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Reality Realm US
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00:00My BMI is 42 and I'm at high risk. Even nine months pregnant, I wasn't this heavy.
00:07There's a smell to this. There is, yeah. And it's got a green tinge to it.
00:14I might just put your eyelid down so I can see the redness there.
00:18I walk down the stairs with my hand on the handrail and my other hand on the banister and I go down step by step really carefully because I'm in pain.
00:38I think sometimes I might die and I've got to get out. I've got to see people. I feel closed in, so closed in.
00:48Morning. Morning.
00:59Morning.
01:18Daniel let's go let's go let's go now come and have a seat how are you yeah good thank you yeah
01:30come and have a seat over here now tell me what's brought you in to see us today okay so I got this
01:35tattoo done a couple of days ago okay and it's just a bit bit red bit inflamed it's not the worst
01:41but it was angry it was like painful it was hot as well okay okay I'd sort of best get checked good
01:48idea yeah really good idea so you had it done two days ago and it's getting more red and you're
01:53obviously a bit of a pro at having tattoos aren't you yeah exactly so I've noticed this was not quite
01:58right right so this isn't healing the same as the other ones do and and the pain level uh it did wake
02:04me up last night okay this never happened before and what about in yourself any temperatures fevers
02:08yeah a bit of a little bit of a temperature but nothing to be too concerned okay I just but I
02:12have been taking hyperproof and trying to get the inflammation down good well okay I mean we always
02:17worry a little bit but looking at it I mean you're quite right here it looks lovely doesn't it yeah
02:21it's very sort of white and normal around it and here it's quite red and angry isn't it because what
02:25worries me a little bit is if we put your other hand next to it although there's the redness there
02:30actually you can see there's some redness here okay here and it wasn't like that yesterday so it was
02:34very like defined yeah and actually if I feel it so that's quite pale and that's quite warm so you
02:40can feel it's quite hot isn't it yeah so it's hot it's red and possibly a little bit smaller now we
02:45do expect it when we tattoo the body yeah okay a bit of trauma a bit of trauma to the body where did
02:50you have it done just to check uh here and under perfect it was a good legit yeah yeah I think it's
02:56probably just because the area it wasn't a holiday no no no no okay so that's good news that's good
03:03the fact that the redness is more than it was yesterday tells us that instead of going in the
03:08right direction of getting less it's actually going in the opposite direction of getting a bit worse
03:11we're all covered in bacteria and things on our skin and when we chew a tiny little needle of putting
03:16the ink in there's a small chance there always is even in really good reputable places that we push a
03:20tiny bit of bacteria in and we get an infection yeah so let's zap it sweetheart okay it's flu
03:26cloxacillin this is the best antibiotic for skin bugs okay the problem is you get rid of it very
03:30quickly so you have to take it four times a day oh so it's a little bit like a bit of an annoying
03:34just because your body you pee out the antibiotic and you want to keep the antibiotic in the blood so
03:38it's killing off the bug to get you better okay how many days a week that's fine it's fine it's
03:42got to be dead it's my fault getting the tattoos but what is important is if you have something like
03:47this if it gets red and sore and angry you need to come and see it yeah so I went to the
03:50pharmacist and she was like to be honest I think you should just go so you went to the pharmacy
03:53first good on you we like that and actually they will stop a lot of people I need to come in
03:57yeah but they're quite right she was like just go in yeah thank you so much good luck with it
04:01just keep it clean don't need to do anything else special to it and it will heal up okay amazing
04:04thank you for thank you so much all the best nice to see you don't you bye bye bye bye bye
04:07come and take a seat oh look at you you're so big yeah so big and how's everything going
04:18yeah good yeah did you have a nice birthday for him we did did a little uh party at my grandma's
04:25house just in the garden bit suspicious about the cake yeah do you know what I don't think I've been
04:30to one one-year-old's birthday party and they haven't cried yeah yeah oh bless him and how's
04:38everything going sort of like moving around is he pulling himself up yes he is yeah I feel like
04:43he's days away from walking oh wow very speedy crawler now yes yes you are and are you breastfeeding
04:51full uh just stopped two weeks ago fine and how are you feeling from that yeah fine yeah yeah breasts
04:56okay yeah do you have his red book I do a chance do you want me to grab it um it's just yeah so um I'll
05:03go through the ones that we're doing today so one year vaccinations it's four injections um two in each
05:11leg if he does get a temperature please do give him cow pole okay but this shouldn't last longer
