- 7 hours ago
Any Given Day: Cork University Hospital - Season 1 - Episode 02
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00:00On any given day, some 800 inpatients, 800 outpatients and over 240 emergencies are cared
00:08for in one of Ireland's busiest hospitals, Cork University Hospital.
00:12It will take just one patient to come in, that just completely stops you and reminds
00:18you that, whoa, this is somebody's worst day of their lives.
00:21On any given day, some 4,000 staff come to work here, a place where life-changing decisions
00:27are made every minute, and every decision counts.
00:31Because I see a lot of sadness, I get great pleasure giving people the good news when I
00:37can.
00:39Here I am, hold my hand.
00:41You're having a heart attack.
00:43Filmed using 27 cameras, following patient journeys across the hospital, each story in
00:49this series was captured in just one single day.
00:52Together, they tell a bigger story of any given day.
00:57I'm here for a long haul, you're not getting rid of me.
01:02I just broke down what is going on.
01:05I'm getting the chance she didn't get, so I have to grasp it.
01:09A good shift is where you come out the door happy, thinking, I made a positive difference
01:17today.
01:18And that's really it.
01:21What's the difference?
01:29Message received, thanks.
01:34Look, I am getting absolutely hammered.
01:37Hi, it's Lane over in Aeney.
01:39I'm just wondering, is that bed ready yet?
01:41You don't have no beds, but like, 4C are taking patients off of you.
01:44They're not gone yet?
01:47Yeah, does that mean you have one space?
01:52Yeah, so does that mean we give it 40 minutes, 20 minutes, 30 minutes?
01:59Okay, look, it's half as one now.
02:01Will we be over by half as two?
02:02Will the handover and the patient be up in the ward and everything like that?
02:06Fabulous.
02:17A four-year-old girl, Madison, is being rushed to hospital by ambulance.
02:22She is suffering prolonged seizures.
02:25It's a question of your airway.
02:27Robin, are you okay on drugs?
02:28Yeah, I think that would be on antibiotics and fluids.
02:31You might need a second person.
02:34Emergency consultant Rory O'Brien is leading the team in Resos.
02:38Rachel, I think access is going to be the thing.
02:40With a sick child, you need a lot of people, but you want things to be calm.
02:44You want things to be measured.
02:45Do you mind doing assessment?
02:47You want to be making the best decisions.
02:49Prolonged seizures, we know, aren't good for you.
02:5350-minute seizure, had a further one-minute seizure.
02:55The oxygen going to your brain, which is what you're trying to protect,
02:58may be reduced, which can affect brain metabolism.
03:02So, we need to stop the seizure.
03:04Madison's mother, Shannon, called the ambulance.
03:07I know what seizures are like.
03:09I just felt there was something just different about this one.
03:12We gave the rescue medication after five minutes, which I administered myself,
03:15and the jerking of the body stopped.
03:18But then the lips started twitching, and the eyes were starting to roll into the back of her head.
03:22And her breathing is starting to be affected, which had never happened with Madison before.
03:27She had a seizure this morning at approximately 29, lasting 16 minutes.
03:33When we got to her...
03:34Madison's condition has continued to deteriorate en route to hospital.
03:38Her breathing is compromised.
03:42She looked lifeless, like, as if she was gone.
03:46Just see that, like, when they're pushing the bag down and your child is, like, unresponsive.
03:51It's, it's, it's horrible.
03:54That's clearly a major concern because I'm wondering, is this a problem with her airways?
03:58Is that why she's not breathing appropriately?
04:00Is it a problem with her lungs?
04:01Is it a problem with her circulation system?
04:03Or is it a problem with her neurological system, with her brain?
04:10I thought we were never going to get there.
04:14Can I get access to it?
04:16Yeah.
04:18All right.
04:18We're here.
04:20We're here.
04:24We're here.
04:25We're here.
04:25We're here.
04:26We're here.
04:28We're here.
04:28We're here.
