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00:15I feel trapped in my legs.
00:21I've had this many, many years.
00:25People stare and point.
00:29It's taken a lot of my life.
00:33If I can't get help, I feel that I will just be left till I can't walk.
00:43I just want a normal life.
01:06So have you got the keys for the house yet?
01:07Yeah.
01:08Yeah, they do.
01:09Do you need anything?
01:10Yeah, wardrobes.
01:11I have three, so I don't need any more.
01:14Maybe you'd like them?
01:15Yeah, I would love them.
01:16Yeah?
01:17We've got a cycle.
01:21Morning.
01:22Morning.
01:24Dr Craython's office, how can I help?
01:26Hello.
01:27Hey.
01:29Are you in charge today?
01:31Oh, hey.
01:31Yeah, yeah, yeah.
01:32Because I have Sam coming in, and it would be okay to block off the afternoon for her,
01:37because she's pretty complicated, so I want to make sure she gets all the time that she needs.
01:41Yeah, sure.
01:41I'll do that right now, actually.
01:59My condition started probably sort of 20-odd years ago with a protruding lump.
02:05Daddy.
02:07No, Lucy.
02:08My doctors, they weren't sure what it was.
02:11Seven.
02:12It's just progressively got worse.
02:15Come on, darling.
02:16Come.
02:16Come.
02:17Let's sit.
02:18No.
02:24The pain is really unpleasant.
02:28My legs can get very hot.
02:31They are ugly.
02:36Where my ankle is, it goes right in, and then my feet are massive.
02:42The skin just flakes off.
02:46I've got quite a lot of sores on my legs.
02:48If I knock them, it bleeds a lot.
02:51I eventually had a diagnosis of lymphedema, and it's a build-up of fluid in a limb or limbs.
03:00They are very heavy.
03:02I can barely lift my legs up.
03:05I'm stuck because I can't get help.
03:17Hi, Sam.
03:18Hiya.
03:19Are you all right?
03:20Yeah, not bad.
03:21Hi.
03:21Hi, Moosey.
03:25I suppose you want to walk, do you?
03:28Thanks, Gordon.
03:30See you in a bit.
03:30Thank you very much.
03:32As I live alone, my sister Michelle and her husband Gordon are my main support.
03:38Things that I used to take for granted, like walking into town, you can't do any more.
03:45It's nice for Gordon to do the dog again.
03:48Yeah, he doesn't mind.
03:50You know he'd do anything to help.
03:51How are your legs?
03:53They're not very good at the moment.
03:55They've still got the sores.
03:58Oh, that's very warm.
04:00Yeah.
04:01They're just so heavy.
04:03Fingers crossed Dr Emma can help.
04:06We want you back to the bouncy Sam, and you're happy, chatty,
04:12making little jokes, all that that you've lost because of your condition.
04:21I'll grab your coat, Sam.
04:23Moose, you stay in your bed, darling.
04:26Gordon will be back later.
04:28We used to go walking a lot.
04:31We used to play badminton.
04:35And slowly, each little bit that she used to do has gone.
04:47It's not how she's meant to be.
04:54And you're in with me with Sam later, but I think I'm just going to go and grab some lunch
04:58now.
04:58OK.
04:59See you then.
05:00Yeah, see you soon.
05:00Hello.
05:09Welcome aboard the Southern Service to London, Victoria.
05:13How are you finding the journey?
05:15You know what it's like.
05:16My legs just get irritated, but then I don't normally do any journeys, so no pain, no gain.
05:21It's going to be worth the journey.
05:23Yeah.
05:32That's it.
05:34I am an admin coordinator within the NHS.
05:41In your own time?
05:43Yeah.
05:44I'm not going into the office at the moment because I had a bit of a fall at work.
05:50One of the main problems is having shoes on my feet.
05:53It's really painful.
05:55One whale, Bec?
05:56No problem.
05:58Oh, that's great.
05:59That's step.
06:00Never had one of those before.
06:02Thank you so much.
06:08I hope you got your positivity pants on today.
06:11I've got two pairs on.
06:13Good.
06:17Oh, it's here.
06:18There you go, guys.
06:21That's my stomach's just gone down to my kneecaps.
06:32Hiya, it's Sam.
06:33I'm here to see Dr Emma.
06:34Fantastic.
06:35Can you just take a seat?
06:36I'll let her know you're here.
06:37Perfect.
