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00:08Hello surgery last night I probably got up 20 times but I feel like I'm not going to breathe
00:15no more scary isn't it I had an aggressive game of paddle but that shouldn't do too much damage
00:27between having Crohn's acromegaly bilateral glaucoma which is really upsetting and then
00:34this to come on top of us everything seems to be going downhill now
00:40you know that you had a toe taken off yeah yeah that was because the blood supply
00:45to the toe wasn't great so because my toe was black
00:52I just black out and when you wake up I just lie there and I think what in God's name
00:58am I doing
00:58down here
01:03so
01:32hi good morning surgery how can I help
01:34now how can we help today so I've had a sore hand okay yep when I got an x-rayed
01:40last Monday
01:41and it came back fine okay it's obviously not okay so tell me a bit about it so about a
01:48year
01:48and a half ago I hurt at traveling didn't think anything of it and it's been fine since then
01:55and then last weekend I was gardening nothing you know out of the ordinary but it was really this
02:03whole section here was really swollen and this finger yeah so I thought yeah that it would be
02:09broken it hurts a lot along here okay the swelling has gone down but it's still not normal it's not
02:17normal is it I mean if we put the hands together yeah to each other I mean there's definite swelling
02:21around here compared to here yeah and we've also got some other changes here haven't we
02:24would that be arthritis
02:27but but why would I have arthritis
02:29you're young yeah you're young it is right before all of this happened do you ever get sort of joint
02:34aches and pains
02:36yes okay yeah and is it in different joints or just all the small joints or bigger hips knees I
02:43sometimes yes get pain in the shoulder okay and do your hands hurt I mean obviously this one when you
02:50make a fist and things I mean can you do that I can but this one was like last week
02:54it was really sore
02:55I mean looking at so these little swellings at the end yes these are called hepatitis nodes they're they are
03:02part of
03:03osteoarthritis which is a wear and tear arthritis of that so you're only 53
03:08yes it's miz I mean that is I know it's miserable to have though but that is a sort of
03:13type of arthritis
03:14and it's my right hand which I'm very dominant right-handed okay and what do you do for work
03:18I'm not working now okay did you used to use your hands a lot typing and stuff
03:22okay but I do worry about this a little bit the problem is that in sometimes for women more than
03:28men lucky us is that we sometimes get conditions that develop yeah where almost like our body
03:34attacks our joints okay and it's sort of an called an autoimmune disease and it can sometimes present
03:39with joint problems if it is just wear and tear and things then we can go to a hand physio
03:43we can
03:44try and see someone we can get you some help yep but if it is an inflammatory a sort of
03:48what we call an
03:49autoimmune disease where your body's attacking the joint we need to stop that from happening
03:53because otherwise it'll attack more joints and then it can damage them and we don't want that to
03:57happen it's better to know about it now than further down the track definitely because then we go and
04:01see a rheumatologist who's like a joint doctor you know that we can do to try and stop if that's
04:05happening if there is just sort of wear and tear the most important thing you do is keep your hands
04:09moving right yeah because if we don't use them and the muscles waste and just because you've got it at
04:15fifty feet doesn't mean everyone automatically follows the same path that's going to get worse
04:19and worse and worse until your hands completely unusable some people it developed and then it
04:22stays quiet the same for years I mean hopefully it'll go back to nothing yeah but it might then
04:27flare up again in a few years time and things but if that's the course then we'll learn how to
04:30manage
04:31it when it does it yeah but we need to be sure that we're not going to miss something that
04:34we could
04:34do something about yeah so so it means another blood test okay sorry no that's fine Monday morning nine o
04:40'clock
04:40perfect okay all right thank you very much okay not at all nice to see you let me let you
04:45out there
04:45we go thank you all right take care all the best bye bye uh mark please yes hello hello how
04:54are you
04:54sir i'm well how are you doing any better i've been better yeah i've got a student with me do
04:59you mind
04:59if she sits in no no yeah come through you guys can sit on the couch if you like pull
05:03it down a bit
05:04for you so you can jump up there there you go real take a seat how's it been since yesterday
05:08we spoke on
05:09the phone diarrhea abdominal cramps yeah any better eased off not as frequent still not fully every
05:16time i go yeah it's been a very long time since i feel like i had a proper nice kit
05:19and what's caused
05:20all this any obvious triggers any undercooked foods takeaways anything like that that's what i thought it
05:24was i assumed it was food poisoning then after a couple of days sit up there please baby cakes
