- 2 days ago
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00:09Morning surgery.
00:10I ended up in A&E on Saturday with the pings.
00:14I could barely, like, even talk.
00:18You've had a few of those falls recently, haven't you?
00:20Oh, I've had five of them.
00:22It always happens when you can't get up
00:24because there's nothing to hold on to.
00:26Oh, gosh.
00:29From your, like, perspective, would you think I have ADHD?
00:33You know, it's a spectrum, isn't it?
00:34We're probably all on one part of the spectrum.
00:41She was so determined to see her first grandchild.
00:45Well, she certainly was looking to make the most
00:47of whatever time she had.
00:51He just woke up one morning and wasn't all there.
01:06I'm...
01:09Well, I'm...
01:12and I'm...
01:16and I'm...
01:19I'm...
01:22And I'm...
01:25So, I'm...
01:30Hello.
01:30How are you?
01:32How are you?
01:33Sick.
01:35Oh, dear.
01:35Right.
01:35Come and have a seat.
01:36Do you want to tell me what's happened?
01:37I had this pretty much when I came in, and I had it for five days.
01:41OK.
01:41It was a sore throat and...?
01:43Yeah, just aching all over.
01:44OK.
01:45It's a hot temperature.
01:46I'm feeling just generally rough.
01:48Horrible.
01:48Yep.
01:48I started the antibiotics on the Friday.
01:51By Saturday, I could feel it coming down.
01:53OK.
01:54Saturday night, Sunday, it was like shingles came out.
01:58Ah.
01:58Various different spots, a few on my face, about six, seven, even so on my stomach and a few
02:04on my legs.
02:05OK.
02:06Really itchy.
02:07Sort of blistery spots?
02:08Yes.
02:09And did they all then scab over, sort of thing?
02:11Then, Monday, I woke up and I felt a tingle in my throat again.
02:15Mm-hm.
02:16And it's just started, and I thought, oh, God, not another sore throat, but it's just
02:19gone back to what I had previously.
02:21Back to square one again?
02:22And now it's too...
02:23And you took the antibiotics for...
02:25A week.
02:25A week.
02:26I'm interested in the spots, because it's interesting, you felt grotty and you had all
02:29of this.
02:30It's just, there aren't very many things that cause blisters to sort of pop up at various
02:34places all over the body.
02:35OK.
02:36And you mentioned shingles that it could be, and the shingles is only in one place.
02:40So it's in one strip, or one part of your arm, or just one side of the face, it's never
02:44both sides.
02:46But the virus, the sort of, the bug that causes shingles is chickenpox virus.
02:50Yes.
02:51And do you think this was chickenpox?
02:53I mean, you said you've got children.
02:54Have you seen chickenpox in the kids recently?
02:56No, the kids had chickenpox, both about two years ago.
02:59I had chickenpox as a kid.
03:00You did, or you didn't?
03:01I did.
03:02You did?
03:02OK.
03:03Did this look anything like chickenpox?
03:04Yeah.
03:04So I wonder if it was, I mean, sometimes you can get chickenpox again, but it's just,
03:09it's one of the few rashes that causes blisters, and they come up both sides of the body, and
03:13it can make you feel awful, especially as an adult.
03:15Yeah.
03:16But then you've stopped the endopause, and your throat's come back.
03:18Yes.
03:19Yeah.
03:19My throat has really swelled up again.
03:21I can't eat.
03:23At the moment I'm taking Coca-Cola, more Paracetamol, and I have Proprofen.
03:27And is there anything else going on at the moment, or mostly just the throat?
03:31Yeah, just the throat.
03:32I mean, I ache and musk, I feel really sort of tender.
03:35Any temperatures and fevers like today?
03:38I'm 38 when I just left the house.
03:40Horrible.
03:41So it's definitely come back, hasn't it, with a vengeance, and it sounds horrible.
03:43No, it's just strange that it's...
03:44Horrible.
03:45Right, let's have a look.
03:45Oh, yes, it's in it.
03:46Right, let's have a look first of all in the back of the throat.
03:48If you don't mind opening really wide, and say, ah.
03:51Ah.
03:53Ah.
03:54There is quite a lot of white stuff all over your tonsils, sweetheart.
03:59Ah.
03:59Can I just feel your neck?
04:01I mean, this is swollen, isn't it?
04:03Yes.
04:03I mean, I don't know what your neck normally looks like, but it looks quite puffy, and it's
04:07all very puffy.
04:07Is that very tender?
04:08Yes.
04:09I think there's a couple of things we could do, Dominic.
04:10One thing I'm wondering is, can I take a swab?
04:13We need to know what the germ is, because at the moment, when we see common things, we
04:17throw the commonest antibiotics at it, but sometimes, if it doesn't work, is it the
04:20right antibiotic, and were we on it for long enough, is the other question.
04:24So, if you don't mind just opening wide, I'm just going to tickle back of the throat.
04:28Okay, well done.
04:29One.
04:30And the other side, I'm just going to do that side.
04:32Sorry.
04:33Perfect.
