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00:05morning surgery i mean it moves and it feels really yeah a bit clunky okay yeah it's the
00:13best way to describe it oh no yeah is it very sore very yeah it smells a bit i'm afraid
00:25how far can you manage before you start to get breathless
00:28around about 15 feet okay so not very much at all
00:35i know i'm in a panic mode and i just don't want to think of the worst
00:40and you don't have any family or a history of breast cancer
00:46as soon as you announce oh i'm pregnant it's like oh you're a write-off you can't do the same
00:52things
00:52that everyone else can do so people don't invite you out
00:59so
01:33Terence?
01:39Hi, come on in.
01:40Have a seat.
01:42How are you?
01:43All right.
01:45I've stopped smoking about seven months ago, so I've been going to the gym.
01:49Well done.
01:50And I'm finding I've got a problem with my elbows now.
01:54Thinking back, I got hit while I was on a push bike and sort of done a Mexican wave with
02:00my feet.
02:01I got hit from behind.
02:02Yeah.
02:02But I went down really hard on both elbows.
02:06Feeling this elbow, it doesn't feel right.
02:09Oh, they're like, yeah.
02:11Is there a pain there, though?
02:12Yeah, especially when I start doing weights and that.
02:16Do you mean that little lumpy bit there?
02:17Well, yeah.
02:18Don't know whether it's soft tissue or bone.
02:20Is there any pain here?
02:22No.
02:22Nope here?
02:23No.
02:23Nope here?
02:24Yeah.
02:25Yeah, yeah.
02:26And how tender?
02:27It's pretty tender, yeah.
02:29So it's just there.
02:30I mean, it definitely is a little bit of a lump.
02:32Yeah.
02:33That's okay?
02:34Yeah, it just feels a bit grindy, you know?
02:37I want you to pull your arm in towards you.
02:39I'm going to pull it away.
02:40That's okay?
02:41That's fine.
02:41Yeah, push away.
02:42Yeah.
02:43Good.
02:43And just your arms up like that.
02:46Okay.
02:46And no tingling, numbness?
02:48No.
02:48Nothing like that in the arm?
02:49Okay.
02:50So when did that happen?
02:51Oh, November last year.
02:54Okay, it's a while ago.
02:55Yeah.
02:55And at the time, so you...
02:57It was badly bruised and really sore for weeks, but I thought, yeah, yeah, right, you
03:02know, normal sort of airborne attitude rather than get it x-rayed and check it out.
03:10Prior to the sort of lifting in the gym and things, how has it been?
03:13A bit clunky.
03:14Okay.
03:15Yeah.
03:16It's the best way to describe it, yeah.
03:18I think let's x-ray it.
03:20Okay.
03:20All right.
03:21Just because of the weight and because of that lumpy...
03:22Yeah.
03:23So, I mean, it moves and it feels really...
03:25Yeah.
03:26I think there is a lumpy bit that you can feel moving.
03:28Yeah.
03:29And at least then you know that it's fine.
03:32Chelsea, I'll put the x-ray on the system so you can just walk up.
03:35But I think it would be good just with that lump.
03:36I'll get a priority anyway as a war veteran for x-rays and that, so.
03:41So, yeah, so just walk in and get that done.
03:43And as long as the x-ray doesn't show anything, then it will just be physio and taking it from
03:47there.
03:47Brilliant.
03:47All right.
03:48And I'll just fill out a repeat.
03:49For the...
03:51Gaviscon and...
03:52Yeah, I'm fine.
03:52I can do them today.
03:54Land proper.
03:54So, I'm using it quite regularly.
03:56It all depends what I eat.
03:58I've done both of those.
03:59What about the statin?
04:00No, I'm all right on them.
04:01I've actually had to adjust my diet since I stopped smoking.
04:05So, keto, no carbs, no pasta, no rice, no potatoes.
04:10And you're feeling better for it?
04:11I feel worse when I break it.
04:14I get ill.
04:15Well, it makes you stick to it.
04:16Well, yeah.
04:17I mean, I broke it the other week because the Jersey new potatoes, the royals were out.
04:23They're only around for a few weeks.
04:24I better try them.
04:26You'll be fighting for it by the time you go for your foot surgery.
04:29Definitely.
04:30All right.
04:30I've got to give myself half a chance, haven't I?
04:33Bye.
04:33Nice to see you.
04:34Bye, Doc.
04:37Bye.
04:38What's up with Naomi?
04:43Hello.
04:44Hiya.
04:45Hello.
04:46Hello.
04:46Say hello, Mama.
04:47You're coming into my room.
04:48Look, here we go.
04:50Come and have a seat.
04:52Oh, Dr. Faisen, hiya.
04:53Well, how's the little one?
04:54Yeah, she's fine, but no, she has...
04:57Come and have a seat.
04:58Oh, thank you.
04:59Hello.
04:59Say hello, Mommy.
05:01Hi.
05:01So, she's coughing a lot.
05:03Okay.
05:03And it's like since two weeks.
05:06I thought this is normal and with the time it will go, but now it's a lot of coughing during
05:13the night, especially.
