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00:06Last week it was a really bad smell coming from right here. Like really, really bad.
00:14We have cockroaches, we have mice, sewage coming out, bathrooms coming up in the kitchen,
00:20these things and it's constant. It moves around doesn't it? It's like water inside
00:28process. Yeah it does, it feels quite squishy doesn't it?
00:33If you're gonna die, you're gonna die. Get out and enjoy yourself. Don't call me and wait
00:38for death. Get out and enjoy it. That's why I look at it. Very positive, I like it.
00:46One of the biggest things that predict outcome is often motivation, but you're the most motivated
00:50person I know. It's really frustrating. Here she is, isn't it? Yeah.
01:10Morning! Morning!
01:13Morning!
01:28Good morning, Circe.
01:32Claire, please.
01:36Hi.
01:37Hello.
01:38I don't think we've...
01:39Have I seen you before?
01:40Dr Prestwich.
01:41You look familiar.
01:42Have you seen my...
01:43Maybe my children?
01:44Perhaps, yes.
01:45They're usually the ones...
01:47The main ones to worry about.
01:49Exactly.
01:50How can I help?
01:52I've had this weird lightning pain,
01:55sort of across here.
01:58I saw my cousin, she does some therapies,
02:00and she said to me,
02:02oh, yeah, that's that.
02:03And I can't remember what she said.
02:05But combined with the headache,
02:07and then I had it this morning,
02:09and it sort of comes and then it goes.
02:10If you feel my head, this side,
02:13it's a bit swollen.
02:15Okay, so the headache started...
02:18This morning.
02:19This morning.
02:19I took some Nurofen,
02:21and I've taken Paracetamide,
02:22and it's still, I can feel it's still there.
02:25If I had just had the headache,
02:27I wouldn't be so worried.
02:29But it was this electrical thing.
02:31I get it about twice a week.
02:33So like a zapping kind of sensation?
02:36Yeah, exactly.
02:36Does that feel deep or superficial?
02:38Deep.
02:39Deep, yeah.
02:39Okay.
02:40Any sensitivity to light or sound?
02:42I mean, I live with three children,
02:43so I think I've got sort of noise PTSD,
02:47but not particularly.
02:49Okay, all right.
02:50Let's examine you now,
02:51do some observations.
02:53Just keep your head still,
02:54and try and follow the shiny bit of my pen, please.
02:58Any double vision?
02:59No.
03:00The eye movements look normal to me,
03:02so right now you're going to look at me again,
03:06cover that eye.
03:08Great, looking here.
03:09Tell me when you see my fingers moving.
03:11My cheating.
03:11Looking at my nose?
03:13Great.
03:14No.
03:15Okay.
03:16Yeah.
03:17Yeah.
03:18Yeah.
03:19Okay, all right.
03:20So just close your eyes to me.
03:21Can you feel that touch on your forehead?
03:23Mm-hmm.
03:23Does it feel the same on both sides?
03:25Yeah.
03:25And here?
03:26Mm-hmm.
03:27And here?
03:28Yeah.
03:28Okay, you can open them now.
03:30So we've just tested cranial nerves.
03:31The only thing I haven't done
03:32is looked in the back of the eye,
03:34which I would like you to get done
03:35with an optometrist for an eye check
03:37and an eye health check.
03:38Mm-hmm.
03:39This is the most thorough exam I've ever had.
03:43Usually it's, can you take two paracetamol?
03:46Well, that's probably going to be the advice,
03:47but let's see.
03:50I'm just going to pull on you.
03:51Does that feel okay?
03:51That feels nice.
03:53What, was it improves your headache?
03:55I like, I like that.
03:57Yeah.
03:58Can I just check the other side for comparison?
04:00Yeah.
04:02And that all looks fine too.
04:04I mean...
04:05Okay.
04:07I don't think there's anything worrying going on.
04:11So, you know, sometimes when a headache comes on
04:13really, really suddenly,
04:14we think, is there something going on in the brain?
04:17It doesn't sound like that kind of headache
04:18and there's no neurology to go with it.
04:20So I think the most likely headache
04:22that you're experiencing at the moment
04:23is a tension headache,
04:24which is where the head is essentially being squeezed
04:27by the muscles and soft tissue around the head
04:29because they're being pulled on
04:31by muscles in the neck, shoulder and back.
04:34So that squeezing pressure,
04:36as well as being painful,
04:39can give some other symptoms as well.
04:42Yeah, this is day one of this headache.
04:43There might not even be a day two,
04:44but if there is,
04:45I'm going to give you a headache diary
04:47and we can start logging things.
04:48If anything changes, we can, you know,
04:50we can review it.
04:51Is that okay?
04:52Yeah, that's great.
04:53And, yeah, do come back to us...
04:55...if these headaches don't settle down or get worse.
04:58Thank you so much.
05:00Pleasure.
05:00Bye.
05:01Take care.
05:01Bye-bye.
05:06Sophia?
05:07Hi.
05:10Come on through.
05:12Come and take a seat.
05:14My name's Emily.
05:15How are you today?
05:16Very good, thank you.
05:18How are you?
05:19Good, thank you.
05:21How can I help you?
05:22So I've come in, I think, for a swab test...
05:25Yeah.
05:25...for an endometriosis diagnosis.
05:28So you've spoken to the doctor about this?
05:29Yes, yes.
05:30This is kind of the preliminary part of it,
05:33so I've already been in for an ultrasound as well.
05:37Perfect.
05:38Are you currently using any form of contraception
05:41or hormonal pills to try and regulate everything?
05:43No.
05:44Okay, great.
05:44So what we would normally do for this is two types of swabs.
05:50We'll do a swab to check for thrush and bacterial vaginosis,
05:54just to see if there's any infections there,
05:55and then also a swab for STIs,
05:58so we look at chlamydia and gonorrhea specifically.
06:00Is that okay?
06:01Brilliant.
06:02So if I could ask you, please, just to remove everything
06:04and then head on the pillow and paper towel over your waist.
06:08Are you ready?
06:10Yes.
06:10Perfect.
06:12What have you got planned for the rest of your day today?
06:15I'm actually going into work.
06:17What do you do?
