- 2 weeks ago
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TVTranscript
00:00MUSIC
00:10Morning, surgery.
00:13I'm told that cobwebs are the best thing.
00:17That's not advice that I'm familiar with.
00:19That is my modern tablet for all day.
00:23You must feel like you're rattling sometimes.
00:25It's a lot, really.
00:27This foot is normal.
00:29Yes.
00:30This foot looks like a Cornish pasty.
00:35I got out of bed, and all of a sudden,
00:37all of a sudden, I was pouring with blood.
00:39My nightdress was full of blood.
00:46It's good, John.
00:47It's really good.
00:59It's good.
01:00It's good.
01:01It's good.
01:05ORCHESTRAL MUSIC CONTINUES
01:24Vernon? Yep? Hello, morning.
01:28We're in here today, it's a bit warm, but not too bad.
01:31Have a seat. Shall I sit here?
01:33No, you get this seat. I need to play on the computer sometimes.
01:36Sorry, sorry, sorry.
01:37No, no, no, don't be silly. What's happened?
01:39Now I've got a lot of complaint.
01:41Oh, dear.
01:42Erm, I had some pain.
01:45OK.
01:46I don't know if it was liver or whatever, but it was round here.
01:50It was very hard. OK.
01:52And then it moved to here.
01:55Oh. So how long has all this been happening for then?
01:58Well... Weeks? Sort of...
02:00Months, months. OK.
02:02I think over half a year.
02:04But my stomach...
02:06Mm.
02:07I had some funny...
02:09As I get up in the morning, straight away I go to the toilet,
02:13and that was not normal.
02:15So that was going to the toilet to open your bowels?
02:17Yes.
02:18It was a bit funny.
02:19I mean, I didn't mind it, but it wasn't usual.
02:21No, so it was a change for you.
02:23Yeah.
02:24I'll just show you something, Doctor.
02:26Yeah.
02:27That is my amount of tablet for all day.
02:29So you line these up?
02:30Wow, that's a lot of tablets.
02:32I take all this in the morning.
02:33Yeah.
02:34That is the supplements that I take myself.
02:36OK.
02:37So you've got these ones that we give you, these in the evening.
02:39And these, these... Yeah.
02:40And do you know why you're taking all these tablets, Vernon?
02:42Well, I know some of them when I had that heart attack and that stroke and thing.
02:47I know some of them is in that area.
02:49Yeah.
02:50But blimey.
02:51So the problem is that each one of these tablets is there for a reason,
02:55and it does seem like a lot.
02:56You must feel like you're rattling sometimes.
02:58It's a lot, man, really.
02:59Yeah.
03:00Just think about it.
03:01It's 14, 15 tummies.
03:02Yeah.
03:03But you're going to live to 100 with all of these,
03:04because we're going to keep you going, my friend.
03:05Oh, 100?
03:06Really?
03:07So you've got to keep going with them.
03:08And I think...
03:09I am slightly worried about the fact...
03:10Can I just have a feel of your tummy?
03:11Yes.
03:12Is that all right?
03:13Come and pop up on here.
03:14Let me just...
03:15If you just...
03:16That's why I want to come and see you, Doc,
03:17because I've been seeing you.
03:18When I had my heart attack, it was you.
03:20I know.
03:21When I had my stroke, it was you who came to my thing.
03:23Can I just have a feel of your tummy?
03:24Yes.
03:25OK.
03:26Any pain in your tummy now?
03:27No.
03:28And if I just press at the back, any pain in the...
03:30The pain was up here, Doctor.
03:32So it's much higher, isn't it?
03:33Right there, the pain was.
03:34OK.
03:35Stay sitting.
03:36I'm just going to have a listen to your heart for a minute.
03:40Strong as a horse.
03:41Oh.
03:43Not as a human?
03:44No.
03:45As a horse.
03:46But that's all your tablets that you're taking, keeping your heart good.
03:48So that's good.
03:49I'm a little bit more worried about your bowels and things.
03:51A slight change in bowel habit needs to be checked.
03:55OK.
03:56So what I will do, sweetheart, is that do you think you can drop in a stool sample for me?
04:00A poo?
04:01Yes.
04:02And if this is negative, then I'm happy with that.
04:03Then we'll move on and work out what else we need to do.
04:05OK?
04:06And let me just get you a pot.
04:07OK.
04:08OK.
04:09So this is how we do it.
04:10It's called a fit test.
04:11This is how we do it.
04:13Yeah.
04:14There's a song.
04:16I know there's a song.
04:17You've got a lovely voice.
04:19This is the test we do.
04:20It's very easy to do.
04:21The instructions tell you what to do.
04:22And then drop it back round here.
04:23So I won't seal it, but I'll give you all of this.
04:26All right?
04:27Go and have your breakfast.
04:28Have a break.
04:29And you take care.
04:30All the best.
04:31Bye-bye, Vernon.
04:32Bye-bye.
04:34Bye-bye.
04:35Have a nice day, all right?
04:36Yeah.
04:37Cosimo?
04:38Cosimo?
04:39They're calling me.
04:40OK.
04:41Bye.
04:42So take a seat.
04:43My name's Anna McHugh.
04:44I'm one of the doctors.
04:45It's nice to meet you.
04:46You too.
04:47Thanks for seeing us.
04:48No worries.
04:49So what's been going on?
04:50Do you know what's been going on?
04:52Yes.
04:53I feel good that I came down.
04:54Good.
04:55Thank you, Doc.
04:56So what's been going on?
04:58Do you want to show her?
04:59So he basically has got an infected thing.
05:02But it was massive yesterday, and I got it out.
05:05Can you see?
05:06But it's really painful for him.
05:08When did this all start?
05:10When did it happen?
05:11Yesterday morning.
05:13Oh, so quite quick.
05:14So you've been 24 hours of...
05:15Yeah, you woke up with it, didn't you?
05:17And did you bang your finger off anything?
05:19I don't know.
05:21OK.
05:22What did you do?
05:23I just woke up with it.
05:24You just woke up with it.
05:25OK.
05:26You weren't digging in the ground or anything like that, or biting your nails or anything?
05:31No.
05:32And have you ever had it?
05:33Has he ever had anything like this before?
05:35No.
05:36I have.
05:37I remember I have.
05:38Did you?
05:39Well, we have a little look.
05:40So I just didn't want to leave it and it to get worse again.
