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00:00Hello surgery last night I probably got up 20 times but I feel like I'm not going to breathe
00:10no more scary isn't it I had an aggressive game of paddle but that shouldn't do too much damage
00:19between having Crohn's acromegaly bilateral glaucoma which is really upsetting and then
00:29this to come on top of us everything seems to be going downhill you know that you had a toe taken
00:37off yeah yeah that was because the blood supply to the toe wasn't great so because my toe was black
00:43I just black out and when you wake up I just lie there and I think what in godsend am I doing down
00:54here
01:02hiya morning surgery I can help now how can we help today so I've had a
01:32sore hand okay yep when I got an x-rayed last Monday and it came back fine okay it's obviously
01:39not okay tell me a bit about it so about a year and a half ago I hurt it traveling didn't think
01:48anything of it and it's been fine since then and then last weekend I was gardening and nothing you
01:55know out of the ordinary but it was really this whole section here was really swollen and this
02:01finger yeah so I thought yeah that it would be broken it hurts a lot along here okay the swelling
02:10has gone down but it's still not normal it's not normal is it I mean if we put the hands together
02:13yeah each other I mean there's definite swelling around here compared to here yeah and we've also
02:18got some other changes here haven't we would that be arthritis but why would I have arthritis you're
02:24young yeah you're young it is right before all of this happened do you ever get some joint aches and
02:29pains yes okay yeah and is it in different joints or just all the small joints or bigger hips knees I
02:38sometimes yes get pain in the shoulder okay and do your hands hurt I mean obviously this one when you
02:45make a fist and things I mean can you do that I can but this one was like last week it was really
02:50sore I mean looking at so these little swellings at the end yes these are called hepatitis nodes
02:56there they are part of osteoarthritis which is a wear and tear arthritis of the house now you're only
03:0253 it's miz I mean that is I know it's miserable to have though but that is a sort of time it's my right
03:09hand which I'm very dominant right-handed okay and what do you do for work I'm not working now
03:14okay did you used to use your hands a lot typing and stuff but I do worry about this a little bit
03:20the problem is that in sometimes for women more than men lucky us is that we sometimes get conditions
03:26that develop yeah where almost like our body attacks our joints okay and it's sort of an
03:31called an autoimmune disease and it can sometimes present with joint problems if it is just wear and
03:37tear and things then we can go to a hand physio we can try and see someone we can get you some help
03:40yep but if it is an inflammatory a sort of what we call an autoimmune disease where your body's
03:45attacking the joint we need to stop that from happening because otherwise it'll attack more
03:49joints and then it can damage them and we don't want that to happen it's better to know about it
03:53now than further down the track definitely because then we go and see a rheumatologist who's like a
03:57joint doctor you know that we can do to try and stop if that's happening perfect if there is just
04:01sort of wear and tear the most important thing you do is keep your hands moving right yeah because if we
04:06don't use them and the muscles waste and just because you've got it at 50 doesn't mean everyone
04:12automatically follows the same path that's going to get worse and worse and worse until your hand
04:15is completely unusable some people it develops and then it stays quite the same for years i mean
04:20hopefully it'll go back to nothing yeah but it might then flare up again in a few years time and
04:23things but if that's the course then we'll learn how to manage it when it does it yep but we need to
04:28be sure that we're not going to miss something that we could do something about yeah so so it means
04:31another blood test okay yeah sorry no that's fine monday morning nine o'clock perfect okay all right
04:37thank you very much okay not at all nice to see you let me let you out there we go all right take
04:41care all the best bye bye uh mark please yes hello hello how are you sir i'm well how are you doing
04:51any better i've been better yeah i've got a student with me do you mind if she sits in no no yeah come
04:56through you guys can sit on the couch if you like pull it down a bit for you so you can jump up there
05:00there you go real take a seat how's it been since yesterday we spoke on the phone
05:04diarrhea abdominal cramps yeah any better eased off not as frequent still not fully every time i go
05:11yeah it's been a fair old time since i felt like i had a proper night's kit and what's caused all
05:15this any obvious triggers any undercooked foods takeaways anything like that that's what i thought it
05:19was i assumed it was food poisoning then after a couple of days sit up there please baby cakes