05:28as i say after the second third day still weren't easing off that was when i was maybe looking at
05:35other
05:35stuff i wasn't sure if it was to do my hernias because i've got three hernias because i've been
05:39going to the gym yeah i'm sure if i've disrupted them with an illness like this the most important
05:44thing is you're not dehydrated so you check your blood pressure to make sure heart rate etc have a
05:48feel of your tummy to make sure that's okay as well um are you going to help do you want
05:54to pop this on
05:55your dad's finger for me yeah on the other hand there you go that goes in there yeah that's it
06:01that's it that's it well done really good we'll make a doctor out of you yeah i think
06:06how does that work so it uses um light it uses infrared light to measure the heart rate and how
06:13much oxygen is going through the bloodstream it's very clever so oxygen levels 98 which is really good
06:18heart rate 76 which is really good so you can take that off
06:21so simple what are you going to do nothing because you're a terror
06:29great so your blood pressure is a tiny bit on the high side but actually i'm not worried about
06:33that at all an illness like this we worry if it's too low uh would it be a kid to
06:37have a feel of your
06:37tummy on the couch yeah sure right kids you've got to come out it's time to go on the couch
06:41it's my
06:41turn to go on the couch yeah you guys are there you go over there with a giraffe very quick
06:46any pain at the moment it's tender it's tender not necessarily all the time
06:50but it's i can feel it's tender so that's uncomfortable good that's absolutely fine
06:57i'm just gonna have a listen to your bowel sounds i'll be two seconds let's get this
07:07good absolutely fine thank you all done so your bowels are nice and active that's really good tell me
07:11about it yes well yeah you you obviously know that i think why don't we get a stool sample sent
07:18off just to make sure sure and then take it from there and in the meantime just keep doing what
07:22you're doing hydrating well yeah bland foods for now brilliant let me see if i got any stickers for
07:26you guys shall we have a look you're in luck i've got four left which one would you like oh
07:31what do you
07:32want my one nice that's a good choice and what one would you like you don't want one are you
07:38sure
07:38you're too old are you too cool for school that's all right i don't mind right all right thank you
07:43very
07:43much let me give you a poo sample to give us and then i'll label it for you as well
07:46so that it's all
07:47done perfect appreciate that so this is for daddy to have some tests baby cakes because that ain't been
07:51well where is that it's just a pot to do what uh we won't we won't discuss that maybe yeah
07:58i'll tell
07:58you outside i'll tell you outside i'll tell you outside there we go all right you're working
08:06you're gonna stay here oh do you want to stay and help that'll make my day much more fun it'll
08:11make
08:11my day easier yeah i can imagine oh say bye high five violet say bye please bye bye take care
08:17see you
08:17later i'll tell you you know you're nosy little nana reena's saying why am i shouting because she
08:23can't hear me okay shush why do you laugh like that sound like the grinch
08:37the grinch what does he say i'm going to ruin your christmas
08:49nice to see you and you too now you're looking well very glamorous i like your dress you'd hardly
08:53think i would come with a medical complaint i like your shoes matching your handbag look at
08:57you i've had them for years and the dress oh you look so lovely how are you i've been very
09:03tired and
09:03exhausted and i've been very unhappy with this diagnosis of bulbous penphoid is that what they've
09:11said a sudden stabbing pain a prickly pain and then i get a terrible itch and i literally have to
09:17scratch scratch scratch just to relieve it yes and then it oozes and then it bleeds bullous pemphigoid
09:24is a rare skin condition that can affect people often in the older ages of life over 60 and it
09:30starts
09:31as a sort of flat itchy rash on the skin that can then develop into blisters and then these blisters
09:36can
09:36become really big really painful and can be actually quite dangerous when they burst lead to infections and
09:41ulcers and other things and let's have a look at it because i can see it quite dramatically on your
09:45legs here there that looks really and all these spots for you are all over okay and also on my
09:54like here this from scratching and here oh i can see them there bullous pemphigoid is an autoimmune
10:01condition so normally our body has an immune system that attacks bugs viruses germs when they come into
10:06the body but sometimes it turns on itself and it starts to affect the skin and that's what's
10:11happening here it makes me want to scratch it it looks so itchy doesn't it it's horrible terrible
10:16it's been in my mucosal tissues it's been also my lips along here those bumps and also on my eyelids
10:23actually inhibited me from doing the things that i'd like to do or going out can you think of anything
10:27what causes it to get worse i think recently um a friend of mine died suddenly and then a few
10:34months ago