06:18Marketing.
06:19So, yeah.
06:20So is that all on, what is that, on like social media?
06:22Yeah.
06:22Or...
06:23So it's like Instagram, TikTok.
06:25Well, it goes over my head.
06:27I know it's such a great sort of use of like pre-advertising
06:31and things like that, but I...
06:33It's got a good mix of different things in it.
06:35It's always good to hear when people enjoy their jobs.
06:37Yeah.
06:38Okay, so if I can get you just to drop your knees outwards
06:41to whatever feels like a comfortable position for you.
06:44That's brilliant.
06:45Just opening up the speculum.
06:48Doing really well.
06:49Are you okay?
06:50Yeah.
06:51Okay, first swab.
06:53Done.
06:55And then last swab.
06:58All done.
07:00Well done.
07:00Perfect.
07:01You did so well.
07:02Are you okay?
07:03Yeah, all good.
07:09Well done.
07:13Brilliant.
07:14Well, give us a call on Monday.
07:17We will go through your results.
07:20Any issues, just let me know.
07:21My name's Emily.
07:22Perfect.
07:22Thank you so much, Emily.
07:23Good luck with everything.
07:26Have a good day.
07:27You too.
07:31I'm always getting some weird stuff sent to my email.
07:34Every time I open my emails, I'm always seeing cats and dogs.
07:37I don't know what it is.
07:38Now I've got a horse.
07:39Oh, my God.
07:41I've got a badge.
07:42Must be some group thing.
07:43I'm going to reply to one of these.
07:45I'm going to go, that's a cute cat.
07:48No, they are so cute.
07:50Come and have a seat.
07:51Thanks for coming down.
07:53Thanks for seeing me.
07:54Now, how are you?
07:56Not great, to be honest.
08:00Yeah, I'm going to try not to cry, but I feel like I'm already starting.
08:06Just take your time.
08:07Don't worry.
08:10I know you've had a really tough time, haven't you?
08:36Let me say, while you have a minute, that you've had the horrible long COVID, haven't you?
08:40And you had COVID, I think, was it July or something, 2021?
08:43It was a while ago, wasn't it?
08:45Yeah.
08:45And it really knocked you for six, didn't it?
08:47And then you were under all these sort of specialists and it's affected all sorts, hasn't it?
08:50Yeah.
08:50Over the course of three years, built up to working 30 hours.
08:55And then I sort of burnt out, which just wasn't functioning well.
08:59And I decided I needed to go on sick leave.
09:02Yeah.
09:03But it's been really hard and I got COVID again.
09:05I can't believe this.
09:06That's the second week.
09:07You are the most unlucky person.
09:08And I didn't even go anywhere.
09:10Where did you get COVID?
09:11My boyfriend.
09:12So he's going into the office every day and poor thing, he came home with it.
09:16I mean, it's easily done, isn't it?
09:18It just shows it doesn't matter how many people you see, you only see one.
09:21Exactly.
09:21But you can't put yourself in a rubber ball and, you know, never see anybody ever.
09:26Yeah.
09:26That'd be ridiculous.
09:27I think that's the fourth time.
09:29And so it's been, instead of sort of recovering from the burnout, I've been recovering from COVID because it hits
09:37me really hard and I get all of the symptoms.
09:41So each time you get COVID, it sort of brings you back to square one again.
09:44Yeah.
09:45So like I've got stomach problems from COVID, which I've seen a consultant about.
09:49And that was sort of, you know, I was tapering off the medication.
09:52I'm now back on the full medication.
09:55So poor Emma had COVID quite badly early on in the pandemic and it resulted in leaving her with some
10:01huge amount of symptoms of long COVID.
10:03She's fatigued, she's dizzy, she just feels really unwell and it's required her, she hasn't been able to work.
10:07She was just getting everything back on track and getting back into work and then she got COVID again.
10:12And unfortunately, that's been a bit of a setback.
10:15I'm hopeful that it's not going to be as big a setback as perhaps it was first time and that
10:18she's got the support from the long COVID clinic who are really helping her.
10:21And hopefully with the support from us and from them, we can get Emma back on track and back into
10:26work, which she's desperate to do as soon as possible.
10:29Yeah, it's been really hard.
10:30And I'm just sort of a bit scared of going back to work, actually, because it was it was really
10:38hard when I stopped sort of being able to function properly.
10:43And I'm just, yeah, and it's also a lot to sort of accept that I don't think I'm going to
10:51be able to work full time.
10:52I mean, the good thing is that you have got better.
10:56You know, you were functioning, working 30 hours a week, you know, really picking up.
11:00And then it's gutting that it's happened.
11:02And maybe we can learn something from that.
11:04And if you say you've got burnout, well, what may be caused that?
11:06Can we look back and think, well, how can we prevent that coming?
11:09Did we go up too quickly?
11:10Did we were you doing too much outside of work?
11:13Was it, you know, were you not doing enough outside of work?
11:15You know, we can look at that and try and perhaps explore.
11:17And I remember someone once describing COVID, long COVID to me, that most of us wake up in the morning
11:21with our battery full and we're ready to go for the day.
11:23And you're waking up and you haven't been charged all night, so you've only got that little bit.
11:27And if you do too much, you're out, you're drained and you can't.
11:31So it's just sneaking in while you slowly build it back up.
11:34But you did build it back up last time, so it does work.
11:37Yeah.
11:38The one thing is that if you're not ready, you're not ready.
11:43And if you go back too soon, it won't work.
11:46Yeah.
11:46If you'd broken your leg and it was a physical injury and you had a physical job, you'd be like,
11:50well, I can't work.
11:52And because we can't see it and you look lovely and healthy, that you sort of look in the mirror
11:56and think, well, I should be okay.
11:58But it's not.
11:59It's a problem.
12:00One of the biggest things that predicts outcome is often motivation.
12:03And if someone's not motivated to do something, it's really hard to get better.
12:07But you're the most motivated person I know.
12:09So I honestly think we'll get there.
12:11It's just a slow, ploddy road.
12:14Frustrating.
12:15It is, isn't it?
12:16Yeah.
12:17But you've done it before.
12:19And you've got up to 30 hours a week and you're brilliant.
