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00:16I feel trapped in my legs.
00:21I've had this many, many years.
00:25People stare and point.
00:29It's taken a lot of my life.
00:33If I can't get help, I feel that I will just be left till I can't walk.
00:43I just want a normal life.
01:06So have you got the keys for the house yet?
01:08Yeah, yeah, I do.
01:09Do you need anything?
01:10Yeah, wardrobes.
01:11I have three, so I don't need any more.
01:14Maybe you'd like them.
01:15Yeah, I would love them.
01:16Yeah?
01:17We've got a cycle.
01:21Good morning.
01:22Morning.
01:24Dr. Creighton's office, how can I help?
01:26Hello.
01:27Hey.
01:29Are you in charge today?
01:31Oh, hey.
01:31Yeah, yeah, yeah.
01:32Because I have Sam coming in, and it would be OK to block off the afternoon for her, because
01:37she's pretty complicated, so I want to make sure she gets all the time that she needs.
01:41Yeah, sure.
01:41I'll do that right now, actually.
01:59My condition started probably sort of 20-odd years ago with a protruding lump.
02:05Daddy.
02:07Who's he?
02:08My doctors, they weren't sure what it was.
02:12It's just progressively got worse.
02:14Come on, darling.
02:16Come.
02:16Come.
02:17Let's sit.
02:18No.
02:24The pain is really unpleasant.
02:28My legs can get very hot.
02:31They are ugly.
02:36Where my ankle is, it goes right in, and then my feet are massive.
02:42The skin just flakes off.
02:46I've got quite a lot of sores on my legs.
02:48If I knock them, it bleeds a lot.
02:52And I eventually had a diagnosis of lymphedema, and it's a build-up of fluid in a limb or limbs.
03:00They are very heavy.
03:02I can barely lift my legs up.
03:05I'm stuck because I can't get help.
03:17Hi, Sam.
03:18Hiya.
03:19You all right?
03:20Yeah, not bad.
03:21Hi.
03:21Hi, Moosey.
03:25I suppose you want to walk, do you?
03:28Thanks, Gordon.
03:30See you in a bit.
03:30Thank you so much.
03:32As I live alone, if my sister Michelle and her husband Gordon are my main support, things
03:39that I used to take for granted, like walking into town, you can't do any more.
03:45It's nice for Gordon to do the dog again.
03:48Yeah, he doesn't mind.
03:50You know he'd do anything to help.
03:51How are your legs?
03:53They're not very good at the moment.
03:55I've still got the sores.
03:58Oh, that's very warm.
04:00Yeah.
04:01They're just so heavy.
04:03Fingers crossed Dr Emma can help.
04:06We want you back to the bouncy Sam and you're happy, chatty, making little jokes, all that
04:15that you've lost because of your condition.
04:21I'll grab your coat, Sam.
04:23Moose, you stay in your bed, darling.
04:25Gordon will be back later.
04:28We used to go walking a lot.
04:31We used to play badminton.
04:35And slowly, each little bit that she used to do has gone.
04:47It's not how she's meant to be.
04:54And you're in with me with Sam later, but I think I'm just going to go and grab some lunch
04:58now.
04:58See you then.
05:00Yeah.
05:00See you soon.
05:01Bye-bye.
05:09Hello.
05:09Welcome aboard the Southern Service to London, Victoria.
05:13How are you finding the journey?
05:15You know what it's like.
05:16My legs just get irritated.
05:18But then I don't normally do any journeys, so no pain, no gain.
05:21It's going to be worth the journey.
05:23Yeah.
05:31That's it.
05:34I am an admin coordinator within the NHS.
05:41In your own time?
05:43Yeah.
05:44I'm not going into the office at the moment because I had a bit of a fall at work.
05:50One of the main problems is having shoes on my feet.
05:53It's really painful.
05:55One well, Bec?
05:56No problem.
05:58Oh, that's great.
05:59That step never had one of those before.
06:02Thank you so much.
06:08I hope you got your positivity pants on today.
06:11I've got two pairs on.
06:13Good.
06:17Oh, it's here.
06:18There you go, guys.
06:21That's my stomach.
06:22It's just gone down to my kneecaps.
06:32Hiya, it's Sam.
06:33I'm here to see Dr. Emma.
06:34Fantastic.
06:35If you just take a seat, I'll let her know you're here.
06:37Perfect.
06:37Thank you very much.
06:41So sit here and shout.
06:42That'd be perfect.
06:43Yeah.
06:44I bought some of those photos just to show that I actually had legs at some point.
