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00:060 is feeling completely normal, 10 is feeling like a death at all. How do you feel?
00:10About 9.
00:17And there's all these bloody hallucinations around me.
00:19There's one that's always sitting in my place.
00:21That's horrible.
00:24How long has it been there for?
00:26A long time.
00:27What, more than a month?
00:28Oh, yes.
00:29You can't leave that.
00:30That's a long time for it to be there.
00:35I was up a ladder.
00:36I was fitting a window and the expanding foam tin exploded in my face.
00:41It just went off.
00:46I want to change my life.
00:47Because I'm 20 years old.
00:49I want to stop, like, the drugs and everything.
00:52The main thing is you're motivated to change.
01:14I don't want to change my life.
01:20I'm a little bit more.
01:28That's the end of my life.
01:30Good morning, surgery.
01:35Hello. Hi. How's it?
01:37Hello.
01:39Come on in. Come and have a seat.
01:44How are you doing?
01:45Well, look, at the moment, I'm a bus driver.
01:49Right.
01:50And I'm just getting this pain on my feet.
01:53OK.
01:53I don't understand. It's not swollen or anything.
01:56No, but it hurts.
01:57It hurts, yeah.
01:57And how long's it been doing that for?
01:59The last couple of days.
02:01OK.
02:02Now, my foot pedal, because I'm driving a different bus now, it's higher.
02:07OK.
02:07So I've got to push a bit more pressure on it.
02:09OK. And how long have you been driving the different bus?
02:12Since the 24th.
02:13OK, so just a few weeks.
02:15And have you banged your foot or any trauma to your foot?
02:17Anything that you can think of?
02:18Anyone trodden on your foot at a party or something?
02:21No, no. Well, I'm too old to go to a party.
02:23Oh, I don't believe that.
02:23Yeah, I'm too old to go to one of them now.
02:26Let's have a look at it.
02:27Let's have a look at it.
02:28Yeah.
02:28I mean, where exactly does it hurt?
02:29When I put pressure on it.
02:31OK.
02:33So when you're taking a step and sort of bending it.
02:35Yeah.
02:35OK.
02:36And I'm going to press along the bones here.
02:38Nothing there.
02:39Nothing.
02:39No.
02:40But when you try and take a step and bend.
02:42Yeah.
02:43Then it starts.
02:43And it's across here.
02:44Yeah.
02:45OK.
02:46Have you done any massive walking or anything like that?
02:48I walked from Fulham to Clapham Junction.
02:51I've been doing it for the last few nights.
02:53I'm trying to get, because I've got diabetes as well.
02:56OK.
02:57So I'm trying to get, you know what I mean?
02:58Lose a bit of tummy.
02:59Lose a bit of tummy.
03:00Yes.
03:00Do you normally walk quite a bit?
03:03Not really.
03:03Not that distance, no.
03:04Not that distance.
03:05Because there is a condition called a march fracture.
03:08Because it's what soldiers used to get when they marched.
03:10Because if you march a long way and use your bone.
03:12Because you bend your foot every step you take.
03:15Yeah.
03:15Sometimes you can inflame.
03:16It's not necessarily fractured.
03:18Like we have to go to a fracture clinic or have operations or anything.
03:20But you can damage the bone inside.
03:22Yes.
03:23And are you wearing these shoes, sort of trainers?
03:24No, I'm wearing shoes.
03:26But my shoes is not, you know, flat.
03:28It's kind of a bit of...
03:29OK.
03:29It's a bit worn.
03:30Yeah, the heels.
03:31You know what I mean?
03:32So I wonder actually if that's what's causing it.
03:35Yeah.
03:36Really important what shoes we walk in.
03:38We need the best supportive shoes you can wear.
03:41Best thing to do when a muscle and joint and things like this get inflamed.
03:43Is a little bit to rest it.
03:45And try not to walk quite so much on it.
03:47Well, I'm working tomorrow but I'm not working Saturday.
03:50I can give you some anti-inflammatory medicine just for a short time.
03:53Yeah.
03:53That will really help take away the inflammation and make it feel so much better.
03:57But I'll rest it on Saturday.
03:58So Saturday, I was going to...
04:00I'm going to stay at home.
04:01There must be some sport on.
04:03No, I just watch a bit of DVD.
04:04You're not a big sport fan.
04:05No, I am.
04:06I'm a Tottenham fan.
04:07So I love me Tottenham and that.
04:09Do you know what I mean?
04:09They won the Europe, you know?
04:11They did.
04:11They did amazingly well, didn't they?
04:13Yeah, yeah.
04:13My son's an Arsenal fan.
04:14Oh, well, me and him wouldn't get on then.
04:16No, you wouldn't.
04:17No, you wouldn't.
04:17He was most cross about that.
04:20I bet he was.
04:21Well, look, let's do that.
04:23Yeah.
04:23I'm going to send both prescriptions just through.
04:25Yeah.
04:25Thank you very much.
04:25All right.
04:28Hello.
04:29Hi.
04:30Hi.
04:31Hi.
04:32Hi.
04:32Hi.
04:32Hi.
04:32Hi.
04:32Hi.
04:33Hi.
04:34Hi.
04:43Hi.
04:45Hi.
04:50Hi.
04:51Hi, hopey.
04:53Hi.
04:53Hi, Dr Presterich.
04:54Nice to meet you.
04:56Great.
04:56Yeah, how can I help?
04:59Obviously, Hope's got a bit of a complex background with her epilepsy
05:03and her autism, but she's had a cough and cold for the last six days.
05:07She's had fevers reaching 39.8 and she's just overall said that she
05:13She feels funny.
05:15She's now complaining again of headaches.
05:17I want to be a doctor and I will work.
05:20You want to be a doctor when you grow up, do you?
05:22That's good.
05:23That's really good.
05:24Do you want to show the doctor where it hurts?
05:26Yeah.
05:28My neck is...
05:29Just there, yeah?
05:30And headache?
05:31Where's your headache?
05:33Where's your headache?
05:35You said it's at the back, isn't it?
05:36Like before.
05:37Temi pain?
05:38No.
05:38It makes me nervous about her when she's then complaining about her headaches and stuff
05:43and, like, saying she feels funny because I know, obviously, illness lowers her seizure threshold.
