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00:00Good morning surgery.
00:07I've got a lump in my armpit that's been growing for like a year and a half.
00:11Yeah, yeah, yeah.
00:16Really soft.
00:17I'm sorry.
00:18Does it help to rub it or anything?
00:20I should leave it calm and it's hurt.
00:22I do rub it, but...
00:23Yeah.
00:24Sorry.
00:25Are you a warrior?
00:28Yes.
00:29Because I always think I'm going to die.
00:35When you feel it, say yes.
00:37Yes.
00:38Yes.
00:39Yes.
00:46You live up.
00:48It's still there.
00:49It's still there.
00:50It's still there.
00:51Go.
00:52Um...
01:02Um...
01:03You.
01:04What a new deal.
01:05Oh, yeah, goody, goody, goody.
01:06Henry, please, Mike. Hello, how are you? Good to see you again. Yeah, likewise. How are
01:32you doing? I'm guessing not well, otherwise you wouldn't be here. I'm so sorry. It's getting
01:37a bit bigger, isn't it? I think it probably got bigger like a couple days after I saw you. And
01:41then like, it came to a head over the weekend. And then on Sunday morning, as I was in the hot
01:46compress, like I noticed when I took it away, there was like yellow stuff on it. So then I assumed it
01:50popped. But actually, I don't think the swelling's gone down at all. The pain's gone. How's your
01:54vision at the moment? Is that okay? It's actually still a bit blurry. Like I literally noticed it
01:57as I walked out of the house to come here. Any other symptoms? Fever, nausea, vomiting,
02:01and I'll have that going on for next. Good. So you feel otherwise well. I'm just going
02:07to lift the eyelid and pull the eyelid up a little bit. I just want to have a look on the
02:11underside really. Yeah, you can see where it's scarred over. Sorry, this is uncomfortable
02:17a bit. All right. Good.
02:25Do you think the ointment helped? Did it help a little bit? I don't know if it did, to be
02:35honest with you. Fine. I think the infection's gone because it looks very dry. It doesn't
02:39look like there's any more sort of pus in it or anything like that, which is good. Yeah.
02:42But I think we need to try now and get on top of the inflammation for you. I'm just thinking
02:46how best to do that. What I could do is give you a very, very, very weak one. So normally,
02:50the hydrocortisone we use is 1%, but I could try and prescribe 0.5%, which is even weaker.
02:56And say, just use it for a few days, really, just to really help bring that inflammation
03:00down. And we can give that a go. See how you go with it. Yeah. Does that sound okay?
03:04Yeah. Any idea on that time frame as to when that's going to be better? It's so variable.
03:08So some people, unfortunately, will be troubled with this for months. I don't think that's going
03:12to be the case here. I hope such words. But other times, you know, sort of 10 days,
03:16two weeks, that kind of ballpark figure is sort of more common. From here onwards,
03:21I would hope it wouldn't be as long as that, because we've already endured all of that time
03:25before. Okay. Perfect. Yeah. Here we go. Any questions at all? That's it. Thank you very much.
03:29Yeah. Good. Okay. All right. Awesome. Thank you very much.
03:31Thank you. No pleasure. You're very welcome. Take care.
03:33Right. So you're here for your smear test. Yes. They've been trying to do it for about a year
03:46because I'm overdue. Okay. But every time they try and do it, they can't do it because I've been
03:50examined because I was on this pre-cancer pathway for a while. Okay. Okay. So you've had some abnormal
03:58smears before? Not for a while. Okay. I think they've been okay for a while, but I'm... Is it
04:04every five years? Yeah. That's right. Yeah. I'm long overdue the five-year one. Okay. So we are a little...
04:09Not long. We've had worse, but you are... We were due it. For me, I am. I'm usually really efficient.
04:14Well, we're going to... We'll do it now. We'll do it today, and then we can get it done.
04:17Because I've got to have another ultrasound on Friday for the pre-cancer pathway. Okay.
04:21So I just thought I can't leave it. And tell me, what's happening on that pathway?
04:24It was a suspected cancer pathway. Every investigation they tried to do was unsuccessful,
04:29so they took me in to give me a hysteroscopy. And they didn't do the smear there and then or
04:33anything in the hospital? Not that we know of. Not that we know of. I mean, sometimes they do,
04:38but they would have told us it had we done it. They said it looked normal. They have said. The good
04:43news is that they're not overly worried and that they've discharged you off the cancer pathway. Great.