06:37Thank you very much.
06:41So sit here and shout.
06:42That'd be perfect.
06:43Yep.
06:44I bought some of those photos just to show that I actually had legs at some point.
06:49Do you remember that?
06:50That was your hindu.
06:52Which one?
06:52That one.
06:54No, which hindu?
06:55Oh, sorry.
06:56I keep forgetting you've been married a few times.
07:00Whenever I've seen anyone sort of medical, I feel like people don't know what to do with me.
07:05It's all okay.
07:13It's all okay.
07:14A few deep breaths.
07:26Hi, Sam.
07:27Oh, hi.
07:27Hi, nice to meet you.
07:28I'm Dr Emma.
07:29Hi.
07:30Come with me.
07:32Michelle's coming with me, if that's okay.
07:33Michelle.
07:34And is Michelle your sister?
07:35Yes.
07:35Yes.
07:35Yes.
07:36I can tell.
07:37My sister and I are so similar as well.
07:40Sometimes she'll go in somewhere and then they'll ask her questions about the skin.
07:45And my sister's like, I am not Emma.
07:49Okay, come on in.
07:51Have a seat.
07:52This is Mottie, he's our nurse.
07:53Hello.
07:54Nice to meet you.
07:55So, Sam, what have you come to Senior Biting Clinic?
07:59My legs.
08:01I have been diagnosed with lymphedema.
08:04You can probably see by the size of my legs.
08:08Your feet look so tiny.
08:09I did have legs at one point.
08:13That's all the sisters.
08:15Aww.
08:15That's gorgeous.
08:16That's me.
08:17Fabulous legs.
08:18The next one, probably more obvious, and that's me there on the end.
08:23Oh, yeah.
08:24Look at the hair.
08:25Look at the hair.
08:26I know.
08:27Scary hair.
08:29Very delicate little ankles.
08:31I did.
08:31Yeah.
08:32Incredibly small ankles.
08:34You sort of look at that and you think, oh my God, I've gone from that to this.
08:38And what about in your family?
08:40Is there anyone else who has swollen legs like this?
08:42And have you ever been on any medication?
08:44Only antibiotics, you know, if you've had a chest infection or something.
08:48Yes.
08:48So really, you've been very well and then, out of the blue, your legs started to swell up.
08:53Yeah.
08:54I kept on sort of mentioning it to the doctor and nothing really got done.
08:59So then I pushed it a bit seven years ago and they just kind of looked at my feet and
09:04said,
09:05oh, you've got lymphedema, but they would want me to lose weight before they even consider me for any help.
09:13Obviously, I can't move that well, so I'm sort of in that sort of catch-22 situation.
09:19I've gone from walking and doing lots of other things to nothing.
09:24And it's just, it's completely and utterly changed.
09:32It's changed my life.
09:34It's changed my life.
09:36Okay.
09:37Yeah.
09:37So, I mean, this means a lot.
09:40Yes.
09:40Definitely.
09:41I don't think people really understand.
09:43They see the size of my legs.
09:45They just think I'm just some fat person, you know, and it can be quite hurtful.
09:52Because there's so many reasons why somebody has extra weight and the idea of having your legs as swollen as
10:00this and then expecting you to be able to do some exercise is just quite frankly ridiculous.
10:07So, not an awful lot of help with these then over the last 10 years.
10:11Cosmetic is what they say to you, isn't it?
10:14That's not my favourite word.
10:17It's what, somebody has used the fact that this is a cosmetic problem?
10:20Yes, yes, I was told more than once.
10:23I just felt like I've got no hope.
10:26You're worried that you're going to end up in a wheelchair, aren't you?
10:29I don't want to.
10:30I'm independent.
10:31I want to be able to keep on my feet.
10:34Yeah.
10:34In a way, you're my last resort, because I don't know where to go.
10:39I don't know where to go from here.
10:57Can I take a message?
11:01Right, okay.
11:02Oh, your poor legs.
11:03I'm going to need help.
11:05I'm afraid I can't lift them.
11:06Goodness.
11:08You've been dealing with this for so many years.
11:12Yes.
11:13Ready?
11:13One, two, three.
11:14Sorry.
11:14And then the other one.
11:15One, two, three.
11:18Let me go get Emma for you.
11:20Lovely.
11:20Thank you so much.
11:23So I can see that these really are like having two toddlers on your legs.