05:23as i say after the second third day still weren't easing off that was when i was maybe looking at
05:30other stuff i wasn't sure if it was to do my hernias because i've got three hernias because
05:33i've been going to the gym yeah i'm sure if i've disrupted them with an illness like this the most
05:38important thing is you're not dehydrated so you check your blood pressure to make sure heart rate
05:43etc have a feel of your tummy so that's okay as well um are you going to help do you want to pop
05:50this on your dad's finger for me yeah on the other hand there you go that goes in there yes open that
05:55that's it that's it well done that's what i mean really good we'll make a doctor out of you yeah i
06:01think i'll just start working so it uses um light it uses infrared light to measure the heart rate and
06:07how much oxygen is going through the bloodstream it's very clever so oxygen levels 98 which is
06:12really good heart rate 76 which is really good so you can take that off that's it simple
06:17what are you gonna do nothing because you're a terror
06:22that's great so your blood pressure is a tiny bit on the high side but actually i'm not worried
06:28about that at all an illness like this we worry if it's too low uh would it be okay to have a feel
06:32of your tummy on the couch yeah sure right kids you've got to come on the couch it's my turn to go on
06:37the couch yeah you guys are there you go over there with a giraffe very quick any pain at the
06:42moment it's 10 it's tender not necessarily all the time it's 10 i can feel it's tender so
06:47that's uncomfortable good that's absolutely fine i'm just gonna have a listen to your bowel sounds
06:54i'll be two seconds let's get this
06:56good absolutely fine thank you all done so your bowels are nice and active that's really good
07:06tell me about it yes well yeah you you obviously know that i think why don't we get a stool sample
07:12sent off just to make sure and then take it from there and in the meantime just keep doing what
07:17you're doing hydrating well bland foods for now brilliant let me see if i got any stickers for you
07:22guys shall we have a look you're in luck i've got four left which one would you like oh what do you want
07:27what do you want one nice that's a good choice and what one would you like you don't want one
07:33you're too old are you too cool for school that's all right i don't mind right all right thank you
07:38very much let me give you a pre-sample to give us and then i'll label it for you as well so that
07:42it's all done perfect appreciate that this is for daddy to have some tests baby cakes
07:46glad ain't been well it's just a pot to do what uh we won't we won't discuss that maybe yeah i'll
07:53tell you outside tell me i'll tell you outside there we go we'll take it from there all right
08:00you're working you're gonna stay here oh do you want to stay and help that'll make my day much
08:05more fun it'll make my day easier yeah i can imagine say bye high five violet say bye please
08:10bye bye violet take care see you later i'll tell you then you nosy little nana
08:16really say why am i shouting because she can't hear me okay shush
08:20why do you laugh like that
08:23sound like the grinch
08:28the grinch
08:33what does he say i'm going to ruin your christmas
08:37nice to see you and you too now you're looking well very glamorous i like your dress you'd hardly
08:48think i would come with a medical complaint i like your shoes matching your handbag look at you
08:52i've had them for years and the dress oh you look so lovely how are you i've been very tired and
08:59exhausted and i've been very unhappy with this diagnosis of bulvus pemphigoid is that what they've
09:06said a sudden stabbing pain a prickly pain and then i get a terrible itch and i literally have to scratch
09:13scratch scratch just to relieve it yes and then it oozes and then it bleeds bulvus pemphigoid is a rare
09:20skin condition that can affect people often in the older ages of life over 60 and it starts as a sort of
09:26flat itchy rash on the skin that can then develop into blisters and then these blisters can become
09:31really big really painful and can be actually quite dangerous when they burst lead to infections and
09:36ulcers and other things and let's have a look at it because i can see it quite dramatically on your
09:40legs here yeah there so that looks really and all these spots are all over okay and also on my like
09:49here this from scratching and here i can see them there butler's pemphigoid is an autoimmune condition
09:56so normally our body has an immune system that attacks bugs viruses germs when they come into the
10:01body but sometimes it turns on itself and it starts to affect the skin and that's what's happening here
10:07it makes me want to scratch it i mean it looks so itchy doesn't it it's horrible terrible it's been in
10:11my mucosal tissues it's been also my lips along here those bumps and also on my eyelids actually
10:18inhibited me from doing the things that i'd like to do or going out can you think of anything what
10:23causes it to get worse i think recently a friend of mine died suddenly and then a few months ago i heard
