we've got it.
09:06It creeps in sort of slowly.
09:08Oh, yes.
09:08And I think looking back and then, and it was great because you used to walk, I remember
09:11I used to see you walking to work, you were teaching and off you'd go at crack of dawn
09:15every day.
09:16She worked up until 2017, I think.
09:17I know, which was amazing, which is brilliant.
09:19And I think, but that's, you know, Parkinson's is a really difficult one, isn't it?
09:22It is difficult.
09:23I wake up about 2, 2.30 and then I just can't get back to sleep.
09:27Has the melatonin come through?
09:28Because I know her Parkinson's doctor prescribed it for being, struggling to sleep.
09:33So obviously with all the involuntary movements, she struggles to sleep.
09:36Melatonin, two milligrams.
09:37Yeah, it is the two.
09:38Yeah, you can pick it up literally now on the way home because they'll have it, I'm sure,
09:41in stock.
09:41Have you experienced people having hallucinations and stuff like mum's had?
09:44Like, is there anything that you know of that could help?
09:47The problem is that Parkinson's, it does affect so many bits and part of it is, is, you
09:51know, the way our brain connects.
09:52So hallucinations and seeing things or being worried about things, people often become
09:56quite paranoid.
09:58Parkinson's disease is a global degenerative brain disease that's caused by a lack of
10:02dopamine in the brain, a chemical that allows our nerves and muscles and things to work
10:06properly.
10:07Parkinson's disease is well known for its motor effects, which are the muscle and movement
10:11problems that it causes.
10:12But it also causes multiple other problems, including dizziness, constipation, loss of smell,
10:17nerve pain, bowel problems.
10:19To the hallucinations that Lisa's experiencing.
10:22Well, you know what's horrible for me is I walk into my lounge, that's my lounge, I'm
10:26supposed to be sitting there quietly, watching me television, whatever, and there's all
10:30these bloody hallucinations around me.
10:32There's one that's always sitting in my place.
10:34Is it a person that's sitting in your place?
10:36People, animals, it changes.
10:38I used to know.
10:39But at the worst, there was like, the house was full of snakes, you know, and she was terrified.
10:42I remember you saying there was spiders or a dog was biting and there was...
10:46Cats biting her feet and she asked, you know, is it legal for people to be doing, setting
10:50up these experiments in my front room?
10:52You know, that kind of...
10:53That's horrible.
10:54I have to say, every time.
10:56You're going to have to go.
10:57You're sitting in my place.
10:58This is my bed.
10:58One person's bed.
10:59One person.
11:00It's not going to take five.
11:01You've got to go.
11:03Get off.
11:03And you're still having it every day?
11:04All day, every day?
11:05It is every day at the moment.
11:06It is still every day.
11:24I think, Lisa, it's not like...
11:26You don't have to live with those hallucinations.
11:27I'm sure we can help with those.
11:29And that's really horrible.
11:30It's really appalling because I just cannot get back to sleep at that point in time.
11:34And the thing is, in your head, you sort of know they're not really there, but when
11:37they're real people and real animals and real things...
11:40At the worst.
11:41At the worst, she really believes it.
11:42She's woken me up at 1 a.m. in the morning because she's trying to get dogs to leave the
11:45front room.
11:46That was only a week ago.
11:48So when was the last time you slept eight hours through the night?
11:50Oh, my goodness.
11:52Yes, yes.
11:53Same for me.
11:54Long time.
11:55I don't think I've got eight hours sleep in years either.
11:58I had to get up because we got up at half past five because we've got medication.
12:02We always get up at half past five for medication.
12:03Sophie starts her work as well.
12:05I mean, it's a full-time job, isn't it?
12:06It's a military operation in our house.
12:08Thank God for the, you know, social services carers that we get as well.
12:12And thank God for you as well.
12:14It's a lifesaver for me.
12:15I wouldn't be able to do it otherwise.
12:16Sophie has registered as a carer for her mother and plays an absolute key role in Lisa's care.
12:22And without Sophie, I don't know quite really where we'd be.
12:25She has put her own career on hold.
12:27She's had lots of challenges in her own life.
12:29But she's totally stepped up to help her mother.
12:32And we try and support her as much as we can.
12:34What's interesting, Lisa, is actually a really good night's sleep may help.
12:39And I do wonder actually whether we try the melatonin as the change this time, this month maybe, and to see.
12:46And if she's still getting them.
12:46And if you're still getting them, then we look at your other medicines.
12:49So the sooner we can get on to that mood, the sooner we'll get to that.
12:51So I would go to OZ now.
12:52He'll have it in stock.
12:53He'll literally have it tonight.
12:54We can start it tonight.
12:55Absolutely.
12:55That's another thing, actually.
12:56You've asked if you could speak to someone like talking therapy.
12:59I was wondering about that.
13:00Yeah.
13:00Yeah.
13:01Yeah, I can try it.
13:03I think, Lisa, I think your mood does get affected.
13:05And I would be surprised if you'd said it hadn't.
13:07Because I think living with this sort of thing is never easy.
13:10The quickest way to do it is to self-refer on the website.