05:16than 24 hours and then the last one is the mmr the measles mumps and rubella the mmr might cause a
05:23temperature a rash or sore throat a bit swollen it shouldn't last longer than a day or two um however
05:28please do come and see us if you um are worried about anything how does that sound yes sounds good
05:35very curious don't you know it's absolutely fine and are you going back to work or have you gone
05:45back to work yeah going back on the 16th who's going to be looking after him my mum's gonna watch
05:51him a bit once i'm burst back and then perfect yeah i'll be in there three okay so i'll just ask
05:57you to pop him on his turn him around just a little bit so his legs are going down this way
06:01and then if you just cuddle him give him a big hug and hug his arms and then i'll do one leg when i
06:07say we'll turn him around do your leg and then cuddles afterwards but if you want to stop at any point
06:11just let me know all right my sweets ready i'm sorry i'm sorry
06:21i'm sorry i'm sorry i'm sorry oh i'm sorry yes please
06:33i'm sorry
06:35i'm sorry
06:37i'm sorry
06:39i'm sorry
06:41okay thanks
06:43you're okay
06:45oh my sweet i'm sorry great boy there you go you want this
07:00oh it's a lot some real tears here oh okay all finished i promise yeah yeah well done i'm sorry
07:11perfect thank you
07:20bye
07:27our baby i'll be a really good mom yeah i think you would be do you think you'd be a strict mom
07:33i'll be a chill mom i wouldn't be strict oh god brother is there something you've got to say
07:38i'll be the godmother i'll watch her kids absolutely not yes we'll be fine what about you you think
07:44you'll be strict yeah probably really i wouldn't be that straight like if you want to have fun go
07:48have fun have fun in a good way i'll support you absolutely not you're like that crazy auntie
07:53i will be honestly i'm a crazy auntie we'll have fun together
07:58how are you doing i'm doing good i'm loving to see you i'm loving the look yeah
08:12how are you doing i'm not too bad you know not too bad at all yeah yeah in a while it's been a little
08:17while but taking along taking along pretty good yeah however um i developed this lump on my throat
08:25about a week and a half ago right it was probably about the size of a 50 pence piece
08:32there by my by my adam's apple yeah it's actually gone down right quite a bit before that nothing
08:39before that nothing i've never had any problem with my throat uh and that just suddenly developed
08:45overnight literally and you're not more croaky than normal i know you've got croaky boys anyway um
08:51not really not it doesn't hurt when i swallow or anything like that but it's only when i go to
08:58touch it that it's a bit sensitive okay yeah um and you feel it where right here yeah yeah
09:06right above your adam's apple to the end of your adam's apple actually but it's it's like it's
09:10a little lumps one two three yeah three one yeah and then it's like a bigger one here yeah and you
09:19feel absolutely fine fine yeah i'm just gonna feel your neck sure i don't know if it's a thyroid plane
09:28up or not okay so no particular no tenderness around it either no nothing can i just get you to lie
09:37down cheer just have a relax so that all your muscles are nice and relaxed yep
09:46and tender yeah painful not so much now yeah tend to be yeah so i i thought like you it would be more
10:00like thyroid but this is too much in the skin i can just wiggle it about i can get behind it but you
10:06can understand yeah yeah totally
10:20my cysts from hair that's grown inwards instead of outwards they're very much in the skin there's
10:36probably an infection there i'm going to treat it with some antibiotics and i'm hoping that it will
10:41have dissipated in about two weeks right if it's not or if it's getting worse come back quicker but i'll
10:48put you down for a review in two weeks but it's not deep enough to be your thyroid so i'm reassured
10:53by that but it's good for you to be aware of things too interestingly they feel as though they've
10:58been there a little while i know you've only felt them for a week and a half but you think literally
11:02a week and a half yeah um probably just popped up and it kind of seemed to have got slightly bigger
11:11but it's remarkably in the last two days it's gone down going down and i think what would help
11:17it go down quicker along with what i'm going to give you would be a warm flannel just resting it
11:23there heating it up and you know maybe some gentle massage will just disperse those cysts
11:29right while treating you with antibiotics okay i think just gently not squeezing it or anything like
11:34that and then i'm hoping that it will have shrunk and reduced considerably by the time i see you next
11:44time if it isn't then you'll consider other things like scans and stuff like that brilliant great nice
11:51to see you nice to see you as well thank you very much yes no worries i'll see you in a couple of weeks
11:56all right okay take care bye bye now
11:58this is kelly hello good morning
12:09how are you today yeah i'm okay not bad my name is milu i'm the dietitian and you are referred to me
12:16regarding weight management yes how have you been recently any recent changes in your diet in your
12:22lifestyle it just seems to be a long long road it's not like i was always like a bigger woman
