- 2 days ago
Category
📺
TVTranscript
00:00Hello surgery
00:10Last night I probably got up 20 times
00:14But I feel like I'm not going to breathe no more
00:16Scary isn't it?
00:20I had an aggressive game of paddle
00:22But that shouldn't do too much damage
00:24Between having Crohn's acromegaly
00:30Bilateral glaucoma
00:32Which is really upsetting
00:34And then this to come on top of us
00:36Everything seems to be going downhill, ma'am
00:40You know that you had a toe taken off?
00:42Yeah
00:43Yeah, that was because the blood supply to the toe wasn't great
00:46Because my toe was black
00:48I just black out
00:54And when you wake up?
00:55I just lie there and I think
00:57What in God's land am I doing down here?
01:18Hiya, morning surgery, I can help
01:34Now, how can we help today?
01:36So I've had a sore hand
01:38Okay, yep
01:39When I got it x-rayed last Monday
01:41And it came back fine
01:42Okay
01:43It's obviously not okay
01:45So tell me a bit about it
01:46So about a year and a half ago
01:49Okay
01:50I hurt it
01:51Travelling
01:52Didn't think anything of it
01:54And it's been fine since then
01:55And then last weekend
01:57I was gardening
01:59Yeah
02:00Nothing, you know, out of the ordinary
02:01But it was really this whole section here
02:04Still swollen, isn't it?
02:05Was really swollen
02:06And this finger
02:07Yeah
02:08So I thought, yeah
02:09That it would be broken
02:10It hurts a lot along here
02:12Okay
02:13The swelling has gone down
02:15But it's still not normal
02:16It's not normal, is it?
02:17No
02:18If we put the hands together
02:19Yeah
02:20I mean there's definite swelling
02:21Around here compared to here
02:22Yeah
02:23And we've also got some other changes here
02:24I know
02:25Haven't we?
02:26Would that be arthritis?
02:27But why would I have arthritis?
02:29You're young
02:30Yeah, exactly
02:31You're young, it is right
02:32Before all of this happened
02:33Do you ever get joint aches and pains?
02:35Yes
02:36Yes
02:37Okay
02:38Yeah
02:39And is it in different joints
02:40Or just all the small joints
02:41Or bigger hips, knees?
02:43I sometimes, yes, get pain in the shoulder
02:46Okay
02:47And do your hands hurt?
02:48I mean obviously this one hurts
02:49Yes
02:50When you make a fist and things
02:51I mean can you do that?
02:52I can but this one was
02:54Like last week
02:55It was really sore
02:56I mean looking at it
02:57So these little swellings at the end
02:59Yes
03:00These are called hepadin's nodes
03:01They're
03:02They are part of osteoarthritis
03:04Right
03:05Which is a wear and tear arthritis
03:06Okay
03:07So you're only 53
03:08Yes
03:09It's miz
03:10I mean that is
03:11I know
03:12It's miserable to have though
03:13But that is a sort of type of arthritis
03:14And it's my right hand
03:15Which I'm very dominant right handed
03:17Okay
03:18And what do you do for work?
03:19I'm not working now
03:20Okay
03:21Did you used to use your hands a lot?
03:22Yes, typing and stuff
03:23Okay
03:24But I do worry about this a little bit
03:25The problem is that
03:26Sometimes for women more than men
03:28Lucky us
03:29Is that we sometimes get conditions that develop
03:32Yeah
03:33Where almost like our body attacks our joints
03:35Okay
03:36And it's sort of an
03:37Called an autoimmune disease
03:38And it can sometimes present with joint problems
03:40Right
03:41If it is just wear and tear and things
03:42Then we can go to a hand physio
03:44We can try and see someone
03:45Yes
03:46We can get you some help
03:47Yep
03:48But if it is an inflammatory
03:49Sort of what we call an autoimmune disease
03:50Where your body is attacking the joint
03:51We need to stop that from happening
03:53Because otherwise it will attack more joints
03:55And then it can damage them
03:56Okay
03:57And we don't want that to happen
03:58We need to know about it now
03:59Than further down the track
04:00Definitely
04:01Because then we go and see a rheumatologist
04:02Who's like a joint doctor
04:03You know that we can do
04:04To try and stop
04:05If that's happening
04:06Okay perfect
04:07If there is just sort of wear and tear
04:08The most important thing you do
04:09Is keep your hands moving
04:10Right
04:11Because if we don't use them
04:12And the muscles waste
04:13And just because you've got it at 50 feet
04:15Doesn't mean everyone automatically follows the same path
04:18That it's going to get worse and worse and worse
04:19Until your hands are completely unusable
04:20Some people it develops
04:22And then it stays quite the same for years
04:24Okay
04:25Hopefully it will go back to nothing
04:26Yeah
04:27But it might then flare up again
04:28Yeah
04:29In a few years time and things
04:30But if that's the course
04:31Then we'll learn how to manage it
04:32Okay
04:33When it does it
04:34Yep
04:35But we need to be sure that we're not going to miss something
04:36That we could do something about
04:37Yeah
04:38Yeah
04:39Sorry
04:40No that's fine