13:13And you can do it for your mum.
13:16I wonder whether we pencil in again for four weeks' time to come back.
13:19We review.
13:20We see where we're at.
13:21How the sleep has been.
13:22Has that worked?
13:23Okay.
13:23We'll do.
13:24We'll do, yeah.
13:25Okay, so it's all right.
13:26Well, look, lovely to see you, sweetheart.
13:27And I'll see you in a few weeks.
13:28And let's hope a good night's sleep makes a bit of a difference and we can see.
13:31Thanks a lot.
13:32Okay, take care.
13:32Nice.
13:33All the best.
13:33Take care, Sophie.
13:34Thank you so much.
13:35Thanks.
13:35Bye-bye.
13:35What we do to check this is just ask for a urine sample.
13:39Is that something that you'd be able to do?
13:41No.
13:42Can I give you a...
13:42The word before.
13:43When I get up in the morning, it's the first thing I have to do.
13:47Literally.
13:48He's going to come back and give us something to collect your pee-pee with.
13:51Okay.
13:53Yeah.
13:54I've been peeing, peeing, peeing, peeing.
13:58Diabetics often do pee a bit more.
14:00Not every six, seven minutes.
14:01We also need a urine sample for me as well.
14:03Oh.
14:04Just check kidney function.
14:07Will you do that today?
14:08Would you be able to do that today?
14:09Or do you want to come back for it?
14:10Oh, I might try and do it today.
14:12Okay, fine.
14:13Do you think you'll be able to go to the loo while you're here?
14:15Yeah, I could do it now, Sean.
14:16I mean, you're always bringing in, aren't you?
14:18I know, I know.
14:19I have the bladder of an 80-year-old woman at the moment.
14:25Okay, thank you.
14:27How are you?
14:29Oh, I'm not too clever, to be honest.
14:31I feel tired all the time.
14:33I'm Dr Prestowich.
14:35Nice to meet you.
14:36Nice to meet you, doctor.
14:37So, as you said on the phone to me, you're used to getting up a couple of times in the night.
14:42Well, occasionally.
14:44Yeah.
14:45But did it increase?
14:45Especially if I drank a lot.
14:48Yeah, because you have a couple of pints in the evening, don't you?
14:50Yeah, yeah.
14:50If I drank a lot, I'd get up once, maybe in the night, and go to the toilet.
14:55Now, I'm waking up at 2 o'clock after, I have to go to the toilet again.
15:00And then I'll go back to bed.
15:02Three hours or two hours later, I have to get up again.
15:05So, it's starting to affect your quality of life.
15:07Yeah, yeah.
15:08So, what we need to work out is, are you getting these symptoms because your bladder,
15:13when it gets a little bit of urine in there, it's sending a signal to your brain saying,
15:16I need to go.
15:18And that's something that we call overactive bladder.
15:20And it can be influenced by, you know, how much you drink, what you drink as well.
15:25So, you know, alcohol and caffeine can be implicated.
15:28The alcohol was the one that worried me.
15:30I thought, could it be affecting my kidneys or whatever?
15:33Saturdays, I meet friends, and the most I have is three pints.
15:38Yeah, three pints every night would be excessive.
15:40What I tend to do is, I go home and I have some Baileys.
15:44Okay.
15:44I like sweet stuff.
15:45And is it most days you're on the Baileys then?
15:47Yes, yes.
15:48I'll have a good glass of Baileys then, anyway.
15:51Okay.
15:51So, it's likely that you are going over 14 units, and long term, that will be damaging
15:58for your health.
15:59Do you have a think about, are there ways that you can cut that down, having some dry
16:05days as well in between?
16:06It's very hard.
16:07It's very boring.
16:08Yeah, it's a breaker habit.
16:09Watching that television drives me mad.
16:12So, we've digressed a little bit.
16:14So, we talked about potentially overactive bladder.
16:16The other thing we need to think about is the prostate.
16:20So, if the prostate is enlarged, that can make it difficult for you to empty your bladder
16:25because of where it sits.
16:27It sits around the urethra, or wherever your urine comes out of.
16:30If the prostate's enlarged, which doesn't mean cancer, but if it's enlarged, then it can
16:35cause problems of straining, having to go often, getting up at night.
16:39I can understand that, yeah.
16:41I think that it would be a good idea to examine the prostate today, which doesn't include a
16:45rectal examination.
16:46Oh, good.
16:47If that's okay.
16:48Yeah.
16:48We should also test your urine as well.
16:50I did fetch a little drop.
16:51I thought...
16:51Have you got a sample here?
16:53Yeah.
16:53That's brilliant.
16:56Emily.
16:56Yes.
16:57What time would you be able to...
16:59I suspect my baby is actually asleep.
17:01Oh, it's gorgeous.
17:05No, thanks.
17:07Well, hopefully...
17:07Chubby little boy.
17:09Have a seat.
17:10I'm Dr. Dodger.
17:10Should I just go ahead and light?
17:11Yeah, you can just pop in there.
17:13So, what can I do for you today?
17:14So, I've had a rash on the back of my neck for...