12:29and i've struggled with my weight i never struggled with my weight when i was young i used to always be
12:33active after i had my son i bounced back and i don't know whether it was after i lost my mom um 10 years
12:41ago i went on antidepressants one of the side effects was rapid increased appetite okay my bmi is 42 and i'm
12:48at high risk even nine months pregnant i wasn't this heavy okay so like i was like right enough's
12:54enough so when i was working at school last year i started doing intermittent fasting okay the weight
12:59was dropping i dropped half a stone in a week are you still doing intermittent fasting no because i'm
13:05now off on the summer holidays from school okay so the routine's changed i just feel stuck like with
13:11just getting moving what i need to do is like increase my sort of knowledge of things that i
13:17you know i like i think it's as well the cooking like for example because when i was at work they
13:23used to provide a meal if they provided a meal with salmon i'd eat it yeah so i think it's it's just the
13:28it's learning to to to to have a love for cooking because you know we are what we eat so we will start
13:35with calorie counting for one week to four weeks it's up to you if you could do it for four weeks
13:42better if not only one week would be fine which one would be better for you application or simply
13:48like food diary for a few days i mean what you mean and i use apps yeah which one is it's my fitness pal
13:55most oh yeah yeah yeah i used that before uh-huh try to learn from it okay not just putting numbers there
14:02you put five cashew nuts you will see it's like 120 kilo calories for the first week just don't make
14:10any changes in your diet it just wants you to have a report of your current diets then after one week
14:17you can set a goal with the application you can say i want to lose two three kilos per month and it
14:24gives you a total calorie is it called my fitness my fitness but i'll send you everything as a message
14:30and we also have this model which is very easy quarter of your plate this is really important
14:38from carbohydrates preferably complex brown carbohydrates if you do bread brown bread what
14:45about just cutting out the bread if you usually do brown carbohydrates they are high in fiber oh okay
14:51so you need to compensate your fiber intake like portion size is the key and half of your plate from
14:58vegetables and vegetables and controlling your oil intake one tablespoon of any oil even like the best
15:05olive oil has 120 kilo calories you won't be able to control your life your diet all the time you're not
15:13a robot okay so if you found those goals difficult if you needed something like a tailored diet plan
15:22then we can work on that together it's the yes the calorie stuff it's just being consistent and
15:28getting but i just felt i just needed do you know like a little bit of help to yeah so perfect let's
15:33see how it goes but it's so bad i'm sitting there thinking about diet coke i know it's the blood sugar
15:38levels that like obviously don't worry about the diet coke for now you won't be able to change
15:42everything all in one go okay so let's see how it goes okay thank you thank you bye-bye
15:55uh fabia please hi there hi come through i'm george one of the doctors nice to meet you
16:01hi george how are you i'm i'm actually okay right now good it's a silly question i know when you come
16:06to the doctor how can i help today i've been having some strange symptoms recently that i'd like
16:12some follow-up on or some advice on um i don't know i saw your patches consultation yeah so um it says
16:18something about regurgitation so i'm guessing is that sort of upper gi regurgitation yeah well it started
16:24maybe a few weeks ago like i would be but i've been burping quite a lot more than normally uh the first
16:29few times it was just liquor that i was brought i was bringing up but yesterday i brought bile up and
16:33my my um throat was feeling a bit you know sore normal how long has that been going on for you
16:38uh so that the burping's been going on for like a couple of months but the like bringing stuff up
16:43past two weeks um any sort of acidic taste in the back of the throat yesterday there was yeah but
16:47before then no and any abdominal pain sort of quite high up that often radiates up into the chest
16:52not high no i wouldn't say i have much pain yeah good any heartburn reflux no not really good
16:59um and you mentioned a change in bowel habits yes so um i haven't been going to the toilet as often
17:05as normal and when i do is i have a constipation or diarrhea so it can alternate between the two
17:11yeah fair enough and any blood mixed in with the no no and how long have you noticed that change for
17:15is it coincide with the sort of regurgitation that has been happening for the past couple of months i
17:20would say yeah and appetite is that okay for you yeah yeah you don't get full very quickly after
17:25eating no i've always had really good good perfect that's good and any bloating abdominal bloat uh
17:29yeah i would say i've had some bloating i'm not sure if it just like coincides with you know when
17:33my periods do or something but yeah which brings me really neatly onto the next sort of questions
