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00:00Morning surgery. I ended up in A&E on Saturday with the peens. I could barely like even talk.
00:13You've had a few of those falls recently, haven't you?
00:15Oh, I've had five of them. It always happens when you can't get up because there's nothing
00:20to hold on to. Oh, gosh. From your like perspective, would you think I have ADHD?
00:27You know, it's a spectrum, isn't it? We're probably all on one part of the spectrum.
00:35She was so determined to see her first grandchild.
00:40Well, she certainly was looking to make the most of whatever time she had.
00:46He just woke up one morning and wasn't all there.
00:57Hello. How are you? Come on, James. Thank you.
01:15Hello, how are you? Come on to you. Thank you. How are you? Uh, sick. Sick? Oh dear. Right, come and have a seat. Do you want to tell me what's happened?
01:32I had this pretty much when I came in and I had it for five days. Okay, because of a sore throat and... Yeah, just aching all over. Okay.
01:40It's a hot temperature. I'm feeling just generally rough. Horrible. Yep. Started the antibiotics on a Friday. By Saturday, I could feel it coming down. Okay.
01:49Saturday night, Sunday, it's like shingles came out. So I had various different spots. A few on my face, about six, seven, even so on my stomach and a few on my legs. Okay.
02:00Really itchy. Sort of blistery spots? Yes. And did they all then scab over sort of thing?
02:06Well, then Monday, I woke up and I felt a tingle in my throat again. Mm-hmm.
02:11And it's just started and I thought, oh, God, not another sore throat, but it's just gone back to what I had previously.
02:16You're back to square one again. And now it's... And you took the antibiotics for... A week. A week.
02:20I'm interested in the spots because it's interesting. You felt grotty and you had all of this.
02:25It's just there aren't very many things that cause blisters to sort of pop up at various places all over the body.
02:30Yeah. And you mentioned shingles that it could be and the shingles is only in one place.
02:35Right. So it's in one strip or one part of your arm or just one side of the face. It's never both sides.
02:41But the virus, the sort of the bug that causes shingles is chickenpox virus.
02:45Yes. Yes.
02:46And do you not think this was chickenpox? I mean, you said you've got children.
02:49Have you seen chickenpox in the kids recently?
02:51The kids had chickenpox both about two years ago. Okay.
02:54I had chickenpox as a kid.
02:55You did or you didn't? I did.
02:56You did? Yeah.
02:57Okay. Did this look anything like chickenpox? Yeah.
03:00So I wonder if it was, I mean, sometimes you can get chickenpox again, but it's just, it's one of the few rashes that causes blisters.
03:06And they come up both sides of the body and it can make you feel awful, especially as an adult.
03:10Yeah.
03:10But then you've stopped the antibiotics and your throat's come back.
03:13Yes.
03:14Yeah.
03:14My throat has really swelled up again.
03:16I can't eat.
03:18At the moment I'm taking Coca-Cola, more Paracetamol, Iproprofen.
03:22And is there anything else going on at the moment or mostly just the throat?
03:25Yeah, well, just, yeah, just the throat.
03:27I mean, I ache a musket.
03:29I feel really sort of tender.
03:30Any temperatures and fevers like today?
03:33I'm 38 when I just left the house.
03:35Horrible.
03:36So it's definitely come back, hasn't it, with a vengeance.
03:38It's just strange.
03:39Horrible.
03:39Right, let's have a look.
03:40Oh, yes, it's in it.
03:41Right, let's have a look first of all in the back of the throat.
03:43If you don't mind opening really wide and say, ah.
03:46Ah.
03:47Ah.
03:48Ah.
03:48There is quite a lot of white stuff all over your tonsils, sweetheart.
03:54Can I just feel your neck?
03:56I mean, this is swollen, isn't it?
03:58Yes.
03:58I mean, I don't know what your neck normally looks like, but it looks quite puffy.
04:01It's all very puffy.
04:02Is that very tender?
04:03Yes.
04:04I think there's a couple of things we could do, Dominic.
04:05One thing I'm wondering is, can I take a swab?
04:08We need to know what the germ is, because at the moment when we see common things,
04:11we throw the commonest antibiotics at it, but sometimes if it doesn't work, is it the
04:15right antibiotic, and were we on it for long enough is the other question.
04:19So, if you don't mind just opening wide, I'm just going to tickle back of the throat.
04:23Okay, well done.
04:24One.
04:25And the other side, I'm just going to do that side.
04:27Sorry.
04:28Perfect.
04:29So, the lab will tell me what it is and what's the best antibiotic to get rid of it.
04:33I mean, last week with the antibiotics, it was insane.
04:36The next day, I started to feel better.
04:38Annoyingly, I think it's just broken back through, hasn't it?
04:41I mean, it's a raging tonsillitis is what you've got.
04:44Yeah.
04:44We need 10 days of antibiotics.
04:46Okay, let's get rid of it, sweetheart.
04:48Let's get rid of it.
04:48The surgery will contact you as soon as this comes back, if there's anything we need to do.
04:52Yeah, fantastic.
04:53Are you taking some time off work?
04:55Not causing me too much stress.
04:57I mean, I think with a fever, you should...
04:58I'm a three-year-old and a four-year-old, it's much more stressful than work.
05:01They're probably the reason you got this in the first place, isn't they?
05:04They bring everything home, don't they?
05:06All right, take care, Dominic.
05:07Bye-bye.
05:09Bye, come on through.
05:11How are you?
05:11Hi, good, thanks.
05:12Have a seat.
05:14Congratulations, I haven't met Artie yet.
05:16He looks really well.
05:17What can I do for you today?
05:19So, Artie is four months corrected now because he was six weeks premature.
05:24So he's four weeks corrected, five and a half months actual, something like that.
05:28And developmentally, no concerns with him.
05:32Fixing and following really well.
05:33I don't think he's got any issues with his actual vision because, you know, he plays with
05:38his toys, he grabs his toys, he smiles at us, etc.
05:41But what I have noticed is that when you're looking at him normally, his eyes are fine.
05:45Yeah.
05:46But when he is playing with his toys and anything that's up close to his face, he goes really
05:51quite cross-eyed and has a squint, which I know in newborns isn't a concern.
