- 4 hours ago
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00:09Afternoon surgery I've been coming here for more than 30 years
00:12I used to come into this room and get my baby's weight
00:16Oh, that's so good
00:21Did you just feel a palpitation?
00:23Hmm
00:25What do you think they're going to kill me tomorrow?
00:28They're going to cull it off
00:32When I get these stomach attacks
00:35I feel I ought to fart
00:38But I can't
00:43I think then it might be a good idea to take him up to the hospital
01:02I think it might be a good idea to take him to the hospital
01:22Hayley, hiya
01:25Hi Hayley, come on through
01:27We're in here today
01:29Hello
01:29How are you doing?
01:31I'm alright
01:31Haven't seen you for ages
01:32Yeah, it's been a while
01:34How have you been?
01:35I'm alright, yeah
01:36Good
01:36What are we up to today, sweet chap?
01:38I got bit by a fox yesterday
01:40You got bitten by a fox?
01:42Yeah
01:42Oh, what happened there?
01:44So I was walking home and I was sat on the floor petting a cat
01:48And then a fox bit me
01:49Oh, wow
01:50Okay
01:50I've like pulled my hand out of its mouth
01:52And it's kind of all of its teeth have scraped
01:54How horrid
01:56Was it really scary?
01:57I have a phobia of foxes
01:59I like them, so I'm just like
02:01But in London, like in a city?
02:03Yeah, yeah
02:03Did it bleed at the time?
02:05No, it was kind of like leaking like clear fluids at one point from there
02:10Okay
02:12But no
02:12But it looks, let's just have a look through time
02:14I mean it obviously has broken the skin though
02:16So is that its teeth marks?
02:17Yeah, so this is where it bit
02:19And then I kind of lifted my hand to shake it off
02:22And it was like on me
02:23So I shook my hand a few times and then it slid off
02:26You are a lot braver about it than I am
02:28So what I can do is
02:29It doesn't look infected now
02:30So I don't think we need antibiotics by mouth
02:32But I'm going to give you some antibiotic cream to put on it
02:34Okay
02:34Just to kill off any bacteria in the area to try and settle it
02:36Perfect
02:37If at any point here, over the weekend
02:38It gets bigger and redder and more painful
02:41Then it is really important to seek medical help
02:43So phone 111
02:44They can tell you where to go
02:44If there's a GP and walk-in centre place
02:46Okay, yeah
02:47The second thing is
02:48We do tend to recommend a tetanus booster
02:51So that's an injection of a syndrome
02:52But I can do that for you now if you want
02:54Tetanus
02:54It's found in the soil
02:55And things like that
02:56And because foxes and animals are rooting around
02:59Yeah
02:59You know, on the ground and things
03:00That there is a chance of tetanus
03:02So we would recommend a booster
03:03Yeah, that's fine
03:04Is that all right?
03:05Let's just, I think
03:06Let me give you the cream
03:07Let me do the cream for the fox
03:08So do the foxes come right up close?
03:11I mean, they should be
03:12That's why I was a bit worried
03:13Because I love foxes
03:15And I was petting a cat
03:16And it literally came up and bit my shoe
03:18Why do you like foxes?
03:20Because I feel sweet
03:20Maybe stick with dogs
03:22They're a bit kinder
03:23So let me get a little needle
03:26I'll be one sec
03:27Here we go
03:28Good job you came in
03:30Yeah, honestly
03:31Blooming foxes
03:34Okay, so
03:35We'll just do a little scratch
03:36In the top of your arm
03:37Are you left or right-handed?
03:39It doesn't really matter which side it goes
03:40Um, right
03:43Let's have a look
03:44Okay, let's do it in that side
03:45So I'll just get it ready
03:46Okay
03:47Right, little scratch
03:48Look away, rest your arm
03:49Let your arm go floppy
03:50That's it
03:51Little scratch
03:52No, well done, sweetheart
03:53It's fine
03:54It's fine
03:55It's finished
03:56Was that it?
03:57Oh, it was nothing, isn't it?
03:58That was actually nothing
03:59Did it hurt?
04:00No, not at all
04:01Well, you're very brave
04:02And I will enter that onto your record, sweetheart
04:04That we've done that
04:05So at least you know you're boosted
04:06But don't go anywhere near foxes
04:08Yeah
04:09Right, that's absolutely fine, sweetheart
04:10So keep your arm moving a little bit
04:11That will be fine
04:12It's a lot easier to look after you
04:13If you stay well
04:14I can tell you that
04:15Make my job easier
04:16Thank you
04:16All right, nice to see you, Heidi
04:17Take care, sweetheart
04:18Bye-bye
04:18Bye
04:19This way
04:23Would you like a drink now?
04:24We have registered tonight
04:26Hello
04:26Hello
04:27Are you guys ready?
04:27Dr. George
04:28Hold on
04:30Hello
04:31How are you?