04:41Monday morning 9 o'clock
04:42Perfect
04:43Okay
04:44Sounds good
04:45Thank you very much
04:46Okay not at all
04:47Nice to see you
04:48Let me let you out
04:49There we go
04:50Thank you
04:51All right
04:52Take care all the best
04:53Bye-bye
04:54Mark please
04:55Yes
04:56Hello
04:57Hello
04:58How are you sir
04:59I'm well how are you doing
05:00Any better
05:01I've been better
05:02I've got a student with me
05:03Do you mind if she sits in
05:04No no you crack on
05:05Yeah yeah
05:06Come through
05:07Take a seat
05:08How's it been since yesterday
05:09We spoke on the phone
05:10Diarrhea
05:11Abdominal cramps
05:12Yeah
05:13Any better
05:14Eased off not as frequent
05:15Still not fully
05:16Every time I go
05:17Yeah it's been a very long time
05:18Since I felt like I had a proper nice kick
05:19And what's caused all this
05:20Any obvious triggers
05:21Any undercooked foods
05:22Takeaways
05:23Anything like that
05:24That's what I thought it was
05:25I assumed it was food poisoning
05:27Then after a couple of days
05:28Sit up there please baby cakes
05:29As I say after the second
05:31Third day
05:32Still weren't easing off
05:34That was when I was maybe
05:35Looking at other stuff
05:36I wasn't sure if it was to do my hernias
05:37Because I've got three hernias
05:38Because I've been going to the gym
05:39Yeah
05:40I wasn't sure if I've disrupted them
05:42With an illness like this
05:43The most important thing is
05:44You're not dehydrated
05:45So you check your blood pressure
05:46To make sure
05:47Heart rate etc
05:48Have a feel of your tummy
05:49To make sure that's okay as well
05:50Are you going to help?
05:51Do you want to help?
05:52Do you want to help?
05:53Do you want to pop this on your dad's finger for me?
05:56Yeah
05:57On the other hand
05:58There you go
05:59Goes in there
06:00That's it
06:01That's it
06:02Well done mate
06:03Really good
06:04Well done mate
06:05We'll make a doctor out of you
06:06Yeah I think
06:07How does that work on you?
06:08So it uses light
06:09It uses infrared light
06:11To measure the heart rate
06:12And how much oxygen is going through the bloodstream
06:15It's very clever
06:16So oxygen levels are 98%
06:17Which is really good
06:18Heart rate is 76%
06:19Which is really good
06:20So we can take that off
06:21So simple
06:22Thank you mate
06:23Well done
06:24What are I going to do?
06:25What are you going to do?
06:26Nothing
06:27Because you're a terror
06:29Great
06:30So your blood pressure is a tiny bit on the high side
06:32But actually I'm not worried about that at all
06:34In an illness like this we worry if it's too low
06:36Would it be okay to have a feel of your tummy on the couch?
06:38Yeah sure
06:39Right kids you've got to come out
06:40Is it daddy's turn to go on the couch?
06:41It's my turn to go on the couch
06:42Yeah
06:43You guys can sit there
06:44You go over there with the giraffe
06:45Very quick
06:46Any pain at the moment?
06:47It's tender
06:49Not necessarily all the time
06:50I can feel it's tender
06:52So
06:53That's uncomfortable
06:54That's absolutely fine
06:57I'm just going to have a listen to your bowel sounds
06:59I'll be two seconds
07:00Just get this
07:07Good
07:08Absolutely fine thank you
07:09All done
07:10So your bowels are nice and active
07:11That's really good
07:12Tell me about it
07:13Yes
07:14Well yeah
07:15You obviously know that
07:16I think why don't we get a stool sample sent off
07:18Just to make sure
07:19Yeah sure
07:20And then take it from there
07:21And in the meantime just keep doing what you're doing
07:22Hydrating well
07:23Yep
07:24Bland foods for now
07:25Brilliant
07:26Have I got any stickers for you guys?
07:27Shall we have a look?
07:28You're in luck
07:29I've got four left
07:30Which one would you like?
07:31Oh
07:32Which one would you like?
07:33Nice
07:34That's a good choice
07:35And what one would you like?
07:36I don't want one
07:37You don't want one?
07:38No he's too old
07:39Are you too old are you?
07:40Too cool for school
07:41That's alright I don't mind
07:42Right
07:43Thank you very much
07:44Let me give you a poo sample to give it as
07:45And then I'll label it for you as well
07:47So that it's all done
07:48Perfect
07:49Appreciate that
07:50This is for daddy to have some test baby cakes
07:51Glad that ain't been well
07:52Yeah but where's that?
07:53It's just a pot
07:54To do what?
07:55We won't discuss that
07:57Maybe we'll
07:58Why?
07:59I'll tell you outside
08:00Tell me
08:01I'll tell you outside
08:02There we go
08:03We'll take it from there
08:04Working
08:05Alright
08:06You're working
08:07You're going to stay here
08:08Do you want to stay and help?
08:09That'll make my day much more fun
08:10It'll make my day easier
08:12I can imagine
08:13Bye
08:14High five
08:15Say bye please
08:16Bye
08:17Take care see you later
08:18I'll tell you
08:19I'll tell you
08:20You're nosy little nana
08:21Rina say why am I shouting?