04:32We're here.
04:33We're here.
04:34We're here.
04:35She's had one more seizure en route with a right focus there, also tonic, her limbs stiffened
04:40also.
04:41Just get back up for yourself, yeah?
04:42Yep.
04:43No doubt.
04:43Yep.
04:44Hey, Madison!
04:45Hello!
04:46Hello!
04:50See where is it?
04:54Must stiff there.
04:56No.
04:56No.
04:57No.
04:57No.
04:57No.
04:58No.
04:59No.
05:03No.
05:07No.
05:07No.
05:09No.
05:23No.
05:25No.
05:35No.
05:35No.
05:36No.
05:37No.
05:38No.
05:38No.
05:38No.
05:45No.
05:47No.
05:49No.
05:52No.
05:55and she was stiff on the right side so and eyes were slightly deviated to the right so probably
06:01seizing there was uncertainty as to whether madison would need to be placed on a ventilator
06:07so you do need to introduce that idea early on because you have to prepare madison's parents
06:12for that very possible outcome i just said to my mom i can't lose her i can't lose my child
06:41howard grice has motor neuron disease he is in cuh today with his wife yvonne to check the
06:47progression of the condition my name is howard rice i was born in sheffield yorkshire in 1966
07:02i moved to tower in county cork in 1994 with my partner yvonne i have motor neuron disease
07:11it has affected my speech and swallow amongst other things as well
07:20howard is treated by a multi-disciplinary team including respiratory physiotherapist kevin o'sullivan
07:27i've really been without speech since about a year and a half ago so i use this app to communicate
07:33now
07:34from your point of view how is the breathlessness
07:41a recording of my speech was made when it was deteriorating what you hear now is a repaired
07:47version of my sleep it can be frustrating but you get used to it
07:54you've done this before yeah big deep breath in coffee into the mask and we're going to see how
08:01showing up we'll be doing three or four go on i'll turn away from you otherwise i'll be laughing and
08:10not
08:10about to do it when howard laughs his whole body would shake his face would just erupt and he just
08:17you'd laugh with him because you don't know what he was laughing at but you laugh with him you know
08:23it's difficult watching him and knowing what he was like before
08:28he was very talkative he was the life and soul of the party he'd be the first in and the
08:33last to leave
08:35just just a top guy you know recover big breath cough
08:45the motor neurone disease it's a severe degenerative disorder of the nervous system
08:50and we don't unfortunately have a cure for it we do have
08:55limited medical therapy which is shown to slow things down but unfortunately it doesn't stop the
09:00disease from progressing and my cervical spine identified a disc at c5-6 but his symptoms were
09:06consultant neurologist ashling ryan has been treating howard since his diagnosis
09:11it's always difficult to communicate the diagnosis of motor neurone disease to a patient
09:16you never get used to it you try to be there for that person and be the go-to link
09:23or be the
09:24coordinator for their care for as long as you can a small dip today compared to the last time you're
09:31in clinic okay the most common cause that people die of finally in motor neurone disease is respiratory
09:37failure and even if your lungs are okay and you've never smoked a day and you've perfectly healthy lungs
09:43we still need innervation of our chest muscles to actually move our rib cage up and down and and that
09:50slowly over time fades for patients with motor neurone disease
09:56and relax okay i know take a breather give a minute you're gonna have to be doing this another
10:03two or three times as well okay and he likened it to a thief taking from you the whole time
10:09the thief has got his hand in your back pocket and he's taking everything he's taking your speech
10:14your mobility better it's like a gradual chipping away of the person that you are i had always been
10:23a very active person and felt the threat of losing my ability to continue living as i had been accustomed
10:28to would be a very difficult challenge
10:35a lot of negative emotions anger fear sadness worry it's a head wrecker
10:44super well done oh okay and there's your other soft collar then it's like i'll see how it is
10:48and that's our number on that one isn't it yeah that's fine just you have it okay
10:51yeah how are you we'll see you again okay and we'll be in touch
10:54bye bye
10:59are you from limerick no i'm from cork
11:03why would you think i'm from limerick
11:04do i yeah thanks i don't know is that a compliment or not
11:13the best lucky girls in the country who
11:16limerick ladies are the best oh so it's a compliment thank you