04:50As in, they don't think it's cancer. Great. So I think that's one good news. Great, great.
04:54But they still want to see you and follow up and deal with things because they need to find out
04:57what's happening. Suddenly I got another ultrasound and I thought, oh, no. And I think it was...
05:01And we referred you. Was it because of the wound lining? Well, I kept bleeding. Yeah. But I just
05:07decided to stop taking the HRT because I think that was causing the problem. Okay. Right. Let's hop up.
05:13Would you like a chaperone? No, I'm fine. Someone else in the room just to be here. No, no, no.
05:16No, no. No, you're all right. Come on, have a seat. Let me close this. I've put that there and you can
05:21put that across your middle. So if you've got a dress on, it's probably just as easy to either
05:25just hitch it up a little bit or whatever. Yeah, exactly, exactly. Take off from the waist down
05:29and then we all can get the bits ready. Okay. Are you ready? Yes, yes, yes. I think when you have
05:33bleeding, sweetheart, and you're sort of what we call post-menopausal and we have some bleeding,
05:37then we've got to think, well, why? Yeah. And therefore, we've got to go down the route where we start
05:41looking into it because then we can work out what it is. Exactly, exactly. So it's really important. So it's great to get the
05:46all clear, but then we must make sure it stays the all clear and then we can see. So you just be
05:50as comfortable as you can. You'll feel a little bit of cushioning. I'm sorry it's a bit cold.
05:53It's okay. There we go. I'm sorry, sweetheart. It's okay. You all right? Yeah. Okay. There we go.
06:01It's okay. I did loads of squats at the gym this morning. They were hurting. They were hurting more
06:05than this will hurt. Right, let me knock those off. Let me get you some tissue, sweetheart. Job done.
06:11Well, there we go. You can tick that one off your list. The results will come back to Emily and she
06:17will then contact you and let you know the results. Okay. And as you know, it will most of the time
06:22comes back normal, but sometimes if they're not 100% happy, they come back to us and very occasionally,
06:29we have to repeat it. Hopefully not. Yeah. Very occasionally, they have to see you in that
06:32colposcopy clinic where they want to have a little closer look at it. Yeah. But they test it all on there.
06:37Yeah. And as you said, it's been normal a few times recently, so fingers crossed it'll be all right.
06:41Thank you very much. Thanks, Elizabeth. Okay, let me let you go.
06:43Anyway, good luck with your scan then on Friday. Thank you. And nice to see you as always.
06:47Thank you. Thank you. All right. Take care. All the best. Bye bye. Bye bye.
06:49Door open or closed? Leave it open. That's fine. Thank you. Thank you.
06:56Simon, please.
07:03Hello. Good morning. How are you?
07:07Uh, slightly slow. Oh, sorry to hear that. Come through, take a seat.
07:12Good to see you. How can I help today?
07:16Um, what it is, I've got, um, I'm having a lot of trouble with my back.
07:21Okay. Uh, because I've got osteoarthritis in the spine anyway.
07:24Mm-hmm. I'm not sleeping very well. Um,
07:29sometimes if I lie on my back or I'll turn or signs, I get a sharp pain down my back.
07:33Mm-hmm.
07:33And the top of my leg's going numb. Mm-hmm.
07:35And it's gone for about half an hour and I don't know what the problem is.
07:38But it's happening quite regularly. Mm-hmm.
07:41How long has the pain been as bad as this for, would you say, roughly?
07:44Every three days I get excruciating pain and got a trap nerve or something like that.
07:47Yeah, absolutely. Sounds like potentially.
07:50Um, quite frustrating. I'm trying to get up in the morning. I can't get up because my leg's numb.
07:54Yeah, yeah, yeah.
07:54And every time I try and stand on it, I'm having trouble.
07:56Yeah, always on the left side or...?
07:58It's always on the left side, yeah.
07:59Yeah.
07:59Any injuries or trauma recently that might have set it off or made it worse?
08:02Um, well, not since when I was hit by the e-scooter, no.
08:05Yeah.
08:05It's getting worse and worse than when I was more irritable.
08:08Yeah.
08:08Also, someone helped me sleep at night with the amitripline because I haven't got any left.
08:14Is the amitripline helping a bit?
08:15Yeah, it helps. Helps a bit.
08:17You're on two tablets of those, 20 milligrams. Yeah.
08:20So there is scope for that to go up a little bit if needed.
08:23Yeah.
08:23We can always consider that.