04:32You've grown
04:33High five
04:34You've grown
04:34Oh no, let's do that again
04:35We missed
04:35You missed, you missed
04:36We're here
04:37We're here
04:37This one
04:38Oh my goodness
04:38What is your mum feeding you?
04:40You're massive
04:41You were this big when I last saw you
04:43Come away, please
04:43Good to see you
04:44How are you both?
04:45We're good
04:45You can do my job if you like
04:47You're more than welcome
04:48Careful
04:49How can I help you?
04:51He has been really lethargic
04:53Temperature kind of spiking, dropping
04:55I managed to look in his throat this morning
04:58And his tonsils looked really big
04:59Yeah
05:00I mean, he slept last night and the night before 12 and a half hours
05:04Oh wow
05:05Any increased work of breathing?
05:06Struggling to breathe, working hard?
05:08No
05:08Good
05:09And vomiting at all
05:10Anything like that
05:11Lovely
05:12Any change in behaviour
05:13Other than obviously sleeping a little bit more and stuff
05:15He's really lethargic
05:16He was just asking in the car
05:18If it's time for bed
05:19Okay, well can I have a little look in your mouth?
05:22Can you open your mouth for me?
05:23Freddie, can you show
05:25Dr George your wobbly too?
05:27Let me have a look
05:28I can't see
05:28Can you stick your tongue out as well for me?
05:31Say, oh yeah
05:31They are pretty big aren't they?
05:33Uh-huh
05:33Ah, amazing
05:34Can I listen to your breathing as well?
05:35I'm just going to put this on your back, okay?
05:38Good job
05:39You can play with it, that's fine
05:41Okay, I'll come closer
05:42Good lad
05:44Oh, you're going to look
05:44Okay, you look in my mouth, Freddie
05:46You are doing such a good job, Freddie
05:48Where did they come from?
05:49And is he coughing with it or not?
05:51Not that I've noticed
05:53He's not been snotty or anything
05:54No, yeah
05:55So I'm thinking maybe it is bacterial actually
05:58Rather than viral
05:58So probably a bacterial plantivitis
06:00I think we need to get you some antibiotics
06:03Um, I'll send the prescription to the pharmacy
06:06See how he goes with it
06:07Well done
06:07Do you want a sticker?
06:08Look what I've got for you
06:10Are you ready?
06:11Which one would you like?
06:13Fishy
06:14The fishy, nice
06:15There you go
06:16Where are you going to stick it?
06:18There
06:19Brill
06:20I'm going to get another high five
06:21Because you did so well last time
06:23Amazing
06:23It's really good seeing you
06:24I haven't seen you for a long time
06:26Right, see how you go
06:27Any problem store just come back
06:28But otherwise I think you'll be absolutely fine
06:30Look how tall you are
06:32Oh my goodness
06:33You're growing
06:36Careful, careful
06:36Okay, we'll get there
06:38Keep us posted
06:38Any problems
06:39Just let me know
06:39Thank you
06:40Oh, Freddie, come back
06:43Freddie
06:44Come back please
06:51Hello
06:51Hi, come in, come and have a seat
06:53I'm Megan, how are you?
06:54Hello Megan
06:56So, you rang up earlier
06:57I think you've been having some palpitations
06:59Is that right?
07:00Well, my blood pressure is suddenly very high
07:03And I've got the palpitations right now
07:06I've been away in Greece
07:09It was high before I went
07:10And I felt not going to say anything about that
07:12Because I won't be able to go on holiday
07:14So I have survived holiday
07:16But I do think I need to have a look at it
07:19Can I have a feel of your wrist?
07:20Okay
07:21Sorry if my hands are cold
07:23The palpitations
07:24Are they constant?
07:26Do they come and go?
07:28Come and go a bit
07:29Okay
07:30Do you get any other symptoms alongside it?
07:33No
07:33Any dizziness, pain
07:34Shorts of breath?
07:35No, there's a very dull sort of feeling around here
07:39And how long has that been there for?
07:42Only three weeks ago
07:43And is that how long you've had the palpitations for as well?
07:47Well, I'm a typical woman
07:49In that I tend not to take notice of my things
07:52Do you know what I mean?
07:53Just get on
07:54Yeah
07:58So yeah, your blood pressure is on the higher side
08:00At the moment
08:00Can I have a listen to your heart?
08:03Is that okay?
08:04What do you need me to do?
08:05What you already are is absolutely fine
08:07Just like
08:07Sorry this is cold
08:10Cold is welcome
08:14Did you just feel a palpitations?
08:16Hmm
08:19Okay
08:20Have you ever had an ECG done before?
08:23A heart tracing?
08:25I don't think so
08:26As a paramedic in general practice
08:28We work alongside the duty doctors
08:30For kind of urgent, on-the-day appointments
08:33Kind of chest infections, heart palpitations
08:36Those sort of things
08:37In Irene's case
08:38I was able to utilise my paramedic skills
08:40In performing an ECG there and then
08:43Okay, put myself on there
08:44Don't worry about shoes
08:45Okay
08:46And I'll just set up the equipment
08:49Be honest with me
08:51How long have you had the palpitations for?