05:57Yeah.
05:57But I did read that if that's still happening quite consistently after four months, it might
06:03be, is it strabismus or could be?
06:05Yeah.
06:05So sometimes we do get ophthalmology to have a little look.
06:09Yeah.
06:09Strabismus is an eye condition commonly known as a squint.
06:12An intermittent squint is normal in newborns and this is as the brain learns to coordinate
06:17the eyes.
06:18We do expect, though, that squints resolve around three to six months of age.
06:21If a squint persists, we want to get ophthalmology to assess it to see if it's either an underlying
06:26condition or something called amblyopia, which is basically a lazy eye and does require treatment.
06:31But I, yeah, I don't know if I'm being too premature with this and actually he's only
06:35four months so there could still be time.
06:37Yeah.
06:38It's only when he's playing with it.
06:41Like, when you look at him normally, it's not there.
06:44If he plays with things like here, like when he's playing midline and then he brings things
06:49to his mouth, for example.
06:50What's this, mister?
06:53Can you see a little bit there?
06:54Yeah, very slight.
06:56But sometimes it's a lot more noticeable.
06:59Do they ever go in opposite directions?
07:00Not that I think I've seen.
07:02Okay.
07:02Like, can you see a little bit?
07:04Yeah, it's just the left one does move further in.
07:07Yeah, that's it.
07:09And the left even more so.
07:10Yeah, so there, that's it.
07:12Yeah.
07:12Yeah.
07:12So they will both go in, obviously, you know, if I did it to you and we, all the finger
07:16to your nose, your eyes would go in.
07:19Yeah.
07:19But yeah, the left definitely does it more than the right.
07:23But I think it might be worth us just asking ophthalmology to have a look.
07:27Yeah.
07:27Because I feel like he's had so many things.
07:30I know.
07:30Otherwise.
07:31Yeah.
07:31And we don't want to completely ignore it.
07:33You know, yes, it can be normal to begin with, but normally we expect squints to improve
07:37a bit.
07:38Yeah.
07:38And I think realistically, it's not going to be a big deal.
07:41Okay.
07:42Amazing.
07:42A referral would be really helpful.
07:43Yeah.
07:44So I'll get that done.
07:45Okay then, mister.
07:47But nice to see you.
07:47And I'll do the ophthalmology referral.
07:51Right.
07:51Come on then, mister.
07:53Let's go.
07:54Thank you so much.
07:55Not at all.
07:56You should hear from them.
07:57If you don't hear anything in the next three or four weeks, let us know.
07:59Okay.
07:59Will do.
07:59All right.
08:00Take care.
08:01Bye.
08:01Bye.
08:01Bye.
08:05Just in case you get more, just in case you get thirsty.
08:07I'm not drinking that.
08:08It's from yesterday.
08:09You've got fur in a bin?
08:10Yeah.
08:11Well, I'll water the plant for it.
08:14Such a waste of water.
08:16What are you doing?
08:17What?
08:17Do you need to tap, do you need to tap?
08:19I'm just having a slow day.
08:21I've been having a slow day for like a month now.
08:24It needs more plant food.
08:25I don't have...
08:26That's what it needs.
08:29What do you think I just sit here with plant food?
08:34It...
08:34How can I help today?
08:41Do you want to tell doctors?
08:43Can I tell the doctor?
08:44I think you better, because I can't remember what it is.
08:47At the beginning of the year, Colin started getting forgetful.
08:51But it sort of deteriorated very fast.
08:54We were put in touch with the memory clinic, and an assessor came round, and he thinks it's not the normal sort of dementia.
09:05He thinks he may have had some mini-strokes.
09:08Ah, OK.
09:09That would have caused it.
09:10And he was going to book an MRI, but I think these days MRIs are very difficult things.
09:17And then he discharged him.
09:19Hmm.
09:20So since then, we're just...
09:22A bit in limbo.
09:23We don't really know what's going on.
09:24Yeah, exactly.
09:25Oh, no.
09:25That's not good.
09:26And how has your memory been since then?
09:29I don't think I've used it.
09:32Ah, fair enough.
09:33Have you noticed that there's been a decline since that assessment?
09:35Um, it's not too bad some days, and other days are not as good.
09:42And it's the funny thing, it's a very, very short memory.
09:46Hmm.
09:47You can ask me a few times a day, you know, how old am I?
09:50And then I say, what, that old?
09:53Do you not feel, do you not feel 89?
09:56Me?
09:57Yeah.
09:58No, not at all.
10:00How old do you feel?
10:02I feel younger than 89.
10:03Yeah, good.
10:05How's your mood?
10:08Good.
10:08Good spirits?
10:09Yeah.
10:09Is it OK most of the time?
10:11Yes.
10:11Yeah.
10:12And are you sleeping well?
10:13Yes.
10:14Yeah.
10:14Some nights, some nights, yes.
10:16Better than others.
10:17Not as good.
10:18Ah.
10:19Yeah.
10:19Any questions?
10:38Any questions, Annabelle?
10:39My wife has always had a question.
10:41Not too personal.
10:43Everyone over the age of 50 now should have it done.
10:47OK.
10:48Because you're getting old.
10:49Not as old as you.
10:51My little action man.
10:52Any questions before we go?
10:54My wife kills me if I don't ask the right questions.
10:56That is good.
10:57Absolutely.
10:57She keeps you right.
10:58You going shopping?
11:00Oh, do you want anything we're going to shop?
11:02Come on, Annabelle.
11:04Love you.
11:04Any changes in behaviour or personality, nothing like that?
11:14No.
11:14Good.
11:15It's the same naughty.
11:17Same old you.
11:18Yeah.
11:19Good.
11:19Excellent.
11:20Really good.
11:21So, yeah, I think we need to get that ball rolling again for you because it would be good
11:24to get some investigations and see what we can do.
11:27Is there any point in taking a scan to see what's happening in there?
11:31Any lesions or...?
11:32A hundred percent, yeah.
11:33I think there is, yeah.
11:34We can definitely do that.
11:35Now, as GPs, we're very limited.
11:37They only let us do so many things.
