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00:00morning surgery my BMI is 42 and I'm at high risk even nine months pregnant I wasn't this heavy
00:09there's a smell to this there is yeah and it's got a green tinge to it
00:17I just put your eyelid down so I can see the redness there
00:23I walk down the stairs with my hand on the handrail and my other hand on the banister
00:35and I go down step by step really carefully because I'm in pain
00:41I think sometimes I might die and I've got to get out I've got to see people I feel closed in so
00:50a closed day
01:04morning
01:05morning
01:05morning
01:06morning
01:07morning
01:09morning
01:11morning
01:14Daniel let's go let's go let's go now come and have a seat how are you yeah good thank you yeah
01:35come and have a seat over here now tell me what's brought you in to see us today okay so I got this
01:40tattoo done a couple of days ago okay and it's just a bit bit red bit inflamed it's not the worst but
01:46it was angry it was like painful okay okay okay I'd sort of best get checked good idea really good
01:54idea so you had it done two days ago and it's getting more red and you're obviously a bit of
01:59a pro at having tattoos aren't you yeah exactly so I've noticed this was not quite right right so
02:04this isn't healing the same as the other ones do and and the pain level uh it did wake me up last
02:09night okay this never happened before what about in yourself any temperatures fevers yeah a little
02:14bit of a temperature but nothing to be too concerned okay I just but I have been taking
02:18hyperproof and trying to get the inflammation down good well done okay I mean we always worry a little
02:23bit but looking at it I mean you're quite right here it looks lovely doesn't it yeah it's very sort
02:27of white and normal around it and here it's quite red and angry isn't it because what worries me a
02:31little bit is if we put your other hand next to it although there's the redness there actually you
02:35can see there's some redness here and it wasn't like that yesterday so it was very like defined
02:40yeah and actually if I feel it so that's quite pale and that's quite warm so you can feel it's quite
02:45hot isn't it yeah so it's hot it's red and possibly a little bit swollen now we do expect it when we
02:50tattoo the body yeah okay a bit of trauma a bit of trauma to the body where did you have it done just
02:56to check uh here and under perfect it was a good legit yeah yeah I think it's probably just because
03:01the area it wasn't a holiday no no no no okay so that's good news the fact that the redness is more
03:10than it was yesterday tells us that instead of going in the right direction of getting less it's
03:14actually going in the opposite direction of getting a bit worse we're all covered in bacteria and things
03:18on our skin and when we chew a tiny little needle of putting the ink in there's a small chance there
03:22always is even in really good reputable places yeah that we push a tiny bit of bacteria in
03:26and we get an infection yeah so let's zap it sweetheart okay it's flucloxylin this is the
03:31best antibiotic for skin bugs okay the problem is you get rid of it very quickly so you have to take
03:36it four times a day oh so it's a little bit like a bit of an annoying just because your body you pee
03:41out the antibiotic and you want to keep the antibiotic in the blood so it's killing off the bug to get
03:44you better okay how many days a week that's fine it's fine it's got to be done it's my fault
03:48getting the tattoos but what is important is if you have something like this if it gets red and
03:53sore and angry you need to come and see us yeah so i went to the pharmacist and she was like to be
03:56honest i think you should just go so you went to the pharmacy first good on you we like that and
03:59actually they will stop a lot of people i need to come in yeah but they're quite right she was like
04:04just go in yeah good luck with it just keep it clean okay you need to do anything else special to
04:08it and it will heal up okay amazing thank you for that thank you so much all the best nice to see you
04:11come and take a seat oh look at you you're so pink yeah and how's everything going yeah good yeah
04:24did you have a nice birthday for him we did we did a little uh party at my grandma's house just in the
04:31garden bit suspicious about the cake yeah do you know what i don't think i've been to one one year
04:36birthday party and they haven't cried yeah yeah oh bless him um and how's everything going sort of
04:44like moving around is he pulling himself up yes he is yeah i feel like he's days away from walking
04:50oh wow very speedy crawler now yes yes you are and are you breastfeeding uh just stopped two weeks ago
04:58fine and how are you feeling from that yeah fine yeah yeah that's okay yeah do you have his red book
05:03chance do you want me to grab it um it's just yeah so um i'll go through the ones that we're doing
05:09today so one year vaccinations it's four injections um two in each leg if he does get a temperature
05:17please do give him cowpole okay but this shouldn't last longer than 24 hours and then the last one is
05:23the mmr the measles mumps and rubella the mmr might cause a temperature a rash or sore throat a bit swollen