17:21I actually don't know how long it is because obviously I can't see the back of my neck, but
17:25I've been aware of it being itchy for quite a long time.
17:29Is it months or...?
17:31I would say probably more like years.
17:33Years, okay.
17:33Yeah, which I know isn't great.
17:35I should have had it looked at, but every time I see, like, my mum is constantly saying,
17:40like, stop itching.
17:42Okay.
17:42I need to go and have it looked at.
17:43And sometimes it gets quite, like, if I itch it too much, like scabby.
17:47Yeah, okay.
17:48When did someone first say, oh, there's a rash though, or there's...?
17:51I think it's actually probably since I have my baby because I never used to wear my hair up.
17:57Yeah.
17:57And now I always have to because it's always pulling my hair.
18:00So I don't think anyone would have seen it before, yeah.
18:02And any rashes anywhere else on your body?
18:04Uh, no.
18:07And you've never suffered from anything like psoriasis or a family history of psoriasis?
18:12Um, no.
18:13So it's quite a well-defined area.
18:17I don't know if you've seen a photo of it.
18:18Yeah, it's like a sort of circle.
18:21So sometimes that suggests a slight fungal infection because it's so perfectly marked from the skin to your, from your normal skin to where the rash is.
18:30Right.
18:30And there are definitely areas which you can see you've scratched and it's a bit inflamed.
18:36Sometimes psoriasis on the scalp can present a bit like that with these kind of plaques, but it is just one area.
18:42The rest of your scalp looks totally fine.
18:44You've never had similar areas on the rest of your body?
18:47No, I don't think so.
18:48I think today let's treat it as a possible area of kind of fungal infection.
18:54Okay.
18:54But we're also going to give a mild steroid which will settle down the redness and things anyway.
18:58It could be psoriasis and you've just got this one bit there, in which case the fungal cream is not going to do anything.
19:04But just because it is that one area, I think we should at least try it.
19:07If there's bits that start to weep or anything when you're on the treatment, we might need to give some antibiotic cream for that.
19:12I can give you like the steroid in a shampoo.
19:15Okay.
19:15It's a little bit stronger, but at least then you could just put it on that bit in the hair as well.
19:20And then I'll give you the antifungal, I'll give that in a cream.
19:23Okay.
19:24Yeah.
19:24And then try that and then we'll review maybe in three weeks and see how you're getting on.
19:29Cool.
19:30If it's not with a withdrawal, then we'll take a photo and ask dermatology.
19:33All right.
19:33Both are fine though, breastfeeding, so that's not a problem.
19:36Okay, great.
19:36Obviously, if anything flares up, then just let us know.
19:40Perfect.
19:41All right.
19:41Cool.
19:42Thank you so much.
19:43Not at all.
19:43Let me get the door for you.
19:44Thanks.
19:45Travis is down my ankles.
19:49Yes, please.
19:50Yeah.
19:56Right, so just bring your knees up to your chest a bit more, both of them, please.
20:01Okay.
20:01Any point you're uncomfortable and want me to stop, please say, okay?
20:04We'll stop straight away.
20:05Okay.
20:06All right, so take some deep breaths for me.
20:08Okay now.
20:11Keep breathing.
20:12We're done now.
20:18I'm just going to dip that urine sample.
20:19Did you say it was here in the back?
20:21Am I okay to grab it?
20:22Yeah.
20:23There's two bottles in here.
20:24One was a drink.
20:26Oh, that's a urine sample.
20:28Right.
20:29Okay.
20:29That's what I managed to do.
20:30Okay, so I'm going to have to give you a sterile container for that.
20:33I did make sure I gave it all clean and all that.
20:36Yeah, I'm sure you did, but the front desk can give you a sterile pot and you can provide
20:43a sample.
20:43In terms of the examination, so I was able to feel the prostate.
20:48It doesn't feel like it's enlarged or irregular at all, which is reassuring.
20:52Because there's a lot of people that snuffed it over the years.
20:55Yeah.
20:57And nothing else abnormal on the examination at all.
21:00Okay.
21:01Oh, that's good, isn't it?
21:02So that is reassuring.
21:03In a couple of weeks' time, there is a blood test as well, which is called PSA.
21:07PSA is used as screening for prostate cancer, but it's not a perfect test.
21:15But it's not a good idea to do it when you've just had the prostate exam done, because it
21:19can be elevated.
21:20I think what I'd like to focus on at the moment, based on the urine that I've just seen, I
21:26think that you probably are not drinking enough water during the day.
21:30We aim for between two to three litres of fluid in the day.
21:33That is it.
21:34Yeah.
21:34Yeah, because when the urine is very concentrated as well, that can irritate the bladder and
21:38make you need to pee because of that irritation, not because the bladder is full.
21:43And then let's have a follow-up.
21:46After you've had this blood test in a couple of weeks, see how your symptoms are.
21:50Okay?
21:51If they haven't improved with these measures, then maybe there are some medications that
21:55we can try.
21:57Oh, thank you very much.
21:58Yeah.
21:59Yes, when I was taking people's blood, they kept saying to me, you are so good.
