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Short filmTranscript
00:00Here, you have a really large lump.
00:03The baby, I call it, yeah.
00:05It's a big baby, isn't it?
00:06Big baby, yeah.
00:07Twins.
00:1520 years, my life was on hold.
00:18I kept my problem to myself.
00:20I couldn't share it with anybody else.
00:23I couldn't tell anybody else.
00:24I couldn't show it to anybody else.
00:27I know I have a problem, but I just ignore it.
00:31It's just like some monster in your back.
00:37I had it for nearly 20 years.
00:40A lot of small lump, and it started getting bigger and bigger and bigger.
00:44It makes me feel low, very, very low.
00:48It makes me feel dirty.
00:49I can't even bear to look at it.
00:52I really can't bear it. Horrible.
00:55You think it's going to be okay.
00:59You know you're in the back of your mind. It's not okay.
01:03Because of my lump, I spend a lot of time on my own.
01:06I don't want anybody to mention it.
01:08Oh, what's on your back?
01:09I'm permanently hiding myself from the people.
01:17And I'm here with Dr. Emma.
01:19Look at Emma, please.
01:20Without my lump in my back, he would be different.
01:23He'd be happy at retirement.
01:26That's my hope, if Emma can remove this lump from my back,
01:31I'd be a young man again.
01:33Hi Najib.
01:34How are you?
01:34I'm Dr Emma.
01:36Come with me. I'm good. How are you?
01:37Thank you. Thanks very much. Good.
01:40We're just down here.
01:43OK, Najeeb, come on in.
01:45OK, so tell me what you've come along with today, Najeeb.
01:53Yeah, you're not alone.
01:59I see lots and lots of people who have done exactly the same thing,
02:03and then years go by.
02:08For ten years? Yeah.
02:11So this is a big step, then, isn't it?
02:12Very big, very big step.
02:15You know, it's a really big step.
02:16It is. And you're very, very brave for doing it.
02:18That's what I think. Yeah.
02:20So I'm pleased that I'm going to get a chance to see it.
02:23Thanks very much.
02:24I'll take my shirt off. Yes, please.
02:26I'm just going to come round the back, is that OK?
02:28Because I think if you stand up, you'll be too tall for me.
02:31OK.
02:33I can see it already through your shirt, for sure.
02:36Oh, my goodness.
02:41OK.
02:42Now, I'm just going to touch around this, if that's OK,
02:44and you can just tell me if you can feel anything sharp or sore
02:47or painful or...?
02:49No.
02:50OK.
02:52Gosh, this is amazing, Najeeb.
02:55This is amazing.
02:57OK, so this certainly feels like it's a lipoma,
02:59a super, super fatty lipoma.
03:02So a lipoma is purely just a collection of fat cells.
03:06Yeah.
03:06And all the fat cells kind of merge together,
03:09and they're hidden within the skin somewhere.
03:13And how...
03:14What are you thinking now that I'm touching this?
03:16Do you feel OK?
03:17No, I feel OK with you, definitely.
03:19Yeah?
03:20Good.
03:20Yeah, but...
03:21OK, well, this is definitely right at the top of my lipoma lists,
03:25I have to say.
03:26Yeah, I think you are the winner.
03:28This is XXXL.
03:30OK, you can pop your shirt back on,
03:32because it's quite chilly in here.
03:34OK.
03:34Yeah.
03:35So how do you think this first started on your back?
03:38I was once...
03:39I was in the second floor, you know, talking to my friends,
03:43and it was like a balcony with the...
03:47What do you call them? The rails.
03:49OK, yeah.
03:50And I was...
03:51Leaning back.
03:52Leaning back, and I went.
03:53So did the railings just give way?
03:55Is that what happened?
03:56The railing gave way, and what saved me
03:59is like a canopy outside the takeaway.
04:02Oh, my gosh!
04:03When I went there, I hid the canopy, and I dropped.
04:07I broke my hand twice.
04:09What did the people in the shop say?
04:11They couldn't believe it when I stood up
04:13and I walked... I walked home.
04:15Oh, my God!
04:17I think I was drinking, so I didn't feel the thing.
04:21Well, we saved you. You were nice and floppy.
