- 2 weeks ago
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00:00Dementia is something that we all fear. We used to think that if I've got it, I don't want to know, there's nothing I can do about it. And that is not true.
00:14Is that hurt when you do that? It's just here. You have me a little bit. Oh, yes, yes. This morning, my son, I accidentally just knocked my nuts. And I was like, I thought I was going to explain.
00:34In the shower, I just lost all my energy. And I was next lying down with a towel behind my head. I don't remember anything else after that.
00:45I sat here in the mornings and I think, oh, would it be easy for me to just go to sleep? No, it won't. I know you. You get bored. And when you get bored, you get down.
00:55Morning. Morning.
00:56Morning.
00:57Morning.
00:58Morning.
00:59Morning.
01:00Morning.
01:01Good morning, Sergey.
01:02Hi.
01:03Hi.
01:04Hi.
01:05Hi.
01:06Oliver.
01:07Hello.
01:08Oliver.
01:09Hello.
01:10Hi.
01:11Hi.
01:12Hi.
01:13Come on through.
01:14Dr. Pearson, how are you?
01:15Hi, not bad, thanks.
01:16Good, good.
01:17Come and have a seat.
01:18Now, how can we help today?
01:19So, I came in like past five, six months ago.
01:20Oh, I'm sorry.
01:21I'm sorry.
01:22I'm sorry.
01:23I'm sorry.
01:24I'm sorry.
01:25I'm sorry.
01:26I'm sorry.
01:27I'm sorry.
01:28I'm sorry.
01:29I'm sorry.
01:30I'm sorry.
01:31I'm sorry.
01:32Good morning, Sergey.
01:33Hello.
01:34Oliver.
01:35Hello.
01:36Hi.
01:37Hiya.
01:38Come on through.
01:39Dr. Pearson, how are you?
01:40Hi, not bad, thanks.
01:41Good, good.
01:42Come and have a seat.
01:43Now, how can we help today?
01:45So, I came in like past five, six months ago.
01:49Okay.
01:50For a ganglion cyst.
01:52It was like sort of this size about six months ago and it comes up, it comes down.
01:57It's related to, I think, when I do gym training.
02:00Okay.
02:01It's not going down really and it's really affecting my range of motion.
02:04It kind of, it doesn't hurt too much but like it does, if I really push it back, it kind of does.
02:09So, let's have a look at it.
02:10If you put both hands flat on here, let's have a look.
02:11So, you can see it straight out, can't you?
02:13Yeah.
02:14And is it tender at all?
02:15No.
02:16If I push it hard, it doesn't really hurt.
02:17Nothing too much.
02:18Can I just feel it round?
02:19Yeah, go for it.
02:20So, it is, it's quite, it moves a bit, doesn't it?
02:22Yeah.
02:23Yeah, it's quite fun to play with.
02:24And it's quite sort of jelly-like, isn't it?
02:25A ganglion cyst, we think, is the fluid from the joint that sort of comes out and forms a cyst.
02:29And if you bend your wrists like that, yeah, then it's really noticeable, isn't it?
02:33So, it's nothing to worry about.
02:34It's not a cancerous lump.
02:35It's nothing, you know, concerning.
02:37But the problem is, sometimes they go away on their own and that's why we often say to people,
02:40just wait and see what happens.
02:41And often they go, do you know what the old fashioned thing was to get rid of it?
02:44A Bible, they call it Bible cyst, right?
02:46A Bible.
02:47Smash it.
02:48It's a hardback book everyone had in their home.
02:50And so everyone used to pick up a hardback book and bash it.
02:52Trouble is, don't do that because you'll damage the bones and other things and we don't like that anymore.
02:55But a sort of trauma to it sometimes just disperses it.
02:59And if you told me it was doing no harm, not interfering with your wrist, you were still able to live your life 100%,
03:04then you don't have to remove it at all.
03:06You can live with it till you're 100.
03:07But it's when they're in awkward places.
03:09Unfortunately, if it does start to interfere with function, we do say, let's think about having to get removed.
03:14It does affect my range of movement.
03:16So that wrist comes back quite hard, doesn't it?
03:19And that one less, it's blocking it, isn't it?
03:21You can't bend there.
03:22I mean, I think what we would do, if we refer to the hospital, we're not signing you up to go into the theatre to have it done.
03:27We're signing you up to go and speak to a surgeon about it, who does these all the time.
03:30And if you then decide, you know what, I don't want to do it, you can walk away.
03:33You might as well do it.
03:34I'll write straight down to them now, okay? And they will call you, book you in.
03:37Brilliant, thanks so much.
03:38Either way, I think it's good to do something about it.
03:40All right, no worries. Listen, good luck with everything.
03:42And, yeah, you'll hear from them, they'll give you a ring in the next week or so.
03:45Okay. Cheers.
03:46Take care, bye-bye.
03:50Aska?
03:51Oh, yes, miss me.
03:54How are you?
03:55I'm fine now, I see you, I feel great.
03:58Come on in.
04:00So, how are you?
04:01I'm good.
04:02I haven't seen you in ages.
04:03You are so lucky.
04:06You know, I had a knee surgery, and it seems like the knee surgery has gone wrong.
04:14Okay.
04:15First, I cannot bend my knee whatsoever.
04:17Okay.
04:18It goes that much, and that's it.
04:19Okay, and you can't fully...
04:20Yeah.
04:21Yeah.
04:22Secondly, the nerve system is painful, and the bottom of my feet, at night, it gets hot.