10:35i heard from another brother of a friend who had committed suicide that really shocked me oh and
10:40i'd only heard from him a week before no inclination so that really upset me of course and i just
10:46thought
10:46why is everything so sad around me
11:07am i allowed to say you look fabulous thank you that's very kind come on through kate come on through
11:12you look nice so do you where are you going i'm actually not going anywhere
11:19jacqueline you're looking very well today am i yeah i'm not come through take a seat
11:24you look well feeling well actually yeah that's what we like to hear better than falling apart
11:31you look very good thank you in your hat that you're wearing it's very chic every time i put it
11:36on
11:36i feel like frank spencer the itch has been aggravated it's been a lot more prevalent
11:43since this because i'm still trying to get over i'm sure of hearing that i'm so sorry to hear that
11:49that sounds really so i thought you know between having crohn's acromegaly bilateral glaucoma which
11:56has really upset me because i've very limited vision on the left eye and then this to come on top
12:00of
12:00it so everything seems to be going downhill and i'm trying to just keep as healthy as i can
12:04when you look amazing when you've got all these conditions i think the stress sort of when you're
12:09stressed the stress is definitely aggravated the frequency this last few weeks very very common
12:14i mean almost all skin conditions do react to stress i'm worried that it's stopping you doing things
12:19very much so very so i've not been going to stay with anybody do you think talking to someone would
12:24help some counseling where you're talking to a counselor who can sometimes help you with some of
12:28the feelings of perhaps not wanting to go out or feeling a bit apprehensive or a bit nervous
12:33lacking in confidence because i've always been outgoing and bubbly and positive but
12:37that has waned you're only 76 you've got a fair few more years on this planet thank you very much
12:42and we want to enjoy them and you have a right to enjoy them and we should try and see
12:46if we can
12:46help get that back and i totally hear that the skin is a big thing holding you back so let's
12:50deal
12:51with that i think we can get rid of a lot of this i think if we put the right
12:55cream on i think if we
12:56have a really strict regime of a certain cream that has a sort of a bit of anti-itch in
13:00it to put on
13:01after the shower or bath then we could put on top a steroidy type cream and then we target the
13:07little
13:07bits and another thing i had which helped at the time it was a tablet called fixer something benadine
13:14it's an anti-aller it's like an anti-itch tablet that's really cool i really think we should start that
13:19again and and i'll refer to the counseling and i think it's a i think it's a it's a it's
13:24a good
13:25thing and they will contact you there's always a little bit of a wait so it won't happen tomorrow
13:29that's okay i understand again it's in the pipeline and you can talk about your friend and what's
13:32happened in the difficult time you've had over the last couple of years or so all right and then
13:37i'll come with you to the desk now and we'll book a follow-up thank you very very much lovely
13:42to
13:42see you how's the lip looking better but um the stitches as i thought they might not have
13:47are not dissolving so we came back was wondering if you could have us just a snip at them is
13:52that
13:53okay with you yeah it won't be painful i promise yeah he wouldn't he wouldn't let me do it no
13:57that's
13:57how would you feel about lying on the couch and then i'll put a bit of wet gauze just to
14:03clean it
14:04and then i'll use a little tweezer and then we'll just cut it a little bit so it shouldn't be
14:07painful
14:07at all and if you want me to stop of course i will not problem is that okay yeah great
14:11let's do it
14:13all right there you go so you just need to lie down and chill for five minutes that's quite nice
14:21how's your day been okay yeah you've been up too much no no just chilling yeah very good right
14:28he was supposed to do cricket but we went to the dentist and they said oh while while he's still
14:33healing probably not the best thing fair enough as his teeth got a bit of a bad and did they
14:36give you
14:37all clear your teeth are okay they're quite happy yes good good an x-ray lovely good so it's just
14:45going to feel a little bit cold this is literally just clean salty water lovely good
14:58tiny babe but it doesn't touch your skin so don't worry about this is just tweezers so i'm going to
15:03pull that
15:12well done are you able to turn your head that way a little bit for me
15:20well done god you're hard as nails you're very good you're not even flinching
15:26look at that any advice on scar it'll heal really nicely um pop a bit of epimax on it
15:33that just keeps it nice and moisturized um prevents it sort of drying out and then you'll be absolutely
15:38fine i don't think you'll even notice it to be honest okay in a few weeks i've got it all
15:49good absolutely fine well that's you done let me bring this back down for you thank you so much
15:54my pleasure any problems come back if it's looking infected or anything well done you did a great job