05:42Yeah.
05:43So it looks like what's called a paronychia.
05:45It's quite sore, isn't it?
05:46I'm sorry.
05:47So there's definitely a collection of pus there and it looks like it's infected.
05:52Yeah.
05:53We'll try four times a day an antibiotic cream.
05:56OK.
05:57And if you've noticed that it's not improving, let's say in 48 hours, then we can, yeah, we
06:02can give you an oral antibiotic.
06:04OK.
06:05At the end, can I have a sticker?
06:06OK.
06:07Oh, would you like a sticker?
06:08Yes.
06:09I think we do have one.
06:11I have some options for you.
06:13What do you say?
06:14Oh, gosh.
06:15Um...
06:16What's your favourite animal?
06:17A lion.
06:18Yeah.
06:19Perfect.
06:20Do you see what it says?
06:22Awesome.
06:23Nice.
06:24Well done.
06:25Thank you so much.
06:26No problem at all.
06:27What did you say?
06:28What did you say?
06:29Say thank you.
06:30Bye.
06:40Jack, please.
06:42Jack.
06:46And here.
06:47Hello.
06:48How are you doing?
06:49Lovely to meet you.
06:50I've been reading all about you and I had a chat with Dr Pearson as well.
06:53You poor thing.
06:54Yeah, no, it's crazy.
06:55It sounds like it's been a whirlwind of a few weeks for you.
06:56Yeah.
06:57How are you getting on?
06:58Actually, better than I thought I would.
07:00OK.
07:01I think, kind of, after going through brain surgery, I thought I would need a bit more time
07:05to feel back to normal, but actually...
07:06And what are the initial symptoms that you had that sort of prompted this whole...
07:10Honestly, I'd never had any symptoms prior to the seizure that I actually had that put
07:15me in hospital.
07:16So just a one-off seizure, went into hospital, did a scan, they found a benign brain tumour,
07:20thankfully.
07:21Thankfully, yeah.
07:22Thank goodness.
07:23And then you were into surgery straight away, cut it all out.
07:25Brilliant.
07:26So Jack is a young lad who presented initially to the hospital services having had a seizure.
07:33On investigation, it was found that he had meningioma, which is a type of brain cancer.
07:38So he was rushed into emergency surgery and it was removed.
07:42Thankfully, it was a benign tumour.
07:44Fine.
07:45OK.
07:46And how's the recovery been?
07:47You say, I mean, I've had my sleepless nights for sure.
07:50You poor thing, you've been through the mill, haven't you?
07:52What are we doing today?
07:53How can we help today?
07:54So I've been feeling like some chest pain whilst lying down.
08:00And initially I thought it might be muscular.
08:03You know, it just felt muscular, but it's only on the right side.
08:07There are many complications after such major surgery.
08:11One thing that we do worry about a lot is something called a pulmonary embolism,
08:14which is a blood clot that affects the blood vessels around the lungs.
08:18And that can often present with sharp shooting chest pain.
08:21And it's been now three or four nights where I've, you know, it's been quite painful.
08:26And I've kind of had strained breathing, difficulty breathing.
08:30There's no way to do it.
08:31There's no way to do it.
08:35There's no way to do it.
08:36There's no way to do it.
08:37No way to do it.
08:38I don't know if you do it on purpose.
08:39I don't know if you do it on purpose.
08:41I'm not doing it on purpose.
08:43I swear to God, that's how I'm typing.
08:45Look, even on my phone, yeah, like...
08:47I'm like this as well, like...
08:49It's just the nails.
08:51Don't be a hater.
08:53We a lover, yeah?
08:55I'm always a lover, baby.
08:57That's how I like it.
08:59I'm like this as well, like...
09:01It's just the nails.
09:03Don't be a hater. We a lover, yeah?
09:05I'm always a lover, baby.
09:07That's how I like it.
09:15Jennifer.
09:17Come on through.
09:19Tell me... Right.
09:21...what's been going on for you?
09:23We'll have a little look at this foot.
09:25Oh, yes. Right, there you go.
09:27So, excuse the toenails.
09:29You can pop the foot down and we'll get the story first.
09:31Okay, so I've just been on a fitness week.
09:33Okay.
09:35My navicular bone was really hurting.
09:38Are you medical?
09:39Navicular bone is very...
09:40No, I'm horsey.
09:41Oh, you're horsey. Okay.
09:43Sorry.
09:45When I was on my fitness week,
09:47this toe hurt like mad when I was pressing it down.
09:51And since then, the side of this...
09:53The bone up the side here has been really hurting.
09:56Yep.
09:57And obviously you can see that it's hugely swollen.
09:59Quite swollen, yeah.
10:00Can I ask, did you have any trauma to it?
10:02Did you fall or go over on it or anything like that?
10:05I jumped off a five bar gate.
10:06Okay.
10:07And I know it's really hot at the moment,
10:08so I know people's feet are likely to swell.
10:10Yes.
10:11But this foot is normal.
10:12Yes.
10:13This foot looks like a Cornish pasty.
10:14But we definitely have an injury on that foot.
10:17Okay, well, we'll examine you here.
10:19I'm just going to move the foot, okay?
10:21Okay.
10:22It hurts on top of the toes.
10:24Top of the toes.
10:25Keep your leg where it is.
10:26Just move the ankle bone like this.
10:27Like that?
10:28Yeah, exactly.
10:29It hurts on the outside.
10:30Okay.
10:31And move your toes up and push down as if you're pressing on a pedal.
10:34Fantastic.
10:35Is that painful?
10:36Nope.
10:37Okay.
10:38So it's more than likely that you've done some musculoskeletal damage,
10:40so kind of a ligament or something like that.
10:42Great.
10:43So what I think we should do is the usual.
10:45Yeah, rest, ice, elevate and compress.
10:49Okay.
10:50Then I'll give you anti-inflammatories for a week
10:53and I'll give you a tummy tablet alongside that.
10:56That's kind.
10:57Yes.
10:58I think that once we get this injury rehabbed,
11:00I think physio is also a good idea.
11:02We need to definitely give this some time to heal
11:05and hopefully we'll be on to a winner.
11:07That would be really good.
11:08Yeah.
11:09That's really kind.
11:11Lovely to meet you.
11:12Where are you from in Ireland?
11:13Cork.
11:14Oh, are you?
11:15Yeah.
11:16Oh, yeah.