05:15So, tell me, so it started two weeks ago, you said?
05:17Two weeks ago.
05:17Hi, Mommy.
05:18Hello.
05:18And her main symptoms at the moment, we've got the coughing.
05:21Only coughing.
05:22Only coughing.
05:22Nothing else.
05:23Is she pulling at her ears, anything?
05:24Yeah, yeah, sometimes, yeah.
05:26I think she has some pain.
05:27Yeah, okay, we'll have a look.
05:29And high fevers?
05:30No, no, no, she's fine.
05:31Look how smart you look today.
05:33You've dressed up for me.
05:34How fantastic.
05:35Right, I'm going to do a few little checks.
05:37Yeah.
05:37And we'll see what's going on.
05:39Just put this.
05:40Hello.
05:40You don't want me to.
05:41No, Mommy.
05:41Well done, well done.
05:44Good girl.
05:44Well done.
05:45Okay, okay.
05:46It's okay.
05:46It's okay.
05:47That's it.
05:4736.8.
05:49So, what I would like to do is have a look in her ears.
05:52I know my little face.
05:54Head.
05:55Okay.
05:57Really red.
05:58Really red.
05:59It's as red as your jumper.
06:01It just means that there's a bit of infection.
06:03Now, it could be the end of the infection if she's a lot, lot better.
06:07But if she's still coughing.
06:08It's still coughing, yeah.
06:11So, she is quite mucusy.
06:12I'm just a little bit worried because the ears are so red and angry.
06:15And she's been like this for 10 days or so, you say.
06:1710 days, yeah.
06:18Yeah, 10 days.
06:19I wonder if she does need a short course of antibiotic.
06:21Yeah, I think so.
06:22Just to clear the mucus, clear the ears, get her better.
06:25Let me give her.
06:26Is she allergic to anything?
06:29Fools.
06:29Only fools.
06:30Okay.
06:30So, she's got some allergies and things, doesn't she?
06:33She has banana allergy, but she has a lot of...
06:36Banana allergy?
06:37That's gutting.
06:38Yeah, but she has a lot of sensitivity.
06:40Gluten, eggs, soya, potatoes.
06:44Wow.
06:44And she's been tested for all this, like in...
06:46I make a taste at home.
06:49When she eats the gluten, her reflux, like vomiting 100 a day,
06:53and when her reflux disappeared, eczema shows.
06:56Lots of allergies she has.
06:58It's really difficult for me.
07:00And going, because I would like to start working, you know,
07:02but it's difficult to start her at the nursery, because they are like 10...
07:07So many allergies.
07:08That you've not gone back to work, because you're sort of frightened to leave her with anyone else,
07:12because of all of...
07:12I have photos, I have...
07:14Let's have a look at the photo.
07:15I mean, that sounds terrible.
07:17It's terrible.
07:17Yeah, like that.
07:18Oh, my goodness me.
07:19I was giving her gluten and everything, but after that...
07:22Because we tell you to give...
07:23Oh, gosh, it's really the skin's broken down and bleeding.
07:26So often in consultations, while we're dealing with one problem,
07:29sometimes we can notice or the patient can sometimes just mention another thing that's come up
07:33that they didn't necessarily book the appointment for,
07:35and sometimes, ironically, that can actually often be more important,
07:38perhaps, than the original reason.
07:40So in this case, what became apparent during the consultation
07:43is actually there's a very big problem of allergies.
07:45So that was a really important issue that we needed to address there and then.
07:49Can I get the paediatrician to see her, the children's doctor to see her?
07:53Then they can do a sort of extensive allergy testing.
07:56We can try and work out perhaps what she's really allergic to,
07:59which ones she'll grow out of, which ones we have to be careful with,
08:01and how best to manage it.
08:02Yeah, please.
08:03And there are also dieticians to help you with paediatric...
08:06There are lots of children with allergies, and they can go to nursery.
08:09Nurseries can manage it and schools, but we need to be really sure what it is
08:13and test her against some bits and pieces to make sure
08:15how much do we have to have in place to help her and things,
08:18because that must be hard enough looking after children this age,
08:21no matter with all of this with you.
08:22It's so difficult. It's really, really difficult.
08:25Seeing her, like, scratching all the time. It's so hard.
08:28It's really hard. All of it is manageable.
08:30All of it we can help you with, definitely.
08:32So I think, can I write to the hospital and ask them,
08:34and we'll get the dietician, and we'll get people to try and help you with this,
08:37because this must be really difficult.
08:40Yeah, really.
08:41And yet, she looks fantastic.
08:42She looks fantastic.
08:42You're doing such a good job.
08:44Let me send her some antibiotics straight away down to your chemist.
08:47I'll get that sorted out, a letter, and then I'll send you an appointment,
08:50and let's try and get you some help with all of this.
08:52Okay, stop. Well, listen, nice to see you.
08:54Well done, Naomi. You were very good today.
08:56Even though you didn't like me sticking things in your ears,
08:58but I get that, because that's all. Fair enough.
09:00Nice to meet you. See you soon. Bye.
09:02All right. Well, good luck, sweetheart.