05:47You don't want her to, yeah, exactly.
05:48How are her seizures generally controlled at the moment?
05:52They're okay.
05:53Yeah.
05:54She had three in May.
05:56So whatever it is at the moment, it hasn't triggered anything?
05:59But we do want to keep it at home.
06:01Right.
06:01So, Hope, are you okay just to come and sit down whilst I do things like check your temperature?
06:06This goes in your ear.
06:07Is that okay?
06:08Yeah.
06:11So, temperature is normal at the moment.
06:13It's nice to see.
06:15That's good.
06:16I feel good.
06:17That's perfect.
06:18Yeah.
06:20So, good option levels.
06:22There's the heartbeats.
06:25Yay!
06:26Yeah.
06:27Now, it's helpful to see you breathing.
06:29Shall we go do that behind the curtain so I can actually see the chest?
06:32Sure.
06:32Okay.
06:33Yeah.
06:33Do you want me to lift your arm?
06:35Good job.
06:36There you go.
06:36You won't be alone.
06:37Doe is with you.
06:42You're a pro.
06:43Okay.
06:44Can you do a big, big cough?
06:45Big one.
06:47Really good.
06:48Okay.
06:49Okay.
06:49Her chest is clear.
06:50Okay, perfect.
06:51I asked her to cough because there were some sounds.
06:54Rattling, yeah.
06:54But they're not cleared.
06:55Okay.
06:56And then last but not least, I just want to have a little peek in your ears if that's okay.
07:01Which one should we do for us?
07:02Ready?
07:03One, two, three.
07:03Lie on mummy.
07:05Hoppe.
07:05Lie on mummy, baby.
07:07Chew.
07:08Oh, okay.
07:08Okay, okay.
07:09Hope, hope.
07:10It's okay.
07:10All right.
07:11We're going to stop.
07:11We're going to stop.
07:12All done.
07:13What's your favourite colour?
07:15Or do you want to go for the animal?
07:18That's a very good choice.
07:20Good girly.
07:21Based on what I'm seeing, I think that we don't need to give any antibiotics at the moment.
07:26Okay.
07:26The weekend is coming up.
07:28And you've got valid concerns about if she deteriorates and the risk of that inducing
07:32a seizure for her.
07:34So I'm happy to send a prescription to the pharmacy so that if anything happens over the
07:39weekend, is there a change in how she looks?
07:41Is she no longer well enough to go and place new symptoms like vomiting, drowsiness, rash?
07:47Sure.
07:47You can start taking it.
07:49Okay.
07:49Brilliant.
07:50Wonderful.
07:50Okay, perfect.
07:51Thank you so much.
07:52Can you say thank you to the doctor?
07:53Thank you, doctor.
07:55High five.
07:56Go on.
07:58Thanks very much.
08:00Bye.
08:00Thanks for seeing us.
08:01Bye.
08:02Bye.
08:02Lisa.
08:03Hello.
08:04Hi.
08:04Come on through.
08:05Nice to see you.
08:06Nice to see you.
08:07I haven't seen you for ages.
08:08You're looking really well.
08:09Are you coming in?
08:11Do you want me to wheel this in?
08:13Right.
08:13We're in room four, so we've not got very far to go.
08:16Okay.
08:16It's slightly cooler the further this way down the corridor as well, which makes it a little
08:20bit easier.
08:21So how have you been?
08:23Well, I've not been brilliant, really.
08:26Okay.
08:26Oh, I fell, didn't I?
08:27That was the first thing that happened.
08:29Yeah, so you had the fall, and we've had the urine infections, haven't we?
08:32Yeah.
08:32So I mean, that's been the big problem.
08:33And how's your mood?
08:35How are you feeling?
08:36Not just too good.
08:38It's been better than it was, though.
08:40It's been very bad because of all the fact that I, you know, don't want to be sort of like,
08:46don't want to give in to the whole thing.
08:48I know.
08:49And that's the problem with Parkinson's.
08:51It's such a horrible disease, isn't it?
08:53And it sort of progresses a bit.
08:55And you've been so good.
08:56I mean, how many years ago have you had it?
08:57I can't even remember now.
08:58Well, I was in 2012.
09:002005 from the frozen shoulder.
09:01Yeah.
09:022012 officially.
09:03Parkinson's is a tricky one because there's not, you don't wake up one morning and suddenly
09:06we've got it.
09:06It creeps in sort of slowly.
09:08And I think looking back and then, and it was great because you used to walk.
09:11I remember I used to see you walking to work.
09:12You were teaching and off you'd go at crack of dawn every day.
09:15You worked up until 2017, I think.
09:17I know, which was amazing, which is brilliant.
09:19And I think, but that's, you know, Parkinson's is a really difficult one, isn't it?
09:22It is difficult.
09:23I wake up about 2, 2.30 and then I just can't get back to sleep.
09:27Has the melatonin come through?
09:28Because I know her Parkinson's doctor prescribed it for being, struggling to sleep.
09:33So obviously with all the involuntary movements, she struggles to sleep.
09:36Melatonin, two milligrams.
09:37Yeah, it is the two.
09:38Yeah.
09:38You can pick it up literally now on the way home because I'll have it, I'm sure, in stock.
09:41Have you experienced people having hallucinations and stuff like mum's had?
09:44Like, is there anything that you know of that could help?
09:47The problem is that Parkinson's, it does affect so many bits.
09:49And part of it is, you know, the way our brain connects.
09:52So hallucinations and seeing things or being worried about things, people often become quite paranoid.
09:58Parkinson's disease is a global degenerative brain disease that's caused by a lack of dopamine in the brain,
10:03a chemical that allows our nerves and muscles and things to work properly.
10:07Parkinson's disease is well known for its motor effects, which are the muscle and movement problems that it causes.
10:12But it also causes multiple other problems, including dizziness, constipation, loss of smell, nerve pain,
10:18bowel problems, to the hallucinations that Lisa's experiencing.
10:22Well, you know what's horrible for me is I walk into my lounge.
10:24That's my lounge.
10:26I'm sitting there quietly, watching me television, eating with food, whatever.
10:29And there's all these bloody hallucinations around me.