11:17My husband got divorced in Cork.
11:18Oh, God.
11:19Great place.
11:20Everyone has a story from Cork, I think.
11:21They do.
11:22Can I listen to your breathing?
11:23Is that okay?
11:24Yes.
11:25Great.
11:26Can you take a few deep breaths in and out for me?
11:27Lovely.
11:28Take a very deep breath in and then force out as quick,
11:29as hard as you can.
11:30Oh, it's not bad.
11:31Okay.
11:32Okay.
11:33Okay.
11:34And then you breathe deeply in and out through your mouth.
11:37Nice deep breaths for me.
11:38Lovely.
11:39Yeah, that sounds pretty good.
11:40That sounds pretty good.
11:41Which is good news.
11:42Okay.
11:43Oh, it's not bad.
11:44Okay.
11:45Any shortness of breath when you're up and about?
11:46No.
11:47Sort of walking around and stuff?
11:48No.
11:49No.
11:50No.
11:51No.
11:52Good.
11:53Any wheezing sounds coming from the chest that you've noticed?
11:54No.
11:55Not.
11:56Well, I mean, a force, I mean, force wheezing, yeah, but like trying to loosen the
12:01chest, like the chest up.
12:02Fine.
12:03And have you managed to bring anything up?
12:04No.
12:05It's been really dry, right?
12:06And you mentioned it's only been sort of three or four minutes.
12:08Yeah.
12:09Yeah.
12:10Yeah, that sounds pretty good.
12:11Yeah, that sounds pretty good.
12:12That sounds pretty good, which is good news.
12:13Any shortness of breath when you're up and about?
12:14No.
12:15Sort of walking around and stuff?
12:16No.
12:17No.
12:18Good.
12:19Any wheezing sounds coming from the chest that you've noticed?
12:20Mmm, not.
12:21Well, I mean, a force, I mean, force wheezing, yeah, but like trying to loosen the, like,
12:24the chest up.
12:25Yeah.
12:26Fine.
12:27And have you managed to bring anything up?
12:28No.
12:29It's been really dry, right?
12:30Because it's only been sort of three or four nights maybe.
12:32Yeah.
12:33So it's Saturday afternoon, I've been feeling this.
12:34Yeah.
12:35We did like a big day out, which he hasn't done a lot of exercise in a while.
12:39Yeah, of course.
12:40So when he came home, that's when it started to hurt.
12:43Are you able to lie on the couch?
12:45Yeah, for sure.
12:46Is that okay?
12:47Grand.
12:48Lovely.
12:49Really, really good.
12:50And it's all on this side?
12:51Yeah.
12:52All on that right side, yeah.
12:53When I can pinpoint the pain when it's really bad, it's kind of in behind here.
12:57Right there.
12:58Yeah, kind of there.
12:59Yeah.
13:00Yeah.
13:01Fine.
13:02Can I get you to take a deep breath in and out for me?
13:05Good.
13:06Really good.
13:07Are you able to sit up for me?
13:14Brilliant.
13:15That's really good.
13:16Thank you so much.
13:17So there's good air entry throughout.
13:18Normal sounds.
13:19So no crackles, no wheeze.
13:20The thing that I was thinking of as well is, could there be a bit of crepita?
13:23So air in the wrong bit?
13:24Right.
13:25I'm not feeling that or sort of getting a sense of that.
13:27So I'm really reassured it's nothing serious.
13:29Yeah.
13:30It most likely is muscular.
13:31Now what you could do is use a bit of ibuprofen gel, a topical therapy just to rub into that
13:36area.
13:37Exactly.
13:38Voltrol, whichever one.
13:39If there's any other symptoms, so the shortness of breath is getting worse on exertion or when
13:43you're upright and stuff, then come and let us know.
13:46If the chest pain is happening not just on lying down and not in certain positions, again,
13:51it's something to let us know about.
13:52Do you have time now for a quick blood test?
13:54Yeah, sure.
13:55Yeah.
13:56Sharp scratch.
13:57Three, two, one.
13:59There we go.
14:04So these results should be back by tomorrow actually.
14:07And then our policy is that if they're really abnormal, we'll contact you.
14:10If you don't hear from us, you can assume they're fine, but of course you're welcome
14:13to call for the results.
14:14All right.
14:15Perfect.
14:16Thank you very much.
14:17Great.
14:18My pleasure.
14:19You're very welcome.
14:20All right.
14:21Jim.
14:22Come on, sweet, sweet tap.
14:23Hello.
14:24Come on in.
14:25Come and have a seat.
14:26How are you doing?
14:27No, 50-50.
14:28You poor thing.
14:29So tell me what's happened.
14:30Um, I think since we started this journey, I have lost, I was at my biggest 24 stone.
14:46I'm now 13 and a half stone.
14:47Wow.
14:48I mean, you do look fantastic to tell you.
14:50You look really good.
14:51And obviously I can tell you're really pleased with yourself.
14:52I don't know.
14:53It's just, I got discharged.
14:55I was doing really well.
14:56I feel like my ADHD at the time, because of the severity of it, it was masking quite a
15:01lot of my borderline and how much I was actually really struggling with that.
15:05Okay.
15:06Yeah.
15:07So I thought I was doing all right.
15:08Things weren't terrible at the time.
15:09It weren't great.
15:10But I thought I could deal with everything that was on my plate.
15:11Yeah.
15:12Yeah.
15:13Thought I'd process stuff I clearly hadn't processed.
15:14Okay.
15:15And then I got to stop the aeroproprozole, but I was only ever on five.
15:18So I've known Shane since she was a child and she's been struggling with her weight and
15:22her mental health for most of her life.
15:24And we've been trying to help support her through both of these challenging journeys.
15:28She's managed to drop her weight and her BMI considerably.
15:31And it will hopefully help with some of her musculoskeletal problems.
15:34Her mental health has often been a challenge and that often comes in combination with being
15:39overweight.
15:40And she's currently under the crisis team who are there to help us when things are really
15:43very difficult.
15:44So are you on anything then at the moment?
15:46Nothing at all.
15:47And do you think you can manage without anything?
15:51If the support is there.
15:53Yeah.
15:54Yeah.
15:55But what support do you think would help?
15:57I don't, I have no neighbour, I have no one to speak to.
16:00And friends and stuff from Fulham, are they able to come?
16:03I don't have many friends.
16:04And it's difficult isn't it?