11:39But the good news is, for MRI scans of the brain, if we're querying dementia, they do actually
11:46allow us to request those scans.
11:48And the reason I asked about the personality change is because in frontotemporal dementia,
11:52people often who are normally very placid and nice can become very, very violent and
11:57really change in their behaviour.
11:58So, again, I'm not hearing that.
12:00So, if anything, it might very well be a vascular type of dementia because of the damage to the
12:05blood vessels over the years and stuff.
12:07The scans will be really good.
12:09That will sort of tell us one way or another.
12:11And then we can put steps in place to help and to help sort of slow down that progression
12:15potentially.
12:15There are medications available.
12:18What sort of help do you feel you need at the moment?
12:20Do you feel like you need carers to come and help or someone to come in and make sure it's
12:25safe for you at home?
12:26You know, put grab rails if you need them.
12:28I would like a grab rail in the bathroom by the bath, yes.
12:31Let's do that.
12:31We can refer you then to adult social care.
12:33Not a problem at all.
12:34Okay, lovely.
12:36My pleasure.
12:37Thanks for coming in and sharing all this with us because I know it's a really difficult
12:41thing to talk about.
12:42Don't think blah, blah into you.
12:44It's true.
12:44It's just so funny.
12:45He just woke up one morning and it wasn't all there.
12:50Yeah, absolutely.
12:51Leave it with me.
12:52I'll be in touch and I'll do all the referrals and stuff for you.
12:56Any problems, just come back.
12:57Don't hesitate.
13:00I'm going to take care.
13:06I want to show you this.
13:08Look, do you think this will look good on me for my birthday?
13:14Oh, hello.
13:16Yeah, that's lovely.
13:19I want to show you.
13:21This is a dress I might wear for my birthday.
13:25Where are you going again?
13:26For brunch.
13:27You're going to wear that to brunch?
13:29What club after?
13:30Brunch is at lunchtime, you know.
13:32Well, not really a brunch.
13:32It's like a resort to restaurants eat.
13:34Not brunch.
13:35Yeah, an evening.
13:36It's not brunch.
13:37Fine.
13:37Okay, that's nice.
13:39I look forward to the pictures.
13:40Hello.
13:40So come on in and take a seat.
13:44Thank you very much.
13:44My name is Anna McHugh.
13:45It's very nice to meet you.
13:47So tell me, Craig, what's been going on for you?
13:49I've got a rash that's been under my arm for ages.
13:53So how long has it been going on for?
13:55Probably had it eight months, nine months.
13:58It doesn't itch.
13:59It's sort of blotchy.
14:01I've heard it a few times.
14:03They thought it might be stress-related because my previous job, I was a bit stressed.
14:07But now I've moved happier job, happier setup, but obviously still got the remnants.
14:12Okay.
14:12GPs, they gave me cream.
14:14Cream did nothing.
14:15What brings it on?
14:16Is there anything?
14:17I have no idea.
14:18Do you find that it's hot weather?
14:20No.
14:21It doesn't seem to be related to a deodorant or anything, to be honest.
14:25Okay.
14:25Will we have a little look?
14:26That's absolutely fine.
14:28So you've tried a few antifungal creams.
14:31Yes.
14:31And I found a lot of them actually.
14:33Sorry.
14:34Oh, yeah.
14:34And have you been in the sun or anything like that?
14:38I haven't, to be honest.
14:39I actually haven't done much in the sun.
14:41It looks like something called Petraeus's Versicolor.
14:44Oh, okay.
14:45So it is fungal.
14:46Yes.
14:46And I'm going to give you, it's actually a shampoo.
14:48I've got one or two spots that have started on the side, but I never used to have on the side,
14:52so I thought I'd rather get it sorted.
14:54Yeah, absolutely.
14:55I'll give you a, it's actually a shampoo that you use.
14:59Oh, okay.
14:59And you leave it on for five minutes and then wash it off.
15:01And I think because it's been going on for nearly eight months now, you know, we can try this.
15:07And if you find that it isn't fully resolved, just come back and see us.
15:12So where is the best place to send the antifungal treatment?
15:15Possibly to Boots, if possible, yes.
15:17I'll send them there.
15:18That's perfect.
15:18And just come back and see us if anything's getting worse or not improving.
15:22Perfect.
15:22No, thank you very much.
15:23I do appreciate it.
15:24All good.
15:27Jane.
15:30How was the holiday?
15:33Beautiful.
15:33The holiday was marvellous.
15:35Almost reached the end of it without any injuries.
15:38I think next time you go away, I'm going to pack bubble wrap so you can wrap over your legs.
15:45I can show you where it happened.
15:47That was the plane we were getting onto, and you can see that lady is stepping up that big step.
15:52Is that where you bashed it?
15:54It does look like a bit of a lethal step, in all fairness.
15:57Luckily, my daughter was with me and able to salvage the awful mess.
16:03It's always a mess and blood pouring down.
16:06Are you okay putting your leg up?
16:08Yep, that's fine.
16:10Okay, let's see the damage.
16:12They've layered it up here.
16:14Oh, you've had a nasty laceration.
16:17Sorry.
16:18Oh, dear.
16:19What a mess.
16:20My legs are never a thing of beauty.
16:23It doesn't look like there's any infection there.
16:26So the steristrips, we are leaving on.
16:30Right.
16:30Because if I take them off, it'll burst apart.
16:34Exactly that.
16:35So we can keep them on because they're keeping this dead skin in place.
16:41We're trying to sort of move the skin up.
16:43Yeah, you can see where you've pushed it up.
16:45So you've done it that way, haven't you?
16:48No.
16:48If you pull it down, you're going to pull that flap.
16:51So whoever dresses this from now on, you need to lift every dress in this way.
16:57Right.
16:57Yeah?
16:58Right.
16:58At least it was at the end of the holiday and not the beginning.
17:02If you start finding it sore and it's red and it's tracking, that's when you need the antibiotics.
17:08Try and keep this leg as dry as possible and try and book in GP.
17:14Surgery for about Wednesday.
17:15Yeah.
17:17Okay.
17:17But there's no signs of infection.
17:19It looks good.
