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00:06Dementia is something that we all fear. We used to think that if I've got it,
00:10I don't want to know there's nothing I can do about it. And that is not true.
00:24This morning, my son, I accidentally just knocked my nuts. And I was like,
00:29I thought I was going to explode.
00:34In the shower, I just lost all my energy. And I was next lying down with a towel behind my
00:39head.
00:39I don't remember anything else after that.
00:44I sat here in the mornings and I think, oh, would it be easy for me to just go to
00:50sleep?
00:51No, it won't. I know you, you get bored. And when you get bored, you get down.
01:10Morning! Morning!
01:28Good morning, Sergei.
01:31Hello.
01:32Oliver.
01:33Hello.
01:34Hi.
01:37Hiya.
01:37Come on through.
01:38Dr. Pearson, how are you?
01:40Hi, not bad, thanks.
01:40Good, good.
01:41Come and have a seat.
01:43Now, how can we help today?
01:44So I came in like five, six months ago for a dangling cyst.
01:51It was like sort of this size about six months ago, and it comes up, it comes down.
01:57It's related to, I think, when I do gym training.
02:00It's not going down really, and it's really affecting my range of motion.
02:04It kind of, it doesn't hurt too much, but like it does, if I really push it back, it kind
02:08of does.
02:09So let's have a look at it.
02:09If you put both hands flat on here, let's have a look.
02:11So you can see it straight out, can't you?
02:13Yeah.
02:13And is it tender at all?
02:15No.
02:16If I push it hard, it doesn't really hurt.
02:17Can I just feel it round?
02:19Yeah, go for it.
02:19So it is, it's quite, it moves a bit, doesn't it?
02:22Yeah.
02:23Yeah, it's quite fun to play with.
02:24And it's quite sort of jelly-like, isn't it?
02:25A ganglion cyst, we think, is the fluid from the joint that sort of comes out and forms a cyst.
02:28And if you bend your wrists like that, yeah, then it's really noticeable, isn't it?
02:33So it's nothing to worry about.
02:34It's not a cancerous lump.
02:35It's nothing, you know, concerning.
02:37But the problem is, sometimes they go away on their own, and that's why we often say to people,
02:40just wait and see what happens.
02:41And often they go, do you know what the old-fashioned thing was to get rid of it?
02:44A Bible.
02:45They call it a Bible cyst, right?
02:46A Bible.
02:46You smash it.
02:47It's because it was the only hardback book everyone had in their home.
02:50And so everyone used to pick up a hardback book and bash it.
02:51The trouble is, don't do that, because you'll damage the bones and other things,
02:54and we don't like that anymore.
02:55But a sort of trauma to it sometimes just disperses it.
02:59And if you told me it was doing no harm, not interfering with your wrist,
03:02you were still able to live your life 100%, then you don't have to remove it at all.
03:05You can live with it until you're 100.
03:07But it's when they're in awkward places.
03:09Unfortunately, if it does start to interfere with function, we do say, look, let's think about how to get removed.
03:14It does affect my range of movement.
03:16So that wrist comes back quite hard, doesn't it?
03:18And that one less, it's blocking it, isn't it?
03:20You can't bend there.
03:22I mean, I think what we would do, if we refer to the hospital,
03:24we're not signing you up to go into the theatre to have it done.
03:27We're signing you up to go and speak to a surgeon about it who does these all the time.
03:30If you then decide, you know what, I don't want to do it, you can walk away.
03:33Might as well do it.
03:34I'll write straight down to them now, OK?
03:35And they will call you, book you in.
03:37Brilliant.
03:37Thanks so much.
03:38Either way, I think it's good to do something about it.
03:39All right, no worries.
03:40Listen, good luck with everything.
03:42And yeah, you'll hear from them.
03:43They'll give you a ring in the next week or so.
03:44OK.
03:45Take care.
03:45Bye-bye.
03:50Asker?
03:51Oh, yes, miss me.
03:52Hi.
03:53Hi.
03:54How are you?
03:54I'm fine now.
03:55I see you.
03:56I feel great.
03:57Come on in.
03:59So, how are you?
04:00I'm good.
04:02I haven't seen you in ages.
04:04You are so lucky.
04:08You know, I had a knee surgery.
04:11And it seems like the knee surgery has gone wrong.
04:14OK.
04:15First, I cannot bend my knee whatsoever.
04:17OK.
04:18It goes that much and that's it.
04:19OK, and you can't fully...
04:20Yeah.
04:21Yeah.
04:21Secondly, the nerve system is painful.
04:25And the bottom of my feet, at night, it gets hot.
04:29I googled what it is, and the Google said when your bottom of my feet is hot, it means
04:33your nerve system is crying.
04:36OK, yeah.
04:36It's asking to be fixed.
04:38OK.
04:39So, we'll have a look at that.
04:40When was the surgery?
04:42A year and a half, two years, or something like that.
04:44What did they do in the...
04:46Can you remember what it was?
04:46They did partial, partial knee replacement.
04:49When they do that, they just replace the medial compartment of the knee.
04:53And so, that's possibly where they felt that you had the degeneration.
04:57Oh, they felt wrong.
04:58I asked to refer again.
05:01This is maybe only a year and a half, a year and a bit ago.
05:04Yeah.
05:04And no response whatsoever.
05:07OK.
05:07So, are they telling me that I have to stay with this pain forever?
05:13Or is it possible to fix it?
05:15Let's have a quick look at that.
05:16Just sit up on the bed.
05:17Oh!
05:18Right.
05:19I'm going to have a quick feel.
05:21Let's bend it right in.
05:23That's the max.
05:24That's the maximum.
05:24And where does that hurt when you do that?
05:27It's just here.
05:28OK.
05:28Let's see.
05:29I tell you, I need a little bit.
05:30Oh, yes.
05:31Then that's really cool.
05:32OK.
05:32And just straighten it for me.
05:33OK.
05:34When I walk, it clicks.
05:36OK.
05:37When you're walking, does it ever give away beneath you?
05:39Never.
05:39Nothing like that.
05:40OK.
05:40All right.
05:41You can get dressed.
05:42Let me help you out.
05:45You all right?
05:46Yeah, I am fine.
05:48I really need to fix this because I want to do exercise.
05:51I want to walk a lot and I don't want to go anywhere where I click, click, click.
05:55It's just like hanging.