08:53I suppose I've been having these palpitations for a while now
08:58Are we talking months, weeks, days?
09:01No, we're probably talking a few months
09:04How are you feeling at the moment?
09:06Well, yes
09:07I think my heart is palpitating a bit
09:28Have you found a pulse?
09:29It's always difficult there
09:30I just call it that
09:33Do you feel the palpitations?
09:35Yeah, I get
09:36Yes
09:36Getting a little bit of pain here
09:37And if I feel your pulse today
09:39Is that okay?
09:39Sure
09:40I felt a little bit of irregularity in your pulse
09:44So what I'm going to do is book you in for a routine ECG
09:47Right
09:47Two, three, four, five, six
09:54Okay
09:54Come down
09:55But it's still a little bit on the high side
10:02All right
10:04Shout when you're getting one
10:08Okay, I can feel a palpitation now
10:10Okay
10:11I'm just recording it
10:13An ECG is a heart tracing
10:15Which looks at the waveform of the heart
10:18It's very good at showing if there's anything sinister going on
10:22Like an arrhythmia
10:24Anything that would be causing palpitations
10:26Or anything more sinister like a heart attack
10:29Okay
10:30There we go
10:30Right
10:31Oh, I'm why
10:33So, good news
10:34Your heart's beating
10:37I could tell that
10:38Yeah
10:39At the moment it's lovely and regular
10:41It doesn't look anything sinister
10:43But we do need to do some bloods
10:46Okay
10:46Because there's a multitude of reasons as to why
10:48You would get palpitations
10:50Do you have a blood pressure machine at home?
10:53I do
10:54So what I'd like you to do
10:56Is a week's worth of blood pressure readings
10:58Morning and evening
10:59Make sure you're sat down for about 10 minutes
11:01Before you do it so you relax
11:03There we go
11:05I'm slightly surprised that
11:09That you're not saying
11:11Yes, you have high blood pressure
11:12You need to do something
11:13You are having high blood pressure at the moment
11:15But we wouldn't necessarily start you on medication straight away
11:20Without getting a mean average over the week
11:22What we can do today
11:24Is some blood tests as well
11:26To check the kidney function
11:27Those sorts of things
11:28Because your kidneys basically
11:29Are the ones that regulate your blood pressure
11:32What I don't want to do is put you on the wrong medication
11:34That then causes your blood pressure to drop too much
11:37Okay
11:38So I can take them now
11:39Why don't we do that?
11:41Yeah
11:42You okay with blood?
11:43You're not gonna
11:44Although you don't like
11:45I shall look away
11:47But I'm not bothered too much
11:48It's fine
11:50I'll tell you a secret
11:51I don't like having my bloods taken either
11:54No?
11:55Don't mind taking people's bloods?
11:57Well that's the good thing
12:02There we go
12:03Pinch there for me
12:04Thank you
12:04All done
12:06Okay
12:06So by Monday
12:09We should have all the results
12:11There we go
12:11Thank you
12:12Lovely
12:12All done for you
12:14Thank you very much
12:14And yes, any problems we'll be letting you know
12:16Okay
12:17Bye bye
12:17Look after yourself
12:18Okay
12:19You know where we are if you need us
12:20Okay
12:21Thanks, bye bye
12:21Bye bye
12:41Oh my god, it's so fun
12:42Is it tangled again?
12:44Yeah, it gets a bit tangled
12:48There you go
12:49It's so fun, look
12:52Henry, Lindsay
12:53Hello, Henry
12:55Swat your mouth
12:58Hello
12:59Right, so let me have a look
13:00So who's the important person today?
13:02Henry is
13:03Henry
13:03So Henry has got really bad hay fever
13:06Oh
13:07And last night he didn't sleeve a wink
13:08And the reason I brought him is I'm worried about his breathing
13:11Okay
13:11He was wheezing
13:12Yeah, so you're breathing quite hard, aren't you, Henry?
13:15Yeah, it's difficult for me if I'm not
13:19To get the air in, is it?
13:21So basically he's been taking Pyritees
13:23Excellent
13:24But it's the chest I'm worried about
13:26It's the breathing
13:26And do you have any known breathing problems at all?
13:29No
13:29No asthma, nothing like that that we know of?
13:31Okay
13:31But then I wondered maybe if he's got asthma
13:34You know, if he's breathing
13:35Because I know it's linked
13:36What am I going to do with this?
13:39Put it on my heart rate
13:40Come and stand up for me
13:41Look how tall you are now
13:42Let's have a look
13:43Can we just lift up your t-shirt a little bit?
13:44He will apologise that he hasn't brushed his teeth this morning
13:47Doesn't matter
13:48Okay
13:48Now I'm going to put this in here
13:52And this side I'm just going to put on here
13:54It doesn't hurt, but it might feel a bit cold
13:56So he is a bit wheezy, isn't he?