06:49Do you remember that?
06:50That was your hindu.
06:52Which one?
06:53That one.
06:54No, which hindu?
06:55Oh, sorry.
06:56I keep forgetting you've been married a few times.
07:00Whenever I've seen anyone sort of medical, I feel like people don't know what to do with me.
07:06Okay.
07:14A few deep breaths.
07:26Hi, Sam.
07:27Oh, hi.
07:27Hi, nice to meet you.
07:28I'm Dr. Emma.
07:29Hi.
07:29Come with me.
07:30Come with me.
07:31Come with me.
07:32Michelle's coming with me, if that's okay.
07:33Michelle.
07:34And is Michelle your sister?
07:35Yes.
07:35I can tell.
07:38My sister and I are so similar as well.
07:40Sometimes she'll go in somewhere and they'll ask her questions about the skin.
07:45And my sister's like, I am not Emma.
07:49Okay, come on in.
07:51Have a seat.
07:52This is Mottie.
07:53He's our nurse.
07:53Hello.
07:54Nice to meet you.
07:56So, Sam, what have you come to see me about in clinic?
07:58My legs.
08:01I have been diagnosed with lymphedema.
08:04You'll probably see by the size of my legs.
08:08Your feet look so tiny.
08:09I did have legs at one point.
08:13That's all the sisters.
08:15Oh, that's gorgeous.
08:16That's me.
08:17Fabulous legs.
08:18The next one, probably more obvious, and that's me there on the end.
08:23Oh, yeah.
08:24Look at the hair.
08:25I know.
08:26Look at the scary hair.
08:29Very delicate little ankles.
08:31I did.
08:31Yeah.
08:32Incredibly small ankles.
08:34You sort of look at that and you think, oh, my God, I've gone from that to this.
08:38And what about in your family?
08:40Is there anyone else who has swollen legs like this?
08:42And have you ever been on any medication?
08:44Only antibiotics, you know, if you've had a chest infection or something.
08:48So, really, you've been very well.
08:50Yeah.
08:50And then, out of the blue, your legs started to swell up.
08:54Yeah.
08:54I kept on sort of mentioning it to the doctor.
08:56And nothing really got done.
08:59So, then I pushed it a bit seven years ago.
09:02And they just kind of looked at my feet and said, oh, you've got lymphedema.
09:07But they would want me to lose weight.
09:09Yeah.
09:09Before they even consider me for any help.
09:13Obviously, I can't move that well.
09:16So, I'm sort of in that sort of catch-22 situation.
09:19I've gone from walking and doing lots of other things to nothing.
09:24And it's just, it's completely and utterly changed.
09:33It's changed my life.
09:34It's changed my life.
09:36Okay.
09:37Yeah.
09:38So, I mean, this means a lot.
09:40Yes, definitely.
09:41I don't think people really understand.
09:43They see the size of my legs.
09:46They just think I'm just some fat person, you know.
09:49And it can be quite hurtful.
09:52Because there's so many reasons why somebody has extra weight.
09:57And the idea of having your legs as swollen as this and then expecting you to be able to do
10:03some exercise is just, quite frankly, ridiculous.
10:07So, not an awful lot of help with these then over the last 10 years.
10:11Cosmetic is what they say to you, isn't it?
10:14That's not my favourite word.
10:17Somebody has used the fact that this is a cosmetic problem.
10:20Yes, yes, I was told more than once.
10:23I just felt like I've got no hope.
10:26You're worried that you're going to end up in a wheelchair, aren't you?
10:29I don't want to.
10:30I'm independent.
10:31I want to be able to keep on my feet.
10:34Yeah.
10:34In a way, you're my last resort.
10:36Because I don't know where to go.
10:39I don't know where to go from here.
10:57Can I take a message?
11:01Right, OK.
11:02Oh, your poor legs.
11:03I'm going to need help.
11:04I'm afraid I can't lift them.
11:06Oh, goodness.
11:08You've been dealing with this for so many years.
11:12Right.
11:13Ready?
11:13One, two, three.
11:14And then the other one.
11:15One, two, three.
11:17Oh, thank you.
11:18Let me go get Emma for you.
11:20Lovely.
11:20Thank you so much.
11:23So I can see that these really are like having two toddlers on your legs, aren't they?
11:28Yes, they are.
11:29Some weight in them.
11:31The lower legs just completely swollen and they are bigger than your thighs.
11:36Yes.
11:37It's almost like the opposite way round, isn't it?
11:40Yeah.