04:29I Googled what it is, and Google said when your bottom of my feet is hot, it means your nerve system is crying.
04:36Okay, yeah.
04:37It's asking to be fixed.
04:38Okay.
04:39So, we'll have a look at that.
04:40When was the surgery?
04:41A year and a half, two years, or something like that.
04:44What did they do in the...
04:45Can you remember what it was?
04:46They did partial knee replacement.
04:49When they do that, they just replaced the medial compartment of the knee, and so that's possibly where they felt that you had the degeneration.
04:57Oh, they felt wrong.
04:58I asked to refer again.
04:59Yeah.
05:00This is maybe only a year and a half, a year and a bit ago.
05:04Yeah.
05:05And no response whatsoever.
05:06Okay.
05:07So, are they telling me that I have to stay with this pain forever, or is it possible to fix it?
05:15Let's have a quick look at that.
05:16Just sit up on the bed.
05:17Oh!
05:18Right.
05:19I'm going to have a quick feel.
05:21Let's bend it right in.
05:23That's the max.
05:24That's the maximum.
05:25And where's that hurt when you do that?
05:27It's just here.
05:28Okay.
05:29Let's see.
05:30I tell you, I need a little bit.
05:31Oh, yes.
05:32Then that's really cool.
05:33Okay.
05:34And just straighten it for me.
05:35Okay.
05:36When I walk, it clicks.
05:37Okay.
05:38When you're walking, does it ever, like, give away beneath you?
05:39No.
05:40Never.
05:41Nothing like that.
05:42Okay.
05:43All right.
05:44You can get dressed.
05:45Let me help you out.
05:46You all right?
05:47Yeah, I am fine.
05:48I really need to fix this because I want to do exercise.
05:51Yeah.
05:52I want to walk a lot, and I don't want to go anywhere where I click, click, click.
05:55It's just like hanging.
05:57It doesn't click too much examining it, but I think we definitely need orthopedic input
06:01because what we want to do is make sure that we've got the best out of your knee that you can have.
06:04Yes, this is exactly.
06:05Exactly.
06:06This is what I want.
06:07So it will be a specialist physio that assesses you, and then they will decide if you need
06:10to go back and see orthopedics again, but that's kind of the gateway back to orthopedics.
06:15Do you feel you need any painkillers or pain relief?
06:17I would not take that.
06:18You don't.
06:19I know you're not keen on it.
06:20No?
06:21Okay.
06:22All right.
06:23So it's nice to see you.
06:24Thank you so much.
06:25Have a great day.
06:26You are the best.
06:27Thank you so much.
06:28Have a great day to you.
06:29You too.
06:30All right.
06:31Bye.
06:32Open?
06:33Open's perfect.
06:34Bye.
06:35Bye.
06:36Jane.
06:37Hello.
06:38Come on through.
06:39Do you want me to help bring your bag?
06:40That's okay.
06:41It's all right.
06:42I've got it.
06:43Shall I get you go?
06:44I'll find it.
06:45Are you sure?
06:46Yes, I must be as independent as I can.
06:47I know.
06:48Well, you're very good.
06:49You're quite right.
06:50Walking as much as pos.
06:51I think this was booked before.
06:54Before we had a chat.
06:55That's all right.
06:56Come and have a seat.
06:57But on the other hand, I'm not sorry to see you because, do you know, I don't want
07:00to be sort of dramatic, but I sort of feel sometimes as if life, what's it all about?
07:07I know.
07:08Because I'm having such a lot of trouble with everything seems to have.
07:13Gone wrong or something.
07:14Sort of caught up with me now.
07:16I mean, obviously I'm still living alone and I intend to.
07:20Yep.
07:21Because I think it would be, it would probably finish me off if I went into a home.
07:25Yeah.
07:26Which I would try to avoid.
07:27But I think the thing is that I do get, I get very dizzy.
07:32But I'm sort of, now I'm worried because a friend of mine who's very sweet, she will
07:37say to me, yes, well, I told you that the other day.
07:40And that, of course, really, it really bothers me because I'm forgetting.
07:45I know what you mean, that everything just feels like it's not working very well, isn't
07:48it?
07:49It's not working.
07:50And I know that you're finding you're slower and we can't quite remember things.
07:54And I know, do you think I've got something like, I was looking it up in the dictionary
07:59today.
08:00What is that thing called multi?
08:02Not multiple sclerosis.
08:03Yes.
08:04Something like that.
08:05It is funny.
08:06Yeah.
08:07No.
08:08So I don't think you have that, which is good news.
08:09Do you remember you went to the memory clinic?
08:10I did.
08:11Not long ago.
08:12Yes.
08:13And wait, they did a scan of your head.
08:14So the reason we know it's not multiple sclerosis is because they didn't find that on the scan.
08:18And that's how they would, where they would find it.
08:20Oh, I see.
08:21But what they did find was some little vascular, very early vascular problems, which causes
08:26the memory and some of the symptoms that you're getting.
08:29So we're just waiting to hear back from them.
08:30Oh, I see.
08:31So I've got something, I like it.
08:33I like it.
08:34They have said it's a sort of early type of dementia.
08:36I know.
08:37I like the way you put it.
08:39It's dementia.
08:40Well, cause that word itself worries people a bit sometimes.
08:43Hell of me.
08:44Does it?
08:45Well, of course it does.
08:46I had a file about, yeah, about eight weeks ago.
09:05I was coming down the stairs and I just missed a step.