04:34So, the lab will tell me what it is, and what's the best antibiotic to get rid of it.
04:38I mean, last week, with the antibiotics, the next day, I started to feel better.
04:44Annoyingly, I think it's just broken back through, hasn't it?
04:47I mean, it's a raging tonsillitis, is what you've got.
04:49We need ten days of antibiotics.
04:51Okay, let's get rid of it, sweetheart, let's get rid of it.
04:54The surgery will contact you as soon as this comes back, if there's anything we need to do.
04:58Yeah, fantastic.
04:59Are you taking some time off work?
05:00Not causing me too much stress.
05:02I mean, I think with a fever, you should...
05:03Having a three-year-old or a four-year-old is much more stressful than work.
05:06They're probably the reason you got this in the first place, isn't they?
05:09They bring everything home, don't they?
05:12All right, take care of it. Bye-bye.
05:14Hi, come on through.
05:16How are you?
05:17Good, thanks. Have a seat.
05:19Congratulations, I haven't met Artie yet.
05:21He looks really well.
05:22Yeah.
05:22What can I do for you today?
05:24So, Artie is four months corrected now, because he was six weeks premature.
05:29So, he's four weeks corrected, five and a half months actual, something like that.
05:35And, developmentally, no concerns with him.
05:37Fixing and following really well.
05:39I don't think he's got any issues with his actual vision, because, you know, he plays with his toys, he
05:44grabs his toys, he smiles at us, etc.
05:45But, what I have noticed is that, when you're looking at him normally, his eyes are fine.
05:51Yeah.
05:51But, when he is playing with his toys and anything that's up close to his face, he goes really quite
05:57cross-eyed.
05:58And, has a squint.
05:59Which, I know in newborns isn't a concern.
06:02Yeah.
06:02But, I did read that if that's still happening quite consistently after four months, it might be, is it strabismus
06:09or could be?
06:10Yeah.
06:10So, sometimes we do get ophthalmology to have a little look.
06:14Yeah.
06:14Strabismus is an eye condition, commonly known as a squint.
06:17An intermittent squint is normal in newborns, and this is as the brain learns to coordinate the eyes.
06:22We do expect, though, that squints resolve around three to six months of age.
06:26If a squint persists, we want to get ophthalmology to assess it, to see if it's either an underlying condition,
06:32or something called amblyopia, which is basically a lazy eye and does require treatment.
06:37But, yeah, I don't know if I'm being too premature with this, and actually, he's only four months, so there
06:41could still be time.
06:42Yeah.
06:43It's only when he's playing with it.
06:46Like, when you look at him normally, it's not there.
06:49If he plays with things like here, like when he's playing midline, and then he brings things to his mouth,
06:55for example.
06:55Yeah.
06:56What's this, mister?
06:59Can you see a little bit there?
07:00Yeah, very slight.
07:01But sometimes it's a lot more noticeable.
07:04Do they ever go in opposite directions?
07:06Not that I think I've seen.
07:07Okay.
07:07Like, can you see a little bit?
07:09Yeah, it's just the left one does move further in, doesn't it?
07:13Yeah, that's it.
07:14And the left, even more so.
07:16Yeah, so there, that's it.
07:17Yeah.
07:17Yeah, yeah.
07:18So they will both go in, obviously, you know, if I did it to you and we, or finger to
07:22your nose, your eyes would go in.
07:24Yeah.
07:25But yeah, the left definitely does it more than the right.
07:28But I think it might be worth us just asking Ophthalmology to have a look.
07:32Yeah.
07:32Because I feel like he's had so many things otherwise.
07:35I know.
07:36Yeah.
07:36We don't want to completely ignore it.
07:38You know, yes, it can be normal to begin with, but normally we expect squints to improve a bit.
07:43Yeah.
07:43And I think realistically it's not going to be a big deal.
07:46Yeah.
07:47Okay.
07:47Amazing.
07:47A referral would be really helpful.
07:50Yeah.
07:50Okay then, mister.
07:52But nice to see you and I'll do the ophthalmology referral.
07:56Right.
07:57Come on then, mister.
07:58Let's go.
07:59Thank you so much.
08:01Not at all.
08:01Thank you for that.
08:02If you don't hear anything in the next three or four weeks, let us know.
08:04Okay.
08:04Will do.
08:05All right.
08:05Take care.
08:06Bye.
08:10Just in case you get more.
08:11Just in case you get thirsty.
08:12I'm not drinking that.
08:13It's from yesterday.
08:15You got thrown in a bin?
08:16Yeah.
08:16Well, I'll water the plant for it.
08:19Such a waste of water.
08:21What are you doing?
08:22What?
08:23But you need a tap.
08:24Do you need a tap?
08:24I'm just having a slow day.
08:26I've been having a slow day for like a month now.
08:30It needs more plant food.
08:31I don't...
08:31That's what it needs.
08:33So...
08:35What do you think?
08:36I just sit here with plant food.
08:45How can I help today?
08:46You want to tell doctors?
08:48Can I tell the doctor?