12:21And your employer, I can tell you now, they would have booted you out if they didn't think you were
12:23worth having back.
12:24So the fact they're being so supportive means they want you to come back.
12:27It's just we have to do it carefully.
12:29Okay?
12:30Yeah.
12:30All right.
12:31Well done, sweetheart.
12:32Well, listen, good luck with everything.
12:34Don't forget your brolly.
12:35I think you might need it.
12:36Thanks so much.
12:36Well done.
12:37Not at all.
12:37It's nice to see you.
12:38Take care.
12:39All the best.
12:39Bye-bye.
12:40Bye-bye.
12:43So my name's Safa.
12:44I am doing your blood test today.
12:47And it's just all routine bloods for you today.
12:49So we're doing like your full blood count, your diabetes, cholesterol, liver, kidneys, thyroid.
12:53We've got your vitamin D in there and your B12 as well.
12:57Amazing.
12:57And also your ferritin.
12:59That's also added.
13:01Okay.
13:01So which arm is usually best for bloods?
13:04You've got lovely veins.
13:06Whichever one you would prefer me to go into.
13:09I mean, this is my mousing hand, so maybe that one.
13:11Yeah, that's fine.
13:12I cycled over, so everything should be like ready to pump out.
13:17That's good.
13:20Does Sam still work here?
13:21Yeah, she does.
13:22She's actually on leave at the moment.
13:24Yeah.
13:26Slight scratch.
13:27I only actually became a HCA just one year ago.
13:32Before that, I was a phlebotomist as well.
13:34I can do bloods, blood pressure, ECGs, vaccinations, diabetes checks.
13:40I think when you work as a receptionist, obviously you do get that one-to-one, but I think it's
13:46just that one-to-one in the room.
13:48Yeah, I love my role as a HCA.
13:50I remember coming here when I turned 40 MOT.
13:55Okay.
13:56Because Sam gave it to me.
13:58She was so funny.
13:59Because I got like an A-plus on my report.
14:02That's good.
14:03And she was really impressed.
14:05And I was like, okay.
14:08That's so funny.
14:10So if everything went fine with it, then it's usually every five years that you're called
14:14in for another check.
14:15That's all done.
14:16I'll just take the needle out.
14:24So with the results, they should be back maybe by Wednesday or Thursday.
14:29We say give us a call.
14:30Anything urgent, a doctor will be in contact straight away.
14:35Okay.
14:36All done.
14:36Beautiful.
14:37Thank you so much for your time.
14:39You're welcome.
14:39That's okay.
14:40Have a super day.
14:41You too.
14:46Oh, is that delivery?
14:48Oh, yes.
14:48It's been delivered.
14:50It's been delivered.
14:52What is it?
14:53Let me have a look.
14:54It's so cute.
14:55That.
14:56I like it.
14:57I've got my heels as well.
14:59I'm wearing my long, my thick black heels.
15:01Oh, my God.
15:02Why are you considering buying stuff?
15:03It's been delivered.
15:04I'm so happy.
15:09Hi, Ho.
15:10Hello.
15:10Come on through.
15:12Good morning.
15:14Maybe good.
15:15Maybe good.
15:15We're at London weather.
15:17Come and have a seat.
15:18How are you?
15:19I'm more happy to visit the museum than GP.
15:21Okay.
15:22Well, tell me, what's brought you in, though, to see us today?
15:25Sorry, I used Google Translate a little bit.
15:26That's okay.
15:27Let's have a look.
15:27Swelling on the neck that appeared a month ago.
15:29Okay.
15:30Painful?
15:31It's not painful like cutting.
15:35Okay.
15:35Like you burn your skin.
15:36Yep, yep.
15:37And when I put my neck like that.
15:39Then you can feel it.
15:40It looks like I have ping pong ball inside.
15:43And any problem swallowing?
15:45Little bit.
15:46And food?
15:46You can eat food, okay?
15:47No, food is okay.
15:48Okay.
15:49But it's happened no long time ago.
15:51It's six, seven.
15:52Six, seven weeks.
15:54Weeks.
15:54Come and have a seat on here.
15:55Let's just have a look at it.
15:56Okay.
15:57We can have a look and compare left and right.
15:58So that side is quite flat.
16:01And that side, there's quite a bulge, isn't there?
16:03Can I press it very gently?
16:04Yeah, yeah, yeah.
16:17A little bit.
16:17Okay, then it's pulling.
16:20It's pulling because it's attaching to the muscle, perhaps, and pulling a little bit.
16:23Let me just have a listen.
16:25I don't think it's got any blood in it, but let me just check.
16:30No, it's fine.
16:33No.
16:34Can't hear anything in there, which is good.
16:35And it's funny, and it's been there so much, and it's growing.
16:39Okay.
16:40Come and have a seat.
16:41Come and have a seat.
16:41Let's just have a chat.
16:42Is it lymph or not?
16:45So a lymph node?
16:47Because you know why I'm afraid?
16:48My wife has cancer.
16:49Oh, dear.
16:50Yes, I'm sorry.
16:51And she has operation the same.
16:52Okay.
16:53And the doctor checks under and there as well.
16:55And I'm in panic.
16:56Maybe I have the same problem.
16:58How is your wife?
16:59You mentioned your wife is pulling.
17:00The doctor guarantees five years' life.
17:03No more, but if lucky, it will be more.
17:06Okay.
17:06But five years is gone.
17:07Wow, and she's still okay?
17:09Yeah, yeah, because we have a lot of chemical and radiation.
17:13Okay.
17:14And she loses her immunity.
17:17Yeah, but it doesn't matter.
17:17This is life.
17:18Well, it's difficult, though, but I can understand why then you'd worry if lumps and things come up.
17:23We need to check.
17:23So it doesn't feel like a lymph node, because normally a lymph node is a bit firmer and is smaller.
17:29This feels more like a sort of what we call a fatty lump, perhaps a lipoma.
17:34Before it starts, this one starts growing as well.
17:38Maybe it's going there.
17:39No, you see this one.
17:39Let's have a look.
17:40So this is a small cyst here as well, isn't it?
17:42It starts from there.