05:30it shouldn't last longer than a day or two um however please do come and see us if you um are
05:37worried about anything how does that sound yes sounds good yeah
05:40very curious don't know it's taking all the tissue absolutely fine
05:46and are you going back to work or have you gone back to work yeah going back on the 16th who's going
05:53to be looking after him and my mom is going to watch him a bit while i'm back and then yeah i'll get
05:59now three okay so i'll just ask you to pop him on his turn him around just a little bit so his legs
06:04are going down this way and then if you just cuddle him give him a big hug and hug his arms and then
06:10i'll do one leg when i say we'll turn him around do your leg and then cuddles afterwards but if you
06:15want to stop at any point just let me know all right my sweets ready i'm sorry i'm sorry
06:22i'm sorry i'm sorry oh i'm sorry i'm sorry i'm sorry
06:43oh my sweet i'm sorry great boy there you go you want this
07:03oh it's a lot real tears here oh okay all finished i promise
07:13yeah well done i'm sorry
07:16perfect thank you
07:22bye
07:25oh baby i'll be a really good mom yeah i think you would be do you think you'd be a strict mom
07:37i'll be a chill mom i want to be strict god brother is there something you've got to say
07:42i'll be the godmother i'll watch her kids absolutely not yes we'll be fine what about you
07:48you think you'd be strict yeah probably really i wouldn't be that straight like if you want to
07:53have fun go have fun have fun the good way i'll support you absolutely not you're like that crazy
07:57auntie i'm not getting my kids with you honestly what a crazy auntie we'll all have fun together
08:03michael
08:08how are you doing i'm doing good i'm loving to see you i'm loving the look yeah how are you doing
08:17i'm not too bad you know not too bad at all yeah yeah in a while it's been a little while but
08:23taking along taking along pretty good yeah however um i developed this lump on my throat
08:29about a week and a half ago right it was probably about the size of a 50 pence piece um there by my
08:38by my uh adam's apple yeah it's actually gone down right quite a bit before that nothing before that
08:45nothing i've never had any problem with my throat uh and that just suddenly developed overnight
08:51literally and you're not more croaky than normal i know you've got croaky boys anyway um not really
08:57not it doesn't hurt when i swallow or anything like that but it's only when i go to touch it that
09:04it's a bit sensitive okay yeah um and you feel it where right here yeah yeah right above your adam's
09:12apple yeah and then your adam's apple actually but it's it's like it's going to be a little lumps
09:17one two three yeah three one two and then it's like a bigger one here yeah and you feel
09:24absolutely fine fine yeah i'm just going to feel your neck sure
09:27i don't know if it's a thyroid plane up or not okay so no particular no tenderness around it either
09:39no nothing can i just get you to lie down she'll just have a relax so that all your muscles are nice
09:47and relaxed yep
09:51i'm tender yeah painful not so much now yeah came to be yeah so i i thought like you it would be
10:05more like thyroid but this is too much in the skin i can just wiggle it about i can get behind it
10:11but you can understand my concern yeah yeah totally
10:13my cysts from hair that's grown inwards instead of outwards they're very much in the skin
10:41there's probably an infection there i'm going to treat it with some antibiotics
10:44and i'm hoping that it will have dissipated in about two weeks right if it's not or if it's
10:51getting worse come back quicker but i'll put you down for a review in two weeks but it's not deep
10:56enough to be your thyroid so i'm reassured by that but it's good for you to be aware of things too
11:01interestingly they feel as though they've been there a little while i know you've only felt
11:05them for a week and a half but if you think literally a week and a half yeah um probably
11:10just popped up and it kind of seemed to have got slightly bigger but it's remarkably in the last
11:18two days it's gone down going down and i think what would help it go down quicker along with what
11:23i'm going to give you would be a warm flannel just resting it there heating it up and you know
11:30maybe some gentle massage will just disperse those cysts right while treating you with antibiotics
11:36okay i think just gently not squeezing it or anything like that
11:40and then i'm hoping that it will have shrunk and reduced considerably by the time i see you next time
11:50if it isn't then you'll consider other things like scans and stuff like that
11:54brilliant great nice to see you nice to see you as well thank you very much yeah no worries i'll see
12:00you in a couple of weeks all right okay take care bye-bye now
12:03this is kelly hello good morning
12:11how are you today i'm okay not bad my name is milu i'm the dietitian and you are referred to me
12:21regarding weight management yes how have you been recently any recent changes in your diet in your
12:27lifestyle it just seems to be a long long road it's not like i was always like a bigger woman