08:49I think you better, because I can't remember what it is.
08:52At the beginning of the year, Colin started getting forgetful.
08:56But it sort of deteriorated very fast.
08:59Hmm.
09:00We were put in touch with the memory clinic.
09:03Hmm.
09:04And an assessor came round.
09:06Hmm.
09:06And he thinks it's not the normal sort of dementia.
09:11Hmm.
09:11He thinks he may have had some mini strokes.
09:13Ah, okay.
09:14That would have caused it.
09:15Hmm.
09:16And he was going to book an MRI.
09:19But I think these days MRIs are very difficult things.
09:22And then he discharged him.
09:25So since then we're just...
09:27A bit in limbo.
09:28We don't really know what's going on.
09:29Yeah, exactly.
09:30In limbo.
09:30Oh, no.
09:31That's not good.
09:31And how's your memory been since then?
09:34I don't think I've used it.
09:37Hmm.
09:37Fair enough.
09:38Have you noticed that there's been a decline since that assessment?
09:41Yes.
09:41Um, it's not too bad some days.
09:44Hmm.
09:45Some days are better than others.
09:46And other days are not as good.
09:47Hmm.
09:47And it's the funny thing, it's a very, very short memory.
09:51Hmm.
09:52You can ask me a few times a day, you know, how old am I?
09:55And then I say, what?
09:56That old?
09:57Hmm.
09:59Do you not feel...
09:59Do you not feel 89?
10:01Me?
10:02Yeah.
10:03No.
10:04No, at all.
10:05How old do you feel?
10:07I feel younger than 89.
10:09Yeah.
10:10Good.
10:10How's your mood?
10:13Good.
10:14Good spirits?
10:15Yes.
10:15Is it okay most of the time?
10:16Yes.
10:16And are you sleeping well?
10:18Yes.
10:19Yeah.
10:19Some nights, some nights, yes.
10:22After than others.
10:22Not as good.
10:23Ah.
10:24Yeah.
10:42Any questions?
10:43Any questions out about me?
10:44My wife has always said question.
10:46Ha!
10:46Ha!
10:47Ha!
10:47Not too personal.
10:49Everyone over the age of 50 now should have it done.
10:52Okay.
10:53Cause she's getting old.
10:54Not as old, I know I'm still tired.
10:55as you my little action man any questions before we go my wife kills me if i don't ask the
11:01right
11:01questions that is good absolutely she keeps you right you're going shopping oh do you want anything
11:06from the shop come on out love you
11:15any changes in behavior or personality nothing like that no good it's the same naughty same old
11:23you yeah good excellent really good so yeah i think we need to get that ball rolling again for you
11:28because it would be good to to get some investigations and see what we can do
11:32is there any point in taking a scan to see what's happening in there any lesions or 100 yeah i
11:39think
11:39there is here we can definitely do that um now as gps we're very limited there's only they only let
11:43us do so many things but the good news is for mri scans of the brain if we're querying dementia
11:50they
11:51do actually allow us to request those scans and the reason i asked about the personality change
11:55is because in frontotemporal dementia people often who are normally very placid and nice can become
12:01very very violent and really change in their behavior so again i'm not hearing that so
12:05if anything it might very well be a vascular type of dementia because of the damage to the blood vessels
12:10over the ears and stuff um the scans will be really good that'll sort of tell us one way or
12:16another
12:16and then we can put steps in place to help and to help sort of slow down that progression
12:20potentially there are there are medications available what sort of help do you feel you
12:24need at the moment do you feel like you need carers to come and help or someone to come in
12:29and make
12:29sure it's safe for you at home you know put grab rails if you need them i would like a
12:34grab rail in
12:35the bathroom yeah let's do that we can refer you then to adult social care not a problem at all
12:39okay lovely thanks my pleasure thanks for coming in and thanks for sharing all this with us because
12:45i mean it's a really difficult thing to talk about don't think that happened to you it's true
12:49just so funny he just woke up one morning and yeah it wasn't all there yeah absolutely leave it with
12:57me i'll be in touch and i'll do all the uh referrals and stuff for you any problems just come
13:02back don't
13:02hesitate thank you good take care
13:11i want to show you this look do you think this would look good on me for my birthday
13:21hello yeah that's lovely i want to show you
13:27this is a dress i might wear for my birthday surgery oh where are you going again for brunch
13:32you're gonna wear that to brunch what club after brunch is at lunch time you know well not really
13:37a brunch it's like a resort to restrooms eat not brunch yeah an evening it's not brunch fine okay
13:43that's nice i look forward to the pictures hello hi how are you so come on in take a seat
13:49thank you very
13:49my name is anna mccue it's very nice to meet you so tell me craig what's been going on for
13:54you i've
13:55got a rash that's been under my arm for ages so how long has it been going on for probably
14:01had it
14:02eight months nine months it doesn't itch it just it's it's sort of blotchy i've heard it a few times
14:08they thought it might be stress related because my previous job i was a bit stressed but now i've moved
14:13happier job happier setup but obviously still got the remnants okay um gps they gave me cream cream
14:19did nothing what brings it on is there anything i have no idea because do you find that it's hot
14:24weather or if you were no it doesn't seem to be related to a deodorant or anything to be honest
14:30okay well we have a little look that's absolutely fine so you've tried a few antifungal creams uh
14:36yes and i found another one actually sorry oh yeah yeah and have you been in the sun or anything