16:05Like real friends.
16:06Yeah.
16:07And it's hard to let people in and...
16:08My mental health is always just everything, I don't know, something about, I don't know.
16:12If I'm happy I'm manic.
16:13I'm not just having a good day or anything, there's something wrong with me.
16:17If I'm sad, I'm depressed, there's always something wrong with me.
16:20I always am mentally ill to a lot of the extended friendship group and it feels like
16:25no one ever trusts me.
16:26And what I'm saying, they don't check in on me, they've never...
16:30The ignorance around mental health, that we people are frightened of it, they don't know
16:33how to do it, so they often don't pick up the phone because they're not quite sure what
16:36to ask and what to say and things, so it's not so much that they don't like necessarily
16:40as a person, they just don't know how to approach it.
16:42I can understand I'm not the easiest.
16:44And the fact you're engaging with the crisis team now is great and I think if they do want
16:47you to start on medicine obviously we'll help support that.
16:49You know what it's like for me, I've been in and out of hospital being stabbed and poked
16:54and scammed since the age of 11 and it doesn't look like it's going to stop.
16:58The ADHD hierarchy team have been amazing.
17:00OK, fine, brilliant.
17:01So far so good.
17:02So I don't think we've got a shared care yet.
17:04No, not yet.
17:05I'm still dose deciding.
17:06So of course as you know we're happy to support that.
17:08So once you're stable we'll take over that and I think we'll try and just keep things moving.
17:12The only other question I had was I have a plastic surgery appointment on the 10th of July at Chelsea and West.
17:17You have it?
17:18What are we asking them for?
17:19Tummy, tuck, arms, boobs.
17:20OK.
17:21Because if you've lost all that weight and you've got all this excess skin it is horrible.
17:24Yeah.
17:25They will want to know that your weight has been stable for at least two years.
17:27It's been coming down.
17:28Because they'll be nervous to operate if your weight is fluctuating.
17:31The problem is when you have a weight of that weight it will have impacts on your body.
17:35You did the right thing, you've dealt with that but now we've got all the other bits and pieces that we'll try and deal with.
17:39Thank you, thank you.
17:40Well done, sweetheart.
17:41Well done, good luck with things.
17:42You take care.
17:43Thank you so much.
17:44All the best.
17:45Bye-bye.
17:53Martin.
17:54Yes.
17:56Hi Doctor.
17:57Hi there.
17:58Hi there.
17:59Come on in.
18:04Hi, I'm Doctor.
18:05Hi, I'm Doctor Prestowich.
18:06Nice to meet you.
18:07How are you doing?
18:08I've got this backache.
18:09I don't know what can do about that.
18:11Backache?
18:12Well, I've got this curvature of the spine.
18:14Yes.
18:15How long have you had this abnormal curvature of your spine?
18:17Well, it's sort of gradually got worse over a number of years really.
18:21Right.
18:22I suppose for a couple of years or so.
18:25Okay, so it's not something that you had all throughout your life.
18:28No.
18:29No, no, no.
18:30I think, yeah.
18:31Okay.
18:32And any idea what's led to that?
18:33I did work in the post office and I think I've always carried things on one side.
18:39I don't know really.
18:40Okay.
18:41I mean, I can only assume that that has something to do with it really.
18:44Wow.
18:45It's all right when I'm sitting down the line there.
18:47Right.
18:48But when I'm walking, I find it's getting worse really.
18:52And where is the pain?
18:54Um, I mean, the bones are sticking out a bit there really.
18:58Yeah.
18:59So that down in the lower back area?
19:00Yeah.
19:01Yes.
19:02Have you ever seen a bone specialist about this?
19:04No, I haven't, no.
19:05I did have an x-ray a year or two ago.
19:08It's okay if I examine your back?
19:09Yeah.
19:10Yeah.
19:11Can you come and come behind here for me, please?
19:19And are you standing as straight as you can right now?
19:22Um, almost, yeah.
19:24This is where it's hurting you the most?
19:26Yes.
19:27Yeah.
19:28I mean, it's sort of painful I lean against you.
19:31Just trying to feel where your hips are as well.
19:33Yeah.
19:34Okay.
19:36And this is getting worse than when Dr. Minkinsler saw it?
19:40Yes.
19:41Okay.
19:45So July last year, we did an x-ray.
19:48Um, I'm inclined to repeat x-rays.
19:53Yeah.
19:54It's getting worse.
19:55Uh, and I'm referring you not to physiotherapy, to an orthopaedic specialist.
20:00Yeah.
20:01Yeah.
20:02Yeah.
20:03Yeah.
20:04It is a significant deformity, isn't it?
20:06Yeah.
20:07Yeah.
20:08Uh, it's really impacting you day to day as well.
20:12Yeah.
20:13Limiting your function, causing you pain.
20:14Uh, that, that being said, Martin, I'll refer you to them.
20:17I, I, I don't know what the treatment options are.
20:20No, no.
20:21No, no.
20:22So I don't know what your expectation should be in regards to what they can do.
20:25Well, yes, it would just be nice to know what they are.
20:27Yeah.
20:28Yeah, of course.
20:29Yeah.
20:30What the options are, really.
20:31Do you, do you live on your own, Martin?
20:32No, it's with me, my brother.
20:33Your brother?
20:34Yeah.
20:35Okay.
20:36Is he in good health?
20:37Yes, yes.
20:38Okay.
20:39He is 80.
20:40Okay.
20:41So he, he's a bit older than you.
20:42Yeah.
20:43And so you're, you're living in a house together.
20:45Yes.
20:46But you have no one else coming in with help at all?
20:48No, no.
20:49Okay.
20:50And, and do you feel like there's anything you do need extra help with at the moment?
20:53Um, not particularly.
20:55Okay.
20:56That's good.
20:57Yeah.
20:58So what I'm going to do now is I'm going to request, um, x-rays of the, um, thoracic and
21:02lumbar spine.
21:03Right.
21:04And then once we've got those back, I'm going to put them in a referral, send them to the orthopaedic
21:06team.
21:07Okay.
21:08The most pressing thing is, is, you know, getting that x-ray done.
21:11Yes.
21:12Yeah.
21:13Yeah.
21:14Great.
21:15Okay.
21:16Do you have a hand?
21:17There it is.
21:18Yeah.
21:19Okay.
21:20I like that.
21:21Okay.
21:22Thank you, doctor.