22:05One patient walked into my room, she was like, you are so pretty.
22:10I was like, thank you.
22:13And when I was in Libby's room, the fish tank went, and she goes, what's that?
22:17I said it was the fish tank.
22:18She goes, go save the fish then.
22:21I was like, it's not real fishes.
22:23They're just toys.
22:24Why is it hot?
22:34Is it Amin?
22:38Are you all right?
22:39You all right?
22:39Yeah, come on through.
22:40Have a seat.
22:41I'm Dr. Dodgons.
22:43So what can I do for you?
22:46I still have chest.
22:47It's hurting.
22:47I still feel cold inside.
22:49You get me?
22:50I can't breathe.
22:51Okay.
22:51That's it.
22:51I was with the judge last time.
22:54He gave me a paper.
22:55Yeah.
22:56And I drop it in a wallet.
22:57Okay.
22:57And I can't take it go.
22:59So you've not had the chest XA yet?
23:01No, I didn't do that, yeah.
23:02That's fine.
23:02Okay.
23:03When George saw you a week ago, you were coughing up some blood.
23:06Yeah.
23:07How's that been in the last week?
23:09Is it the same?
23:10I cough a lot.
23:11But like once of like after 10.
23:15You get me?
23:15So one time in 10, there's some blood.
23:18When I cough, cough, cough, cough, cough.
23:19Now I see a little bit of blood.
23:20Okay.
23:21And do you have asthma?
23:22Of course I have asthma.
23:23You've always had asthma.
23:24And I want to stop smoking.
23:25I want to stop.
23:26You get me?
23:27Okay.
23:27And is it cigarettes you're smoking?
23:29Cigarette, weed, and I want to stop like the medication, the bad medication for outside.
23:34You get me?
23:35Because like I'm going to be crazy or something or like that.
23:41I want to stop like the drugs and everything.
23:44Okay.
23:45And I can't like.
23:47How can I do?
23:47And are you getting any help with that at the moment?
23:49No, yeah.
23:50But now I'm in addiction.
23:51And what is it that you're taking at the moment?
23:53Brigadolim.
23:54Yeah.
23:55Tramadol.
23:56Okay.
23:57And weed.
23:58Okay.
23:58And every day?
23:59Every day.
24:00Every day.
24:00Okay.
24:01And injecting any drugs?
24:02That's it.
24:03And the big mistake over there I did look.
24:06Look.
24:08And look.
24:09Sometimes it's too loud I cry.
24:11Any thoughts of harming yourself at the moment?
24:36Right.
24:36Well, I didn't get you.
24:37Your mood.
24:38How is your mood at the moment?
24:40My mood?
24:40Yeah.
24:40Bad, bad, bad, bad.
24:42I was born here.
24:42My family took me to Algeria then I came back.
24:45The mistake, I came without them.
24:47Because you know someone like he lived without his family, his mom, his dad.
24:51He's there in another country.
24:53The country you live alone then you lost your house and you live like a homeless.
24:57Then you live from front to front.
24:58And when like your friends they give you that they say like they make you happy.
25:02Like you like you go in the way with your friends.
25:06Then after that I was addiction.
25:10So for the drugs, the medications you're taking, have you been taking those ones for a while?
25:15For a while, yeah.
25:16Yeah.
25:17And you're buying those?
25:18I buy them because like they help me for depression and a lot of things.
25:21So Amin is a very vulnerable patient.
25:25So he's currently homeless and really doesn't have much support in the UK since he moved here.
25:30Unfortunately he has got himself addicted to prescription drugs that he's buying elsewhere.
25:36Tramadol is an opiate painkiller.
25:38So from the same family is kind of morphine and things.
25:41Pregabalin is a neuropathic painkiller so he tends to treat nerve pain.
25:45And have you ever received any help with drugs, alcohol services?
25:50No, no, no.
25:50Never been to Turning Point?
25:51Okay, and if I gave you a number would you call them to try and get some help?
25:55I wish you'd give me a, they help me.
25:58They will help with the drugs but they also have some talking therapy and things available.
26:02I was like, when I was in Nigeria I was like footballer, you know that?
26:05I was being under 16, I was...
26:07Amazing.
26:07I was in the National.
26:09Do you play any football here?
26:10I wish to find, but now I can't like, I play for five minutes then...
26:14Okay, so you really notice it.
26:16I died.
26:16Like when I play football I forget everything.
26:19Okay, well we need, I mean we need to get the chest sorted for you.
26:22Okay, because we need to, you know, especially if football is something you really enjoy playing.
26:26Let me have a look at the chest.
26:27So what I want you to do is just deep breaths through your mouth for me.
26:32One big deep breath there.
26:34Okay.
26:34I mean, listening to your chest, it mainly sounds clear.
26:38There was the odd little crackle.
26:39I think it's probably worth us covering with you some antibiotics for a chest infection.
26:43These are the blood forms that I want you to go and get done at Chelsea for a chest infection.
26:48Okay, so you just walk in.
26:50You need to call Turning Point because what we need to do is get you the help.
26:54I want to change my life.
26:55Okay.
26:55Because I'm 20 years old.