05:57It doesn't click too much examining it, but I think we definitely need orthopedic input
06:00because what we want to do is make sure that we've got the best out of your knee that you
06:04can have.
06:04Exactly.
06:05This is what I want.
06:06So it will be a specialist physio that assesses you and then they will decide if you need to
06:10go back and see orthopedics again.
06:12But that's kind of the gateway back to orthopedics.
06:15Do you feel you need any painkillers or pain relief?
06:17I would not take that.
06:18You don't.
06:18I know you're not keen on it.
06:19No.
06:20OK.
06:20All right.
06:21So it's nice to see you.
06:22Have a great day.
06:23You are the best.
06:24All right.
06:24Thank you so much.
06:25Have a great day to you.
06:26You too.
06:26All right.
06:27Bye.
06:27Bye.
06:29Open.
06:30Open's perfect.
06:31Bye.
06:32Bye.
06:32Bye.
06:36Jane.
06:36Hello.
06:37Come on through.
06:38Do you want me to help bring your bag?
06:40That's OK.
06:41It's all right.
06:42I've got it.
06:42Shall I get you go?
06:43I'll find it.
06:44Are you sure?
06:45Yes.
06:45I must be as independent as I can.
06:47I know.
06:47Well, you're very good.
06:48You're quite right.
06:49Walking as much as pos.
06:51I think this was booked before we had a chat.
06:55That's all right.
06:55Come and have a seat.
06:55But on the other hand, I'm not sorry to see you because, do you know, I don't want to be
07:00sort of dramatic, but I sort of feel sometimes as if life, what's it all about?
07:07I know.
07:07Because I'm having such a lot of trouble with everything seems to have gone wrong or sort
07:14of caught up with me now.
07:16I mean, obviously I'm still living alone and I intend to.
07:20Yep.
07:20Because I think it would probably finish me off if I went into a home, which I try to
07:26avoid.
07:27But I think the thing is that I do get, I get very dizzy, but I'm sort of, now I'm
07:34worried
07:34because a friend of mine who's very sweet, she will say to me, yes, well, I told you that
07:39the other day.
07:40And that, of course, really, it really bothers me because I'm forgetting.
07:45I know what you mean, that everything just feels like it's not working very well, isn't
07:48it?
07:49It's not working.
07:49And I know that you're finding you're slower and we can't quite remember things.
07:54And I know, do you think I've got something like, I was looking it up in the dictionary
07:58today, what is that thing called multi...
08:01Not multiple sclerosis?
08:03Yes.
08:03Something like that?
08:04It is funny.
08:05Yeah.
08:06No.
08:06So I don't think you have that, which is good news.
08:08Do you remember you went to the memory clinic not long ago?
08:11Yes, yes.
08:12And wait, they did a scan of your head.
08:13So the reason we know it's not multiple sclerosis is because they didn't find that on the
08:17scan, and that's how they would, wherever they would find it.
08:20Oh, I see.
08:20But what they did find was some little vascular, very early vascular problems, which causes
08:26the memory and some of the symptoms that you're getting.
08:29So we're just waiting to hear back from them.
08:30So I've got something, I like it.
08:33They have said it's a sort of early type of dementia.
08:36I like the way you put it, it's dementia.
08:39Well, because that word itself worries people a bit sometimes.
08:43Tell me, does it?
08:44Well, of course it does.
09:02I had a fall about, yeah, about eight weeks ago.
09:06I was coming down the stairs, and I just missed a step.
09:08I'm losing my balance a bit.
09:09Okay.
09:10I think it's that.
09:11I have had a lot of falls recently.
09:13How many do you think you've had in the last month?
09:16Fifteen.
09:17Fifteen?
09:17Yeah.
09:18Wow.
09:18I'm walking along, minding my own business, and the next thing I know, I'm flat on my face.
09:22You ever have falls at all?
09:23Are you falling over?
09:24I've had a few falls, yeah.
09:25But that's why I've got this.
09:26And have you had falls in the house or outside?
09:29I have, yeah, I've had some outside.
09:30But both in and out?
09:31Yeah.
09:31Okay.
09:32And it was yoga you were doing, wasn't it?
09:33Oh, yeah.
09:34Before, yeah.
09:34I had three or four falls.
09:36Bum, bum, bum.
09:37But I refused to stay in.
09:42Are you all right?
09:44No, I had another tipple on Friday.
09:47What, a drink?
09:49No, not that tipple.
09:52What, you fell?
09:53You didn't.
09:54I did.
09:56Right, I got...
09:58When did you...
09:59I was on my balcony.
10:00I think what happened, the toe of my shoe caught the wheel.
10:04Okay.
10:05Of course, I fell on the floor, didn't I?
10:07Oh, God.
10:08So I thought, oh, God, I've got to get up.
10:10All of a sudden, George, our maintenance man, he came out of his office.
10:15He got his arms under me and just stood me up.
10:18But I've got a lump.
10:20Is that where you...
10:21Where the way I fell.
10:22Luckily, it wasn't this one.
10:24So if you don't mind having a look...
10:26Right, lift this up.
10:28Show me where it is.
10:30Here.
10:31Down your bum?
10:32Yeah, it's on my bum, actually.
10:34Oh, you've got a huge bruise.
10:36Is it a bruise?
10:37I don't really want to get a doctor to have a look.
10:40You don't need to.
10:41That's all right if it's only a bruise.
10:43Right, pull yourself up.
10:44Right.
10:46You ain't got to go to hospital.
10:48It doesn't hurt.
10:49It's just when I sit down, it's a bit sore.
10:52And this has been playing me up and all.
10:54Why?
10:54Maybe I hit that as I went down.
10:57I hope you didn't.
10:58Not that.
10:58I hope not.
10:59You've got to stop falling over.
11:01This leg's getting so weak.
11:04I think that's what's doing it.
11:05Well, when you fractured that hip, you started putting a lot of pressure onto this one.
11:11On the other one, yeah.
11:12Your blood flow down this leg is not great.
11:15That might be why.
11:17Right, let's get you off.
11:18Woo-hoo-hoo, look at that.
11:21That's good.
11:22Yes.
11:22Good.
11:24Otherwise, I would not be going woo-hoo-hoo.
11:26I'll be going, oh, goddammit.
11:28I'm glad that's good.
11:31We have life.
11:32Roll it for me.
11:33And that has got better as well.
11:36Right.