11:27Aren't they?
11:28Yes, they are.
11:29Some weight in them.
11:31The lower legs just completely swollen and they are bigger than your thighs.
11:36Yes.
11:37They are the, it's almost like the opposite way round, isn't it?
11:40Yeah.
11:41It's interesting how it's spared around these natural joints.
11:45And partly it's because they're compressing against each other.
11:48So it's stopping them from swelling up.
11:50And then what's happened is you've got these outpouchings.
11:54There are these little weak areas.
11:55They're just full of fluid.
11:57So the pressure that's happening inside the skin pushes them out.
12:03And you have hundreds and hundreds of these nodules right the way across.
12:07And the reason why it has the scale that you're seeing and the dryness is because it's not
12:12being fed properly, this skin.
12:14It's under too much stress from all of the fluid.
12:17And it's just not getting enough nutrients to it.
12:20And actually it also means that it's much more likely to have infections appear.
12:25This is the skin just saying, I need a bit of help.
12:28I'm under pressure.
12:31So this is definitely a condition called lymphedema.
12:34The lymphatic system in the body is not working quite as it should do.
12:39And all of the lymph fluid, which is this very watery substance that's responsible in our body
12:45for carrying waste in our immune system and things, it gets stuck.
12:49And for most people, their lymphatic drainage works like a pump.
12:53And it pumps all of the fluid back up.
12:56But unfortunately, something's gone wrong in your legs.
12:59And that lymphatic pump is just not working anymore.
13:03And that's why all of this fluid just gathers and gathers and gathers.
13:07Can you have any idea why it's happened to me?
13:11Some people get it after infections, but it doesn't sound like that's been the case.
13:16Sometimes some medicines can cause it, but again, you don't fit into that category either.
13:20A lot of people will get this because of genetic reasons.
13:23But the very idea that this is just simply cosmetic is more than frustrating
13:28because essentially everything in dermatology is a cosmetic problem,
13:32because everything is visible.
13:34I almost find it like an insult in a way.
13:36It is an insult. You're exactly right.
13:38This is a medical problem that needs a medical plan put in place to get this better.
13:44And the only way really to do that is to reduce the excess weight that you have
13:49and with something called compression.
13:51So number one, we know that for some people, they naturally just put on weight.
13:58And often it can be related to just the way that we process our food.
14:02I think it would be really worthwhile using some of these new injections that we have called GLP-1 agonists
14:09to help get that under control.
14:11Number two is speaking to the lymphedema clinic that I'm very close to.
14:16And you need to have a course of intensive, usually inpatient, compression therapy.
14:22Yeah.
14:22Compression works by mimicking that pump that's not working anymore.
14:27So you start off with a whole lot of great pressure down here
14:31in order to drive any of the fluid that's in the bottom of the legs all the way up.
14:36I'm just, you know, truly grateful.
14:38It will make a massive difference to me.
14:40It really will, thanks.
14:42OK.
14:43We'll make you cry.
14:47Do you mind if I just have a look at your face?
14:49Because I think your skin's a bit red.
14:52So you have some papules and pustules, which are the little spots.
14:56You have some telangiectasia, which is the broken blood vessels.
14:59And we can see this red, slightly dry patch.
15:04That this is a very classic kind of a rosacea.
15:07This is totally unrelated to the lymphedema in the legs.
15:10But today, if you're up for it, I can do a laser treatment.
15:14Oh, that would be lovely.
15:15And we'll just get it started.
15:20Come on in.
15:22And Sam, this is Fritz.
15:23Oh, hiya.
15:24Our laser special nurse.
15:26Whilst the lymphedema in Samantha's legs is pretty challenging to treat.
15:31Sorry.
15:32I got you here.
15:34The rosacea is something that I can help with quite easily.
15:38Have you ever had a laser treatment before?
15:40And for hair.
15:42So it's kind of the same, really.
15:44And immediately afterwards, it gets a bit more swollen.
15:47But it's just for a couple of days.
15:50One, two, three.
15:52That's it, OK?
15:54Mm-hm.
15:56Very good.
15:57And then over here.
16:00It's weird.
16:01It's like cold, but burned.
16:03Yep.
16:04You're doing very good, because most people jump.
16:06This is a laser that anything that's red in the skin absorbs the light energy and converts it to heat.
16:16And in that process of heating them up, it essentially destroys them.
16:21Done.
16:23That's it.