10:30from another brother of a friend who had committed suicide that really shocked me oh and i'd only heard
10:36from him a week before no inclination so that really upset me of course and i just thought why is
10:41everything so sad around me
11:03am i allowed to say you look fabulous thank you that's very kind come on through come on through
11:07you look nice so do you where are you going i'm actually not going anywhere
11:14now jacqueline you're looking very well today am i yeah i'm not come through take a seat you look
11:20well feeling well actually yeah that's what we like to hear better than falling apart
11:26you look very good thank you in your hat that you're wearing very chic every time i put it on i feel like
11:32frank spencer the itch has been aggravated it's been a lot more prevalent since this because i'm still
11:40trying to get over i'm sure of hearing that i'm so sorry to hear that that sounds really so i thought
11:45you know between having crohn's acromegaly bilateral glaucoma which has really upset me because a very
11:52limited vision on the left eye and then this to come on top of it so everything seems to be going
11:57downhill and i'm trying to just keep as healthy as i can well you look amazing when you've got all these
12:01conditions right i think the stress sort of when you're stressed the stress is definitely aggravated
12:05the frequency this last few weeks it's very very common i mean almost all skin conditions do react
12:11to stress and i'm worried that it's stopping you doing things very much so very so i've not been
12:16going to stay with anybody do you think talking to someone would help some counseling where you're
12:20talking to a counselor who can sometimes help you with some of the feelings of perhaps not wanting
12:25to go out or feeling a bit apprehensive or a bit nervous lacking in confidence because i've always been
12:30not going a bubbly and positive but that has waned you're only 76 you've got a fair few more years on
12:36this planet thank you very much and we want to enjoy them and you have a right to enjoy them and we should
12:40try and see if we can help get that back and i totally hear that the skin is a big thing holding
12:45you back so let's deal with that i think we can get rid of a lot of this i think if we put the right
12:50cream on i think if we have a really strict regime of a certain cream that has a sort of bit of anti-itch in
12:55it to put on after the shower or bath then we could put on top a steroidy type cream and then
13:01we target the little bits and another thing i had which helped at the time it was a a tablet
13:07called fix or something felidine it's an anti-aller it's like an anti-itch tablet that was really good
13:12i really think we should start that again and i'll refer to the the counseling and i think it's a i
13:18think it's a it's a it's a good thing and they will contact you there's always a little bit of a
13:22weight so it won't happen tomorrow that's okay but again it's in the pipeline and you can talk
13:26about your friend and what's happened and the difficult time you've had over the last couple
13:29of years or so all right and then i'll come with you to the desk now and we'll book a follow-up thank
13:34you very much lovely to see you how's the lip looking better but um the stitches as i thought
13:42they might not have i'm not dissolving so we came back i was wondering if you could have us just a
13:46snip at them is that okay with you yeah it won't be painful i promise yeah he wouldn't he wouldn't
13:51let me do it no that's fine how would you feel about lying on the couch and then i'll put a bit of
13:57wet gauze just to clean it and then i'll use a little tweezer and then we'll just cut it a little
14:01bit so it shouldn't be painful at all and if you want me to stop of course i will not problem is that
14:05okay yeah great let's do it all right there you go so you just need to lie down and chill for five
14:14minutes that's quite nice how's your day been okay yeah been up too much no no just chilling yeah very
14:22good right he was supposed to do cricket but we went to the dentist and they said oh while while he's
14:27still healing probably not the best thing fair enough as his teeth got a bit of a bad and did they
14:31give you the all clear your teeth are okay they're quite happy yes good good an x-ray lovely good
14:39so it's just going to feel a little bit cold this is literally just clean salty water
14:53tiny babe it doesn't touch your skin so don't worry about this is just tweezers so i'm going to pull that
15:01well done are you able to turn your head that way a little bit for me
15:15well done god you're hard as nails you're very good you're not even flinching
15:21look at that any advice on scar it'll heal really nicely um pop a bit of epimax on it that just keeps
15:28it nice and moisturized um prevents it sort of drying out and then you'll be absolutely fine i
15:33don't think you'll even notice it to be honest okay in a few weeks i've got it all
15:44good absolutely fine well that's you done let me bring this back down for you thank you so much
15:49my pleasure any problems come back if it's looking infected or anything well done you did a great job