17:20Oh, that's very reassuring.
17:22Your daughter's done a wonderful job.
17:25Well, keep her up to date.
17:26I need to be current treatment.
17:29Remember, the most important rule is lift up with that dressing.
17:33From the bottom.
17:34Yes.
17:34From the foot.
17:35Yep.
17:35Because you don't want to reopen that.
17:37No.
17:38Ooh, makes you go funny.
17:39Yeah, exactly.
17:41All done.
17:42Marvellous.
17:42Well, thank you very much indeed for seeing me today.
17:45Pleasure.
17:46Thanks very much.
17:47Take care.
17:48Thanks a lot.
17:50Yeah, but just let me know when you've done it.
17:55Her dress is really nice.
17:57Oh, Miss Honey's always got nice dresses, don't you?
18:00Love it.
18:01Katie.
18:02I said Miss Honey always got nice dresses.
18:04Miss Honey?
18:05Oh, yes.
18:06She resembled us Miss Honey.
18:08Are you Matilda?
18:10Are you Miss Trunchbull?
18:12Oh, my gosh.
18:13You are...
18:14I'm wanting surgery.
18:21Hello, Sophia.
18:21I'm Dr Pearson.
18:22Hello.
18:23Thanks for coming down.
18:24Come and have a seat.
18:25Now, how are you?
18:26I'm okay.
18:27So, you've come in to talk about this gynaecological problem that you've been having.
18:33Do you mind saying what are the symptoms and what you've been experiencing?
18:36Yeah, so I've just had, like, a lot of pain for over, like, a few years now.
18:40I was diagnosed with PCOS a couple of years ago.
18:43I had my bloods tested, and there was quite a lot of imbalances, apparently, according
18:48to them.
18:49But over the past six months or so, I've been having extra symptoms, so kind of extra pains,
18:56but specifically in, like, the left ovary kind of region.
18:59I kind of ignored it initially, because I thought it could be a cyst or something like
19:03that.
19:04But over time, it just progressively got worse and worse and worse.
19:07And I ended up in A&E on Saturday with the pain.
19:12And I kind of have pain between my periods, and I had a really heavy period and a really
19:17long period last time.
19:19It was, like, ten days, which, again, is quite long.
19:22That is long.
19:23That's miserable.
19:23The next one starts again, but actually, that's miserable, isn't it?
19:26So, heavy periods, long periods, you've got to do, and this pain that's all over.
19:31And your bowels, any change in your bowel habit at all?
19:33I have noticed a little bit of a change, yeah.
19:36So, like, when I'd have the pain or what I'd call the flare-ups, say, I would tend to want
19:41to go to the toilet all the time, so I kind of felt like that might be connected.
19:45Yeah.
19:45And your sort of general well-being in yourself?
19:48I feel exhausted all the time.
19:50Like, the energy level's just really high.
19:52How do you manage that, then?
19:53Are you able to cope?
19:53I mean, working and things?
19:54Are you working?
19:55I am working, yeah.
19:57Yeah, and it's kind of difficult for me to, like, stay energised and focused and motivated
20:01just because I'm also in pain all the time.
20:05It does cause quite a bit of issues.
20:06It sounds like it's interfering with a lot of your days in a month, is that?
20:10Yeah.
20:26I had a pain up here.
20:28Oh, okay.
20:29I ate some meat.
20:30My son cut it up into long pieces, and I think I ate that, and it was quite painful up
20:35here.
20:35It's terribly painful.
20:37It does look a bit swollen.
20:38It does a very swollen, yeah.
20:40Yeah, it's absolutely agony.
20:43Last night, it's...
20:44Causing a lot of pain.
20:45Yeah.
20:46Any pain doing that?
20:47Yeah.
20:47That's a bit sore.
20:48Yeah, okay.
20:50Every now and again, when I move my arm, I get sharp pains come down my arm to my elbow.
20:54Ongoing infection there.
20:56You can see it.
20:57Oh, bless you.
20:58Poor thing.
20:58I guess a pain's shooting here and here.
21:00Yeah.
21:01It was hurting like hell.
21:08Now, how do you feel now with that pain?
21:11It's not obviously as bad now as it was on Saturday, because on Saturday I could barely
21:15like even talk.
21:16And is there anything you're worried about that this could be?
21:18The one thing that it sounded a lot like was endometriosis.
21:22I mean, that's what I'm thinking as well along the same lines.
21:24I think it does sound like it could be you've got so many symptoms, don't you, of that?
21:28Yeah.
21:29I suppose one thing that we need to be careful of is that there isn't a cyst or something,
21:32because when you have polycystic ovaries, sometimes one cyst does grow, and then that
21:35in itself can spit out some hormones and make you feel horrible and everything else.
21:38So we ought to do an ultrasound scan to make sure there isn't anything new acutely
21:42that's happened, that there isn't a sort of four centimetre cyst sitting there
21:44or something, but of course the way sometimes to really diagnose endometriosis is partly
21:49through the history, and sometimes then we go to the gynecologist, they can look into
21:53the pelvis and have a look at where the womb lining that should be staying in the womb
21:58and only bleeding in the womb, but endometriosis, as you know, probably is the womb lining
22:01spilling out to other parts of the pelvis.
22:03So when you're on your period and it's bleeding and it's responding to all the hormones, so is
22:07the cells on your rectum that's making you feel like you need to poo all the time, or
22:10on your bladder, or on your ligaments that pull so you've got the side left or right
22:14sided pain, so it could well fit with this picture.
22:18Did you read anything about the treatment for endometriosis?
22:20I think a lot of people I know who are on it are on birth control to kind of maintain
22:24and manage it.
22:25I've been on a couple bits of birth control that hadn't really responded well.
22:30I mean, I'd be open to trying again to see, but obviously it's not like the preferable route.
22:36I think let's do the test perhaps and find out what's going on, and then that is an option,
22:39but there are other things, and sometimes the gynecologist can do the sort of camera in,
22:44and they can literally treat the little bits.
22:46They can zap the cells that are in there.
22:47If they see a little patch of endometriosis, they can sort of burn it.
22:50It sounds horrible, but they get rid of it.