09:08I'm losing my balance a bit.
09:09Okay.
09:10I'll take a stab.
09:11I have had a lot of falls recently.
09:13How many do you think you've had in the last month?
09:15Fifteen?
09:16Fifteen.
09:17Yeah.
09:18Wow.
09:19I'm walking along minding my own business and the next thing I know I'm flat on my face.
09:22You ever have falls at all?
09:23Are you falling over?
09:24I've had a few falls, yeah.
09:25But that's why I've got this.
09:26And have you had falls in the house or outside?
09:28I have, yeah.
09:29I've had some outside.
09:30But both in and out?
09:31Yeah.
09:32Okay.
09:33And it was yoga you were doing, wasn't it?
09:34Oh, yeah.
09:35I had three or four falls.
09:37But I refuse to stay in.
09:42Are you alright?
09:44I had another tipple on Friday.
09:47What, a drink?
09:49No, not that tipple.
09:51What, you fell?
09:53You didn't?
09:54I did.
09:55Right, I got...
09:57When did you...
09:58I was on my balcony.
09:59I think what happened, the toe of my shoe caught the wheel.
10:04Okay.
10:05Of course I fell on the floor, didn't I?
10:07Oh, God.
10:08So I thought, oh, God, I've got to get up.
10:10All of a sudden, George, our maintenance man, he came out of his office.
10:15He got his arms under me and just stood me up.
10:18But I've got a lump.
10:19Is that where you...
10:20Where the way I fell.
10:21Luckily it wasn't this one.
10:22So if you don't mind having a look.
10:23No, of course I don't.
10:24Right, lift this up.
10:25Show me where it is.
10:26Here.
10:27Down your bum?
10:28Yeah, it's on my bum, actually.
10:29Oh, you've got a huge bruise.
10:30Is it a bruise?
10:31I don't really want to get a doctor to have a look.
10:32You don't need to.
10:33That's all right if it's only a bruise.
10:34Right, pull yourself up.
10:35Right.
10:36You ain't got to go to hospital.
10:37Doesn't hurt.
10:38It's just when I sit down, he's a bit sore.
10:39And this has been playing me up and all.
10:40Why?
10:41Maybe I hit that as I went down.
10:42I hope you didn't.
10:43It's not that.
10:44It's not that.
10:45It's just when I sit down, he's a bit sore.
10:46And this has been playing me up and all.
10:47Why?
10:48Maybe I hit that as I went down.
10:49I hope you didn't.
10:50It's not that.
10:51I hope not.
10:52You've got to stop falling over.
10:53This leg's getting so weak.
10:54I think that's what's doing it.
10:55Well, when you fractured that hip, you started putting a lot of pressure onto this one.
11:11On the other one, yeah.
11:12Your blood flow down this leg is not great.
11:16That might be why.
11:17Right, let's get you off.
11:19Woo-hoo-hoo!
11:20Look at that.
11:21That's good.
11:22Yes.
11:23Good.
11:24Otherwise, I would not be going woo-hoo-hoo.
11:26I'd be going, oh, god damn it.
11:28I'm glad that's good.
11:31We have life.
11:32Roll it for me.
11:33And that has got better as well.
11:36Right.
11:39We need some of that.
11:40Ta-da.
11:41You've been doing it a while now, Doris.
11:43If I don't know your leg by now, I never will.
11:46Doris?
11:47Tearing me up today.
11:49Roll it, roll it.
11:50I know.
11:51I felt very low.
11:52Did you?
11:53When I got up this morning.
11:54I always do, first thing in the morning.
11:56Yeah, but you said you're never good in the morning, are you?
12:00No.
12:01No.
12:02Okay, lift slightly.
12:03I just want to dry your leg.
12:06Done, my dear.
12:07Right.
12:08If I was born in 1930, what does that make me?
12:13I get confused with that.
12:15You used to be an accountant.
12:16You're good at that.
12:17You're going to be 95 in November this year.
12:20Don't look a day over 21.
12:22I don't know if I can reach that long.
12:24Oi.
12:25Don't think I'll reach that long.
12:26Thank you very much.
12:27Doris?
12:28I sat here in the mornings and I think, oh.
12:31Would it be really easy for me to just go off to sleep?
12:34No, it won't.
12:35I know I'm getting a bit despondent.
12:37Do you want to speak to someone about it?
12:39Nah.
12:40Oh, I had somebody on the phone the other day.
12:43Saying about somebody coming in.
12:46Even if they only sit and we have a chat.
12:48They have a befriending service.
12:50So they come round, they have a cup of tea with you.
12:52They do Parsons Green Fae.
12:54You can have Christmas dinner at the town hall with them.
12:57So say yes, please.
12:59I see what I have.
13:00Because I know you, you get bored.
13:02And when you get bored, you get down.
13:04I don't really get bored, Sam, because I read a lot.
13:08Which I like.
13:09Get a good book.
13:10So why are you feeling like you can go asleep and that would be the end of it?
13:13Why do you feel like that?
13:14I let the library go because I couldn't get up there.
13:17Okay.
13:18So you can't get books, is that what you mean?
13:20I can't get books down the charity shop.
13:21What books do you like?
13:22What books do you like?
13:23I like the fiction stories.
13:25What about?
13:26Romance, but not that smutty moment.
13:29Yeah, yeah, I know.
13:30Not like Fifty Shades of Grey?
13:32None of that?
13:33I will put out a I need some books from everyone I know.
13:38And I'll bring up a couple of bags.