15:54all right take care see you again yes likewise all the best take care
16:00hi paul it's reena from the fuller medical center
16:08paul can you hear me
16:11it's reena from the surgery from the surgery
16:14paul can you hear me hi paul can you hear me now it's reena from the surgery
16:27getting more and more wound up we couldn't hear this
16:29so any changes in terms of your symptoms are you feeling wheezy breathless yeah it's been fine
16:46this year i haven't really had the hay fever symptoms as bad as i you know used to usually
16:52when my hay fever's bad that's when i get wheezy and the breathing's bad unless i get a chest infection
16:58you know in the winter or unless i was running for the bus but because i've not really been
17:02getting the bus so i can give you an inhaler to keep at home to use just in case if you then you
17:09know become you know more wheezy more breathless the blue one is not really recommended anymore
17:14because it's not really treating asthma so it is more like to open up your airway to help you at that
17:21point to breathe so it probably works for about two hours or so but it wouldn't last for the whole day
17:27so it would be something called a symbicote has two ingredients in it a mild steroid to help to
17:32reduce the inflammation of your airway and also something to open up your airway compared to the
17:38blue one it opens up for a bit longer why would i not just have the blue one because the blue one is
17:43not treating asthma it's not really helping so let's say if you're feeling wheezy likely your your airway
17:49is a bit inflamed that one wouldn't clear the inflammation it just opens up to help you to breathe
17:55it's scary when you can't breathe or when your chest is tight so i think like when i was wheezy or
18:00if i'd run for the bus yeah and then it'd be tight then i'd take that and i think sometimes i used it as
18:05like a a panic you know like it was a panic reliever more than like anything else because i'd like
18:11my chest would be tight and then i'll take that and then i'd you know i'll think okay it's okay now could
18:15be psychological as well i think as well if you you know if you've got lots of stress going on as well and
18:21then you panic and or you're breathless i think it's big where i've come i've just become code
18:25dependent on it yeah where it's like you know i just reach for it because i know like oh when my
18:31chest is tight like i have a puff if you're happy to i'll give you a new one yeah as a standby inside
18:39of the blue one like you said if you're catching a bus you feel breathless you can then do one path
18:44and then maybe towards the winter time when you feel okay you do need that on a regular basis then
18:51give us a call come in we're gonna refer you to do another test that inhaler how you use it is you
18:57twist the bottom you'll hear a click you breathe out to empty your lung you then do a quick and deep
19:04breath in and then hold your breath for 10 seconds i'll send your video to watch but yeah in the meantime
19:11if you you know symptoms get worse any problem give us a call yeah okay okay yeah okay thank you no
19:17problem thank you thank you bye
19:24edward
19:31how's everything okay good come in have a seat i'm dr dutchin thanks for seeing me not at all what can
19:37i do for you today so i've been experiencing some sort of growing pain started off as sharp and
19:43painful when i stretched either backwards or when there was any pressure exerted and then that more
19:50focused pain i sort of around the belt like right there yeah has sort of expanded from pressure tenderness
19:59to more dull sort of numbing kind of pain slightly into the back yeah slightly down the leg and
20:08so around here it's just so much so that i feel i had to yeah come in because obviously it's progressed
20:14over about a week and is the pain there all the time yeah it is there all the time but mild and
20:20any pain down below any pain in the testicles no no lumps that you felt nothing like that okay do you
20:26mind if we have a feel of the tummy would that be all right take this jacket off all right just pop
20:30up on the bed i'm just gonna have a feel if that's all right yeah see that's that's a little bit
20:40more sort of yeah around there yeah yeah i can definitely fit yeah that one's a little bit this
20:49side's fine nothing there okay so if it was this side that's obviously where your appendix is so unless
20:55you're one of those people that has things on the opposite side which is unlikely but you are quite
21:00sorry that's okay it's it's sore yeah yeah
21:20okay relax keep your hands and feet inside the ride at all times
21:25and down here any pains yeah it does mommy's tummy's lovely and soft
21:33yeah a few times i feel like i'm gonna vomit and i can hear the bow sounds and they sound normal
21:38okay i'm just gonna press gently let me know if it's painful
21:43i can feel it though but it's not painful good i'm just scared of eating because i know if i eat it
21:48will just go right through me any problems peeing going for a wee no rushing to the loo to do