12:34and i've struggled with my weight i never struggled with my weight when i was young i used to always be
12:38active after i had my son i bounced back and i don't know whether it was after i lost my mom
12:45um 10 years ago i went on antidepressants one of the side effects was rapid increased appetite
12:51okay my bmi is 42 and i'm at high risk even nine months pregnant i wasn't this heavy okay so like i
12:58was like right enough's enough so when i was working at school last year i started doing intermittent
13:02fasting okay the weight was dropping i dropped half a stone in a week are you still doing intermittent
13:08fasting no because i'm now off on the summer holidays from school okay so the routines changed
13:14i just feel stuck like with just getting moving what i need to do is like increase my sort of
13:20knowledge of things that i you know i like i think it's as well the cooking like for example because
13:26when i was at work they used to provide a meal if they provided a meal with salmon i'd eat it yeah so
13:32i think it's it's just the it's learning to to to to have a love for cooking because you know we are what
13:39we eat so we will start with calorie counting for one week to four weeks it's up to you if you could
13:45do it for four weeks better if not only one week would be fine which one would be better for you
13:51application or simply like food diary for a few days i mean what you mean and i use apps yeah which
13:58one is it's my fitness pal most oh yeah yeah yeah i used that before uh-huh try to learn from it okay
14:05not just putting numbers there you put five cashew nuts you will see it's like 120 kilo calories
14:12for the first week just don't make any changes in your diet it just wants you to have a report
14:18of your current diet then after one week you can set a goal with the application you can say i want
14:26to lose two three kilos per month and it gives you a total calorie what is it called my fitness my
14:32fitness but i'll send you everything as a message and we also have this model which is very easy
14:39quarter of your plate this is really important from carbohydrates preferably complex brown carbohydrates
14:47if you do bread brown bread what about just cutting out the bread if you usually do brown carbohydrates
14:53they are high in fiber oh okay so you need to compensate your fiber intake like portion size is the key
15:01and half of your plate from vegetables and controlling your oil intake one tablespoon of
15:08any oil even like the best olive oil has 120 kilo calories you won't be able to control your life
15:16your diet all the time you're not a robot okay so if you found those goals difficult if you needed
15:24something like a tailored diet plan then we can work on that together it's the yeah it's the calorie
15:30stuff it's just being consistent and getting but i just felt i just needed do you know like a little
15:35bit of help to yeah so perfect let's see how it goes but it's so bad i'm sitting to think about diet
15:41coke i know it's the blood sugar levels that like obviously don't worry about the diet coke for now
15:45you won't be able to change everything all in one go okay so let's see how it goes okay thank you
15:51thank you bye-bye
15:52uh fabia please hi there hi come through i'm george one of the doctors nice to meet you
16:06hi george how are you i'm i'm actually okay right now good a silly question i know when you come to the
16:12doctor a bit in general how can i help today i've been having some strange symptoms recently that
16:16i'd like some follow-up on yeah of course um i don't know what you can see i saw your patches
16:21consultation yeah so um it says something about regurgitation so i'm guessing is that sort of upper
16:25gi regurgitation yeah well it started maybe a few weeks ago like i would be but i've been burping quite
16:32a lot more than normally uh the first few times it was just liquid that i was brought i was bringing up
16:36but yesterday i brought bile up and like my um throat was feeling a bit you know sore normal
16:41how long has that been going on for uh so that the burping's been going on for like a couple of
16:45months but the like bringing stuff up past two weeks um any sort of acidic taste in the back of
16:51the throat yesterday there was yeah but before then no and any abdominal pain sort of quite high up
16:55that often radiates up into the chest not high no i wouldn't say i have much pain yeah good any heart
17:01burn reflux no not really good um and you mentioned a change in bowel habits yes um i haven't been going
17:08to the toilet as often as normal and when i do it's like a constipation or diarrhea so it can alternate
17:15between the two yeah fair enough and any blood mixed in with the no no no and how long have you noticed
17:20that change for is it coincide with the sort of regurgitation that has been happening for the past couple
17:24of months i would say yeah and appetite is that okay for you yeah yeah you don't get full very quickly
17:29after eating no i've always had really good good perfect that's good and any bloating abdominal
17:34bloating uh yeah i would say i've had some bloating i'm not sure if it just like coincides with you
17:38know when my periods do or something but which brings me really neatly onto the next sort of