11:40It's interesting how it's spared around these natural joints.
11:45And partly it's because they're compressing against each other, so it's stopping them from swelling up.
11:50And then what's happened is you've got these outpouchings.
11:54There are these little weak areas.
11:55They're just full of fluid.
11:57So the pressure that's happening inside the skin pushes them out.
12:03And you have hundreds and hundreds of these nodules right the way across.
12:06And the reason why it has the scale that you're seeing and the dryness is because it's not being fed
12:13properly, this skin.
12:14It's under too much stress from all of the fluid and it's just not getting enough nutrients to it.
12:21And actually, it also means that it's much more likely to have infections appear.
12:25This is the skin just saying, I need a bit of help.
12:28I'm under pressure.
12:31So this is definitely a condition called lymphedema.
12:34The lymphatic system in the body is not working quite as it should do.
12:39And all of the lymph fluid, which is this very watery substance that's responsible in our body for carrying waste
12:46in our immune system and things, it gets stuck.
12:49And for most people, their lymphatic drainage works like a pump and it pumps all of the fluid back up.
12:56But unfortunately, something's gone wrong in your legs and that lymphatic pump is just not working anymore.
13:03And that's why all of this fluid just gathers and gathers and gathers.
13:07Can you have any idea why it's happened to me?
13:11Some people get it after infections, but it doesn't sound like that's been the case.
13:15Sometimes some medicines can cause it, but again, you don't fit into that category either.
13:20A lot of people will get this because of genetic reasons.
13:23But the very idea that this is just simply cosmetic is more than frustrating because essentially everything in dermatology is
13:31a cosmetic problem because everything is visible.
13:34I almost find it like an insult in a way.
13:37You're exactly right.
13:38This is a medical problem that needs a medical plan put in place to get this better.
13:44And the only way really to do that is to reduce the excess weight that you have and with something
13:50called compression.
13:52So number one, we know that for some people, they naturally just put on weight.
13:58And often it can be related to just the way that we process our food.
14:02I think it would be really worthwhile using some of these new injections that we have called GLP-1 agonists
14:09to help get that under control.
14:11Number two is speaking to the lymphedema clinic that I'm very close to.
14:16And you need to have a course of intensive, usually inpatient, compression therapy.
14:22Compression works by mimicking that pump that's not working anymore.
14:27So you start off with a whole lot of great pressure down here in order to drive any of the
14:33fluid that's in the bottom of the legs all the way up.
14:36I'm just, you know, truly grateful.
14:38It will make a massive difference to me.
14:40It really will, thanks.
14:42OK.
14:43It'll make me cry.
14:47Do you mind if I just have a look at your face?
14:49Because I think your skin's a bit red.
14:52So you have some papules and pustules, which are the little spots.
14:56You have some telangiectasia, which is the broken blood vessels.
14:59And we can see this red, slightly dry patch.
15:04This is a very classic kind of a rosacea.
15:07This is totally unrelated to the lymphedema in the legs.
15:10But today, if you're up for it, I can do a laser treatment.
15:14Oh, that would be lovely.
15:15And we'll just get it started.
15:20Come on in.
15:22And Sam, this is Fritz.
15:23Oh, hiya.
15:25Our laser special nurse.
15:27Whilst the lymphedema in Samantha's legs is pretty challenging to treat...
15:31Sorry.
15:32I got you here.
15:34The rosacea is something that I can help with quite easily.
15:38Have you ever had a laser treatment before?
15:41And for hair.
15:42So it's kind of the same, really.
15:44And immediately afterwards, it gets a bit more swollen.
15:47But it's just for a couple of days.
15:50One, two, three.
15:52That's it.
15:53OK.
15:56Very good.
15:57And then over here.
16:00It's weird.
16:01It's like cold, but burned.
16:03Yeah.
16:04You're doing very good because most people jump.
16:06This is a laser that anything that's red in the skin absorbs the light energy and converts it to heat.
16:16And in that process of heating them up, it essentially destroys them.
16:21Done.
16:23That's it.
16:25Googly.
16:26You're like, thank you for blasting me.
16:28Thank you for freezing my face off.
16:31Very good.
16:33So the plan for Samantha's rosacea is a skin care program with creams in combination with some laser sessions.
16:40OK.
16:41You can gradually and slowly sit up and we can help you.
16:44But even more importantly, I need to urgently speak to the lymphedema experts about her legs.
16:50Honestly, it's one of the worst cases of lymphedema I have seen.
16:54Her mobility is really suffering.
16:56We need to get on with this straight away.