08:23Because she can't hear me
08:24Okay shush
08:25He he he he he he he
08:27Why do you laugh like that?
08:29He he he he he he
08:31Sound like the Grinch
08:33The Grinch
08:38What does he say?
08:40I'm going to ruin your Christmas
08:42Nice to see you
08:49And you too
08:50Now you're looking well
08:51Very glamorous
08:52I like your dress
08:53You'd hardly think I would come with a medical complaint
08:55I like your shoes matching your handbag
08:57Look at you all
08:58I've had them for years
08:59And the dress
09:00Oh you look so lovely
09:01How are you?
09:02I've been very tired and exhausted
09:04And I've been very unhappy with this diagnosis of
09:08Bulbas penphoid
09:10Is that what they've said?
09:12A sudden stabbing pain
09:14A prickly pain
09:15And then I get a terrible itch
09:17And I literally have to scratch scratch scratch
09:19Just to relieve it
09:20Yes
09:21And then it oozes
09:22And then it bleeds
09:23Bulbas penphigoid is a rare skin condition
09:26That can affect people often in the older ages of life
09:29Over 60
09:30And it starts as a sort of flat itchy rash on the skin
09:33That can then develop into blisters
09:35And then these blisters can become really big
09:37Really painful
09:38And can be actually quite dangerous when they burst
09:40Lead to infections and ulcers and other things
09:42And let's have a look at it
09:43Because I can see it quite dramatically on your legs here
09:46Yeah
09:47There
09:48That looks really odd
09:49Pleasant for you
09:50And all these spots
09:51Are all over
09:52Okay
09:53And also on my
09:54Like here
09:55This
09:56From scratching
09:57And here
09:58Oh I can see them there
10:00Bulbas penphigoid is an autoimmune condition
10:02So normally our body has an immune system that attacks bugs, viruses, germs
10:06When they come into the body
10:07But sometimes it turns on itself
10:09And it starts to affect the skin
10:10And that's what's happening here
10:12It makes me want to scratch it
10:13Yes
10:14It looks so itchy
10:15Doesn't it?
10:16It's horrible
10:17It's been in my mucosal tissues
10:18It's been
10:19Also on my lips
10:20Along here
10:21There's bumps
10:22And also on my eyelids
10:23It's actually inhibited me from doing the things that I'd like to do
10:26Or going out
10:27Can you think of anything that causes it to get worse?
10:29I think recently a friend of mine died suddenly
10:32Oh I'm sorry
10:33And then a few months ago I heard from another brother of a friend who had committed suicide
10:39And that really shocked me
10:40Oh dear
10:41And I'd only heard from him a week before, no inclination
10:43So that really upset me
10:44Of course
10:45And I just thought why is everything so sad around me
10:53Am I allowed to say you look fabulous?
11:10Thank you, that's very kind
11:11Come on through Kate
11:12No, come on through
11:13You look nice
11:14So do you
11:15Where are you going?
11:16I'm actually not going anywhere
11:17Ah
11:19Uh Jacqueline
11:20You're looking very well today
11:21Am I?
11:22Yeah
11:23Come through
11:24Take a seat
11:25You look well
11:26Feeling well actually
11:27Yeah
11:28That's what we like to hear
11:29Better than falling apart
11:31You look very good
11:32Thank you
11:33In your hat that you're wearing
11:34Very chic
11:35Every time I put it on I feel like Frank Spencer
11:38Oh no
11:40The itch has been aggravated
11:42It's been a lot more prevalent
11:44Since this
11:45Because I'm still trying to get over
11:46I'm sure
11:47The shock of hearing that
11:48I'm so sorry to hear that
11:49That sounds really sad
11:50Doesn't it
11:51Between having Crohn's
11:53Acromegaly
11:54Bilateral glaucoma
11:55Which has really upset me
11:57Because I have very limited vision
11:58And the left eye
11:59And then this to come on top of it
12:01So everything seems to be going downhill
12:02And I'm trying to just keep as healthy as I can
12:04And keep positive
12:05Well you look amazing
12:06When you've got all these conditions
12:07I try
12:08I think the stress
12:09The stress has definitely aggravated the frequency
12:11This last few weeks
12:13And it's very very common
12:14I mean almost all skin conditions do react to stress
12:16Yes
12:17I'm worried that it's stopping you doing things
12:19Very much so
12:20Very
12:21So I've not been going to stay with anybody
12:22Do you think talking to someone would help?