17:42questions really any change to periods are they regular they're um i'm two days late now but i think
17:48that's quite normal for me yeah perfect really good what i'd like to do if it's okay is have a little
17:52feel of your tummy today and then maybe we can think about some investigations that might be useful
17:55just uh rule some things out and are you in any pain or discomfort at the moment no lovely so yeah
18:02sometimes it could be because the stomach's producing a bit too much acid and it can be
18:05causing these types of symptoms often you do feel it but sometimes you don't we call it sort of a
18:09silent reflux and it presents in these other sort of more vague ways really so if i press there is
18:14that okay for you it's a bit uncomfortable a bit tender yeah okay that's all fine it's lovely and soft
18:20so that's a really good sign there's no abnormal masses or anything uh untoward like that lovely
18:26absolutely fine thank you so much all really good so i think yeah what we should do is um to
18:32investigate the change in bowel habit there are a couple of poo tests we should do just to make
18:36sure we're not missing anything we should also check for a bacterial infection in the stomach called
18:41helicobacter pylori and so sometimes that can cause these sort of upper gi type of symptoms
18:46so we can easily screen for that if you've got it we can easily eradicate it we just give you some
18:49antibiotics and that sorts it out for you as well as that we should maybe think about doing some
18:54bloods just to make sure kidneys are okay liver's okay no sign of anemia thyroid diabetes the whole
19:00lot really just to make sure and then we'll take it from there does that sound good the general
19:04principles are sort of avoid the triggers so we know the big triggers are caffeinated drinks
19:10fizzy drinks citrus fruits chocolate ultra processed food pastries and things like that
19:15uh tomatoes stuff like that so yeah all the good stuff unfortunately you can still have that but
19:20just in moderation really to help um mitigate the symptoms really um and then there's a sample box
19:27outside so you can just drop it in there whenever you're ready and we'll take it from there okay thank
19:31you have a good day you too bye now
19:39you just text people on messages and what's up as a no socials i don't like texting people on messages
19:45it feels too serious no then whatsapp feels like i'm like a middle-aged one me and my message
19:51what's up yeah my mom's a middle-aged woman so that checks and she's made me into a middle-aged woman now
20:05afternoon surgery
20:08oh god let me give you a how are you hello where are you you all right you're not coming in no no no
20:17he's gonna have a quiet afternoon he's gonna have a doze now you've been avoiding me i've been
20:22in hospital i know you have sweet aren't you poor things have been awful it has been dreadful oh no
20:27because you were in for a while weren't you 10 weeks 10 weeks yes i had two days to put that on
20:35and two nights out oh no and then you had to go straight back in again yeah straight back in i had
20:42a urine infection well they wrote and said you had sepsis that was when i went in i had sepsis oh
20:50and it took them a while to figure out why i had sepsis that i had an infected stone in my gallbladder
20:58i have several stones in my gallbladder and i have to have an operation to remove them but i've written
21:07a list of things i've got to talk to you about go tell me what what can we do today then first of all
21:14i need a referral to a physio about my mobility yeah so tell me because you had you've had falls
21:23and everything haven't you oh my goodness let's have a look when did you do that one a couple of
21:30days ago it's got my nose too that's why i've got my glasses on my nose so it banged across there and
21:36across there yeah so where are you falling just in the home yeah dripping over my slipper you know
21:43my foot but is that because with the ms you can't sort of feel and you can't you don't know where the
21:48feet are going so yes and i can't look down because if i look down i lose my balance and i fall forward
21:55so got one of those walking frames okay so you use the wheelchair for outside and the frame for inside i've
22:02got one on the floor that i sleep on and then i walk down the stairs okay my hand on the handrail and
22:11my other hand on the banister okay and i go down step by step really carefully because i'm in pain do
22:21you feel i worry about you coming down the stairs a little bit no no the council said they'll put a
22:26stair lift brilliant for me have the council given you any sort of time frame for this thing do you think
22:31maybe we could chase them up do you want me to give them a bit of oh i'd love it in the right
22:35direction and sort of ask if we can do it if you could okay yes that would be amazing nicolette
22:40suffers from multiple sclerosis ms and has done for many years and sadly it is progressing now i've
22:46looked after her for 20 years i remember she used to walk in to see me and then we started using a frame
22:51and now she's in a wheelchair but again she's taken these steps although they're disappointing and hard for
22:56her she's amazing how she's managed to to rally through and with the help of her partner and her