17:37really any change to periods are they regular they're um i'm two days late now but i think that's
17:43quite normal for me yeah perfect really good what i'd like to do if it's okay is have a little feel of
17:47your tummy today and then maybe we can think about some investigations that might be useful just to
17:51rule some things out and are you in any pain or discomfort at the moment no lovely so yeah
17:57sometimes it could be because the stomach's producing a bit too much acid and it can be
18:00causing these types of symptoms often you do feel it but sometimes you don't we call it sort of a
18:04silent reflux and it presents in these other sort of more vague ways really so if i press there is
18:09that okay for you it's a bit uncomfortable a bit tender yeah okay that's all fine it's lovely and soft
18:15so that's a really good sign there's no abnormal masses or anything uh untoward like that lovely
18:21absolutely fine thank you so much all really good so i think yeah what we should do is um to
18:27investigate the change in bowel habit there are a couple of poo tests we should do just to make
18:31sure we're not missing anything we should also check for a bacterial infection in the stomach called
18:36helicobacter pylori and so sometimes that can cause these sort of upper gi type of symptoms
18:41so we can easily screen for that if you've got it we can easily eradicate it we just give you some
18:44antibiotics and that sorts it out for you as well as that we should maybe think about doing some
18:49bloods just to make sure kidneys are okay liver's okay no sign of anemia thyroid diabetes the whole
18:55lot really just to make sure and then we take it from there does that sound good the general
18:59principles are sort of avoid the trigger so we know the big triggers are caffeinated drinks uh fizzy drinks
19:06citrus fruits chocolate ultra processed food pastries and things like that uh tomatoes stuff like that so
19:13yeah all all the good stuff unfortunately we still have that but just in moderation really to help
19:17um mitigate the symptoms really um and then there's a sample box outside you can just drop it in there
19:23whenever you're ready and we'll take it from there okay thank you have a good day you too bye now
19:28do you just text people on messages and whatsapp as a no socials i don't like texting people on messages
19:41it feels too serious no then whatsapp feels like i'm like a middle-aged woman me and my message
19:46you're on whatsapp yeah my mom's a middle-aged woman so that checks and she's made me into a middle-aged
19:52room in that afternoon surgery
20:05let me give you a how are you oh hello where are you you all right you're not coming in no no no
20:12he's gonna have a quiet afternoon he's gonna have a dose now you've been avoiding me i've been in
20:17hospital i know you have to tell you poor thing has it been awful it has been dreadful oh no because
20:23you were in for a while weren't you 10 weeks 10 weeks yes oh good i had two days to put that on
20:31and two nights out oh no and then you had to go straight back in again yeah straight back in i had
20:37a urine infection well they wrote and said you had sepsis that was when i went in i had sepsis
20:44oh and it took them a while to figure out why i had sepsis that i had an infected stone in my gallbladder
20:53i have several stones in my gallbladder and i have to have an operation
21:00to remove them but i've written a list of things i've got to talk to you about go tell me what what
21:07can we do today then first of all i need a referral to a physio about my mobility yeah so tell me because
21:16you had you've had falls and everything haven't you oh my goodness let's have a look when did you do that
21:23one a couple of days ago it's got my nose too that's why i've got my glasses on my nose so it banged across
21:30there and across there yeah so where are you falling just in the home yeah dripping over my
21:37slipper you know my foot but is that because with the ms you can't sort of feel and you can't you don't
21:42know where the feet are going something yes and i can't look down because if i look down i lose my
21:48balance and i fall forward so got one of those walking frames okay so you use the wheelchair for
21:54outside and the frame for inside i've got one on the floor that i sleep on and then i walk down the
22:02stairs okay with my hand on the handrail and my other hand on the banister okay and i go down
22:11step by step really carefully because i'm in pain do you feel i worry about you coming down the stairs
22:18a little bit no no i'm the council said they'll put a stair lift brilliant for me have the council
22:23given you any sort of time frame for this thing do you think maybe we could chase them up do you
22:27want me to give them a bit of a sort of boot in the right direction and sort of ask if we can do it
22:31if you could yes that would be amazing nicolette suffers from multiple sclerosis ms and has done
22:38for many years and sadly it is progressing now i've looked after her for 20 years i remember she used to
22:43walk in to see me and then we started using a frame and now she's in a wheelchair but again she's
22:49taken these steps although they're disappointing and hard for her she's amazing how she's managed to