21:54lots of weird yeah yeah that's what we get on the older so yeah really really good perfect that's
22:00absolutely fine thank you so much really good examination that's where it is so it's really
22:05really painful maybe it's a strain or something you know i had an aggressive game of paddle but that
22:12shouldn't do too much damage i mean you can strain a muscle do you think you could do a quick urine
22:16sample sure yeah whatever needs to be done i think then at least we can rule out any
22:20urine issue the toilet is literally just there if you just do that quick i'll just dip it
22:39and what about at night how's the pain being it's not kept you no it hasn't kept me away so in the
22:44urine we're just looking for things like blood in the urine um unlikely to be a kidney stone from
22:50your symptoms but just to kind of rule out anything like that the urine looks completely clear though
22:56so there's no blood no white cells so that is good have a seat so where your pain is if it was on the
23:03right hand side i would be worried about your opinions because you are in quite a lot of pain
23:08it could be muscle strain but you are quite tender i think what we do is we sit on it for a few days
23:16i'm going to request an ultrasound just in case the pain doesn't go but if over the next few days you
23:22think it's worse then the next step would really be going to to a and e where they might do some imaging
23:27sooner you could definitely take some some paracetamol or something just to try and ease the pain
23:33and hopefully it will just ease off but there's nothing today that spells something urgent does that sound
23:37all right that sounds like good news then thanks if it gets worse please come back we'll do all
23:42right thank you very much have a great afternoon
23:56let me come around and say bye when are you going uh 20. where are you going to move oh wow three months
24:03i'm going silent ah spiritual journey okay are you gonna go bold oh what you're a woman in one minute
24:11she's become a monk are you gonna become a monk mate oh let's see no i'll see i'll see you in six months
24:17then okay good you know i pray for us praying for us yeah scarlet hello you're falling asleep on me oh you've got
24:28headphones on right don't wait come on come on in we've got your injection to do today have you got
24:35your injection with you yes i have it with brilliant brilliant okay fantastic so this is it so this is
24:42your injection to help control the hormones to keep the hormones in check isn't it okay and how are you
24:49feeling in yourself today i'm feeling good good let's do your injection let me just get it ready for
24:57you yeah and then if we can get some hormones yeah let me just draw it up i want to make sure we get
25:06all of the medicine in here i have the family yeah fine but they're grown up already no they are they're
25:14getting bigger and bigger they change so quickly don't they yeah and all you ever want for them
25:19is them to be happy you know that's the only that's the last thing that my mother said i just want you
25:24to be happy did she and your mother's no longer with us no no i mean i think that's all most mothers
25:30do and you are happy you say exactly bits we can help with better but good for you well look let's do
25:37this this week so we need to do it so we did it on the left last time so we'll do it on the right hand
25:42side okay so the right hand side is this one okay so do you want to lie down sit down or do you stand
25:47up how was easier you're happy to extending okay if we lift up that's brilliant it'll just be a sharp
25:53scratch straight into the bottom nothing at all okay i'll put that all on the computer and you still
26:01see your specialists at the hospital at all yes of course and they're happy with everything yeah yeah
26:07they're happy with everything what i can do is we'll do it again in three months are you okay for all
26:11your other prescriptions or you need some more they have the hormones yes so we can do those i'll
26:17send all those down to your pharmacy so that will be ready straight away and do you want a prescription
26:23for the injection again and then you collect it and you're very good at doing that and i'll put a
26:27reminder on and you try and remember in between us we'll make sure we get it done don't worry i do
26:32remember yeah yeah thank you for everything so that's the prescription and the other one's gone to
26:37your chemist and i'll see you in three months if not exactly thank you and i want to see you like
26:42that oh i don't know in november we'll be in summer dresses but we can see no but you don't like like
26:48nice you're very sweet you're very sweet thank you thank you very much and i'll see you in a few months
26:54any problems you ring us if you need to yes thank you all right thank you bye-bye nice to see you nice
27:00to see you i'm dr dudgeon nice to meet you nice to meet you as well so last week were you taking your
27:09dosset back to the pharmacy you know the box with your medicines in and why were you doing that because
27:15i didn't need any tablets okay i don't like taking pills if i'm not used to okay and do you know any