12:24Some counselling where you're talking to a counsellor
12:26Who can sometimes help you with some of the feelings of
12:29Perhaps not wanting to go out or feeling a bit apprehensive
12:31Yes
12:32Or a bit nervous
12:33Lacking in confidence
12:34Because I've always been outgoing and bubbly and positive
12:37But that has waned
12:39You're only 76
12:40Yes
12:41You've got a fair few more years on this planet
12:42Thank you very much
12:43And we want to enjoy them
12:44And you have a right to enjoy them
12:45And we should try and see if we can help get that back
12:47And I totally hear that the skin is a big thing holding you back
12:50Yes it is
12:51So let's deal with that
12:52I think we can get rid of a lot of this
12:54I think if we put the right cream on
12:56I think if we have a really strict regime of a certain cream
12:59That has a bit of anti-itch in it to put on after the shower or bath
13:03Then we could put on top a steroid-y type cream
13:06And then we target the little bits
13:08And another thing I had which helped at the time
13:10It was a tablet called Fex or something
13:14Felidine
13:15It's like an anti-itch tablet
13:16That was really good
13:17I really think we should start that again
13:19And I'll refer to the counselling
13:21Thank you
13:22And I think it's a good thing
13:25And they will contact you
13:27There's always a little bit of a wait
13:28So it won't happen tomorrow
13:29That's okay I understand
13:30But again it's in the pipeline
13:31And then you can talk about your friend
13:32And what's happened
13:33And the difficult time you've had
13:34Over the last couple of years or so
13:36All right
13:37And then I'll come with you to the desk now
13:38And we'll book a follow-up
13:39Thank you very, very much Josh
13:40Lovely to see you
13:42How's the lip?
13:44Looking better
13:45But the stitches
13:46As I thought they might not have
13:48Are not dissolving
13:49So we came back and was wondering
13:51If you could have just a snip at them
13:52Is that okay with you?
13:53Yeah
13:54It won't be painful I promise
13:55Yeah he wouldn't let me do it
13:56No that's fine
13:57How would you feel about lying on the couch
14:00And then I'll put a bit of wet gauze
14:03Just to clean it
14:04And then I'll use a little tweezer
14:06And then we'll just cut it a little bit
14:07So it shouldn't be painful at all
14:08And if you want me to stop of course I will
14:10Not a problem
14:11Is that okay?
14:12Yeah
14:13Right
14:14There you go
14:16So you just need to lie down and chill
14:19For five minutes
14:20That's quite nice
14:21How's your day been okay?
14:22Yeah
14:23Been up too much?
14:24No
14:25Not really
14:26Just chilling
14:27Very good
14:28Right
14:29He was supposed to do cricket
14:30But we went to the dentist
14:31And they said oh
14:32While he's still healing
14:33Probably not the best thing
14:34Oh fair enough
14:35As his teeth got a bit of a bash
14:36And did they give you the all clear?
14:37Your teeth are okay?
14:38They're quite happy?
14:39Yes
14:40Good good
14:41An x-ray
14:42Lovely
14:43So it's just going to feel a little bit cold
14:46This is literally just clean salty water
14:49Lovely
14:51Tiny bed but it doesn't touch your skin
15:00So don't worry about it
15:01This is just some tweezers
15:02So I'm going to pull that
15:04Well done
15:05Are you able to turn your head that way a little bit for me?
15:19Well done
15:21You're hard as nails
15:22You're very good
15:23You're not even flinching
15:24Look at that
15:27Look at that
15:28Any advice on scarves?
15:29It'll heal really nicely
15:31Pop a bit of Epimax on it
15:33That just keeps it nice and moisturised
15:35Okay
15:36Preventing sort of drying out
15:37Okay thank you
15:38Absolutely fine
15:39I don't think you'll even notice it to be honest
15:40Okay
15:41Perfect
15:42In a few weeks
15:43I've got it all
15:45Good
15:50Absolutely fine
15:51That's you done
15:52Let me bring this back down for you
15:53Thank you so much
15:54Thank you so much
15:55My pleasure
15:56Any problems come back
15:57If it's looking infected or anything
15:58Well done
15:59You did a great job
16:00Take care
16:01Nice to see you again
16:02Yes likewise
16:03All the best
16:04Take care
16:05Hi Paul
16:06It's Rina from the Fuller Medical Centre
16:13Paul can you hear me?
16:16It's Rina from the surgery
16:19From the surgery
16:24Getting more and more wound up
16:25Before we couldn't hear this
16:29Take a seat
16:30Can I have your outfit?
16:31Oh Thank you
16:32Thank you
16:33Take a seat
16:34So
16:35Any changes in terms of your symptoms
16:37Are you feeling wheezy?
16:38Bruveless?