22:52It isn't necessarily a long, long, long-term fix, but it does help for a bit.
22:57Have you ever tried any of the sort of, there's slightly more specific painkillers that sometimes
23:01we use around period.
23:03People take naproxen.
23:04I don't know if you've ever tried that.
23:06I've not tried naproxen.
23:07They're anti-inflammatories, and actually they sort of help with the condition.
23:11Now, they're not treating endometriosis.
23:12They're not going to stop it coming if you feel a little bit less pain and things.
23:16It's not going to solve it, but I think it might help a little bit.
23:18If I send it through, it'll explain it all on there.
23:21Just take it with some food when you next have your period or period pains,
23:23and let's see if this helps a bit, and I'll get a scan and the referral and things all sorted out from here.
23:28Yeah, thank you.
23:29All right, well, nice to see you.
23:30Good luck with things, Richard, and then let's speak when we get all the results.
23:33Yes, thank you so much.
23:33All right, all the best.
23:34Bye-bye.
23:35Bye-bye.
23:38Hello.
23:39Hi, come on in.
23:42Have a seat.
23:43I'm Dr. Dudgeon.
23:44We've met before.
23:45Yes.
23:46Yeah.
23:46The reason I've come now, you know, my right eye has gone sort of smaller.
23:51Okay.
23:51And some friend of mine said, you know, you better have it checked.
23:55You never know.
23:56Is this a normal old age, or is there something odd?
24:00It sort of feels as if it's drooping, and I can feel it sometimes almost sort of...
24:06On the eyelid.
24:07Yeah, closing.
24:08And how's your vision?
24:09Well, I need glasses, but I don't think it has affected that.
24:14When did you last have an eye test?
24:15Can you remember?
24:16Yes, last June, July, so I'm due for one again soon, or August, yeah.
24:22Okay, and when you last went for an eye test, was it a problem then, or would you say it's...
24:25No, no, they didn't even say anything, but I know now looking back even at photographs,
24:31you know, it's sort of, you know, but is it anything to worry about?
24:35We'll have a look if that's okay, and then we'll talk about it.
24:37Yeah.
24:38Just look straight at me.
24:39Oh, at you.
24:42And no dry eyes, nothing like that.
24:45They feel okay otherwise.
24:46Well, at one period, it was, you know, sort of bothering me, a bit of spurning, but actually
24:53both eyes.
24:54I think it was pollution, because I went to the boots chemist, and they gave me some drops,
24:59and it was okay.
25:00Then it settled.
25:00Yeah, so...
25:01Okay.
25:01I just want you to follow my finger.
25:09Good.
25:10And can you screw your eyes up really tight?
25:12Perfect.
25:13Don't...
25:13And then just keep them shut for a minute.
25:15I'm going to try and open them.
25:17So if you screw them up really tight...
25:21That's fine.
25:22Okay.
25:22And puff your cheeks out.
25:24Good.
25:25And can you lift your eyebrows up?
25:29That's fine.
25:30And you can feel me touching your face?
25:31Yes.
25:31That feels the same on both sides.
25:33Yeah.
25:33Okay.
25:34So it does look like you've got...
25:36We call it ptosis.
25:37It's just when the eyelid droops a little bit.
25:39Oh.
25:40And you can see on the right, it's kind of drooped further than on the left.
25:45Yeah.
25:45And it is covering a bit of your pupil.
25:47Would you say it affects your vision?
25:49No.
25:50I don't think it does.
25:52No.
25:53So the reason I'm making you smile and puff your cheeks out and raise your eyebrows
25:56is I'm just testing the rest of the muscles on your face.
25:59Yeah.
25:59But they all look fine.
26:00Okay.
26:00So you can lift your eyebrows up equally.
26:02When you smile, your cheeks both puff out.
26:04So that's good.
26:05Okay.
26:05So I think it is just the eye that's affected.
26:08I think you should go for the eye test just so that the optician can have a look at your
26:13eye, have a look at the back of your eye.
26:15We will ask ophthalmology to have a little look at you.
26:17What we don't want to do is it to start to affect your vision.
26:21It's nothing serious anyway.
26:23I don't think so because it's just that one that's affected.
26:27Okay.
26:27All right.
26:28Thank you very much.
26:29Okay.
26:30Bye.
26:30Nice to see you.
26:35I'm going to take a picture of our feet.
26:40Should I post it on my story?
26:42Look how cringy we are.
26:43We're both wearing the same shoes today because I never wear dunks.
26:47We would never be foot models.
26:49Do you know that?
26:50Come.
26:52Ready?
26:53Ready?
26:53One, two, three.
26:55It's really.
26:57Well, we could be feet models because our feet are quite cute actually but not with shoes on.
27:02It's not looking good, bro.
27:05Alexander, please.
27:07Hey there.
27:10Okay, I'm doing it.
27:10I have a student with me.
27:11Is that okay?
27:12That's absolutely fine.
27:13Lovely.
27:13I'm George, one of the doctors.
27:14Good to meet you.
27:14Very nice to meet you, George.
27:16How can I help today?
27:18I mean, I came in a few weeks ago because I had a radial head replacement.
27:23Yes, I was told to sort of come in if any of the screws were looking like they were going
27:28to come through.
27:29Yeah, yeah, yeah.
27:30Apparently, I'm a little bit skinnier than most patients because they said that if these
27:34come through and there's an open fracture, then they have to repeat the whole surgery
27:39all over again and take out the elbow and it would be a nightmare.
27:42Oh, no.
27:43But I was just wondering if you could recommend anything basically.
27:46Is it causing any problems at all?
27:47Not really.
27:48I mean, it's like the pain is way better than it was.
27:51Obviously, because I've gone through a month, the pain's been so intense.
27:54I just really don't want to have to repeat that again.
27:57Yeah, of course.
27:57And what's the range of motion like?
27:59Yeah, it's really, really good.
28:01I was told if you get 50% range of motion after this surgery, you're doing well.
28:06So I was pretty happy with that.
28:08Okay, brilliant.
28:09And how did you do this again?
28:11Like the most innocuous way, I was playing paddle.