17:44After that, it's going there.
17:45So this one first and then this one.
17:47That's interesting.
17:48But this one's going up when I have blood pressure 200.
17:52Okay.
17:52And after that, it starts going like pain a little bit.
17:55Okay.
17:56I don't know.
17:56It's together or separate.
17:57How long do you think the lump at the back of the head?
18:00How many weeks?
18:01Is it months?
18:03No.
18:03It's years.
18:04Years?
18:05Okay.
18:05Because first time, you know, when this problem starts, you start scratch like a mosquito bite you.
18:11After that, you start questioning, what is this?
18:13Because I don't like hospital, you know, and I come in to you because wife tells me, get out.
18:19Yeah, yeah.
18:19Good.
18:19Your wife is quite right to send you to us.
18:21I genuinely don't think this is anything cancer-y or horrible, but I think we should do a scan, an
18:27ultrasound scan, and check both the lump on the back of the head and the big one here, and just
18:31make sure what's going on.
18:32Okay?
18:33The important thing is, when lumps come, you come see us.
18:36We'll make sure it's all right.
18:37Okay, thank you.
18:37Okay, don't you worry.
18:38We'll do the scan.
18:39We'll get an appointment and check.
18:40Okay?
18:41Take care, Scott.
18:42Bye-bye.
18:42Nice to see you.
18:43Was it done?
18:44No, no, it's fine.
18:49Oh, well.
18:50Shall I just turn it off and on again?
18:53Yesterday was your printer.
18:54I know.
18:54There was paper.
18:55Yeah.
18:55Replace drum.
18:56I've done all that.
18:58Everything is brand new in here, so this should not be.
19:01So maybe we'll need to just turn it off and...
19:04All right.
19:05I'll turn everything off and on.
19:06How do I do that?
19:07Is this it?
19:10No.
19:12Yeah, let's see.
19:15Oh, you're a lifesaver.
19:17There you are.
19:17Thank you so much.
19:18That's perfect.
19:19I've brought all the others away.
19:25Hello.
19:30Good morning.
19:31Hi.
19:32How are you?
19:33All right.
19:35I have a seat.
19:37Yeah.
19:38How's it going?
19:39What's been happening?
19:41Yeah, I just recently, I feel dizzy.
19:44Yeah.
19:44And the last time, last Thursday, so after that, I just lie down in bed.
19:52Yeah.
19:53And when I lie down, I feel, oh, it's worse.
19:56Yeah.
19:56The room is spinning.
19:57Yeah.
19:57Yeah.
19:58Next day, I feel, oh, it's gone.
20:00Okay.
20:01So I'm lazy and also I'm working.
20:04Yeah.
20:04Yeah.
20:04What work do you do?
20:06Uh, barista.
20:07Okay.
20:07Yeah.
20:07This is why sometimes I'm worried.
20:10I think I will have a problem because it happened maybe about more than one month ago.
20:15Same thing?
20:16Yeah.
20:16The same feeling.
20:18And any other symptoms?
20:19Otherwise, you're, well, your toilet is okay.
20:23Yeah.
20:23Your appetite.
20:24I have no problems.
20:25You have no ear issues?
20:27I don't have.
20:28Any sore throat, ears?
20:28No.
20:29All okay?
20:30No.
20:30I'm thinking maybe high blood pressure.
20:34We can check.
20:35Can you take your jacket off?
20:38My mother has had these problems.
20:44High blood pressure.
20:46And after that, she had stoop.
20:48Yeah.
20:50On February, my birthday, my memory is gone for about 10 minutes.
20:55Yeah.
20:55He brought that back home.
20:56Yeah.
20:56Yeah.
20:57Yeah.
20:57I couldn't remember anything.
20:59This was in February.
21:00February, my birthday.
21:02Went out, celebrated, and I lost my memory.
21:06We can't say for sure that it isn't a vascular event, something to do with the brain and the vessels.
21:14So if it is happening acutely, go to hospital, get seen that day.
21:37If this keeps happening, it's not a good thing, and it may be something benign, something called benign positional vertigo,
21:45or it could be something else vascular which needs investigation.
21:50I'm going to get you to lie on here with your head, just to get you to lie on here
21:55with your head, just to see your head really high up, over the edge.
21:57Yeah.
21:58And keep your eyes open.
22:00Okay.
22:01I did an examination called the Hawke-Pike Maneuver and Treatment, which is Anthony's Maneuver.
22:08And the Hawke-Pike Maneuver is to look for benign paroxysmal positional vertigo.
22:15Fairly quickly, we're going to sit on the end of the bed, keeping your eyes open the whole time.
22:21Keeping your eyes open.
22:22The idea of the Maneuvers are to realign the crystals in the middle ear, and therefore realign the brain to
22:32think that you are now not dizzy.
22:35Any different?
22:37Still feel this side is heavier than this side.
22:41Yeah.
22:41Check your ears out.
22:46So, feeling sick at all, and dizziness right now?
22:50Well, your ears are mildly inflamed, that side.
22:56No.
22:58Well, that ear is...
23:02Did it tickle?
23:03Yeah.
23:04That ear is a little bit inflamed, and it could be distabling your balance control.
23:11Yeah?
23:12Come and have a...
23:13Just be careful in case you do.
23:15And you said you'd maybe had a memory loss that was in February, briefly.
23:21Yeah.
23:22I don't know why.
23:24And you didn't do anything about it?
23:26The same.
23:27I'm lazy.
23:30Because with vertigo, it can sometimes be a tiny little vascular event, and what you're describing, where you've lost your
23:38memory, that can be a vascular event, too.
23:41What's that mean?
23:42Vascular is to do with your vessels inside your head, brain, you know, arteries, veins, that sort of thing.
23:51And if there was a small little clot or something, tiny, tiny, it can affect your balance.
23:58I can give you tablets, which can help, but they're kind of masking the symptoms.
24:02If it was me, I'd probably want to have scans and things like that.
24:07So I'd refer you.
24:08Yeah.
24:09Yeah.
24:09There is something called a dizzy clinic, which is very good.
24:12We'll do blood tests, general ones, anyway.
24:15So they're going to give you a form for the blood test at reception, and we should talk when we've
24:20got the bloods.