16:39Yeah it's been fine this year
16:40I haven't really had the hay fever
16:41No
16:42No
16:43No
16:44No
16:45No
16:46No
16:47No
16:48No
16:49No
16:50No
16:51No
16:52No
16:53the hay fever symptoms as bad as I you know used to usually when my hay fever is bad that's when
16:59I get wheezy and the breathing's bad unless I get a chest infection you know in the winter or unless
17:04I was running for the bus but because I've not really been getting the bus so I can give you an
17:10inhaler to keep at home to use just in case if you then you know become you know more wheezy more
17:16breathless the blue one is not really recommended anymore because it's not really treating asthma
17:21so it is more like to open up your airway to help you at that point to breathe so it probably works
17:29for about two hours or so but it wouldn't last for the whole day so it would be something called
17:33a symbicote has two ingredients in it a mild steroid to help to reduce the inflammation of your airway
17:39and also something to open up your airway compared to the blue one it opens up for a bit longer why
17:45would I not just have the blue one because the blue one is not treating asthma it's not really
17:50help so let's say if you're feeling wheezy likely your your airway is a bit inflamed that one wouldn't
17:56clear the inflammation it just opens up to help you to breathe it's scary when you can't breathe
18:02or when your chest is tight so I think like when I was wheezy or if I'd run for the bus yeah and then
18:07it'd be tight then I'd take that and I think sometimes I used it as like a panic you know like
18:12it was a panic reliever more than like anything else because I'd like my chest would be tight and then
18:17I'd take that and then I'd you know I'll think okay it's okay now could be psychological as well
18:22but I think as well if you you know if you've got lots of stress going on as well and then you
18:26panic and or you're breathless I think it's big where I've come I've just become co-dependent on it
18:31yeah where it's like you know I just reach for it because I know like oh when my chest is tight like
18:37I have a puff if you're happy to I'll give you a new one yeah as a standby instead of the blue one
18:45like you said if you're catching a bus you feel breathless you can then do one puff and then maybe
18:50towards the winter time when you feel okay you do need that on a regular basis then give us a call
18:57come in we gonna refer you to do another test that inhaler how you use it is you twist the bottom
19:03you will hear a click you breathe out to empty your lung you then do a quick and deep breath in
19:09and then hold your breath for 10 seconds I'll send your video to watch but yeah in the meantime
19:15if you you know symptoms get worse any problem give us a call yeah okay okay yeah okay thank you
19:22thank you Edward how's everything okay good come in have a seat I'm Dr. Dutchman thanks for seeing
19:41me not at all what can I do for you today so I've been experiencing some sort of growing pain started
19:47off as sharp and painful when I stretched either backwards or when there was any pressure exerted
19:53and then that more focused pain that's around the belt like right there yeah has sort of expanded from
20:03pressure tenderness to more dull sort of numbing kind of pain slightly into the back yeah slightly
20:12down the leg and so around here it's just so much so that I feel I had to yeah come in because obviously
20:18it's progressed over about a week and is the pain there all the time yeah it is there all the time
20:23but mild and any pain down below is any pain in the testicles no no lumps that you felt nothing like
20:30that okay do you mind if we have a feel of the tummy would that be all right take this jacket off all
20:35right all right just pop up on the bed I'm just gonna have a feel if that's all right
20:44yeah see that's that's a little bit more sort of yeah around there yeah yeah I can definitely
20:52yeah that one's a little bit this size fine nothing there okay so if it was this side that's
20:58obviously where your appendix is so unless you're one of those people that has things on the opposite side
21:02which is unlikely but you are quite sorry that's okay it's it's sore yeah yeah
21:16okay relax keep your hands and feet inside the ride at all times
21:32and down here any pains yeah it does mommy's tummy's lovely and soft
21:38yeah a few times I feel like I'm gonna farm it and I can hear the bowel sounds and they sound normal
21:43okay I'm just gonna press gently let me know if it's painful no I can feel it though
21:49but it's not painful good I'm just scared of eating because I know if I eat it will just go right
21:54through me any problems peeing going for a wee no not rushing to the loo to do lots of yeah yeah
22:00that's what we get on the older it's yeah really really good perfect that's absolutely fine thank you
22:06so much really good examination that's where it is it's really really painful maybe it's a strain or
22:12something you know I had an aggressive game of paddle but that shouldn't do too much damage
22:19I mean you can strain a muscle do you think you could do a quick urine sample sure yeah whatever
22:23needs to be done I think then at least we can rule out any urine issue the toilet is literally just
22:29there if you just do that quick I'll just dip it
22:44and what about at night how's the pain being it's not kept you awake no it hasn't kept me away so in
22:49the urine we're just looking for things like blood in the urine and unlikely to be a kidney stone from
22:55your symptoms but just to kind of rule out anything like that the urine looks completely clear though
23:01so there's no blood no white cells so that is good have a seat so where your pain is if it was on the
23:08right hand side I would be worried about your appendix because you are in quite a lot of pain it could be
23:14muscle strain but you are quite tender I think what we do is we sit on it for a few days I'm going to
23:21request an ultrasound just in case the pain doesn't go but if over the next few days you think it's
23:28worse then the next step would really be going to A&E where they might do some imaging sooner you could
23:33definitely take some some paracetamol or something just to try and ease the pain and hopefully it will
23:38just ease off but there's nothing today that spells something urgent does that sound all right that