04:24We do know that lipomas do sometimes start
04:27because of a blunt, you know, a dull injury to the skin.
04:31So in some cases it is the body trying to protect itself.
04:35So maybe that is the...
04:37Oh, OK.
04:37Maybe that is the trigger off it.
04:39And because it is quite so big...
04:42Yeah.
04:42..it's definitely one that would be best done while you're asleep.
04:46Yeah, OK.
04:47So our plan is going to be is that you're going to see my colleague
04:53and he is going to do the operation to remove this for you.
04:58Yes, yes.
04:59You'll be free when this is not there.
05:01Oh, I'll be a different man.
05:03Yeah.
05:04Everything I do will be very, very nice, you know, whatever.
05:06Yeah, I suspect it's going to be the little things like that
05:08where you might go to a restaurant and someone says,
05:10I'll take your coat and you go,
05:11yes, take it!
05:13Yeah.
05:15OK, Najib, well, I'm going to make this referral across.
05:17OK.
05:18And then I'll see you back after the surgery
05:20and you can tell me exactly the things that you have done.
05:23Thanks a lot.
05:24OK.
05:30I can't imagine it, you know.
05:32Wake up without the lump in your back.
05:35And I can't wait to see the surgeon now and have an operation.
05:39I will start a new life, a new chapter, new everything.
05:49I didn't notice it until I was in Hayden
05:52when I was in the Coldstream Guards.
05:55From about 1960, yeah, for 60 years then,
05:58I know it's been there.
06:01But further around, I'll be like that Quasimodo.
06:05I definitely don't like anybody looking at it.
06:08And I definitely don't like anybody talking about it.
06:14I have quite a large lump on my hip, which I hate, I detest it.
06:19It is annoying and it's blooming embarrassing, really.
06:25I want to look for some money.
06:27Oh, here's a tenpence here.
06:29No!
06:31Alan's lump has got to a stage it's so big that it's affecting him.
06:36And that's not Alan.
06:39He's very conscious of it now.
06:40If it's visible to anyone, he'll try and jokingly laugh it off.
06:47But I know him and I know that it is affecting him more than he says.
06:53I feel right uncomfortable with myself.
06:56I've seen people, like, pointing.
06:58And I've known for a fact that's what they're pointing at.
07:02It's horrible.
07:07Hello.
07:08We're here to see Dr Emma.
07:10Sure, can you just take a seat?
07:14I just need Dr Emma to tell me that it can be removed.
07:17And if I have to take it home with me, I'll be really annoyed.
07:22Hi there, hi.
07:23Is it Alan?
07:24Yeah, yeah.
07:25Do you want to come with me?
07:26I certainly will.
07:28So what have you come to show me today?
07:30I've come to show you what a growth I've got on my eye, my hip,
07:33that I want removed and I need it removed seriously.
07:36And I'm hoping that's why you're in a good mood to do it for me.
07:40How long has it been there for?
07:42Well, 60 years to my knowledge.
07:4460 years?
07:45Yeah.
07:46It started, I think, when I was in the army.
07:4864 or 65, I was bit with a camel in Hayden.
07:51It bit me arm and then it bit me hip here.
07:54And I had a funny feeling that caused it.
07:56It was only small, but then it's slowly getting bigger and bigger.
07:59Sometimes trauma can either start them off
08:02or sometimes, if you've got one, can make it bigger.
08:05What kind of an effect is this having on you now?
08:07It's causing me concern more than anything now.
08:10OK, I'm going to have a look at this now.
08:12Is that OK?
08:13Oh, yeah.
08:13Yeah.
08:14I'd say I go to bed at 11.
08:16Do you want to look now?
08:18Yeah, I want to see the 60-year-old camel bitten lipoma.
08:22Oh, yeah.
08:23Oh, yeah.
08:24It has given you a tump.
08:26Isn't it?
08:28It's a decent size, isn't it, Alan?
08:30Is it?
08:31Yeah.
08:31Yeah.
08:32It's a good one.
08:33It wibbles.
08:34Is that sore if I push in there?
08:36Yeah.
08:37Yeah.
08:38And then you can sit back down again.
08:41OK, so this is definitely a lipoma,
08:43and it feels like it should be straightforward enough for me to remove.
08:47Oh, lovely.