16:00all right take care see you again yes likewise all the best take care
16:05all right
16:05hi paul it's reena from the fuller medical center
16:12paul can you hear me it's reena from the surgery from the surgery
16:23paul can you hear me hi paul can you hear me now it's reena from the surgery
16:31i'm getting more and more wound up before we couldn't hear me
16:39take a sip oh thank you thank you take a sip
16:45so any changes in terms of your symptoms are you feeling wheezy breathless yeah it's been fine this
16:51year i haven't really had the hay fever symptoms as bad as i you know used to usually when my
16:58hay fever's
16:58bad that's when i get wheezy and the breathing's bad unless i get a chest infection you know in the
17:03winter or unless i was running for the bus but because i've not really been getting the bus
17:08so i can give you an inhaler to keep at home to use just in case if you then you
17:14know become you
17:15know more wheezy more breathless the blue one is not really recommended anymore because it's not really
17:20treating asthma so it is more like to open up your airway to help you at that point to breathe
17:27so it probably works for about two hours or so but it wouldn't last for the whole day so it
17:32will
17:32be something called a symbicote has two ingredients in it a mild steroid to help to reduce the
17:38inflammation of your airway and also something to open up your airway compared to the blue one it
17:43opens up for a bit longer why would i not just have the blue one because the blue one is
17:48not treating
17:48asthma it's not really help so let's say if you're feeling wheezy likely your your airway is a bit
17:55inflamed that one wouldn't clear the inflammation it just opens up to help you to breathe it's scary
18:01when you can't breathe or your chest is tight so i think like when i was wheezy or if i'd
18:05run for the
18:06bus yeah and then it'd be tight then i'd take that and i think sometimes i used it as like
18:10a a panic
18:11you know like it was a panic reliever more than like anything else because i'd like my chest would be
18:17tight and then i'll take that and then i'd you know i'll think okay it's okay now could be psychological
18:22as well i think as well if you you know if you've got lots of stress going on as well
18:26and then you
18:26panic and or you're breathless i think it's big where i've come i've just become codependent on it
18:31yeah where it's like you know i just reach for it because i know like oh when my chest is
18:36tight like i
18:38have a puff if you're happy to i'll give you a new one yeah as a standby inside of the
18:44blue one like you
18:45like if you're catching a bus you feel breathless you can then do one puff and then maybe towards the
18:51winter time when you feel okay you do need that on a regular basis then give us a call come
18:57in we're
18:58gonna refer you to do another test that inhaler how you use it is you twist the bottom you'll hear
19:04a
19:04click you breathe out to empty your lung you then do a quick and deep breath in and then hold
19:11your
19:11breath for 10 seconds i'll send you a redo to watch but yeah in the meantime if you you know
19:17symptoms
19:17get worse any problem give us a call yeah okay okay yeah okay thank you no problem thank you thank
19:23you
19:29bye bye edward
19:36how's everything okay good come in have a seat i'm dr dutchin thanks for seeing me not at all what
19:42can
19:42i do for you today so i've been experiencing some sort of growing pain started off as sharp and painful
19:48when i stretched either backwards or when there was any pressure exerted and then that more focused
19:56pain i sort of around the belt like right there yeah has sort of expanded from pressure tenderness to
20:05more dull sort of numbing kind of pain slightly into the back yeah slightly down the leg and so around
20:14here it's just so much so that i feel i had to yeah come in because obviously it's progressed over
20:19about a week and is the pain there all the time yeah it is there all the time but mild
20:24and any pain
20:26down below is any pain in the testicles no no lumps that you felt nothing like that no okay do
20:31you mind
20:31if we have a feel of the tummy would that be all right take this jacket off all right just
20:35pop up on
20:36the bed i'm just gonna have a feel of that somewhere yeah see that's that's a little bit more sort
20:46of
20:46yeah around there yeah yeah i can definitely fit yeah that one's a little bit this side's fine nothing
20:55there okay so if it was this side that's obviously where your appendix is so unless you're one of those
21:00people that has things on the opposite side which is unlikely but you are quite tender sorry that's
21:06okay it's it's sore yeah okay relax keep your hands and feet inside the ride at all times
21:32and down here any pains yeah it does mommy's tummy's lovely and soft
21:38yeah a few times i feel like i'm gonna vomit and i can hear the bow sounds and they sound
21:43normal
21:43okay i'm just gonna press gently let me know if it's painful no i can feel it though but it's
21:49not
21:49painful good i'm just scared of eating because i know if i eat it will just go right through me
21:55any problems peeing going for a wee no rushing to the loo to do oh yeah yeah that's what we
22:01get on the