11:38We need some of that.
11:40Ta-da.
11:41I've been doing it a while now, Doris.
11:43If I don't know your leg by now, I never will.
11:47Doris?
11:47Tearing me up today.
11:49Roll it, roll it.
11:50I know.
11:51I felt very low.
11:52Did you?
11:52I never actually rolled it.
11:54I always do, first thing in the morning.
11:56Yeah, but you said you're never good in the morning, are you?
12:00No.
12:01Okay, lift slightly.
12:03I just want to dry your leg.
12:06Done, my dear.
12:08Right.
12:08If I was born in 1930, what does that make me?
12:13I get confused.
12:15You used to be an accountant.
12:16You're good at that.
12:17You're going to be 95 in November this year.
12:20Don't look a day over 21.
12:22I don't know if I can reach that long.
12:24Oi.
12:25Don't think I'll reach that long.
12:26Thank you very much.
12:27Doris?
12:28I sat here in the mornings and I think, oh, would it be easy for me to just go off
12:33to sleep?
12:34No, it won't.
12:35I know I'm getting a bit despondent.
12:37Do you want to speak to someone about it?
12:39Nah.
12:40Oh, I had somebody on the phone the other day saying about somebody coming in, even if they're only sitting,
12:47we have a chat.
12:48They have a befriending service.
12:50So they come round, they have a cup of tea with you.
12:52They do Parsons Green Fae.
12:54You can have Christmas dinner at the town hall with them.
12:57So say yes, please.
12:59I see what I'm saying.
13:00Because I know you, you get bored and when you get bored, you get down.
13:03I don't really get bored, Sam, because I read a lot, which I like.
13:09So why are you feeling like, you know, you can go asleep and that'll be the end of it?
13:13Why do you feel like that?
13:14I let the library go because I couldn't get up there.
13:17Okay.
13:18So you can't get books, is that what you mean?
13:20I can't get books down the charity shop.
13:21What books do you like?
13:22What books do you like?
13:23I like the fiction stories.
13:25What about?
13:26Romance, but not that smutty moment.
13:29Yeah, yeah, I know.
13:30Not like Fifty Shades of Grey?
13:32None of that?
13:33I will put out a I need some books from everyone I know and I'll bring up a couple of
13:40bags.
13:40All right, lovey.
13:41Well, we'll have to get you some books because I can't have you not reading.
13:46Get me some books.
13:47I will.
13:48Thank you very much.
13:48And I'll see you on Friday, same time, same place.
13:52Okay, my lovey.
13:53Bye, Doris.
13:54Bye.
13:56Dementia is something that we all fear.
13:58We used to think that if I've got it, I don't want to know because it'll follow on and there's
14:03nothing I can do about it.
14:04And that is not true.
14:05With dementia, it's really important to know about it because then we can help.
14:09And there are different forms of dementia.
14:11Some have medication.
14:12Some are more about controlling blood pressure and cholesterol and things like that.
14:16You're doing really well in all parts of it.
14:18We're just waiting for the final assessment with them.
14:20But it's so important if people like yourself will ever have any memory problems or feel things aren't quite right
14:26to do something about it.
14:27Such a good doctor.
14:28And then you just, then we can help you.
14:30The most important thing is we just keep you safe.
14:33Dementia, unfortunately, is a condition that we're seeing more and more of as we're all living older, probably.
14:39And Jane, in this case, has a type of vascular dementia and she's under the vascular clinic.
14:43Dementia is a really scary condition for lots of patients.
14:45And when you live on your own, it can create its own challenges and our role is to make sure
14:51that the patient is safe, is stable at home, that if the dementia is progressing, what extra support we need
14:56to put in.
14:56So actually seeing her regularly is really helping her manage her condition.
15:01Keeping your brain busy, doing bridge is really important.
15:05Seeing your friends, really important.
15:07When we've talked to you before, you've very clearly said to me, I want to stay in my home.
15:12And you mentioned it here today, you don't want to move.
15:15Because another option is moving to somewhere where they can perhaps, there'd be more support around, people to see, people
15:21to watch.
15:22But you've lived in your house, I think, for quite a long time, haven't you?
15:25Of course, yes.
15:26But you're making it work, keeping you at home with the lady, Shakira, coming in and helping you, your nice
15:31lady who's helping.
15:32And I think we're asking the memory clinic and the support where they can give us.
15:36Right.
15:36And it might be medication, it might just be some advice, talking to people who are in a similar position
15:41or people who, they've helped people through it.
15:43And they can give you some advice about things, trying to make it safe and as practical at home.
15:48And then why don't we book an appointment?
15:50Yes.
15:50And we'll give you a ring on the morning of the appointment, just to, A, make sure we've got it.
15:56As I say, I haven't got my diary.
15:56No, but we'll write it down for you now and then we'll ring you in the morning of the day.
16:00Right, let's go to the front desk and we can get Millie or whoever on the front desk, they can
16:03sort it out for us.
16:04Okay, fine.
16:05All right?
16:05Yes, perfect.
16:05We'll help you with your coat.
16:06But you're doing really well, Jane, and don't worry.
16:09Pretty little shoes.
16:10You're all right?
16:10Aren't they lovely?
16:11Look at this shoe.
16:12It's freezing today.
16:13There's no socks on and it's blooming freezing outside.
16:15As a matter of fact, it has got a bit cool.
16:18But the sun's still shining.
16:19Well, I know, but not here it's not.
16:23Oh, gosh.
16:23Thank you so much.
16:28Agnieszka?
16:29Yes, hi.
16:31Hi, come on in.
16:33I'm good.
16:33How are you?
16:34Let me get another chair.
16:38Have a seat.
16:41So, how are things?
16:42They asked me to do.
16:43Yes, perfect.
16:44I can take that for you.
16:45I'm just going to dip it in a minute.
16:46So, it's about the varicose vein, basically.
16:48Okay.
16:49So, I don't know where to get these injections.
16:52So, last time when I was pregnant, they given me injection to dilute the blood.
16:57So, they gave you injections during the pregnancy?
17:00Yes, exactly.
17:01It got swollen and the heavier I became, then it was painful.
17:05I couldn't stand on the leg as well.
17:07Am I all right to have a feel of this?
17:08Any pain here?
17:09No, this one is fine, yeah.
17:11But this one, I had cramps at night when I started and then I couldn't feel my feet,
17:18basically.