22:53to rally through and with the help of her partner and her family but often us as the gps get very
22:58involved in any sort of social support or anything else that we need to do allowing her to live her
23:02life to its maximum potential at the moment despite the disabilities that the ms has thrown in
23:08i have had very low mood i think that was due to being in hospital or you think it's just yes it was
23:15being in a room on my own completely on my own gosh um there was no pictures on the walls no tv i just
23:23had plain walls to look at or a window that i could look out of and i could see the tree
23:33in the distance and see the wind blowing the leaves on the trees and i used to watch the sunrise
23:40the sunset
23:59are they itchy a little bit
24:01they are really long that's kind of scary they do look a bit scary i know
24:09and is it not just like when you open your eyes
24:12this is just black like this yeah yeah it is yeah really but is there like a black line at the
24:17top of your little bit yeah but i can clear i can see though my vision still clear but just they're
24:23just so god damn nice yeah like spider legs aren't they hi
24:35they were really worried about you you were poorly weren't you i was really ill i didn't realize just
24:39how ill i was actually and i was talking about people that weren't there i was also having
24:47um my nights were filled with dreams about my son um who died that was on my mind constantly and
24:57what i did wrong and where i went wrong if you're starting to get muddled which you may not realize
25:02because we often don't if we're getting confused but people who know you really well and start
25:06thinking mum you're talking rubbish or you yeah you know if you start having funny vivid dreams
25:11something come to us sooner you've lost a lot of weight because you've been gone for such a long
25:15time hiding i know i know and i've missed you and i've missed you know our well we can book again
25:21and come book our routines back again and things to do it yes i'll get these bits and pieces sorted
25:26out today thank you i've changed your prescription as per what the hospital sent us a list of what you
25:31were on do you need more of them today or have you got enough of everything i think i've got enough
25:36at the moment just for the next month and let's go and make an appointment for a few weeks at the
25:40desk so at least then we can thank you that's it gonna i think i've done everything and i'll do
25:47taps prescription oh that's enough thank you very much so michael straight on the bed is that on the
25:57bed oh yeah sure it was okay on monday wasn't it it wasn't yeah it was okay you tolerated it okay and
26:03this time i took some painkillers ahead of time so well done if this has not improved within four
26:08weeks yeah you have to be referred to tissue viability if there's no improvement after four
26:14weeks okay tissue viability yeah you know you said that they think the ulcer has come from because
26:21you're veiny yeah because they did the ultrasound i've been having a look okay sickle cell is well known
26:28to cause ulcers yes so sorry it's okay
26:36are you on antibiotics for this no no i'm not you're not in the first week they gave me amoxicillin
26:43see amoxicillin is it's not the first line it's not what we would give you for wounds we would give
26:48you flu clocks i'll get one of the doctors to send one across for you yeah it has improved no am i
26:57wrong in thinking i'm just gonna swab it sorry michael it's okay i actually don't feel that that's
27:03because you're high on painkillers probably yeah i think you definitely need flu croxycyllin because
27:11there's a smell to this there is yeah yeah and it's got a green tinge to it and green is pseudomonas
27:19it's that thick bit in the middle
27:26it's so hard to moisturize as well because everything you put on your leg the plasters
27:32won't stick to after um so okay you need help with that no no it's okay i think i got it this
27:38one is that one is opening it's longer so it's a bit tight so when i'm out if i'm moving yeah it's
27:46good yeah but because you've got an ulcer at the ankle area you've got to be more prone to swelling
27:51yeah so if you cut your foot at all straight to the doctors and say i've had an ulcer oh okay yeah
28:00because you now you've had one ulcer have another you can get more unfortunately so all done all done
28:07thank you okay all good yeah yeah thank you very much i leave you to it let us send this off and see
28:13but it does take about six weeks okay the results okay don't forget to book my appointment
28:20i'll phone up to book yeah thank you you see why he joined me
28:25yes because it's me yeah thank you
28:33you're going to end up breaking that chat and then we're not going to know how to fix it
28:36i'm trying to push it up oh my god it's not going up do you know how to push this chair going up
28:42do the thing you have those magic hands i don't know how
28:48go on my babes thank you my babes oh how do i say it back forward it's the other oh
28:58you touched it and now i did it first
29:01you're blooming hiya have your appointment
29:08come and have a seat nice to see you so i'm dr pearson nice to meet you now how are you i'm good