22:01older it's yeah really really good perfect that's absolutely fine thank you so much really good
22:07examination that's where it is it is really really painful maybe it's a strain or something
22:13you know i had a an aggressive game of paddle but that shouldn't do too much damage i mean you
22:19can
22:19strain a muscle do you think you could do a quick urine sample sure yeah whatever needs to be done
22:23i think then at least we can rule out any urine issue the toilet is literally just there if you
22:30just do that quick i'll just dip it
22:43and what about at night how's the pain being it's not kept you away no it hasn't kept me away
22:48so
22:49in the urine we're just looking for things like blood in the urine um unlikely to be a kidney stone
22:55from your symptoms but just to kind of rule out anything like that the urine looks completely clear
23:01though so there's no blood no white cells so that is good have a seat so where your pain is
23:08if it was
23:08on the right hand side i would be worried about your appendix because you are in quite a lot of
23:12pain
23:13it could be muscle strain but you are quite tender i think what we do is we sit on it
23:20for a few days
23:21i'm going to request an ultrasound just in case the pain doesn't go but if over the next few days
23:26you
23:27think it's worse then the next step would really be going to to a and e where they might do
23:31some
23:31imaging sooner you could definitely take some some paracetamol or something just to try and ease the
23:37pain and hopefully it will just ease off but there's nothing today that spells something urgent does
23:42that sound all right that sounds like good news and if it gets worse please come back will do all
23:47right
23:47thank you very much thank you very much have a great afternoon
24:00let me come around and say bye when are you going uh 20. where are you going to move oh
24:07wow three months
24:08i'm going silent oh spiritual jersey okay are you gonna go bold oh what you're a woman in one minute
24:16you should become a monk are you gonna become a monk mate okay no i'll see i'll see you in
24:22six months then
24:22okay good you know i pray for us praying for us yeah scarlet hello you're falling asleep on me oh
24:33you've
24:33got headphones on right thank you don't wait come on come on in we've got your injection to do today
24:40have you got your injection with you yes i have it with brilliant brilliant okay fantastic so this is
24:46it so this is your injection to help control the hormones to keep the hormones in check isn't it
24:52okay and how are you feeling in yourself today i'm feeling good good
24:57it's okay well let's do your injection let me just get it ready for you yeah and then if we
25:04can get
25:05some hormones and your hormones yeah let me just draw it up i want to make sure we get all
25:12of the
25:12medicine in here i have the family yeah fine but they're grown up already no they are they're getting
25:19bigger and bigger they change so quickly don't they yeah and all you ever want for them is them to
25:25be happy
25:25you know that's the only that's the last thing that my mother say i just want you to be happy
25:30did she your mother's no longer with us no no i mean i think that's all most mothers do and
25:35you are
25:36happy you say a lot of times i think it's exactly bits we can help with to make this better
25:40but good for
25:41you well look let's do this this week so we need to do it so we did it on the
25:44left last time so we'll do
25:46it on the right hand side okay so the right hand side is this one okay so do you want
25:51to lie down sit
25:52down or do you stand up how was easier you're happy to extending okay if we lift up that's brilliant
25:56it'll just be a sharp scratch straight into the bottom nothing at all okay i'll put that all on
26:04the computer and you still see your specialists at the hospital at all yes of course and they're happy
26:10with everything yeah yeah they're happy with everything what i can do is we'll do it again in
26:15three months are you okay for all your other prescriptions or you need some more have the hormones
26:19yes so we can do those i'll send all those down to your pharmacy so that will be ready straight
26:25away
26:26and do you want a prescription for the injection again and then you collect it and you're very
26:30good at doing that and i'll put a reminder on and you try and remember in between us we'll make
26:34sure we get it don't worry i do remember yeah thank you for everything so that's the prescription
26:40and the other one's gone to your chemist and i'll see you in three months if not exactly thank you
26:45and
26:45i want to see you like that nice and beautiful i don't know in november we'll be in some addresses
26:50but we can see no but you don't like like nice and with a nice figure you're very sweet thank
26:56you
26:56thank you very much and i'll see you in a few months any problems you ring us if you need
27:01to
27:02yes thank you all right thank you bye-bye nice to see you nice to see you
27:08i'm dr dudgeon nice to meet you nice to meet you as well so last week were you taking your
27:14dosset back to the pharmacy you know the box with your medicines in and why were you doing that because
27:20i didn't need any tablets okay i don't like taking pills if i'm not used to okay and do you