23:01family but often us as the gps get very involved in any sort of social support or anything else that
23:06we need to do allowing her to live her life to its maximum potential at the moment despite the
23:10disabilities that the ms has thrown in i have had very low mood i think that was due to being in
23:17hospital or you think it's just yes it was being in rome on my own completely on my own gosh and there
23:25was no pictures on the walls no tv i just have plain walls to look at or a window that i could look out
23:33of and i could see the tree in the distance and see the wind blowing the leaves on the trees
23:43and i used to watch the sunrise and the sunset
23:57that's kind of scary they do look a bit scary i know and is it not just like when you open your eyes
24:17this is just black like this yeah yeah it is yeah really but is there like a black line at the top of
24:23your little bit yeah but i can clear i can see though my vision still clear but just they're just
24:28so god damn nice yeah like spider legs aren't they hi
24:39they were really worried about you you were poorly weren't you i was really ill i didn't realize just
24:44how real i was actually and i was talking about people that weren't there i was also having
24:52um my nights were filled with dreams about my son um who died that was on my mind constantly and
25:02what i did wrong and where i went wrong if you're starting to get muddled which you may not realize
25:07because we often don't if we're getting confused but the people who know you really well and start
25:11thinking mum you're talking rubbish or you yeah you know if you start having funny vivid dreams
25:15something come to us sooner you've lost a lot of weight because you've been gone for such a long time
25:20riding in the hospital i know and i've missed you and i've missed you know our well we can book again
25:26and come book our routines back again and things to do it yes i'll get these bits and pieces sorted
25:31out today thank you i've changed your prescription as per what the hospital sent us a list of what you
25:36were on do you need more of them today or have you got enough of everything i think i've got enough
25:41at the moment just for the next month and let's go and make an appointment for a few weeks at the
25:45desk so at least then we can thank you that's it i'm gonna i think i've done everything and i'll do
25:52taps prescription oh that's enough very much so michael straight on the bed is that on the bed oh yeah
26:03sure it was okay on monday wasn't it it wasn't it was okay you tolerated it okay and this time i took
26:08some painkillers ahead of time well done if this has not improved within four weeks yeah you have
26:15to be referred to tissue viability if there's no improvement after four weeks okay tissue viability
26:21yeah you know you said that they think the ulcer has come from because you're veiny yeah because
26:28they did the ultrasound i've been having a look okay sickle cell is well known to cause ulcers
26:36yes so sorry it's okay are you on antibiotics for this no no i'm not you're not in the first
26:46week they gave me amoxicillin see amoxicillin it's not the first line it's not what we would give you
26:52for wounds we would give you flu flu clocks i'll get one of the doctors to send one across for you
26:59yeah it has improved no am i wrong in thinking i'm just gonna swab it sorry michael that's okay
27:07actually don't feel that that's because you're high on painkillers probably
27:13yeah i think you definitely need flucloxacillin because there's a smell to this there is yeah yeah
27:19and it's got a green tinge to it and green is pseudomonas it's that thick bit in the middle
27:28it's so hard to moisturize as well because everything you put on your leg the plasters
27:36won't stick to you after um so okay you need help with that no no it's okay i think i got it
27:43this one is that one is opening it's longer so it's a bit tight so when i'm out if i'm moving
27:50yeah it's good yeah but because you've got an ulcer at the ankle area you're going to be more
27:55kind of swelling yeah so if you cut your foot at all straight to the doctors and say i've had an
28:03ulcer oh okay yeah because you now you've had one ulcer you can have another you can get more
28:09unfortunately so all done all done thank you okay all good yeah yeah thank you very much i leave you
28:15to it let us send this off and see but it does take about six weeks okay the results okay don't
28:22forget to book my appointment okay i'll phone up to book yeah thank you you see why he joined me
28:30yeah it's because it's me yeah thank you
28:37you're gonna end up breaking that chair and then we're not gonna know how to fix it i'm trying to
28:41push it up oh my god it's not going up do you know how to push his chair going up do the thing
28:48you have those magic hands i don't know how go on my babes thank you my babes oh
28:59oh how do i say it back forward it's the other oh you touched it and now it's broken i didn't
29:05she nailed it first hiya have your appointment
29:09come and have a seat nice to see you so i'm dr pierson nice to meet you now how are you i'm good
29:19good good in the last month i've noticed that my balance is a little bit off okay and i was just up