11:25dr jason vanderveld is on duty in the emergency department and also on call for emergencies
11:31outside of the hospital
11:32you have the golf car seven minutes out of um yeah i mentioned it's cold and stiff but i'm sure
11:38it's
11:39beyond any help now roger now the golf car's on its way that's perfect thank you very much
11:49so
11:54cyclist george fuller has dislocated his kneecap jason will seek to realign it
12:08i stumbled into pre-hospital care don't know if i'll do it again i'll probably be a vet in the
12:12life
12:17all right i was a lifeguard beach bum didn't do great at school
12:23joined the ambulance service really enjoyed it absolutely loved being a paramedic
12:28i just won't go
12:32use the top finger on the top to actually
12:36strengthen it and i'm gonna not do anything to you for two minutes i actually want you intoxicated
12:40and then i'm gonna straighten it got injured but i still wanted to carry on and so i suppose that
12:47injury in myself enabled me to go to college study further and so we're in medical school
12:53i'm gonna do bigger breaths than that i think it's that community of pre-hospital care that's so
12:58special your head will swim that's fine right i just want you completely intoxicated deep breaths
13:06deep breaths you're doing perfect well done you're doing perfect deep breaths and relax yourself down
13:16there we go there we go well done deep breaths you've done magically keep going just turning the kneecap the
13:25right way around well done you've done brilliantly okay
13:33all straight just like an in well no yeah thank you all right i'm out of here that's
13:44jason is dispatched to a serious incident near formoy a man has been kicked directly
13:49in the chest by a racehorse bottom line is people do not get injured at the front door
14:09of the hospital you get ill or injured at home on the farm in the workplace on the road and
14:16our
14:16role is to bring the expertise of the hospital to where you've become ill or injured to slow down
14:23hopefully hold the dying process
14:31i see a man in a farm yard he's after being kicked by a horse
14:37the big worry you've taken a full force of a massive animal kicking you into the chest
14:44that energy has to go somewhere it hits your chest wall bruises in the lung bruises to the heart
14:52i have to assume the worst at this stage yeah so it was just a straightforward kick into the chest
15:00and you didn't get thrown backwards you did he did up against this one here he's it okay
15:06and did you hurt your back at all you did okay so you're in charge your own pain
15:14you've got to be very very vigilant that they haven't damaged the spinal cord
15:18bones can break they can break all the way through to your back
15:20any pain to the chest oh yep that's the one he was in a lot of pain
15:35and the horse was still standing between me and james so i couldn't get to him all i could think
15:41about was what damages after being done and when i heard it was in the chest all i could think
15:47about
15:47was what's going on inside in him right now get you in the ambulance with a much much better look
15:53at
15:53you i'd like me out i was gonna do it yeah it won't be far off it so far off
15:59it just go with it
16:00okay i'm just going to get some some scared
16:05james let's have a quick look at your lungs all right just while you know
16:15when you see someone you love lying on a stretcher and they're pinned down to it and their eyes start
16:21to roll and the color drains from their face is he bleeding internally i didn't know what was happening
16:29that's when we all got really frightened four-year-old madison was rushed to cuh earlier today
16:46the team have successfully stopped her seizures but she is yet to regain consciousness
16:54we just wanted her to come around like it's far to open our eyes so she knew that we were
17:11there
17:12can i hold her hand is all right sure sure i'm holding because it was a bit cold so
17:16she is cold there's one thing seeing her have a seizure but to see her the way she was like
17:24literally out cold from being given medication to keep her comfortable
17:36and we're just talking to her and like saying come on baby like you're okay like we're here
17:43and you just want to be with your child and make like take her place so she isn't going through
17:48what
17:48she's going through it's very hard it's very very hard
17:55she's been fighting since the day she came into this world we never thought she would do anything that
18:02she's doing like now but madison like she just surprises us every day with how like strong