27:21of the tablets that were in there no no when do you think you last took them okay when i was in
27:27hospital to take my toes off did someone tell you to stop taking them no no what what made you decide
27:33to stop because there were tablets everywhere you felt there were too many i'm not used to taking tablets
27:39okay but you had been on them a few years hadn't you no no as long as i'm breeding i don't care
27:46can i talk through the medicines and why they wanted you to take them yeah okay so two of them
27:52one called aspirin and one called clopidogrel are to help your blood you know that you had a toe taken
28:00off yeah yeah that was because the blood supply to the toe wasn't great that because my toe was black
28:07exactly okay and so you're on those medications to try and keep the blood supply good to the rest of your body
28:14and then you're also on a statin have you ever heard of statins so cholesterol can build up fatty
28:20deposits in the blood the statins lowers that and again that's part of the trying to keep the blood
28:27flowing to all your toes and things the last one was a tablet called pregabalin which must have been
28:34for pain so normally for nerve pain do you have any pain no okay i mean i think if you have no pain
28:42let's stop the pregabalin and then you've got one less tablet but i'd ideally like you to take the
28:50other four four so the aspirin and the clopidogrel for the blood the statin for the cholesterol and then
28:57the lansopazole to protect your stomach from the other two i drink plenty of guinness that and keep
29:03it clear one the lansopazole be good for the guinness too oh that's all right all right how much
29:10guinness do you drink three or four points a day okay and have you always drunk that much yeah i used
29:16to drink 14 points a day okay so you're drinking less much less yeah how do you feel your memory is
29:21it's all right when i need it yeah how would you feel about coming to see sam next door just for
29:28some blood tests and how would you feel if she did a test of the memory as well yeah yeah we could get
29:35that all i know somewhere with the dosage do you feel now you know what they're for yeah they definitely
29:41want the tablets every day for the rest of your life to keep that blood flowing the rest of my life i
29:46want to have long left of us oh i think you've got a bit but the tablets will help all right
29:51should i help you back out i'm still alive
29:59just stand one sec i'm just gonna get the door
30:05you've done this before haven't you yeah a few times
30:08that's all booked him what's going on yeah you can enjoy no thank you i don't drink you don't drink no
30:26i can have fun without a drink how do you do i just be a jolly person i don't know what that is
30:31well there you go that's why you have to have a pint and i don't thank you very much bye bye
30:38how can i help today i just cannot breathe okay i put my head down on the pillow and
30:50and all of a sudden i can't breathe right so i have to get up and i do that hour after hour through
30:59the night i was a bit lucky this morning i put my head down at six o'clock and i woke up about seven
31:05okay that was good but mainly it's a lack of uh oxygen yeah you're feeling short of breath at
31:13night time two years ago i didn't have this problem last night i probably got up 20 times oh no so
31:20sleep's really disrupted really disrupted absolutely how long has all this been going on for six months
31:26my body has got no energy especially here feeling tired my thighs as well yeah i can hardly get up you
31:37know but i feel like i'm not going to breathe no more scary isn't it you know really gasping for
31:44breath i just felt a bit desperate did you have a sore throat before this cough i went to am7 and went and
32:09saw a concert on the night of the concerts i got a really really bad sore throat to the point where
32:14i couldn't even swallow like saliva have you had a look at the back of your thing oh mom has yeah yeah
32:20i did and it was weird it looked really weird you know like like see-through yeah apparently i was
32:24saying it looked translucent yeah okay it was weird it was weird you know yeah your weird throat she's
32:30picked up a sore throat from me i think does it feel like you're swallowing sharp knives and things
32:35like that yeah open wide and set r black okay good it does look very sore back there it is
32:51so i'm going to have a seat i'm dr pierson hello how are you doing good thanks so i know you spoke to one
32:56of the gps yesterday but i wondered do you mind telling me what's happening how are you feeling um
33:01so i don't know if it's related to my coil yeah basically i had it put in two weeks ago two weeks
33:06ago yeah so everything was fine it wasn't i just had normal symptoms yeah but i've been really ill
33:12since for a week now kind of like fluey and like i think maybe like throat cold just feeling like
33:21really bad like my glands are bad i've had tonsillitis a few times okay but i have actually
33:27had my tonsils taken out ah so it must have been bad for them to take them out i was like five when