10:32There's one that's always sitting in my place.
10:35Is it a person that's sitting in your house?
10:36People, animals, it changes.
10:38I used to know.
10:39But at the worst, there was like, the house was full of snakes, you know.
10:42And she was terrified.
10:42I remember you saying there was spiders or a dog was biting and there was...
10:45Yeah, cats biting feet.
10:47And she asked, you know, is it legal for people to be doing, setting up these experiments in my front
10:51room?
10:52You know, that kind of...
10:53That's horrible.
10:54I have to say, every time.
10:56You're going to have to go.
10:57You're sitting in my place.
10:58This is my bed.
10:58One person's bed.
10:59One person.
11:00It's not going to take five.
11:01You've got to go.
11:03Get off.
11:03And you're still having it every day?
11:04All day, every day?
11:05It's every day at the moment.
11:06It is still every day.
11:24I think, Lisa, it's not like you don't have to live with those hallucinations.
11:27I'm sure we can help with those.
11:29And that's really horrible.
11:30It's really appalling because I just cannot get back to sleep at that point in time.
11:34And the thing is, in your head, you sort of know they're not really there.
11:37But when they're real people and real animals and real things...
11:40At the worst, at the worst, she really believes it.
11:42She's woken me up at 1am in the morning because she's trying to get dogs to leave the front room.
11:46That was only a week ago.
11:48So when was the last time you slept eight hours through the night?
11:50Oh, my goodness.
11:51Long way back.
11:52Long way back.
11:52Yes, yes.
11:53Same for me.
11:54Long time.
11:55I don't think I've got eight hours sleep in years either.
11:58I had to get up because we got up at half past five.
12:01We always get up at half past five.
12:03Sophie starts her work.
12:04I mean, it's a full-time job.
12:06It's a military operation in our house.
12:08Thank God for the, you know, social services carers that we get as well.
12:12And thank God for you as well.
12:14It's a lifesaver for me.
12:15I wouldn't be able to do it otherwise.
12:16Sophie has registered as a carer for her mother and plays an absolute key role in Lisa's care.
12:22And without Sophie, I don't know quite really where we'd be.
12:25She has put her own career on hold.
12:27She's had lots of challenges in her own life.
12:29But she's totally stepped up to help her mother and we try and support her as much as we can.
12:34What's interesting, Lisa, is actually a really good night's sleep may help.
12:39And I do wonder actually whether we try the melatonin as the change this time, this month maybe, and to
12:45see.
12:45And if she's still getting them.
12:46And if you're still getting them, then we look at your other medicines.
12:49So the sooner we can get on that melatonin, the better.
12:51So I would go to OZ now.
12:52He'll have it in stock.
12:53He'll literally have it tonight.
12:54We can start it tonight.
12:55Yeah.
12:55That's another thing, actually.
12:56You've asked if you could speak to someone like talking therapy.
12:59I was wondering about that.
13:00Yeah.
13:01Can I try?
13:03I think, Lisa, I think your mood does get affected.
13:05And I would be surprised if you'd said it hadn't.
13:07Because I think living with this sort of thing is never easy.
13:10The quickest way to do it is to self-refer on the website.
13:13And you can do it for your mum.
13:16I wonder whether we pencil in again for four weeks' time to come back.
13:19We review.
13:20We see where we're at.
13:21How the sleep has been.
13:22Has that worked?
13:23Okay.
13:23We'll do.
13:24We'll do, yeah.
13:25Okay.
13:25Well, look, lovely to see you, sweetheart.
13:27And I'll see you in a few weeks.
13:28And let's hope a good night's sleep makes a bit of a difference and we can see.
13:31Thanks a lot.
13:32Okay, take care.
13:32Nice.
13:33All the best.
13:33Take care, Sophie.
13:34Thank you so much.
13:35Thanks.
13:35Bye-bye.
13:36What we do to check this is just ask for a urine sample.
13:39Is that something that you'd be able to do?
13:41No.
13:42Can I give you a...
13:42The word before.
13:43When I get up in the morning, it's the first thing I have to do.
13:47Literally.
13:48He's going to come back and give us something to collect your pee-pee with.
13:51Okay.
13:53Yeah.
13:54I've been peeing, peeing, peeing, peeing.
13:58Diabetics often do pee a bit more.
14:00But not every six, seven minutes.
14:01We also need a urine sample from you as well.
14:03Oh.
14:04Just check kidney function.
14:07Will you do that today?
14:08Would you be able to do that today?
14:09Or do you want to come back for it?
14:10Oh, I might try and do it today.
14:12Okay, fine.
14:13Do you think you'll be able to go to the loo while you're here?
14:15Yeah, I could do it now, if you want.
14:16I mean, you're always being, aren't you?
14:18I know, I know.
14:19I have the bladder of an 80-year-old woman at the moment.
14:25Okay, thank you.
14:27How are you?
14:29Oh, I'm not too clever, to be honest.
14:31I feel tired all the time.
14:34I'm Dr Prestowich.
14:35Nice to meet you.
14:36Nice to meet you, darling.
14:37So, as you said on the phone to me, you're used to getting up a couple of times in the
14:41night.
14:42Well, occasionally.
14:44Yeah, but did it increase?
14:45Especially if I drank a lot.
14:48Yeah, because you have a couple of pints in the evening, don't you?
14:50Yeah, yeah.
14:50If I drank a lot, I'd get up once, maybe in the night, and go to the toilet.
14:55Now, I'm waking up at 2 o'clock after, I have to go to the toilet again.
15:00And then I'll go back to bed.
15:02Three hours or two hours later, now, I have to get up again.
15:05So, it's starting to affect your quality of life.
15:07Yeah, yeah.
15:08So, what we need to work out is, are you getting these symptoms because your bladder,
15:13when it gets a little bit of urine in there, it's sending a signal to your brain saying,
15:16I need to go.
15:17And that's something that we call overactive bladder.
15:20And it can be influenced by, you know, how much you drink, what you drink as well.
15:25So, you know, alcohol and caffeine can be implemented.
15:27The alcohol was the one that worried me.
15:30I thought, could it be affecting my kidneys or whatever?