24:20So if you go today, I'll have them next week.
24:22I'll give you a call next week, and we can discuss.
24:24Yeah?
24:25But I'm going to do the referral anyway.
24:27If you get the vertigo again, badly, where you're vomiting, you should go to hospital for it.
24:34Okay.
24:35You know, you've had it three episodes so far, which I can't really explain.
24:39I've tried to treat you today for this vertigo.
24:43Has it made any difference?
24:45Do you feel any different from when you came in or not?
24:47Not really.
24:48Not really.
24:48Yeah, fine.
24:49Then it needs investigating.
24:51Thank you so much.
24:51All right, you're welcome.
24:52Have a good day.
24:53I really appreciate it.
24:54No problem.
24:54Take care.
24:55Get to the phone.
25:01Harry, please.
25:02Yeah.
25:02Hello.
25:03Sorry for the wait.
25:04Don't worry about that.
25:04Come through.
25:05Oops.
25:07How are you doing?
25:08Oh, painful at the moment, Doc.
25:11Take a seat.
25:15Right, what are we doing today?
25:17It seems to have happened this morning.
25:18Yeah.
25:19But at the end of it, so.
25:21Okay.
25:22That's it.
25:23There's nothing else.
25:24So there's soreness on the tip of the penis?
25:26Yeah.
25:26Yeah, fair enough.
25:27Just since this morning?
25:28Yeah.
25:28Fine.
25:28Okay.
25:29Take a seat.
25:29Yeah, make yourself comfortable.
25:30Have a bit of a chat first.
25:31Yeah.
25:32And how do you feel in yourself?
25:33Any pain in your tummy or around the bladder area?
25:36No pain in stomach.
25:38No round there at all.
25:40Good.
25:40Nothing.
25:41And any skin changes anywhere on the body other than on the tip of the penis?
25:44Just on the end.
25:46Yeah.
25:46It's better when I'm walking.
25:47That's the trouble with this.
25:49I just wonder if you have any.
25:50We'll have a look and see what we can do for it.
25:52Can I get you on the couch?
25:54I'll close the curtain and I'll come in.
25:56Is that all right?
25:56Yeah.
25:57Leave me out here.
25:58Yeah, please.
25:59That would be great.
26:02All right.
26:03Take your time.
26:03If you lie on your back and then just lower your bottom things and let me know when you're
26:08ready and I'll come through.
26:12Are you comfy like that?
26:14Lovely.
26:14Right.
26:14Let's have a little look now then.
26:16So all you need to do is just lower this.
26:17Is that okay if I help?
26:18Yeah.
26:18Very well.
26:23Oh dear.
26:24That is a bit red, isn't it?
26:25Yeah.
26:25It's flamed.
26:26I think it's just a bit of a fungal infection.
26:29Is it?
26:29Yeah.
26:30I'm going to give you a cream for that and that should settle it.
26:33You apply it twice a day for two weeks and that should sort it out.
26:37Just on the end.
26:38Exactly.
26:39Just on the...
26:39Where it's sorted.
26:40Pull the skin and back.
26:41Yeah, exactly that.
26:42All right.
26:43Yep.
26:43You're sorted.
26:44All right.
26:46You're done?
26:47Lovely.
26:47Great.
26:47Come through.
26:48So it's a skin condition called balanitis.
26:51Yeah.
26:51It's just a very little infection which we can easily treat.
26:54Yeah.
26:54Really good to keep hygiene standards high.
26:57So make sure you're cleaning everything, changing your underwear, all that kind of stuff every day.
27:01Yeah.
27:01And that should really help as well.
27:03But I'll give you the cream.
27:04I'll send it to the pharmacy and you can collect it today.
27:07Okay.
27:08All right.
27:08Any questions for me?
27:10No.
27:11No.
27:11As long as I can get that stuff this afternoon.
27:13Yep.
27:14Absolutely.
27:14Start with that on the end.
27:15Yep.
27:15Give it a go.
27:16If it gets worse or it's not helping.
27:18Is it two or three times a day you do it?
27:19Twice a day for two weeks.
27:21Morning and evening.
27:22Evening.
27:22Exactly.
27:23Thanks very much, Doc.
27:24Don't forget your stick.
27:25Oh, I need my stick.
27:26Yeah.
27:27Can't go far.
27:28Can't go far without that.
27:29No.
27:30Rarely getting out of the pub, though.
27:32Oh, no.
27:32Well, how often are you going to the pub?
27:34No, it's very rare now.
27:36So, you're drinking less.
27:37Like, I used to go about dinner times and nights, you know.
27:39Hmm.
27:39Now, I might just go out in the afternoon for a couple and then stay in in the afternoon.
27:42It's good to keep active, though.
27:43Well done.
27:44I always see you up and about, so that's good.
27:46Got to keep on the move.
27:47Don't fancy dying too soon.
27:49No.
27:50You've got many years ahead of you.
27:51Don't you worry about that.
27:51I've still got people to annoy.
27:52Yeah.
27:53I love it.
27:54What do you think I come back in here for every other day, Doc?
27:56Wait, that's what we're here for.
27:57You're more than welcome.
27:58I'm only joking, Doc.
28:00All right, take care.
28:00Take care.
28:01Thank you, Doc.
28:02You too.
28:02Bye now.
28:06I'm going to take a jacket off and you warm it.
28:10Hmm?
28:13Huh?
28:18Amelia.
28:19Hi.
28:19Hiya.
28:20You OK?
28:21Come on in.
28:21We're in here today.
28:22Right, you go.
28:23Hello.
28:23Hello, how are you?
28:24I'm good.
28:25How are you doing?
28:25I'm not bad, thank you very much.
28:26Now, which seat do you want?
28:27You get a choice of these two.
28:28Which one would you like?
28:32Why don't you sit on that one?
28:33Because then if we need to have a look at anything, it's a bit easier, isn't it?
28:35Maybe that's more sensible.
28:36So, tell me, why are we in today?
28:39What's happened?
28:40So, three weeks ago or four weeks ago, we were here as well.
28:43Yeah.
28:43She had grommets placed, like, last February.