27:26know any
27:26of the tablets that were in there no no when do you think you last took them okay when i
27:31was in
27:32hospital to take my toes off did someone tell you to stop taking them no no what what made you
27:38decide
27:38to stop because there were tablets everywhere you felt there were too many i'm not used to taking tablets
27:43okay but you had been on them a few years hadn't you no no as long as i'm breeding i
27:49don't care
27:50can i talk through the medicines and why they wanted you to take them yeah okay so two of them
27:57one called aspirin and one called clopidogrel are to help your blood you know that you had a toe taken
28:05off yeah yeah that was because the blood supply to the toe wasn't great so because my toe was black
28:12exactly okay and so you're on those medications to try and keep the blood supply good to the rest of
28:18your
28:18body and then you're also on a statin have you ever heard of statins so cholesterol can build up fatty
28:25deposits in the blood the statins lowers that and again that's part of the trying to keep the blood
28:32flowing to all your toes and things the last one was a tablet called pregabalin which must have been
28:39for pain so normally for nerve pain do you have any pain no okay i mean i think if you
28:46have no pain
28:47let's stop the pregabalin and then you've got one less tablet but i'd ideally like you to take the
28:55other four four so the aspirin and the clopidogrel for the blood the statin for the cholesterol and
29:02then the lansopazole to protect your stomach from the other two i drink plenty of guinness that would
29:08keep it clear wouldn't it the lansopazole be good for the guinness too oh that's all right all right
29:15how much guinness do you drink three or four points a day okay and have you always drunk that much
29:20yeah
29:20i used to drink 14 points a day okay so you're drinking less much less yeah how do you feel
29:26your memory
29:26is it's all right when i need it yeah how would you feel about coming to see sam next door
29:33just for
29:33some blood tests and how would you feel if she did a test of the memory as well yeah yeah
29:39we could get
29:40that all i know some well with the doset do you feel now you know what they're for yeah they
29:45definitely
29:45want the tablets every day for the rest of your life to keep that blood flowing the rest of my
29:50life i
29:51have only a bit long left i was oh i think you've got a bit but the tablets will help
29:55all right
29:56should i help you back out i'm still alive
30:04just stand one sec i'm just gonna get the door
30:10you've done this before haven't you yeah a few times
30:20that's all booked tim yeah you can enjoy no thank you i don't drink you don't drink no
30:30i can have fun without a drink how do you do i just be a jolly person i don't know
30:36what that is
30:36well there you go that's why you have to have a pint and i don't thank you very much bye
30:47bye
30:48how can i help today i just cannot breathe okay i put my head down on the pillow and
30:55and all of a sudden i can't breathe all right so i have to get up and i do that
31:01hour after hour
31:03through the night i was a bit lucky this morning i put my head down at six o'clock and
31:09i woke up my
31:09half past seven okay that was good but mainly it's a lack of uh oxygen yeah you're feeling short of
31:17breath at night time two years ago i didn't have this problem last night i probably got up 20 times
31:24oh no so sleep really disrupted really disrupted absolutely how long has all this been going on for
31:29six months my body has got no energy especially here feeling tired my thighs as well yeah i can hardly
31:41get up you know but i feel like i'm not going to breathe no more scary isn't it you know
31:48really gasping for breath i just felt a bit desperate
31:51so i don't hear that
32:11did you have a sore throat before this cough i went to am7 and went and saw a concert on
32:15the night of the
32:16concerts i got a really really bad sore throat to the point where i couldn't even swallow like saliva
32:22have you had a look at the back of your throat oh mom has yeah yeah i did and it
32:26was weird
32:26it looked really weird you know like like see-through yeah apparently i'm saying it looked transnescent
32:30yeah okay it was weird it was weird you know so mama's freaked you out yeah your weird throat
32:34she's picked up a sore throat from me i think does it feel like you're swallowing sharp knives and things
32:40like that yeah open wide and set r black okay good it does look very sore back there it is
32:56come and have a seat i'm dr pearson hello how are you doing good thanks so i know you spoke
33:01to one of
33:01the gps yesterday but i wondered do you mind telling me what's happened and how are you feeling um so
33:06i
33:06don't know if it's related to my coil yeah basically i had it put in two weeks ago two weeks
33:11ago yeah so everything was fine it wasn't i just had normal symptoms yeah but i've been really ill
33:17since for a week now kind of like fluey and like i think maybe like throat cold just feeling like
33:26really bad like my glands are bad i've had tonsillitis a few times okay but i have actually
33:31had my tonsils taken out ah so it must have been bad for them to take them out because i