17:00Dear Professor Gordon, I'd be very grateful if you could see my patient who is presented with bilateral leg lymphedema.
17:07Dr. Crathorn's office, how can I help?
17:09I am grateful for your thoughts regarding potentially inpatient compression for this patient.
17:14With kind regards, yours sincerely.
17:16Hi, Emma.
17:17Your next patient's here now.
17:18Oh, brilliant.
17:19I've just dictated a letter over to Professor Gordon about Sam.
17:22OK.
17:22Do you mind to get that sent out urgently?
17:24Yeah, absolutely.
17:25No worries.
17:38Good morning.
17:40Just received the parcel with my medication in it for the weight loss.
17:45It's a pen.
17:49And that's the first one done.
17:51Thank you very much.
18:05Very good, filling up your water bottle.
18:07I am being much better.
18:08I'm drinking two litres every single day.
18:11That's a nice new water bottle.
18:12It matches the scrubs.
18:13Yeah, I know.
18:13It matches them exactly.
18:15Yeah.
18:15Let's see how long I can have this one before I lose it.
18:18Two hours.
18:19Two hours.
18:23Rosie, I'm going to bring Samantha in here with the lymphedema team.
18:27Can we use this room?
18:28Yeah, sure.
18:28I'll get a prep for you.
18:29Thanks.
18:31Today is a crucial day in determining the treatment plan for Samantha's lymphedema.
18:36Hi.
18:37Hi.
18:38How are you doing?
18:39Good to see you.
18:39Oh, good to see you.
18:40Hi, Paul.
18:41How are you doing?
18:42Good to see you, yeah.
18:43OK, let's go through.
18:44Professor Gordon is a real expert in lymphedema,
18:47and Mark is a manual lymphatic drainage therapist.
18:51My hope is that Professor Gordon and Mark
18:54reduce the size and swelling of her legs.
18:56I've brought some friends to see you this time.
18:59I want friends.
19:03So this is Sam,
19:04and you can really see the amount of lymphedema
19:07and the kind of destructive changes it's now causing.
19:09Yeah, it's lighted everything that I do.
19:12We can help.
19:13Don't worry.
19:13In your case, fat attracts fluid,
19:15so we need to have less fat on the body,
19:18so you're retaining less fluid,
19:19but also when we're overweight and we're sitting down all day,
19:22the tummies are squashing the groins,
19:23which is where the lymphatic fluid and blood in the veins
19:26is trying to drain, and it's struggling.
19:28So if I could wave a magic wand for you today
19:30and help you lose weight quickly,
19:32your lymphatic system would already start to respond.
19:35She's just started on weight loss injections.
19:37Brilliant, so you're making steps already.
19:39Unfortunately, we can't cure lymphedema.
19:41Intensive treatment is what you need.
19:43We're going to do six weeks with you,
19:44so lots of padding,
19:45and then a really tight bandage, but it's comfortable.
19:49We also need you to be active,
19:50to be moving in those compression bandages
19:52and to be losing the weight.
19:54How does all of that sound?
19:55I'm excited and nervous.
19:58Shall we let you get on with your magic?
20:00Do it.
20:00LAUGHTER
20:04Right, so first of all,
20:05I'll put some cream on.
20:07Samantha is understandably nervous,
20:09so Mark is going to apply the compression bandages now
20:13to give her an idea of what to expect.
20:16Are you ready?
20:16Yeah.
20:17I quite often get cramp.
20:19Because it's an alien weight
20:20and your muscles are not built to lift that kind of weight,
20:23so that's why you're getting cramp.
20:25Saying yes to this treatment is a big commitment
20:28because she has to be prepared to come down
20:31and stay in London on her own for six weeks of treatment.
20:36The processes I'm going to go through every single day.
20:39Every single day,
20:40because in an ideal world,
20:42as the fluid comes out and the shape improves
20:44and the volume goes down,
20:45the bandage will fall off
20:46if we don't change it enough.
20:51I'm going to be walking like sort of Donald Duck or something.
20:54You will for the first couple of days.
20:59They look like moon boots on your legs, don't they?
21:02They feel like moon boots.
21:03Yeah.
21:04They're going to feel heavier,
21:05but once you start moving,
21:06you'll realise your legs are stronger than this bandage,
21:09so it'll feel less weird as time goes by.
21:11Can't wait to see what it's going to look like.
21:13I can't either.
21:16So how the next six weeks will work
21:18is that Samantha's going to be staying
21:20in an inpatient hotel
21:22that's right beside the Lymphedema Centre.