15:33Saturdays, I meet friends, and the most I have is three pints.
15:38Yeah, three pints every night would be excessive.
15:40What I tend to do is, I go home, and I have some Baileys.
15:43Okay.
15:44I like sweet stuff.
15:45And is it most days you're on the Baileys then?
15:47Yes, yes.
15:48I'll have a good glass of Baileys every night.
15:50So it's likely that you are going over 14 units, and long term, that will be damaging for your health.
15:59Do have a think about, are there ways that you can cut that down, having some dry days as well
16:05in between?
16:06It's very hard.
16:07It's very boring.
16:08Yeah, it's a breaker habit.
16:09Watching that television drives me mad.
16:12So we've digressed a little bit.
16:14So we talked about potentially overactive bladder.
16:16The other thing we need to think about is the prostate.
16:20So if the prostate is enlarged, that can make it difficult for you to empty your bladder because of where
16:26it sits.
16:27It sits around the urethra, wherever your urine comes out of.
16:30If the prostate's enlarged, which doesn't mean cancer, but if it's enlarged, then it can cause problems of straining, having
16:37to go often, getting up at night.
16:40Yeah, I can understand that.
16:41I think that it would be a good idea to examine the prostate today, which doesn't include a rectal examination.
16:46Oh, that's so good.
16:48Yeah.
16:48We should also test your urine as well.
16:50I did fetch a little drop of salt.
16:52Have you got a sample here?
16:53Yeah.
16:53That's brilliant.
16:56Emily.
16:56Yes.
16:58Hey.
16:59Pass that.
17:00My baby is actually asleep.
17:01Ah.
17:03Aw, it's gorgeous.
17:05No, thanks.
17:07Hopefully he shall be a little boy.
17:09Have a seat.
17:10I'm Dr. Dutton.
17:10Should I just go to him, Mike?
17:12Yeah, you can just pop him there.
17:13So what can I do for you today?
17:15So I've had a rash on the back of my neck for, I actually don't know how long it is
17:22because obviously I can't see the back of my neck,
17:25but I've been aware of it being itchy for quite a long time.
17:29So months or?
17:31I would say probably more like years.
17:33Years, okay.
17:33Yeah, which I know isn't great, I should have had it looked at, but every time I see, like, my
17:39mum is constantly saying, like, stop itching.
17:42Okay.
17:42I need to go and have it looked at.
17:43And sometimes it gets quite, like, if I itch it too much, like scabby.
17:47Yeah.
17:48Okay.
17:48When did someone first say, oh, there's a rash there, or there's...
17:51I think it's actually probably since I have my baby, because I never used to wear my hair up.
17:57Yeah.
17:57And now I always have to, because I'm always pulling my hair, so I don't think anyone would have seen
18:01it before, yeah.
18:02And any rashes anywhere else on your body?
18:04Uh, no.
18:07And you've never suffered from anything like psoriasis or a family history of psoriasis?
18:12Um, no.
18:15So it's quite a well-defined area.
18:17I don't know if you've seen a photo of it.
18:18Yeah, it's like a sort of circle.
18:21So sometimes that suggests a slight fungal infection, because it's so perfectly marked from the skin to your...
18:28from your normal skin to where the rash is.
18:30Right.
18:30And there are definitely areas which you can see you've scratched, and it's a bit inflamed.
18:36Sometimes psoriasis on the scalp can present a bit like that with these kind of plaques, but it is just
18:41one area.
18:42The rest of your scalp looks totally fine.
18:44And you've never had similar areas on the rest of your body?
18:47No, I don't think so.
18:49Okay.
18:49No.
18:49I think today, let's treat it as a possible area of kind of fungal infection.
18:54Okay.
18:54But we're also going to give a mild steroid, which will settle down the redness and things anyway.
18:58It could be psoriasis, and you've just got this one bit there, in which case the fungal cream is not
19:02going to do anything.
19:04But just because it is that one area, I think we should at least try it.
19:07If there's bits that start to weep or anything when you're on the treatment, we might need to give some
19:11antibiotic cream for that.
19:12I can give you the steroid in a shampoo.
19:15Okay.
19:16It's a little bit stronger, but at least then you could just put it on that bit in the hair
19:20as well.
19:20And then I'll give you the antifungal, I'll give that in a cream.
19:23Okay.
19:23Yeah, and then try that, and then we'll review maybe in three weeks and see how you're getting on.
19:30If it's not resolving at all, then we'll take a photo and ask dermatology.
19:33All right.
19:33Both are fine, though, breastfeeding, so that's not a problem.
19:36Okay, great.
19:37Obviously, if anything flares up, then just let us know.
19:40Perfect.
19:41All right.
19:41Cool.
19:42Thank you so much.
19:43Not at all.
19:43Let me get the door for you.
19:44Thanks.
19:48Trails it down the ankles.
19:49Yes, please.
19:50Yeah.
19:56All right, so just bring your knees up to your chest a bit more, both of them, please.
20:01Okay.
20:01Any point you're uncomfortable and want me to stop, please say, okay?
20:04We'll stop straight away.
20:05Okay.
20:06All right, so take some deep breaths for me.
20:08Okay, now.
20:11Keep breathing.
20:14We're done now.
20:18I'm just going to dip that urine sample.
20:19Did you say it was here in the bag?
20:21Am I okay to grab it?
20:22Yeah, there's two bottles in here.
20:24One was a drink.
20:26Oh, that's a urine sample.
20:28Right, okay.
20:29That's what I managed to do.
20:30Okay, so I'm going to have to give you a sterile container for that.
20:33I did make sure I gave it all clean and all that.
20:36Yeah, I'm sure you did, but the front desk can give you a sterile pot and you can provide
20:43a sample.
20:43Well, in terms of the examination, so I was able to feel the prostate.
20:49It doesn't feel like it's enlarged or irregular at all, which is reassuring.
20:52Because there's a lot of people that snuffed it over the years.
20:55Yeah, and nothing else abnormal on the examination at all.
21:00Oh, that's good, isn't it?
21:02So that is reassuring.
21:03In a couple of weeks' time, there is a blood test as well, which is called PSA.
21:07PSA is used as screening for prostate cancer, but it's not a perfect test.