08:24Um, how else is it affecting your life at the moment? Are you still able to get out and about?
08:29Well, getting out and about, I mean, I'm playing long green balls, but it's got to the stage where,
08:33um, I can't wind this down as far to roll the ball anymore, so it's, uh, difficult.
08:39Yeah, yeah.
08:39Trying to, um, have a life.
08:54Okay.
09:05Francesca.
09:07Hi.
09:10Hi.
09:12How are you?
09:13I'm good, thank you.
09:14Come and take a seat.
09:15How are you?
09:17Oh, I'm so hot.
09:19Oh, I bet you are.
09:21How many weeks are you now?
09:22first I'll be 32 on Friday how's it been second time round it's I would say very
09:30different like I felt I'm way bigger than I was yeah and just yeah it's just
09:38hard with the toddler so Wilbur turned two a couple of weeks ago so he's like
09:43really in there yeah you know toddler tantrum very active I bet climbing up
09:47everything oh my god it's really hard either when you look back at when you
09:51were pregnant the first time yeah you think oh that was actually fine you're
09:57looking after another one yeah but yeah so we're going to do an RSV today and the
10:04hoop and cough vaccination did you have RSV for your last one I don't think it
10:07was around with Wilbur yeah so RSV is a respiratory virus that is responsible
10:13for sort of common colds and coughs yeah and however it can lead on to pneumonia
10:17and bronchiolitis um which is you know particularly bad for for babies and then
10:22the hoop and cough is exactly the same as the one that you have before exactly so protecting them for
10:29their eight weeks um first eight weeks of life before they have their um eight week vaccinations
10:33perfect it's very unlikely to get side effects from these other than um sore arms or do them both today
10:39if you're happy with that yeah fine um sore arms um might be a little bit red a little bit achy
10:45that should subside within a day or two yeah there is always a chance with all vaccinations that you
10:50might get sort of mild flu-like symptoms a bit of an achy body whatnot but with these two it is unlikely
10:55however if you're worried about anything just just let me know okay perfect are you feeling well today
11:00other than yes i'm pregnant yeah no i'm feeling fine perfect yeah and remind me you don't have any
11:07allergies do you no i don't know lovely oh it's very exciting yeah very exciting okay so we will do
11:17the RSV in your left arm so we'll start with this side of that's okay sure so just relax your arms yeah
11:23relax it down just like that relax from your shoulder all right sharp scratch
11:29one done
11:36okay sharp scratch
11:41perfect
11:46so next time i see you will be for the vaccination
11:53that's crazy isn't it um but if you need anything though in a long time just um just let me
11:59know but yeah so much luck with everything thank you so much so nice to see you yes i'll be to you
12:04too
12:04thank you take care bye
12:05bye
12:06would it be okay today just to examine you is that all right yeah sure so whenever you're ready
12:16if you stand up for me i'm just going to press down the spine
12:20so you can see how there is a bit of asymmetry there so you know this shoulder is a bit lower than
12:26this one because you're compensating because you're in so much pain yeah that's very common
12:29to see that
12:30a bit tender there a bit of spinal tenderness i agree sort of around l23 l4 sorry sorry
12:42are you able to bend forward for me stop when it's painful so only go as far as you can
12:46bend forward yeah yeah so it's yeah it's fine stop and then if you bend back for me
12:51yeah so very limited range of motion isn't it yeah okay if you slide one arm down one leg
12:56yeah and the other side for me yeah very very limited we need to get that back really sort
13:02of mobilized and moving around back pain can be really debilitating um it can lead to a lot of
13:07sick days a lot of time off work and can cost the economy you know millions a year so it's
13:12really important to um manage it uh as best as we possibly can and prevention is obviously
13:18far better than cure uh so having good posture strengthening core muscles making sure that
13:23we're exercising in a safe way and are looking after our bodies um is really really important
13:27can i get you on the couch would that be okay in simon's case clearly the pain was having a
13:33very big impact on his quality of life on his abilities to sleep etc if the pain is a bit
13:38more complex if there's pain radiating into the buttocks or into the legs with potential
13:42nerve involvement that then might mean that we refer patients for more specialist intervention
13:47at times um a lot of the time we can still manage that in the community as well but um really
13:52understanding the impact the patient's uh pain is having on them is very important and that
13:57helps us to determine whether we need to seek specialist intervention or not
14:00how's that pain oh i'm sorry i'm just gonna lift this leg up
14:08it's okay
14:11tender
14:17ouch
14:17yeah oh bless you sorry lift this leg up push me up good push me down
14:22good push me out with this one push me down
14:25oh yeah yeah yeah it's gone numb really sorry it's gone numb sorry it's alright