28:45So, grommets last February.
28:47Like, 2 to 20, 24.
28:48OK, so about 18 months.
28:4920, 24.
28:49Amelia's had grommets put in, which we often use when a patient has glue in,
28:53the ear, which is when fluid builds up in the middle part of the ear.
28:56That can stop sound transmitting clearly through, so the hearing isn't so good.
28:59And for a child, that's really important at these really formative learning years.
29:03So, what the ENT doctors do is put a little grommet, which is a tiny piece of plastic,
29:08just to make a sort of almost like a vent in the eardrum to allow some fluid to come
29:12out, to allow the pressures to equalise, to sort out this middle ear problem.
29:15The problem with these types of things and having any intervention and grommets, foreign
29:19bodies, as we call them, in the ear, is that sometimes it's slightly prone to infection.
29:24So, four weeks ago, her ear started bleeding.
29:26Oh.
29:27From the inside.
29:28OK.
29:28We got here.
29:29Yeah.
29:30And the guy says, oh, it's probably falling out.
29:32Yeah.
29:32That's why it's bleeding.
29:33So, I was like, OK, fine.
29:34And the bleeding stopped after, like, a week.
29:36OK.
29:36It was fine.
29:37OK.
29:37But then, since last week, there was a really bad smell coming from my ear.
29:41OK.
29:41Like, really, really bad.
29:44And the smell hasn't gone away.
29:46It's still exactly the same.
29:48OK.
29:48This morning, it was like, there was something going, but I cleaned it out lightly.
29:52OK.
29:53And then...
29:53Sort of crusting and, like, dry...
29:54Was it dry coming out overnight?
29:56Very dry.
29:57And...
29:58But I got a phone call from school.
30:00It started bleeding again.
30:01Any temperature?
30:02I mean, is she unwell?
30:02I mean, you obviously sent her to school today and things.
30:04No.
30:04So, she's well and happy.
30:05There's nothing wrong.
30:06As far as hearing, you think we're listening and doing things?
30:10It's OK.
30:10She says, what, here and there.
30:12But I'm not sure if that's...
30:13Yeah, I don't know.
30:14OK.
30:14But overall...
30:15So, come over here, because you're so tall.
30:17Look how tall you've been, pal.
30:18I think that's over the summer holiday.
30:19You're five now.
30:20And what year are you in at school?
30:22You're in year one.
30:23Have you started reading yet?
30:26I bet you have.
30:27You're a Clever Claus.
30:27She can read already.
30:29I knew you would, you see, Clever Claus.
30:30Now, what we need to do is have a look inside of your ear.
30:33It tickles a little bit, so you're a good girl staying still.
30:36OK.
30:36And do we have any follow-up with the ENT for the grommets?
30:39Or they just said they'll fall out?
30:40No, we've been discharged now.
30:41Do you want to see the grommet?
30:42Look at that.
30:44A little white tube.
30:45It looks like a hammer bead.
30:46Oh, yeah, yeah.
30:46It looks like a little bead that's in there.
30:48But it's good.
30:49You never have anything to go.
30:49So that's coming out, and it will fall out on its own.
30:51Yeah.
30:51We don't need to do anything.
30:52Yeah, exactly.
30:53Let's have a look.
30:54So I can see there's been a bit of blood on your ear.
30:56Look, there's a bit of blood on the outside of your ear just there.
30:59That's OK.
31:00It doesn't make me worry, but I'm just going to have a look inside, OK?
31:02And you try and stay still.
31:04We'll have a look really gently.
31:06There's quite a lot of blood in there to see past.
31:08OK.
31:09And the grommet, let me see if I can see it.
31:12I can't see it.
31:13Yeah.
31:14I think it's come out on this side, but it's definitely still in on the other side.
31:18Yeah.
31:19The canal is a little bit wet and sticky, and that's what you're seeing coming out.
31:23Yeah.
31:24And sometimes what can happen, I can't smell it now, but sometimes it can.
31:28We can get a bit of an infection in the ear canal.
31:30Yeah.
31:31So rather than inside the ear, it looks like it's the canal that's a bit wet.
31:35Do you ever put your finger in your ear and wiggle your ear?
31:38We do sometimes, do we?
31:39OK, that's OK.
31:40But sometimes when you do that, it causes a little bit of damage,
31:42and that could have caused a little bit of bleeding and a little bit of thing.
31:45But there's no grommet in there, so it's not your fault.
31:47It doesn't matter.
31:48But I wonder whether rather than just throwing,
31:51I don't want to throw antibiotics at her and things like that,
31:53can I take a swab of it, which is just like a cotton wool,
31:55but let's find out what it really is.
31:57Yeah.
31:57Because if there's a smell, a smell normally means infection.
32:01Yeah.
32:01Now, it could be fungal, it could be bacterial, it could be viral.
32:03So there's lots of different things that can cause funny smells.
32:06Let's find out what it is.
32:07Yes.
32:07Then when we find out what it is, the lab will then tell us,
32:10it's X, Y, Z, and this is how we treat it.
32:13Yeah.
32:13And then we actually know what we can do.
32:14Because I didn't want to buy anything over the counter,
32:15because I didn't know if the grommets were still in there or not.
32:17So the grommets aren't, I can't see the grommets.
32:19The eardrum looks good.
32:20Yeah.
32:20Which is why she's not got a temperature, she's well, she's happy.
32:23I think this is an outer ear problem.
32:25OK.
32:25So all I need to do, I'm going to show you what I'm going to do, and I'll talk you
32:29through it.
32:29And it doesn't hurt, it's quite fun.
32:31But you must never do this at home.
32:33This is only something for the doctor to do, OK?
32:36You stand up for me, really tall.
32:38I can stand on my tickle stone.
32:39Right, well I want you to stand, let me see.
32:41Very good.
32:41Now if you stand like that, and you're just feeling funny,
32:44like I'm, like I'm scratching the inside of your ear, aren't I?
32:47Isn't that funny?
32:48Can you feel it tickles a bit, doesn't it?
32:50OK, so we'll get a good sample, then we can work out actually what the bug is.
32:54Well done, sweetheart.
32:55What we're going to do is, let's, if she's not unwell, don't wait.