21:15But it's not a good idea to do it when you've just had the prostate exam done, because it
21:19can be elevated.
21:20I think what I'd like to focus on at the moment, based on the urine that I've just seen, I
21:26think
21:26that you probably are not drinking enough water during the day.
21:30We aim for between two to three litres of fluid in the day.
21:33That is it.
21:34Yeah, because when the urine is very concentrated as well, that can irritate the bladder and
21:38make you need to pee because of that irritation, not because the bladder is full.
21:43And then let's have a follow-up.
21:46After you've had this blood test in a couple of weeks, see how your symptoms are.
21:50Okay?
21:51If they haven't improved with these measures, then maybe there are some medications that
21:55we can try.
21:57Oh, thank you very much.
22:03Yes, when I was taking people's blood, they kept saying to me, you are so good.
22:05One patient walked into my room, she was like, you are so pretty.
22:09I was like, thank you.
22:13And when I was in Libby's room, the fish tank went, and she goes, what's that?
22:17I said it was the fish tank.
22:18She goes, go save the fish then.
22:21I was like, it's not real fishes.
22:23They're just toys.
22:30Why it's hot?
22:34Is it Amin?
22:36Alhamdulillah, it's all good.
22:38I miss you.
22:39You all right?
22:39Yeah, come on through.
22:40Let's see.
22:41I'm Dr. Dodgons.
22:43So, what can I do for you?
22:46I still have chest, it's hurting, like, I still feel cold inside.
22:49You get me?
22:50I can't breathe.
22:51Okay.
22:51That's it.
22:51I was with George last time.
22:54He gave me a paper.
22:55Yeah.
22:56And I drop it in a wallet.
22:57Okay.
22:57And I can't take it go.
22:59So, you've not had the chest x-ray yet?
23:01No, I didn't do that, yeah.
23:02That's fine.
23:02Okay.
23:03When George saw you a week ago, you were coughing up some blood.
23:06Yeah.
23:07How's that been in the last week?
23:09Is it the same?
23:10I cough a lot, but, like, once of, like, after ten.
23:14You get me?
23:15So, one time in ten, there's some blood?
23:18When I cough, cough, cough, cough, cough, now I see a little bit of blood.
23:21Okay.
23:21And do you have asthma?
23:22Of course I have asthma.
23:23You've always had asthma.
23:24And I want to stop smoking, I want to stop, you get me?
23:27Okay.
23:27And is it cigarettes you're smoking?
23:29Cigarette, weed, and I want to stop, like, the medication.
23:32The medication, the bad medication for outside, you get me?
23:35Because, like, I'm going to be crazy or something, girl, like that.
23:41I want to stop, like, the drugs and everything.
23:44Okay.
23:45And I can't, like, how can I do?
23:47And are you getting any help with that at the moment?
23:49No, yeah, but now I'm addicted.
23:51And what is it that you're taking at the moment?
23:54Brigadolim.
23:54Yeah.
23:55Tramadol.
23:56Okay.
23:57And weed.
23:58Okay, and every day?
23:59Every day, every day.
24:00Okay, and injecting any drugs?
24:02That's it.
24:03And the big mistake over there, I did look.
24:06Look.
24:08And look.
24:09Sometimes, it's too loud, I cry.
24:33Any thoughts of harming yourself at the moment?
24:35Like, why?
24:37I didn't get you.
24:38Your mood?
24:38How is your mood at the moment?
24:40My mood?
24:40Yeah.
24:40Bad, bad, bad, bad.
24:42I was born here, then my family took me to Algeria, then I came back.
24:45The mistake, I came without them.
24:47Because, you know, someone, like, he lived without his family, his mum, his dad, his day in another country.
24:53The country, you live alone, then you lost your house, then you live, like, homeless, then you live from front
24:58of friends.
24:58When, like, your friends, they give you, they say, like, they make you happy.
25:02Like, you, like, you go in the way with your friends.
25:05Mm-hmm.
25:06Then after that, I was addiction.
25:10So for the drugs, the medications you're taking, have you been taking those ones for a while?
25:15For a while, yeah.
25:16Yeah, and you're buying those?
25:18I buy them because, like, they help me for depression and a lot of things.
25:22So Amin is a very vulnerable patient.
25:24So he's currently homeless and really doesn't have much support in the UK since he moved here.
25:30Unfortunately, he has got himself addicted to prescription drugs that he's buying elsewhere.
25:36Tramadol is an opiate painkiller, so from the same family as kind of morphine and things.
25:41Pregabalin is a neuropathic painkiller, so he tends to treat nerve pain.
25:45And have you ever received any help with them?
25:48Drugs, alcohol services, never been to Turning Point?
25:51Okay, and if I gave you a number, would you call them to try and get some help?
25:55I wish if you'd give me a... They help me.
25:58They will help with the drugs, but they also have some talking therapy and things available.
26:02I was, like, when I was in Nigeria, I was, like, footballer, you know that?
26:05I was under 16.
26:07I was...
26:07Amazing.
26:07I was in the National.
26:09Do you play any football here?
26:10I always still find, but now I can't, like, I play for five minutes, then...
26:14Okay, so you really noticed it.
26:16I died.
26:16Like, when I play football, I forget everything.
26:19Okay.
26:20Well, I mean, we need to get the chest sorted for you, okay?
26:23Because we need to, you know, especially if football is something you really enjoy playing.
26:26Let me have a look at the chest.
26:27So what I want you to do is just deep breaths through your mouth for me.
26:32One big deep breather.
26:34Okay.
26:36I mean, listening to your chest, it mainly sounds clear.
26:38There was the odd little crackle.
26:39I think it's probably worth us covering with you some antibiotics for a chest infection.
26:43These are the blood forms that I want you to go and get done at Chelsea for a chest infection.
26:48Okay, so you just walk in.
26:50You need to call Turning Point, because what we need to do is get you the help.
26:54I want to change my life.
26:55Okay.
26:55Because I'm 20 years old.
26:56I mean, you're so young, and, you know, the main thing is you're motivated to change.
27:00Yes.
27:01I'll also refer, but let's book you some follow-up to come back.
27:04All right, and then we'll have the chest infection and the blood results, and we can go through them.