09:03Take care. Take care. Nice to see you.
09:04Nice to see you. Bye-bye.
09:06Bye.
09:11Nice, sir.
09:15Hi. Come on in. Have a seat.
09:18I'm Dr. Dudgeon. We met before.
09:19Yes.
09:20What can I do for you?
09:21We went away for my birthday, and then my partner proposed,
09:24and then we had a very lovely...
09:27We come back. I had a very nice surprise party.
09:30But, unfortunately, his mum diagnosed with cancer,
09:33and she gave us that news yesterday.
09:37My partner just was so emotional, either myself.
09:41We really didn't expect that.
09:44Bless her.
09:45She just had that, obviously, for only 10 days,
09:48and they said it's quite aggressive.
10:05I've got an ear problem.
10:06Now, I had this a couple of weeks ago.
10:09Anna was given some drops that seemed to sort it out.
10:12My ear's been really bothering me for a long time.
10:14It's my left ear, and it just feels like there's loads of pressure inside it.
10:17The worst thing that I'm so worried, that's in my ears.
10:21Right, OK.
10:22Like, it feels like I want to stick my finger in it
10:25and, like, clear it all the time.
10:27You know, I've just got this pervenous tinnitus.
10:29Is that right, you know?
10:30It's like going to a loud pomcot so you can't hear a thing.
10:33My partner has a feeling she seems to think
10:35it's because I've always got ear buds in.
10:38That part of the eardrum that I can see is bulging out towards me,
10:41which suggests that it is a eustachian tube issue.
10:43Did you use a cotton bud or anything like that?
10:45No, no, no.
10:46Just your finger?
10:46Yes.
10:51Well, it is really good.
10:54How were things?
10:55Getting worse.
10:56Oh, no.
10:57Nothing worked.
10:58Oh, really?
10:59I am finding that because of the ear thing, I'm very, very wary.
11:04Mm.
11:04Walking.
11:05Yeah.
11:06Yeah.
11:07So it must be a balanced thing, love.
11:09Of course, I'm slower.
11:13Yeah.
11:13Much slower than I've ever been.
11:15Mm-hmm.
11:16And, um, quite depressed, really.
11:19Oh, no.
11:20Well, it's this move and everything, and I can't handle this because I've lived here for...
11:28Yeah, many years.
11:29...18 years or so, and I'm losing my home.
11:31I'm going into something else, but it won't be the same.
11:33It won't be the same.
11:34You're right, and a lot of people around you won't be there anymore, and so that's going
11:37to take its toll, of course.
11:38Because I'm not a sort of person who gets depressed.
11:43I've tried to see the good outlook and things, but I'm not anymore.
11:47Oh, I'm sorry.
11:48But never mind.
11:49Everybody's...
11:50Well, no, what can we do to help?
11:51Because there's lots we can do.
11:52There's nothing for that, and I don't want to take antidepressants or anything.
11:56No, I'm not suggesting you do.
11:57Absolutely.
11:57I agree.
11:58I don't think we need to go down that room.
11:59I wouldn't take anything like that, you know.
12:01No, I think I need to get my own head into accepting.
12:07Acceptance is key, and I think, you know, I sort of say that to anybody, really.
12:10I think it's really important, and knowing that you won't feel like this forever.
12:14You know, it's a transient thing, and things will get better.
12:17And as I say, 87 next birthday, so it's...
12:23I don't like being older.
12:25I know, but I always say to you, what's the alternative?
12:27What's the alternative?
12:28You know?
12:29I'm a terrible...
12:29You're doing much better than you think you are.
12:31I'm a terrible poser.
12:32Oh, no, it's all good.
12:34Not a problem at all.
12:34For the ear, I'm going to have another look at the ear for you now.
12:37And the other one isn't as good now.
12:40Ah, this is the...
12:42I can't hear now.
12:44Yeah, don't worry.
12:44That's the really bad one, but this is getting the same.
12:50Yeah, there's loads of wax in there.
12:54Okay, on the other side.
12:56This is the bad one.
13:01Yeah.
13:02This is very, very bad.
13:04Let me put this on your finger to check your heart rate.
13:06So both ears are blocked.
13:08There's some earwax in both.
13:09But on the right side, there's a little white coating.
13:13So I'm wondering if there's a tiny fungal infection that's causing all the discomfort.
13:17But you gave me something for fungal infection.
13:20I did last time.
13:21How long have you been using it now, do you think?
13:23I think it's only lasted for about three days because it's so small.
13:27So small, I see.
13:28You definitely can use it for a bit longer.
13:30I'll give you a new one.
13:31I'll prescribe a new one.
13:32Okay, let's have another go.
13:34Good.
13:35Keep us posted.
13:36Any problems, just come back.
13:37Let me know.
13:38Your vital signs are all normal.
13:39Your temperature, heart rate, oxygen levels, pristine.
13:42So very good.
13:44Yeah, that's the best bit.
13:46That's working really well.
13:48Oh, thank you, love.
13:49No, my pleasure.
13:50You're very welcome.
13:51Have a good weekend.
13:51Take care.
13:52Bye, love.