13:40All right, lovey.
13:41Well, we'll have to get you some books because I can't have you not reading.
13:45All right, my lovey.
13:46Get me some books.
13:47I will.
13:48Thank you very much.
13:49And I'll see you on Friday, same time, same place.
13:52Okay, my lovey.
13:53Bye, Doris.
13:54Bye.
13:55Dementia is something that we all fear.
13:58We used to think that if I've got it, I don't want to know because it'll follow on and there's
14:03nothing I can do about it.
14:04And that is not true.
14:05With dementia, it's really important to know about it because then we can help.
14:09And there are different forms of dementia.
14:11Some have medication.
14:12Some are more about controlling blood pressure and cholesterol and things like that.
14:16You're doing really well in all parts of it.
14:18We're just waiting for the final assessment with them.
14:20But it's so important if people like yourself will ever have any memory problems or feel things aren't quite right to do something about it.
14:27Such a good doctor.
14:28And then you just, then we can help you.
14:30The most important thing is we just keep you safe.
14:33Dementia, unfortunately, is a condition that we're seeing more and more of as we're all living older, probably.
14:39And Jane, in this case, has a type of vascular dementia and she's under the vascular clinic.
14:43Dementia is a really scary condition for lots of patients.
14:46And when you live on your own, it can create its own challenges.
14:50And our role is to make sure that the patient is safe, is stable at home,
14:54that if the dementia is progressing, what extra support we need to put in.
14:57So actually seeing her regularly is really helping her manage her condition.
15:01Keeping your brain busy, doing bridge is really important.
15:05Seeing your friends, really important.
15:07When we've talked to you before, you've very clearly said to me,
15:10I want to stay in my home.
15:12And you mentioned it here today, you don't want to move.
15:15Because another option is moving to somewhere where they can perhaps,
15:18there'd be more support around, people to see, people to watch.
15:22But you've lived in your house, I think, for quite a long time, haven't you?
15:26Of course, yes.
15:27You're making it work, keeping you at home with the lady, Shakira, coming in and helping you,
15:31your nice lady who's helping.
15:33And then I think we're asking the memory clinic and the support where they can give us.
15:36Right.
15:37And it might be medication, it might just be some advice,
15:39talking to people who are in a similar position or people who,
15:42they've helped people through it and they can give you some advice about things,
15:45trying to make it safe and as practical at home.
15:48And then why don't we book an appointment and we'll give you a ring on the morning of the appointment,
15:53just to make sure we've got it.
15:55As I say, I haven't got my diary.
15:56No, but we'll write it down for you now and then we'll ring you in the morning of the day.
16:00Right, let's go to the front desk and we can get Millie or whoever on the front desk,
16:03they can sort it out for us.
16:04Okay, fine.
16:05All right?
16:06Yes, perfect.
16:07But you're doing really well, Jane, and don't worry.
16:09Pretty little shoes.
16:10Are they lovely?
16:11Well, my feet are freezing today, there's no socks on and it's blooming freezing outside.
16:15As a matter of fact, it has got a bit cold, but the sun's still shining.
16:19Well, I know, but not here it's not.
16:22Oh gosh, thank you so much.
16:28Agnieszka?
16:29Yes, hi.
16:31Hi, come on in.
16:32Hi, how are you?
16:33I'm good, how are you?
16:34Let me get another chair.
16:36It's okay.
16:38Have a seat.
16:40So how are things?
16:42Can I ask me to do?
16:43Yes, perfect.
16:44I can take that for you.
16:45I'm just going to dip it in a minute.
16:46So it's about the varicose vein basically.
16:48Okay.
16:49So I don't know where to get these injections.
16:52So last time when I was pregnant, they given me injection to dilute the blood.
16:57So they gave you injection during the pregnancy?
17:00Yes, exactly.
17:01It got swollen and the heavier I became, then it was painful.
17:05I couldn't stand on the leg as well.
17:07Yeah.
17:08Am I all right to ever feel like there's any pain here?
17:10No, this one is fine, yeah.
17:11No.
17:12But this one, I had cramps at night when I started and then I couldn't feel my feet basically,
17:19so.
17:20And then when I…
17:21Any pain when I press over the area today?
17:23Not like this.
17:24It's more when I walk.
17:25Yeah, okay.
17:26And you've not noticed the actual legs become bigger?
17:28No.
17:29I'm just going to measure them if that's okay.
17:32Perfect.
17:33So they're exactly the same size.
17:38So that's good.
17:39The things we worry about are blood clots.
17:41Okay.
17:42So right now you can see this is a varicose vein that was swollen.
17:45Yeah.
17:46It's not particularly tender.
17:47It's not hot to touch.
17:48Your leg as a whole isn't swollen.
17:50Yeah.
17:51It's going to be tomorrow.
17:52So I think the best thing to do I would either go to maternity triage or they should be able
17:56to tell you who your midwife is.
17:57But basically what we need to do is whether they want to put you back on the injections.
18:01Okay.
18:02Yep, yep.
18:03Did you want me to check the heartbeat today?
18:04Would be nice actually to hear, yeah.
18:06Yeah?
18:07Before last week I was concerned that because I'm not putting any weight, you know.
18:11Okay.
18:12For some reason with this pregnancy I'm losing weight.
18:15And feeling movements now?
18:17Not yet.
18:18Okay.
18:19That's totally normal.
18:25Is that it?
18:26I got it.
18:27And then baby's moving around every time I put the probe.
18:30There you go.