13:58Yeah
13:58I can hear your lungs
13:59If you look at mummy
14:00I can hear them whistling away
14:01Let's have one finger, can we, my friend?
14:05Let's try this one
14:07Okay, so we're just going to leave that there for a minute
14:09He's doing what we call quite a lot of work
14:11Yeah
14:12With his breathing
14:12Yeah, that's what I was wearing
14:13And it's exhausting
14:14Yeah
14:16All night it was like this
14:18His oxygen is just a little bit low
14:21You all right, Dani?
14:23I'm trying to get more oxygen in
14:25Oh no, that's very sweet of you
14:26You just breathe normally
14:27I want you to relax
14:28His lungs are definitely wheezy
14:30Which is air whistling
14:31So we need to open those airways up
14:32And we can do that with an inhaler
14:34And do you know about how to use inhalers at all?
14:36No, I've never
14:37So what we could do is
14:39Go and get it
14:41Bring it back
14:42And we could have a go with it here
14:43And just to practice it
14:44And then just make sure
14:45That he's okay
14:48Okay, my friend?
14:49Okay
14:50On it
14:51On it
14:51Okay
14:52All right, so I'm going to see you in a few minutes
14:54Thank you so much, Dani
14:55But just come back whenever
14:55I'll just keep going through them
14:56And then I'll grab you as soon as I can
14:58Wonderful
14:58Bye
14:58All right, bye-bye, sweetheart
15:00See you in a minute
15:04How are you doing?
15:05Are you well?
15:06Yes
15:06How can I help today?
15:08I think it's something in there
15:10Like insect
15:11Or maybe a bed bug
15:13Oh, okay
15:13See, you can see my skin
15:15Oh, yeah
15:16And my body
15:17And have you seen any bed bugs
15:18Or anything like that?
15:19No, I can't see
15:20I'd like
15:21I bought all the spray
15:22And spray but still biting us
15:24Really itchy
15:25Itchy every day
15:26Let's have a closer look for you
15:28We'll just make sure
15:29I think we need to try an antihistamine medication
15:31A tablet to take
15:32That will really help
15:35Yeah
15:35Yeah
15:36Yeah, it looks really
15:37Oh, bless you
15:37You can see it all over
15:39And then I'm just going to look there
15:40That's all clear
15:41Lovely
15:42Good
15:42So no sign of scabies
15:43Or anything like that
15:44Which is good
15:44If you
15:45If I take off my
15:46Yeah, I'll look in a second
15:47Yeah, yeah, absolutely
15:48You're fine
15:48Lovely, yeah, go for it
15:49This one is like really
15:52Yes, absolutely
15:54Oh, bless you
15:55Pull this leg
15:56Yeah, lift your leg up for me
15:57That's fine
15:59Yeah
15:59The good news is
16:00None of them look infected
16:01There's just lots of inflammation
16:03Because of the irritation
16:04Under the skin
16:04Of the whatever has bitten you
16:07But I agree
16:07It is pretty, you know
16:09Significant, isn't it?
16:11Double check
16:11Make sure there are
16:12You know, have a look in the bed
16:13Make sure there are no bed bugs
16:14The best treatment for bed bugs
16:16Is really washing everything
16:17At a very high temperature
16:18And then in the mattress
16:20You're going to maybe
16:21Have to think about
16:21Treating that
16:22Or getting a new mattress
16:24I mean, if you can't see any bed bugs
16:25They're probably not there
16:26How can I see the bed bugs?
16:28You see them
16:28They're tiny
16:29They're tiny?
16:30Yeah, I'll show you a picture
16:30Okay
16:31Let me find the picture for you
16:33They look like this
16:34And you can really see them
16:36Oh, okay
16:36They look like that
16:38They're quite, you know
16:39But I check in my bed
16:40I didn't see anything
16:40You can't see
16:41Yeah, that's fine
16:41So it probably isn't bed bugs
16:42It's probably just other insects
16:44That are biting you
16:45Do you sleep with
16:46Like the window open and things?
16:47It's been a bit warm recently
16:49Yeah, yeah
16:49Sometimes I open the window
16:51Yeah, and it could be
16:53It could be related to that
16:53Anything else I can help with?
16:55No
16:55The prescription
16:57I'll go to the pharmacy
16:58Collect it today
16:58Thank you, John
16:59Cheers
16:59My pleasure
17:00You're very welcome
17:00Take care
17:06Sinead?
17:07Yep
17:07Hi
17:09Come on through
17:10Hi there
17:11Come and take a seat
17:12My name's Emily
17:13How are you today?
17:14I'm good
17:15How are you?
17:15Good, thank you
17:16Okay, so you're here
17:17For a cervical smear
17:18Yeah
17:18Is this your first one?
17:20Yes
17:20How are you feeling about it?
17:22Fine
17:22Good
17:23All good
17:23Brilliant
17:24Do you know what we're testing for today?