17:19And any pain when I press over the area today?
17:22Not like this.
17:23It's more when I walk.
17:25Yeah, okay.
17:25And you've not noticed the actual legs become bigger?
17:28No.
17:29I'm just going to measure them, if that's okay.
17:35Okay.
17:35Perfect.
17:35So, they're exactly the same size.
17:38So, that's good.
17:39The things we worry about are blood clots.
17:40Okay.
17:41So, right now, you can see this is a varicose vein that was swollen.
17:45It's not particularly tender.
17:46It's not hot to touch.
17:47Your leg as a whole isn't swollen.
17:50Yeah.
17:50Yeah, I mean, you're 20 weeks tomorrow.
17:51So, I think the best thing to do, I would either go to maternity triage or they should
17:55be able to tell you who your midwife is.
17:57But basically, what we need to do is whether they want to put you back on the injections.
18:02Okay.
18:02Lovely.
18:02Yeah.
18:03Did you want me to check the heartbeat today?
18:04Would be nice, actually, to hear, yeah.
18:06Yeah.
18:07Before last week, I was concerned that, because I'm not putting any weight, you know.
18:10Okay.
18:11For some reason, with this pregnancy, I'm losing weight.
18:15And feeling movements now?
18:17Not yet.
18:18Okay.
18:18That's totally normal.
18:25Is that it?
18:26I got it.
18:27And then baby's moving around every time I put the probe.
18:30There you go.
18:31That's it nice and clear.
18:32Okay.
18:32That's glad that it's finished, okay?
18:35Happy?
18:36Yes, very happy.
18:37Yeah, make sure it's in a bit.
18:39Good.
18:39Let me just grab you some tissue.
18:45Okay.
18:46All right, so keep an eye on it.
18:46Thank you so much.
18:47But if that swelling gets worse or anything, you definitely, definitely need seen.
18:52Lovely.
18:52Thank you, yeah.
18:53Have a lovely one.
18:54Nice to see you.
18:54Bye.
18:57Sika.
18:59Wow.
19:05Sorry, sorry, it's my heels.
19:07Yeah, cut them down then.
19:09Oh, I mean, you've literally got, you have claws.
19:15The Grinch nails.
19:22Nicholas.
19:22Hi.
19:23Hello, hi.
19:26Come and have a seat.
19:27Thanks.
19:30Now, what can we do to help today?
19:32Yeah, so a bit of an odd one.
19:34So, on Thursday, I woke up and my, like, my testicles were quite sore.
19:39Okay.
19:40And it's a weird one.
19:42When I lie down, absolutely fine.
19:44Nothing.
19:45When I stand up, and it's now gone from the left side, which was really tender, to now the
19:51right side, and, like, gone into my groin and lower back.
19:55Okay.
19:57And, obviously, as you do, you Google it.
19:59Yep, good.
20:00And kidney stones could be one thing, or what, but that's just still, you know, once I'm up
20:05and walking, fine, but that first part in the morning has been the last four days have
20:10been, like, and, like, just, like, this morning, my son, like, accidentally just knocked
20:15my nuts.
20:16And I was, like, I thought I was going to explode.
20:18And I've been, sort of, waking up in the night, which I don't usually do.
20:22Okay.
20:22And when you wake up in the night, is that because you need to do a wee?
20:25No, no, no.
20:25So, actually going for a wee is fine.
20:27It's not painful at all.
20:29Okay, good.
20:29And I've, like, gone round the ball and stuff.
20:32There's nothing that feels, like, lumpy.
20:33Okay, so that's good.
20:34So it doesn't feel different to you, to what normal.
20:36No, it just hurts.
20:37And have they swollen up?
20:38Not that I was aware of.
20:39Okay.
20:40And what about any other symptoms?
20:41Any discharge from the penis?
20:43Nothing.
20:43Anything different like that?
20:44Absolutely nothing.
20:44And do you think you're at risk of an STD, a sort of sexual transition?
20:47Is there any sort of change in your partner or anything like that?
20:49No, no, no, no.
20:49Do you feel that you've had a fever?
20:51I had probably, like, not 24 hours, like, 12 hours where I just felt, like, hot and ill.
20:56Okay.
20:56And that was probably two weeks ago.
20:59Okay.
21:00And then this morning, again, I woke up and I was, like, the back of my head was a bit
21:03wet.
21:03A bit sweaty.
21:04I feel like I'm hotter than I usually would be.
21:07Okay, let's check your temperature and see.
21:08Yeah, and I felt, you know, I felt well enough to play cricket yesterday.
21:12I was, like, actually, I feel all right.
21:13Nothing's going to stop you playing cricket.
21:14But then I woke up this morning, I was, like, I'm really aching.
21:16Can I just check your temperature just to be sure?
21:18Yeah.
21:18It goes in here.
21:2035-1.
21:20You don't feel hot, hot, but obviously something's not quite right.
21:23Yeah, yeah, I feel a bit clammy more than anything.
21:25Do you mind if we have a look at your balls?
21:27No, that's fine.
21:27Do you mind?
21:28If you don't mind, just lie down on the bed.
21:48Let's have a look.
21:49How does it feel now?
21:50That right one does feel like...
21:52Something's not quite right.
21:54Okay, can I feel really gently?
21:55I know it's...
21:56And if I just press...
21:57So we'll start with this left one.
21:59How does it...
21:59Is that feeling okay?
22:00Is that painful?
22:00That's feeling much better.
22:01Much better.
22:02Still a bit tender.
22:03Okay, and the right one?
22:04Like, that feels really tender.
22:06And is it tender there if I press?
22:08Yeah, sorry.
22:09No, no, no, that's fine.
22:10Okay, and lie down for me on the bed.
22:11I know it's bad, but your wife's like, do you want to have sex?
22:14I was like, absolutely not.
22:15Not on your belly.
22:16Not on the moment.
22:17I'm just going to feel really gently.
22:18I don't want to hurt you.
22:19No, no, no, don't worry.
22:20It does feel quite warm as well.
22:23It feels much warmer than the other side.
22:25And a little down there.
22:26And if I feel this side, is that okay?
22:28Yeah, that feels fine.
22:29Okay, and this side here.
22:32Is that a bit sore?
22:33Yeah.
22:33It means there's an infection in here, which is what we need to get rid of.
22:36And that probably explains the sweating and feeling hot.