14:43i
14:43haven't be honest i actually haven't done much in the sun it looks like something called petriasis
14:49versicolor okay so it is fungal yes and i'm going to give you it's actually a shampoo i've got one
14:55or two spots that are stored on the side but i never used to herb on the side so i
14:58thought yeah
14:59rather get it sorted yeah absolutely i'll give you a it's actually a shampoo that you use and you leave
15:04it on for five minutes and then wash it off and i think um because it's been going on for
15:09nearly eight
15:09months now yes you know we can try this and if you've found that it isn't fully resolved just come
15:14back and
15:15see us so where is the best place to send the antifungal treatment possibly to boots if it's
15:21possible yes i'll send them there that's perfect and just come back and see us if anything's getting
15:26worse or not improving perfect no thank you very much i do appreciate it all good
15:32jane thank you
15:36how was the holiday beautiful the holiday was marvelous almost reached the end of it without any
15:43injuries i think next time you go away i'm gonna pack bubble wrap so you can wrap over your legs
15:50i can show you where it happened that was the plane we were getting on to and you can see
15:54that
15:55lady is stepping up that big step is that where you bashed it it does look like a bit of
16:00a lethal
16:01step in all fairness yeah luckily my daughter was with me and able to salvage the awful mess it's
16:09always a mess and blood pouring down are you okay putting your leg up yep that's fine okay let's see
16:16the damage they've layered it up here oh you've had a nasty laceration sorry oh dear what a mess my
16:25legs
16:26are never a thing of beauty it doesn't look like there's any infection there so the stery strips
16:33we are leaving on right because if i take them off it'll burst apart exactly that so we can keep
16:41them
16:41on because they're keeping this dead skin yes yes in place we're trying to sort of move the skin up
16:48yeah
16:49you can see where you've pushed it up so you've done it that way haven't you
16:52no no if you pull it down you're gonna pull that flap so whoever dresses this from now on you
17:00need
17:00to lift every dressing this way right yeah right at least it was at the end of the holiday and
17:06well
17:06it was if you start finding it's sore and it's red and it's tracking no that's when you need the
17:12antibiotics try and keep this leg as dry as possible and try and book in GP surgery for about wednesday
17:21yeah okay but there's no signs of infection it looks good oh that's very reassuring thank you
17:27your daughter's done a wonderful job well keep her up to date i need to be a current treatment remember
17:34the most important rule is lift up with that dressing yes yep because you don't want to reopen that
17:42no oh makes you go funny exactly um all done marvelous well thank you very much indeed for
17:49seeing me today that pleasure thanks very much take care thanks a lot
17:58yeah but just let me know when you've done it her dress is really nice
18:02oh miss honey's always got nice dresses don't you love you i said miss honey always got nice dresses miss
18:09honey oh yes she resemblance with honey are you a tilda are you miss trunchbull oh my gosh you are
18:20morning surgery
18:26hey i'm dr pierson hello thank you thanks for coming down come and have a seat now how are you
18:31okay
18:33so you've come in to talk about this gynecological problem that you've been having mind saying what are
18:39the symptoms and what you've been experiencing yeah so i've just had like a lot of pain for over
18:44like a few years now and i was diagnosed with pcos yeah a couple years ago i had my bloods
18:50tested and
18:50there was quite a lot of imbalances apparently according to them but over the past six months
18:56or so i've been having extra symptoms so kind of extra pains but specifically in like the left ovary kind
19:04of region i kind of ignored it initially because i thought it could be a cyst or something like that
19:09um but over time it just progressively got worse and worse and worse and i ended up in a and
19:15e on
19:15saturday um with the pain and i kind of have pain between my periods and i had a really heavy
19:21period
19:21and really long period last time it was like 10 days which again is quite long that is long that's
19:28the next one starts again but i know so that's miserable isn't it so heavy periods long periods
19:33you've got different and this pain that's all over and your bowels any change in your bowel habit at
19:38all i have noticed a little bit of a change yeah so like when i'd have the pain or what
19:44i'd call the
19:44flare-ups say i would tend to want to go to the toilet all the time so i kind of
19:49felt like that might be
19:49connected yeah and your sort of general well-being and in yourself i feel exhausted all the time like the
19:55energy levels just how do you manage that then are you able to i mean working and things are you
20:00working i am working yeah um and it's kind of difficult for me to like stay energized and focused
20:06and motivated um just because i'm also in pain all the time it does cause quite a bit of it
20:12sounds
20:12like it's interfering with a lot of your days in a month yeah
20:31i had a pain up here okay i ate some meat my son cut it up and the longer pleases
20:37and i think i ate that
20:38and it was quite painful up here it's terribly painful it does look a bit swollen it's very
20:44swollen yeah yeah it's absolute agony last night is causing a lot of pain yeah any pain during that
20:52yeah that's a bit sore yeah okay every now i'm gonna want to move my arm i get sharp pains
20:57come down
20:58my arm to my elbow ongoing infection there you can see it oh bless you poor thing i guess a