14:30does it help to rub it or anything no i should leave it a couple of minutes i do rub it but
14:34yeah sorry
14:36whenever you're ready you can come back round take your time do you need a hand
14:41yeah one of the main problems is like when i'm in lying back because i like my life is
14:49getting myself up having to sit on the bed for a while
14:53yeah just to get used to it get sources
14:56just take a seat there
14:59okay what i think we should do is a few things we can increase the amitriptyline if you like
15:06just for a few nights to see how you get on with it you can definitely go up to three quite easily
15:11if you want a little bit of um cocodomol or something like that just to you know for those
15:16paroxysms of pain when it's really really bad you can take a couple of cocodomol not a problem at all to do that
15:22um and then i think we should refer you to the musculoskeletal team just to see if there's anything else that needs to be done
15:27um things to look out for if there's any complete loss of sensation between the legs
15:32if the pain's getting worse um if there's any loss of balance that kind of stuff just let us know as
15:37well all right we'll see how you go okay we'll take it from there all right i'll send the prescription
15:42to the pharmacy for you okay thank you very much thank you take care
15:46and here i'll go yep ready
15:57hiya how are you doing good you i'm fine okay i'm sam so i'm gonna do your diabetes check today so i'm
16:05gonna do your bloods give you a urine test check your feet do you know how much you weigh um 80 kilograms
16:12maybe do you smoke nope i mean not regularly social yeah do you drink alcohol then yeah yeah
16:22santiago is a young healthy active guy who came in for his annual diabetic health check santiago has
16:30type 1 diabetes type 1 diabetes is your body doesn't produce insulin it's an autoimmune condition it's
16:38classed as a chronic condition so on average how much do you drink a week no like maybe two three
16:44pints like after a football match yeah do you play football yeah are you good i mean you should
16:52ask that that to my friends but i think i think i different myself i think they would say yes you're
16:58decent who do you support who do i support you've got to be very careful now wrong choice who do you
17:05support chelsea yes okay well i suppose if you're in fulham i've arrived quite like early or a few
17:15years ago here but like where are you from i'm from argentina do your family live in argentina yeah you can
17:21relax sharp scratch do they come here at all uh they came once i also went back like twice since i moved
17:33okay pop your finger on there for me nice and hard so do you play any other sport so i'm trying to
17:40get into golf but i'm i'm not doing i'm not doing good my dad's always he says he's at the office which
17:47means he's in the golf course but he's rubbish he still goes
17:55and then you do the one
18:14well i can lose my arms in it
18:16right so i need to buy some more blue dresses yeah it's got pockets when she's heavily heavily
18:26pregnant everyday mona yeah shoes off feet up okay don't don't get surprised with my how do you call
18:37this the fungal is it fungal now here here yeah yeah so next time you cut your toes yeah i want you to cut
18:46them and put the nails in here okay and bring it in for me okay but this looks like classic fungal toenail
18:55okay right close your eyes no treating when you feel it say yes yes yes yes yes yes yes yes
19:11during an annual health check we do a foot check where we check for any signs of infection
19:22and we also use a monofilament device which checks for loss of sensation or auto sensation to the feet
19:29we check to make sure there's no open ulcers no wounds and make sure that you've got feeling
19:38because if not then we can action it so it's really important to attend your annual
19:45diabetes check you've got some hard skin to the bottom yeah of your feet
19:52so when you're in bed at night if you put some um moisturizer on the bottom of your feet okay
19:58rub it into the your feet both feet and then put cotton socks on okay that's great you've done liver
20:06kidney fibres cholesterol diabetes iron the whole lot amazing okay okay okay some i appreciate
20:12thanks so much take care have a good weekend best wishes for chelsea next season best wishes for
20:17fuller not bye bye come on in take a seat my name is anna mccue i'm one of the doctors so what's been
20:34going on um i originally just wanted to get um bloods done because okay back home in australia i usually
20:41have an iron infusion but i've noticed that it's not a normal practice here yeah iron infusion
20:46um so i think it's worth just getting my bloods done anyway but i've just been like
20:50absolutely exhausted all the time i've got a lump on my armpit that's been growing for like a year
20:56and a half okay we'll definitely take a look at that yeah that's good definitely good to know yeah
21:00so um when did you notice on this occasion that you were feeling a little bit more tired than usual
21:07honestly it's been the last last maybe a couple of months okay it's just progressively getting worse