29:14good good in the last month i've noticed that my balance is a little bit off okay and i was just up
29:21um visiting my mom up in newcastle i was talking to them about it and they said it could be an inner
29:27ear thing yeah yeah yeah so tell me what happens when you feel your balance i do i just feel a
29:33little bit wobbly when i like stand up okay yeah so as soon as you get up a bit yeah do you feel
29:39you're falling to one side yeah a little bit okay falling to the right i think okay tipping over to
29:46the right of it yeah and do you have you ever passed out or collapsed or fainted or anything like
29:50that no no do you does it ever happen when you're at rest or just lying in bed or sitting down it's
29:55only when you stand up and things is it yeah or walking or walking yeah okay do you get any visual
30:01problems or headaches or anything i'm visually impaired but other than that no so tell me about
30:07your eyesight what's happened um so i it started i was born blind and then they figured that out when
30:13i was 10 days old oh gosh um i was rushed into surgery at 10 days old and i regained sight in my
30:20left eye wow but i haven't noticed this balance thing recently before yeah okay and it was glaucoma
30:26was it yeah it was yeah okay so that's rubbish isn't it to have that when you're a little bit yeah so
30:32you've been able to sort of school and go through things you can say i live independently i brilliant have
30:38a job you know yeah just a couple more questions with it yeah have you noticed any change in your
30:43vision though no above what normal isn't you like you don't think it's anything to do with
30:47no eyes at all nothing and that's always my go-to is yeah my if my vision changes immediately go to
30:54the ophthalmologist but no there's been no changes and there's no way you're pregnant or anything no
30:58no no definitely not definitely not okay i'll let you go any young woman who's dizzy and feels a bit
31:02funny oh i know okay it's been several months oh all right so we'll put that one aside yeah and you
31:09recently had some blood tests i have yeah your blood count is lovely and normal your liver's
31:14lovely your thyroid your vitamin d your diabetes test is clear as a whistle the only one was your
31:19kidneys were a little bit dehydrated on that day so we just wanted to repeat it can i do things like
31:24check your blood pressure one is that's all right let me just grab my machine so this just goes on your
31:30arm okay and this will just take a minute i've had blood blood pressure taken so many times
31:37i'm sure you have i'm sure you have you're a pro at it all now yeah um 26 surgeries on my eyes
31:4426 i know it's crazy they're more planned and things are they um well presumably in my life but
31:51i mean things are stable right now so one two five seventy five so that's good news have you had
31:57any cough or cold recently or picked up a virus on the tube no no ear pain no can i have a look in both
32:05of them so just need prodding them a little bit let's just have a look do you ever get itchy ears
32:12do you ever put your finger in your ear and want to scratch them and itch them a little bit yeah
32:16because the ear canal cooks quite sort of red and a bit angry so do you wear air pods or anything
32:21like that yeah it's just sometimes that can inflame and but that's not really the inner ear which is
32:26what affects balance and that's a little bit the same that side actually but the eardrum looks lovely
32:31there's not lots of fluid in it there's not lots of wax it looks good i mean that's sort of incidental
32:37more sort of outage you do swimming no i don't one thing i can do to get help with the ears a little
32:42bit is there's a very good spray that we can use to try and clear the ears to stop the sort of any
32:46irritation and itch and it'll get rid of the redness for you but i still think we need to find out what's
32:50causing this because yeah the weird balance thing can i just have a listen to your heart for one
32:56second you don't need to move or anything i'm just going to put this on your chest just going to put
33:00it in just listen to your heart for a second sorry that's my phone not my heart no that's all right
33:10yeah strong normal going lovely and steady and things in balance is controlled in our inner ear
33:15inside which is strange isn't it but sometimes when we have some sort of ear symptoms it can
33:20change the blood flow a bit to our ears and make us feel a bit it's odd so i think it'll be
33:24interesting to see if the spray makes any difference so you can have it in your bag and
33:27just take it as and when if you do need it still doesn't answer what it is so we still need to come
33:32back to investigating it i just want to do an ecg as well a reading of the heart now i'm sure you've
33:36probably had lots of them if you had loads of anesthetics and yeah your bloods are good but we'll
33:41double check those anyway again and then we'll sit down and go through it all and see how we're
33:44getting on thank you so much not at all so we'll see you on thursday sounds good and you're going
33:49to the chemist to pick up everything yes all right thank you okay nice to meet you margaret you take
33:52care look after yourself all the best bye bye bye alice hello i've got to go in now go in but i need one