18:08she is and we're just so proud of how far she's come
18:14i was only 19 when i found out i was pregnant with madison i was happy sad scared
18:22my partner james found out i was pregnant three weeks after meeting him i was like oh my god like
18:28what like does he want this like is he going to walk and leave me on my own but he
18:32didn't
18:32he said we we did this together and there's no one going back like we'll do it together
18:38the birth was it was like it was hard but it was beautiful and i was just you know i
18:43was so happy
18:44that like my body was able to bring madison into the world and that i had james's support as well
18:51and then everything changed everything changed
18:58we went in with the consultant and they said madison has been diagnosed with dyrk 1a syndrome
19:04we were like so worried i was like what is wrong with her like
19:11she's the only child in the republic of ireland that's been diagnosed with it
19:15like i think there's like 30 something kids in the whole world with it like it's very rare
19:22madison like can't talk she's autistic she's epilepsy feeding problems walking problems
19:29there's so many to do with her disability like she suffers from constipation reflux like there's so much
19:38i weigh very heavily on how the parent is viewing their child they'll know the condition better than
19:44than i will they'll know the nuances madison is extremely ill and will need to be closely monitored
19:50in the coming hours she's now getting oxygen to to her brain but things can change at the drop of
19:58a hat
20:00madison can start seasoning again and her oxygen levels can start going down again and her breathing can
20:05become depressed again so you maintain a holding pattern
20:15james is very he's a very caring person very kind he said and no matter what we'll be the best
20:21parents and show our kids like what love is like as well like show them that like no matter what
20:26we're
20:26always going to be by their sides it is hard like it's very challenging and it's like it's around the
20:34clock care like it's constant constant medications dosage dosage change hospital admissions
20:42they're entrusting you with their child so at this moment they are saying you need to come in you need
20:50to help us i i couldn't imagine what it's like it's that lack of control having to give control over
20:57to the team it must be very uncomfortable kind of feeling for the family to to do that
21:06we're living it every day this is what our life is with madison every day
21:16cuh it's like a big city with little villages you know each of our own little set group that we
21:23work
21:23with and but then we kind of call to the neighbors every now and then for the bottle of milk
21:27you know
21:32you okay james yeah the bike's very rotate where's my neve where's neve neve's outside there
21:4049 year old james fenton was kicked in the chest by a racehorse
21:46emergency doctor jason is concerned he may have life-threatening chest and back injuries
21:52paramedics are preparing to move james to cuh
21:54two specific points thoracic spine upper thoracic spine and and lower thoracic spine
22:02and he's also tender into the lumbar spine if you have a chest wall injury excruciatingly painful
22:07because every time you breathe it's pain i have not got a ct scanner that's going to tell me
22:13definitively that those lungs are not contused or that heart is not bruised so that my first priority
22:20is just getting as much analgesia as he needs to enable him to breathe effectively
22:42so he was on cloud nine i think it was the results of the the ketamine in his system
22:48he didn't feel like he was here with us um he proposed again i love you and we'll get married
22:58we'll get married next week really yeah yeah i was eight months pregnant trying to keep calm
23:14i was just trying to think how am i going to juggle all of this and i'm going to be
23:18on my own doing all
23:19of it what if this is more serious and that the ketamine and all the other drugs he's on are
23:27masking
23:28what he's actually going through howard has motor neuron disease following his respiratory assessment
23:45earlier he and his wife yvonne are waiting to see consultant neurologist ashling ryan
23:55hi how are you come on in um take a seat there heart can i just get a sense of
24:02what you can do
24:03there you so just arms up if you can good and keep that up against me good keep that up
24:08good maybe a
24:09little weak there push down for me nice and strong and push down nice and strong okay good he still
24:14has
24:14quite good strength in his arms and legs so he's walking he's able to be independent in many aspects