16:25Googly.
16:26You're like, thank you for blasting me.
16:28Thank you for freezing my face off.
16:31Very good.
16:33So the plan for Samantha's rosacea is a skincare programme with creams in combination with some laser sessions.
16:40OK?
16:41You can gradually and slowly sit up and we can help you.
16:44But even more importantly, I need to urgently speak to the lymphedema experts about her legs.
16:50Honestly, it's one of the worst cases of lymphedema I have seen.
16:53Her mobility is really suffering.
16:56We need to get on with this straight away.
17:00Dear Professor Gordon, I'd be very grateful if you could see my patient who is presented with bilateral leg lymphedema.
17:07Dr Crathorn's office, how can I help?
17:09I am grateful for your thoughts regarding potentially inpatient compression for this patient.
17:14With kind regards, yours sincerely.
17:16Hi Emma, your next patient's here now.
17:18Oh brilliant.
17:19I've just dictated a letter over to Professor Gordon about Sam.
17:22OK.
17:22Do you mind to get that sent out urgently?
17:24Yep, absolutely.
17:25No worries.
17:38Good morning.
17:40Just received the parcel with my medication in it for the weight loss.
17:45It's a pen.
17:49And that's the first one done.
17:51Thank you very much.
18:05Very good filling up your water bottle.
18:07I am being much better.
18:08I'm drinking two litres every single day.
18:11That's a nice new water bottle.
18:12It matches the scrubs.
18:13Yeah, I know.
18:13It matches them exactly.
18:14Yeah.
18:15Let's see how long I can have this one before I lose it.
18:18It's been two hours.
18:23Rosie, I'm going to bring Samantha in here with the lymphedema team.
18:27Can we use this room?
18:28Yeah, sure.
18:28I'll get a prep for you.
18:29Thanks.
18:31Today is a crucial day in determining the treatment plan for Samantha's lymphedema.
18:37Hi.
18:37Hi.
18:38How are you doing?
18:39Good to see you.
18:39Oh, good to see you.
18:40Hi, Paul.
18:41Good to see you.
18:42Yeah.
18:43Okay, let's go through.
18:44Professor Gordon is a real expert in lymphedema and Mark is a manual lymphatic drainage therapist.
18:51My hope is that Professor Gordon and Mark reduce the size and swelling of her legs.
18:56I've brought some friends to see you this time.
19:00I want friends.
19:03So this is Sam and you can really see the amount of lymphedema and the kind of destructive changes it's
19:09now causing.
19:09Yeah, it's lighted everything that I do.
19:12We can help.
19:13Don't worry.
19:13In your case, fat attracts fluid, so we need to have less fat on the body so you're retaining less
19:18fluid.
19:19But also when we're overweight and we're sitting down all day, the tummies are squashing the groins,
19:23which is where the lymphatic fluid and blood in the veins is trying to drain and it's struggling.
19:28So if I could wave a magic wand for you today and help you lose weight quickly, your lymphatic system
19:33would already start to respond.
19:35She's just started on weight loss injections.
19:37Brilliant.
19:37So you're making steps already.
19:39Unfortunately, we can't cure lymphedema.
19:41Intensive treatment is what you need.
19:43We're going to do six weeks with you.
19:44So lots of padding and then a really tight bandage, but it's comfortable.
19:48We also need you to be active, to be moving in those compression bandages and to be losing the weight.
19:54How does all of that sound?
19:55I'm excited and nervous.
19:57Yes.
19:58Shall we let you get on with your magic?
20:00Do it.
20:04Right, so first of all, we'll put some cream on.
20:07Samantha is understandably nervous, so Mark is going to apply the compression bandages now to give her an idea of
20:14what to expect.
20:15Are you ready?
20:16Yeah.
20:17I quite often get cramp.
20:19Because it's an alien weight and your muscles are not built to lift that kind of weight, so that's why
20:24you're getting cramp.
20:25Saying yes to this treatment is a big commitment because she has to be prepared to come down and stay
20:32in London on her own for six weeks of treatment.
20:36The processes I'm going to go through every single day.
20:39Every single day, because in an ideal world, as the fluid comes out and the shape improves and the volume
20:45goes down, the bandage will fall off if we don't change it enough.
20:52I'm going to be walking like Donald Duck or something.
20:54You will for the first couple of days.
20:59They look like moon boots on your legs, don't they?