34:01yeah you're looking well no i'm not i think you're looking really well i'm happy to see you likewise come
34:07through it's been a while lots of stories to tell you good good take a seat make yourself comfortable
34:14right okay i'm suffering complete panic attacks are you when i'm in my flat it can come on just like
34:24that i have to get up and go out the house is there a tablet you can help me just calm down when it
34:30comes on me where i don't have to feel that way what sensations do you notice when it happened a lot of
34:37fear i've got fear i've got fear i think sometimes i might die i've got to get out i've got to see
34:43people i feel closed in so closed in yeah and and and that's happening quite a lot lately and it's
34:51frightening me
35:13is a tablet you can help me i mean there is but they're highly highly addictive that's the problem
35:18what is it diazepam if you had very physical symptoms of anxiety where you were having
35:23palpitations if you're sort of very sweaty a bit tremulous with it then there's a beta blocker we can
35:28use very safely oh yeah somebody said you could give me a bit of blood yeah propranolol we can try
35:33that but it doesn't sound like that's the symptoms you're experiencing because i get in a really bad
35:37state even at half two in the morning i come out of the house because i'm panicking at two in the
35:43morning i do honestly because i know i have to come out how's the smoking going as well by the
35:48way oh yeah i'm still off the cigarettes well done that's incredible that's really good yeah but there
35:54is another problem oh yeah it's another problem when you stop smoking you eat more you eat more exactly
36:00yep this is what i wanted to ask you today i would like you to give me that majority injection the
36:07difficulty is on the nhs at the moment they say we can only use it if the following criteria are met
36:13your bmi is over 40 and we can calculate that today and you've got four different medical
36:18problems so the arthritis and the hip pain absolutely counts as one without a doubt
36:23but then they've got to be things like diabetes high blood pressure high cholesterol all of those
36:28other things well i must have all that look at the size of me i mean your diabetes marker is nice
36:32and low your cholesterol is high so i'll give you that there's there's two can we check your weight
36:36today yeah all right yeah let's give it a go and then you know i didn't stop smoking i put on more
36:41weight well of course you will absolutely and and the weight loss will help definitely take the
36:45pressure off here wait on on sorry no it's all right don't worry can you manage oh lovely good
36:53are you okay nice and steady i need to let go because it's going to affect that just for a second
36:57so 86 fine don't tell me what it is okay fine don't tell me what it is stuff off there you are lovely
37:04right let's check yeah i mean your bmi is 35. i don't know what it should be it should be less
37:10than 25. oh yeah it's a bit high i was thinking maybe if you gave me that for a little while while
37:17i had the operation yeah and then um i wouldn't have to say you know what i think we can make a case
37:23for it i think it will really benefit you i really do and i'm sort of not saying that lightly but
37:28guidelines are there for a reason they're just a guide they're not sort of set in stone we are seeing
37:33more and more people come to the surgery um asking for uh monjaro prescriptions we are quite
37:38limited however with who we can and can't initiate it for alice is waiting to have a hip operation i
37:44felt that by giving her monjaro it would help to optimize her for surgery so it's a short-term
37:49measure for her really just to help bring that weight down nice and quickly to make it a little
37:52bit safer for her to go under general anesthetic how do you feel about giving yourself an injection i'm
37:57not worried about any of that okay great i just want to have this operation done quickly in Maine
38:03yep i'm willing to do anything to get out of pain yeah it's not nice to be in pain
38:08no and maybe when i've had all the pains gone i might have a holiday you should definitely treat
38:13yourself you definitely deserve it after 18 years absolutely you deserve it so yeah see how you get
38:18okay thank you very much all right my pleasure you're very welcome you are lovely thank you very
38:22much bye see you later i play hockey it's good for you enjoy it yeah i love it i couldn't live without
38:34it recently i've just been playing a lot of rugby football i think it's just taking its toll so you're
38:39feeling a bit more nice i played tennis a while ago and i just kept playing too much so it hurt then when i
38:46was playing a rugby match i hit my head okay it was a mild one but then the big one was on my knee
38:52worried that it might be internal bleeding because there's no bruise or anything i'll get an occasional
38:57sort of quite bad twinge but it does affect the only couple of sports that i do which are archery and
39:03pistol shooting i took a hard hit a couple weeks ago straight through the shoulder they actually thought
39:08i got knocked out because i was down for a little bit so were you going in for the tackle or were they