28:14I think it was like basically I jumped up and as I fell, I think I dislocated it and then
28:20broke my humerus bone.
28:22But then because of that, my body fell on my arm and it broke all of this.
28:27Poor thing.
28:28That's horrendous.
28:29Yeah, it was pretty intense.
28:30I'd never broken a bone before.
28:31How about that?
28:32Oh, gosh, I know you've got all this.
28:32But I broke every bone in my arm.
28:35Is that painful if I press?
28:36A little bit.
28:37It's okay.
28:38I'm very used to it by now.
28:40So I think like the screws back on the other side, I think are okay.
28:43Yeah, I agree.
28:44But I think it's just this one here that like I'm a little worried that it's going to come
28:50through and then I'll be...
28:51I agree.
28:52Any sort of pain shooting down the arm at all?
28:55Yes, I think.
28:56So a bit of bone chipped off during the surgery and then nestled in between my nerves.
29:01So I get a bit of shooting pain down my arm.
29:03Yeah.
29:04But I think they're going to remove that in the next surgery.
29:06I think what we should do, maybe...
29:08I'm wondering if we should get an x-ray for you just to see how things are...
29:12Yeah, yeah, yeah, sure.
29:13So that when you see them, they'll sort of have that.
29:15And yeah, I think we just write to orthopedics again and just say, look, this is starting to
29:19come through a little bit.
29:20Sorry.
29:21Cool.
29:21No, no, that's totally fine.
29:22That's fine.
29:24More insanely than I can possibly imagine.
29:27Oh, bless you.
29:28It's horrendous.
29:28They do say breaking of bones is horrendous.
29:30It's so painful.
29:31I think it's because the elbow, because all the nerves are there.
29:33But I think like...
29:34Because you normally associate pain with being like a 0 to a 10, I thought I'd reached like
29:39a 7 before this.
29:40But I think I'd only reached like a 4.
29:42Oh, gosh.
29:43Good luck.
29:44Love so much more.
29:45I'm all done.
29:46All right.
29:46Thank you so much.
29:47All right.
29:48Thank you so much.
29:48All the very best.
29:49Really appreciate it.
29:49Take care.
29:50Take care.
29:50Cheers.
29:50Take care.
29:56How can I help?
29:58I don't know how to start.
29:59Do you?
30:00Well, my mom told me that I should come in for an appointment to talk about if I have
30:05any mental health issues or ADHD.
30:09Why do you think she's suggested that?
30:10Well, like, since I was like young, I've always like struggled with like, I don't know, like
30:16example, for subjects that I really enjoy, like maths, where to me it requires like less
30:21thinking.
30:22I was always like able to like study for it.
30:26But subjects like English and like history and all those subjects, when it involves writing,
30:31it's so much more difficult.
30:33Yeah.
30:33Have you ever had that assessed at school?
30:36You're writing now?
30:37Because it sounds like you're really good at numbers and it's the writing bit that you're
30:41having a problem with.
30:42Do you think that's how it feels?
30:44That's how it feels a lot.
30:45Tell me more about why you think it's a mental health issue rather than sort of, you know,
30:52concentrating or problem with letters and numbers.
30:57If I would be in like a conversation with someone, I'll be talking to them and then I'll
31:02just stop hearing what they say.
31:03Like, like my mind will be onto something else all the time and then obviously the person
31:08will find it rude and I would just be like, I'm very sorry.
31:11I didn't mean to.
31:12Yeah.
31:13Over the last like two, three months, I've been working now as a barista.
31:17Yeah.
31:17So like, I'll be making the coffee and they would talk to me and then I would begin
31:22like the conversation when they speak to me, I would hear it and then for every reason
31:26I would either forget or I just wouldn't hear it.
31:29Yeah.
31:30Even my manager went up to me and they were like, I feel like you should really work time
31:33skills.
31:33Yeah.
31:33And I was like, yeah, I'm sorry.
31:35I'm trying the best as I can.
31:37And your mood, do you get tearful on your own?
31:40You know, do you ever get really sad?
31:43Is that, do you ever get like that?
31:44When I'm alone and I just like me and my thoughts, I feel like I'm constantly overthinking.
31:50Have you ever felt low that you wanted to harm yourself or anything like that?
31:54Have you?
31:55I wouldn't say harm myself, but there'll be times where I'll be like, I might just be in
31:59bed for like hours and hours of a day, even though I have stuff to do.
32:03And I'll just not want to do anything.
32:05I'll just want to be like, stay in my room and do nothing.
32:08Yeah.
32:10It's quite an impressive brace, isn't it just?
32:26It's like another trouser leg, isn't it?
32:28I mean, goodness me.
32:29My poor knee.
32:30I don't normally wear this.
32:32It's just if I'm on the...
32:33Good going bursitis, haven't you?
32:35Well...
32:35That's huge.
32:36Now, this knee sounds like there's crinkle paper in it.
32:39Every time I try to get up.
32:41You can see the difference.
32:43Yes, definitely.
32:44In the knees.
32:44It's very arthritic.
32:45But it'd be okay to have a little feel of that.
32:46Yeah, I'd love you to.
32:48I started to get a pain in my knee here.
32:50And then over the weekend, it blew up.
32:53I'm still getting in trouble with my knee.
32:55It just goes, you know.
32:57I wish it would go to Cyprus with me attached to it, but no.
33:00Anyway.
33:00Okay, Doris.
33:07Come through.
33:08We're ready.
33:11I have a student with me.
33:12Do you mind if you sit in?
33:13I knew you had because I saw the feet.
33:15Oh, very good.
33:16Lovely to see you.
33:17It's lovely to see you because it's good days and bad.
33:22And I've got soaking wet, as you can see.
33:25It's horrible out there.
33:26How are you?
33:26Are you all right?
33:27Good.
33:28I have an ear.
33:30I've got two.
33:30Two, I hope.
33:31But one of them's been playing me up for a little while.
33:34And I've also got, I think, porosis of the knee.
33:38That knee is killing me.
33:39Oh, dear.
33:39But there you are.
33:40That's right.
33:41And how long has the ear been bothering you for?
33:43Well, it's crusty.
33:45Yeah.
33:46It's the only way I can describe it.