29:26um visiting my mom up in newcastle i was talking to them about it and they said it could be an inner
29:32ear thing yeah yeah yeah so tell me what happens when you feel your balance is off i just feel a little
29:38bit wobbly when i like stand up okay yeah so as soon as you get up a bit yeah do you feel you're
29:44falling to one side yeah a little bit okay falling to the right i think okay tipping over to the right
29:51of it yeah and do you have you ever passed out or collapsed or fainted or anything like that no
29:56no does it ever happen when you're at rest or just lying in bed or sitting down it's only when you
30:00stand up and things is it yeah or walking or walking yeah okay do you get any visual problems or
30:06headaches or anything i'm visually impaired but other than that no so tell me about your eyesight
30:12what's happened um so i it started i was born blind and then they figured that out when i was 10 days
30:19old oh gosh um i was rushed into surgery at 10 days old and i regained sight in my left eye wow but i
30:27haven't noticed this balance thing recently before yeah okay and it was glaucoma was it yeah it was yeah
30:33okay so that's rubbish isn't it to have that when you're a little bit yeah so you've been able to
30:38school and go through things you can see i live independently i really have a job you know yeah
30:44just a couple more questions with it yeah have you noticed any change in your vision though no
30:49above what normal is now you like you don't think it's anything to do with no eyes at all and that's
30:54always my go-to is yeah my if my vision changes immediately go to the ophthalmologist but no there's
31:00been no change and there's no way you're pregnant or anything no no definitely not definitely not
31:05okay all right i'll let you go any young woman who's dizzy and feels a bit funny oh i know okay
31:10it's been several months okay all right so we'll put that one aside yeah and you recently had some
31:14blood tests i have yeah your blood count is lovely and normal your liver's lovely your thyroid your
31:20vitamin d your diabetes test is clear as a whistle the only one was your kidneys were a little bit
31:25dehydrated on that day so we just wanted to repeat it can i do things like check your blood pressure
31:30one here is that's all right let me just grab my machine so this just goes on your arm okay and
31:37this will just take a minute i've had blood blood pressure taken so many times i'm sure you have
31:44you're a pro at it all now yeah um 26 surgeries on my eyes i know it's crazy i'm all planned and
31:52things well presumably in my life but i mean things are stable right now so one two five 75
31:59so that's good news have you had any cough or cold recently or picked up a virus on the tube
32:06no no ear pain no can i have a look in both of them so just me prodding them a little bit let's just
32:13have a look do you ever get itchy ears do you ever put your finger in your ear and want to scratch them
32:19and itch them a little bit yeah because the ear canal cooks quite sort of red and a bit angry
32:24something do you wear air pods or anything yeah it's just sometimes that can inflame and but that's
32:30not really the inner ear which is what affects balance and that's a little bit the same that side
32:35actually but the eardrum looks lovely there's not lots of fluid in it there's not lots of wax
32:39it looks good i mean that's sort of incidental more sort of outage do you do swimming no i don't
32:45one thing i can do to get help with the ears a little bit is there's a very good spray that we
32:49can use to try and clear the ears to stop the sort of any irritation and itch and it'll get rid of the
32:53redness for you but i still think we need to find out what's causing this because yeah the weird
32:57balance thing can i just have a listen to your heart for one second you don't need to move or anything
33:03i'm just going to put this on your chest just going to put it in just listen to your heart for a second
33:09sorry that's my phone not my heart no that's all right
33:15yeah strong normal going lovely and steady and things in balance is controlled in our inner ear
33:20inside which is strange which is strange isn't it but sometimes when we have some sort of ear
33:24symptoms it can change the blood flow a bit to our ears and make us feel a bit it's odd so i think
33:29it'll be interesting to see if the spray makes any difference so you can have it in your bag and
33:32just take it as and when if you do need it still doesn't answer what it is so we still need to come
33:37back to investigating it i just want to do an ecg as well a reading of the heart now i'm sure you've
33:41probably had lots of them if you had loads of anesthetics and yeah your bloods are good but
33:45we'll double check those anyway again and then we'll sit down and go through it all and see
33:49what we're getting on thank you so much so we'll see you on thursday and you're going to the chemist to
33:54pick up everything yes all right thank you okay nice to meet you margaret you take care look after
33:58yourself all the best bye bye alice hello i've got to go in now go in but i need one yeah you're
34:07looking well no i'm not yeah i think you're looking really well see you likewise come through it's been