13:55Because of my anxiety, I just get freaked out since yesterday.
13:59It's just in my head.
14:00I just want to...
14:02I've done the checks that women normally do,
14:05but I've never done with the doctors or with the professionals.
14:09Yeah.
14:09It's hard for anyone to receive a cancer diagnosis of a loved one,
14:12but I think for someone with anxiety,
14:14especially an element of health anxiety,
14:16it's normal for them to worry whether they might have cancer too.
14:19I know I'm in a panic mode
14:21and I just don't want to think of the worst.
14:24And you don't have any family history of breast cancer?
14:28No.
14:29So prior to you obviously checking your breasts
14:31since you got the news yesterday,
14:33you hadn't noticed any lumps or bumps or...
14:36I don't know.
14:37Okay, do you want me to check them today?
14:38Would that reassure you?
14:39No.
14:39So just pop behind the curtain
14:42because that's okay.
14:44What we're really doing is looking for any change or any lumps.
14:47So breast tissue isn't always completely smooth.
14:50Okay.
14:50So the best thing is if you're aware of what your breasts feel like.
14:53Okay.
14:53All right, that side all feels fine.
14:55I'm just going to...
14:55And I feel that even sometimes I bone it in here.
14:59I was like, that's my bone.
15:00Yeah, those are your ribs.
15:01Yeah, yeah.
15:02They do feel a bit lumpy,
15:03but yeah, they're definitely your ribs.
15:04All right.
15:05And the best place to check sometimes is the shower.
15:08There's been lots of improvements in breast cancer treatment,
15:10but we know that the earlier the cancer's picked up,
15:13the better the outcomes.
15:14So it's really important for women to self-check their breasts
15:16and attend the GP if they notice any changes or any lump,
15:19and also once offered to them to attend their mammogram screening.
15:23How are you feeling about that?
15:24Do you feel a bit more relaxed?
15:26Yeah.
15:26Yeah?
15:27You know, and I think getting a shock diagnosis, I'm sorry.
15:32I'll just feel sorry.
15:33She's a very nice lady, and I don't have my family here,
15:36but she's just been such a nice lady for the last two years.
15:39I've been with their family.
15:41I don't normally panic.
15:42I was like, I didn't want to talk to anyone
15:45because I felt like they would think I'm crazy.
15:47No, no, not at all.
15:48And I think if at any point, you know, you feel your breasts and think,
15:51oh, actually, is that a lump or that feels different?
15:54Always just come in, OK?
15:56But today I can't feel any lumps that I'm concerned about, OK?
15:58And it's totally normal, I think,
16:00when you get told about a diagnosis like that
16:01to be anxious for your own health as well.
16:03Yeah.
16:03So if you have any other concerns, come in.
16:06All right.
16:07Thank you so much, Doug.
16:08Bye.
16:09Cheers.
16:15I had someone come in with their little dog in their bag.
16:21And I didn't see it until after,
16:23and he goes, look at the little rat.
16:25She said, it's my daughter's little rat.
16:27And he put it on the floor.
16:28I was like, OK.
16:29The only dog I would accept here is a sausage dog.
16:33Oh, the other day I had a patient.
16:34They were wearing a bracelet, and it was a little sausage dog.
16:37Did you tell her, my best friend's...
16:39No.
16:52Hi.
16:52Lenny?
16:53Hi.
16:55Hi.
16:56Are you winding?
16:57Hi.
16:58I can't believe he's a year.
16:59I know.
17:00Look at you.
17:01You're such a big boy.
17:04Hey.
17:04You're so big.
17:06Hi.
17:07How's everything going?
17:08Yeah.
17:08Oh, good.
17:09Amazing.
17:10Good.
17:11Oh, bless him.
17:13Perfect.
17:14So, today, it's four vaccinations.
17:17Two in each thigh.
17:20The first one will protect him and cover him from haemophilius influenzae B and mellinger
17:25cockle C.
17:26The second one is the neumococcal vaccination.
17:28The next one is the mellinger cockle B. And then the last one is the MMR.
17:32So, this is the first of two doses.
17:35This will protect him against measles, mumps, and rubella, which is really important at the
17:38moment with the measles outbreak.
17:40It is very likely that his legs might be a bit sore.
17:43He doesn't know what's coming yet.
17:44I know.
17:45And he doesn't have any allergies.
17:47No.
17:49And are you working at the moment?
17:50I'm back to work, yeah, for two days a week, so.
17:53Remind me, are you doing something sports?
17:54No, TA with autistic children.
17:57Ah.
17:57Yeah.
17:58And you're enjoying being at work?
18:00Yeah, it's really nice to be back, to be fair.
18:02Good.
18:05Hey, guys.
18:08Best way to do this is just hug his top half, hold his arms in, and then I'll do the
18:13rest.
18:13And please feel free to look away yourself as well.
18:16All right, are you ready?
18:18That's it.
18:19Ready?
18:19Sorry, my sweet.
18:20Oh, no, I'm sorry.
18:25All right.
18:26I'm sorry.
18:27All right.
18:28Okay.
18:29I'm sorry.