32:59Let's find out what it is.
33:01This will come back quite quickly, and then we deal with it.
33:03Right.
33:03OK, right, we've got that, so I've got mummy's number, so I know how to call you.
33:06But obviously if anything changes, blood's coming out a lot.
33:08Yeah.
33:09Anything different, bring her straight back.
33:10But no fingers in the ears.
33:12Commonest calls.
33:12I appreciate it.
33:13Thank you so much.
33:14Take care.
33:14Bye-bye.
33:14Bye.
33:15Bye.
33:16Bye-bye.
33:48Morning.
33:49Morning, thank you.
33:50How are you doing?
33:51Good, now I'm here.
33:53Yeah.
33:53We're going to barrage you with a lot of questions and answers.
33:57How are things?
33:58I've had ongoing problems with my flat.
34:01Right.
34:02Sewage coming out, bathrooms coming up in the kitchen.
34:06What, through the pipes?
34:07Yeah, the door, the cupboard, the cooker.
34:09Yeah, yeah.
34:11Yeah, yeah.
34:11Now I'm suffering with these little, like, fruit flies and things.
34:13Oh, yeah, yeah, yeah.
34:14So my daughter loves her to death.
34:16Hmm.
34:16She's told me what to do, like, vinegar, this, that, and in the sink, hot water, who's nesting
34:22in the drainage.
34:23Done all that.
34:25And then my hands.
34:26Yeah.
34:26I mean, I love my own home.
34:28It's super dry.
34:29I have got a barrage of all different kinds of creams.
34:33I put the rubber gloves on.
34:35Yeah, yeah.
34:36For a little while.
34:37Because of the Raynaud's.
34:38Yeah.
34:39And I had to chip this down myself.
34:41It grows a bit.
34:42Raynaud's disease is a vascular problem and can predispose you to having problems in your
34:50extremities.
34:51Your hands may feel cold.
34:53They may feel painful.
34:54They change colour.
34:55Easily an infection can get hold because of the lack of circulation.
34:59I've been to Nigeria.
35:01You've been to Nigeria?
35:02Yeah.
35:02Yeah, okay.
35:03Never come home with nothing.
35:05Yeah, yeah, yeah.
35:06This is London, England.
35:08Yeah, yeah, I know.
35:09In my home.
35:09Probably because, yeah, because of what's gone on and the smell.
35:13I feel horrible within myself.
35:15In an ounce.
35:16Yeah, yeah.
35:16I don't even cook in my house.
35:18Yeah, yeah.
35:18My daughters, both of them.
35:19They bring me this for the oven, none.
35:22Yeah, yeah.
35:22This for the microwave.
35:23And then, I mean, with a fan.
35:26Yeah.
35:26Because of all these things.
35:28And it's constant.
35:29Yeah, yeah.
35:56We have cockroaches, we have mice.
36:00You're cleaning and, it's all right, I'll take your time.
36:03I'm just going over to the shop.
36:05And then the mice, I'm OCD now because.
36:08Yeah, stress is in.
36:10Yeah, we need to treat it.
36:12It's an itch.
36:13Yeah.
36:14Does the itch wake you up?
36:15It's annoying.
36:17Mm.
36:17And then my nails, I've had to trim it down because it's scratched my arm.
36:21And the histamines?
36:23You're trying anything for it?
36:23I do take the hay fever one because I feel like I've come out in, like.
36:27Which one?
36:28Itch is for purity.
36:30Purity.
36:31Purity, yeah.
36:32Okay, yeah.
36:32Yeah.
36:32But this, this is a contact dermatitis, contact dermatitis, and it's due to many different
36:38things.
36:39And all the things you've been talking about can cause this.
36:42The stress.
36:45Mm.
36:46Moisture, rubber gloves, you said travel, dehydration can cause it.
36:51So if you're on long flights, this can all affect it.
36:55And the more moisture you put on, the better.
36:58And it's due to all those different things.
37:00Sharon's clearly got a number of issues and a lot going on with her housing, and that really
37:07needs to be sorted out.
37:08Skin issues can be a sign of stress, understandably, and that doesn't help.
37:13But she's itching, so histamines being produced.
37:18She needs to have antihistamines.
37:21Some of the spots looked infected.
37:23So she really needs to use the moisturisers and steroids to promote that healing process.
37:29And I know you've got loads of potions and stuff.
37:32Wherever you wash your hands the most, you keep this cream that I'm going to give you,
37:35and you use it as a soap, yeah?
37:39Then you dry your hands, and then you put more as a moisturiser.
37:42Same cream.
37:43Okay.
37:43As a soap and a moisturiser.
37:45And then I'm going to give you another cream, which is a steroid-type cream.
37:49Don't be scared about the word steroid.
37:51No.
37:52You're going to use that separately twice a day.
37:55Use that for 10 days, twice a day.
37:59It'll all be written on it.
38:00After you've put the steroid cream on, when it's dry, you put more of the moisture cream on.
38:05It's going to make a big difference, but if it hasn't made a difference in a good 10 days, come
38:10and see me again.
38:11So have you got an appointment for them to come, or not?
38:15Council?
38:15No?
38:16Oh, I kind of give up.
38:20It's been so long.
38:20And they said, when are they coming?
38:22No.
38:23Unless somebody cancels, it's a three-week in between each shabby job.
38:28Do you need any help with contacting the council?
38:30No, they know me.
38:31Okay.
38:32Okay, fine.
38:32I was going to say, we have link workers who can liaise between you and the council.
38:37No, I do myself.
38:38Okay.
38:38Okay, fine.
38:39All right.
38:41Well, I thank you for seeing me.
38:42You're welcome.
38:43Good luck with the...
38:44Well, thank you.
38:45You're welcome.
38:46Take care.
38:48How are you feeling about your asthma?
38:50It's been very bad lately.
38:52Very bad.
38:53Very bad.
38:53I've been using my inhaler most days.
38:57Oh, it's not bad.
39:01Went to add the...
39:03To blow in the...
39:05Oh, yeah, the breathing test.
39:06When I blew in, I went a bit giddy, and my body started shaking.
39:11You should never think you're quite all right with asthma, because you're not.