08:47Yeah, so it should be fine.
08:49So you're going to do it?
08:50Yeah.
08:51Get it right out of my mind now.
08:52Were you worried I was going to say no?
08:54Yeah, a little bit, yeah.
08:55We'll get you through to theatre, OK?
08:57Right, yeah, please.
09:03After my wife, it's the first thing I see in the morning.
09:10You almost become fixated on it.
09:13I want red.
09:15To me, it's very worrying.
09:19It's about the size of a tennis ball.
09:22If it continues growing at this rate,
09:24I don't think he'll be able to move his head very much.
09:27It's just mad.
09:31About five years ago,
09:32I was scheduled to have surgery to remove this,
09:36but I was diagnosed with an advanced prostate cancer,
09:41and so surgery on this had to be postponed
09:43for my prostate cancer surgery.
09:48You all right, Mum?
09:49Yes, thank you.
09:49Where's Dad?
09:50He's in the kitchen.
09:51The prostate cancer was a shock to us all.
09:54What are you doing?
09:55Can I have a feel of it?
09:57Go on.
09:58And I'll poke it.
09:59I wonder what it's like.
10:01Ooh!
10:02It's way firmer than I thought it was.
10:03It moves about, so that's a thing.
10:05You've got to understand that this lump bothers us.
10:10But until it's out,
10:12we'll always be worried.
10:13Is it cancer again?
10:15No matter what I say to them,
10:17they worry.
10:19I can't talk about how important they are to me.
10:34How are you, Bill?
10:34How are you doing?
10:35I'm very well, thank you.
10:37Nice to see you.
10:37I'm Dr Emma.
10:38Do you want to come with me?
10:39Are you coming as well?
10:39Yes, please.
10:42She wouldn't miss it.
10:46Tell me what you've come along with today.
10:49I brought my friend Jimmy.
10:51Our Jimmy.
10:53Our Jimmy.
10:53That's a good Scotsman's name for a lump on his neck.
10:56No, I just call it the lump.
10:57The lump.
10:59That's a generic term she uses for both of us.
11:03I like that.
11:05So when did this start?
11:07I became aware of it about 12 years ago.
11:10And the doctor said, no need to do anything with it.
11:15And it just grew.
11:18Yeah.
11:19And it started being a real nuisance for me five, six years ago.
11:23That's a long time, isn't it?
11:24Because, I mean, it might just be me.
11:27It might just be the way that you're sat.
11:29But it does look like you're holding yourself over to one side.
11:33You know, you're not really sitting up straight.
11:35Do you think that's got worse because of this?
11:36Yeah, absolutely.
11:37Definitely.
11:38It's been with me for a while.
11:40And there were a series of interventions that prevented this being removed.
11:45I found out I got prostate cancer.
11:47So I had a surgery for prostate cancer.
11:49They told me I'd need radiotherapy.
11:51I had 18 months long haul recovering from the radiotherapy.
11:57We said that nearly go on the back burner.
11:59It's become a significant part of my life that I'd like to lose.
12:05Yeah.
12:05To be honest with you.
12:07Now, I am desperate to meet Jimmy.
12:10Do you want a formal introduction?
12:12Yeah, I do.
12:15Hi, Jimmy.
12:16It does feel about the size of a big, like a goose egg, I'm going to say.
12:21Yeah.
12:22It really does stick out quite clearly.
12:25I wonder then, do you remember getting a big bang on the side of the neck?
12:29I came off a motorbike and did serious damage to my neck.
12:33Sometimes it is a blunt trauma that actually sets off lipomas.
12:37It's a little bit like your fat cells making an airbag.
12:40Yeah.
12:40You know, I'm going to, like, toughen myself up here in case I get another attack.
12:45When Jimmy has a growth spurt, he itches beyond belief.
12:50And that's the skin stretching?
12:52Yeah.
12:52Yeah, so any time it stretches, it's a bit like when you're pregnant,
12:55your belly itches because the skin is stretching.
12:59So it's a similar kind of thing.
13:00You get a pain associated with this?
13:02It all aches around this side of my neck pretty much consistently.
13:06Yeah.
13:06OK, so this is definitely a lipoma.
13:11So is this a benign lump?
13:13And the answer to that is yes.