18:31That's nice and clear.
18:32Good.
18:33Glad that we're finished.
18:34Okay.
18:35Happy?
18:36Yes, very happy.
18:37Yeah, make sure it's in a bit.
18:39Good.
18:40Let me just grab you some tissue.
18:45Okay.
18:46All right, so keep an eye on it.
18:47Thank you so much.
18:48If that swelling gets worse or anything, you definitely, definitely need seen.
18:52Lovely.
18:54Have a lovely one.
18:55Nice to see you.
18:56Bye.
18:57Take care.
18:58Wow.
18:59Oh.
19:00Sorry.
19:01Sorry.
19:02It's my heels.
19:03Yeah, cut them down then.
19:04Oh.
19:05I mean, you literally have claws.
19:06The Grinch nails.
19:07Nicholas.
19:08Hi.
19:09Hello.
19:10Hi.
19:11Come and have a seat.
19:12Thanks.
19:13Now, what can we do to help today?
19:14Yeah, so a bit of an odd one.
19:16So, on Thursday, I woke up and my testicles were quite sore.
19:17Okay.
19:18And it's a weird one.
19:19When I lie down, absolutely fine.
19:20Nothing.
19:21When I stand up, and it's now gone from the left side, which was really terrible,
19:26I'm going to turn away from my feet.
19:28Okay.
19:29A little bit.
19:30In the back, it's not a bad thing.
19:31Yes.
19:32What can we do to help today?
19:33Yes, a bit of an odd one.
19:34So, on Thursday, I woke up and my testicles were quite sore.
19:39Okay.
19:40and it's a weird one when I lie down yeah absolutely fine nothing when I stand
19:45up and it's now gone from the left side which was really tender to now the right
19:52side and like gone into my groin and lower back okay and I've obviously as
19:58you do you google it yep good and kidney stones could be one thing or what but
20:03that's just still you know once I'm up and walking yeah but that first part in
20:08the morning has been the last four days have been like and like just to like
20:12this morning my son I accidentally just knocked my nuts and I was like I thought
20:17I was gonna explode and I've been sort of waking up in the night which I don't
20:21usually do okay and when you wake up in the night is that because you need to do
20:24a wee no no no actually going for a wee is fine it's not painful at all and I've
20:29like gone round the ball and stuff there's nothing that feels like lumpy okay so that's good so it doesn't feel
20:35different to you know what just just and have they swollen up not that I was aware
20:39of okay and what about any other since any discharge from the penis nothing
20:43different absolutely nothing do you think you're at risk of an STD or any sort of change
20:48your partner or anything like that do you feel that you've had a fever I had
20:51probably like not 24 hours like 12 hours where I just felt like hot and ill and
20:57that was probably two weeks ago okay and then this morning again I woke up and I was
21:01like the back of my head was a bit wet a bit sweaty I feel like I'm hotter than I
21:05usually would be okay let's check your temperature yeah and I felt you know I
21:09felt well enough to play cricket yesterday I was actually I feel nothing's gonna
21:13stop you playing but then I woke up this morning I was like I'm really aching can
21:16I just check your temperature just to be sure yeah 35-1 you don't feel hot hot but
21:21obviously something's not correct yeah I feel bit clammy more than anything do you
21:26mind if we have a look at your balls do you mind if you don't mind just lie down on the bed
21:30let's have a look so how does it feel now that right one does feel like something's not quite
21:53right yeah okay can I feel really generous and and if I just press so we'll start with this left one
21:58how does it is that feeling okay is that that's feeling much better much better
22:02tender okay and the right one like that feels really tender and is it tender there if I press
22:08yeah yeah sorry no no no that's fine okay and lie down for me on the bed and no it's bad but your
22:12wife's like do you want to have sex I was like absolutely not at the moment I'm just gonna feel
22:18really generous I don't want to hurt you no no no don't worry it does feel quite warm as well it feels
22:23much warmer than yeah the other side and then if I feel this side that's okay yeah that feels fine
22:29okay and this side here is that a bit sore yeah it means there's an infection in here which is what
22:35we need to get rid of and that's probably explains the sweating and feeling hot let's let me get you
22:39just if you just stand up again but one second one other thing just gently I just want to do if
22:43you just give me a cough no there's no hernia there at all right let me leave you to get dressed so
22:47if you come and have a seat and then we can get you onto something and get rid of this so what do
22:53you think it could be so basically there's the testicle and then there's the sort of epididymis
22:57and the the sort of tubes that come out the testicle that bring everything out yeah and sometimes for
23:00some reason they can just get infected and interestingly when you were born in your mum's
23:05tum your testicles for men they develop around your kidneys around the back yeah and then they travel
23:11down through your groin and drop into your scrotum and when they travel down they leave a sort of
23:16pathway it's all connected which is why when we've got a problem in the scrotum it radiates back up
23:20that pathway and that's where your glands are sitting so you've got the symptoms of an infection
23:25so what we ought to do is is treat the infection and it's most likely rather than the actual testicle
23:29itself it's more likely to be the tubes around it I think it's definitely worth us sending a urine
23:34sample today yeah because what that will do not that I think it's a urine infection as such yeah but
23:39it will tell us if there's any microscopic blood fine so I think let's rule it out let's just do that to
23:44be sure of the urine yeah absolutely I would expect this to get better okay quite quickly so I think
23:48what we'll do is I'll probably give you a ring later on in the week just to see how it's going
23:51and hopefully then all done good we don't the urine will be clear we don't need to do anything more
23:54fine but if you say well it's got better but it's still definitely a bit bigger on the right or a bit
23:59different then we do ultrasounds and scans and things okay are you allergic to anything no there's a
24:04very good antibiotic called doxycycline which works really really well for this great and normally we
24:07do it for about 10 days to really sometimes 14 days to get rid of this fine if we pee into that then we collect