26:56I mean, you're so young and, you know, the main thing is you're motivated to change.
27:01Yes.
27:01I'll also refer, but let's book you some follow-up to come back.
27:04All right.
27:05And then we'll have the chest infection and the blood results and we can go through them.
27:08All right.
27:08All right.
27:09Bye, Mim.
27:12Who's buying sweets then in your household?
27:14If I'm tired or stressed out, then I'll go and buy.
27:20Yes.
27:20Because I can feel my brain going, give me chocolate.
27:23Okay.
27:24Sometimes my diet's not that good because I'm addicted to kind of like chocolate chip cookies.
27:29I try to eat them, not too often, but, you know, if you're in the shop buying other things,
27:34I'll just do that.
27:34Yeah, it's easily done, isn't it?
27:35Yeah, yeah.
27:36Are they better than the orange ones?
27:40Oh, wow.
27:41Of course, they have.
27:42They've got blue in it.
27:43Mmm, the dark pink ones are nice.
27:46That's one in my mouth right now.
27:48No, I mean, I do munch on us some shortbread now and again.
27:51Yeah.
27:52That's between you and me, doesn't it?
27:55That's fair enough.
27:56If I'm feeling tired or stressed out, I'll eat snacks all day long from when I get up to when I go to bed.
28:02So I can eat three Snickers bars in a day easy and a family-sized bag of wine gums.
28:12Giovanna?
28:17Thank you very much.
28:18Hi there.
28:19All right.
28:20Come and take a seat.
28:22How are you today?
28:24Yeah.
28:24Oh, we're stuck.
28:25It's my charger.
28:28Fine, fine.
28:29Okay.
28:29I feel lost with that one more.
28:31Yeah.
28:31It's like an addiction.
28:32Okay, great.
28:33So we're doing all of your routine bloods today, including your HbA1c, which is your pre-diabetes markers.
28:41Oh, yeah.
28:41What we need to try and do to stop you getting to that diabetes category is really have a look at your sugar intake.
28:50Okay.
28:50Yeah.
28:51Would you say that you eat quite a bit of sugar, so cakes or juice or?
28:58Cereal.
28:59Cereal, yes.
29:00Cereal can be quite sugary.
29:01Frosty.
29:01I shouldn't eat a frosty, should I?
29:02No.
29:03But I like frosty.
29:04Frosties is a really sugary one.
29:07So is there anything that you think that you can replace it with that you like that's less sugary?
29:12Maybe the plain cornflakes.
29:16That's got sugar.
29:18Why hasn't got sugar?
29:20Things like porridge or oats.
29:23Toast.
29:24Toast.
29:25So bread's fine, but when you're getting your bread, have a look for some whole grain bread.
29:30Whole grain.
29:31Rather than white bread.
29:32Oh, yeah, bread.
29:33Oh, yeah, yeah.
29:34And what are you putting on them?
29:36Butter.
29:36Butter and jam.
29:38Okay, so jam, jam isn't a good one.
29:41But when you were in hospital and you had cereal, they sort of used to cereal and toast
29:49and they used to give you little, little jam, little jam things.
29:53I know.
29:53Oh, so they're misleading.
29:54They're misleading.
29:56Yeah.
29:57So, you know, it's just because you're in that zone of being, you know, quite high risk.
30:04When they took all the relevant tests when I was in hospital for diabetes, I was okay.
30:09Brilliant.
30:09We are nearly done.
30:10Could you press down there for me, please?
30:12Well done.
30:12That's great.
30:13Yes.
30:13Yes.
30:13And do you drink alcohol?
30:21No.
30:21No.
30:22No.
30:23No, that's why I don't drink.
30:25I think my only vice is sweets.
30:27But no one's perfect.
30:28How would you feel about speaking to our dietician?
30:31Yeah.
30:31Do you think we can organise that for you?
30:33Yeah, that'd be fine.
30:34Fine.
30:34What I'm going to do is speak to reception and get them to book you an appointment for
30:38that and then give you a call.
30:40Yep.
30:41All good.
30:42Can I help you?
30:43I think you've got two jackets there, haven't you?
30:45I know.
30:45I know.
30:46I know.
30:46I can't.
30:47I've got to learn.
30:48I've got to learn how to dress.
30:49I know.
30:50You're doing very well.
30:54Brilliant.
30:54Well done.
30:55I suppose I shouldn't have this.
30:57Oh, probably.
30:59Probably not.
31:00I'm sorry.
31:01You can have coffee and you can have tea, but just without the sugar in.
31:05Without the sugar.
31:05Yeah.
31:06Right.
31:06Thank you very much.
31:09Bye-bye.
31:18I fell on the train.
31:19The train braked.
31:21Me and another kid went flying down the whole...
31:24Even though the train was packed, the train was packed, but somehow everyone moved to the
31:28side like this and me and this kid went flying all the way down to the end.
31:37You know, everything seems...
31:38Yesterday, did I tell you I nearly got run over outside here?
31:40Yeah, I don't know what's going on.
31:42All the bad luck is coming.
31:45It's just...