24:20but unfortunately that will change over time and then it's dealing with the challenges that that
24:26brings up and how is he going to manage how is he going to is he going to be able
24:30to walk around his
24:31house is he going to be able to dress himself et cetera et cetera and this time pull towards you
24:36i've got fantastic support from yvonne there are things i can no longer do for myself that she now
24:42helps me with and she's had to handle my frustrations yeah i'm fairly good at releasing emotion
24:50i don't like bottling it up better that it comes out
24:55and just the grip strength just squeeze me tight there okay and squeeze right here so yeah that's
25:00a little weaker than left hand isn't it how's the strength in the leg i just like to look after
25:04him
25:05you know it's not a big deal it's just that's what you do for somebody that you love i think
25:10we have a an issue with the wedding ring the fingers have swollen oh and we can't get it off
25:15it
25:16looks to me like it probably needs cutting off they will have a ring cutter they always have one
25:20down in the emergency room because sometimes this happens i mean it's a sort of a difficult thing to
25:25you know cut the wedding ring um do you want that done today if we could organize not really want
25:31to
25:31think about that a little bit it's nice to just sit and be together and hold hands it's just a
25:38bit of
25:38closeness amongst all the hustle and bustle that's a precious moment maybe the next time you're coming
25:46or if that's too far away we can get it done in between
25:52we all know how it ends but the challenge is to make the most of the remaining time i have
26:00despite my deteriorating health i still feel very fortunate i have a loving family i have a lot to be
26:08thankful for
26:11i don't think about what i may miss but concentrate on what i have enjoyed over the last 20 of
26:18years with
26:18them
26:22life's too short for all those to be worrying about how it all ends
26:26the trick is to enjoy each day
26:36was he playing yeah it was sports so that was sports day
26:41everything yeah tag rugby i think first and last time i think we're giving you more medication there
26:49now dude okay
27:0464 year old tim murphy has advanced lung cancer
27:08today doctors will attempt to surgically remove the cancer in a bid to save his life
27:19the consultant came in and told me that tim had a tumor on his lung and it was cancer
27:30i've had two uncles that actually died of lung cancer so
27:36i just thought oh god here we go he's gone
27:46i just remember dr collins's initial words were oh it's a big boy was what she called the tumor
27:56and what's the data part 19th to july 62. i first met tim in the autumn of last year we
28:03would have
28:03discussed his case in our a multidisciplinary team meeting and we would have looked at all his images
28:08and made a decision that actually pre-surgery chemotherapy with immunotherapy i read i suppose
28:14a regimen that we call neoadjuvant was the right way forward for tim and the whole purpose of that would
28:19be to shrink down the cancer because as he currently was with his diagnosis he probably would have lost
28:25his entire lung if he had gone straight for surgery great we might have a quick look at the board
28:29then
28:31when i walk through the hospital there is professional persona that kicks in
28:36but one of the hardest things that i do is when i you know have patients and have to tell
28:42them that this
28:43cancer is going to shorten their life significantly that they um are you know going to not be around
28:51for their children or their grandchildren you know we give people hope we buy people time
28:59but it is emotionally very draining it can be really um hard to shake it off at the end of
29:07the day and to
29:08you know head home and pretend that i just you know put in a nine to five okay so it's
29:13coming
29:13following a regime of chemo and immunotherapy to reduce tim's tumor surgeon kishore dodakula will
29:19attempt to remove his cancer completely also hoping to save his lung okay so if we look at the
29:26differences i suppose in where we were after 12 weeks of treatment um there's obviously been significant
29:34change you can see it sees a big cancer here and then you know obviously much smaller now you never
29:39know till you really go in but i i'll try and save but you know yourself you know unless we
29:44go in we
29:44won't know do you smoke no so he's off them now two years since the 14th of april there was
29:55a point
29:56i know tim doesn't know this but i felt very angry at him like initially it took everything in my