17:28Explain it
17:28Yeah, explain it
17:29Yeah
17:29Of course
17:30Of course
17:30So we're testing for HPV
17:32Human papilloma virus
17:33Yes
17:33So it's very common
17:35About 80% of men and women
17:36Will have it at some point
17:37In their life
17:38Mm-hmm
17:38The reason that we test for this
17:40Is because this is what can cause
17:41Abnormal cell changes
17:42Yes
17:42In your cervix
17:43Which, if left untreated
17:45Could potentially lead to cervical cancer
17:47Yes
17:48But not for 10 to 15 years' time
17:50So it's really, really
17:50Slow-leaning cell growth
17:51Okay
17:52If you do get any abnormal results
17:54Really isn't anything to worry about
17:55Mm-hmm
17:55Majority of the time
17:56The body's immune system
17:57Will sort it out
17:58With very little intervention from us
17:59And we just watch and wait
18:00For that to happen
18:01Okay
18:01Does that all sound okay?
18:03Yep
18:04Perfect
18:04So, the way that we do the cervical smear
18:07We use a disposable plastic speculum
18:09With a bit of lubrication on
18:10To go inside your vagina
18:12Mm-hmm
18:13I'll open it up very slightly
18:14To find your cervix
18:16And then I'll swab for five seconds
18:17And then we're done
18:18Yep
18:18Any point you want to stop
18:21You're not happy
18:22You feel uncomfortable
18:23Just let me know
18:24Okay
18:24And we'll stop straight away
18:25Okay
18:25Yeah
18:25Perfect
18:26Brilliant
18:26Are you happy that it's just us
18:28In the room
18:29Would you like a chaperone?
18:30No, yeah, that's fine
18:31Fine, brilliant
18:31Okay, great
18:32Let's just pop the screen here
18:34Give me one moment
18:43Okay
18:44Are you ready?
18:45Yes
18:45Lovely
18:47Cervical screenings can be really daunting
18:49And I completely understand that
18:51You put yourself in a very vulnerable position
18:54There are lots of ways that this can be managed
18:57So, if you would prefer to go with a loved one
19:00Go with a friend
19:01You're very welcome to do that
19:04Ah, well done
19:06Perfect
19:07First one done
19:08Yeah
19:08It's the worst one out of the way
19:10Brilliant
19:10Do you have any questions at all?
19:13Yeah, how often are you supposed to be getting them?
19:16So, providing that everything's normal
19:18Yes
19:18Every five years
19:20If you come back with HPV positive
19:23But no abnormal cells
19:25We will then bring you back for yearly cervical smears
19:28Okay
19:29If it comes back HPV positive with abnormal cells
19:33Then you'll get invited to colposcopy
19:35They just have a closer look
19:36Yeah
19:36Okay
19:37And then you normally will go on to yearly smears up to that
19:39Yeah, yeah, yeah
19:40Okay, that sounds
19:41That sounds okay
19:41That sounds great
19:42Yeah
19:42Brilliant
19:43Thank you
19:44Thank you
19:45It was lovely to meet you
19:45Have a lovely rest of your day
19:46You too
19:47Bye
19:48Bye
19:49Bye
20:05Henry
20:06Come on for me my friend
20:08Come on darling
20:11Right
20:11You get the special chair today
20:14So
20:15We're going to use this now
20:17we're gonna put that across there it doesn't hurt okay you ready then what
20:21we're gonna do mum is we're gonna puff two puffs in so one two and now Henry
20:26you're gonna take some deep breaths in and out that's perfect okay and ideally
20:31ten nice breaths with two puffs and if we're worried I'm gonna give him some
20:36extra puffs now just to get the medicine in good boy I'm just gonna give another
20:42couple how you feeling yeah better you see and we can give up to ten puffs into
20:48it if we're really worried no because I think if you really really need more than
20:57ten and we're not calming down after ten hours we're gonna go to the hospital okay
21:00that's fine that's good we're gonna have a day at home today with mom okay and
21:05let's just have a look at your tummy so we're a bit calmer here on the
21:08breathing chest but then we would like to see you this afternoon just because
21:12you're gonna have a few hours of playing with this at home Henry will you say
21:16thank you very much the doctor thank you and we'll see you a bit later all right
21:21take care bye-bye sweetheart bye-bye
21:29David please hello good to see you and you you're looking well thank you come
21:38through so you can see make yourself comfortable thanks lovely how can I help
21:47today well I get these stomach attacks okay I feel I ought to fart but I can't yeah
21:56it normally comes in the afternoon I say normally it's happened two or three times
22:01and it goes on for the whole of the afternoon whereabouts is the abdominal pain can you point all
22:07over all over so generalized abdominal pain and when you get it how long does it last
22:11for typically before then it eases off to begin with it's quite a quite last quite a long time so
22:19is that kind of discomfort where you feel actually I need to open my bowels actually nothing
22:23come normally if I had that sort of pain I'd go and open my bowels that would normally alleviate
22:28it yes it sounds like the pain might be crampy kind of comes and goes almost yes a bit of
22:34a cramp
22:35yes probably you're right and what does the pain feel like how would you describe it I think they're
22:40best described severe pain in my stomach
22:58I just thought I would double check yeah that that will change in bowel habits okay it's very hard to
23:04go to the toilet there are more nerve endings in the gut than anywhere else in the body so there's
23:09lots going on down there the lower part of my body
23:12there's something wrong just that's a bit tender there on the left yeah that's really