13:14Good news.
13:15Obviously, the easiest way of removing it is to cut it out.
13:18So if you're happy enough, we can get it done today.
13:21Delighted.
13:22Delighted.
13:23OK, come with me.
13:28It's a horrible, ugly thing I've got between my legs.
13:33And it's uncomfortable, it's degrading, it's making me embarrassed.
13:38And I just want rid of it before I do something I regret.
13:44When I was 40, I got food poisoning and it was a fried rice, I did it.
13:49And I brought everything on.
13:53My legs were swollen and then my knees were swollen.
13:56And then I noticed this lump on the inside of my thigh.
14:01And it just grew and grew and grew.
14:06Because the size of it, I call it my baby.
14:10It's really uncomfortable.
14:14That's not far from the floor, really.
14:16It's grotesque, it's horrible.
14:21PHONE RINGS
14:23Oh, it's cold out there today.
14:25Oh, hi!
14:26Here's your bread.
14:28It's life now.
14:29It's like he's got none.
14:31I bit sore last night.
14:32His skin's very dry and itchy.
14:34Plenty of toque on it.
14:35Yeah.
14:36Your mum will do it later.
14:38That she always does.
14:39Look after him.
14:41Right, let's get you washed.
14:44I can't put my pants on.
14:46I can't put my socks on.
14:47I can't put my shoes on.
14:48And, you know, I'm a burden.
14:50Can you see the redness there?
14:52Ow!
14:54Well, I can't go anywhere.
14:55I can't leave him.
14:56Because sometimes he has panic attacks as well.
14:58So you have to be with him all the time.
15:02Oh, does that feel dry?
15:03Mm.
15:05I feel sore.
15:07Sometimes it does get too much for me.
15:10But I love him to bits, so we'll keep going.
15:13My dad's been in and out of hospital three times,
15:15and I was sexist.
15:17Which is very, very worrying.
15:20They phoned my family and said,
15:21you better come and say goodbye to him,
15:22because he's not coming out.
15:25They can't go like this anymore.
15:29They really need some help.
15:31They don't like my mum and dad.
15:33What years have you got life living like this?
15:38Good morning.
15:39You've come to see Dr Emma. It's great.
15:41Hi, morning. Please take a seat.
15:47I can't wait to meet Dr Emma,
15:48and I just hope that she can do something for me.
15:52Quite nice in here, isn't it?
15:56Hiya, Graham.
15:57Yes, good morning.
15:58Hiya, nice to meet you. I'm Dr Emma.
16:00Nice to meet you as well. Come with me.
16:03Thank you very much.
16:04All right.
16:05Yes, fine, thank you.
16:07Got a bit of a long corridor down here.
16:09Oh, well.
16:10We get by, don't we?
16:13So, Graham, tell me what's been happening with your skin.
16:16I've got a swelling to my legs and my thigh.
16:19But all started 27 years ago.
16:22It's building up,
16:23and it's giving this huge lump on the inner thigh.
16:25I can see it just hanging on this side,
16:27but you don't have the same thing on this side.
16:28It's just starting on the other side,
16:30like it did from a few years ago with this side.
16:33Okay.
16:33So, how long has the lump been there?
16:35I think it's been there maybe over two years.
16:38Okay.
16:38It starts off small, and then it just grew and grew and grew.
16:42Because of the size of it, it drops.
16:45Yeah.
16:46And I did weigh it last year.
16:48I got a little scales on a stool,
16:50and I just flopped on the scales,
16:53and it weighed 10 pounds then.
16:54That's quite talented to be able to lift that up
16:57and put it on the scales.
16:58I'm quite impressed with that.
17:00How is that affecting you kind of emotionally?
17:03It affects me health, affects me walking, mental.
17:05I'm just fed up with it.
17:07I mean, I'd like to get a knife and just put some holes in it
17:10and just let it leak.
17:12Well, don't.
17:13I'm here to help you with that so that you don't do that.
17:15That's why I'm here.
17:16Right.
17:16Well, let's get the bits and pieces off so we can have a lick.
17:20Is that all right?
17:21That's fine, yeah.
17:21Good.
17:27Okay, Graeme.
17:29If at any point anything is sore, just you let me know.