21:12like i'm really struggling to just get through a work day and okay yeah yeah tell me a little bit
21:17more about the lump so is it multiple lumps i'll have i'll examine you in a moment it's just one here
21:23okay anywhere else no it's just this one i noticed it maybe last last february okay and has it changed
21:32it's getting bigger okay um and it's it's becoming sore like even if i'm just like resting it's like this
21:37achy pain and and is it ever red hot or anything no no not that i've noticed okay and any lumps or
21:44bumps anywhere else not that i've noticed okay my nan actually died of breast cancer so yeah yeah
21:50is there anyone else in the family with well my mum passed away from melanoma so okay i'm sorry
21:55cancer's just running right from the females in my family unfortunately i'm sorry to hear that
22:12good luck with the veins okay like a challenge do you have a good vein i doubt it sorry that's my
22:27blood is solidifying okay so i'm just pressing along the the veins back of the leg what you think it
22:33might be deep vein flumbus or something awful because you've had barricus veins for a long long long
22:39time but the pressure's built up so now we've got the sort of discoloration which isn't going to go
22:44away because he did offer to sort out the barricus veins still as well they're painful they throb
22:48they're sensitive to the sun it's quite bad actually who did
22:56edward oh hello hold on i remember the script oh
23:01uh come in come in have a seat i'm megan how are you oh i'm i'm well a number of years ago i had
23:11trouble with varicose veins i took one out okay doctor said do you want to see i said not bloody
23:15likely you know what i saw the pharmacist today about was should i get a pair they go right up up
23:22up oh what stockings like compression stockings yeah i said the pharmacist well are the knee ones
23:30okay or can i get one up the thigh is the main concern here about the stockings or have you
23:37had any other symptoms have you had any swelling any pain along along the veins not really um even
23:44a bit of a pain but nothing more than the twins but i'm just worried that i don't want to get any worse
23:49you know yeah yeah can i have a feel is that right yeah yeah i'll just have a shower you're safe
23:56just clean my hands you're safe as well warm hands thank god any pain when i press along the
24:02vein it's the size of these nodule things pain along here oh up here sometimes but not much
24:08did they ever get red or hot not really these look like almost bruises or a bit of blood where it's
24:14it's popped it slightly oh right and because i can touch them it feels different to the vein ah
24:19you've not you can get something called phlebitis which is to do with inflammation in the varicose
24:25veins and it can be quite uncomfortable and hot to touch and painful now you haven't got any of that
24:31which is good but people worry about dvts yeah yeah yeah yeah yeah um i mean have you had any recent
24:38long-haul flights i fly to australia every year yeah when did you last fly uh it flew back in january
24:43in january okay so it's not relatively recent last less than six months ago often for a lot of people
24:50who travel on long-haul flights they can buy compression stockings over the counter for this
24:54guy he had some varicose veins quite significant leading all the way up to his groin uh with his
25:00frequent trips abroad his age and the varicose veins it puts him at a slightly higher risk of getting a dvt
25:08because before you we would consider like um compression stockings really what you should
25:16have is a doppler it involves there's two ways you can do it one way is they put two blood pressure
25:20cuffs on each like one on each leg and one on the arm you lay flat for about 20 minutes and they measure
25:27your venous return oh right and they measure to see if there's any what we call atherosclerosis in the
25:33arteries so like plaque build-up but i don't think they did well i mean i can't remember so long ago
25:38now what we don't want to do is if you've got a big build-up is giving you lots of compression
25:44and then there's an issue of you having problems with like venous supply getting blood supply getting
25:48to the legs yeah that's all right your feet are they often purple yes yeah okay i think you'd benefit
25:58from a doppler to check how your venous supply is okay and now she tells me so i'll get that sorted
26:07for you one of the things that concerned me about this patient was that his feet were purple this
26:12suggested to me that he probably had some venous insufficiency which means that his vein system
26:18isn't working properly so then he's getting pooling and discoloration i keep walking everywhere you're
26:23walking everywhere can you feel your toes okay then continue doing what you're doing because
26:27that's fantastic and like i said if it starts to get painful along the vein like hot to touch painful
26:33when you're touching it let us know but if it's more deep in the calf then i'll be a bit more concerned
26:39yeah okay but i'll get those all sorts of you look after yourself i'll have a look at referring you on
26:45to um get a doctor yeah okay to check make sure your your blood supply is all good yeah i said there's