39:14You think you've got everything's fine, and then the spanner gets thrown in the works.
39:24Mr. Who's?
39:26Yeah.
39:31Take a seat.
39:34How are you today?
39:36Yeah, yeah, same as ever.
39:37Yeah.
39:38My name is Tracy.
39:39I'm a pharmacist here.
39:40Um, so, you're coming for a, um, asthma COPD review today.
39:45You're going me up for it.
39:46I didn't ask for it.
39:47You want me to come in.
39:48Sure.
39:49How are you feeling about your breathing, then?
39:51I know I've got problems, but it doesn't really affect me, so...
39:55Sure.
39:56Are you...
39:56I don't have a breath, that's all.
39:58Do you get out of breath?
39:59Oh, yeah.
40:00Is it on a daily basis, or...?
40:02On a permanent basis.
40:05Sort of, I mean, expect it, because obviously you've got COPD.
40:09I was a six-a-day smoker.
40:11I mean, come on, you can't expect any other.
40:12But you stopped smoking now, so...
40:14I'm 20, some odd year ago, yeah.
40:15So that's a good thing, yeah, exactly.
40:18Are you okay walking on a flat surface?
40:21Like...
40:21Yeah, if it's a rise, it could be a small rise in order to be a big one.
40:25So, uphill or stairs.
40:27I'm out of breath.
40:27I'm out of breath.
40:28Sure.
40:28But otherwise, I can just get on with it.
40:31I take my inhalers every morning, and I keep my blue one on me all the time, so...
40:36As I am now, I'm happy.
40:38Okay.
40:39Fine.
40:39This is why I'm looking at something.
40:41I always believe this.
40:43If I get ill...
40:45Yeah.
40:45Get to see a doctor.
40:46Yeah.
40:47I have been ill since I had corona.
40:49Before that, I was hospitalised every year with my chest problems.
40:53Right.
40:54Since I had that...
40:55Yeah.
40:56I haven't.
40:57Nothing.
40:57In that case, if you're happy with it, let's just keep it...
41:01I'm happy with everything.
41:01I'm only here because you people rang me, and if I said no, then they'll be ringing me every
41:07Every Tuesday.
41:08Yeah, so...
41:10I've come in, so...
41:11No problem.
41:12Okay.
41:12The way I look at it is this way.
41:15I'm 83 years of age.
41:17And you're still doing...
41:18I've got 10 years to live if I pass over tomorrow.
41:23Don't say that.
41:23Don't say that.
41:24That's the way I...
41:24No, no.
41:25The way you're going to look at it, logically.
41:27Yeah.
41:27Never say you're going to die tomorrow.
41:30You're going to die in 10 years time.
41:32Yeah.
41:33But I can't.
41:34I don't even know I'm going to bloody...
41:3583 years of age.
41:36I could just go to my sleep tonight.
41:38Don't worry about it.
41:39Get on with it.
41:40Get on with it.
41:41Yeah.
41:41And enjoy it every day.
41:43You've got 10 years to live.
41:45And you'll always have 10.
41:46And when I'm 108, I've got 10 years to live.
41:49You know you're not going to get that.
41:50I've got a friend who claps in the street.
41:52Yeah.
41:53He's 72 years of age.
41:55Yeah.
41:55He won't come outside the door, you know.
41:58I said, why not?
41:59He said, I'll clap.
42:01He said, I'll clap.
42:02He said, I'll clap.
42:02I want to clap.
42:02But if you clap, nobody's going to find you.
42:05He said, get out.
42:07If you're going to die, you're going to die.
42:09Get out and enjoy yourself.
42:11Don't call me and wait for death.
42:13Yeah.
42:13Get out and enjoy it.
42:14That's the way I look at it.
42:15Very positive, I like it.
42:17That's how it used to be, yeah.
42:18Okay.
42:20I think I'm happy with it.
42:22And you are happy with it.
42:23Yes, yes.
42:24So, let's just keep it as it is.
42:26When I see you next year, you still get 10 years to live.
42:30That's right.
42:30If you look at it any other way, you're just giving up on the most.
42:33That's the way I look at it.
42:34No.
42:35That's the way I look at it.
42:36But you're happy with it though?
42:37I'm happy with it.
42:39Good.
42:39If you're happy with it, I'm happy with it.
42:40I'm happy with it.
42:41You take care, okay?
42:42Yeah, you look out to yourself now.
42:44Bye-bye.
42:46I appreciate it.
42:47I'll see you in a few weeks.
42:48Let the reins calm down a bit.
42:50Yeah, hopefully.
42:50Thank you very much.
42:53See you.
42:55Thank you very much, Doctor.
42:56Don't forget your diet coat.
42:57No, thank you.
42:58Bye-bye.
42:58You're going to calm down on those, remember.
43:00Yes.
43:00See you later.
43:01Bye-bye.
43:01Bye now.
43:02All right.
43:03Well, look, any problems, give us a shout and I'll send you all the information.
43:06All right.
43:06Have a good day.
43:07Have a nice to see you.
43:07Bye-bye as well.
43:07Bye-bye.
43:08See you.
43:08Bye-bye.
43:09Bye-bye.
43:10Bye-bye.
43:15Bye-bye.
43:19Bye-bye.
43:19Bye-bye.
43:26Bye-bye.
43:31Bye-bye.
43:34Bye-bye.
43:36Bye-bye.
43:36Bye-bye.
43:38Bye-bye.
43:38Bye-bye.
43:39Bye-bye.
43:40Bye-bye.
43:40Bye-bye.
43:41Bye-bye.
43:42Bye-bye.
43:43Bye-bye.
43:44Bye-bye.
43:44Bye-bye.
43:44Bye-bye.
43:46Bye-bye.
43:46Bye-bye.
44:07¶¶
44:15¶¶
44:15When I had my blackout faceplant, I'd just go boom.
44:20I've had 38 surgeries in 25 years.
44:24I haven't had my period in seven months.
44:26Okay, that's a whole other story.
44:32I'm not liking the look of this. I'm a little bit worried.
45:01I'm not liking the look of this. I'm a little bit worried.
45:04That's what I've challenged.
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