31:45Something's wrong happening.
31:50Hello, surgery.
31:51So you're new to the practice?
31:53I am, yes.
31:55What can I do for you today?
31:56Well, I've just moved back to London for sort of family support network with the up-and-coming
32:03treatment, which I'm about to have soon.
32:04What's the treatment that you've moved here for?
32:07Um, it's for cataracts and I need to be near my sister who's been sort of driving me around.
32:13But at the same time, I need to, you know, bring all the information over from my past history and what's happened and also with my shoulder injury from the same accident.
32:23For the eye side of things, what I'll do is I'll refer you to ophthalmology here.
32:27They will reassess you before, um, surgery anyways.
32:30Tell me about the shoulder.
32:32So the shoulder was all part of the same incident.
32:34When I was up a ladder, I was fitting a window and the expanding foam tin exploded in my face.
32:40It just went off.
32:41You're not supposed to do that.
32:42And I sort of pulled back on the ladder and obviously if I'd have let go of the ladder, I would have gone.
32:48Um, but it wrenched the muscles in my shoulder because I held on so tightly, closed my eyes.
32:53But that caused the, um, trauma in the eye.
32:56Yeah.
32:57It was on the set of the cataract.
32:58Yeah.
32:58And sort of tore ligaments in my shoulder.
33:01And when was that?
33:02It was about two years ago now.
33:04You've had some physio on the shoulder.
33:05I have, yeah.
33:06Yeah.
33:06And that's helped a lot, but it's not cleared it up and I was due to have a, another scan.
33:10And have you had some imaging on it in the past?
33:13No.
33:13No.
33:14Okay.
33:14Yeah.
33:14So it was going to be the first.
33:15Yeah.
33:15Yeah.
33:16Are you still working?
33:17No.
33:18Okay.
33:18And have you had to stop that because of the injuries?
33:20Because of everything.
33:21Yeah.
33:22I tried to go back to work this year and I dropped a box on my hand and now I can't make a fist with this finger.
33:30Okay.
33:30So they, they said it's called trigger finger.
33:32Yeah.
33:33And so I've been doing the, uh, tests, but I still can't completely fully close it.
33:38I can't.
33:38Close it.
33:38I've just no strength in that.
33:39We can get a hand therapy to have a look.
33:41I'll have a quick look at the shoulder.
33:43Okay.
33:44Do you want to just stand up for a second?
33:45Sure.
33:45Um, any pain down here?
33:48No, it's, it's sort of, I'd have to identify where the pain is for you.
33:51It's sort of.
33:51Sort of in there.
33:52Yeah.
33:52It's really deep in there.
33:54And if I press very hard, it's very painful.
33:56Okay.
33:57And can you lift the arm up above the head?
34:00That hurts.
34:01Okay.
34:01Just pop both arms up like this for me.
34:03I'm going to push down and just push up, push down.
34:05Good.
34:06Any pain there?
34:06Yeah.
34:07Yeah.
34:07That's painful.
34:08In there, yeah.
34:08And then just put your hand behind your back.
34:10Okay.
34:11And push me, push me away.
34:13No, that's definitely.
34:13Yeah.
34:14Okay.
34:14And have a seat.
34:15Sure.
34:16The shoulder, it might be something to do with the rotator cuff.
34:19That's what they said before.
34:20Yeah.
34:20I definitely think there's some damage there.
34:22And if you were going to have a scan, it may be that the next step is a scan.
34:25Yeah.
34:25So instead of just referring you to physio, I'll refer you to our kind of musculoskeletal
34:28specialist team who have access to imaging.
34:31All right.
34:31That's great.
34:31And then you should hear from hand therapy about the hand just to kind of continue the
34:34therapy you have.
34:35Okay.
34:35And then they just wait for the letter for the...
34:37Yeah.
34:37So there will be a bit of a wait for the eyes.
34:39I know.
34:39I'll obviously put that you've moved area and that you were on the wait list for surgery.
34:42That's so good.
34:43Yeah.
34:43I feel confident.
34:45All right.
34:45Thanks, Doctor.
34:46Have a good afternoon.
34:47You too.
34:47Take care.
34:48I'm Dr Pearson.
34:49We've met before, but not for a while.
34:51Now, how are you?
34:53Terrible.
34:54Yeah.
34:55So, because you were in on Friday, was it, and saw the doctor and you've been to hospital
34:59and all sorts.
35:00So, just before the bank holiday weekend, I was fine.
35:04Yeah.
35:05And then in the middle of the night, I started throwing up.
35:07And ended up in A&E.
35:10Mm-hmm.
35:11And they were worried about a blockage.
35:14Mm-hmm.
35:15Did an x-ray, decided it was just constipation.
35:18Okay.
35:19Gave me some lexatives, went home.
35:21Nothing happened for a day or two.
35:23And then, somewhere between then and now, it's just got worse again.
35:28Okay.
35:28And he hasn't eaten anything for basically a fortnight.
35:30So, literally not eating and drinking anything very much.
35:32I'm drinking water and sweet tea and sweet coffee.
35:36That's about it.
35:36So, the main symptoms you've got left with at the moment are what exactly?