33:48It doesn't hurt, but it itches.
33:50It drives me mad.
33:51Yeah, fair enough.
33:52Any discharge from it?
33:53Anything coming out of it?
33:54Not really.
33:55That comes with, if I do scratch it, and as I've got long nails, I can...
34:02Hopefully you're not doing too much damage when you're doing that, I hope.
34:04I hope not.
34:05Fair enough.
34:06But, I mean, it seems such a silly thing.
34:08No, not at all.
34:08But it's going on and on and on.
34:11It's not silly at all.
34:11I'm glad you came in.
34:13Any dizziness, rotational vertigo type of symptoms?
34:16Not at the moment.
34:17Good.
34:18I think that's coming.
34:19Well, I mean, hopefully not.
34:20I hope not.
34:22I will fall.
34:23I don't know why.
34:24I know you've had a few of those falls recently, haven't you?
34:26Oh, I've had five of them.
34:27Oh, dear.
34:28The point is, with a fall, it always happens where you can't get up because there's nothing
34:33to hold on to.
34:34Oh, gosh.
34:35Even at home, if you know, I mean, I'm not near a chair or anything.
34:39So, I have to, you know, sashay along.
34:44So, if somebody doesn't come and help you up, I think you'll be there till nine o'clock
34:48at night.
34:49And do you have everything you need at home, like walking aids?
34:51Oh, yeah.
34:52I've got all of them.
34:53Have you seen the guys at the falls clinic, the specialists?
34:56Have you seen them?
34:57No.
34:58No.
34:58Are you happy to go and see them?
35:00Oh, yeah.
35:00Yeah.
35:01Can I look in your ears?
35:02You can.
35:03Can I look in your good one first, just to see what normal's like for you?
35:09Perfect.
35:10Textbook ears.
35:11I love it.
35:11Amazing.
35:12Really?
35:13Pristine.
35:14Oh, well done.
35:16Well done you.
35:17I've got something.
35:17Well done you.
35:18You've got loads going on, right?
35:21That's brilliant.
35:22Really good.
35:23Yeah, you can see the eardrums bulging out towards me ever so slightly.
35:27It's nothing to worry about.
35:28And the canal looks a bit inflamed and angry.
35:31So, yeah, I'm going to give you a little spray for it.
35:33It's just going to help calm down that inflammation.
35:35And then, what's going on with this knee?
35:38I feel it's osteoporosis.
35:40Osteoporosis or osteoarthritis?
35:42Oh, well, how would I know?
35:44Well, I suppose that's...
35:46Look at the size of it.
35:47It looks osteoarthritic to me.
35:49It looks like osteoarthritis.
35:50Yeah, but let's have a little closer look.
35:52Is that better than the other one?
35:53Yeah, infinitely.
35:53Is it?
35:54100%.
35:54Yeah, absolutely.
35:55Oh, thank you.
35:56I live on my own.
35:58Yeah.
35:58And I say, I'm walking around the flat saying to myself, why are you doing this to me?
36:03Are you managing okay at home?
36:05Yeah.
36:06Yeah.
36:07Do you need any help?
36:08It's more...
36:09I don't mind.
36:10I'm used to being on my own.
36:12Yeah.
36:12It's my son.
36:13Could you do something with my son?
36:15He's driving me mad.
36:17What have you got in mind?
36:18Oh, I love it.
36:23Oh, my pleasure.
36:24You've given me a good laugh there.
36:26Let's have a little.
36:28He's all right.
36:29Don't you understand me?
36:30He's not a bad...
36:31Yeah, no, of course not.
36:31I mean, if I didn't have him, I don't...
36:33Oh, now I can feel all that.
36:34Tender, isn't it?
36:35Yeah.
36:37He says the neighbours are complaining.
36:39My television's too loud.
36:41Now I can't either hear it.
36:42So what's the point of having a celly?
36:45With your hearing aids in, do you still need to turn the volume up quite high?
36:48No.
36:48No.
36:49Well, then that's fine.
36:50Put your hearing aids in and watch the telly.
36:51Not a problem at all.
36:53Yeah, well, I didn't put them in because of in case...
36:55Yeah, just have a look.
36:56Absolutely.
36:56No, it's looking good.
36:57I'll give you a spray for it, like I said.
36:58I think the knee, there's a bit of wear and tear there.
37:01And that's what's causing all the pain.
37:03If you want, we can use a bit of ibuprofen gel to rub into it.
37:06I think that'll really help.
37:07Yeah.
37:07And then we'll refer you to the Falls Clinic again.
37:09I'll chase it up for you because I don't think they've seen you, it looks like.
37:13Wonderful.
37:13And then we'll see how we go.
37:14Is that all right?
37:15Lovely.
37:16That's fine.
37:17Very helpful.
37:18Good.
37:20Take care of yourself.
37:21Have a lovely weekend.
37:22And my son as well.
37:22All the best.
37:23Lovely to see you again.
37:25Likewise.
37:26All the best.
37:26Have a lovely day.
37:27Bye now.
37:27I hope you're learning something.
37:29I hope so.
37:30Even if it's only from us.
37:31I hope so too.
37:33Thanks.
37:34Bye now.
37:38I can't believe it.
37:40He's not worried.
37:41I'm spending my life riding.
37:44You don't need to worry, do I?
37:45In one ear.
37:47Dr. Horch will sort you out.
37:48Don't worry.
37:49He will.
37:50He will.
37:50He's an expert.
37:51He's great, isn't he?
37:52He's lovely.
37:53I know.
37:53I know.
37:54In actual fact, I'm thinking of getting him cloned.
37:56I was just thinking I haven't seen you for ages.
37:59I know.
38:00I know.
38:00It's been busy.
38:01But you haven't changed a bit.
38:02Well, you're in good hands, you see.
38:03You don't need to see me anymore.
38:05But it's nice to see you.
38:06You're looking very well.
38:07Keep my fingers crossed.
38:09Good for you.
38:09Keep your fingers crossed.
38:10But it's nice to see you again.
38:12And you.
38:12Bye-bye, start.
38:13Bye-bye.
38:16You know, I've known you for a long time, actually.