21:04pain
21:04shooting here and here it was hurting like hell
21:14now how do you feel now with that pain it's not obviously as bad now as it was on saturday
21:18because
21:19on saturday i could barely like even talk and is there anything you're worried about that this could
21:23be the one thing that it sounded a lot like was endometriosis yeah i mean that's what i'm thinking as
21:28well along the same lines i think it does sound like it could be you've got so many symptoms don't
21:33you of that i suppose one thing that we need to be careful of is that there isn't a cyst
21:37or something
21:37because when you have polycystic ovary sometimes one cyst does grow and then that in itself can spit
21:41out some hormones and make you feel horrible and everything else so we we ought to do an ultrasound
21:45scan to make sure there isn't anything new acutely that's happened that there isn't a sort of
21:48four centimetre cyst sitting there or something that but of course the way sometimes to really
21:52diagnose endometriosis is partly through the history and sometimes then we go to the gynaecologist
21:57they can look into the pelvis and have a look at where the the womb lining that should be staying
22:03in the womb and only bleeding in the womb but endometriosis as you know probably is the womb
22:06lining spilling out to other parts of the pelvis so when you're on your period and it's bleeding and
22:10it's responding to all the hormones so is the cells on your rectum that's making you feel like you
22:14need to poo all the time or on your bladder on your ligaments that pull so you've got the side
22:19left side with pain so it could well fit with this picture did you read anything about the
22:24treatment for endometriosis i think a lot of people i know who are on it are on birth control
22:28to kind of maintain and manage it i've been on a couple bits of birth control that hadn't really
22:33responded well i mean i'd be open to trying again to see but obviously it's not like the preferable
22:40route i think let's do the test perhaps and find out what's going on and then that is an option
22:45but
22:45there are other things and sometimes the gynecologist can do the camera in and they can
22:50literally treat the little bits they can zap the cells that are in there if they see a little patch
22:53of endometriosis they can sort of burn it it sounds horrible but they get rid of it it's it isn't
22:58a
22:58necessarily a long long long term fix but it does help for a bit have you ever tried any of
23:04the sort
23:04of this slightly more specific painkillers that sometimes we use around period people take naproxen i
23:09don't know if you've ever tried that i've not tried naproxen they're anti-inflammatories and actually
23:14maybe they sort of help through the condition now they're not treating endometriosis they're not
23:18going to stop it coming if you feel a little bit less pain and things it's not going to solve
23:22it
23:22but i think it might help a little bit if i send it through it'll explain it all on there
23:26just take
23:26it with some food when you next have your period or period pains and let's see if this helps a
23:30bit
23:30yeah and i'll get a scan and the referral and things all sorted out from here yeah thank you all
23:34right well look nice to see you good luck with things which i and then let's speak when we get
23:37all the
23:37results yes thank you so all right all the best bye bye bye bye hello hi thank you have a
23:48seat i'm
23:49dr dudgeon we've met before yes yeah the reason i've come now you know my right eye has gone sort
23:55of
23:55smaller okay and some friend of mine said you know you better have it checked you never know is this
24:01a
24:01normal old age or is there something odd it it sort of feels as if it's drooping and i can
24:09feel it
24:09sometimes almost sort of on the eyelid yeah closing and how's your vision well i i need glasses but i
24:17don't think it has affected that when did you last have an eye test can you remember yes last june
24:23july
24:23so i'm due for one again soon or august yeah okay and when you last went for an eye test
24:28was it a problem
24:29then no no no they didn't even say anything but i know now looking back even at photographs you know
24:36it sort of you know but is it anything to worry about we'll have a look if that's okay and
24:41then
24:42we'll talk about it just look straight at me oh at you and no dry eyes nothing like that they
24:50feel okay
24:51otherwise well at one period it was you know sort of uh uh bothering me a bit of spurning but
24:58actually
24:58both eyes i think it was pollution because i went to the boots chemist and they gave me some drops
25:04and
25:04it was okay yes okay i just want you to follow my finger
25:14good and can you screw your eyes up really tight perfect don't and then just keep them shut for a
25:20minute i'm going to try and open them so if you screw them up really tight
25:26that's fine okay and puff your cheeks out good and can you lift your eyebrows up
25:34that's fine and you can feel me touching your face yes that feels the same on both sides yeah okay
25:39so it does look like you've got we call it ptosis it's just when the the eyelid droops a little
25:44bit
25:45oh and you can see on the right it's kind of drooped further than on the left yeah and then
25:51it is
25:51covering a bit of your pupil would you say affects your vision no i don't think it does no so
25:58the
25:58reason i'm making you smile and puff your cheeks out and raise your eyebrows is i'm just testing the
26:03rest of the muscles on your face but they all look fine so you can lift your eyebrows up equally
26:07when
26:08you smile your cheeks both puff out so that's good so i think it is just the eye that's affected