26:51no news everywhere i don't know i see my legs coming apart oh my god look after yourself okay bye
26:58this door open oh yeah leave it open yeah take care of yourself i will i will let you mail
27:06at night time would you notice any kind of drenching night sweats where you would have to change the
27:11sheets or the pajamas or anything no no no nothing like that um have you noticed any change in your
27:16bowel habit no any blood in the poo black tarry steels anything like that no i mean there was um a few
27:24months ago well i noticed it and i was i didn't and then just sort of passed but can you describe that a
27:29little bit more was it red when you're wiping or well both and then like it was you could see that there
27:35was blood in the stool for sure and was it painful to pass the poo um not like stomach wise no i didn't
27:43really know what to think of it so i just i was like something might pass through okay okay that's
27:48definitely good to know as well though is it okay if i examine your tummy and i have a feel of that
27:52lump under your armpit yeah no worries and if you just pop the top up perfect now my hands are freezing
28:01that's okay even in this okay just let me know if you have any discomfort nice
28:10any pain there when i'm present um not really i've been there just a little bit yeah okay and you
28:17can sit up for me now i'm gonna feel the lymph nodes in the neck okay yeah they they have been
28:24swollen when i've been getting sick like really big yeah but
28:31okay okay can you put your hand on my elbow and i'm just going to feel under the armpit
28:40can you point to where you can feel
28:44okay and relax again
28:49okay and you can sit back down for me
28:50so the tummy's nice and soft i can feel what you're feeling under the armpit have you noticed
29:03any lumps or bumps in the breasts at all i had i've i had a biopsy in my left breast for i had fibro
29:11genomas and that was maybe like 2021 okay yeah and since then are you good at um checking your
29:20breasts for any i've got breast implants it's really hard okay um but nothing that you've i've not that
29:25i've noticed yeah okay yeah having breast implants doesn't put you at any higher risk of having breast
29:31cancer and there's no particular special or different way where you should be checking your
29:36breast if you do have implants i think you know generally knowing what's normal for you so looking
29:41for any asymmetry pain skin changes or puckering or nipple discharge and obviously relating to this case
29:49lumps under the armpits and those are all things where you absolutely should go to your gp to check
29:55so what i might do is bring you back in another point just to have a full examination of the breasts
30:00because sometimes when we have a lump under the armpit yeah we just want to make sure that there's
30:05nothing else um going on and we can send you through to the to the breast team in that okay
30:11in that context okay yeah um and then uh with regards to the tiredness um there are a few blood
30:19tests that i'm thinking that we should do definitely so i want to look at your iron stories and your um
30:24to make sure that you're not anemic i also will do a celiac screen as well to see if there's an underlying
30:29cause for having had low iron in the past and things like thyroid function as well yeah is that okay does
30:34that make sense perfect it may well be that we then send a referral off to the breast team just to
30:40double check sure because a lump under the armpit we just need to yeah yeah and fully examine yeah
30:46does the same time next thursday work for you yeah should be fine so we'll do blood tests and then
30:53i'll examine you next week and more than likely send you to the breast team just to make sure that
30:58we're covering all our bases okay all right questions for me uh no that's all yeah thank
31:03you so much you too cheers
31:10do you mind if i park this in here there we go okay ready
31:18how's it going how's this young lady she's all right she's all right a few complaints but yeah
31:22yeah yeah yeah have a seat thank you you want to sit you want to stand or sit my you know sit on
31:28daddy's knee yeah no stand or sit come up okay what's been happening so she's been complaining from
31:35about since maybe friday night when she's peeing that it hurts okay yeah her pee is quite strong
31:41smelly as well yeah yeah okay um so yeah so that's been going on now since any temperatures does she feel
31:47hot no no um and it's also during the night as well where it's the most strongest for her yeah so she
31:53wakes up at maybe two or three o'clock in the morning and complains that she's out of nappies at
31:57night she doesn't wear a nappy at night she does wear a nappy yeah yeah but she says it hurts yeah
32:04and then she does you know the typical crossing of it yeah so it's important that we get a urine test
32:10before we start treatment okay if she's unwell we'd say put her on sort of a general antibiotic amoxicillin
32:17it's the usual children's one but uh the result then may show that it's a different i thought it
32:23might be better okay how easy what do you yeah this is the next question yeah how easy how easy am i