21:25She will be there Monday to Friday,
21:27and then at the weekend,
21:28she'll get a bit of a break
21:29to go back and see her friends and family,
21:31because this is going to demand a lot of her,
21:34both physically and emotionally.
21:57It's that what your walking stick's for.
21:59Yeah, that's what my stick's for.
22:03I have to be honest,
22:04it's going to be really intense
22:06being away for six weeks.
22:09This is your energy.
22:10Oh, lovely.
22:12But you have to do these things
22:14to get a better quality of life.
22:21Oh, this is sweet.
22:23Wow, look at this.
22:26Microwave, little stove.
22:28So, apart from Moosey,
22:30it's got everything I need.
22:33You are, man.
22:35Yeah, I'm fine.
22:36You're going to be OK?
22:37Yeah, I'll be fine.
22:39I'm feeling a bit emotional.
22:41Everything's just happened so quickly,
22:43and it's going to be hard.
22:46Bye.
22:46Take care, darling.
22:47Bye.
22:47Bye, bye, bye.
22:48Bye, because she's really on her own.
23:11Hi, Anne.
23:12Hello.
23:13Hi, Anne.
23:13Nice to meet you.
23:14This is Anna.
23:15Hi, Anna.
23:16How are you?
23:17I'm all right, thank you.
23:18How are you?
23:19Very well, indeed.
23:20Nice to see you again.
23:23Right.
23:23So, first of all,
23:25we're going to have a look
23:25at these lovely legs.
23:31So, there's an excoriated area.
23:34Yes, somebody accidentally
23:36rammed me with a pram.
23:37It looks wet.
23:38Because it's just water
23:39pouring all over it,
23:40all the time.
23:41It's not got chance
23:41to heal or anything.
23:43It's really painful.
23:44Well, you'll be sitting there,
23:45and I'll be like this.
23:47Yeah.
23:47It really brings me down.
23:49I'm going to measure you now.
23:52I'm going to draw some dots on you,
23:53and Anna's going to write
23:54some of these down.
23:55So, we're going to start
23:56nine centimetres up.
24:00Can you hold that for me?
24:01Oh, yeah, sure.
24:0651.2
24:0853.4
24:1165.2
24:13How many more?
24:1566
24:17So, we'll remeasure them
24:18again at the end,
24:19and we can impress everybody
24:20and say it's gone down
24:21by X centimetres.
24:24Right.
24:25So, we're going to start
24:25these bandages.
24:26Ready?
24:27Yeah.
24:27Just going to go over your foot
24:28and up to your ankle.
24:31Oh, sorry.
24:32Yeah, it's very sore at the back.
24:33Sorry.
24:34Sorry.
24:37I feel like my toes are quite little.
24:39They'll soon be in proportion.
24:43So, in the early stages of this,
24:45we need to pad the ankle
24:48so that when the bandage
24:49goes around it,
24:50it doesn't dig in there,
24:51and fluid from your foot
24:52can just pass out.
24:56We call it the shelf.
25:03Good.
25:05You can expect
25:06more trips to the loo.
25:08This fluid has to come out somewhere.
25:10We want it to chase up here,
25:12up through the middle,
25:13into your bloodstream,
25:14your kidneys to pick it up
25:15and wee it out.
25:16The more mobile you are,
25:18the more fluid will come out.
25:19Yes.
25:20Sitting with your legs down
25:21like this
25:21is counterproductive.
25:23Yeah.
25:24I'll come back tomorrow
25:25and we'll reboundage
25:26the same as today.
25:28Take care.
25:32Oh, dear.
25:36It's like Velcro,
25:37this stuff.
26:04So, I had my first week
26:06of the leg wrapping.
26:08I could probably win an award
26:10for the amount of pee
26:11that I've done.
26:12I pee at least
26:14seven or eight times a night.
26:17It's a lot of wee.
26:18That's all I can say.
26:24I've been signed off
26:25for six weeks from work.
26:27A lot of people
26:28probably wouldn't like
26:29being on their own,
26:30waiting for treatment
26:32every day
26:33and I've been okay.
26:46It's almost hypnotic
26:48watching them wrap my legs.
26:52how they know
26:54where to
26:57apply the pressure
26:58and stuff like that.
27:02It's just very clever.
27:19Oh, hi.
27:20Hi, Sam.
27:21Nice to see you.
27:21How are you?
27:22Yeah, I'm fine, thank you.
27:24Well, well, well.
27:25Look at these tiny little legs.