38:19Since you're a baby.
38:20And it's great that you've come.
38:22And I think we can help you.
38:23I think some talking therapy is going to help you.
38:26But how do you feel about medication to help lift your mood a bit?
38:30For me, I would want to learn as much information about medication before I take it.
38:35Sure, yeah.
38:36Because you're an intelligent person.
38:37You want to know everything about it.
38:38And why take a chemical if you don't have to?
38:40So I am going to refer you.
38:43They should contact you within two weeks.
38:46Or they'll assess you on the phone and then decide which direction they want to direct you to.
38:52And there's talking therapy.
38:54There's individuals.
38:55There's group.
38:55All those sorts of things.
38:57It's really brave of you to come and talk about it.
39:00Have you got any questions?
39:01Well, I would like to have some clarity.
39:04So I can stop thinking about it.
39:06Do you, from your perspective, do you think I have ADHD?
39:10I think, you know, it's a spectrum, isn't it?
39:13Of course.
39:13And, you know, we're probably all on one part of the spectrum.
39:17I think, yes, you probably are on one part of it.
39:19But I think there might be other issues with that as far as numbers and letters.
39:25But you're very intelligent.
39:27You've got good insight.
39:29And you know I'm here.
39:30And you know where I am.
39:32And feel free to come and see me.
39:34I'll be seeing you again and I'll do a phone call review anyway to make sure you get the appointment.
39:41Okay.
39:41Okay.
39:41So I'll put you down for a telephone call in two weeks.
39:44Yeah.
39:45To see how things go.
39:45If, in the meantime, you feel bad about or worse or anything like that, you know, just come and see me.
39:50Of course.
39:51I will.
39:52Okay.
39:53Yeah.
39:54All the best.
39:55Have a good day and we'll be in touch.
39:57Of course.
39:58See you.
39:58So, this is a question.
40:11Do you keep your eggs in the fridge?
40:12Yeah.
40:13Do you keep your ketchup in the fridge?
40:14Yeah.
40:15You put your ketchup in the fridge?
40:16Do you keep fruit in the fridge?
40:19Depends what fruit it is.
40:20Is it bananas?
40:21No.
40:21They go brown quickly.
40:23Not apples though or anything?
40:24No, I don't put apples in the fridge.
40:26It's too hard when you bite it.
40:27Come on, man.
40:28Even you know that.
40:34How are you?
40:35Oh, I'm not too bad.
40:37I'm so sorry to hear about that.
40:39Oh, yeah.
40:39I'll pop it up him if you want.
40:41Yeah.
40:42Are you managing okay?
40:43Yes.
40:44It's a cure-its egg, isn't it?
40:45It sort of hits you when you least expect it and when you sort of think it's going to be tough is actually when you're ready for it.
40:53And it doesn't affect you so badly.
40:55Yeah.
40:56And then when it's sort of, I don't know, something happens, you're not expecting it and then it sort of hits you.
41:02You can't sort of function for a bit.
41:04But she set such a strong example, I can't really, I'm not allowed.
41:08She was amazing.
41:09She was amazing.
41:10She really was.
41:11She was an amazing woman.
41:12Yeah.
41:13Yeah, absolutely.
41:1445 years.
41:1545 years?
41:16Yeah.
41:16Yeah.
41:17Yeah.
41:17But you've got the, you've got 45 years.
41:20You've got 45 years.
41:21I've got 45 years.
41:23But your family, are you doing okay together?
41:25Well, yeah, yeah, we're very much together.
41:28Yeah, exactly.
41:29It's been sort of a...
41:30Going to go on holiday or anything?
41:33We haven't, well, yes, we are planning to go away Christmas because Christmas, we can't do Christmas at home.
41:39That's going to be too much.
41:40Yeah.
41:40So we'll go away for Christmas.
41:41And I bet Yvette gave you a list of...
41:45Yeah, well, that's the problem.
41:47She was Mrs Christmas.
41:49She'd think about Christmas 364 other days of the year as well.
41:53Yeah.
41:54A standard I cannot achieve myself, I'm afraid.
41:58Sharp scratch.
42:01Mums, we go overboard, don't we?
42:04Yes.
42:05Yvette had got so many canyons fitted in her time.
42:09So there's...
42:10She'd come to me.
42:12How's your granddaughter?
42:14She's great.
42:15She's coming on a pace now.
42:16She's really developing.
42:18How old is she now?
42:1916 months.
42:20Yvette was so happy that she...
42:22Well, she ate.
42:23...got to see.
42:24Got to see her.
42:25And then she attended her first birthday as well.
42:27Yeah, it's amazing.
42:27So that was extraordinary.
42:28And got her nickname.
42:29So she became Goo.
42:31Did she become Goo?
42:32She became Goo.
42:33So she got...
42:34Incredible.
42:34She got the nickname in.
42:35She was so determined to see her first grandchild.
42:41Well, she certainly was looking to make the most of whatever time she had.
42:45All done, sir.
42:46Okay.
42:47Thanks very much.
42:48You...
42:48Well, you're very welcome.
42:49And it's nice to see you.
42:50You too.
42:51You're looking well.
42:52Are you...
42:52Thanks.
42:53You keeping well?
42:53Yeah, yeah.
42:54Not bad.
42:55Good.
42:55Just, you know, getting on with life.
42:57Yes, quite.
42:58Grandkids.
42:59Keep me busy.
43:00That'll do it.
43:01You take care.
43:02Thanks very much.
43:03Bye, John.
43:04Bye.
43:06Thank you so much for your help.
43:08No, not at all.
43:08I'll speak to you next week.
43:09All right, then.
43:11Remember, it's fasting from midnight.
43:13Eh?
43:13Nothing to eat from midnight when you come.
43:15Yeah, I've got to remember that one.
43:17When's the food's on afterwards?
43:18Thanks very much.
43:19Bye.
43:20Brilliant.
43:21Thanks very much.
43:21Pleasure.
43:22Take care.
43:22All the best.
43:22You two.
43:23Bye now.
43:23Bye-bye.
43:24Bye-bye.
43:24Bye-bye.
43:54The End
44:24The End
44:54The End
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