21:02They do. They feel like moon boots.
21:03Yeah.
21:04They're going to feel heavier, but once you start moving, you'll realise your legs are stronger than this bandage, so
21:09it will feel less weird as time goes by.
21:11Can't wait to see what it's going to look like.
21:13I can't either.
21:16So how the next six weeks will work is that Samantha's going to be staying in an inpatient hotel that's
21:23right beside the lymphedema centre.
21:25She will be there Monday to Friday, and then at the weekend she'll get a bit of a break to
21:30go back and see her friends and family,
21:31because this is going to demand a lot of her, both physically and emotionally.
21:57It's that what your walking sticks for.
21:59Yep, that's what my sticks for.
22:03I have to be honest, it's going to be really intense being away for six weeks.
22:09Zero.
22:10Oh, lovely.
22:12But you have to do these things to get a better quality of life.
22:21Oh, this is sweet.
22:23Wow, look at this.
22:26Microwave, little stove.
22:29Apart from Moosey, it's got everything I need.
22:33You're fine.
22:35Yeah, I'm fine.
22:36You're going to be OK?
22:36Yeah, I'll be fine.
22:39Oh, I'm feeling a bit emotional.
22:41Everything's just happened so quickly, and it's going to be hard.
22:46Bye.
22:46Take care, darling.
22:47Bye.
22:47Bye, bye, bye.
22:48Because she's really on her own.
23:11Hiya.
23:12Hello.
23:13Nice to meet you.
23:14This is Anna.
23:15Hi, Anna.
23:16How are you?
23:17How are you?
23:18I'm all right, thank you.
23:18How are you?
23:19Very well, indeed.
23:20Nice to see you again.
23:23Right, so first of all, we're going to have a look at these lovely legs.
23:31So there's an excoriated area.
23:34Yes, somebody accidentally rammed me with a pram.
23:37It looks wet.
23:38Because it's just water pouring all over it all the time.
23:41It's not got chance to heal or anything.
23:43It's really painful.
23:43Well, you'll be sitting there and I'll be like this.
23:46Yeah, sure, sure.
23:47It really brings me down.
23:49I'm going to measure you now.
23:52I'm going to draw some dots on you.
23:54And Anna's going to write some of these down.
23:55So we're going to start nine centimetres up.
24:00Can you hold that for me?
24:01Oh, yeah, sure.
24:0651.2, 53.4, 65.2.
24:13How many more?
24:1566.
24:17So we'll remeasure them again at the end and we can impress everybody and say it's gone down by X
24:22centimetres.
24:24Right, so we're going to start these bandages. Ready?
24:27Yeah.
24:27Just going to go over your foot and up to your ankle.
24:31Oh, sorry.
24:32Yeah, it's very sore at the back.
24:33Sorry, sorry.
24:37I feel like my toes are quite little.
24:39They'll soon be in proportion.
24:43So in the early stages of this, we need to pad the ankle so that when the bandage goes around
24:50it, it doesn't dig in there and fluid from your foot can just pass out.
24:56Yeah.
24:56We call it the shelf.
25:03Good.
25:05You can expect more trips to the loo.
25:08This fluid has to come out somewhere.
25:10We want it to chase up here.
25:12Right.
25:12Up through the middle, into your bloodstream, your kidneys to pick it up and wee it out.
25:16The more mobile you are, the more fluid will come out.
25:19Yes.
25:20Sitting with your legs down like this is counterproductive.
25:23Yeah.
25:24I'll come back tomorrow and we'll re-bandage the same as today.
25:28Take care.
25:31Oh dear.
25:36It's like Velcro this stuff is.
26:04So, I had my first week of the leg wrapping.
26:08I could probably win an award for the amount of pee that I've done.
26:12I pee at least seven or eight times a night.
26:17It's a lot of wee.
26:18That's all I can say.
26:24I've been signed off for six weeks from work.
26:27A lot of people probably wouldn't like being on their own.
26:30Waiting for treatment every day and I've been okay.
26:46It's almost hypnotic watching them wrap my legs.
26:52How they know where to apply the pressure and stuff like that.
27:02It's just very clever.
27:19Oh, hi.
27:20Hi Sam.
27:20Nice to see you.
27:21How are you?
27:22Yeah, I'm fine, thank you.
27:24Well, well, well.
27:25Look at these tiny little legs.
27:27Just my shins have been a bit uncomfortable.