18:30I love my job, but giving childhood vaccinations is possibly one of the worst parts of it, but
18:38it is so important.
18:42The reason we do four injections at once is because it can be quite distressing for the children
18:47and for the parents, and actually to do it all at once and get it over and done with
18:52is a lot better than prolonging it and spreading it over several appointments.
18:56All right.
18:57All done.
18:59All done.
19:01All finished.
19:03Oh, that was well done.
19:06I know.
19:06Hey, go look at you break!
19:08Oh, boy.
19:08i'm not i'm not coming near you anymore i promise all finished they're the worst we won't do that
19:17many for any other one come in and let's lay down all finished all finished there we go
19:27well done any any worries any concerns let us know okay say bye thank you bye gorgeous boy well
19:36done well done take care okay come on you oh okay perfect yeah yeah yeah perfect and pop that one
19:52down
19:53your blood pressure when you did this one at 9 30 were you feeling lightheaded or dizzy
19:57no not really i just not long got up really okay
20:15okay thanks a bit brighter in here yeah yeah how's it going so i've been getting groin pain
20:22quite a bit for like it probably happened about 10 years ago but i've been managing it sort of with
20:28local um painkillers and things like that um which has stopped me from running and exercising really
20:34it's a long time yeah for a long time yeah but but more recently it's kind of got worse
20:40yeah and and like last week i was trying to walk and i was walking with my with my partner
20:44and daughter
20:45yeah and they were basically walking off and leaving me because i just couldn't move because
20:48the pain was so much right and it feels like it's a stabbing pain um in my in my hip
20:54yeah and
20:55uh in my groin but also now it's kind of like i can feel it now with pain in my
21:00in my thigh as well
21:01you know when you get off the toilet you're having to push yourself off rather than you know back in
21:05the day you could just jump up you know come on a little lie down on here and you can
21:09show me
21:10lift this one up as you can yeah same this side yeah particularly or no no force me down
21:21okay hold on now try and push me out to this wall i could feel it sort of catching there
21:27when i push
21:27that that way okay you can stand up and you never had any hip problems before no no nothing i've
21:36always
21:36been being sporty and healthy yeah exactly yeah but now it's walking as well and i'm thinking oh my god
21:42it's getting worse i think you do need an x-ray for a start okay and then probably go and
21:48see the
21:49musculoskeletal team which is connected to orthopedic and they'll be the ones if i need like a corticone
21:54injection or something they'll be the ones that do it okay i mean at the moment i'm managing i'm kind
21:59of
21:59managing it with you know topical um ibuprofen creams and things you've taken naproxen in the past i have
22:08worried me about gastric irritation um the because i've had my gallbladder out so um yeah i've had a
22:15lot of sort of gastritis and pain from from from that problem but what i'm frightened of is that it
22:21might aggravate it but yeah i guess if it does just stop it okay so you're going to get a
22:26map as well
22:26as an approximate and if you get indigestion later take another omeprazole okay that's lovely thank you
22:32very much yeah thanks for you thanks for being so understanding and seeing me so quickly yeah no
22:37worries thank you take care
22:43water oh i don't know my water oh there it is
22:55juliet oh hello sorry didn't mean to shout call you now that's heavy i'm a all right come on in
23:01how
23:01are you doing um ish come on in oh you've moved rooms i've well only temporary i'm sort of in
23:10and
23:10out different rooms we're all just juggling around but actually this room is a bit cooler so i quite
23:15like this room so i think i might upgrade and try and stay very sensible come and have a seat
23:22the good
23:22news is i've got a tentative date to have the stones removed gosh that's good news yeah excellent when is
23:30it not this friday okay following friday oh wow so really soon like the 18th um and i had a
23:38plea assessment appointment yes most of it went okay until i said when i was in hospital at the end
23:48of march i developed a pressure sore on my ankle and then they weren't very happy with it no oh
23:54do
23:54they think it's infected or something well they've they've taken the swab okay okay well we mustn't
24:00let this delay the operation i mean i'm hoping that it won't delay the operation i've been waiting
24:05since october i know and they didn't put any antibiotics or anything they just took a swab at
24:10the moment yeah yeah can you manage i'll tell you what do you get it's probably going to be easier
24:15if
24:15we sit up yeah here let me juliet has been a patient of ours for many years and suffers from
24:19deformities of the bones and a lifelong disability sometimes unfortunately because we're trying to
24:25help her with her mobility and walking she has to wear a brace on her feet to allow her to
24:29walk
24:29but these braces are quite sturdy because they need to be and they in themselves can rub and catch on
24:34the
24:34bone and cause skin problems i'm up you're up right let's have a look i'm just going to peel this
24:40off
24:41and let's have a look oh no yeah so is it very sore very yes oh you poor thing
25:06i'm getting married next saturday congratulations thank you but all week i've had a bad sort of
25:12fogging panel that's where it is and if i can't bear down all my weight on it because it hurts
25:17how are
25:18you doing how's the ankle it's really helped i'm still i've got about four days left of antibiotic
25:24i had a major infection in my foot sure i was in hospital for two weeks okay with ivy antibiotics
25:29it was all this disinfection is that tender as i press you couldn't have done that last week it's okay