34:13a while lots of stories to tell you good good take a seat make yourself comfortable
34:18all right okay i'm suffering complete panic attacks are you when i'm in my flat it can come
34:29on just like that i have to get up and go out the house is there a tablet you can help me just calm
34:35down when it comes on me where i don't have to feel that way what sensations do you notice when it
34:40happened a lot of fear i've got fear i think sometimes i might die and i've got to get out i've
34:47got to see people i feel closed in so closed in yeah and and and that's happening quite a lot lately
34:56and it's frightening me
35:17is there a tablet you can help me i mean there is but they're highly highly addictive that's the
35:23problem what is it diazepam if you had very physical symptoms of anxiety where you were having
35:28palpitations if you're sort of very sweaty a bit tremulous with it then there's a beta blocker
35:33we can use very safely oh yeah somebody said you could give me a beta block yeah propranolol we can
35:38try that but it doesn't sound like that's the symptoms you're because i get in a really bad state
35:42yeah even at half two in the morning i come out of the house because i'm panicking at two in the
35:48morning i do i wouldn't do that because i know i have to come out how's the smoking going as well by
35:53the way oh yeah i'm still off the cigarettes well done that's incredible that's really good yeah but
35:59there is another problem oh yeah it's another problem you're gone yeah when you stop smoking you eat more
36:04you eat more exactly yeah this is what i wanted to ask you today i would like you to give me that
36:10majora injection the difficulty is on the nhs at the moment they say we can only use it if
36:16the following criteria are met your bmi is over 40 and we can calculate that today and you've got four
36:22different medical problems so the arthritis and the hip pain absolutely counts as one without a doubt
36:28but then they've got to be things like diabetes high blood pressure high cholesterol all of those
36:33other things i must have all that look at the size of me i mean your diabetes marker is nice and low
36:38your cholesterol is high so i'll give you that there's there's two can we check your weight
36:41today yeah all right yeah let's give it a go and then we'll see you know since stopped smoking i put
36:46on more weight well of course you will absolutely and and the weight loss will help definitely take
36:50the pressure off right on the on sorry no it's all right don't worry can you manage oh lovely good
36:58are you okay nice and steady i need to let go because it's going to affect that just for a second
37:02so 86 fine don't tell me what it is okay fine don't tell me what it is there you are lovely right
37:09let's check yeah i mean your bmi is 35. i don't know what it should be it should be less than 25. oh yeah
37:17it's a bit high i was thinking maybe if you gave me that for a little while while i had the operation
37:24yeah and then um i wouldn't have to know what i think we can make a case for it i think it will
37:29really benefit you i really do and i'm sort of not saying that lightly but guidelines are there
37:34for a reason they're just a guide they're not sort of set in stone we are seeing more and more people
37:39come to the surgery asking for monjaro prescriptions we are quite limited however with who we can and
37:45can't initiate it for alice is waiting to have a hip operation i felt that by giving her monjaro it would
37:51help to optimize her for surgery so it's a short-term measure for her really just to help bring that weight
37:55down nice and quickly to make it a little bit safer for her to go under general anesthetic
38:00how do you feel about giving yourself an injection i'm not worried about any of that okay great
38:04i just want to have this operation done quickly of name yep i i'm willing to do anything to get out
38:11of pain yeah it's not nice to be in pain and maybe when i've had all the pains gone i might have a
38:16holiday you should definitely treat yourself you definitely deserve it absolutely you deserve it so
38:22yeah see how you get okay thank you very much my pleasure you're very welcome you are lovely thank you
38:27very much bye see you later
38:35i play hockey it's good for you enjoy it yeah i love it like i couldn't live without it recently i've just
38:40been playing a lot of rugby football i think it's just taking its toll so you're feeling a bit more
38:45nice i played tennis a while ago and i just kept playing too much so it hurt then when i was playing a
38:51rugby match i hit my head okay it was a mild one but then the big one was on my knee worried that
38:57it might be internal bleeding because there's no bruise or anything i'll get an occasional sort of
39:02quite bad twinge but it does affect the only couple of sports that i do which are archery and pistol
39:08shooting i took a hard hit a couple weeks ago straight through the shoulder they actually thought i got
39:13knocked out because i was down for a little bit so were you going in for the tackle or were they
39:18no i got taken out i went down and then i played aussie rules over here i just noticed it was quite