22:38Let me get you dressed.
22:39If you just stand up again for one second, one other thing just gently I just want to do.
22:43If you just give me a cough.
22:44No, there's no hernia there at all.
22:46Right, let me leave you to get dressed.
22:47If you come and have a seat.
22:48And then we can get you onto something and get rid of this.
22:52So what do you think it could be?
22:54So basically there's the testicle and then there's the sort of epididymis and the sort
22:57of tubes that come out of the testicle that bring everything out.
23:00Yeah.
23:00And sometimes for some reason they can just get infected.
23:02And interestingly, when you were born in your mum's tum, your testicles for men,
23:07they develop around your kidneys, around the back.
23:10Yeah.
23:10And then they travel down through your groin and drop into your scrotum.
23:14And when they travel down, they leave a sort of pathway.
23:16It's all connected, which is why when we've got a problem in the scrotum, it radiates back
23:20up that pathway.
23:21Okay, yeah.
23:21And that's where your glands are sitting.
23:23So you've got the symptoms of an infection.
23:25So what we ought to do is treat the infection.
23:27And it's most likely, rather than the actual testicle itself, it's more likely to be the
23:30tubes around it.
23:32I think it's definitely worth us sending a urine sample today.
23:35Yeah.
23:35Because what that will do, not that I think it's a urine infection as such, but it will
23:39tell us if there's any microscopic blood.
23:41Fine.
23:42So I think let's rule it out.
23:43Let's just do that to be sure of the urine.
23:45Yeah, yeah, yeah, absolutely.
23:45I would expect this to get better.
23:47Fine.
23:47Okay, quite quickly.
23:48So I think what we'll do is I'll probably give you a ring later on in the week just to
23:50see how it's going.
23:51Yeah, yeah.
23:51And hopefully then all done, good.
23:53We don't, the urine will be clear and we don't need to do anything more.
23:55Fine.
23:55But if you say, well, it's got better, but it's still definitely a bit bigger on the
23:58right or a bit different, then we do ultrasounds and scans and things.
24:01Okay.
24:01Are you allergic to anything?
24:03No.
24:03There's a very good antibiotic called doxycycline, which works really, really well for this.
24:06Great.
24:07And normally we do it for about 10 days to really, sometimes 14 days to get rid of this.
24:11Fine.
24:11If we pee into that, then we collect the urine and tip it into there, we'll send it off.
24:15Fine.
24:15And watch, I give it to reception.
24:16And give it to reception.
24:17There's a little, they'll give you a bag and there's a, there's a box at the front desk where
24:19we can put it.
24:20Perfect.
24:20Thank you so much.
24:21All right, not at all.
24:21Where is...
24:22Just here, just here, and one at the front desk as well.
24:25All right, take care.
24:26Nice to see you.
24:26And then go straight to the chemist that will be ready in a straightaway.
24:28Fantastic.
24:29All right, take care.
24:30Not still.
24:30Bye-bye.
24:32Do you want to play lots of new corsets?
24:33I'm just, I'm actually a sucker at that game.
24:35I always lose.
24:36You know what game I used to love playing?
24:37It's like a thing, you put the thing in.
24:40I always call something Kinect.
24:42Kinect 4.
24:43That was a little, isn't it?
24:45I even, I always lose on those games as well.
24:47What?
24:48I was just rubbish at games.
24:51Bye.
24:54Mr. Garner.
24:55Oh, hello, doctor.
24:56Hi.
25:03Thanks for coming down.
25:04Yeah, no problem.
25:05So I called you up today because we've noticed that your B12 levels are very low.
25:12So sometimes people are low on B12 because of their diet, but that is not the case for
25:16you, sir.
25:17What you have is a condition called pernicious anemia.
25:22Your immune system that fights off viruses and bacteria, anything outside of your body,
25:28has actually switched to also attack part of your stomach and part of your gut.
25:34Because of that process, your gut is no longer absorbing B12 well from your diet.
25:40So you could eat loads and loads of B12, but you're not going to extract that vital vitamin
25:45from it.
25:45And pernicious anemia is where your own immune system is attacking the parietal cells in
25:50your digestive system.
25:51That leads to problems with malabsorption, not getting the vital nutrients, vitamins that
25:57you need from your diet, specifically B12.
26:00And it's called an anemia because B12 is needed to make healthy red blood cells, and the lack
26:05of it will lead to an anemia on your blood count.
26:08You know this, sometimes I had like dizziness, imbalance, especially when I stand up like
26:17quick.
26:18Dizziness can be a feature of B12 deficiency, but there are other things that can cause this
26:21as well.
26:22The numbness in my feet, still sometimes in my hand.
26:27Yeah, so that could be caused by your diabetes, but it could also be caused by B12.
26:35So it has to be injected.
26:37We have to give it to you, yes, as an injection.
26:40When it's injected, it's all right.
26:42I can live a normal life.
26:47It's not a one-off injection, unfortunately, because the underlying problem is still going
26:53to be there.
26:53It's forever an injection.
26:54We'll be giving you this injection three times a week.
26:57You may notice that you start to feel better.
27:02So I really want to know if any of those symptoms improve after we start giving you these injections.
27:06Should we go ahead with the injection then?
27:08Yes.
27:09Does it hurt?
27:10It would just go into the arm, a bit of a scratch.
27:13Is it an arm?
27:14Okay.
27:14I thought it was in the leg.
27:17Okay.
27:18Are you all right there?
27:20I'm trying to be.
27:22I hate injections.
27:24Yeah, relax and count to ten.
27:27Okay?
27:29One, two, three, four, five, six, seven, eight, nine, ten.
27:43There you go.
27:44You did really well.
27:45So you may notice over the next few weeks that you start to feel better, whether it's
27:50the numbness or tingling.
27:53Your vision might improve.
27:54You know, if you notice any of these symptoms or these changes, you know, feed that back
27:59to us.
28:00And then once you no longer start to feel any better, that's when we would say, okay, we'll
28:06now do the injections every two months.
28:08So we need to see you again in a couple of days for injections.
28:12Okay?
28:14Thank you, Doctor.
28:15I bet you've worked in for the next one now.
28:16Yeah, that's it.
28:18They're up for tomorrow.
28:19Cheers.
28:23Charlotte.
28:24Yes.
28:24Hello.
28:25Come on through.
28:28I can't bear people sitting waiting for ages.