27:27Just my shins
27:28have been a bit uncomfortable.
27:30I don't know why.
27:31It will be uncomfortable,
27:32I'm afraid,
27:33because we've got rid
27:34of the major bulk.
27:36Your nerves
27:37on the edge
27:37of that bone there
27:38were engorged
27:40in that fluid
27:40and now the nerves
27:42on the front of that shin
27:43are going,
27:44oi.
27:45We need to get
27:47your muscles
27:49activated.
27:50Once we can get you
27:52walking,
27:52I believe it will
27:54desensitise the nerves
27:55at the front of this shin.
27:56She needs to understand
27:58that engaging
27:59that muscle tone
28:00in her legs
28:01is going to help
28:02improve her mobility,
28:04her weight loss journey.
28:05I've been moving
28:07as much as I possibly can.
28:10We need to get you
28:11back walking
28:12as soon as possible.
28:13For more or less
28:14the last year
28:15I could manage
28:16a few steps
28:17but not much more.
28:19I'm going to have
28:19to work very hard
28:20but it's really
28:23difficult.
28:31Emma,
28:32I've got you
28:32some lunch
28:33because I know
28:33we've got a really
28:34busy day ahead of us.
28:35As well as the busy day,
28:37I've also thought
28:37I might go and see
28:38Sam after work
28:39just to see
28:40how she's getting on.
28:41She's about halfway
28:41through her compression
28:42therapy now.
28:44I thought I'd give her
28:44a little bit of
28:45moral support.
28:45Oh, that's nice.
28:46So I really
28:47appreciate this.
29:01Oh, hello.
29:02Hiya.
29:03Hello, Lucy.
29:07Hello, darling.
29:08You look really good.
29:10You know that, don't you?
29:13No.
29:14I know,
29:14when you look in the mirror
29:15you don't see
29:16what I see.
29:18Immobility's definitely
29:19better because you
29:20haven't got the weight.
29:22It takes a lot
29:23of hard work
29:24but it's paying off.
29:26As we always say,
29:27love you, bye.
29:28Love you, bye.
29:39Oh, hi, Sam.
29:40How are you?
29:41I'm fine, thank you.
29:42Lovely to see you.
29:43You just caught me
29:44in the middle of unwrapping.
29:46Well, that's exactly
29:47what I wanted, actually.
29:50It's interesting
29:51because even with
29:52all of these dressings
29:53on your leg,
29:54the leg looks smaller
29:56than it did
29:57whenever I saw you.
29:59There you go.
30:00Wow.
30:00Oh, my gosh.
30:02It's all squashed down.
30:04This was such a big,
30:05massive ridge before.
30:07It was.
30:08It was unbelievable.
30:09What does it feel like
30:10when the dressing's off?
30:12Does it feel really light?
30:14It goes...
30:15And how have you been feeling
30:16in the kind of pain
30:18or discomfort?
30:19I'm having quite a lot
30:20of pain in my chin.
30:21Yes.
30:21Right, let me help you
30:22with that.
30:22Oh, lovely, thank you.
30:24And look, you're even
30:24lifting your leg now.
30:26I know, I know.
30:26Well, this is going
30:27to be the thing, isn't it?
30:28It's actually getting
30:29the exercise back
30:30into the muscles.
30:35Takes me back
30:35to A&E days
30:36when I was a junior doctor
30:37you actually used to do this.
30:39Oh, did you?
30:40Yeah.
30:40Oh, wow.
30:42Wow.
30:43Oh, my gosh.
30:45I can hardly...
30:45I cannot believe this.
30:46I've got legs under this.
30:47You do?
30:48You've got ankles
30:49rather than a shell.
30:54Sam is making
30:56just wonderful progress.
30:57So her legs,
30:58they were bigger
30:59than her thigh
31:01and so the very fact
31:02now that they're
31:02almost half the size
31:03of the thigh
31:04is so telling.
31:05Really amazing.
31:07To have made
31:08such progress
31:09is brilliant.
31:10You yourself,
31:11you look so well.
31:13So up until last Friday
31:15I'd lost 29 and a half pounds.
31:18That's amazing.
31:19At the moment
31:19I can't see it so much.
31:21I can see it in my...
31:22I can safely say
31:23it's all going
31:24in the right direction.
31:25Absolutely.
31:26And I know
31:26which way it's going.
31:27Straight out,
31:28up, down,
31:29through my kidney
31:30and in the toilet.