30:07power
30:07not to say you were warned
30:13he had this god-awful cough sometimes he'd nearly choke with it and i just couldn't understand how
30:21he carried on smoking but you just have to try and think of where do we go from here
30:29so we'll start the pre-op they'll check your operation site um later on operation what operation
30:36site just so we always mark where we're going to operate let's handle make sure it's the right
30:40side exactly yeah it's just to check do you know the reason for your admission yeah lung cancer lung
30:47cancer and you're going to this is a surgical ward so you're going to have surgery on yeah let
30:53know yeah is that okay and hopefully they'll be removing hopefully the tumor yeah okay to be told
31:00that the the tumor had shrunk by half was huge we knew then that he could go for surgery we
31:08just had to
31:08see where what they could do who's next of kin okay okay is it partner wife partner i asked the
31:16same
31:16question myself not yet later later this year yeah okay brilliant congratulations the goal is to get
31:27him to surgery so being able to i suppose shrink down his cancer and have it then removed by a
31:33surgeon
31:34is the best outcome and that what we could hope for for tim let's sit down here good ah no
31:40no no
31:40please sit down sure i'm sorry yeah yeah uh how are you feeling great brilliant good the day has come
31:45yeah i heard so yeah so heading into surgery fairly soon yeah the chemotherapy and the treatment you
31:52feeling yeah i feel good i didn't suffer badly with it at all yeah yeah just pins and needles
31:58tiredness yeah beat you up a bit and in addition to beating the cancer up a bit yeah that's the
32:02plan
32:02did that though didn't it yeah yeah good the big fear for us is that you know when the surgeon
32:11goes
32:11in to operate that he doesn't get it all and tim i end up losing the whole lung in order
32:16to try and get
32:17clearance and of course there's risks to surgery i mean having a portion of your lung removed is not
32:23without you know potential for potentially devastating impact it's just that so yeah it is about this i
32:33know we're getting done what we're getting done you know so can't do much more about it
32:49the team has stabilized madison following a series of prolonged seizures earlier today just ring me
33:00madison suffers from a rare genetic condition called dyrk 1a syndrome
33:07we always said from the start when we found out madison was sick like no matter what
33:11we'll deal with it together as a family i do get lonely at times but then i have the like
33:19support of my
33:20mother my father my partner james my siblings his parents and his siblings so like we can just ring
33:27them but it's very hard to like you know kind of explain how you're feeling this is her dad this
33:33is
33:33her dad james i'm constantly blown away just the the level of care and dedication that parents have
33:41you know their whole lives have gone down a path they they didn't think they would go down but you
33:46never
33:46see uh regret you only see love um and it's it's just it's it's mind-blowing
33:57madison will be admitted to the pediatric ward so she can continue to be closely monitored
34:04she's just a lot more stable now so we're happy that we're going to bring her back and then just
34:09kind of wait for her to come around we keep an eye on her and then madison does have needs
34:13and that's
34:14just the way it is but she brings so much happiness to all our lives and everyone is like so
34:19happy like
34:20she puts a smile on everyone's face that she meets just looking forward to the future as our family
34:41james was kicked in the chest by a racehorse earlier today pre-hospital physician jason van der veld is
34:48concerned he may have significant injuries to his chest and spine i've been there with horrific
34:55trauma when it's your own family member you know my son fell off the banisters you know from the
35:02top story down to the bottom story and literally went splat on the tile floor below having to manage
35:10that will always stick with me i live rural i live 50 minutes from the hospital so i had to
35:15switch into
35:16clinician mode did not have any other option and the one thing that i've appreciated is my colleagues
35:27the cuh family because i was able to hand over care with my severely traumatically injured five-year-old
35:35i knew he was in completely safe hands and he's multiple creptice down the left inside of the chest
35:44before james can be sent for a vital ct scan his pain needs to be controlled
35:51all right we're just going to get some local anesthetic and we're going to get uh