23:43sounds like good news everyone if it gets worse please come back we'll do all right thank you very
23:48much for your help have a great afternoon
23:59really let me come around and say bye when are you going uh 20. where are you going to move oh wow three
24:08months i'm going silent oh spiritual journey okay are you going to go bold oh what you're a woman
24:16a woman you should become a monk are you going to become a monk mate okay no i'll see i'll see you in
24:22six months then okay good you know i pray for us praying for us as well yeah scarlet hello you're falling
24:32asleep on me oh you've got headphones on don't worry come on in we've got your injection to do today
24:40have you got your injection with you yes i have it with brilliant brilliant okay fantastic so this is
24:46it so this is your injection to help control the hormones to keep the hormones in check isn't it
24:52okay and how are you feeling in yourself today i'm feeling good good
24:57well let's do your injection let me just get it ready for you yeah and then if we can get some
25:05hormones and your hormones yeah let me just draw it up i want to make sure we get all of the medicine
25:12in here i have the family and everything yeah fine but they're grown up already no they are they're
25:19getting bigger and bigger they change so quickly don't they yeah and all you ever want for them is
25:24them to be happy you know that's the only that's the last thing that my mother say i just want you
25:29to be happy did she your mother's no longer with us no no i mean i think that's all most mothers do
25:35and you are happy you say a lot of times i think it's exactly bits we can help with better but good
25:41for you well look let's do this this week so we need to do it so we did it on the left last time so
25:46we'll do it on the right hand side okay so the right hand side is this one okay so do you want to lie
25:51down sit down or do you stand up that was easier you're happy to extending okay if we lift up that's
25:56brilliant it'll just be a sharp scratch straight into the bottom nothing at all okay thank you i'll
26:03put that all on the computer and do you still see your specialists at the hospital at all yes of course
26:09and they're happy with everything yeah yeah they're happy with everything what i can do is we'll do it
26:15again in three months are you okay for all your other prescriptions or you need to have the hormones
26:20yes so we can do those i'll send all those down to your pharmacy so that will be ready straight
26:25away and do you want a prescription for the injection again and then you collect it and
26:30you're very good at doing that and i'll put a reminder on and you try and remember and between
26:34us we'll make sure we get it done don't worry i do remember yeah yeah thank you for everything so
26:40that's the prescription and the other one's gone to your chemist and i'll see you in three months if
26:44not exactly thank you and i want to see you like that nice and beautiful i don't know in november
26:49we'll be in summer dresses but we can see no but you don't like like nice and very nice figure
26:55you're very sweet thank you thank you very much and i'll see you in a few months any problems you
27:00ring us if you need to yes thank you all right thank you bye-bye nice to see you nice to see you
27:08i'm dr dudgeon nice to meet you nice to meet you as well so last week were you taking your
27:13dosset back to the pharmacy you know the box with your medicines in and why were you doing that because
27:20i didn't need any tablets okay i don't like taking pills if i'm not used to okay and do you know any of
27:26the tablets that were in there no no when do you think you last took them okay when i was in hospital
27:32take me toes off did someone tell you to stop taking them no no what what made you decide to stop
27:39because there were tablets everywhere you felt there were too many i'm not used to taking tablets
27:44okay but you had been on them a few years hadn't you no no as long as i'm breeding they don't care
27:51can i talk through the medicines and why they wanted you to take them yeah okay
27:55so two of them one called aspirin and one called clopidogrel are to help your blood
28:03you know that you had a toe taken off yeah yeah that was because the blood supply
28:08to the toe wasn't great because my toe was black exactly okay and so you're on those medications
28:15to try and keep the blood supply good to the rest of your body and then you're also on a statin
28:21have you ever heard of statins so cholesterol can build up fatty deposits in the blood the statins
28:28lowers that and again that's part of the trying to keep the blood flowing to all your toes and things
28:35the last one was a tablet called pregabalin which must have been for pain so normally for nerve pain
28:42do you have any pain no okay i mean i think if you have no pain let's stop the pregabalin and then
28:50you've got one less tablet but i'd ideally like you to take the other four four so the aspirin and
28:58the clopidogrel for the blood the statin for the cholesterol and then the lansopazole to protect
29:04your stomach from the other two i drink plenty of guinness that would keep it clear wouldn't it
29:10the lansopazole will be good for the guinness too oh that's all right all right how much guinness do you
29:16drink three or four points a day okay and have you always drunk that much yeah i used to drink 14
29:22points a day okay so you're drinking less much less yeah how do you feel your memory is it's all
29:27right when i need it yeah how would you feel about coming to see sam next door just for some blood tests
29:35and how would you feel if she did a test of the memory as well yeah yeah we could get that all
29:40i know sam well with the dosets do you feel now you know what they're for yeah they definitely want
29:46the tablets every day for the rest of your life to keep that blood flowing the rest of my life i want
29:51about long left have i oh i think you've got a bit but the tablets will help all right
29:56shall i help you back out i'm still alive
30:04just stand one sec i'm just gonna get the door
30:10you've done this before haven't you yeah a few times
30:13that's all booked tim what's going on yeah you can enjoy want a cup no thank you i don't drink you
30:28don't drink no i can have fun without a drink how do you do i just be a jolly person i don't know what