24:12the urine and tip it into there we'll send it off fine and okay give it to reception and give it to
24:16reception there's a little they'll give you a bag and there's a there's a box at the front desk
24:19where we can put it perfect thank you so all right not at all where is just here just here and one
24:24at the front desk thank you all right take care nice to see you and then go straight to the chemist
24:27that will be ready straight away fantastic all right take care not at all bye bye do you want to play
24:32not some corsets I'm just I'm actually a suck at that game I always lose you know a game I used to love
24:37playing it's like a thing you put the thing in let's call something connect connect 4 that was a
24:43little I select I even I always lose on those game as well what I was just rubbish at games
24:50thanks for coming down yeah no problem so I called you up today um because we've noticed that
25:10your b12 levels are very low so sometimes people are low on b12 because of their diet but that is
25:15not the case for you sir what what you have is a condition called pernicious anemia your immune
25:22system that fights off viruses and bacteria you know anything outside of your body has actually
25:29switched to also attack part of your stomach and part of your gut because of that process is your gut
25:36is no longer absorbing b12 well from your diet so you could eat loads and loads of b12 but you're not
25:43going to extract that vital vitamin from it pernicious anemia is where your own immune system is attacking
25:49the parietal cells in your digestive system that leads to problems with malabsorption not getting the
25:55vital nutrients vitamins that you need from your diet specifically b12 and it's called an anemia
26:01because b12 is needed to make healthy red blood cells and the lack of it will lead to an anemia on
26:07your blood count you know this uh sometimes i had like dizziness imbalance when especially when i
26:15were stand up like quick dizziness can be a feature of b12 deficiency but there are other things that
26:21can cause this as well the the numbness in my feet still sometimes in my hand yeah so so that could be
26:30caused by your diabetes but it could also be caused by b12 so it has to be injected we have to give it
26:38to you yes yeah as an injection when it's injected it's all right i can i can live a normal life i mean
26:47it's not a one-off injection unfortunately because the underlying problem i know yeah is still going to
26:53it's forever we'll be giving you this injection three times a week you may notice uh that you
27:01start to feel better so i really want to know if any of those symptoms improve after we start giving
27:05you these injections should we go ahead with the injection then yes does it hurt or no i want to
27:10it would just go into the arm a bit of a scratch is there arm okay i thought it was in the leg
27:15okay you're all right there i'm trying to be i hate injections yeah relax and count to 10 okay
27:27one two three four five six seven eight nine
27:40there you go you did really well so you may notice over the next few weeks that you start to feel
27:49better whether it's the numbness or tingling your vision might improve you know if if you notice any
27:56of these symptoms or these changes you know feed that back to us it and then once you no longer start
28:02to feel any better that's when we would say okay we'll now do the injections every two months
28:07so we need to see you again in a couple of days for injections okay thank you i'll get you booked
28:15in for the next one now yeah that's it thank you cheers
28:20charlotte yes hello come on through
28:26i can't bear people sitting waiting for ages so i was like you come on through come and have a seat
28:33now what can we do to help today i have a spot on the end of my nose that's probably been there about
28:37two years okay okay but looking back through photos it's about two years and it's not going anywhere
28:42and it's slightly the redness around it is getting slightly bigger that's probably nothing i think
28:46it's probably a broken vein yeah because i've got a few of those okay but just we ought to be careful
28:51yeah definitely definitely you know i'm glad you've come in so do you think it's growing a bit
28:55getting a bit bigger it's slightly more prominent i think so i do cover it with makeup not today
29:00but i haven't uh i'm finding it hard to cover with makeup so i'm now more aware of it i'm conscious
29:06of it okay i've never had them checked out and this is probably also why i'm here is
29:10yeah at what point do i come and yeah get them sort of checked well we can have a look at them now
29:14whatever but i think there are certain ones where we do worry a little bit more and and sometimes
29:18things on the face if they're changing a bit we ought to just get them checked so we'll have a look
29:21what about sun exposure in your life i mean i probably am not as good as i should be but
29:27and sunbed use things like that oh no no no come and just have a seat on here let's just have a
29:32look at it because the light here is quite good if you just sit on the edge so if we have a look at
29:36the nose so i can just see so it's this bit here can i press very gently is that all right so if you
29:41press so it does go it is a bit like a broken vein but there is a lumpy bit slightly isn't there
29:46and you can sort of feel it and it's just on the edge there and is it sore or tender if i press it's
29:52not sort of like sharp or anything so hopefully it is nothing to worry about the thing that we
29:57worry about a little bit on noses and ear nobes and things are called bcc's basal cell carcinoma
30:02they're not sort of skin cancers really that spread everywhere or become really nasty but they do happen
30:07on prominent places and the end of the nose is one and because it's got the lump if it was just red
30:12and a broken vein i would be less worried but because there's a little bit that sticks out we just need
30:17to be careful and the fact it's perhaps getting a bit more obvious and a bit more difficult to cover up
30:21we ought to check it's not because if they do grow we tend to remove them and the bigger it is the
30:26more sort of scar we're left behind so it's easier just to do it now yeah let's let's get you seen
30:31by the dermatologist come and have a seat have you said you've got a photograph of it have you at all
30:35so the one i took yesterday is oh the one you've done if you've done one yesterday that'd be great