31:38To see Dr. Emma today
31:40was absolutely lovely
31:41and since I've started
31:44the treatment
31:45the advice that came with it
31:46was obviously exercise
31:48which I haven't done
31:50for quite a while.
31:54Everything that's going on now
31:56is all pushing me to walk
31:58which is what I'm trying to do.
32:00It's really nice
32:02to be outside.
32:03It's a life changer for me
32:05and I'm looking forward
32:07to more of it.
32:09understanding of what could I do
32:09because what kind of man
32:09I don't.
32:10Yeah.
32:38I don't live
32:38but it's all
32:38but it's all
32:40Look at you girl. Oh, thank you. Have a good week? Yep, thank you.
32:48Nice to be home for the weekend though. Oh yeah, it's lovely to see you. Moose was getting
32:53excited. Yeah, I'm really looking forward to seeing him. You'll be walking in soon.
32:58That would be good for both of you. Oh yeah. I'll get your bag. He's a good boy. Oh, you
33:07are you feeling? I'm not bad, just tired. The wrapping is quite tight. Intensive. Yes.
33:24Shall we go up the garden? Come on. Yeah. Your legs are looking fantastic. Thank you. It
33:37I think you've got all that padding on still. No. I think it's, look, look at you. Is there
33:43anything that you're worried about at this point? You know, lymphedema is not curable and
33:49it can come back. So the minute any of this stops, it will just come back. You're very
33:54determined. Yes, 100%. Good for you. Thank you for my flowers. I just want to thank you for
33:59what you've done for me and that you always do for me. Anytime. Thank you. Thank you.
34:05Thank you. All right. And a cuddle for you. Good boy.
34:17Oh, hey. Have you been busy? Yeah, really busy. Oh, who do you have next?
34:21Uh, Sam's coming for her last laser. Oh, the patient with lymphedema. Yeah, yeah.
34:25Emma said she's looking really good. Yeah.
34:35Ready, Samantha? Oh, come on. Yeah, good. Come through.
34:39Hi, Samantha. We'll get you up here. Lovely. All right. I should be able to wiggle my bum on
34:46here. Whoa. Look at that. Yay. See? Brilliant. That's how I know that you're getting better,
34:52because the last time we had to help you up. Exactly. Yeah. How are they feeling? Because
34:58they were so heavy. Oh, my God, so much lighter. So the plan will be that after next week,
35:02the dressings will be off permanently. Yes. And you'll be replacing those with stockings
35:07that you do yourself at home. And how are you feeling about that? I'm quite excited really,
35:11just to get on with it and do the next bit. I think that's exactly the right attitude.
35:16Because some people think, oh, I don't want to have to do something every day. But we all have to
35:19do stuff
35:20every day. We all have to brush our teeth every day. Yeah. We all have to put socks on every
35:23day. Yeah.
35:24But you're just going to have rather funky looking stockings.
35:28And the skin in the face that has the rosacea on it, I mean, it's looking so much better, isn't
35:32it?
35:32It definitely is. It's got such a glue, hasn't it? Yeah. Let's put these goggles on. Thank you.
35:39We're going to pop the laser on. One, two, three. That feel OK? Yep. Good.
35:58Do it.
36:00Do it.
36:01Do it.
36:05Do it.
36:07Do it.
36:17I can't believe it's my last day. That's six weeks. Where's that gone? Mark is going to show me how
36:24to manage my condition at home going forward. So that'd be quite exciting and scary, all in one.
36:36Hiya. Hey, how are you? I'm all right, thanks. Excellent. Looking forward to today? Yes, absolutely. You should be. Good,
36:42good, good. So what we're going to do today is work out exactly how much each leg has gone down.
36:48Can you hold that up there for me, Sam? Thank you.
36:55That's measuring 35. Last time, this was how big your leg was. That was 65, now it's 45. That's 20
37:05centimetres. That's a big difference. It's amazing.
37:10We've helped you every day for six weeks. Now the hard bit comes. To keep those volumes as they are,
37:18we've got some garments and some wraps. They're labelled left and right because they're bespoke.
37:22Yeah. And you turn it inside out from the heel. Then you slide your foot in until your heel's in.
37:30And you take the top bit. That's it. Then you'll get that crease out.
37:34It's really important not to have creases because your skin's a bit fragile and then you'll think something's digging in.
37:41That's it.
37:41Is that gone? That's great. They fit good? Yeah. They feel good? Yeah. Excellent. So now we've got one on.
37:47I just want to make sure before we go that you can do it.
37:53Wonderful. Just some wraps now. They're little Velcro wraps. Feels like it could go with a little bit tighter. Give
38:00it a little extra squeeze.