28:31So I was like, come on through.
28:32Come and have a seat.
28:33Now, what can we do to help today?
28:34I have a spot on the end of my nose that's probably been there about two years.
28:38Okay.
28:39Okay.
28:39But looking back through photos, it's about two years and it's not going anywhere.
28:42And it's slightly, the redness around it is getting slightly bigger.
28:45That's probably nothing.
28:46It's probably a broken vein.
28:47Yeah.
28:48Because I've got a few of those.
28:49Okay.
28:49But just...
28:51We ought to be careful.
28:52We ought to check.
28:52Definitely.
28:53Please.
28:53You know, I'm glad you've come in.
28:54So do you think it's growing a bit, getting a bit bigger?
28:56It's slightly more prominent, I think.
28:58So I do cover it with makeup, not today.
29:00Yeah.
29:00But I haven't...
29:01Yeah.
29:02I'm finding it harder to cover it with makeup.
29:03So I'm now more aware of it.
29:06I'm conscious of it.
29:06Okay.
29:07I've never had them checked out.
29:08And this is probably also why I'm here is, at what point do I come and...
29:11Yeah, get them sort of checked.
29:13Well, we can have a look at them now or whatever.
29:14But I think there are certain ones where we do worry a little bit more.
29:16And sometimes things on the face, if they're changing a bit, we ought to just get them checked.
29:20So we'll have a look.
29:21What about sun exposure in your life?
29:24I mean, I probably am not as good as I should be, but...
29:27And sunbed use, things like that?
29:29Oh, no, no.
29:30Come and just have a seat on here.
29:31Let's just have a look at it, because the light here is quite good.
29:34If you just sit on the edge.
29:35So if we have a look at the nose, so I can just see.
29:37So it's this bit here.
29:38Can I press very gently?
29:39Is that all right?
29:40So if you press...
29:42So it does go...
29:43It is a bit like a broken vein, but there is a lumpy bit slightly, isn't there?
29:46And you can sort of feel it.
29:48And it's just on the edge there.
29:50And is it sore or tender if I press?
29:52It's not sort of like sharp or anything.
29:55So hopefully it is nothing to worry about.
29:56The thing that we worry about a little bit on noses and ear nobes and things are called BCCs, basal
30:02cell carcinoma.
30:02They're not sort of skin cancers, really, that spread everywhere or become really nasty.
30:06But they do happen on prominent places, and the end of the nose is one.
30:10And because it's got the lumpy...
30:11If it was just red and a broken vein, I would be less worried.
30:14But because there's a little bit that sticks out, we just need to be careful.
30:17And the fact it's perhaps getting a bit more obvious and a bit more difficult to cover up,
30:21we ought to check it's not, because if they do grow, we tend to remove them.
30:26And the bigger it is, the more sort of scar we're left behind.
30:28So it's easier just to do it now.
30:30Let's get you seen by the dermatologist.
30:32Come and have a seat.
30:33Have you got a photograph of it, have you at all?
30:35So the one I took yesterday is...
30:37Oh, the one you've done, if you've done one yesterday, that'd be great.
30:39And have you sent them to me?
30:40Well, it was on patches.
30:42Yes, that's right.
30:42It's here.
30:43Let me have a look.
30:43There it is.
30:44Brilliant.
30:45We can see its size and everything.
30:46There it is.
30:47Okay, fantastic.
30:48Can I write to the dermatologist?
30:49Yes.
30:50I'll send it through to them, and then they will take it from there.
30:52Okay.
30:53Okay?
30:54Right, but don't worry about it.
30:55I'm glad you're coming.
30:55It's always good with these lumps and bumps and...
30:57Well, exactly.
30:58Particularly as that's the second time my mum said,
31:00have you been to see anyone about it?
31:02You always want to listen to your mother.
31:03She's always right as well, annoying me.
31:05I'm not going for a third.
31:06No, exactly, exactly.
31:07All right, you take care.
31:08Nice to see you.
31:08Bye-bye, Charlotte.
31:09Bye-bye.
31:11I fainted probably a good month ago now.
31:15Ended up in any...
31:16Triggered the whole blood test thing.
31:18Yeah, yeah, yeah.
31:18Sodium levels were really low.
31:19Still getting the dizzy spells, and now I'm also getting my heart going.
31:25Yeah.
31:25I've become very, very light-headed.
31:28Yeah.
31:28My head starts going all over the place.
31:30There's something not quite right in my head still.
31:33Okay.
31:34I'm having the most awful dizzy patches.
31:38I feel like I'm about to faint.
31:40Okay.
31:41I've not fainted.
31:42Good.
31:43I just feel really unwell.
31:50John.
31:51Oh, here we are.
31:52Yes, okay.
31:55I'll ask you to sit in the hot seat, if you don't mind, with the arms.
31:59Hi.
31:59Very good friend of John.
32:00Oh, very good.
32:02What's your own name?
32:03Catherine.
32:03Lovely to meet you, Catherine.
32:04Lovely to meet you.
32:05And John, I'm...
32:06That's a good arm accent I'm hearing.
32:07Very strong.
32:08Good, good, good.
32:09So, tell me, what's been going on?
32:12How can I help?
32:13This morning, I got up, and I was really pleased.
32:15I was awake early.
32:16I like getting up at five in the morning.
32:17Very good.
32:18And I was looking forward to finally getting some work started.
32:20Very good.
32:22Because I had, you know, the heart operation last week.
32:24I do, yeah.
32:25And then I went for a shower.
32:26In the shower, I just lost all my energy.
32:30Right.
32:30I got towards the radiator in the bathroom, and the legs did the wobbly business.
32:35You know when it goes...
32:36Yeah, yeah.
32:37So, then I sort of went down the radiator.
32:40Right.
32:40And I was kicking the wall, trying to get my energy up.
32:43Anyway, then James heard all the noise.
32:45Okay.
32:46And he knows I'm not.
32:47James, I've got some flat shirings with me.
32:50Okay, tenon.
32:51So, he was outside.
32:52My feet were in the way.
32:53But then I tried to climb up again to stand up.
32:56And then I don't remember anything else after that.
32:59Right.
32:59Because James got in.
33:01He caught me.
33:03And I was next lying down with a sort of towel behind my head in the shower.
33:08Okay.
33:08Did he say how long you were out for?
33:11Oh, moments.
33:12Moments.