33:36was like
33:36five when i had them out i was always like choking on food and stuff because they were so massive
33:41and have you had fevers this time i think i actually don't know doesn't matter but if you
33:45got hot and sweating yeah like right now i'm literally like sweating and at night and then
33:50yesterday by the afternoon i was like freezing okay and tell me about the core so the coil's gone in
33:55is it your first coil yeah before is it the Mirena the hormone one okay any people often have
34:01bleeding at the beginning are you having a little bit any discharge or discomfort or anything is it
34:05and pain anywhere so yesterday there was a bit of pain which made me think so normally with the
34:13quality of two weeks into it if it was to have introduced infection or say we'd know about it
34:18normally and we'd have discharge and bleeding and lots of cramping your womb would be trying to get rid of
34:23it like yeah okay good pain sort of proper cramping pain good if you're not feeling that it's probably
34:29more related to all of this that we're doing whatever and i think can i just put my hand
34:33on your tummy just to be sure about you so i'm always just a bit paranoid with it just have
34:37a lie
34:37down on here i just want to press really gently so just tell me if there's any pain as if
34:42i press
34:43no no no no pain here no so normally if there was thing that would be really sore and it's
34:51not okay so
34:52your tummy's nice and soft so let me just check your temperature now 36.3 is that okay so that's
35:01okay okay really so even though you're feeling sweaty and things the temperature is good let's
35:06have a look in your throat and see you open wide for me and say oh it's very red at
35:10the back there
35:10really red and actually as you tell there are some white bits at the back at the very back
35:18and the roof of your mouth yeah and if you just say ah yeah that does look really sorry it
35:23looks
35:23like someone's been rubbing it with sandpaper can i just have a feel of your glands in yeah as well
35:27let's just have a feel it just tickles you know yeah you're quite right look at that great big lymph
35:33nodes yeah in there isn't it yeah i think we've got a clear source of where this is coming from
35:37why
35:37your feet if it looked all normal i'd be more worried about the core but your tummy's soft
35:41yeah it does look really sore i wonder if antibiotics actually might make you feel a bit
35:44better yes i i think i don't know how you feel about them some people are really happy to me
35:49let me do it and i'll send them what i'll do is i'll send them straight to pyramid pharmacy lots
35:52of
35:52vitamin c salt water gargles onto your paracetamol and things like that just to control any sweating
35:57and it'll make you feel a bit better and the antibiotics will kill it all off and any other
36:00problems or anything weird or wonderful come straight back and see us yeah we'll do thank you
36:04you feel better take care good luck all the best bye bye
36:09i just felt a bit desperate yeah well you've definitely done the right thing so i'm glad
36:13you came in 100 now obviously with everything that's going on with your heart and all the
36:19medications you're on so maybe there's a bit of a progression in the heart failure side of things
36:26how are you getting on with your tablets i'll tell you the one pill that seemed to help me
36:31yeah was feruzumide yeah some doctors said about it clearing me lungs it does indeed yeah
36:38offload some fluid would it be okay to examine you today to have a listen to your breathing oh
36:43yes john is a lovely 86 year old man who i've known for about three and a half years now
36:48i've been
36:49involved in his care since the time of his diagnosis of heart failure in heart failure the effectiveness
36:54of the heart to pump the blood around the body is reduced and get backtracking of the blood into the
36:59circulation and a build-up of fluid around the lungs which can cause shortness of breath especially
37:03at night and a build-up of fluid around the legs which can cause leg swelling and that can be
37:07quite
37:08painful and uncomfortable and what do you think is going on what do you think is causing all of this
37:11i can only think of the phlegm in me lungs you know yeah it gets here yeah and then it's
37:19like it's
37:20cutting off the airflow you know yeah i understand your oxygen levels are very good 98 and your heart rate
37:26is normal at 62. are you able just to take your jacket off is that all right thank you nice
37:33deep
37:33breaths if you can lovely
37:43perfect and i'm just going to listen to your heart now
37:48lovely absolutely fine good really really good your chest sounds really clear so there's good air
37:52entry throughout no no yeah everything you're saying sounds like there is a build-up of fluid
37:58around there yeah but when i listen in it's crystal clear there's no fluid that's good news it is good
38:03news but it then makes me wonder what's the best thing to do moving forward for you so i think
38:09what
38:09we need to do is maybe ask the heart doctors again for a bit of help because i'd be really
38:14reluctant to
38:15play around with your meds and in the meantime if you're finding that the higher dose of the feruzamide is