33:32i had them out i was always like choking on food and stuff because they were so massive and have you
33:37had fevers this time i think i actually don't know doesn't matter but yeah like right now i'm literally
33:42like sweating and at night and then yesterday by the afternoon i was like freezing okay and tell me
33:49about the cause so the coil's gone in is it your first coil yeah before is it the morena the hormone
33:54one okay any people often have bleeding at the beginning are you having a little bit any discharge
33:59or discomfort or anything is it and pain anywhere so yesterday there was a bit of pain which made me
34:07think so normally with the coin if two weeks into it if it was to have introduced infection or say
34:12we'd know about it normally and we'd have discharge and bleeding and lots of cracking your womb
34:17would be trying to get rid of it like yeah okay good pain sort of proper cramping pain good if
34:22you're not feeling that it's probably more related to all of this that we're doing or whatever and i
34:27think can i just put my hand on your tummy just to be sure i'm always just a bit paranoid with it
34:32just have a lie down on here i just want to press really gently just tell me if there's any pain as
34:37if i press no no no no pain here no so normally if there was a thing that would be really sore and
34:46it's not okay so your tummy's nice and soft sweet out that's nice so let me just check your temperature
34:51now 36.3 was that okay so that's okay okay so even though you're feeling sweaty and things the
34:59temperature is good let's have a look in your throat and see you open wide for me and say oh it's very red
35:05at the back there really red and actually as you tell there are some white bits at the back at the
35:10very back and the roof of your mouth yeah and if you just say ah yeah that does look really sorry
35:18looks like someone's been rubbing it with sandpaper can i just have a feel of your glands in you yeah
35:22as well let's just have a feel it just tickles you know yeah you're quite right look at that great
35:27big lymph nodes yeah in there isn't that yeah i think we've got a clear source of where this is coming
35:32from why you're feeling if it looked all normal i'd be more worried about the core but your tummy's
35:36soft yeah it does look really sore i wonder if antibiotics actually might make you feel a bit
35:39better yes i i think i don't know how you feel about them some people are really anti to me
35:44let me do it and i'll send them what i'll do is i'll send them straight to pyramid pharmacy lots
35:47of vitamin c salt water gargles onto your paracetamol and things like that just to control
35:51any sweating and it'll make you feel a bit better okay and the antibiotics will kill it all off
35:55and any other problems or anything weird or wonderful come straight back and see us yeah
35:58will do thank you so much good luck all the best bye bye
36:04i just felt a bit desperate yeah well you've definitely done the right thing so i'm glad you
36:09came in 100 now obviously with everything that's going on with your heart and all the medications
36:15you're on so maybe there's a bit of a progression in the heart failure side of things oh how are you
36:22getting on with your tablets i'll tell you the one pill that seemed to help me yeah was furuzumide
36:28yeah some doctor said about it clearing me lungs it does indeed yeah offload some fluid would it be
36:35okay to examine you today to have a listen to your breathing oh yes please stuff john is a lovely 86
36:40year old man who i've known for about three and a half years now i've been involved in his care since
36:45the time of his diagnosis of heart failure in heart failure the effectiveness of the heart to pump the
36:50blood around the body is reduced and get backtracking of the blood into the circulation and
36:54a build-up of fluid around the lungs which can cause shortness of breath especially at night and
36:59a build-up of fluid around the legs which can cause leg swelling and that can be quite painful and
37:03uncomfortable and what do you think is going on what do you think is causing all of this i can only
37:07think of the phlegm in me lungs you know yeah it gets to here yeah and then it's like it's cutting off
37:15the airflow you know yeah i understand your oxygen levels are very good 98 and your heart rate is
37:21normal at 62. are you able just to take your jacket off is that all right thank you nice deep breaths if
37:28you can lovely perfect and i'm just going to listen to your heart now
37:43lovely absolutely fine good really really good your chest sounds really clear so there's good air
37:47entry throughout no no yeah everything you're saying sounds like there is a build-up of fluid around
37:53there yeah but when i listen in it's crystal clear there's no fluid that's good news it is good news
37:59but it then makes me wonder what's the best thing to do moving forward for you so i think what we need
38:05to do is maybe ask the heart doctors again for a bit of help because i'd be really reluctant to play
38:10around with your meds and in the meantime if you're finding that the higher dose of the fruzamide is