23:17that's really painful it's really painful I couldn't even sit down that's how bad I was
23:29I can't part I can't sit on there I can't possibly I can't shit I can use the right words
23:36if you want me to but
23:38would it be okay to have a little feel of your tummy on the couch do you mind
23:43it always amuses me all that's permission I know well we have to any change in bowel habit
23:49is important to flag and to discuss most of the time it's nothing serious but sometimes it can be
23:55due to something really quite serious so it's important to speak to a doctor about it
24:00a little bit round there a bit tender on there yeah just where your bowels are really in the stomach
24:09lovely tummies lovely and soft all done thank you let me just have a quick listen actually with my
24:13stethoscope and then we're all done
24:18yeah really active your bowel sounds are really active which is good nothing to suggest an obstruction
24:23or anything nice like that which is great so we're all done whenever you're ready you can come back
24:26crown shoot your hand brilliant good abdomen soft non-tender none of these horrible signs like
24:34guarding rigidity which is great your bowel sounds are fine so we maybe should do a stool sample to
24:40make sure everything's okay just to rule out something like bowel cancer highly highly unlikely
24:44and then maybe some blood tests as well just to make sure everything's okay how does that sound
24:50fine yeah so we can give you something to relax the lining of the smooth muscles of the bowel
24:55maybe a bit of busker pan or something like that just to see if that settles it
24:59any questions at all no what you're saying i think is that it it's not normal but it's not
25:05anything to worry about 100 and then if the symptoms get worse or the intensity changes or the duration
25:12changes or there are any associated features do come back let us know all right great lovely to see
25:18you yes thank you very much my pleasure take care all the best look after yourself thanks a lot
25:22pleasure you manage with that yeah lovely you're very welcome take care
25:47come and take a seat thank you my name's emily how are you today i'm all right i'm in a
25:53huge
25:53amount of pain oh gosh um i'm here to have sutures removed yep so i've got a letter actually for
25:59you
25:59perfect the hospital gave me um i had spinal surgery two and a bit weeks ago and they i came
26:08out of
26:08hospital a week ago on sunday um basically the surgery involved going through the side
26:18removing a rib and deflating the lung to get the bit of vertebrae that had to come out yeah
26:23but it was sort of major surgery and it was kind of yeah it sounds it yeah it was sort
26:28of quite
26:28something and i think i was so pleased to get home i possibly did too much too soon
26:34and i can see that the doctor prescribed you some codeine is that helping at all
26:39you know i've been having it um i resisted because of constipation are you taking any stool softeners or
26:46anything with the codeine yeah yeah having the odd luxative and it's just playing every day as it
26:52comes yeah my worst amount of pain is if i change position yeah so sitting to standing or vice versa
27:01especially getting out of bed it's agony so what's going to be the most comfortable position would you
27:07prefer to be sitting up yeah that's going to be the best thing okay so do you know what let's
27:11get you
27:11over onto the bed i think if you're able to sit on it is that a good height for you
27:17yeah that's
27:17lovely okay i've been coming here for more than 30 years i used to come into this room and get
27:24my
27:24babies weighed oh really happy memories do you have any yes i've got two oh lovely boy and a girl
27:32three and five oh um super ages aren't they yes yes absolutely it should look very stuck so it might
27:43be a bit sore please that's okay don't worry i'll actually know that's fine
27:49okay i think this is one stitch that's still
27:55there what do you do use a tweezer or something uh yes i'll use a stitch removal
28:13that's healed beautifully that's brilliant to hear yeah really well okay great so just going to do
28:22the one round at the side now now this is a little bit of a thicker stitch
28:29sure that's fine are you okay like that yeah okay please do tell me if i'm pulling too hard okay
28:35yeah okay great yeah that looks really well healed as well lovely i don't think any of them need dressings
28:45okay um keep an eye out for any signs of infection so if the around the area becomes hot or
28:53red or
28:54there's any oozing anything like that if you become unwell yourself with the temperature
28:57yeah okay let us know straight away but they both look really really good fantastic
29:04i really hope that your pain subsides a bit and i think maybe you just need to try and take
29:08it
29:08take it a bit easy and sort of my own worst enemy because you think you can do stuff and
29:14then yeah
29:14it's it's afterwards yeah you can't let the time there anyway oh well well done you thank you i really
29:21appreciate that i've got nothing but praise for the whole team good to hear thank you bye-bye thank you
29:35john come and have a seat i'm megan how are you hi megan but i'm not in good nick at
29:43the moment
29:44no no no what's happened with the knee tell me what's going on well i'm not quite sure when exactly
29:51and how i think i just knocked the knee and then the knee swelled up it was very painful and
29:57i started
29:58to feel as if i was getting a very mild fever but i started to feel when i went home
30:05from work early