35:55uh we're going to get some local anesthetic and try to take the pain that i'm here yeah yeah
36:03it's left side that we're blocking
36:05all right
36:13i seem to be very calm on scene or i my parents on scene is very calm almost non-empathetic
36:18but
36:19actually i have i've been there and i know that the most effective way of managing somebody who's
36:25dramatically injured is to push emotion to one side
36:30and focus on the clinical on what really matters a lot of this is just the ketamine because you don't
36:37feel in control and yourself yourself being the boss normally at work you're always in control aren't
36:44you the day before james's mom had passed away to see a completely opposite side of james being so
36:54vulnerable so upset that his mother had passed away then in so much pain from getting a kick from a
37:01horse
37:01all in the space of 24 hours it was very very hard to know what to do or how to
37:08make things better and
37:09how to be there for him i know you're i know you're hurting a lot so what i'm going to
37:16be doing
37:16is getting a bit of local anesthetic just in two around where it hurts the most
37:26i can see the bruise coming up now i'm what did i just i know i know
37:35i think just one thing at a time all right because in fairness you took quite a belt of that
37:39um
37:39that horse right
37:50no you're definitely not hot enough to be in hell sometimes you call this place hell but it's not
38:00see you edge i'm a pediatric nurse by background um i started off actually as a as an actor over
38:06in
38:06the uk i'm from wales originally um and i went into hospital as a play specialist working with puppets
38:11and children funny really that a lot of the tv stuff which i did as an actor was hospital-based
38:17like i was
38:17extras and casualty and a few other hospital-based programs um so when i first came to work in hospitals
38:23over in the uk i didn't actually like things like injections and blood so i just used to pretend
38:28i was back on set of casualty eugene o'leary has been brought to the emergency department following
38:37a chainsaw accident you were cutting the hedge were you yeah um it needs a few stitches doesn't it
38:47i would think so yeah yeah how many cuts are there's a tone index you wouldn't do with a knife
38:53next time would you eugene's hand was quite simply a mess if you have a wound there bacteria in that
38:59dirt love blood and they just grow and grow and grow oh it's a whole mess isn't it but there's
39:05still
39:06yeah leaf leaf it's a lease on you there'll be heads growing here i think um
39:25one of the most mangled hands that i've had to try and put back together in a long time
39:36do you have any kids i'm not married right doesn't mean you can't have any kids
39:44no one would have me no one would have you you escaped you want to be confident with the patient
39:51and i think that by having the chat with the patient at the same time as you're
39:55doing something very important to his hand i i think it feeds back it reduces his level of stress
40:01what are you going to do what are you going to do my my my father is eight months oh
40:08and my eldest
40:08eight years and then three and five so a nice spread of them yeah all very good all girls oh
40:17all girls yeah blessed among women all that you know so i'll be in big trouble later on in life
40:28that hand was properly mangled with a chainsaw there was so many little bits of skin poking out
40:35ultimately we wouldn't have gotten a very good closure on the wounds so he'll need more long-term
40:41definitive care under the hand surgeons which is the plastic surgeons in our hospital
40:51good afternoon cuhfm hospital radio all day every day with your classics from the 60s and 70s
40:58and the 80s do you remember this guy harry belafonte
41:03okay hey that's me i'm good i'm dave i'll be taking upstairs there now that's good dave tim has
41:10advanced lung cancer
41:13surgeon kishore dodokula is preparing for high-risk surgery to try and remove his tumor
41:18while also saving his lung he won't know until after he has begun the procedure if that will be possible
41:28the most important thing is their life and the second most important thing is get all the cancer
41:36out any operation i suppose done by a cardiothoracic surgeon is life saving because the stakes are
41:43very high if you take out the whole lung the risk is as high as one in ten won't make
41:48it so the priorities
41:50are three one safety so that his life is not in danger number two i want to get all the
41:57tumor out
