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Any Given Day: Cork University Hospital - Season 1 - Episode 03
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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 can.
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, 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
01:17with the future and is where you can see what is going on today, and that's really it.
01:21Yeah.
01:30Ah, Gardie, please.
01:34Gardie in Cork, yes, please.
01:37Thanks, Simone.
01:42Hi, my name is Kate, I'm one of the the CNMs here in the emergency.
01:47department and CUH. Can I let you know about a patient that's after leaving the
01:51emergency department that is confused and we're concerned about? He's under the
01:56influence of alcohol at the moment but he also has an alcohol induced say
02:02encephalopathy so he is confused he does not have capacity and we are concerned
02:08about him and he is also left with an IV line in his arm.
02:16A five-year-old child is being rushed to CUH. She is barely conscious and her vitals are poor.
02:22There was a real panic there to get her in and get her seen because the man in the back
02:27of the
02:27ambulance was like basically trying to call her he was he was really roaring to call her. She was
02:33barely responding to that. He started from on the head then.
02:38We received a call from the ambulance crew. A five-year-old little girl Fia is coming with
02:45complaining of vomiting and her heart rate is slow and her blood sugar is slow.
02:51she's still vomiting so we need to treat all these very fast.
03:00There is a bit of a bumping bug in the house. Her older brother had the same kind of situation
03:05yesterday
03:06but nothing at all to this extent.
03:09Right.
03:10A heart rate of 80. Irregular though but pacemaker.
03:16Oh basically.
03:17Yeah.
03:17Yeah.
03:18Okay.
03:19Let's quickly get a line here and then.
03:23Fia is practically unconscious. She just looks barely breathing and there's just nurses and
03:30doctors just swarming around. I feel like I'm half in the way but don't want to be stepping
03:38back but also don't want to be in the way so like it's just a head full of emotions there
03:45of like what
03:46what where do I go but I don't want to go anywhere.
03:49Okay sweetie.
03:51Shhh.
03:52Shhh.
03:54Shhh.
03:55I'm trying to tell me 21 pacemaker. Any other history.
03:58Just the Down syndrome and after five months I think there were two holes in a hat repaired as well.
04:04What?
04:11I was with Fia all day long, and then she vomited.
04:16But, like, the fact that she was just so, so good all day long,
04:20happy out, playing and just click of the fingers,
04:24and she was wiped out.
04:26She goes downhill really, really fast.
04:30It's scary just how quick...
04:34It is 1.36, pH is 7.315,
04:39bicarb is 22, sodium is 140.
04:42Oh, good girl. She's the best girl. Yeah.
04:48She was becoming unresponsive.
04:51It was getting harder and harder to actually keep counting.
05:04It's all right, it's all good.
05:05No, it's all good.
05:08Oh, yeah.
05:17Surgical oncologist Mark Corrigan has just started his shift.
05:21He specialises in preventative surgery.
05:25We know much more about cancer than we did 10 years ago, 20 years ago.
05:29And the different treatments that we have are really, really effective.
05:33They don't work for everybody.
05:34But for a lot of people, they do.
05:36You know, there's nothing nicer than, you know,
05:38when you give good news to somebody, you say,
05:39look, okay, you've taken them through that horrible moment of,
05:42okay, we've got a problem and we ought to do something with the problem,
05:46to that moment, maybe a couple of years later,
05:48when you finish the follow-up and the surveillance and everything else,
05:50and you say, we've done what we had to do and we'll see you again.
05:55Maybe in Dunes or somewhere else, but not hopefully here.
05:59Today, Mark will operate on Antoinette O'Keefe.
06:04Six years ago, Antoinette received a diagnosis of aggressive breast cancer.
06:12I'm not a big drinker. I don't smoke.
06:15So I was thinking, like, I'm doing all the right things
06:17to prevent cancer coming to my door.
06:20And yet it still came.
06:22You end up into bed and literally, I turned and said,
06:26good night, John. I gave him a kiss and we turned
06:27and he called over and he was like, put his hand on my chest
06:29and he was like, what's that in it?
06:31And I was like, well, I don't know.
06:33I was like, nothing. I said, hang on.
06:35I better check now again.
06:36So I sat up in the bed and I was like, no, that's something.
06:38I said, that's definitely, definitely something.
06:40I don't know where I'll be afterwards.
06:47That's fine.