21:23Nice to meet you.
21:24Thanks.
21:28Gemma.
21:29Hi, y'all.
21:31I should do one of those.
21:32I want one of those cams.
21:33Oh, they're so good.
21:35Come on in.
21:37Hi, y'all.
21:38Hi, y'all.
21:39Hi, y'all.
21:40I'm coming on nearly four years ago, and I ended up having a big accident in my home,
21:45which caused my jaw to be crushed.
21:48It was left inoperable because of the nerve that's in the way.
21:51Okay.
21:52The last couple of weeks, I've had changes.
21:54Like, I've got constant tingling sensation.
21:56Like, I'm getting headaches.
21:57So, all around the back of my ear, like, under my eye and around the back of my neck.
22:03But now, even when I'm talking to you, it's like, the tingling sensation is just constantly
22:08in the side of my face.
22:09Okay.
22:10And I've noticed, like, even in the way that I chew my food and the way that I'm talking,
22:13I'm very conscious and aware that there's a change.
22:16Yeah.
22:17Like...
22:18Have you ever had the tingling before?
22:19Is that completely new?
22:20I've had tingling before, but not all the time.
22:23Okay.
22:24But you would say you've had this tingling?
22:26Yeah.
22:27So, it's been aggravated before, but it's not been long-lasting.
22:30Yeah.
22:31Okay.
22:32And what did the surgeon say when they kind of last saw you?
22:34So, they said that they had to leave it.
22:37Yeah.
22:38Left inoperable because the nerve said it caused me to be paralyzed if they touched it.
22:42Right.
22:43Right.
22:44So...
22:45Oh, yes.
22:46I met...
22:47When was this?
22:48I met him on...
22:49Saturday.
22:50Saturday.
22:51See, you know better than me.
22:52Yes.
22:53So, he came around 7.30.
22:54So, he came...
22:55All right.
22:56A bit later.
22:57Yeah.
22:58A bit later.
22:59So, we drove.
23:00It was a nice drive.
23:01You know better than me.
23:02Yes.
23:03So, he came around 7.30.
23:06So, he came...
23:07All right.
23:08A bit later.
23:09A bit later.
23:10So, we drove.
23:11It was a nice drive.
23:12He was nice.
23:13He even had his hand on my leg like this while he was driving.
23:14I'm like, oh, I feel like a princess.
23:16Wow.
23:17Okay.
23:18He bought all the food.
23:19So, and then we're talking, talking.
23:21And then, obviously, he started kissing me.
23:23All right.
23:24And then, obviously, I'm eating as well.
23:26We did...
23:27One minute.
23:28One minute.
23:29One minute.
23:30You're kissing him while you've got chicken in your mouth.
23:33I was hungry.
23:34Yes.
23:35Okay.
23:36Dirty man.
23:37Hello.
23:38Surgery.
23:39When they'd done the 3D x-ray, it was described as my jaw was crushed.
23:47Ever tried any painkillers for the nerve pain?
23:49I have tried, but nothing is helping at the moment.
23:52And what have you tried?
23:54I've tried naproxen.
23:55I've tried cocodamols.
23:56I've tried normal paracetamol.
23:57I've tried hot and cold compressions on it.
24:02And nothing seems to be making a difference.
24:04Okay.
24:05Let's have a little look in the mouth.
24:07When was the last time you saw a dentist?
24:09About a year ago.
24:11Okay.
24:12But they even struggled because I can't open my mouth as wide as what I used to either.
24:16And any pain kind of internally at the moment?
24:19Or is it just this tingling?
24:20Not internally, no.
24:21It's just a constant...
24:23It's more of an ache, like a fuzzy ache.
24:26Something's constantly on the nerve.
24:28That's what it feels like now.
24:30And if you were to kind of get the exact path where it goes in your cheek, where would you say it is?
24:34So it's all here.
24:35Yeah.
24:36Goes round the back here.
24:37Round the back.
24:38Round, like, to the back of my neck there.
24:39And sometimes I get the thingy under the eye.
24:42You know, it feels like it's twitching, but...
24:45Let me have a quick look in your mouth first.
24:48So I'm just going to feel around the teeth.
24:50Any pain there?
24:51Uh-uh.
24:52And on the upper?
24:53Uh-uh.
24:54There?
24:55Yeah.
24:56Where does that pain?
24:57Right into the cheek?
24:58Yeah.
24:59Okay.
25:00Okay, and this side's okay?
25:01Mm-hmm.
25:02When I press there, is that the same pain?
25:04Yeah.
25:13Just a quick fill of your neck.
25:15Any pain up in here?
25:16Mm-mm.
25:19Any pain when I press along there?
25:21Yeah, it's...
25:23It just feels like I said more than eight.
25:27Okay, and you just smile, show me your teeth.
25:29Good.
25:30Puff your cheeks out.
25:31That's okay.
25:33Yeah, and just open your jaw.
25:35Good.
25:36Okay.
25:37So I think it could be the nerve pain.
25:40It could all be from the injury in the past.
25:44But I think you're quite tender over your teeth.
25:47So in those kind of molars.
25:49So I think probably the first thing to do would be to go and see a dentist
25:53and just check it's not a dental problem.
25:56Okay.
25:57If we then link it back to the injury before and we think it's, you know, nerve pain.
26:02So you have a nerve that kind of goes like this.
26:04Mm-hmm.
26:05So if we think it is a nerve kind of shooting through, then we can give nerve painkillers
26:09rather than your simple paracetamol, ipofen, those kind of things.
26:12Yeah.
26:13So that definitely would be an option that we could consider.
26:14But I think at the moment with it being new and with you being really, really tender
26:18when I, you know, press over the teeth, I think you need to see a dentist initially.
26:22So I would try and get even an emergency appointment and try and get in there.
26:25And at least then they can be like whether there's any infection.
26:28And then once you've seen a dentist, obviously if they can't refer you
26:31or they want you to see us about the pain or, you know, we need to get in touch with all surgeons again,
26:35we can definitely do that.
26:36Is that all right?
26:37That's fine.
26:38All right. Thank you so much.
26:39Not at all.
26:52Oh, it's like lava out there today as well, isn't it?
27:05Oh, God, yeah.
27:06I sweat a lot.
27:08It just runs down my face.
27:10Are you not hot in that?
27:11Yeah, I don't wear T-shirts.
27:13I don't care about my fat arms.