32:29gonna do that um the other option is cotton wool you know put it down there and then when she's gone
32:41you just squeeze it out into this okay i think but we'll give you all this anyway
32:48just by label on it for you we're gonna put your pp in there and then someone's gonna look at it
32:53and tell me if you have something wrong yeah yeah
32:58you want to choose oh you want a sticker my hair which one what do you want we've got shark starfish
33:06turtle octopus which one do you want you choose you want the octopus okay jellyfish daddy oh sorry
33:12jellyfish sorry not yeah yeah don't know my nose man you want that one you want to put it on your you
33:16want to put it on your uh yeah you can show all your all your friends and becas you got a sticker
33:22daddy gets these to go yay party bags okay there you go thank you you're welcome any problems give
33:30us a call yes and if i see the urine test back early i'll give you a call okay thanks thank you for
33:36coming hi hi do i get a wave hi thanks for coming see you
33:47if i eat anything in the morning i immediately feel bloated and full and if you sort of pass wind and
33:52needs does that help i'm not able to very much but i don't usually anyway do you feel like now
33:56bloated a little bit with more wind um yeah maybe a little bit okay um does the pain improve after a
34:03bowel movement or passing wind i feel like i really need to go yeah actually pain
34:12do you think it's because you have the latte why don't you just be cramping up because you've
34:16mixed the milk and the chips and then sweets
34:22maria hello come on in how are you not good not good oh dear in again that's all right pleased to see
34:31you we're in here today that's why i'm crawling in again yeah so what's happened you know last week i had
34:40terrible diarrhea first okay and then total conservation bloated like this on sunday nothing
34:47and i didn't so i went to chelsea in westminster so he was rather a thing this is all painful
34:55he couldn't feel a blockage okay my blood okay and sent me home now it's again it's constant pains
35:03here okay it's like this i sent you a copy of those what i could copy from the test from the
35:11hospital yeah yeah it looks like my liver and kidney is something because we've had sort of tummy upset
35:17and problems for quite a while haven't we and we sent you to the sort of the urgent clinic to try and
35:22get them to find out what it was didn't we she didn't she run tests and she did a lot of tests and
35:27they put cameras in and everything didn't they nothing and yeah then the other day when i was
35:33pooping it looked like blood i'm just thinking of having a whole body scan maybe well you pretty
35:38much got a whole body scan before didn't they just a few weeks ago so they did a whole ct what they
35:43call the thorax abdomen pelvis they did all of it from top to bottom and here from here all the way
35:49down and here i am again so they didn't find cancer or anything horrible which is what we all worry
35:54about yeah and they've said that everything was fine the heart the lungs they didn't find any swollen
36:00lymph nodes or glands they said the liver gallbladder pancreas spleen adrenal glands kidneys bladder are all
36:08normal even bladder bladder all normal but they did say that you've got a condition i don't know if you
36:14know about it called diverticular disease your our intestine sort of comes and it looks like this and
36:19it's nice and bobbly like that and it comes down and out and we go to the loo so that's what it
36:26should but with diverticular disease we end up with these little pockets oh that stick out and the poo
36:31comes up and round and out it can get stuck in these and cause them to be inflamed and bloaty and sore and
36:38horrid they said no other abnormality in the colon nothing else in the pelvis but you do have these and
36:44now what i wonder happens is that some days might not be so bad other days might be horrible yeah do
36:51you pass a lot of wind do you find you're quite windy well sometimes i don't have to take something
36:55okay to help it yes and the problem is that that's what can happen here the sort of gas can build up
37:00and then it's stuck and it can't go around and if gas if the walls get stretched to the colon it's really
37:05uncomfortable and it can be really horrible why don't we start with just seeing if we can get something
37:11to help you with the one thing you know is going on which can cause the bloating and we have a poop
37:15test we can do a poop test and we can just check that there's nothing there yes that there's no blood
37:29so
37:37are you a warrior yes because i always think i'm going to die and what do you think you're going
37:43to die of something horrible some cancer or something the problem is that we all worry about
37:47this and sometimes that worry just grows a bit doesn't it i think it's getting is sort of because
37:53i've had so many friends yeah i'm sure that's frightening isn't it but that's my age i mean
37:59but but that's the problem that that's going to keep on happening isn't it instead of going forward
38:03that's why i accept it yeah but it's just sad it is yeah you know i said oh can i go on holiday