33:12So, prior to going down the radiator, did you feel like the heart was going very quickly?
33:19I had no experience of what my heart was doing one way or the other.
33:23Okay.
33:23I didn't feel the heart.
33:24No pain in the chest or any breathlessness.
33:27Nothing.
33:27No.
33:27No breathlessness at all.
33:29So, in the context of having heart surgery last week, sometimes it can be because the
33:36blood pressure is low.
33:38If it's okay, just do the blood pressure.
33:40We can pull it off.
33:41Yeah.
33:42And I will want to listen to your heart and lungs as well, if that's okay.
33:47So, your blood pressure is quite low.
33:49I'm going to listen to your heart and lungs.
33:51If this is continuing to happen, I would prefer to see if we can do this, you know, with just
33:57getting in contact with the team that knows you well.
33:59Yeah.
34:01But, having said that, if it's an emergency, it's A&E.
34:06So, I'll listen to your heart and lungs.
34:07If you want to A&E today.
34:09I think that if it's continuing to happen.
34:12Nice deep breaths for me.
34:14Sounds like it is.
34:15Deep breath.
34:35Do you know how much you weigh, by any chance?
34:37Yes, 80 kilos.
34:38Sorry, 80.5.
34:41Very precise.
34:42Amazing.
34:42Yeah, because I weighed myself this morning.
34:45This is your weight over the last seven years.
34:48How much was?
34:49You would benefit from trying to reduce it a bit.
34:53Yeah, I'm trying, yeah.
34:55I have in the past had regimes of dieting.
34:58Okay.
34:59I did lose a lot of weight, but gradually it came back again.
35:03I lost a lot of weight about four or five years ago.
35:07I lost, like, four stone.
35:09Yeah.
35:10But it's gone back on.
35:15Georgina.
35:16Hello.
35:18Hello.
35:18Hi.
35:19Come on through.
35:21Welcome to my sauna.
35:23Oh, my goodness.
35:23It's, like, quite warm in here, I'm afraid.
35:25Come and have a seat.
35:25Hello.
35:26I'm Dr. Pearson.
35:27How are you?
35:27I'm moderately good.
35:29Yeah, moderately good.
35:30Yeah, yeah.
35:30How can we help today?
35:31So, about a year ago, I had problems with my thyroid.
35:35Okay.
35:35I had thyroiditis.
35:36Oh.
35:37Oh, okay.
35:37And was on some medication, sorted itself out.
35:42Okay.
35:43I am now not feeling 100%.
35:45Okay.
35:46I have been putting on weight like nobody's business.
35:50I'm probably about a stone, stone and a half heavier than I was this time last year,
35:54but it seems to happen in, like, very short period of time.
35:58Okay, so that's frustrating in itself, isn't it?
36:00Yeah, and I feel like my thyroid is swollen.
36:04Okay.
36:04And I'm just, just...
36:06Want to double check.
36:07Yeah, exactly.
36:08Totally fair enough.
36:08And I am perimenopause, for sure, 100%.
36:12Yeah.
36:12So, I know that all of these things are...
36:15Might all be connected.
36:16It's the weight thing that's really concerning me, because I've changed nothing about my lifestyle.
36:21If anything, I'm more active now than I've ever been.
36:23Diet hasn't changed.
36:24I joined another yoga studio in the last six months.
36:28I'm glad you've come, because, actually, that's the sort of thing that we need to check.
36:31Yeah.
36:31And is it upsetting you?
36:32Is it sort of frustrating?
36:33It's frustrating.
36:34I go to put on clothes in the morning, and I can't put on the same clothes I put on
36:37a month ago.
36:38You know, it's, like, ridiculous.
36:39So, your symptoms at the moment, so there's obviously the weight that's doing it.
36:42You feel something, perhaps, in your neck as well.
36:45Energy levels?
36:46Not fantastic.
36:47Okay.
36:48Can I check your thyroid?
36:49Yeah, of course.
36:49Is that correct?
36:50Yeah, yeah, yeah.
36:50Please do.
36:50Can I look from the front?
36:51Do you feel your neck is bigger when you look in the mirror?
36:54Yeah, I do.
36:54Does it feel different to you?
36:55Okay, okay.
36:56And the sort of fullness I feel is from here.
36:59Yeah.
37:00Can I go and get you a glass of water?
37:01Yeah, of course.
37:02Because then, if you remember, when you do have an enlarged thyroid, when you drink, it moves up and down,
37:04so we can feel it.
37:05Yeah, sure.
37:05So, if I just go and grab you a quick glass of water, is that all right?
37:08I'll be back in one second.
37:09So, your thyroid gland, which sits like a bow tie in your neck, controls our metabolism.
37:13And when it becomes underactive, it means the thyroid is not producing enough of the hormone.
37:18So, patients feel really tired all the time, almost like their on-off button has been switched to off.
37:23Put on weight, a bit sluggish.
37:25So, there is a little bit of fullness.
37:27Yeah.
37:28And it's a little bit higher than I'd expect it to be necessarily, but not always.
37:32And can we do it one more time, just a bit further down?
37:35It does affect women slightly more commonly than men.
37:38It affects around the age of sort of 40s, 50s.
37:40It starts to develop.
37:41Trouble is, at that age, we're often starting to develop perimenopause symptoms.
37:45And everybody just gets up in the morning and feels a bit tired, a bit achy, a bit this.
37:49And people often just put it down to ageing and life.
37:53Whereas, actually, sometimes we can find hypothyroid and it becomes quite apparent.
37:57I mean, you've seen pictures of people with a goiter, as they call it, like a thyroid.
38:00But they've got massive thyroid.
38:03And it's difficult sometimes to tell, you know, whether we've got it.
38:06But I can definitely feel something moving.
38:07I think there might be.
38:08So I think we absolutely, without a doubt, need to do this blood test to work out what your thyroid
38:12function is doing.
38:13Yeah.
38:14See what the...
38:15Because we can get the blood test done very quickly and get the results back very quickly.
38:17Perfect.
38:18If it's gone skew-iff, we can get you back on some treatment.
38:21Yeah.
38:21But we'll also probably need to involve the endocrinologist to find out again why and what's happening.
38:25Yes, we did last time.
38:25Let's get the bloods done first.
38:27If it's thyroid, it's sort of easy because then we know we can treat it.
38:31Yeah.
38:31But if it comes back normal, then we've got to look at what else could be causing it because something
38:36else is doing.