06:50I remember being told on the Friday, the toy show was on.
06:54I had toy show bags made up.
06:56And I remember sitting there and I kept crying.
06:58I hadn't told the girls.
06:59I kept crying thinking, oh, my God, is this going to be my last one?
07:03Like, afraid it was going to happen.
07:05Something bad was going to happen.
07:07And I kept saying, like, is this going to be my last one?
07:09Oh, my God, please, will it be my last one?
07:11I haven't had enough time.
07:12Sorry, I'll get emotional.
07:14But, yeah, that was a really hard part.
07:20You never think it's going to happen to you.
07:22And then when it turned out, it was something, obviously.
07:26The whole world changes immediately.
07:29You know, it's like somebody just turns on a switch and everything changes.
07:35You've no heart surgery.
07:36No, not like that.
07:41I had to have a full mastectomy.
07:42That was totally different.
07:45Looking down that day, you know, it's like, holy shit, like, it's gone.
07:48Excuse my language.
07:49I was like, holy shit, it's gone.
07:50Like, and it's just, yeah, it was weird.
07:56To be honest, having had your surgery done recently, I expect they're fine.
08:01While the mastectomy on Antoinette's right breast cleared her cancer,
08:05tests revealed that she has a variant to the BRCA gene,
08:08which means that the chance of developing cancer in her left breast is very high.
08:13She has made the hard decision to remove that breast
08:16and is in CUH today for a mastectomy and reconstruction.
08:20Well, Antoinette.
08:22How are you?
08:23Good.
08:23All set?
08:24Yep.
08:25Yeah?
08:26All set as well.
08:27Okay.
08:27I've known Antoinette quite a long time now.
08:30And, I mean, she was very clear the minute that this was identified as a potential cause,
08:35it was no.
08:36It was, I want to take control.
08:38I want to manage my own risk.
08:39I want the information.
08:40And what are we going to do about it?
08:42The plan is today, mastectomy on the left-hand side to reduce the risk.
08:45We're going to be taking the nipple and the areola.
08:47Yeah.
08:48And then, Mr Chasher will be doing the reconstruction with the implant.
08:52No surgery underneath the arm today, so different to the last time.
08:55Any questions you want to ask us?
08:56Um, no.
08:57I don't think so.
08:57No, just get on with it, Mark.
08:59Yeah.
09:00No.
09:01All right.
09:02All right.
09:02We'll see you inside in a little bit.
09:03Thanks a minute.
09:04All right.
09:04See you guys.
09:05This is something I get to do.
09:07I know I have this gene, so I had my tubes and ovaries removed in March.
09:13I'm taking something that I know right now is healthy.
09:15I'm taking this breast away, I'm like, and I'm going to put myself to the surgery again.
09:22I'm thinking of my kids like I'm here for a long haul, not getting rid of me.
09:35Oh, my God.
09:36How did the wedding go?
09:38Oh, it was great.
09:39Yeah.
09:39It was fabulous.
09:40Have you any photos?
09:41It was so long ago now.
09:42And did you go on any honeymoon or anything?
09:46I went to Italy for a week.
09:47Oh, lovely.
09:48Lovely.
09:49Let's see how ugly you are.
09:50Go on.
09:54Oh, jeez.
09:55You actually look like you go on in a movie.
10:06The pediatric allergy clinic in CUH is busy.
10:10Patients here are treated for a range of challenges, including food allergies.
10:16I was trained in Peru, then I went to Spain, and then I finished with my fellowship doing pediatric allergy.
10:23Cork has one of the biggest pediatric allergy service in the country.
10:27So I said, this is a good opportunity, so I wanted to come here, and it changed my life.
10:33In 90% good things, 10% more stress.
10:36We need to sit down and tell them about the awareness of this, you know, that we are allergic
10:41and we need to carry the EpiPen all the time.
10:43Okay?
10:44Yeah.
10:44Perfect.
10:4711-year-old Ciarán O'Connell was diagnosed with a severe peanut allergy at an early age.
10:54I can't eat peanut or else I'll start getting sick in my throat when I start closing in.
10:59And I'll have to get like a needle in my thigh there.
11:03And I kind of have to carry around the medicine bag all the time with me, like whenever I go
11:09places.
11:10It kind of annoys me sometimes.
11:12And I won't have to check the ingredients on anything, like, because every time I have something I just have
11:17to like check it, so.