25:36now this looks new is it oh i look at my body and think now how could i do that
25:44i know do you know
25:46what that is easily done i think we need to get you on some antibiotics probably for it because
25:53if there's any infection in this which i'll break it down 10 times quicker so we've got to try and
25:59stop
25:59it it smells a bit i'm afraid as well which means it's normally a little bit infected to try and
26:03get it
26:04down but it doesn't look dirty and and unclean or whatever it just and there's some tissue around
26:09it that's re-healing they've done the swab so i will chase that okay and that will tell me exactly
26:14what bug is in there but i think we should rather than wait three or four days to get that
26:19back put
26:19you on some antibiotics straight away let's try and protect it a bit so we'll just stick that across
26:24there like that but we need to keep an eye on it and just get some so i'll get the
26:29nurses to
26:29properly have a look at it for you and they can do a better job than me at that but
26:33we'll get
26:34that done i mean i hope juliet that this isn't a reason for them not to do the operation just
26:38because we've got the wound but that's why even more reason to put you on the antibiotics now so
26:42we make sure we don't get sick so then we don't end up cancelling the operations yeah so i will
26:46send
26:46this antibiotic uh it's morning and night and we do need to get sam to have a look at this
26:52oh goodie
26:53so she's got an appointment on friday afternoon can you come down on friday friday friday friday let me
26:58just check my diary oh that's better okay let me help you down you're okay oh i'm down okay all
27:05right
27:05let's get let's get sam to have a proper look at it okay get that that room sorted out for
27:11you
27:12right diary friday yes 11th yeah the 11th oh look it looks blank is that all right yes let's go
27:20for it
27:20let's go for it at 2 30. so she can have a look oh orthotics that's next week oh good
27:30okay so that's
27:31what we were chasing for so now we need to say to them this is what it's caused yeah they've
27:34got to get
27:35the boot and the brace better so it's not rubbing can we somehow put the straps at the side or
27:40something
27:41different i don't know i'll send the prescription through to oza now so you can take that straight
27:45away lovely and then we'll see you on friday and then hopefully we'll still get that operation the
27:50following friday yes all right take care not at all nice to see you bye bye to take care bye
27:56oh wrong
27:56direction yeah that way yeah i know you're gonna walk out not a good idea no that way last window
28:01take
28:02care bye bye take care bye uh derek hi should we go through yep come on come on oh oh
28:15dear hello how are
28:17you you're right thank you come through who have you brought with you today pardon oh you're a grandson
28:24lovely i'll bring that round for you so yeah thank you yeah good to see you both how have you
28:32been
28:33still with it breathlessness yeah yeah so that is what do you think could be causing or contributing
28:40to the breathlessness i don't know i walk so far say from here to outside the the place here and
28:49um
28:49you get breakfast if i'm washing up drying up i get breakfast how far can you manage before you start
28:58to get breathless um if you're walking around about 15 feet okay so not very much at all and has
29:06that
29:06changed recently has that got worse recently or has it been like that for quite it's been like it's
29:10inside that here since you had that the problem here i came here about two months ago with uh yeah
29:18pain
29:18here yeah i had x-rays done which came out clear i think we felt it might have been acid
29:25reflux and
29:26sort of the excess weight you were carrying might have been contributing to uh you know sort of a
29:31bit of pressure being exerted on the food pipe and things like that and causing a sort of build up
29:37of
29:37acid to you know to be produced and things i think the main issue for you obviously is the breathlessness
29:41so we need to try and and improve that for you oh yeah derek's shortness of breath was contributed
29:46to by several factors he has got um a chronic uh lung condition called copd chronic obstructive
29:53pulmonary disease as well as carrying a bit of excess weight it's not helping with the breathing side of
29:58things one thing that will really help is is some weight loss so i only got this because when i
30:04stopped
30:04smoking yeah i started putting weight on i went up to about 18 stone at one time yeah i just
30:10put on so much
30:11really common isn't it i don't drink i don't know don't you i've been trying to support for
30:15alcohol my six years brilliant that's really good yeah that's good because there's lots of empty
30:19calories and alcohol get miserable no smoking no drink it's tough isn't it i know but again you know
30:24think of the improvement that the smoking has had on your breathing i know you probably don't feel it
30:27at the moment often when we give up smoking um our appetite comes back we feel much more hungry so
30:32we
30:33end up eating a little bit more so it can be really hard to lose weight uh really common for
30:37people who
30:37have given up smoking to gain weight you know once by the time many years ago i was a milkman
30:42right
30:44and because i used to serve the white city state which had no lifts and they were four stories high
30:49and carrying sort of four or five crates of milk up the top yeah but i kept it 11 7
30:54all the time yeah
30:55yeah yeah yeah walk walk walk walk walk from here to croy and once oh wow you know i used
31:02to love
31:02walking now i hate the thought of walking i get in the car and drive there the mainstay of weight
31:08loss
31:08actually isn't exercise so exercise is brilliant for our body really really important but the way
31:13that you're going to lose the weight is by making very small changes to your diet what you're eating