26:13i think you should go for the eye test just so that the um optician can have a look at
26:18your eye have
26:18a look at the back of your eye we will ask ophthalmology to have a little look at you what
26:23we don't want to do is it to start to affect your your vision yeah it's nothing serious anyway i
26:28don't
26:29think so because it is it's just that one that's affected okay all right thank you very much okay
26:35nice to see you that's like a picture of our feet should i post it on my story look how
26:47cringed we are
26:48we're both wearing the same shoes today because i never wear dunks we would never be foot models you
26:54know that come ready ready one two three three well we could be feet model because our feet are
27:04quite cute actually but not with shoes on it's not looking good bro
27:11uh alexander please hey there
27:15okay i have a student with me is that okay that's absolutely fine lovely i'm george one of the doctors
27:19good to meet you very nice to meet you george how can i help today i mean i came in
27:23a few weeks
27:24ago because i had a um a radial head replacement yes i was told to sort of come in if
27:31any of the
27:32screws were looking like they were going to come through yeah apparently i'm a little bit skinnier than
27:37most patients because they said that if these come through and there's an open fracture then they have
27:43to repeat the whole surgery all over again and take out the elbow and it'll be a nightmare so but
27:48i was
27:48just wondering if you could recommend anything basically is it causing any problems at all not
27:53really i mean it's like the pain is way better than it was obviously because i've gone through
27:57a month the pain's been so intense i just really don't have to repeat that again yeah of course and
28:03what's the range of motion like is it yeah it's a really really good i was told if you get
28:0850 range
28:09of motion after this surgery yeah you're doing well so i was pretty happy with that okay brilliant and
28:14how did you do this again like the most innocuous way i was playing paddle and i sort of like
28:20i think
28:20it's like basically i jumped up and as i fell i think i dislocated it and then broke my humorous
28:27bone but then because of that my body fell on my arm and it broke all of this it was
28:33uh yeah it was
28:34pretty intense i'd never broken a bone before oh gosh i know i broke every bone in my arm
28:40is that painful if i press a little bit it's it's okay i'm very used to it by now
28:45so i think like the screws back on the other side i think are okay yeah i agree um but
28:50i think it's
28:50just this one here that like i agree i'm a little worried that it's going to come through and then
28:56any sort of pain shooting down the arm at all yes i think um so a bit of bone chipped
29:03off during
29:04the surgery and then nestled in between my nerves so i get a bit of shooting pain down my arm
29:08yeah
29:09but uh i think they're going to remove that in the next surgery i think what we should do maybe
29:13i'm wondering if we should get an x-ray for you just to see how things are yeah yeah yeah
29:18sure so
29:18that when you see them they'll sort of have that and yeah i think we just write to orthopedics again
29:22and just say look this is starting to come through a little bit sorry cool no that's totally fine
29:27it hurt more insanely than i can possibly imagine oh that's it it's all right they do say breaking
29:34of bones is horrendous i think it's because the elbows all the nerves are there but i think like
29:39because you normally associate pain with being like a zero to a ten i thought i'd reached like
29:44a seven before this but i think i'd only reached like a four oh god good luck so much more
29:50all done
29:50all right thank you so much all right thank you so much appreciate it take care how can i help
30:03i don't know how to start like well my mom told me that like i should come in for like
30:08an appointment
30:09to talk about if i have any mental health issues or like adhd why do you think she's suggested that
30:16well like since i was like young i've always like struggled with like i don't know like example
30:21for subjects i really enjoy yeah like maths but to me it requires like less thinking i was always like
30:29able to like study for it but subjects like english and like history and all those subjects when it
30:36involves writing it's so much more difficult yeah have you ever had that assessed with at school you're
30:41writing no because it sounds like you're really good at numbers and it's the writing bit that
30:46you're having a problem with do you think that's how it feels that's how it feels a lot tell me
30:51more
30:51about why you think it's mental health issue rather than sort of you know concentrating or problem with
31:00letters and numbers if i would be in like a conversation with someone yeah i'll be talking to them and
31:06then
31:07i'll just stop hearing what they say like like my mind will be onto something else all the time
31:11and then obviously the person will find it rude and i would just be i'm very sorry i didn't mean
31:17to
31:17yeah over the last like two three months i've been working now as a barista so like i'll be making
31:24the
31:24coffee and they would talk to me yeah and then i would begin like the conversation when they speak to
31:29me i would hear it yeah and then for every reason i would either forget or i just wouldn't hear
31:34it yeah even
31:35my manager went up to me and they're like i feel like you should really work time skills yeah and
31:39i was like yeah i'm sorry i'm trying the best i can and your mood do you get tearful on
31:45your own
31:46you know do you ever get really sad is that do you ever get like that when i'm alone and