38:14helping it's perfectly fine to have one tablet at eight in the morning and one at midday i'll do an
38:20urgent referral because i want them to see you quickly the heart doctors just to see i don't
38:25want to get slower and slower exactly exactly i'd rather be out the game you know oh no i don't
38:31i know what you mean i know what you mean i just you know yeah it's really tough with this condition
38:37it's really difficult yeah as long as i can get on a bus that's all that matters to me yeah well let's
38:42aim for that let's let's see if we can get you a bit stronger okay thank you very much any questions
38:46before we go no no i've got the team my wife kills me if i don't ask the right questions that's
38:52good absolutely she keeps you right that's good are you guys managing okay at home yeah yeah you
38:57don't need any extra help or anything no but the way i'm going it won't be long well if you do
39:03let us know because there's lots we can do for help don't suffer in silence i will remember that
39:09yeah i do help with that thank you take care thank you all right my pleasure you're very welcome take
39:22reena yes if you could only eat food for the rest of your life there was a certain color what color
39:27would you pick food one color for the rest of your life yeah but is it like if i say black can i have a
39:33black tomato yeah i don't know red what do you think that's red it's a weird weird option are you
39:44just thinking tomatoes afternoon surgery how are you doing i hear you've been in the wars i keep
39:52falling over i hear my neighbor i called for him i got up and i was okay i turned around to
40:00do something i fell over again and then i just couldn't get up i just black out i don't you don't
40:07feel it coming on no no and when you wake up i just lie there and i think what in godson am i doing
40:14down here it's not always when you're turning or anything like that yes sometimes that but um last
40:21time i actually hurt myself when i fell because i fell over the threshold of the house and the garden
40:28and i had terrific pain down here they're not always when you get up like getting up from the
40:33loo or getting up from a table that might be sitting at you don't you know i no i can't say i do yes now
40:41wait a minute somebody was in the house and i had to speak to them and i got up but i got up very quickly
40:48and i think that didn't help and then i held on to the side while i okay let me let me do my blood
40:56pressure yeah not mine but yours with my machine and how are you doing otherwise i'm fine birthday
41:04birthday next week yes i've got my great-grandchildren coming tomorrow lovely and you cope on your own
41:11okay generally don't you you're very independent yeah
41:18just want you to stand up for me and do it again
41:24no drop sometimes people get a drop when they stand up and that can be a cause of falls and things
41:30so that's important that there isn't a drop no but we're still going to continue because there is a
41:37falls clinic in the hospital which investigate and i think you probably need to really get on
41:44their list because i know you've had little tias in the past as well and also they can test whether
41:49it's your balance you know when you're turning does that do it but generally one doesn't black out
41:55completely if that's happening no but that is doesn't frighten me anymore because i never hurt myself
42:00except last time yeah and that's when somebody said oh you ought to get one of those things around
42:07your neck well you do yeah do you want me to no i don't really want to do that you know if you're on
42:12your own and the neighbours aren't one-sided you know when you can't get through and you're in the
42:17house you're lucky you're in the garden and they were around um well and my grandson is coming next
42:23so it was my birthday and i want him to fix a a grabber at the side of my door so that i can pull
42:30myself and get someone who else independent to do things like that if you want as well yeah someone
42:36to come around occupational health type thing and they'll come and visit and they'll assess what
42:41oh i need somebody like that i'll mention it to them as well i'm going to do a forward referral
42:47anyway it needs investigating and i will chase up the appointments okay yes thanks very much nice to
42:54see you take care thank you bye now bye as always lovely so lovely to see you likewise yes i'm glad
43:03you're doing well thank you take care bye bye thank you very much all right well well done nice to meet
43:08you yeah good luck with your ai thank you thank you very much thanks so much good afternoon bye
43:38you
44:08The pain has been getting so bad that I can hardly get up.
44:17Okay, well that's not acceptable, is it?
44:19The hallucinations must be upsetting, it's horrible.
44:21They don't frighten me that much.
44:22But I remember speaking to you once when the dogs were there and it was horrible and snakes were even worse.
44:28How have you been?
44:29Terrible.
44:30Oh no.
44:30Well, I must sit on this earth for.
44:38I must sit on this earth for.
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