39:24tall and because aussie rules is quite physical you obviously enjoy that you want to get back to it yeah
39:28so that's right
39:33sally oh yeah hello all right let me call you back but i'm about to go into a gp point
39:40uh no no i'll call you back in two minutes here hello hello hi sir come and have a seat
39:47come and take a seat here dr pearson we've met before haven't we uh yeah definitely how are you nice
39:51to see you again you're looking well it's been a few years yeah it has been it has been how are they
39:54all right yeah yeah just graduated from uni this year oh congratulate what did you get what did
39:57you do so i get my results at the end of the month i did criminology and criminal justice
40:02criminology oh my god what are you going to do with that then uh so there's a variety of
40:05things i can do lawyer forensic science police yeah definitely oh it opens lots of doors doesn't
40:11it well congratulations that's brilliant i remember you when you were little so i think you
40:14graduated from uni i feel very old so tell me what's brought you in today so i had a jujitsu
40:20incident a couple weeks back with my eye so there was like a clash of heads as we were sparring and
40:26then i have a bit of eye like trauma like redness yeah there's been like no pain or anything but i just
40:32wanted to get it checked no absolutely so tell me so it was a couple of weeks ago a couple of weeks
40:36and what what exactly happened uh so when we were sparring our heads accidentally clashed and then um it
40:43was initially around here but then it wasn't until i got home that i noticed the uh redness of the eye
40:49and did you have any sort of loss of consciousness did it knock you out or anything like that no i was
40:53fine did you vomit or pass out anything at the time or nothing good good okay let's just have a look
40:59at your eye then just to give my dad like peace of mind because is he a warrior yeah yeah he's the one
41:03who sent you here yeah yeah i um went to parsons green click and he was saying oh they're not like
41:09oh this is their nurses but they're more than uniquely qualified to go it's tricky isn't it because i think
41:14the old-fashioned thing is that you see the doctor yeah but actually there are lots of really
41:18qualified people like the chemists the pharmacists are amazing at dealing with things at parsons
41:22screen we have paramedics and people often who are seeing patients and what they are particularly
41:26good at as well you can tell that is that if they think it's they're not sure about it they have a
41:31very left threshold for phoning us up and going can you see them i think you did the right thing
41:35yeah you did the right thing you can tell dad that i'm very happy you know i'll be happy to call
41:39them right on they are really good i just want to have a look at your eye so if you say straight ahead i'm just
41:45going to shine it in your good eye first okay and if i can i just put your eyelid down for it so i can
41:50see the redness there and if you look over towards the wall sort of that way that's it and you can
41:56move your eye around okay yeah yeah and if you stare at my finger okay and just follow it with your eyes
42:03do you ever see double or is that okay no it's okay so the pupils which is the black bit in the eye
42:08that opens and closes is doing exactly what it should be doing yeah the back of the eye looks lovely and
42:13hair careful there doesn't look i can't see any bleeds or anything horrible to be honest if there was
42:18your vision would be affected yeah yeah you'd have lots of floaters and funny things and you wouldn't
42:21be able we all get the odd floater but you'd have big splodges in your vision things like that so i think
42:25the eyeball is okay the problem is the tiny little blood vessels on the surface it just takes a bit of a
42:31knock and they bleed and they said it was a subcontrovitable that's it hemorrhage so it sounds
42:37like it sounds like a drastic subcontractival hemorrhage it sounds awful it's a tiny little
42:42blood vessel and it shouldn't affect your vision so the key is to try is if your vision starts getting
42:47affected if you start getting headaches if you start vomiting if something strange happens you come
42:52see me straight away okay well done and good luck with your results yeah thank you so much all right but you
42:56take care and we'll just let me know if anything changes all right take care bye-bye not at all nice
43:01to see you all right we'll take care all the very best thank you bye well thank you emily well
43:09done doris to see you next Thursday yes you take care all right lovely to see you
43:39so
43:44so
43:48so
43:52so
44:02Last night, I probably got up 20 times.
44:18I feel like I'm not going to breathe no more.
44:20Scary, isn't it?
44:21You know that you had a toe taken off?
44:23Yeah.
44:23That was because the blood supply to the toe wasn't great.
44:27That because my toe was black.
44:29I just black out.
44:30And when you wake up?
44:31I just lie there.
44:32What am I doing down here?
44:35I just lie there.
44:38I just lie there.
44:40I just lie there.
44:43I just lie there.
44:44I just lie there.
44:47Transcription by CastingWords
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