31:51i just
31:51like me and my thoughts i feel like i'm constantly overthinking have you ever felt low that you wanted
31:57to harm yourself or anything like that have you i wouldn't say harm myself but i'll be time where i'll
32:03be
32:03like i might just be in bed for like hours and hours of a day even though i have stuff
32:07to do yeah
32:08and i'll just not want to do anything i just wanted to be like yeah stay in my room and
32:13do nothing yeah
32:27it's quite an impressive brace in it just it's like another trouser leg isn't it i mean goodness me
32:34my poor knee i don't normally wear this it's just if i'm on the good going bursitis well that's huge
32:41now this knee sounds like there's crinkle paper in it every time i try to get up
32:46you can see the difference yes definitely in the knee very arthritic but it'd be okay to have a little
32:51feel of that yeah i'd love you to i started to get a pain in my knee here and then
32:56over the weekend
32:56it blew up i'm still getting trouble with my knee it just goes you know i wish it would go
33:03to cyprus
33:03with me attached to it but no anyway
33:11okay doris come through we're ready
33:15i have a student with me do you mind if you sit in you have because i saw the feet
33:19oh very good lovely to see you it's lovely to see you because it's good days and bad
33:27and i've got soaking wet as you can see it's horrible out there how are you all right good
33:33i have an ear i've got two two i hope one of them's been playing me up for a little
33:38while
33:39and i've also got i think porosis of the knee that's killing me but there you are that's right
33:46that and how long has the year been bothering you for well it's crusty yeah so the only way i
33:52can describe it it doesn't hurt but it itches it drives me mad yeah fair enough any discharge
33:58from anything coming out of it not really that comes with if if i do scratch it yeah and after
34:04i've got long nails yeah i couldn't hopefully you're not doing too much damage when you're doing that i
34:09hope not but i mean it seems such a silly thing no not at all it's going on and on
34:15and on it's not
34:16silly at all i'm glad you came in um any dizziness rotational vertigo type of symptoms not at the
34:22moment good i think that's coming well i mean hopefully not i hope not i will fall i don't know
34:29why i know you've had a few of those falls recently oh i've had five of them the point is
34:34with a fall
34:35it always happens where you can't get up because there's nothing to hold on to oh gosh even at
34:41home if you know i mean i'm not near a chair or anything so i have to you know sashay
34:48along
34:49so if somebody doesn't come and help you up i think you'll be there till nine o'clock at night
34:54and do you have everything you need at home like walking aids oh yeah have you seen the guys at
34:59the
35:00falls clinic the specialists have you seen them no no are you happy to go and see them oh yeah
35:05yeah
35:06can i look in your ears you can and i look in your good one first just to see what
35:10normal is like for
35:11you thank you perfect textbook ears i love it amazing really pristine oh well done well done you
35:22well done you you've got loads going on right that's brilliant really good yeah you can see
35:29the eardrums bulging out towards me ever so slightly it's nothing to worry about
35:33and the canal looks a bit inflamed and angry so yeah i'm going to give you a little spray for
35:38it
35:38that's just going to help calm down that inflammation and then what's going on with this knee i feel this
35:45osteoporosis osteoporosis or osteoarthritis oh ah well how would i know well i suppose that's
35:51what the size of it it looks osteoarthritic to me it looks like osteoarthritis yeah but let's have
35:56a little is that better than the other one yeah infinitely 100 yeah oh thank you i live on my
36:02own
36:03and i say i'm walking around the flat saying to yourself why are you doing this to me are you
36:09managing okay at home yeah yeah yeah did you get any help more um i don't know i'm used to
36:16being on
36:16my own yeah it's my son could you just something with my son he's driving me mad what have you
36:22got
36:22in mind oh oh i love it thank you you've given me a good laugh there let's have a little
36:32thank you
36:33he's all right don't you understand me he's not i mean if i didn't have him i don't oh now
36:38i can feel
36:39all that tender isn't it um he says the neighbors are complaining my television's too loud now i can't
36:47either hear it so what's the point of having a celly with your hearing aids in do you still need
36:51to
36:52turn the volume up quite high no no well then that's fine put your hearing aids in and watch the
36:56telly not a problem at all yeah well i didn't put them in because i'm in case yeah just have
37:00a look
37:01absolutely no it's looking good i'll give you a spray for it like i said i think the knee there's
37:05a bit of
37:05wear and tear there and that's what's causing all the pain if you want we can use a bit of
37:09ibuprofen
37:10gel to rub into it i think that'll really help yeah and then we'll refer you to the falls clinic
37:14again i'll chase it up for you because i don't think they've seen you it looks like wonderful and
37:19then we'll see how we go is that all right lovely that's fine very helpful good take care of yourself
37:26have a lovely weekend my son as well lovely to see you likewise all the best bye now i hope
37:33you're
37:33learning something even if it's only from us i hope so too thank you thanks my man
37:43i can't believe it he's not worried i'm spending my life writing
37:49you don't need to worry in one ear dr horch will sort you out don't worry he will he will
37:55he's an