17:32To tell you, yeah.
17:33Okay?
17:33So the first thing that strikes me really is looking at your legs.
17:37You have lymphedema in both of your legs,
17:41and then here you have a really large lump.
17:45The baby, I call it, yeah.
17:47It's a big baby, isn't it?
17:48Big baby, yeah.
17:49Twins.
17:49And the big baby is an exaggerated form, really.
17:53These changes on your lower legs.
17:55Yes.
17:56The legs are really quite full of fluid below the knee.
18:00Yeah.
18:01And then what we can see over on this side...
18:03It's starting like that side used to be.
18:05Yeah.
18:05And then as time goes by, it just gets more and more full,
18:09and then it's very difficult then to bring it back.
18:13And then moving up here,
18:15again, you're starting to get the build-up of the fluid.
18:18And when I press on here, you can see my fingerprint is just left behind.
18:23Like deep in it, yeah.
18:24Yeah.
18:24Because of all of the fluid.
18:28The diagnosis of this is something called a massive localised lymphedema.
18:34Typically, we'll just see lymphedema like you have here.
18:37Yeah.
18:37In the lower legs.
18:38In the lower legs.
18:39This is a much rarer form of it.
18:41It's down to the lymphatic system in our body, which is a little bit like our blood system,
18:46except instead of carrying blood, it carries the lymph fluid.
18:51And whenever you have lymphedema, it means that some of these lymphatic channels are blocked.
18:57And it all builds up and builds up, and it causes such massive swelling that things start to merge together.
19:04And then what happens is, is when I just pull this out here, you can see, because these sides rub
19:11together, you then get a build-up of the dead skin essentially.
19:15But also, yeasts can live in here, because this is the most perfect environment for yeast.
19:21And the normal shape of the foot is actually kind of being lost.
19:26The skin has thickened up a lot, and the shape of the toe is all distorted.
19:33Mm-hm.
19:34When your lymphatics aren't working, and then your skin is all damaged like this, you get this kind of decrease
19:40in the local immunity of the skin.
19:41And that really is when, you know, scary stuff can happen, things like sepsis.
19:47So the skin is responsible for the protection of the whole body.
19:53This is not going to get better at all unless we start to try and do something about it.
20:01So there's a few different things that we need to think about in terms of the skin itself.
20:07I mean, we can get your skin much more comfortable.
20:09I need to give you a complete change, actually, in the things that you're putting on and how the skin
20:14is being treated.
20:16Graham's damaged skin and his impaired lymphatic system is no longer protecting him from infection.
20:23The lymphatic system is very important because it houses our immune system.
20:28And when this isn't working properly, he's going to be more at risk of things like infection and sepsis, which
20:34is potentially fatal.
20:38What we need to do is try and work out the next stage of what's going to be the best
20:42thing for clearing these big lumps.
20:46In order to deal with the large swelling in the legs and this big lump in the thigh, I'm referring
20:53him to my colleagues at St George's Hospital.
20:56They are the leading lymphedema team and they are able to get him access to the best possible treatment.
21:04OK.
21:05Well, thank you very much for looking at me.
21:10I'm really happy.
21:12There's light at the end of the tunnel.
21:13Yeah.
21:14So she can help me.
21:16Of course I was.
21:16So I'm really happy.
21:17It's going really well.
21:19I'm glad for you.
21:20I'm glad for you.
21:21Brilliant loser.
21:22Yeah?
21:23Absolutely brilliant.
21:24I'm glad I came now.
21:26Yeah.
21:26It's good to see to me.
21:34It's like an alien monster with scales and things coming off the top of your head.
21:39I think people would be scared if they'd seen my head.
21:43After you.
21:45It's making me become a recluse.
21:52I have multiple lumps across my head, which are...
21:58The first lump appeared 30-odd years ago, which was in the centre of my forehead.
22:05Went to the doctors, had it removed surgically, and from now it has carried on growing and growing.
22:14Currently, I have 14 lumps there in that part of my head.
22:19There is about seven or eight just here.
22:25It's not a pretty sight, and I'd hate other people to see this.
22:30A few months ago, I banged my head on the visor in the van, and it exploded and literally covered
22:36everywhere in blood.
22:39It's been about five years since I've not had a cap on.