27:30I don't know why.
27:31They will be uncomfortable, I'm afraid,
27:33because we've got rid of the major bulk.
27:36Your nerves on the edge of that bone there were engorged in that fluid
27:40and now the nerves on the front of that shin are going, oi.
27:45We need to get your muscles activated.
27:50Once we can get you walking,
27:52I believe it will desensitise the nerves at the front of this shin.
27:56She needs to understand that engaging that muscle tone in her legs
28:01is going to help improve her mobility, her weight loss journey.
28:06I've been moving as much as I possibly can.
28:10We need to get you out walking as soon as possible.
28:13For more or less the last year, I could manage a few steps, but not much more.
28:19I'm going to have to work very hard, but it's really difficult.
28:31Emma, I've got you some lunch, because I know we've got a really busy day ahead of us.
28:35As well as the busy day, I've also thought I might go and see Sam after work,
28:39just to see how she's getting on.
28:41She's about halfway through her compression therapy now.
28:44I thought I'd give her a little bit of moral support.
28:46Oh, that's nice.
28:46So I really appreciate this.
29:01Oh, hello.
29:02Hiya.
29:03Hello, Lucy.
29:06Hello, darling.
29:08You look really good.
29:11You know that, don't you?
29:13No.
29:14I know, when you look in the mirror, you don't see what I see.
29:17Your mobility's definitely better, because you haven't got the weight.
29:22It takes a lot of hard work, but it's paying off.
29:26As we always say, love you, bye.
29:28Love you, bye.
29:33Oh, hi, Sam. How are you?
29:41I'm having fun, thank you.
29:42Lovely to see you.
29:43You just caught me in the middle of unwrapping.
29:46Well, that's exactly what I wanted, actually.
29:50It's interesting, because even with all of these dressings on your leg,
29:55the leg looks smaller than it did whenever I saw you.
29:59There you go.
29:59Wow.
30:00Oh, my gosh.
30:02It's all squashed down.
30:04This was such a big, massive ridge before.
30:07It was.
30:07That is unbelievable.
30:09What does it feel like when the dressing's off?
30:12Does it feel really light?
30:14It goes...
30:14And how have you been feeling in the kind of pain or discomfort?
30:19I'm having quite a lot of pain in my chin.
30:21Yes.
30:21Right, let me help you with that.
30:22Oh, lovely, thank you.
30:24And look, you're even lifting your leg now.
30:26I know, I know.
30:27Well, this is going to be the thing, isn't it?
30:28It's actually getting the exercise back into the muscles.
30:34It takes me back to A&E days.
30:36When I was a junior doctor, you actually used to do this.
30:39Oh, did you?
30:40Yeah.
30:40Oh, wow.
30:42Wow.
30:43Oh, my gosh.
30:45I can hardly...
30:45I cannot believe this.
30:46I feel I've got legs under this.
30:47You do?
30:48You've got ankles rather than a shell.
30:54Sam is making just wonderful progress.
30:57So her legs, they were bigger than her thigh.
31:01And so the very fact now that they're almost half the size of the thigh
31:04is so telling.
31:05Really amazing.
31:07To have made such progress is brilliant.
31:10You yourself, you look so well.
31:13So up until last Friday, I'd lost 29 and a half pounds.
31:17That's amazing.
31:18At the moment, I can't see it so much.
31:21I can see it in my...
31:22I can see it.
31:22I think you can safely say it's all going in the right direction.
31:25Absolutely.
31:26And I know which way it's going.
31:27Straight out, up, down, through my kidney and in the toilet.
31:38To see Dr Emma today was absolutely lovely.
31:42And since I've started the treatment,
31:45the advice that came with it was obviously exercise.
31:48which I haven't done for quite a while.
31:54Everything that's going on now is all pushing me to walk,
31:58which is what I'm trying to do.
32:00It's really nice to be outside.
32:03It's a life changer for me.
32:05And I'm looking forward to more of it.
32:08I don't fucking after I never thought so.
32:22I thought really isn't it?
32:24It's going for me.
32:27European tourne was really nice to have mapped out Lanvin.
32:27It was like when we came next to her we had an embassy in Positionف wear.
32:30And once we saw maybe already doing the construction site,
32:40Look at you girl. Oh, thank you. Have a good week. Yep, thank you.
32:48Nice to be home for the weekend though. Oh yeah, it's lovely to see you.