38:19helping it's perfectly fine to have one tablet at eight in the morning and one at midday i'll do an
38:25urgent referral because i want them to see you quickly the heart doctors just to see i don't want
38:30to get slower and slower exactly exactly i'd rather be out the game you know oh no i don't know
38:36what you
38:36mean horrible i know what you mean i know what you mean i just you know yeah it's really tough
38:41with
38:42this condition it's really difficult as long as i can get on a bus that's all that matters to me
38:46yeah well
38:47let's aim for that let's let's see if we can get you a bit stronger okay any questions before we
38:52go
38:52no no i've got the team my wife kills me if i don't ask the right questions that's good absolutely
38:58she keeps you right that's good are you guys managing okay at home yeah yeah you don't need
39:02any extra help or anything no but the way i'm going it won't be long well if you do let
39:08us know because
39:09there's lots we can do for help yeah yeah don't don't suffer in silence i will remember that yeah
39:14i do let me help with that there you are thank you take care look up thank you all right
39:19my pleasure
39:19you're very welcome take care
39:27reena yes if you could only eat food for the rest of your life there was a certain color what
39:32color would
39:32you pick food one color for the rest of your life yeah but is it like if i say black
39:37can i have a black
39:38tomato yeah red what do you think that's red it's a weird weird option are you just thinking tomatoes
39:52afternoon surgery how are you doing i hear you've been in the wars i keep falling over i hear
39:58my neighbor i called for him i got up and i was okay i turned around to do something i
40:06fell over again
40:07and then i just couldn't get up i just black out i don't you don't feel it coming on no
40:13no and when
40:15you wake up i just lie there and i think what in godsend am i doing down here it's not
40:20always when
40:20you're turning or anything like that yes sometimes that but um last time i actually hurt myself
40:28when i fell because i fell over the threshold of the house and the garden and i had terrific pain
40:35down here they're not always when you get up like getting up from the loo or getting up from a
40:40table
40:40that you might be sitting at you don't you know i no i can't say i do yes now wait
40:46a minute somebody
40:47was in the house and i had to speak to them and i got up but i got up very
40:52quickly and i think that didn't
40:54help and then i held on to the side while i'm okay let me let me do my blood pressure
41:01yeah not mine
41:02but yours with my machine and how are you doing otherwise i'm fine birthday birthday next week yes
41:12i've got my great grandchildren coming tomorrow lovely and you cope on your own okay generally don't
41:17you're very independent yeah just want you to stand up for me and do it again
41:29no drop sometimes people get a drop when they stand up and that can be a cause of falls and
41:34things so
41:35that's important that there isn't drop no but we're still going to continue because there is a falls
41:43clinic in the hospital which investigate and i think you probably need to really get on their list
41:49because i know you've had little tias in the past as well and also they can test whether it's your
41:55balance you know when you're turning does that do it but generally one doesn't black out completely if
42:01that's happening but that is doesn't frighten me anymore because i never hurt myself except last time
42:07yeah and that's when somebody said oh you ought to get one of those things around your neck well you
42:12do yeah do you want me to no i don't really want to do that you know if you're on
42:17your own and the
42:18neighbors aren't one-sided you know when you can't get through and you're in the house you're lucky you're
42:23in the garden and they were around um well and my grandson is coming next week for my birthday and
42:30i want
42:31him to fix a a grabber at the side of my door so i can pull myself to get someone
42:37who else independent
42:38to do things like that if you want as well yeah someone to come around occupational health type
42:44thing and they'll come and visit and they'll assess oh i need somebody like that i'll mention it to them
42:49as well i'm going to do a forward referral anyway it needs investigating and i will chase up the
42:56appointments okay yes thanks very much nice to see you take care thank you bye now bye as always lovely
43:06so lovely to see you likewise yes i'm glad you're doing well thank you take care bye bye thank you
43:11very much all right well well done nice to meet you yeah good luck with your ai thank you thank
43:16you very
43:16much thank you so much thank you good afternoon yeah bye-bye
43:23you
43:48so
43:58so
44:18The pain has been getting so bad, I'm looking at all the girl. Okay. Well, that's not acceptable is it
44:23the hallucinations must be upsetting
44:25It's horrible. Don't frighten me that much, but I remember speaking to you once when the dogs were there and
44:29it was horrible and they were her snakes were even worse
44:33How have you been terrible? Oh, no, what I must sit on this hurtful
44:55You
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