27:08All right, thank you.
27:08All right.
27:09Bye, Mim.
27:12Who's buying sweets, then, in your household?
27:17If I'm tired or stressed out, then I'll go and buy.
27:20Yes.
27:20Because I can feel my brain going, give me chocolate.
27:23Okay.
27:24Sometimes my diet's not that good, because I'm addicted to kind of, like, chocolate chip cookies.
27:29I try to eat them, not too often, but, you know, if you're in the shop buying other things.
27:34Yeah, it's easily done, isn't it?
27:35Yeah, yeah.
27:36Are they better than the orange ones?
27:40Oh, wow.
27:41Of course, they have.
27:42They've got blue in it.
27:44Mmm, the dark pink ones are nice.
27:46I was running in my mouth right now.
27:48No, I mean, I do munch on some shortbread now and again.
27:51Yeah.
27:52I know, that's between you and me.
27:54Absolutely.
27:55That's fair enough.
27:56If I'm feeling tired or stressed out, I'll eat snacks all day long, from when I get up to when
28:01I go to bed.
28:02So, I can eat three Snickers bars in a day, easy, and a family-sized bag of wine gums.
28:12Giovanna?
28:16Thank you very much.
28:18Hi there.
28:19All right.
28:20Come and take a seat.
28:22How are you today?
28:24Yeah.
28:24Oh, we're stuck.
28:25It's my charger.
28:28Fine, fine.
28:29Okay.
28:29I feel lost with that one more.
28:31Yeah.
28:31It's like an addiction.
28:33Okay, great.
28:34So, we're doing all of your routine bloods today, including your HbA1c, which is your pre-diabetes markers.
28:42What we need to try and do to stop you getting to that diabetes category is really have a look
28:48at your sugar intake.
28:50Okay?
28:50Yeah.
28:51Would you say that you eat quite a bit of sugar, so cakes or juice or...
28:58Cereal?
28:59Cereal, yes.
29:00Cereal can be quite sugary.
29:01Frosty.
29:01I shouldn't eat frosty, should I?
29:03No.
29:03But I like frosty.
29:04Frosty's is a really sugary one.
29:07So, is there anything that you think that you can replace it with that you like that's less sugary?
29:13Maybe the plain cornflakes.
29:15That's got...
29:16That doesn't mean that's got...
29:18What hasn't got sugar?
29:20Things like porridge or oats.
29:23Toast.
29:24Toast.
29:25So, bread's fine, but when you're getting your bread, have a look for some whole grain bread.
29:30Whole grain.
29:31Rather than white bread.
29:32Oh, yeah, bread.
29:33Oh, yeah, yeah.
29:34And what are you putting on them?
29:36Butter.
29:36Butter and jam.
29:37Okay, so jam.
29:39Jam isn't a good one.
29:41But when you were in hospital and you had cereal, they sort of used to do cereal and toast
29:49at the side, and they used to give you little jam things.
29:53I know.
29:53Oh, so they're misleading.
29:54They're misleading.
29:56Yeah.
29:57So, you know, it's just because you're in that zone of being, you know, quite high risk.
30:03When they took all the relevant tests when I was in hospital for diabetes, I was okay.
30:09Brilliant.
30:09We are nearly done.
30:10Could you press down there for me, please?
30:12Well done.
30:12That's great.
30:19And do you drink alcohol?
30:21No.
30:22No.
30:23No.
30:24No, I don't smoke with them drink.
30:25I think my only vice is sweets.
30:26But no one's perfect.
30:28How would you feel about speaking to our dietician?
30:31Yeah.
30:32Do you think we can organise that for you?
30:33Yeah, that'd be fine.
30:34Fine.
30:34What I'm going to do is speak to reception and get them to book you an appointment for
30:38that and then give you a call.
30:40Yep.
30:41All good.
30:42Can I help you?
30:43I think you've got two jackets there, haven't you?
30:45I know, I know, I know.
30:46I can't.
30:47I've got to learn, I've got to learn how to dress.
30:49I know, you're doing very well.
30:54Brilliant.
30:54Well done.
30:55I suppose I shouldn't have this shirt.
30:58Oh, probably, probably not.
30:59I'm sorry.
31:01You can have coffee and you can have tea, but just without the sugar in.
31:05Without the sugar.
31:05Yeah.
31:06Right, thank you very much.
31:09Bye-bye.
31:18I fell on the train.
31:19The train braked.
31:21Me and another kid went flying down the whole...
31:24Even though the train was packed, the train was packed, but somehow everyone moved to the
31:28side like this and me and this kid went flying all the way down to the end.
31:36You know, everything seems...
31:38Yesterday, did I tell you?
31:39I nearly got run over outside here.
31:40Yeah, I don't know what's going on.
31:42All the bad luck is coming.
31:45It's just...
31:46Something's wrong happening.
31:50Hello, surgery.
31:52So you're new to the practice?
31:54I am, yes.
31:55What can I do for you today?
31:56Well, I've just moved back to London for sort of family support network with the up-and-coming
32:03treatment, which I'm about to have soon.
32:05What's the treatment that you've moved here for?
32:07It's for cataracts.
32:09And I need to be near my sister, who's been sort of driving me around.
32:13But at the same time, I need to, you know, bring all the information over from my past
32:17history and what's happened.
32:18And also with my shoulder injury from the same accident.
32:24For the eye side of things, what I'll do is I'll refer you to ophthalmology here.
32:27They will reassess you before surgery anyways.
32:30Tell me about the shoulder.
32:31So the shoulder was all part of the same incident.
32:34When I was up a ladder, I was fitting a window and the expanding foam tin exploded in my face.
32:40It just went off.
32:41You're not supposed to do that.
32:42And I sort of pulled back on the ladder.
32:45And obviously, if I'd have let go of the ladder, I would have gone.
32:48But it wrenched the muscles in my shoulder because I held on so tightly, closed my eyes.
32:53But that caused the trauma in the eye.
32:56Yeah.
32:57It was the onset of the cataract.
32:58Yeah.
32:58And sort of tore ligaments in my shoulder.
33:00And when was that?
33:02It was about two years ago now.
33:04You've had some physio on the shoulder.
33:05I have, yeah.