38:36And actually, perimenopause that you mentioned is really responsible for a lot of these symptoms as well.
38:41And I'm sure if you talk to all your friends of...
38:43Absolutely.
38:43And you're, how old, 49, here we go.
38:45So there is a point that actually you'll find there's a lot of women that say from the age of
38:49sort of 45, 50,
38:50that every pound you put on, you have to do like three times as much work to get it on.
38:53It is really difficult sometimes.
38:55But if you throw thyroid in there as well, you're never going to win.
38:58So we'll do an M.O.T. like we do for a car. We'll give you an M.O.T.
39:01We'll check for everything.
39:02Blah, blah, blah, blah, blah.
39:04And it's got all of them on there. Perfect.
39:06Okay, right.
39:06Thank you so much.
39:07So we'll get that done.
39:07And then I'll keep an eye out for them, Georgina.
39:09Keep an eye out for them and then we'll book you back in again when we get the results all
39:12in.
39:12That's great. Thank you so much for your help.
39:13Okay, take care. Not at all. Nice to meet you. All the best.
39:15You too. Bye-bye, Georgina. Bye-bye.
39:18Okay, so that sounds good.
39:20I'm going to listen to the heart, okay?
39:22So that looks like it's healing nicely.
39:24Do you want me to breathe or just carry on?
39:26Stay normal.
39:27I'm going to just feel the pulse at the same time.
39:30Okay, and bring it up there.
39:33Okay.
39:33Did you restart any blood pressure medication since the operation?
39:38I'm back on the same as before and I had taken my medication this morning.
39:43When this happened?
39:45Before this happened.
39:46I think that maybe the medication has made the blood pressure jump down.
39:51And I think that we should look into this a little bit more.
39:54I think I definitely want to get a blood test to make sure that the blood count hasn't dropped significantly.
39:59Sometimes that can happen after an operation.
40:03I want to make sure that the heart isn't in a funny rhythm.
40:06And I want to make sure that the blood pressure medications, I think that they may be too high.
40:12I'm going to arrange a blood test for you and an ECG here at the surgery.
40:17Oh, great.
40:18Yeah, that's really quick.
40:20So we can try and do that as soon as possible.
40:22I'm then going to call cardiology to see what they suggest in terms of do they want to see you
40:27as soon as possible.
40:28Because you're immediately post a surgery.
40:31Okay.
40:31For now, definitely easygoing today.
40:35Nice to meet you.
40:36Thank you very much.
40:37Nice to have been everything.
40:37Thank you so much.
40:38Thank you, doctor.
40:39No worries.
40:40Bye now.
40:40Thank you so much.
40:41Bye.
40:47Patrick.
40:49Hi.
40:49It's us.
40:50Patty.
40:52Hi.
40:53Thank you for seeing us.
40:55Thank you very much.
40:57So this is Patrick.
40:59Hello, Patrick.
40:59And I am Megan.
41:00I'm the mum.
41:00I'm Dr. Prestoich.
41:01Patrick, do you want to have a seat here?
41:03I've noticed that he has a very funny lump on his skin.
41:07And I just wondered if you'd mind having a look, if possible, please.
41:10Okay.
41:11Yeah, of course.
41:12I only noticed about a week ago.
41:14Okay.
41:14Is it itchy at all?
41:16No.
41:17Painful?
41:18No.
41:19So it doesn't really bother you?
41:21No.
41:21It's just there?
41:22There are a few on his body.
41:24Okay.
41:24There are a few.
41:25Let's have a look.
41:26Shall we show hands?
41:27So this.
41:28So that's the most obvious one.
41:31Mm-hmm.
41:31Okay.
41:32Where are the other lumps, Patty?
41:35This.
41:36The other one.
41:37Okay.
41:38There are one on her foot as well, isn't it?
41:40Yeah, there's two.
41:41Take your shoe off.
41:44Oh, okay.
41:45That's an awkward place to look, isn't it?
41:47No, just stand.
41:48Could you stand for me, please?
41:50Yeah, and lift your foot up there.
41:54Yeah.
41:54So, yeah, these look like viral, viral warts.
41:57Okay.
41:58Um, if they're not bothersome, you can just leave them alone.
42:03Okay.
42:04Sometimes they grow, sometimes they disappear as the immune system eventually fights off
42:08the virus that causes them to be.
42:10Okay.
42:11On balance, if this was my son, I probably would go ahead with treatment because they
42:15can get bigger, can become very painful.
42:19Okay.
42:19Um, yeah, and you can keep getting more of them as well.
42:22Usually there's, um, you know, there's a little paint that you put on.
42:24Paint?
42:25Um, yeah.
42:26And it kind of softens the skin and allows the water to kind of crumble away almost.
42:31Oh, okay.
42:31But each one is slightly different, so, you know, speak to the pharmacist and see what
42:35they have.
42:35Thank you very much.
42:37Thank you so much for seeing us.
42:40All right.
42:43Thank you very much.
42:44You're welcome.
42:45Sorry.
42:46Nice to meet you.
42:48If it's not getting better or anything, just let us know.
42:50Great.
42:50All right.
42:51Not at all.
42:52Have a great afternoon.
42:53You too.
42:53Thank you very much.
42:54It has been a pleasure.
42:55Yeah.
42:56And best of luck with the new job.
42:58Thank you very much.
42:59Bye.
42:59No worries.
43:00I will see you there.
43:01See you then.
43:02Take care.
43:02Have fun cleaning.
43:03I know.
43:04You can have mine if you want.
43:05Oh, no.
43:06Well, funsy now.
43:07Thanks.
43:07Bye.
43:08Take care.
43:09A new nail or grow, and you'll have fancy new toenails before you know it.
43:12And you can always just paint the bit underneath.
43:14All right.
43:14Okay.
43:15Good luck, sweetheart.
43:15I hope it's all right.
43:16Take care.
43:19Bye.
43:22Bye.
43:36Bye.
43:42Bye.
43:43Bye.
43:44Bye.
43:44Bye.
43:47Bye.
44:21We have cockroaches, we have mice, these things and it's constant.
44:25You're going to die, you're going to die and enjoy yourself.
44:28Very positive, I like it.
44:29One of the biggest things that predicts outcome is often motivation, but you're the most motivated person I know.
44:34It's really frustrating.
45:02It's really frustrating.
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