30:06straight to bed slept and the the mild fever is just very kind of intermittent okay it's not constant
30:14but there are times i suddenly it feels as if a bit tired achy my body aches i don't know
30:21whether
30:21that's connected to the knee or to the knee or whether it's whether that's coincidental okay can i have
30:27to feel is that all right sorry my hands are cold most of the pain is around i'm just going
30:33to feel
30:33certain areas it's hot it's infected right i think you've got an infected bursitis so it's a sack of
30:41fluid it can happen quite often from overuse or if you knock it a bit of fluid builds up most
30:47of the
30:47time it's fine but it can get infected which is what you've got at the moment right it's very hot
30:52to
30:52touch so it's that causing it would make you feel unwell yeah yeah well that's and it's okay if i
30:58check your temperature yeah of course i'll do your blood pressure as well you've definitely got you've
31:04got a fever yeah have you taken any paracetamide profen i've just been taking the um dibrivo
31:17yeah so we're definitely going to need some antibiotics okay and what i would say is
31:25get some paracetamide in you if you can paracetamide yeah you've got a temperature of 38.5
31:29at the moment what does that mean it means you're you've got a fever it means you're fighting an
31:35infection right so we'll get you on a course of antibiotics for a week right lots of ice and
31:41elevating it okay now i'm going to draw a line if i can find a pencil so at the moment
31:46you're here
31:47you're okay with me drawing on you before i start yeah yeah yeah that's okay put your signature lower
31:51down as well you know side my leg for me sign your leg okay what i'd be worried about okay
31:58is if you're
31:59starting to get kind of here right and here i'll be worried about something called cellulitis
32:05okay which can lead to sepsis in some people well that's not good news is it no no no no
32:11we don't
32:12want that to happen today what i want you to do is just keep an eye on it if it
32:15starts to swell more
32:17and go past these these points here yeah that would be the time i'd recommend going to a and e
32:23oh right just go just go to the hospital they'll give you some iv antibiotics right okay
32:29oh well thank you megan sorry for drawing on you no no no no it's good to know where these
32:34lines
32:34are all right um let me help you the door yeah thanks paracetamol ibuprofen ice okay then yeah
32:41thank you megan i'm sorry look after yourself any problems have a good day yeah have an even better
32:46evening oh thanks
32:53hi there you've been okay yes very well good it's this mole here which dr george said wasn't cancer
33:04yeah yeah so antonia was put into my minor surgery clinic because she had this benign looking mole
33:11and none of the other doctors do minor surgery so it's something that i'm keen on it prevents them
33:18going into hospital to have mole removal done so saving money for the nhs so yeah but with any
33:25procedure we've all got bugs that live on the skin normally um so there's always a potential it can
33:30scar oh i don't mind well i'd rather it came off but it'll be flat yeah i'd rather it came
33:35off because
33:36when i'm rubbing my when i'm washing my i'm drying my back i'm worried i might rip it off or
33:42something
33:42yeah yeah yeah yeah that's fine i thought this top would be all right because then you can just
33:52it's gonna freeze it first yep cutting off the blood supply
34:08you okay yeah i'm fine it's coming off nicely
34:13there's always a potential it can grow again but we just do the same thing it's just a little
34:18fibrous not nothing cancerous it came from nowhere i mean i mean quickly did it well maybe it was there
34:24and then it became um crusty you know and that's when i noticed it nearly on there we go i'll
34:32just
34:32tidy it up a wee bit which might stink
34:37but it looks completely flat i'll send it away anyway just for histology but it's incredibly unlikely
34:44that it would be anything nasty um but we just do it for completion really
34:50have a quick look at it in the mirror but i think it looks absolutely fine
34:53you can i'll cover it up i won't wear a vest yeah keep it covered today and then tomorrow you
34:59can
35:00shower and stuff as normal okay great lovely nice to see you nice to see you i'm glad all well
35:05yeah all
35:06good a bit hot pretenders it is well but we have to keep exercising yeah no good okay thank you
35:12take care
35:13bye bye
35:22henry it's you you're up
35:28right follow the lady in the green sorry you've got all of us that's all right come on in i'm
35:34dr
35:34dudgeon we've met before yeah we have come on in and have a seat you're in the doctor's chair
35:39henry do you okay to sit here for me sit on here of course you sit there so you've been
35:44in see dr
35:44pierce in this morning yes yeah third time in one day three times today yeah wow and his oxygen level
35:53this morning was about 96 wasn't it that's when it went up okay can i have a listen to you
35:59henry can
36:00you just lift your top up for me he doesn't let me listen a deep breath in
36:09when did you say you did the last two puffs an hour okay okay so he's still quite wheezy and
36:15his
36:15oxygen level is sitting around 92 now so what we can do is we can give some puffs here but
36:22i think
36:22then it might be a good idea to take him up to the hospital
36:39have you ever had to go to hospital for your asthma yes you're quite breathless aren't you yeah
36:45very that's what i'm worried about really good seal fill baloney's
36:55one more you go for it