37:56expert isn't he he's lovely yeah i know in actual fact i'm thinking of getting him cloned i was just
38:02thinking i haven't seen you for ages i know i know it's been busy but you haven't changed a bit
38:07well
38:07you're in good hands you see you don't need to see me anymore but it's nice to see you you're
38:11looking
38:11very well keep my fingers crossed good for you keep your fingers crossed it's nice to see you
38:17again bye bye bye bye bye you know i've known you for a long time actually uh since you're a
38:24baby
38:25and um it's great that you've come and i think we can help you i think some talking therapy is
38:30going
38:30to help you but how do you feel about medication to help lift your mood a bit for me i
38:36would i would
38:36want to learn as much like information about medication before i take it because you're an
38:41intelligent person you want to know everything about it and why take a chemical if you don't have
38:45to so i am going to refer you they should contact you within two weeks or they'll assess you on
38:52the
38:52phone and then decide which direction they want to direct you to this talking therapy there's individuals
39:00this group all those sorts of things it's really brave of you to come and talk about it um have
39:05you
39:05got any questions well i would like to know have some like clarity like so i could stop thinking
39:10about do you from your like perspective would you think i have adhd i think you know it's a spectrum
39:17isn't it of course and you know we're probably all on one part of the spectrum i think yes you
39:23probably
39:23are on one part of it but i think there might be other issues with that as far as numbers
39:29and letters
39:30but you're very intelligent you've got good insight and you know i'm here and you know where i am and
39:37feel free to come and see me um i'll be i'll be seeing you in again and i'll do a
39:42phone call review
39:43anyway uh to make sure you get the appointment okay okay so i'll put you down for telephone call
39:48in two weeks yeah to see how things go if in the meantime you feel bad about or worse or
39:53anything like
39:54that you know just come and see me right of course i will thank you all right okay yeah all
39:59the best
40:00have a good day and uh we'll be in touch great see you
40:14so this is a question do you keep your eggs in the fridge yeah do you keep your ketchup in
40:19the
40:19fridge yeah you put your ketchup in the fridge do you keep fruit in the fridge depends what fruit it
40:24is so bananas no they go brown quickly they're not apples though or anything no i don't put apples in
40:30fridge it's too hard when you bite it come on man even you know that
40:39how are you oh i'm not too bad i'm so sorry to hear about that i'll pop it up him
40:45if you want
40:47are you managing okay yes it's a cure it's egg isn't it it sort of hits you when you least
40:52expect it and
40:54when you're sort of think it's going to be tough is actually when you're you're ready for it and it
40:59doesn't affect you so badly and then when it's sort of i don't know so something happens you aren't
41:05expecting it and then it sort of hits you can't sort of function for a bit but she set such
41:11a strong
41:12example i can't really i'm not allowed she was amazing she really was she was amazing woman yeah yeah
41:18absolutely 45 years 45 years yeah yeah yeah but you've got the you've got 45 years you've got 45
41:26years 45 years but your family are you doing okay well yeah yeah yeah we're very much together yeah
41:33exactly it's it's been sort of gonna go on holiday or anything uh we haven't well yes we are planning
41:40to
41:41go with christmas because christmas we can't do christmas at home that's going to be too much
41:45so yeah so i would go with christmas and i bet yvette gave you a list of yeah well that's
41:52the
41:52problem is she she was she was mrs christmas she'd think about christmas 364 other days of the year
41:58as well yeah a standard i cannot achieve myself i'm afraid so sharp scratch mums we go overboard don't we
42:08uh
42:09yes if it had got so many canyons fitted in her time she don't she'd come to me how's your
42:18granddaughter
42:19uh she's great she's coming on a pace now she's really developing how old is she now 16 months i
42:25was so happy that she well she ate got to see got to see her and then she attended her
42:31first birthday
42:31as well so that was extraordinary and got a nickname so she became goo did she become goo she became
42:37goo so
42:38she got she's incredible she got the nickname in she was so determined to see her first grandchild
42:46well she certainly was looking to make the most of whatever time she had all done sir okay thanks
42:52very much well you're very welcome and it's nice to see you you too you're looking well you you keeping
42:58well yeah yeah not bad just you know getting on my life yes quite grandkids keep me busy that'll do
43:06it
43:06you take care thanks very much bye john bye thank you so much for your help
43:13great not at all yeah i'll speak to you next week all right then thank you bye remember it's fasting
43:17from midnight hey nothing to eat from midnight when you come yeah i've got to remember that one
43:22whether it was on the afterwards thanks very much bye brilliant okay thanks very much pleasure take
43:27all the best you two bye
43:43well
43:54yeah
43:56yeah
43:57yeah
43:57yeah
43:57yeah
44:23¶¶
44:28¶¶
44:28You told somebody that you're starting to struggle at home.
44:32Really? I think people put things in my mouth at times.
44:37Do you feel okay in yourself?
44:38I'm sweating my hell.
44:40On Sunday, all of a sudden, I had this blackout of a faded.
44:44It just happened?
44:45Just like that.
44:56¶¶
45:03¶¶
45:12¶¶
45:14¶¶
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