41:57and number three i want to leave behind as much of lung as possible so that he can have a
42:03good quality
42:03of life after this surgery terrifying one of the loneliest times of my life i think i didn't want to
42:14be
42:15thinking about the reality of what could happen and i didn't want to think of my life without tim
42:27okay to start john i was terrified of the surgery it was just all of the risks associated with
42:34just the surgery itself outside of what they were trying to actually remove
42:48i don't remember my life before tim i was separated i didn't ever think i would
42:56meet somebody again but um tim is the one that's the only way i'll put it to see how we
43:05can negotiate
43:10in this loop and this loop
43:13quarter piece two hours into tim's operation kishore has made his decision on what to remove
43:23is
43:32there is a tumor there
43:36sometimes lymph nodes are involved
43:39so
43:51while james's pain has been brought under control there is concern he could have severe damage to
43:57his chest and spine a ct scan has been ordered to assess the damage
44:02and they gave you the ketamine it wasn't pleasant to see the reaction ketamine
44:10it was just the way you reacted to it which we were told is normal anyway
44:19your breathing it was like you couldn't breathe like you were starting to suffocate
44:23and your eyes just went completely wide and still
44:28james is turning 50 this year and i'm 37
44:32but once we got to know each other um it was never never a question brought up between the two
44:39of us
44:40it was evident very early on that things were going in one direction
44:49we was coming up to valentine's and he's just said i hope himself is taking you out and i said
44:54no
44:54no there's no himself so he asked me if i'd go out for a dinner with him on valentine's
45:00and of course i said yes and we went to bella cafe in fermoy but we had to go to
45:10the folding unit
45:10before we went for dinner so i was introduced to horses straight away
45:21he's very sore very specific one side of his chest we're going to get the scans done okay so
45:27andrea's a porter we're going to go down thank you as you've been kicked and you see visible bruises on
45:33the chest wall you don't see visible bruises in the lung the consequences of that don't happen
45:52immediately when james was wheeled away for the scan it was then that i just broke down and i said
46:04what is going on what's going to happen is he going to be okay or not
46:30tim is in recovery following major lung surgery consultant dervila collins is on her way to brief tim's
46:37partner k the best outcome is that the cancer was removed and that tim's lung was saved
46:46he was able to take out just the lobe so do you remember yeah he didn't take the whole no
46:52he didn't
46:53so he's left about two-thirds of the lung in all right fantastic and and take has taken you know
46:58i suppose one of the lobes and a little bit just a little bit of it but he's happy that
47:03he's got
47:03everything took out all the lymph nodes thank you so much i'll be just gonna get i'll be off with
47:09my
47:09tears again that's my job yeah so they send that off now to the lab sometimes we see a little
47:16bit of
47:17cancer i mean we know the stuff worked yes we know from the scans we know that things looked much
47:21better
47:21okay and and so we're really happy with i suppose the kind of the result that we came went to
47:26theater
47:27with yeah just take another two weeks before we get the full information about um oh it's all
47:32relief i hope at least you're you're a little bit more relieved yeah yeah after i'm sure it was a
47:40very
47:40stressful day stressful months while it's good news that most of tim's lung was left in place
47:48there still remains a risk that not all the cancer was removed
47:52what we want is for when the pathologists look at that cancer that's being removed under the microscope
47:59we want to see no cancer we want to see that cancer having melted away with the chemotherapy
48:05and the immunotherapy and that's the win
48:13when we were in the hospital and that we knew that it was a fracture to a rib and that
48:18his spine was okay
48:19you have to look at the positives as well and and see that he was okay at the end of
48:24it but he was
48:25also extremely lucky to be okay at the end of it you get a second chance the family is always
48:31going
48:31to be number one the horses will be all right but really they're the hobby
48:49i'm cancer free live healthy and happy a lot to be said to be living healthy and happy what more
48:58would you want
49:00so
49:13so
49:14so
49:14so
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