33:06Yeah.
33:06And that's helped a lot.
33:07But it's not cleared it up.
33:08And I was due to have another scan.
33:10And have you had some imaging on it in the past?
33:12No.
33:13No.
33:13OK.
33:14So it was going to be the first.
33:15Yeah.
33:15Are you still working?
33:17No.
33:18OK.
33:18And have you had to stop that because of the injuries?
33:20Because of everything.
33:21Yeah.
33:22I tried to go back to work this year.
33:24And I dropped a box on my hand.
33:27And now I can't make a fist with this finger.
33:30So they said it's called trigger finger.
33:32Yeah.
33:33And so I've been doing the test, but I still can't completely fully close it.
33:38I can't.
33:38Close and close it.
33:38I've just no strength in that.
33:39We can get hand therapy to have a look.
33:41I'll have a quick look at the shoulder.
33:43OK.
33:44You want to just stand up for a second?
33:46Any pain down here?
33:48No.
33:48It's sort of, I'd have to identify where the pain is for you.
33:51It's sort of.
33:51Sort of in there.
33:52Yeah, it's really deep in there.
33:53And if I press very hard, it's very painful.
33:56OK.
33:57And can you lift the arm up above the head?
34:00That hurts.
34:01OK.
34:01Just pop both arms up like this for me.
34:03I'm going to push down and just push up, push down.
34:05Good.
34:05Any pain there?
34:06Yeah.
34:07Yeah, that's painful.
34:08In there, yeah.
34:08And then just put your hand behind your back.
34:10OK.
34:11And push me away.
34:13No, that's definitely.
34:14Yeah.
34:14OK.
34:14And have a seat.
34:15Sure.
34:16The shoulder, it might be something to do with the rotator cuff.
34:19That's what they said before.
34:19Yeah.
34:20I definitely think there's some damage there.
34:22And if you were going to have a scan, it may be that the next step is a scan.
34:25Yeah.
34:25So instead of just referring you to physio, I'll refer you to our kind of musculoskeletal specialist
34:29team who have access to imaging.
34:31That's great.
34:31And then you should hear from hand therapy about the hand just to kind of continue the therapy.
34:35OK.
34:35And then they just wait for the letter for the...
34:37Yeah, so there will be a bit of a wait for the eyes.
34:39I know.
34:39I'll obviously put that you've moved area and that you were on the wait list for surgery.
34:42Oh, that's so good.
34:43Yeah.
34:43I feel confident.
34:45All right.
34:45Thanks, Doctor.
34:46Have a good afternoon.
34:47You too.
34:47Take care.
34:48I'm Dr Pearson.
34:49We've met before, but not for a while.
34:51Now, how are you?
34:53Terrible.
34:54Yeah, so, because you were in on Friday, was it, and saw the doctor, and you've been to
34:58hospital and all sorts.
35:00So, just before the bank holiday weekend, I was fine.
35:04Yeah.
35:05And then in the middle of the night, I started throwing up, and ended up in A&E, and they
35:13were worried about a blockage.
35:14Mm-hmm.
35:15Did an x-ray, decided it was just constipation.
35:18OK.
35:19Gave me some lexatives, went home, and nothing happened for a day or two.
35:23And then, somewhere between then and now, it's just got worse again.
35:27But who hasn't eaten anything for basically a fortnight?
35:30So, literally not eating and drinking anything very much?
35:32I'm drinking water, and just sweet tea and sweet coffee.
35:36That's about it.
35:36So, the main symptoms you've got left with at the moment are what exactly?
35:40The thing that's developed is I have a cough.
35:42OK.
35:43A very simple sort of tickle at the back of the throat, but when I cough, I've taken
35:48some water and coughed, and all the water's come out.
35:51And I've just been getting weaker and weaker for the last few days.
35:54Can I have a feel of your tummy, and then listen to your chest?
35:57Would that be OK?
35:58Yeah, if you lie down on there, Charles, I'll pull this curtain around a little bit.
36:01And on a scale of 0 to 10, Charles, if 0's feeling completely normal and everything,
36:07and 10 is feeling like death's a door, how do you feel?
36:09About 9.
36:11OK.
36:13So, that's not great, is it?
36:14Right, you ready?
36:15OK.
36:16Just a couple of deep breaths in for me, Charles, if you can manage it.
36:19Don't worry if you can.
36:21Are you all right?
36:24Are you all right?
36:26Are you all right?
36:27Are you all right?
36:29Are you all right?
36:31Are you all right?
36:44Now I feel like it happened inside my tummy.
36:47I feel like something moving inside.
36:49OK.
36:50How are the stomach symptoms?
36:52It's, um, weird bowels.
36:56And in the morning, after like about an hour after I wake up, I'm still having like bad
37:00stomach-kicking cramps if I don't go.
37:03I never really get pain in my stomach before.
37:05Now I like, you know, so I eat or anything I have to do, I just lie in the bed
37:10and I take
37:10a, like, thank you.
37:11That's when I press, yeah?
37:14Sorry.
37:43Sorry.
37:44Oh, I don't know.
37:46It's just...
37:47Oh, it looks really red and sore, sweetheart, doesn't it?
37:50Oh, you poor thing, that looks so sore.
37:52OK.
37:53And does it hurt when you pee?
37:54Any...
37:55Not too much, actually.
37:56I mean, I can just feel it peeing.
37:57OK.
37:58Are you having to go for a pee more often than normal or anything?
38:00Any sort of...
38:01Going about every couple of hours.
38:02OK, we can certainly give you some cream.
38:04I mean, that definitely looks a bit infected and things too tight.
38:06Let's sit you up.
38:07Well done.
38:08And what I'll do is I'm just going to have a listen at the back.
38:10So there's good air going in and out there, Joel.
38:14Yeah, so the lungs don't sound too bad.
38:16Come and have a seat.
38:17So we did...
38:17So Dr. Presswitch did some blood tests on Friday, obviously.
38:20Yeah, yeah, yeah.
38:20But we were a little bit worried about your blood tests, Charles, because they have come back
38:24and they're OK, but they're not great.
38:26And the one that we're most worried about, really, is the kidneys.
38:29So the kidney blood test has changed slightly.