36:59okay not bad
37:05i'm just gonna give them a call now okay perfect thank you oh hi there i'm my name's dr dudgeon
37:11i just
37:11wanted to let you know about a seven year old i was sending in with wheeze should i put this
37:16though
37:16um see we've seen this morning with oxygen sats about 95 percent in air um but it's come back this
37:22afternoon for review um but the oxygen levels are kind of sitting at about 91 92. he needs to come
37:29by
37:29ambulance yeah all right thanks bye um they feel that you need to go by ambulance just because we need
37:37to get some oxygen when a child's unwell and we're saying actually they need to go to hospital and
37:42that makes parents feel really anxious which is completely understandable what we might do is get
37:47a mask and put the medicine through that through a mask i'm going to go and set that up for
37:51you i'm
37:52just going to go see if we've got the thing to put through a mask
37:57can we get an ambulance for henry for low oxygen levels peds want him by ambulance okay
38:04you have a seat okay two more henry okay and then what i'm going to do is give you a
38:13little bit of
38:13oxygen okay okay let's check one last time one last time one last time just to be sure
38:27henry we're just going to give you a little bit of oxygen okay and then we can give you some
38:31more
38:31help these more in five minutes or so but the ambulance is going to come just to take you to
38:34hospital okay if your oxygen levels are low you're not getting enough oxygen to your brain to the
38:40tissues in your body to your organs if that persists then that that can cause more problems we also
38:46don't know if suddenly they're going to deteriorate or get worse um so it for him it was the safest
38:50thing
38:51to do they can break the speed limit they can break the speed limit and they can go across red
38:57lights
38:59this might be a little bit noisy
39:07give 30 more seconds i just want to make sure you've had all the medicine okay
39:11maybe i could go just to get in the middle possibly let's see how you are henry was really brave
39:16for
39:17children when we're sticking monitors on them when we're putting masks on them and it's really
39:22really scary for them and i think it's important to try and make children feel at ease as possible
39:29hi there come on in this is henry so he's had two 10 puff salbutam and one salbutam nebulizer now
39:37yeah do you want to come and see our ambulance
39:38all right okay we'll walk out and then we'll start doing another nebulizer
39:44okay henry i hope you feel better they'll look after you
39:49all right thank you very much not at all i hope it's all right all right um and if you
39:53need any
39:54follow-up or you know anything in the next few days just give us a call so just call them
39:57and we'll
39:57fit them in all right i hope it goes okay no not at all i'm sorry that's been no no
40:01you've been amazing
40:02all right bye
40:12doris doris doris doris you're in that one yeah
40:19look at you run in there we're in here today okay are you all right yeah oh i don't like
40:31this
40:31hot weather did you sleep oh yeah got to pull the stuff on there
40:36oh
40:42these make me bleed not as well glasses get it all off oh when i go home this comes off
40:49these come off what do you wear at home nothing you do not walk around
40:55do you walk around in the nod oh yeah overnight i've got knickers on and during the day i wear
41:01me knickers you're braver than me oh yeah that's nice doris is a character i love her she makes me
41:10smile because she's never really down for someone to be 94 years old and virtually fully with it
41:19she just makes me laugh right let's get this off
41:25and this one doris
41:28right what's this little ulcer doing it's being a right little devil that one
41:33yeah do you see that yeah it's looking a lot better doris what do you think they're gonna
41:38tell me tomorrow they're gonna cull it off well i thought they might do that this looks all right doris
41:45is it all the pink yeah yeah that means it's granulating so you've got healthy tissue there
41:50that's gone down that's gone down and you're taking the antibiotics yeah yeah ulcers can come
41:57on basically anyone from the age of 50 upwards the one thing they've got in common is smokers so
42:05anyone who smokes are more susceptible to an ulcer doris still smokes around five a day now but like
42:15she says if i stop smoking now i'll be dead within six months so she's going to carry on do
42:21you want
42:21this in there yes please love right pretty goody okay oh let me get the door for you your majesty
42:29thank you very welcome actually it won't be long before i'll have to have some kind of electrical
42:38electrical what oh oh i thought you meant shock therapy i mean i've got a wheelchair as well
42:45upstairs but it's not an electric one all right my darling all right doris i'll see you next monday
42:52see you next monday my love bye bye bye bye lovey yeah bye doris
43:11all right lovely thanks amazing nice to see you all the best sweetheart bye bye bye bye thank you so
43:17much thank you have a lovely day thank you to have a good trip thank you thank you very much
43:23no pleasure
43:23you're very welcome yes thank you bye now all right thank you bye not at all bye
43:33bye
43:53bye
44:25oh no is it very sore very yeah it smells a bit i'm afraid how far can you manage before
44:32you start
44:33to get breathless around about 15 feet as soon as you announce oh i'm pregnant it's like oh you're a
44:40friends
44:48you
44:55you
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