22:43But when I go to meet people, it's like, oh, you know, what are they thinking?
22:48Why is he wearing a cap at 62?
22:51The only person that's really seen the lumps in the last few years is my daughter, and that's the way
22:58I'd like to keep it.
23:00Have you still heard nothing back from the doctors about any diagnosis, like, any ideas at all what it could
23:05be?
23:06No, no feedback or nothing.
23:08I know how difficult it can be for you to get up, go out the door and go to work.
23:14I know he's older, so people think, you know, you've lived your life.
23:18He hasn't been living.
23:19He's been coping.
23:21Hey!
23:22Oh, goodness me!
23:25I've got a baby ears!
23:28My grandchildren, they have never seen me without a cap on.
23:33If they see it and react to it, then that would be devastating for me.
23:40Sorry.
23:46Hi, I'm Chris. Come and see Dr. Anna.
23:49Hello there, Chris. Please take a seat.
23:53Hopefully I could get a diagnosis for the condition and have a definite answer to say it's this or it's
24:01that.
24:04Hiya, Chris.
24:04Hi. How are you doing? All right?
24:06Not so bad.
24:06Come on, Di.
24:09Come and have a seat up on the bed.
24:11So you've been having some problem with your skin, is that right?
24:14Yes, over 30 odd years.
24:16I noticed the first one which was in the forehead.
24:18What was there?
24:19It was just like a big lump, a hard lump.
24:23And so then over the last 30 years, you've just had more and more cum?
24:27Yeah, but I've had several removed.
24:30The last operation, I had big skin graft to cover the patch where he took out the lumps.
24:38Did they tell you at that time what they were?
24:41No.
24:41No.
24:41So you've had this thing for at least three decades and you've had bits and pieces cut out of you,
24:48but you've never been told what it is?
24:50No.
24:50I mean, it would be quite nice to know what you've got and why you've got it.
24:53Yeah.
24:55I really can't wait for you to take your hat off so I can have a look.
24:59Is that okay?
25:00Yeah.
25:03Ready for the reveal?
25:04I am actually.
25:08Yep, I can see that all right.
25:11That is quite obvious actually, isn't it?
25:15Okie dokie.
25:16Let's have a wee look.
25:18So that is a right old big chunk taken out, isn't it?
25:21Mm-hmm.
25:22Do you get problems with that at all, the grafted area?
25:27Some of it's not quite healed still now.
25:29Yeah.
25:32I mean, I'm not going to lie.
25:34I'm excited to fiddle with those.
25:38You just tell me if I'm hurting you, okay?
25:41So they're quite pedunculated.
25:42They wibble around quite a lot.
25:44They feel like a grape that's, you know, been left out for maybe a week or so.
25:53Yeah.
25:53The ones that are ever so slightly...
25:55Going off.
25:56Yeah, ever so slightly squishy.
25:59They're wide on top but they're on a bit of a stocky base.
26:02And this one's a really old withered grape.
26:05Okay.
26:07Oh, they're so impressive.
26:09You've done a great job of growing these, I have to say.
26:11So if this is an Olympic sport, I'll get a gold medal then?
26:15100%.
26:15Yep.
26:18So, do you know what they are or have you got an idea?
26:22I know exactly what this is.
26:23Thank goodness for that.
26:26This is definitely a condition called Brook-Spiegler syndrome.
26:30Wow.
26:31A name at last.
26:32Yeah, you've got a name.
26:33Brook-Spiegler syndrome.
26:35It's pretty special.
26:37It's very rare.
26:38So we don't see it very often.
26:40And they're all something called cylindromas.
26:44They're completely benign.
26:45In other words, they don't turn into anything bad or nasty.
26:49And they're due to a change in one of the genes.
26:54Usually it's passed down from one of your parents.
26:57But sometimes it just appears as a single mutation.
27:00What we can do is help to manage the ones that are problematic for you.
27:06Today, I'm going to do the ones that are really the most cosmetically obvious,
27:10which is the big clump on this side.
27:12Yeah.
27:12Hopefully we'll get the bulk of those ones gone.
27:15Shall we get you in for surgery then?
27:16Does that sound okay?
27:17That sounds wonderful.
27:18That sounds wonderful.
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