11:19And Ciarán's case, Peanut, that is life and death.
11:23At 11, he's very clued in.
11:26He's very aware of it himself.
11:28He checks packaging more than us.
11:31Still, for 11, it's hard to put that into your head to say that you could potentially die from this.
11:37If ever the worst case scenario ever came and he went to an epileptic shock, his system starts shutting down.
11:42Rash forms, cough, the usual gasping for brace.
11:47So obviously that's when you need your auto-injecture and the shot adrenaline.
11:51He needs to be brought to the hospital straight away.
11:55EpiPens are the things that you bought in your leg if you eat a peanut or whatever you're allergic to.
12:01And they kind of, sometimes they look like this.
12:03They can be other types as well.
12:05And I have two for like just everywhere and then two for school.
12:10Ciarán is in CUH today for an oral food challenge.
12:14He is hoping the test will show he is no longer allergic to peanuts, which would mean no longer having
12:19to carry his life-saving EpiPen.
12:23The oral food challenge, they come to Dayward and we will introduce them low doses of, for example, peanut until
12:30we get to an amount that is approximately between 6 to 12 peanuts.
12:35And they don't have any reactions after two or three hours.
12:39We can safely say that they have an oral food challenge negative.
12:44Are you praying?
12:46No.
12:46Okay.
12:48How are you?
12:49Good.
12:49Good.
12:50Good.
12:51So what are you trying today?
12:53Good.
12:53Personally, I think today is Ciarán's last chance of maybe passing the test.
12:57For Ciarán it would be life-changing because it means he'll never have to inject himself, never have to worry
13:03about an epileptic shock anymore.
13:06And he can just go on with his life, eat what he wants and just be happy.
13:12And do you eat other nuts?
13:13Yes.
13:14And this is an important question.
13:16If by any chance we're lucky and you eat peanuts and you don't have a reaction today, will you start
13:23eating peanuts at home?
13:24Yes.
13:24Okay.
13:25Crossing our fingers.
13:26Don't pray.
13:27Okay.
13:33It is going to be weird.
13:35Ciarán is physically going to take a peanut, an actual physical peanut.
13:40It's stage by stage by stage, an eight of a knot, a half of a knot.
13:44And they're just going to try to test, push Ciarán's tolerance as much as they can.
13:48You ready?
13:50This is Murphy's Law, you know?
13:52It only takes one person to introduce it at home that has an anaphylaxis, that maybe they don't know how
13:58to use adrenaline,
13:59and has a really bad output or outcome, and then everything is a mess.
14:04So that is why it's so necessary that every challenge has to be in a hospital-based.
14:11So internet, I'm going to just wipe down, so it's okay.
14:13All right, that?
14:14Good, ma'am.
14:15Well done.
14:16Can you take a take a look at my name?
14:18Every time that we're doing that, we're also observing them, looking if they have that minor reaction or whatsoever,
14:25because we need to look if they're going to start having an anaphylaxis, because we need to up quickly.
14:37Five-year-old Fia was rushed to CUH earlier today. Staff have worked to stabilise her, but she is still
14:44very ill.
14:45Shortly, she will be scanned so the team can investigate further.
14:58If he was born, it was just like any other person. If he was born, and then there was a
15:04bit of silence in the room.
15:05The nurses were checking her over, and we just thought it as that.
15:12It went really quiet, and I was thinking, what's wrong? What's wrong? What's wrong?
15:18And then one of the nurses said, I think that she has Down syndrome.
15:24So, I didn't know what to say.
15:27We didn't know that in any of the checks prior to that.
15:30There was nothing they saw that indicated anyway.
15:42Very short time when Fia was born, her oxygen levels kept dropping.
15:46She had to be brought down to neonatal.
15:49And so we had maybe 15, 20 minutes or so of Jo holding her between us.
16:00I wasn't allowed my phone in the NICU, you know.
16:04So, like, I just spent hours staring at her.
16:07And I'd be just drawing out little hearts with my fingers on her.
16:13That was, like, me just being able to touch her.
16:16I wasn't allowed, like, I wasn't able to hold her or anything, you know,
16:19because she wasn't strong enough for her.
16:23I was going to get in there.
16:24I was going to lay down to Fia. I'm here.
16:25Daddy's there.
16:26I'm here.
16:27Ah.
16:29Do you want to get to when it's done?