38:11somewhere who'd you go with yeah i used to always have one or two and they're all sort of dropping off
38:17are they slowly yeah and they're all dropping off but that's okay it's the problem being the fittest
38:22of a group because then you're the one that's left standing on you i'm about the only one left out
38:27of the lot that we started what about making new friends and different things i have lots of young
38:34friends anyone to go on holiday with any of yeah well i am i always do once a year i force them
38:43good i bet you don't force them very much i'm sure if you suggest i'm trying to zanzibar
38:47in september oh my goodness me that's amazing i'd like to go to zanzibar for longer but 10 days
38:52that's max because what you get people to sort of dog sit yes yes and drives my partner crazy he's 80
38:59and uh on his own with the three of them can he not travel with you or does he not really like
39:04he's autistic he doesn't move he sits in front of okay the computer all day long it's very difficult
39:13but we get on well i've known him for 65 years and are you married is he your partner no he's my
39:19part he was always my best friend i got married to somebody else and then got divorced and went back
39:24now within 11 years now oh okay well he does his we're the best friend we knew each other's families
39:32we grew up in harping so we knew each other you know it works it works he has somebody to talk to i
39:40have somebody to talk to good we all do our own thing yeah yeah i mean they keep you all going
39:45i mustn't complain i'm a bit just of a neurotic but this makes me feel better well i'll tell you
39:51what let's do the test and see but then we'll discuss the result when it comes and then we can
39:54make a plan right i'm going to give you the little sample pot let me get it from the girls at the front
39:59then we can get it sorted out it's all day another uh fit test please bring it back anytime thank you
40:05enjoy take care all the best bye bye how are you well i'm all right i mean because i'm asked to come
40:12not because i want to come but you feel okay yeah yeah i get on with it yeah you know that i knew
40:22that that's why i like seeing you because you know me so your sugar's okay your liver
40:28is still yes it's still there but a strong's good is it good yeah what is it yours is 4.4 wonderful
40:45there you go i spend my life telling people to take statins and it's great when it works well i've
40:54been taken for so many years it's unbelievable i started you on them because i'm on the same ones
41:00that's first of them yeah but you feel okay you don't have achy joints oh i do have achy joints but
41:07then who doesn't i'm 80 years old what do you expect i mean even the bones here hurt my collar bones
41:15hurt but you know tell me about the bones and aches and pains and things tell me about them for instance
41:24we went to the coast and what should have been an hour and a half journey because half the motor
41:30closed did a detail took us three hours so you know i've got that back i've always had so when you get
41:37out of the car oh no in the car in the car while you're going and my hips were hurting yeah yeah okay
41:44wait to get out the car so i mean i'm used to back hurts you know it's all the time yeah yeah it's
41:51part of me it's always the left knee yeah yeah yeah yeah and usually the right hip but i say the other
42:00day it was both hips but then yeah hey yeah something's got to kill me well your joints are not
42:09going to kill you but we want to make we want to make it as joyful experiences going to the coast as
42:15possible i don't really want you in pain blood pressure is a wee bit high as well that's not
42:22because i'll be sitting out there and you're late and i'm always early i'm not happy to just leave that
42:30blood pressure as well what's it now that every day so i would like to check your blood pressure
42:42again are you going your way or you're here now i'm here yeah i'm here what i'm going to do is book
42:49you in in two weeks time with me and sam if she's around yes just do a couple more blood tests
42:56all right check your blood pressure yeah we just send it to the phone and off yeah okay i'll send it
43:03nice to see you anyway and you yeah it's not like coming to the doctors is it when i come to see you
43:10just to see him chat yeah take care yeah all right take care cheers
43:17thank you very much
43:17thank you i'll see you next week thank you
43:47so
44:07so
44:08You've had a few of those falls recently, haven't you?
44:28Oh, I've had five of them.
44:30It always happens where you can't get up because there's nothing to hold on to.
44:34Oh, gosh.
44:34From your perspective, would you think I have ADHD?
44:38It's a spectrum, isn't it?
44:39We're probably all on one part of the spectrum.
44:42He just woke up one morning and wasn't all there.
44:46We're all on one part of the spectrum.
44:47We're all on one part of the spectrum.
44:49We're all on one part of the spectrum.
44:51We're all on one part of the spectrum.
44:57We're all on one part of the spectrum.
44:58It would be a bright energy, which is the same, not all time for you.
45:01We're all on one part of the spectrum.
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