30:36i've done it well there you go that's why you have to have a pint and i don't thank you very much bye
30:47how can i help today i just cannot breathe okay i put my head down on the pillar and
30:55and all of a sudden i can't breathe right so i have to get up and i do that hour after hour
31:03through the night i was a bit lucky this morning i put my head down at six o'clock and i woke up my
31:09half past seven okay that was good but mainly it's a lack of uh oxygen yeah you're feeling short of
31:17breath at night time two years ago i didn't have this problem last night i probably got up 20 times
31:24oh no so sleep really disrupted really disrupted absolutely how long has all this been going on for
31:29six months my body has got no energy especially here feeling tired my thighs your thighs as well
31:40yeah i can hardly get up you know but i feel like i'm not going to breathe no more scary isn't it you
31:47know really gasping for breath i just felt a bit desperate
32:11did you have a sore throat before this cough i went to am7 and went and saw a concert
32:15on the night of the concerts i got a really really bad sore throat to the point where i couldn't
32:19even swallow like saliva have you had a look at the back of your throat oh mom has yeah yeah i did
32:25and it was weird it looked really weird you know like like see-through yeah apparently i was saying
32:29it looked translucent yeah okay it was weird so it's a moment that freaks you out yeah your weird throat
32:35she's picked up a sore throat from me i think does it feel like you're swallowing sharp knives and things
32:40like that yeah open wide and set r black good it does look very sore back there it is
32:56so come and have a seat i'm dr pearson hello how are you doing good thanks so i know you spoke to
33:01one of the gps yesterday but i wondered do you mind telling me what's happening how are you feeling
33:05um so i don't know if it's related to my coil yeah basically i had it put in two weeks ago two
33:10weeks ago yeah so everything was fine it wasn't i just had normal symptoms yeah but i've been really
33:16ill since for a week now kind of like fluey and like okay i think maybe like throat cold just feeling
33:25like okay really bad like my glands are bad i've had tonsillitis a few times okay but i have actually
33:31had my tonsils taken out ah it must have been bad for them to take them out i was like five when i
33:37had them out i was always like choking on food and stuff because they were so massive and have you
33:41had fevers this time i think i actually don't know doesn't matter but i'm yeah like right now i'm
33:47literally like sweating and at night and then yesterday by the afternoon i was like freezing okay
33:53and tell me about the cause of the coils gone in is it your first coil yeah before before is it the
33:57morena the hormone one okay any people often have bleeding at the beginning are you having a little
34:02bit any discharge or discomfort or anything is it and pain anywhere so yesterday there was a bit of
34:09pain which made me think so normally with the colon if two weeks into it if it was to have introduced
34:15infection or say we'd know about it normally and we'd have discharge and bleeding and lots of cramping
34:22your womb would be trying to get rid of it like yeah okay good pain sort of proper cramping pain
34:26okay good if you're not feeling that it's probably more related to all of this that we're doing or
34:32whatever and i think can i just put my hand on your tummy just to be 100 sure about you so i'm always
34:35just a bit paranoid with it let's have a lie down on here i just want to press really gently just
34:40tell me if there's any pain as if i press no no no no pain here no so normally if there was
34:49thing that would be really sore and it's not okay so your tummy's nice and soft so let me just check
34:56your temperature now 36.3 is that okay so that's okay okay so even though you're feeling sweaty and
35:04things the temperature is good let's have a look in your throat and see if you open wide for me
35:08and say oh it's very red at the back there really red and actually there are some white bits at the
35:15back at the very back and the roof of your mouth yeah and if you just say ah yeah that does look
35:22really sorry it looks like someone's been rubbing it with sandpaper can i just have a feel of your
35:26glands in yeah as well let's just have a feel it just tickles you know yeah you're quite right look
35:31at that great big lymph nodes yeah in there isn't that yeah i think we've got a clear source of where
35:36this is coming from why you're feeling if it looked all normal i'd be more worried about the core
35:40but your tummy's soft yeah it does look really sore i wonder if antibiotics actually might make
35:44you feel a bit better yes i i think i don't know how you feel about them some people are really
35:49let me do it and i'll send them what i'll do is i'll send them straight to pyramid pharmacy
35:52lots of vitamin c salt water gargles onto your paracetamol and things that just to control
35:56any sweating and it'll make you feel a bit better and the antibiotics will kill it all off and any
36:00other problems or anything weird or wonderful come straight back and see us yeah we'll do thank you
36:04so much good luck all the best we've done bye-bye i just felt a bit desperate yeah well you've
36:12definitely done the right thing so i'm glad you came in 100 now obviously with everything that's
36:17going on with your heart and all the medications you're on so maybe there's a bit of a progression
36:22in the heart failure side of things oh i see how are you getting on with your tablets i'll tell you
36:29the one pill that seemed to help me yeah was furuzumide yeah some doctor said about it clearing me lungs
36:37it does indeed yeah offload some fluid would it be okay to examine you today to have a listen to
36:42your breathing oh yeah and stuff john is a lovely 86 year old man who i've known for about three and
36:47a half years now i've been involved in his care since the time of his diagnosis of heart failure
36:52in heart failure the effectiveness of the heart to pump the blood around the body is reduced and
36:57get backtracking of the blood into the circulation and a build-up of fluid around the lungs which can
37:01cause shortness of breath especially at night and a build-up of fluid around the legs which can cause
37:06leg swelling and that can be quite painful and uncomfortable and what do you think's going on