30:39and have you sent them to me well it was on patches yes that's right it's here let me have a look
30:43there it is brilliant we can see its size and everything there it is okay fantastic can i write to the
30:49dermatologist yes i'll send it through to them and then they will take it from there okay okay
30:53thank you all right but don't worry about it it's always good thank you lumps and bumps and
30:57well exactly particularly as that's the second time my mum said have you been to see anyone about
31:02it you've always got to listen to your mother she's always right as well annoying i'm not going for a
31:05third no exactly exactly all right you take care nice to see you bye bye bye bye bye
31:09i fainted probably a good month ago now ended up in any which triggered the whole blood test thing
31:17with sodium levels were really low still getting the dizzy spells and now i'm also getting my heart
31:24going yeah i've become very very lightheaded yeah my head starts going all over the place there's
31:31something not quite right in my head still okay i'm having the most awful dizzy patches i feel
31:39like i'm about to faint okay i've not fainted good um i just feel really unwell
31:46john oh here we are yes okay
31:52i'll ask you to sit in the hot seat if you don't mind with the arms hi
31:59very good friend oh very good what's your name katherine lovely to meet you katherine
32:04lovely to meet you and john i'm good i'm very strong good good good good so tell me um
32:11what's been going on how can i help this morning i got up and i was really pleased i was awake early
32:16i like getting up at five in the morning very good and i was looking forward to finally getting
32:19some work started very good because i had a you know the heart operation i do yeah yeah and then i
32:25went for a shower in the shower i just lost all my energy right i got towards the radiator in the
32:33bathroom and the legs did the wobbly business you know when it could yeah yeah um so then i i sort of
32:38went down the radiator right and i was kicking the wall trying to get my energy up anyway then james
32:44heard all the noise okay uh and he knows i'm not james i share the i've got some flat sharers with me
32:50okay so he was outside though my feet were in the way but then i tried to climb up again to stand up
32:56and then i don't remember anything else after that right because james got in he caught me
33:03and i was now next lying down with a sort of towel behind my head in the shower okay did he say how
33:09long you were out for oh moments moments so prior to going down the radiator did you feel um like the
33:17heart was going very quickly i had no experience of what my heart was doing one way or the other
33:23okay i didn't feel the heart no yes or any breathlessness nothing no no breathlessness at all so
33:29in the context of having heart surgery um last week sometimes it can be because the blood pressure
33:37is low uh if it's okay just do the blood pressure we can pull it off yeah um and i will want to
33:43listen to your heart and lungs as well if that's okay um so your blood pressure is quite low i'm gonna
33:50listen to your heart and lungs if this is continuing to happen i would prefer to see if we can do this
33:56um you know with just getting in in contact with the team that knows you well yeah um but having said
34:02that if it is an emergency it's a and e so i'll listen to your heart lungs i think that um if it's
34:11continuing to happen it is nice deep breaths for me it sounds like it is deep breath
34:32you know how much you weigh by any chance yes 80 kilos sorry 80.5 very precise amazing yeah i'm not
34:43worried myself this morning this is your weight over the last seven years how how much was you would
34:50benefit from trying to reduce it a bit yeah i i i'm trying here i have in the past had regimes of
34:58dieting okay i did lose a lot of weight um but gradually it came back again i lost a lot of weight
35:04yeah um about four or five years ago yeah i lost like four stone yeah um but it's gone back on
35:15georgina hello hello hi come on through
35:19welcome to my sauna oh my goodness it's like quite warm in here i'm afraid come and have a seat hello
35:26i'm dr pearson how are you i'm moderately good yeah moderately good yeah yeah how can we help today
35:31um so about a year ago i had problems with my thyroid okay i had thyroiditis oh okay and um
35:39was on some medication sorted itself out okay i am now not feeling a hundred percent okay i have been
35:47putting on weight like nobody's business okay um i'm probably about a stone stone and a half heavier
35:53than i was this time last year but it seems to happen in like very short period okay so that's
35:59frustrating in itself isn't it yeah and i feel like my thyroid is swollen okay um and i'm just just
36:06want to double check exactly totally fair enough and um i am perimenopause for sure 100 yeah um so i
36:13know that all of these things are might all be connected it's the weight thing that's really
36:17concerning me because i've changed nothing about my lifestyle if anything i'm more active now than
36:22i've ever been diet hasn't changed i joined another yoga studio in the last six months i'm glad you've
36:28come because actually that's the sort of thing that we need to check yeah is it upsetting you is
36:32it sort of frustrating it's frustrating i go to put on clothes in the morning and i can't put on the same
36:36clothes i put on a month ago you know it's like ridiculous your symptoms at the moment so there's
36:40obviously the weight yeah that's doing it you feel something perhaps in your neck as well energy
36:45levels not fantastic okay can i check your thyroid yeah of course so if i just look from the front do
36:51you feel your neck is bigger when you look in the mirror does it feel different to you yeah okay okay
36:56and the the sort of fullness i feel is from here yeah can i go and get you a glass of water yeah of
37:01course because then if you remember when you do have an enlarged thyroid when you drink it moves up
37:04and down so we can feel it so if i just go and grab you a quick glass of water that's all right i'll be back
37:08in one second so your thyroid down which sits like a bow tie in your neck controls our metabolism
37:13and when it becomes under active it means the thyroid is not producing enough of the hormone
37:18so patients feel really tired all the time almost like their on off button has been switched to off