27:15It's too hot.
27:17It's hot.
27:19Do you know when it was hitting like 38, 40?
27:21Yeah.
27:22I was sat there with a jumper on.
27:24Were you?
27:28Is it really hot outside now?
27:29It is.
27:31Enjoy the sunshine.
27:32Thank you very much.
27:37It's hot out there today.
27:39I ain't been out for over a week because I've had this bug.
27:42Really?
27:43Yeah.
27:44You did call the other day and said, I'm really unwell.
27:45I took everything.
27:46I've been very unwell.
27:48It's getting on my wick now.
27:50Do you need me?
27:51Yeah.
27:52Come through.
27:53Lovely to see you.
27:54Yeah.
27:55Looking very summery.
27:56You're not well.
27:57I'm sorry to hear that.
27:58No.
27:59I don't know.
28:00Take a seat.
28:01Make yourself comfortable.
28:03Lovely to see you.
28:04So, tell me what's been going on.
28:05How can I help?
28:06I got up on Monday morning.
28:07Yeah.
28:08I'm still a bit dizzy because I've been getting dizzy.
28:09You know, I lost my brother and sister.
28:11Yeah, I know.
28:12In the same week.
28:13I got out of bed and all of a sudden I felt something come down and my nose poured with
28:19blood.
28:20My nightdress was full of blood.
28:21And then I sat down for a little while and I started getting the shakes and then I started
28:26burning up and all my throat and everything.
28:30I'm not well.
28:31Any other symptoms?
28:32Any difficulty swallowing, food not going down, getting stuck?
28:34To tell you the truth, this week, because I don't do any pick, this week all I've had
28:38is toast.
28:39Yeah.
28:40And cold water.
28:41Lots of appetite.
28:42And hot lemon.
28:43Yeah.
28:44And honey.
28:45I just want to get better so I can get out and about.
28:47Of course.
28:48But just from a safety point of view, I just need to know, have you been struggling with
28:52swallowing?
28:53Is food still going down?
28:54Is it getting stuck?
28:55Is it coming back?
28:56No.
28:57But you can still swallow?
28:58Yeah.
28:59And any drooling, any excessive saliva production and drooling, not able to swallow your own
29:04saliva?
29:05No, I spit that out anyway.
29:06That's absolutely fine.
29:07Any rashes on your skin?
29:08No.
29:09Good.
29:10Any headaches?
29:11Yeah, I've had headaches.
29:12Yeah.
29:13All on top.
29:14Yeah.
29:15And what do they feel like?
29:16Well, on Sunday, I was washing up and all of a sudden I had this pain here.
29:20Okay.
29:21And I had to stop.
29:22And did you have any visual changes associated with that?
29:25Yeah, I get goody.
29:26No, sorry, visual changes where you can't see.
29:28Yeah, I've just had the cataract done.
29:30No, sorry.
29:31With that headache that you had on that one side, when that headache happened, was there
29:35any change in your vision?
29:37Any blurred vision?
29:38Loss of vision?
29:39Zigzag lines?
29:40No, just like dizzy.
29:41You know what?
29:42You're going like that.
29:43Yeah.
29:44Okay, so dizziness.
29:45Drinking water, keeping hydrated.
29:46Yeah, I've got to get some today.
29:47That's fine.
29:48And are you passing urine okay?
29:49I've got an infection, I think, again.
29:51Well, but...
29:52Because you know when I go away, it sort of burns worse and it comes up.
29:56Is it?
29:57And it sort of comes up and I got red in the face.
30:00But I do suffer with like...
30:02You get flushes?
30:03Yeah, flushes.
30:04Like a hot flush when you're urinating?
30:06Yeah.
30:07Okay.
30:08I'm just trying to ascertain acutely in the last week or so what the main issues are.
30:21Today, my job is to make sure...
30:22Get rid of this.
30:23Absolutely.
30:24Patients often come to see the doctor with a vast array of different symptoms.
30:31It's really important at the onset to try and establish exactly why the patient is there
30:37to see you.
30:38We don't want to risk missing something serious.
30:40It's perfectly fine to have a list, but maybe tell your doctor what the list is before the
30:46consultation starts or at the start of the consultation so that we can prioritise and
30:50work through the main issues.
30:52Are you able to open your mouth really wide for me?
30:54Ah.
30:55Stick your tongue out and say ah, lovely.
30:56Ah.
30:57Yeah.
30:58Say ah again.
30:59Ah.
31:00Lovely.
31:01So yeah, I think you've got a little stone in that tonsil on the right hand side.
31:03Yeah.
31:04A tonsil of stone.
31:05And you know, very commonly it's just a build up of sort of calcium and things like that.
31:08Will it go?
31:09It will go, absolutely.
31:10But we can help with the discomfort and the symptoms of it for you.
31:13Not a problem at all.
31:14Yeah, because you know it annoys me.
31:15That's why I'm...
31:16Of course, yeah.
31:17So what's caused that?
31:18The infection?
31:19It could be a bit of an infection.
31:20Most likely viral.
31:21And then sometimes you can get a sort of a stone forming as well.
31:24What are you going to give me?
31:25Ah, so I'm going to use a bit of Diflam spray which will help numb the back of the throat.
31:28Yeah.
31:29It'll be really, really good for that.
31:30And then the stone will just work its way out.
31:31Yeah.
31:32If you eat sort of more citrusy fruits and things like that, it will encourage it to work its
31:35way out.
31:36It might be a bit painful if it does.
31:37Tell you what, I do eat strawberries, grapes.
31:39Yeah, that's fine.
31:40Brilliant, absolutely fine.
31:41Yeah, really, really good.
31:42And then in terms of sort of bereavement support, there's an amazing organisation called
31:45Cruise.
31:46That's it.
31:47I told you about it last time.
31:48Yeah.
31:49Have you contacted them or have you thought about it?
31:51No, I haven't.
31:52I don't have the internet on.
31:53Well, that's fine.
31:54I'll give you their phone number.
31:55You don't need the internet.
31:56You can just call them.
31:57She had a big funeral.
31:58Yeah.
31:59I miss her.
32:00Of course you do.
32:01Of course you do.
32:02It's, you know, when these things happen so suddenly, it's really difficult.
32:05At least if it's...
32:06Because they used to phone me every day.
32:08Oh, I'm so sorry, Jacqueline.
32:09I'm really sorry.