32:53Moose was getting excited. Yeah, I'm really looking forward to seeing him.
32:56You'll be walking in soon. That'd be good for both of you. Oh yeah.
33:03I'll get you a bag. He's a good boy. Are you cold? Oh no. Hello.
33:15How are you doing? I'm not bad, just tired. I think you're bad.
33:19The wrapping is quite tight. Intensive. Yes. Shall we go up the garden? Come on. Yeah.
33:30Your legs are looking fantastic. Thank you. It just amazes me.
33:34What they're doing is reducing the size of my legs. And I think you've got all that padding on still.
33:39No. I think it's... Look. Look at you. Is there anything that you're worried about at this point?
33:46You know, lymphedema's not curable and it can come back. So the minute any of this stops,
33:53it will just come back. You're very determined. Yes, 100%. Good for you. Thank you for my flowers.
33:58No. I just want to thank you for what you've done for me and that you always do for me.
34:03Anytime. Thank you. Thank you. Yeah. Thank you.
34:06Oh, and a cuddle for you. Good boy.
34:17Oh, hey. Have you been busy? Yeah, really busy. Oh, who do you have next?
34:21Sam's coming for her last laser. Oh, the patient with lymphedema. Yeah, yeah.
34:25That Mercedes shit's looking really good. Yeah.
34:35Ready, Samantha? Oh, come on. Come on. Yeah, good. Come through.
34:39Hi, Samantha. We'll get you up here. Lovely.
34:43Oh, I should be able to wiggle my bum on here. Whoa! Look at that.
34:48Yay! See? Brilliant. That's how I know that you're getting better because the last time we had to help you
34:55up.
34:56I couldn't lay myself. Exactly. Yeah.
34:57How are they feeling? Because they were so heavy. Oh, my God, so much lighter.
35:00So the plan will be that after next week, the dressings will be off permanently. Yes.
35:05And you'll be replacing those with stockings that you do yourself at home. And how are you feeling about that?
35:10I'm quite excited, really, just to get on with it and do the next bit.
35:14I think that's exactly the right attitude because some people think, oh, I don't want to have to do something
35:17every day.
35:18But we all have to do stuff every day. We all have to brush our teeth every day.
35:22Yeah. We all have to put socks on every day. Yeah.
35:24But you're just going to have rather funky-looking stockings.
35:28And the skin in the face that has the rosacea on it, I mean, it's looking so much better, isn't
35:32it?
35:32It definitely is. It's got such a glue, hasn't it? Yeah.
35:35Let's put these goggles on. Thank you.
35:39We're going to pop the laser on. One, two, three. That feel OK?
35:44Yeah. Good.
36:18I can't believe it's my last day. That's six weeks. Where's that gone?
36:23Mark is going to show me how to manage my condition at home going forward.
36:29So that'll be quite exciting and scary, all in one.
36:36Hiya. Hey. How are you?
36:38I'm all right, thanks. You?
36:39Excellent. Looking forward to today?
36:40Yes, absolutely. You should be. Good, good, good.
36:42So what we're going to do today is work out exactly how much each leg has gone down.
36:48Can you hold that up there for me so? Thank you.
36:55That's measuring 35. Last time, this was how big your leg was.
37:00How do you measure?
37:01That was 65, now it's 45. That's 20 centimetres.
37:06That's a big difference. It's amazing.
37:10We've helped you every day for six weeks. Now the hard bit comes.
37:15To keep those volumes as they are, we've got some garments and some wraps.
37:19They're labelled left and right because they're bespoke.
37:22Yeah. And you turn it inside out from the heel.
37:25Then you slide your foot in till your heel's in.
37:30And you take the top bit. That's it. Then you'll get that crease out.
37:34It's really important not to have creases because your skin's a bit fragile.
37:38Then you'll think something's digging in. That's it.
37:41Is that gone? That's great.
37:42They fit good? Yeah. They feel good? Yeah.
37:45Excellent. So now we've got one on.
37:47I just want to make sure before we go that you can do it.
37:53Wonderful. Just some wraps now.
37:56They're little Velcro wraps. Feels like it could go with a little bit tighter.
38:00Give it a little extra squeeze because if they're too loose,
38:04you're looking down the path of going back to how it was again.
38:07You can't give it an inch because it will take a mile.
38:11Look at that. Lovely jubbly. That fits good.