16:32Come back to the end.
16:34During Fia's time in neonatal, to see her fight through that,
16:39and, like, from day one just come out fighting,
16:45the, oh, good girl.
16:50Seeing what she's went through, none of us should be complaining about anything.
16:56We really shouldn't.
17:00Listen, stay still now.
17:03If he keeps moving, is it okay if you stay with her for the x-ray?
17:07Yeah, it's fine.
17:12I might get you to stay with her, please, because I'm in position here.
17:18The UH is like a beehive.
17:21Everybody's so busy, they know what they're doing, and if you don't talk bee language,
17:26it doesn't look like you know what's going on or it doesn't make sense,
17:29but everyone's working, getting it all done.
17:38Antoinette has made a choice to have her breast removed.
17:42Although it is currently healthy,
17:43she has a harmful variant of her BRCA gene, making her more vulnerable to the risk of developing cancer.
17:52Once I have an idea of what time she'll be out, I'll be back.
17:55And again, I actually can't tell you nothing.
17:57Oh, I know. I know.
17:58Don't take as long as it takes.
18:00John's my rock.
18:01We weren't together six months and he proposed.
18:04I think everyone thought we were insane getting engaged.
18:07Are you sure you don't even know someone after six months?
18:09John was 21, I was 24.
18:11Here we are, 17 years later.
18:14We've grown up together really in that and you know, we've built a life and you know,
18:20we've been best friends and that all down to years.
18:23So, you know, it's been, it's been incredible.
18:27The first part of the operation will be to remove Antoinette's breast.
18:31The second part will be a reconstruction, which will be carried out by consultant plastic surgeon, Justin Chatterjee.
18:39What we're going to do, I'm going to just do some marking.
18:41Is that all right?
18:42Yeah.
18:42OK.
18:43All right.
18:44Before you do that, yeah?
18:46I'm going to, I'm going to get out and let you do this.
18:48Are you sure?
18:49OK, yeah.
18:49Do you have any, we'll give you a phone.
18:51I'll touch you before the, before the, before you leave there, OK?
18:55Oh yeah, yeah.
18:57I did, I found it hard to be inside her.
18:59Yes.
19:00One second.
19:01They were drawing the lines on her body and it was upsetting her.
19:05I didn't want it to be seen that it was affecting me as much either.
19:09You're all not there for a second.
19:11He held my hand through the whole out of it.
19:13Every appointment, everything.
19:17Every moment of weakness that I had, the negative thought.
19:21He'd leave me room with it and say, OK, that, that's, that's it now.
19:28He told me he's fierce too.
19:30And his fear was like losing me.
19:32He's just, he's my soulmate.
19:35I went, had coffee, just took, took a moment and came back then.
19:41I was, you know, you need to be strong.
19:45OK.
19:46OK, dude.
19:48OK, dude.
19:52Great.
19:54Great.
19:58Ciaran is being tested to see if he is still allergic to peanuts.
20:01A negative test will mean he is no longer at risk of a fatal anaphylactic attack.
20:07He has had two small portions of a peanut so far.
20:12They taste good.
20:15They came over then to do the third part of this, which was a half peanut.
20:19I think the nurse made a joke.
20:21She goes, do you like it?
20:21He goes, they're very salty.
20:23I told him, sit back, relax.
20:24He was on his tablet.
20:26And he did give kind of one or two little small coughs.
20:30Like, I was just staring at him, you know, thinking, go on, Ciaran, keep going.
20:33I hope you get to stage five.
20:34I really do.
20:35I really hope you do.
20:36Yeah.
20:37Just keep picking up.
20:39Why don't you have enough?
20:40Just in contact.
20:41I'm not eating you.
20:42And they were looking and I just went like that.
20:45I just tapped my ear like that.
20:46And they looked and you could see all these bubbles forming along Ciaran's ears.
20:49And the nurse called Dr. Trulio and just pure professional came over.
20:54He goes, okay, that's the end of the testing.
20:57This is a positive reaction.
20:59And that's when Ciaran obviously got very upset.
21:02I think he was gutted actually, yeah.
21:03A little bit white dots here that you're having that makes a reaction.
21:08Okay?
21:08Okay, sir.
21:09I will tell you something important.
21:11Okay?
21:13So, sometimes...
21:14Ah, don't worry.
21:15No worries.
21:16This is not going to be a problem.