35:40The thing that's developed is that I have a cough.
35:42Okay.
35:43I have a very simple sort of tickle at the back of the throat.
35:46But when I cough, you know, I've taken some water and coughed and all the water's come out.
35:51And I've just been getting weaker and weaker for the last few days.
35:54Can I have a feel of your tummy and then listen to your chest?
35:57Would that be okay?
35:58Yeah.
35:58If you lie down on there, Charles, I'll pull this curtain around a little bit.
36:02And on a scale of 0 to 10, Charles, if 0's feeling completely normal and everything,
36:06and 10 is feeling like a death's a door.
36:08How do you feel?
36:10About 9.
36:11Okay.
36:13So, that's not great, is it?
36:14Right.
36:15You ready?
36:15Okay.
36:16Just a couple of deep breaths in for me, Charles, if you can manage it.
36:19Don't worry if you cry.
36:20Now I feel like I have pain inside my tummy.
36:47I feel like something moving inside.
36:49Okay.
36:50How are the stomach symptoms?
36:52It's, um, weird bowels.
36:56And in the morning, after like about an hour after I wake up, I'm still having like bad
37:01stomach-kicking cramps if I don't go.
37:03I never really get pain in my stomach before.
37:05Now I like, you know, so I eat or anything I have to do, I just lie in the bed and I take
37:10a like, thank you.
37:11That's when I press, yeah?
37:14Sorry.
37:15Yeah.
37:16Yeah.
37:17How does that feel?
37:18It's a bit, it's uncomfortable.
37:21I'll just examine the whole abdomen for you, just to make sure.
37:24Oh, there.
37:25Oh, so you're sore there.
37:26There.
37:26Oh, you're very tender.
37:28Yeah.
37:28I wouldn't expect it to be as painful as that.
37:31I'm just going to press very gently.
37:32Any pain now?
37:34No.
37:36I've got one other symptom I need to show you.
37:38Yeah, yeah.
37:38I think my penis is infected.
37:42Okay.
37:42Okay.
37:43Well, that can sometimes perhaps...
37:44Oh, I don't know.
37:46It's just...
37:47Oh, it looks really red and sore, sweetheart, doesn't it?
37:50Oh, you poor thing, that looks so sore.
37:52Okay.
37:53And does it hurt when you pee?
37:54Any...
37:54Not too much, actually.
37:56I mean, I can just feel it peeing.
37:57Okay.
37:58Are you having to go for a pee more often than normal or anything?
38:00Any sort of...
38:01I'm going about every couple of hours.
38:02Okay.
38:03We can certainly give you some cream.
38:04I mean, that definitely looks a bit infected and things too tight.
38:06Let's sit you up.
38:06Well done.
38:08And what I'll do is I'm just going to have a listen at the back.
38:10So there's good air going in and out there, Joel.
38:14Yeah, so the lungs don't sound too bad.
38:16Come and have a seat.
38:17So we did...
38:17So Dr. Prestwich did some blood tests on Friday, obviously.
38:20Yeah, yeah, yeah.
38:20But we were a little bit worried about your blood tests, Charles,
38:23because they have come back and they're okay, but they're not great.
38:26And the one that we're most worried about, really, is the kidneys.
38:30So the kidney blood test has changed slightly.
38:33We can just put that on one finger just for a minute.
38:36So what it tells us is, well, first of all,
38:38one of the infection blood tests is raised.
38:40So it says that you have got an infection somewhere on board.
38:43The second one shows that the kidneys, you're very dehydrated.
38:47The kidneys are not working great at the moment.
38:50And we like it normally to be about, say, 70-ish.
38:53The last one we did in January was 76,
38:55and it's dropped right down to 25.
38:57Oh, my God.
38:58We need to check it today.
38:59So I'm going to ask one of my nurses to do a blood test today now before you leave.
39:02So then we can decide whether we can manage this in the community
39:05or whether actually we need to perhaps be in hospital.
39:08Can I just check your blood pressure as well, Charles, would you mind?
39:10No.
39:11So I think we need to put you on some antibiotics straight away to try and get things better.
39:15And I can also give you some cream as well to put on down below that will help.
39:18If at any point, Charles, you feel worse or you, you know, feel confused, you feel dizzy,
39:24you feel real well, we go to hospital.
39:26Yeah.
39:26So the blood pressure, 139.87.
39:28That's fine.
39:30We'll get there.
39:31All right?
39:32Right.
39:32Come and have a seat.
39:32I'll let the nurse know you're ready.
39:34And then she'll give you a shout.
39:36And we'll get all these tests and things sorted out.
39:37And the prescription will be straight over there.
39:39All right.
39:39Not at all.
39:40Just give us a shout if you're worried.
39:41Yeah, great.
39:41And I'll definitely ring you later on today and or tomorrow.
39:43Yeah, because we were...
39:44I couldn't decide yesterday whether to take him up to A&E.
39:46And in the end, I thought, well, what would they have done?
39:47Well, let's try and dodge it.
39:49But if we have to, I'll phone you and let you know.
39:52All right.