31:17in terms of diet and things what's that like what are you eating what's your diet um if i make
31:24a curry
31:24i mean i was told i shouldn't have a whole packet full of rice on it and things like that
31:32uh i don't go on no diet i just eat what i want to eat yeah fair enough and i
31:37and i agree i don't
31:37want you to sort of think about it as going on a diet because if you go on a diet
31:41the theory is
31:42you're going to come off the diet and so you're going to be yo-yoing your weight's going to be
31:45going
31:45up and down what i would recommend though is making very small changes that are easy to adopt and easy
31:50to do without you realizing that you're doing them so still have your curry with your rice and stuff
31:55but reduce the portion size or instead of rice have a substitute like cauliflower rice which you
32:01know tastes just as good really and that's much much healthier for you and if that's something you
32:06could potentially help each other with you know if you could sort of encourage uh your granddad and
32:10stuff i know he looks he looks after me don't you do it yeah no he does because you're cooking
32:15for me brilliant yeah yeah really really good so he can cut down yeah the whole bag of rice
32:21absolutely just do small portions yeah exactly he's listening to all this he will look after me
32:26why don't we meet up again in a few weeks time just to see how you're doing and we can
32:31just touch
32:31base is that all right good good take care thank you all the best bye now
32:43bye bye what are you gonna get for your holiday who me yeah oh i'm going long completely little i
32:48do
32:48like little long nails i need you to send me some designs for me no for you i got on
32:54holiday before
32:54you oh you're going to back to egypt isn't it yes for how long two weeks a week that's lovely
32:59yeah
32:59that's gorgeous i'll show you where i'm staying is there an airbnb no i'm staying in hilton oh hilton
33:06i used to work in hilton hotel they are the one the fanciest hotels ever look at the water there
33:11what is beautiful is it all booked and everything yeah yeah lovely lovely
33:23helena yes hello hi hello come on in you've like
33:27double suddenly it's showing a little bit yeah but i'm uh you're how many weeks now
33:3424 weeks yeah you see two days i have an eye for it i can yeah you can get away
33:39with hiding
33:40it till about now and then of course people start to notice boy girl no idea no idea oh well
33:45it's
33:46gonna be enough of a surprise on the day so we'll find out so that's exciting so what can we
33:49do to
33:50help today um so i think you're meant to have a 20 like a gp appointment for 24 weeks absolutely
33:55yep should we check your blood pressure today and see how you're doing let's see scans have
33:58all been okay in the pregnancy and yeah yeah it's measuring average which is a good sign the the key
34:03is you've crossed the line at 24 weeks so babies that are born do not give birth today but if
34:09you did
34:09give birth today the baby's got a good chance of surviving okay it's rather reality here in a way
34:16your blood pressure is lovely let's have a listen to baby okay if you make yourself comfortable on
34:20here okay excellent so okay there's your baby heart beating right there's that slow one
34:33that's your placenta that's you feeding baby happy content in there seems good
34:42all right let me help you up because you've lost your tummy muscles thank you come back baby seems like
34:47to come and have a seat sweet up um so you're working at the moment because you're done you're
34:52a dancing or singer or something actor yeah yeah and then i do bartending as well oh god okay it's
34:58the joys of uh having the career yeah the career going oh yeah i mean it must be hard it
35:02must be hard
35:03work anything you're worried about um i don't know i think so like over the weekend i got really emotional
35:13like stressed and i didn't know if i was like i think because there's a lot of overwhelming things
35:19trying to kind of compensate the idea you're pregnant yeah and the fact you haven't got much time and then
35:24also trying to live a normal life so you're like trying to do your job and pay bills and then
35:30just like
35:30even just get your washing done on time and i didn't i was questioning if i had prenatal depression
35:37and stuff but i'm not sure okay
35:56how are you i'm good thank you come and take a seat
36:02how many weeks do you know i'll be 32 on friday oh i know how's it been second time around
36:10it's
36:11i would say very different okay congratulations i haven't met arty yet no i think i saw you while i
36:17was pregnant actually yeah the one who has the horrible pregnancy and eating going well yeah going
36:24well having three meals still having um two bottles of formula as well just because he was
36:29five weeks premature yeah a bit of mood okay yeah yeah good i remember getting the discharge summary
36:35when you first came out of hospital oh my gosh horrendous we've had a tough time we've had a tough
36:41time
36:41it's really hard when you're looking after another one it's very different when you don't have as much
36:46time i mean it's also good though because you don't have as much time to kind of worry about things
36:49it's really creeping up yeah it's always hard isn't it because i mean it is overwhelming you're
36:56about to have a baby and have you suffered from depression before um not really i've had like
37:01bouts of anxiety and you said that was sort of last week how are you feeling this week has it
37:04changed
37:05it lifted a bit or are you still feeling a bit i'm feeling calmer okay yeah and have you got
37:09a
37:09partner with you are you uh yeah yeah supportive helpful very supportive that's quite good because
37:14sometimes they're useless and they're not helpful at all great stirring the pot or something but
37:19if they've got somebody that's really that you know that's helpful historically we used to have