37:10what do you think's causing all of this i can only think of the phlegm in me lungs you know yeah it
37:16gets to here yeah and then it's like it's cutting off the airflow you know yeah i understand your
37:23oxygen levels are very good 98 and your heart rate is normal at 62. are you able just to take your jacket
37:28drop is that all right thank you nice deep breaths if you can lovely
37:43perfect and i'm just going to listen to your heart now
37:48lovely absolutely fine good really really good your chest sounds really clear
37:51so there's good air entry throughout no no yeah everything you're saying sounds like there is a
37:57build-up of fluid around there yeah but when i listen in it's crystal clear there's no fluid
38:01that's good news it is good news but it then makes me wonder what's the best thing to do moving forward
38:07for you so i think what we need to do is maybe ask the heart doctors again for a bit of help because
38:14i'd be really reluctant to play around with your meds and in the meantime if you're finding that the
38:18higher dose of the furosemide is helping it's perfectly fine to have one tablet at eight in the morning
38:23and one at midday i'll do an urgent referral because i want them to see you quickly the heart
38:28doctors just to see i don't want to get slower and slower exactly exactly i'd rather be out the game
38:34you know oh no no i don't i know you mean horrible i know what you mean i know what you mean i just you
38:39know yeah it's really tough with this condition it's really difficult as long as i can get on a bus
38:45that's all that matters to me yeah well let's aim for that let's let's see if we can get you a bit
38:49stronger okay thank you very much any questions before we go no no i've got the team my wife kills
38:55me if i don't ask the right questions that's good absolutely she keeps you right that's good are you
38:59guys managing okay at home yeah yeah you don't need any extra help or anything no but the way i'm going
39:06it won't be long well if you do let us know because there's lots we can do for help yeah don't
39:11don't suffer in silence i will remember that yeah i do let me help with that there you are
39:17thank you take care all right my pleasure you're very welcome take care
39:27reena yes if you could only eat food for the rest of your life there was a certain color what color
39:32would you pick food one color for the rest of your life yeah but is it like if i say black can i have a
39:38black tomato yeah red what are you eating that's red it's a weird weird option are you just thinking
39:49tomatoes afternoon surgery how are you doing i hear you've been in the wars i keep falling over i hear
39:59my neighbor i called for him i got up and i was okay i turned around to do something i fell over again
40:07and then i just couldn't get up i just black out i don't you don't feel it coming on no no and when
40:15you wake up i just lie there and i think what in godsend am i doing down here it's not always when
40:20you're turning or anything like that yes sometimes that but um last time i actually hurt myself when i
40:28fell because i fell over the threshold of the house and the garden and i had terrific pain down here
40:36they're not always when you get up like getting up from the loo or getting up from a table that
40:41might be sitting at you don't know i no i can't say i do yes now wait a minute somebody was in the
40:47house and i had to speak to them and i got up but i got up very quickly and i think that didn't help
40:55and then i held on to the side while i'm okay let me let me do my blood pressure yeah not mine but
41:02yours with my machine and how are you doing otherwise i'm fine birthday birthday next week yes
41:12i've got my great-grandchildren coming tomorrow probably and you cope on your own okay generally
41:17don't you you're very independent yeah i just want you to stand up for me you can do it again
41:29no drop sometimes people get a a drop when they stand up and that can be a cause of falls and things
41:35so that's important that there isn't drop no but we're still going to continue because there's a falls
41:43clinic in the hospital which investigate and i think you probably need to really get on their list
41:49because i know you've had little tias in the past as well and also they can test whether it's your
41:55balance you know when you're turning does that do it but generally one doesn't black out completely if
42:01that's happening but that is doesn't frighten me anymore because i never hurt myself except last time
42:07yeah and that's when somebody said oh you ought to get one of those things around your neck well you
42:12do yeah do you want me to no i don't really want to do that you know if you're on your own and the
42:18neighbors aren't one-sided you know when you can't get through and you're in the house you're lucky you're
42:23in the garden and they were around well and my grandson is coming next week it's my birthday and i want
42:30him to fix a grabber at the side of my door so i can pull myself you get someone who else independent
42:38to do things like that if you want as well yeah someone to come around occupational health type
42:44thing and they'll come and visit and they'll assess oh i need somebody like that i'll mention it to them
42:49as well i'm going to do a falls referral anyway it needs investigating and i will chase up the
42:56appointments okay yes thanks very much nice to see you take care thank you bye now bye as always lovely
43:06so lovely to see you likewise yes i'm glad you're doing well thank you take care bye bye thank you
43:11very much all right well well done nice to meet you yeah good luck with your ai thank you thank you very
43:16very much thanks so much thank you good afternoon yeah bye-bye
43:31you
43:46you
44:03you
44:05The pain has been getting so bad, I'm not going to get up.
44:22Okay, well, that's not acceptable, is it?
44:24The hallucinations must be upsetting.
44:25It's horrible.
44:26They don't frighten me that much.
44:27But I remember speaking to you once when the dogs were there, and it was horrible, and the snakes were even worse.
44:33How have you been?
44:34Terrible.
44:34Oh, no.
44:35Well, I must sit on this earth for.
44:37I must sit on this earth for.
44:40I must sit on this earth for.
44:42I must sit on this earth for.
44:45I must sit on this earth for.
44:48Transcription by CastingWords
Be the first to comment