37:23put on weight a bit sluggish so there is a little bit of fullness yeah and it's it's a little bit higher
37:29than i'd expect it to be necessarily but not always and can we do it one more time just a bit further down
37:34it does affect women slightly more commonly than men affects around the age of sort of 40s 50s it
37:40starts to develop trouble is at that age we're often starting to develop perimenopause symptoms
37:45and and everybody just gets up in the morning and feels a bit tired bit achy bit this and people
37:50often just put it down to aging and life whereas actually sometimes we can find hypothyroid and it
37:55becomes quite apparent you've seen pictures of people with a goiter as they call it like a thought but
38:00they've got massive yeah and it's difficult sometimes to tell you know whether we've got it
38:05but i can definitely feel something moving i think there might be so i think we absolutely without
38:10a doubt need to do this blood test to work out what your thyroid function is doing yeah see what the
38:14because we can get the blood test done very quickly and get the results back very quickly perfect
38:18if it's gone skew if we can get you back on some treatment but we'll also probably need to
38:22involve the endocrinologist to find out again why and what's happening last time let's get the bloods
38:26done first if it's thyroid it's sort of easy because then we know we can treat it yeah if it
38:31comes back normal then we've got to look at what else could be causing it because something else
38:36is doing and actually perimenopause that you mentioned is really responsible for a lot of
38:40these symptoms as well and i'm sure if you talk to all your friends of absolutely you're how old 49
38:44here we go so there is a point that actually you'll find there's a lot of women that say from
38:48the age of sort of 45 50 that every pound you put on it you have to do like three times as much
38:52work to get it off it is really difficult sometimes but if you throw thyroid in there as well you're
38:57never going to win so we'll do an mot like we do for a car we'll give you an mot we'll check for
39:01everything and it's got all of them on there perfect okay right they will get that done and
39:07then i'll keep an eye out for them to reach you and keep an eye out for them and then we'll book you
39:10back in again when we get the results all in that's great all right so much okay take care not
39:13still nice to meet you all the best bye bye jordina bye bye okay so that sounds good i'm
39:20going to listen to the heart okay so that looks like it's healing nicely do you want me to breathe
39:25or just carry on stay normal i'm going to just feel the pulse at the same time
39:31okay and bring the top down okay did you restart any blood pressure medication since the operation i'm
39:38back on the same as before um and i had taken my medication this morning when this happened before
39:45this happened i think that maybe the medication has made the blood pressure jump down and i think
39:51that we should look into this a little bit more i think i definitely want to get a blood test to make
39:56sure that the blood count hasn't dropped significantly sometimes that can happen after the uh an operation
40:03i want to make sure that the heart isn't in a funny rhythm and i want to make sure that the
40:08blood pressure medications i think that they may be too high i'm going to arrange a blood test
40:15for you and an ecg here at the surgery oh great yes yeah that's really quick try and do that as
40:21soon as possible i'm then going to call cardiology to see what they suggest in terms of do they want
40:27to see you as soon as possible because you're immediately post a surgery okay uh for now definitely
40:33easy going today all right thank you very much thank you thank you doctor no worries bye now
40:40thank you so much
40:47patrick hi it's us patty okay hi thank you for seeing us thank you very much so this is patrick
40:58hello patrick i am i'm the mom i'm dr prestwich patrick do you want to have a seat here i've noticed
41:04that he has a very funny lumps on his uh skin and i just wondered if you'd mind having a look if
41:09possible please okay yeah of course i only noticed about a week ago okay is it itchy at all no painful
41:17so it doesn't really bother you it's just just there there are a few on his body there are a few
41:25let's have a look shall we show hands so this so that's the most obvious one mm-hmm okay where are the
41:33other lumps patty this okay there are one on her foot as well isn't it yeah there's two take your shoe off
41:42oh okay that's an awkward place to look isn't it um yeah could you stand for me please oh yeah and
41:50lift your foot up there thank you yeah so yeah these look like viral viral warts okay um if they're not
41:59bothersome you you can just leave them alone um sometimes they grow sometimes they disappear as the
42:07immune system eventually fights off the virus that causes them okay on balance if this was my
42:12sun i probably would go ahead with treatment because they can get bigger can become very painful
42:19um yeah and you can keep getting more of them as well usually there's um yeah there's a little
42:23paint that you put on um yeah and it kind of softens the skin and and allows the the water kind of
42:29crumble away almost um but each one is slightly different so you know speak to the pharmacist and
42:34see what they have thank you very much thank you thank you thank you so much for seeing us
42:40thank you thank you thank you very much you're welcome nice to meet you thank you if it's not
42:49getting better when then just let us know great all right not at all have a great afternoon thank you
42:53very much it has been a pleasure yeah and best of luck with the new job thank you very much bye no
42:59worry bye i will see you there see you then take care have fun cleaning i know i will do mine if you
43:04want oh no one month now thanks bye take care a new nail or grow and you'll have fancy new toenails
43:11before you know it and you can always just paint the bit underneath all right okay good luck sweet
43:15i hope it's all right take care
43:27so
43:45so
43:59so
44:07so
44:09we have cockroaches we have mice these things and it's constant you're gonna die you're gonna die
44:26and enjoy yourself very positive i like it one of the biggest things that predicts outcome
44:31it's often motivation but you're the most motivated person i know it's really frustrating
44:39you
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