37:24babies and mum would be here and your granny would be here and your auntie would be here and everyone
37:27supports each other reality in these days especially in london everyone family are miles away we don't
37:32know our neighbors very well it's really difficult and i think that's part of where i've been feeling
37:35as well because i think especially last week i kind of realized i felt quite isolated and lonely in the
37:40process and as soon as you announce oh i'm pregnant yeah it's like oh you're right off you can't do
37:47the same things that everyone else can do so people don't invite you out anymore and stuff like
37:51that and it does happen and people often feel like that so prenatal depression can be a condition that
37:56any woman is at risk of suffering from we think up to perhaps 20 of women who are pregnant can
38:00suffer
38:00from it and it can often present with feelings of anxiety concern overwhelming fear about what the
38:08future holds and people can certainly feel quite lonely it is really difficult and with your sort
38:12of lifestyle as well i'm sure you sometimes work evenings you're traveling you're doing things you're
38:16probably thinking how's this going to fit in with a baby and how's my life going to have to change
38:19but people do it i don't know people somehow manage it and they do do it and it is obviously
38:24easier with
38:24help and money is always a stress for everybody and all this so you know there are ways where we
38:29can
38:29help with things and try and help you you know do it and there are people to talk to about
38:33it symptoms can
38:34vanish once the baby comes but also sometimes they can escalate a bit and develop into postnatal
38:39depression and that's something that we screen every woman for regardless of the mental health
38:44before a baby is born and we try and support all women throughout the postnatal period which can also
38:48be quite tricky what we could do today is there's a really good sort of questionnaire that you could sit
38:53down somewhere quietly and go through and honestly answer the questions yourself and think actually
38:58how do i get how do i genuinely feel if you ever had talking therapy at all yeah i have
39:03so i did
39:04the because obviously nhs offers you know eight free sessions i've done that okay why don't we do
39:09the questionnaire and see what sort of level we might be at and then refer to the counselors
39:14talking therapies as well i feeling a little bit overwhelmed then getting a bit of help and
39:18guidance is never a bad thing okay all right well good luck all the best i'll get the referral sent
39:22off
39:22any problems or if you want to come and have a chat or anything you know where we are
39:28okay when are we having a house party well let me move in fast so you get settled but yeah
39:33soon
39:33no you should do a house party an empty house so that we're not damaging any of your furniture
39:38i trust you not to be damaging exactly i don't get drunk george have you seen this lot in here
39:45exactly i am everyone's designated driver
39:49hey sam hello you all right how are you young man i'm fine and you yeah good have to i'm
39:55gonna do
39:56your blood yeah yeah yeah yeah yeah i saw christina she's doing all right ain't she oh terrific yeah
40:02yeah it's a little bit of because she's uh she's always been a lovely little yeah yeah she has
40:08it's a bit like you you're on life wire ain't ya you're gone gone sam you've got to stop bringing
40:14those pasties in james seriously you're making us all fat yeah i just can't help it it's just no i've
40:23been in the paper one day and uh about the amount of uh people that give uh receptionist abuse and
40:29all
40:29that you know and oh that's terrible oh they've had their fair share in here we all have in here
40:38dear yeah yeah not not so much me anymore thankfully yeah because i'll chase them down the road and beat
40:44them with a stick no i won't i know where they live
40:54i'll get you get you on the way out um okay sorry it's gonna pinch because it's a side vein
41:01okay
41:01sorry right now i'm a fuller boy i could take it you're a fuller boy where are you from in
41:08ireland dublin sharp scratch do you ever go back there do you have a little family there yeah we still
41:14about have a thousand family i think christina was 80 and we went back for that and we had a
41:21wonderful time well see when are you going back have you planned it well i've got my 18th birthday
41:29coming up hey yeah you're 21st but trouble is i took a fancy to the points of guinness and there
41:37was
41:37no stopping me but when in ireland yeah yeah you've got to have a good oh jesus you know what
41:44to say
41:44pour it properly as well you have one and you'll have another yeah you will and it's loaded with
41:50iron is it yeah guinness doesn't mean you should drink it every day but if you want to be strong
41:57have a guinness yeah yeah so i don't not 10 one she said to me don't don't start i said
42:04no whatever
42:05you say you're the boss i said you're a fan so uh she said two points i said right right
42:10she gave you a limit yeah good woman well i didn't stick to it
42:19there's nothing like an obedient or disobedient husbands no all right nice to see you yeah yeah
42:25yeah okay you take care you too i'm only going to follow you because i need to get this blood
42:29out
42:29it's done all yeah you're done for god's sake thank you so much oh lovely to see you you know
42:36it's
42:36really nice to be with you again yeah yeah well you take care and we'll give you a fun haul
42:40i think
42:41you're doing really well keep up the good work pleasure very welcome take care take it nice to see
42:48you i hope you'll start um back to work it goes okay that's all right have a great day yeah
42:54and have
42:54a great trip yeah i will do yeah thank you thank you thank you have a lovely weekend doris bye
43:15so
43:22so
43:24so
43:24so
43:25so
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