32:11Give that number a call.
32:12They're fantastic.
32:13Only when you're ready though.
32:14You know, it's a process.
32:15You will get through this.
32:16It's just a matter of time.
32:17It will get, you know, you'll learn how to deal with it in slightly different ways.
32:20I left all my sisters now.
32:21Oh, I'm sorry to hear that.
32:22You know, we're always here.
32:23If you need anything, do let us know.
32:24Yeah.
32:25Good.
32:26Thank you, Jacqueline.
32:27All the best.
32:28Take care.
32:29Look after yourself, all right?
32:30Thank you very much.
32:31Pleasure.
32:32You're very welcome.
32:43John?
32:44How are we?
32:45Oh, more...
32:46Hopefully, I'm improving.
32:47You feel better?
32:48No, much the same.
32:49Getting pain.
32:50Where?
32:51In your foot?
32:52From down there, yeah.
32:53Right.
32:54But anyway, you're going to tell me that it's improving.
32:55That is wonderful.
32:56Don't know, yeah.
32:57It might be falling off.
32:58I hope not.
32:59How are you feeling?
33:00Are you feeling better in yourself?
33:01Can't say I am, no.
33:02I'm still...
33:03Well, the wounds were...
33:04..failing bit.
33:05..failing big time and trying to get my life organised.
33:06Yeah.
33:07Ready?
33:08Now, what does that look like?
33:10Looks like pretty awful.
33:11No, that's just the cover.
33:12Oh, it is getting smaller, isn't it?
33:13Yeah.
33:14Or is it?
33:15Oh, wait a minute.
33:16Of course it is.
33:17Well, it's looking more than pink to me.
33:18That's looking a bit raw.
33:19It's not raw.
33:20This is healthy.
33:21Okay.
33:22I promise you, this is new skin.
33:23It is, quite nice.
33:24Nice, yeah.
33:25Yeah.
33:26Ready?
33:27Now, what does that look like?
33:28Looks like pretty awful, isn't it?
33:29No, that's just the cover.
33:30Oh, it is getting smaller, isn't it?
33:31Yeah.
33:32Or is it?
33:33Oh, wait a minute.
33:34Of course it is.
33:35Well, that's looking more than pink to me.
33:36That's looking a bit raw.
33:37It's not raw.
33:38This is healthy.
33:39Okay.
33:40I promise you, this is new skin.
33:45It is called epiphils, and epiphils is the final stage of healing.
33:51So this is really, really good.
33:52Which could take forever.
33:54No, but we said a minimum of six weeks, didn't I?
33:57Well, we know now that we're in about the eighth week now.
34:00Yeah, so not too bad.
34:02But I bungled the beginning of it.
34:04Could you pull it on here for me?
34:05Yeah.
34:06That's it.
34:10It's good, John.
34:12It's really good.
34:14I mean, look at that.
34:16Can you see that?
34:17Yeah, yeah, yeah.
34:18And look at this.
34:19It's still white there, but it's receding.
34:22This is impressive.
34:24So, another six weeks.
34:26Now you've got new skin coming through.
34:29I would say probably by next Friday, we'll have a nice pink covering over that.
34:35I think we're getting there.
34:36I really, really do, considering what it was when you first come into now.
34:40Oh, yeah, yeah, yeah.
34:41The bit that's white now, is that dead skin or...?
34:44It's just dried skin.
34:46So, that will regenerate, like sunburn when you burn yourself.
34:51And then after a while, the skin peels, and then you get the new layers of skin coming through.
34:57If it starts coming away, put a me-pore plaster over the top.
35:01One of the ones you gave me?
35:02Yes.
35:03And I was still putting the night stalks on with the...
35:06But make sure they're loose, remember, not tight.
35:09And I want you to offload that ankle as much as possible.
35:15OK.
35:16OK?
35:18We are getting there, sir.
35:19Good.
35:20Take care, John.
35:21Yeah.
35:30Katherine?
35:31The doctor's ready for you. Room four.
35:33Hi.
35:36Hi.
35:37Hi.
35:38How are things?
35:39Fine, actually, yeah.
35:40They're all good.
35:41How are you? What's happening?
35:42I've developed this thing on my head.
35:44Don't know what it is.
35:45It just came out of the blue.
35:47Wow.
35:48It was very obvious yesterday and today, obviously, and the day before I could see something coming up.
35:52Don't know what it is.
35:53I don't know if I've got any other kind of marks on my body.
35:56I haven't noticed any, but I'm a little bit brown, so it might be a little more difficult.
36:00But, yeah, I don't know what it is.
36:02When you came home, you woke up, it was like this?
36:04Yes.
36:05I've been travelling for work, but I just noticed it.
36:09Yeah.
36:10And no way you could have banged it or anything without noticing?
36:14No.
36:15No.
36:16OK.
36:17Well, it's a bruise.
36:18And as with bruising, it's to do with clotting, which is to do with red, white cells, platelets, liver, all those sorts of things.
36:27I know I have had problems in the past with blood clotting.
36:32I know that was picked up in pregnancy and I had hemorrhaging, kind of severe hemorrhaging for my, for births.
36:42Yeah.
36:43There was some underlying thing, but I don't think it was ever followed up on.
36:47OK.
36:48Some people can get spontaneous bruising for no reason.
36:50However, we need to rule out more.
36:52Yeah.
36:53It's a pathological cause, so to speak.
37:14Do you feel well?
37:15Um, fatigued a lot, I would say, generally.
37:18Right.
37:19Is it virally in any way?
37:21No, not really, no.
37:22No sore throats, nothing like that?
37:24No, no, no, no, no, no.
37:26Yeah, apart from the sort of general low level fatigue, I just did an MRI cause I've got pancreatic cysts, which are being monitored.
37:37Yep.
37:38And that was when?
37:39I saw, I had the scan done two weeks ago.
37:42Two weeks ago.
37:43One always gets worried about bruising, spontaneous bruising.
37:47We investigate for every possible cause.
37:50It can be due to a more worrying pathological cause, such as leukaemia.
37:55Or it can just be a symptom that can run in the family, or there can be no cause found.
38:00Pancreatic cysts are very close to the liver, and the liver is where clotting is processed.
38:07So we need to do a blood profile to rule out any more sinister pathological causes.
38:14I can feel a little gland there, I don't know if that's painful at all.
38:20Yeah.