39:13no i got taken out i was down and then i played aussie rules over here i just noticed it was quite
39:19sore and because aussie rules is quite physical you obviously enjoy that you want to get back to it
39:23yeah so that's fair enough
39:28sally oh yeah hello all right let me call you back but i'm about to go into a gp for me
39:32uh no no i'll call you back in two minutes here hello hello hi sir come and have a seat yeah come
39:42and take a seat here dr pearson we've met before haven't we uh yeah definitely how are you nice to
39:46see you again it's been a few years yeah it has been it has been it's been all right yeah yeah just
39:50graduated from uni this year oh congratulations what did you get what did you do so i get my results at
39:54the end of the month i did criminology and criminal justice criminology oh my god what are you
39:58going to do with that then uh so there's a variety of things i can do lawyer forensic science police
40:03yeah definitely oh it opens lots of doors doesn't it well congratulations that's brilliant i remember
40:08you when you were little so i think you've graduated from uni i feel very old so tell me what's put you
40:12in today so i had a jujitsu incident a couple weeks back with my eye so there was like a clash of
40:19heads as we were sparring and then i have a bit of eye like trauma like redness yeah there's been like no
40:26pain or anything but i just wanted to get it checked no absolutely so tell me so it was a
40:30couple of weeks ago and what exactly happened uh so when we were sparring our heads accidentally
40:36clashed and then um it was initially around here but then it wasn't until i got home that i noticed
40:42the uh redness of the eye and did you have any sort of loss of consciousness did it knock you out
40:47or anything like that no no no i was i was fine did you vomit or anything at the time or anything
40:52good good okay let's just have a look at your items just to give my dad like peace of mind because
40:57is he a warrior yeah yeah yeah he's the one who sent you here yeah yeah i um went to parsons green
41:02clinic and he was saying oh they're not like oh yes they're nurses but they're more than uniquely
41:07qualified to go it's tricky isn't it because i think the old-fashioned thing is that you see the
41:11doctor yeah but actually there are lots of really qualified people like the chemists the pharmacists
41:15are amazing at dealing with things at parsons green we have paramedics and people often who are
41:19seeing patients and what they are particularly good at as well you can tell that is that if they
41:23think it's they're not sure about it they have a very left threshold for phoning us up and going can
41:28you see them i think you did the right thing yeah you did the right thing you can tell dad that i'm
41:32very happy you know i'd be happy to call them right on they are really good i just want to have a look at
41:37your eye so if you say straight ahead i'm just going to shine it in your good eye first okay and
41:43if i can i just put your eyelid down so i can see the redness there and if you look over towards the
41:48wall sort of that way that's it and you can move your eye around okay yeah yeah and if you stare at my
41:54finger okay and just follow it with your eyes do you ever see double or is that okay no it's okay so
42:01the pupils which is the black bit in the eye that opens and closes is doing exactly what it should be
42:06doing yeah the back of the eye looks lovely and careful there doesn't look i can't see any bleeds
42:10or anything horrible to be honest if there was your vision would be affected yeah yeah you'd have
42:14lots of floaters and funny things and you wouldn't be able we all get the odd floater but you'd have
42:18big splodges in your vision things like that so i think the eyeball is okay the problem is the
42:23tiny little blood vessels on the surface it just takes a bit of a knock and they bleed
42:27burst blood vessel i think and it said it was a subcontrovitable that's it hemorrhage so it sounds
42:32like it sounds like a drastic subcontractival hemorrhage it sounds awful it's a tiny little
42:37blood vessel and it shouldn't affect your vision so the key is if your vision starts getting affected
42:43if you start getting headaches if you start vomiting if something strange happens you come see me
42:47straight away okay well done and good luck with your results yeah thank you so all right but you take care and
42:52we'll uh just let me know if anything changes all right take care start bye-bye not at all nice to
42:56see you you too all right we'll take care all the very best thank you bye well thank you emily well
43:04done doris i have to see you next thursday yes you take care all right lovely to see you
43:34you
44:04Last night, I probably got up 20 times.
44:13I feel like I'm not going to breathe no more.
44:15Scary, isn't it?
44:16You know that you had a toe taken off?
44:18Yeah.
44:18That was because the blood supply to the toe wasn't great.
44:22That was because my toe was black.
44:24I just black out.
44:25And when you wake up?
44:26I just lie there and I think what in God's end am I doing down here?
44:34I just lie there and I think what in God's end am I doing down here?
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