39:52All right.
39:52Great.
39:52Thank you so much.
39:53No problem.
39:55How's it going?
39:56I have a sort of rash inside my lip.
40:00Inside your lip?
40:01Yeah.
40:02I don't know if you can see anything, because I can't see anything.
40:06And it comes and goes.
40:09I've been putting Savlon on it.
40:11Where is it between the teeth and the...
40:12Yeah.
40:12Yeah.
40:14So a little ulcer-y type thing.
40:16Up there is.
40:18All the way along.
40:20I can see a little ulcer.
40:22You know, like a little...
40:23It goes along there as well, you see.
40:26Yeah.
40:27Are you eating well?
40:29Yes, I do eat very well.
40:32Not so much as I used to, but I've been putting this on it.
40:36And it is very, very painful.
40:38How long has it been there for?
40:40A long time.
40:41More than a month.
40:43Oh, yes.
40:44Because some days it sort of subsides for no reason.
40:47Are you good at vitamin C and citrus and those sorts of things?
40:52Can I be a sign of vitamin C alcohol?
40:55I don't know.
40:56I don't know.
40:56What is vitamin C?
40:57I'm not good at...
40:58Is it trusty things like...
41:00Lemon.
41:00Oranges and lemons?
41:02No, I don't like it.
41:02It's like...
41:03I don't like it.
41:03It's the sign of scurvy.
41:05I've never eaten them all my life, so I'm not going to start now.
41:07Really, I'm not.
41:09Have you anything I can put on it?
41:11I think you probably need to just fill your glands.
41:15Ooh, got a big gland there as well.
41:18No pain, no?
41:19No.
41:19If it's been there that long, I'm going to get you to see somebody fairly quickly in the hospital.
41:27I know you don't want to.
41:28You can't leave that.
41:29That's a long time for it to be there.
41:31And why is it not healing?
41:33Have you seen a dentist?
41:34Frequently.
41:35You do?
41:36Mm.
41:36Mm, good.
41:38I'm going to refer you anyway.
41:38I can't remember if I mention it to them.
41:40I'm going to put you so you go pretty quick.
41:42Even by the next time I see you, you should have heard from them.
41:46Oh, yeah, that's good.
41:47That quick.
41:48Just to make sure.
41:50I don't like going to hospital.
41:51I know.
41:53But, and...
41:54Because they don't know me, and they ask me so many questions.
41:58Yeah, yeah.
41:58From ground level upwards.
42:01Do I do this?
42:02Do I do that?
42:02No, no, no, no.
42:03The answer's always no.
42:08I'm going to Bristol on Wednesday.
42:09Oh, wow.
42:10Okay.
42:11See an old school friend of mine.
42:14We're not yet 90, but...
42:15Yeah.
42:15We'll be 90 in a couple of months' time.
42:18Oh, okay.
42:18Yep.
42:19What a nice birthday thing to do.
42:20Yeah.
42:21Yes.
42:25Yes, I had a quiet birthday, too.
42:27It makes you, what, 61?
42:29Shh.
42:32You will have heard from the hospital by the time I see you, then, about your inner lip.
42:37Can you manage?
42:40I've found you.
42:42There we go.
42:45Well, thank you for seeing me.
42:46Nice to see you.
42:47You take care.
42:47I will.
42:48Bye-bye.
42:48Bye-bye.
42:48Well, it's a nice to see you.
42:50Oh, you're so lovely.
42:52You see, now you're waving at me.
42:54Bye-bye.
42:54Bye-bye.
42:56Bye-bye, my friend.
42:58All right.
42:59Not at all.
43:00Have a great afternoon.
43:01Yeah, you too.
43:02Bye.
43:03Yeah, lovely.
43:03Thank you very much.
43:04Lots of luck with everything.
43:06Bye-bye.
43:07Bye.
43:08Thank you very much.
43:10Bye-bye.
43:11Bye-bye.
43:11Bye-bye.
43:12Bye-bye.
43:13Bye-bye.
43:14Bye-bye.
43:14Bye-bye.
43:15Bye-bye.
43:45Bye-bye.
44:15Bye-bye.
44:21That is my monitor tablet for all day.
44:24You must feel like you're rattling sometimes.
44:26It's a lot, man.
44:26This foot is normal.
44:28Yes.
44:28This foot looks like Cornish pasty.
44:30Got out of bed, and all of a sudden,
44:33and my nose poured with blood.
44:34My night was just full of blood.
44:37It's good, John.
44:39It's really good.
44:40It's real.
44:42In the past,
44:47It takes place to truly be stuck.
44:50It's a little bit недelaimer.
44:52It's really bad.
44:53It's be you.
44:53It's really good.
44:53I'm alive.
44:54It's really good.
44:54It's a lot.
44:55It's a long time to for next,
44:56and all of a sudden,
44:58it's impressive.
44:58It's summer��.
44:59It's almost too triggers.
44:59It's really good.
45:01It's really good.
45:01It's very good.
45:02It's a movie where you're a-
45:02little more.
45:03It's really good.
45:04It's fun, honestly.
45:04Transcription by CastingWords
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