38:21Is it like a bruise tender, is it, in any way?
38:23Yeah, I can feel it.
38:24I can feel it.
38:25Whatever is.
38:26Something.
38:27Something.
38:28Yeah.
38:29So you can't really feel a bump, but you can feel it more tender than the rest of it.
38:31Yeah.
38:32Yeah.
38:33And it's the only place, there's no others running.
38:34Yeah, I haven't noticed anything else.
38:35Yeah.
38:36And I've seen these things, but they're not, nothing, not that I'm aware of anyway.
38:38Yeah.
38:39So I think you do need to go for some blood tests.
38:42I think the sooner you go, the better.
38:44Okay.
38:45And if you go today, I'll have the results tomorrow, basically.
38:48Yeah.
38:49So we'll look out for them, but do call anyway.
38:51Brilliant.
38:53And we'll just have a look at those.
38:54Brilliant.
38:55Thanks a lot.
38:56Thanks a lot.
38:57Yeah, take care.
38:58Bye.
39:05So, tell me what's been going on for you.
39:08So I've noticed some, basically some red patches around my skin.
39:12Okay.
39:13It's a little bump, but it itches.
39:15That eats a lot, burns a lot.
39:17And it's really itchy and uncomfortable.
39:20Some on my torso, some on my arms, some on my legs.
39:23It itches mildly, not sort of horribly.
39:27So they're slightly raised and a bit scaly, aren't they?
39:30Yeah.
39:31So it's on the skin, under here, here, in the back.
39:36Okay.
39:37And on my scalp as well.
39:38Okay.
39:39So pretty diffuse.
39:40Oh.
39:41It's annoying.
39:46Jennifer?
39:47Oh, yes.
39:51As my records probably show, I had a new hip about eight or nine weeks ago.
39:56Looks to be working well.
39:57It's working well.
39:58You pleased with it?
39:59Yes, very.
40:00All I came in for, really, was a prescription for this ointment.
40:05Okay.
40:06Which you said I hadn't had since 1960 or something.
40:10Me?
40:11Somebody did.
40:12Somebody did.
40:13I couldn't believe it.
40:14Right.
40:15Because it was first given to me for something on my leg, which was pretty well healed.
40:19But that's cured it.
40:20But...
40:21Hmm.
40:22Yeah.
40:23So this is fucidic acid cream.
40:25What do you understand about this cream in terms of what it does?
40:29It seems to help.
40:31Yeah.
40:32This isn't a balm for all conditions, really.
40:34It's actually quite specifically just a cream for, like, mild bits of infection.
40:39So, yeah, looking at your skin, can I have a look at that bit there?
40:44Yeah, I do.
40:45Yeah.
40:46So you've had a surgery there, haven't you?
40:47You've got some scarring.
40:49And there's some scale and thickening there.
40:51Does that get a bit itchy?
40:52It gets itchy.
40:53Yeah.
40:54Okay.
40:55It gets a bit sore from time to time.
40:57So it looks like you've got, you know, a few kind of sun-related and maybe age-related
41:03Yeah.
41:04And bits on the arm, on the face.
41:06Yes, exactly.
41:07And down here, you know, on the ankle as well.
41:11This isn't the cream that I would normally give for those.
41:14Oh, really?
41:15For dry skin, I would be using something else, a dry, itchy skin.
41:18I would just be using, you know, an emollient moisturizing cream.
41:23Yeah.
41:24I don't think you need something that's got antibacterial properties in it.
41:26No.
41:27If you ever did get something that looked like a, you know, a skin infection, an early skin infection.
41:32What can I do about this? Because this does worry me.
41:35There's some letters here from dermatology.
41:37I can quickly just have a look.
41:38Yeah.
41:39Yeah, some actinic keratoses on your nose, behind the shoulder, the right side of your forehead.
41:45That's the other thing.
41:46Yeah.
41:47But I put it down to that cream, having made it better.
41:51But you say it didn't.
41:53You know.
41:55So these skin changes are not cancer, but some of them can progress to squamous cell carcinoma,
42:03which is a slowly, locally spreading skin cancer, which can cause, you know, nasty skin breakdown.
42:11It can go into surrounding tissues and, you know, cause bleeding and things like that.
42:15But there's no sort of cream I can put on to ease it because I really felt that that made it better.
42:21Yeah.
42:22So I suspect that all it's doing is just softening this a little bit for you.
42:24Yeah.
42:25So I can give you something that will do that for sure.
42:27Okay.
42:28Yeah.
42:29I'm told that cobwebs are the best thing.
42:32That's not advice that I'm familiar with.
42:34Okay.
42:35Have you...
42:36I must have, er...
42:37Put cobwebs on burns and things.
42:39Okay.
42:40I guess my knowledge, er, isn't very up to date.
42:43Well, I think it's only if you've got very thick ones.
42:46You're going to give me a prescription or can I buy it over the counter?
42:50No, a prescription for you.
42:51Right.
42:52Absolutely.
42:53Okay.
42:54We'll sort you out, okay?
42:55Right.
42:56Thank you very much.
42:57All right.
42:58Thank you so much.
42:59Not at all.
43:00Have a great afternoon.
43:03Just let us know how you're doing.
43:04Thanks, Doctor.
43:05See you later.
43:06All right.
43:07Take care.
43:08Bye-bye.
43:10Bye.
43:11Okay.
43:12Thanks a lot.
43:13Okay.
43:14Good to see you.
43:15And you too.
43:16Thank you so much.
43:17Pleasure.
43:18You're very welcome.
43:19Take care.
43:20All the best.
43:21Bye now.
43:22Bye.
43:23See you later.
43:24Bye.
43:28Bye.
43:58I'm scared to go on my bed.
44:24As I said, enough is enough.
44:26It's having a big impact on your quality of life.
44:28Last week, this was Red War.
44:31All of a sudden, I just woke up to three paramedics.
44:34So you'd had a seizure.
44:36You're worried, OK.
44:37Could it be some sort of throat cancer or whatever?
44:43Catch All That new next Wednesday at 7.
44:47Later, a 17-year-old in need of an urgent liver transplant,
44:50but it's a very risky procedure for him and the surgeons
44:53in a matter of life or death new at 9.
44:56Next, with the systems down and patients collapsing,
44:59it's a shift where every second counts at casualty 24-7.
45:03New after the break.
45:04New after break...
45:08Community of Engineers
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