38:33We can just put that on one finger just for a minute.
38:36So what it tells us is, well, first of all, one of the infection blood tests is raised.
38:40So it says that you have got an infection somewhere on board.
38:43The second one shows that the kidneys, you're very dehydrated.
38:47The kidneys are not working great at the moment.
38:50And we like it normally to be about, say, 70-ish.
38:53The last one we did in January was 76, and it's dropped right down to 25.
38:57Oh, my God.
38:58We need to check it today.
38:59So I'm going to ask one of my nurses to do a blood test today now before you leave.
39:02So then we can decide whether we can manage this in the community or whether actually we need to perhaps
39:07be in hospital.
39:08Can I just check your blood pressure as well, Charles, would you mind?
39:10No.
39:11So I think we need to put you on some antibiotics straight away, OK, to try and get things better.
39:15And I can also give you some cream as well to put on Bambolo that will help.
39:19If at any point, Charles, you feel worse or you, you know, feel confused, you feel dizzy, you feel real
39:25well, we go to hospital.
39:26Yeah.
39:26So the blood pressure, 139.87.
39:28That's fine.
39:30We'll get there, all right?
39:31Right, come and have a seat.
39:32I'll let the nurse know you're ready, and then she'll give you a shout, and we'll get all these tests
39:36and things sorted out, and the prescription will be straight over there.
39:39All right, not at all.
39:40Just give us a shout if you're worried.
39:41Yeah, great.
39:41And I'll definitely ring you later on today and or tomorrow.
39:43Yeah, because we were, I couldn't decide yesterday whether to take him up to A&E, and in the end
39:47I thought, well, what would they do?
39:48Well, let's try and dodge it, but if we have to, I'll phone you and let you know.
39:52All right, great.
39:52Thank you so much.
39:53No problem.
39:55How's it going?
39:56I have a sort of rash inside my lip.
40:00Inside your lip?
40:01Yeah.
40:02I don't know if you can see anything, because I can't see anything.
40:06And it comes and goes.
40:09I've been putting Savlon on it.
40:11Is it between the teeth and the...
40:12No.
40:12Yeah.
40:14So a little ulcer-y type thing.
40:16Up there is.
40:18All the way along.
40:20I can see a little ulcer.
40:22You know, like a little...
40:23It goes along there as well, you see.
40:26Yeah.
40:27Are you eating well?
40:29Yes, I do eat very well.
40:31Not so much as I used to, but I've been pushing this on it, and it is very, very painful.
40:38How long has it been there for?
40:40A long time.
40:41More than a month.
40:42Oh, yes.
40:44Because some days it sort of subsides for no reason.
40:47Are you good at vitamin C and citrus and those sorts of things?
40:52Can I be a sign of vitamin C, like all?
40:55I don't know, what is vitamin C?
40:57I'm not good at...
40:58Is it trusty things like oranges and lemons?
41:02No, I don't like it.
41:02It's like the sign of scurvy.
41:05I've never eaten them all my life, so I'm not going to start now.
41:07Really, I'm not.
41:09Have you anything I can put on it?
41:12I think you probably need to fill you with glands.
41:15Oh, I've got a big gland there as well.
41:18No pain, no?
41:19No.
41:21If it's been there that long, I'm going to get you to see somebody fairly quickly in the hospital.
41:26I know you don't want to.
41:28Because you can't leave that.
41:29That's a long time for it to be there.
41:31And why is it not healing?
41:33Have you seen a dentist?
41:34Frequently.
41:35You do?
41:36Mm.
41:36Good.
41:38I'm going to refer you anyway.
41:38I've never mentioned it to them.
41:40I'm going to put you so you go pretty quick.
41:43Even by the next time I see you, you should have heard from them.
41:46Oh, yeah, that's good.
41:47That quick.
41:48Just to make sure.
41:50I don't like going to ask for you.
41:51I know.
41:53But.
41:54Because they don't know me and they ask me so many questions.
41:58Yeah, yeah.
41:58From ground level upwards.
42:01Do I do this?
42:02Do I do that?
42:02No, no, no, no.
42:03The answer's always no.
42:08I'm going to Bristol on Wednesday.
42:09Oh, wow.
42:10Okay.
42:11See if an old school friend of mine, who's not yet 90, but we'll be 90 in a couple of
42:17years.
42:17A couple of months' time.
42:18Oh, okay.
42:19Yeah.
42:19What a nice birthday thing to do.
42:21Yeah.
42:24Yes, I had a quiet birthday too.
42:27It makes you, what, 61?
42:29Shh.
42:32You will have heard from the hospital by the time I see you then about your inner lip.
42:37Yes.
42:38Can you manage?
42:41I've found you.
42:44There we go.
42:45Well, thank you for seeing me.
42:46Nice to see you.
42:47You take care.
42:47I will.
42:48Bye-bye.
42:48Bye-bye.
42:49Well, it's nice to see you.
42:50Oh, you're so lovely.
42:52You see, now you're waving at me.
42:54Bye-bye.
42:55Bye-bye.
42:56Bye-bye, my friend.
42:58All right.
42:59Not at all.
43:00Have a great afternoon.
43:01Yeah, you too.
43:01Bye.
43:03Yeah, lovely.
43:03Thank you very much.
43:04Lots of luck with everything.
43:07Bye-bye.
43:07Bye.
43:08Thank you very much.
43:10Bye-bye.
43:11Bye-bye.
43:12Bye-bye.
43:13Bye-bye.
43:14Bye-bye.
43:15Bye-bye.
43:22Bye-bye.
43:53Bye-bye.
44:19Bye-bye.
44:20Bye-bye.
44:21That is my monitor tablet for all day.
44:24You must feel like you're rattling sometimes.
44:26It's a lot, man.
44:26This foot is normal.
44:28Yes.
44:28This foot looks like a Cornish pasty.
44:30Got out of bed and all the sudden, and I was poured with blood.
44:34My nightdress was full of blood.
44:37It's good, John.
44:39It's good.
44:40It's really good.
44:40It's really good.
44:42It's really good.
44:42It's really good, you need good mind.
45:09It's heavy, but you're fine.
45:09It's really good.
45:09It's really good.
45:09You
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