38:16We're done, Sam. Let's bring it in.
38:18Let's give you a hug. You've done really, really well.
38:21Take care. Bye-bye. Bye.
38:26From this point onwards, it's all down to me.
38:30All the help that Dr. Emma has put in place for me.
38:36I have to continue. I have to make sure that I follow everything I've been told to the letter.
38:45I cannot go back to having the legs like I had before, and I will keep it up.
38:53I feel positive. I feel happy.
39:08You easily empathise with the concerns of other people.
39:11Yeah. You often prefer to read a book than go to a party.
39:14Yes. What are you doing?
39:16A personality test that tells you if you're an extrovert or an introvert.
39:20OK. Can I do a question? Yeah.
39:22The more people you speak to, the better you feel. Yes.
39:26Do you not? No.
39:28What depends on who you're speaking to, I suppose?
39:30You rapidly get involved in the social life of a new workplace.
39:34No. Yes, you do.
39:36No. You often organise it.
39:38You often prefer to read a book than go to a party.
39:41Absolutely not.
39:43I prefer the party.
39:52We're here.
39:55Last appointment.
39:58Can't wait to see Dr. Emma, see what she has to say.
40:03Hi, Samantha. Oh, hello.
40:05Are you all right?
40:05Yes, we're fine. Thank you.
40:07Hiya.
40:08Hiya. Come with me.
40:11You're walking even faster now, aren't you?
40:13Yes, aren't I?
40:14That's so good.
40:16Come on in here.
40:18So this is Rosie.
40:19Lovely to meet you, Rosie.
40:21Nice to meet you.
40:21Nice to meet you.
40:22Nice to meet you.
40:22Nice to meet you, Michelle.
40:24OK, so look at these legs.
40:27So at the beginning, the legs down here were wider than the legs at the top.
40:32Oh, wow.
40:33But you look completely different.
40:36Not the legs just look smaller, but you look a lot smaller too.
40:39I've lost 21.3 kilos, so just under 47 pounds.
40:44That is amazing.
40:46Amazing.
40:46How do you feel?
40:47I feel great, of course.
40:49Yeah, you've got so much energy, it looks like.
40:52Yeah, it's made massive difference.
40:54And what kind of things do you feel that you've started to do now that you absolutely couldn't do before?
41:00Popping out, popping to the shops, you know, little walks with the dog.
41:04How do you see this difference in her?
41:06She holds herself more.
41:09She's up here rather than down there.
41:12I noticed that.
41:13It's a massive shift.
41:14And you have followed everything to the very letter of the law.
41:18I said I would.
41:19I said I would and I have.
41:21Now, I see that there isn't any compression socks on just now.
41:24Is that just to show me?
41:25I got prepared, yes, to show you.
41:27Well, I can't wait to actually see the legs.
41:29Is that OK?
41:30Yeah.
41:39There you go.
41:40Oh, my goodness.
41:42Look at the fact that you're even holding them up like that.
41:44As far as before, I've never...
41:45Honestly, you could not have done that.
41:47So these legs are getting stronger as well as lighter.
41:56I mean, just what a difference, isn't it?
41:58It's unbelievable, isn't it?
41:59It really is such a difference.
42:06And the skin quality itself looks so much better than it did because it was always a bit raw.
42:12And then this was what we called the shelf.
42:14The shelf, yeah.
42:14And the shelf is overhanging.
42:20The colour, it will continue to change over time.
42:23And these are just all the blood vessels, you see, that support the fact that the leg had got bigger.
42:28And now it's not bigger, but all the blood vessels are all squashed in close together.
42:33And that's why it's that colour.
42:35But you're going to have your compression on.
42:37Yeah, I really don't mind.
42:38Let's stand you up so I can have a look at the back.
42:48I mean, that's just fantastic.
42:59Lost 30% on one leg and 36% on the other.
43:05It's a massive difference.
43:08Well, I'm so delighted at how far you've come in actually what isn't that long a period of time at
43:15all.
43:15No, it's not.
43:16No, I'm so pleased for you.
43:18And I thank everybody that's been involved because...
43:22Because without your help, we wouldn't be where we are now.
43:26Yeah.
43:26So it's just been amazing for Sam.
43:31Thanks for me.
43:32Aww.
43:34Thank you so much.
43:35My pleasure.
43:36It's so lovely to see.
43:39It really is.
43:46All right.
44:07All right.
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