38:01Because if they're too loose, you're looking down the path of going back to how it was again. You can't
38:08give it an inch because it will take a mile.
38:11Look at that. Lovely jabbling. That fits good.
38:16We're done, Sam. Let's bring it in. Let's give you a hug. You've done really, really well. Take care. Bye
38:22-bye. Bye.
38:26From this point onwards, it's all down to me. All the help that Dr. Emma has put in place for
38:34me.
38:36I have to continue. I have to make sure that I follow everything I've been told to the letter.
38:45I cannot go back to having the legs like I had before and I will keep it up.
38:52I feel positive. I feel happy.
39:08You easily empathise with the concerns of other people. Yeah.
39:12You often prefer to read a book than go to a party. Yes.
39:15What are you doing? Personality tests. That tells you if you're an extrovert or an introvert.
39:20OK. Can I do a question? Yeah.
39:22The more people you speak to, the better you feel. Yes.
39:26Do you not? No.
39:28What depends on who you're speaking to, I suppose?
39:30You rapidly get involved in the social life of a new workplace.
39:34No. Yes, you do.
39:36No. You often organise it.
39:38You often prefer to read a book than go to a party.
39:41Absolutely not. I prefer the party.
39:52We're here. Last appointment.
39:58Can't wait to see Dr. Emma, see what she has to say.
40:03Hi, Samantha. Oh, hello. Are you all right? Yes, we're fine, thank you.
40:07Hi. Hiya. Hey, come with me.
40:11You're walking even faster now, aren't you? Yes, aren't I?
40:14That's so good.
40:16Come on in here.
40:18So, this is Rosie.
40:20Lovely to meet you, Rosie. Nice to meet you.
40:21Nice to meet you. Nice to meet you, Michelle.
40:24OK, so, look at these legs.
40:26So, at the beginning, the legs down here were wider than the legs at the top.
40:32Oh, wow.
40:33But you look completely different.
40:36Not the legs just look smaller, but you look a lot smaller too.
40:39Yes. I've lost 21.3 kilos.
40:42Wow. So, just under 47 pounds.
40:44That is amazing. Amazing.
40:46How do you feel?
40:47I feel great, of course.
40:49Yeah, you've got so much energy, it looks like.
40:52Yeah, it's made a massive difference.
40:54And what kind of things do you feel that you've started to do now
40:58that you absolutely couldn't do before?
41:00Popping out, popping to the shops, you know, little walks with the dog.
41:04How do you see this difference in her?
41:06She holds herself more.
41:09She's up here rather than down there.
41:12I noticed that.
41:13It's a massive shift.
41:14And you have followed everything to the very letter of the law.
41:18Absolutely. I said I would. I said I would and I have.
41:21Now, I see that there isn't any compression socks on just now.
41:24Is that just to show me?
41:25I got prepared, yes, to show you.
41:27Well, I can't wait to actually see the legs.
41:29Is that okay?
41:31Yeah.
41:39There you go.
41:40Oh, my goodness.
41:42Look at the fact that you're even holding them up like that.
41:44As far as before, I've never...
41:45Honestly, could not have done that.
41:47These legs are getting stronger as well as lighter.
41:56I mean, just what a difference, isn't it?
41:58It's unbelievable, isn't it?
41:59It really is such a difference.
42:06And the skin quality itself looks so much better than it did
42:09because it was always a bit raw.
42:12And then this was what we call the shelf.
42:14The shelf, yeah.
42:14And the shelf is overhanging.
42:20The colour, it will continue to change over time.
42:23And these are just all the blood vessels, you see,
42:26that support the fact that the leg had got bigger.
42:28And now it's not bigger,
42:30but all the blood vessels are all squashed in close together
42:33and that's why it's that colour.
42:35But you're going to have your compression on.
42:37Yeah, I really don't mind.
42:39Let's stand you up so I can have a look at the back.
42:48I mean, that's just fantastic.
43:00Lost 30% on one leg and 36% on the other.
43:05It's a massive difference.
43:08Well, I'm so delighted at how far you've come
43:11in actually what isn't that long a period of time at all.
43:15No, it's not.
43:16No, I'm so pleased for you.
43:18And I thank everybody that's been involved because...
43:22Because without your help, we wouldn't be where we are now.
43:26Yeah.
43:26So it's just been amazing for Sam.
43:31Thanks for me.
43:34It's so much.
43:35My pleasure.
43:36It's so lovely to see.
43:38It really is.
44:19You
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