21:17We need to make sure that you're okay in giving you that.
21:21Yes.
21:22Yes.
21:22Do you want it to eat peanuts, no?
21:24Yes.
21:25You have to get a Snickers on your own.
21:29I know.
21:29It's disappointing.
21:31Yeah.
21:32I know it is.
21:33You did a really good job though.
21:34You're so proud of yourself.
21:35Yeah.
21:36I know.
21:36Give Ciaran his adrenaline then and literally within, I'd say, 30 seconds, that's...
21:41Joy, the tingling was gone and Joy, he just felt way better on himself.
21:45So, I really hope that's stuck in his head, what adrenaline does to his system basically
21:48just gets him back to normal.
21:51He did it at home then.
21:53How his whole face changed, rash started forming his body, his ears became red and blistered
21:58in the space of minutes.
22:00He's back and he's been with him the whole time.
22:02All his injectors need to be with him, literally, the whole time.
22:05Okay, last couple of things.
22:08How do you feel?
22:09Good.
22:10Bump it.
22:11Okay.
22:11Now we know that he's allergic.
22:14And now we also know that he needs to be careful and take things seriously.
22:19Have you tried pecans?
22:21Pecans?
22:22No.
22:23Okay.
22:24How about Kinder Bueno?
22:25Do you like Kinder Bueno?
22:26Yes.
22:27Okay.
22:28I'm happy with that.
22:29Kinder Bueno is okay.
22:30Nutella is okay.
22:31Just please, no sneakers, no these kind of things.
22:35Okay?
22:36We've never used the EpiPen.
22:38We have a training pen that he has practiced on himself.
22:42The only thing that you're never going to eat so far is?
22:46Peanuts.
22:46Perfect.
22:47So, if it does come to us, will he actually inject himself?
22:52And that's a massive fear.
22:53So you don't have the fear of sticking a needle into your own body.
22:56I know they would save my life, but I think they would hurt.
23:03Take off the topless.
23:04Then you push it in around there until you hear a click.
23:08And then you just hold it for 10 seconds.
23:10The medicine stops, like, my throat closing in.
23:15And it, like, stop me, like, help me to breathe again and stuff.
23:21It is life and death.
23:22That's the bottom line.
23:23It comes down to that.
23:23It literally comes down to that.
23:25It's getting power to the school.
23:27When I hand over the back from now on, it should be aggressive.
23:30This is Kiran's metal kit that needs to be used that will save his life.
23:34And that is the fact of it.
23:46After a diagnosis of cancer in her right breast, Antoinette had a mastectomy.
23:51Tests showed she has a mutation of the BRCA gene, increasing her chance of breast cancer into the future.
23:56She has decided to remove her healthy left breast, followed by reconstruction.
24:02We tend to focus on surgery as if there's a surgeon.
24:06And in this case, there's another surgeon.
24:08But actually, you know, you're looking at about 10 people.
24:12Two arm boards, please. Thank you.
24:17The role of the surgical oncologist is to perform the wrist reduction mastectomy.
24:22What we want to achieve is that we've removed as much of the breast tissue as possible.
24:26And the role of the plastic surgeon is to perform the reconstruction.
24:44The people that we meet who come into a hospital, it's a really unique situation.
24:50Because you're parachuted in to the middle of their lives and to the middle of their confidence,
24:54which is a huge privilege.
25:01It was never going to be an option that was going to keep my breasts and risk it.
25:05I know I have this gene, let's get ahead of it.
25:07I don't want to be in my 50s or my 60s or my 70s or even my 80s fighting breast
25:13cancer.
25:14And can I get two Alices off you, please?
25:17Yeah.
25:20You are meeting people when, you know, yesterday they were on their way to work.
25:25And today they've just got news that's completely changed that.
25:29And so the things you were worried about yesterday just are not what you're worrying about today.
25:32And on a human level, I suppose you're frequently reminded, I suppose, that, you know,
25:40for any of us, we don't know what's around the corner.
25:46It's just, yeah.
25:48But when they go home and they're trying to process all this and they're having a cup of tea or
25:53they're just having a cry.
25:54And, you know, that's where you see the incredible importance of the people around them.
26:01No.
26:02No.
26:03Okay.
26:03I'll come back to it.
26:04There.
26:06Okay.
26:07Hi, John.
26:08Mark here.
26:09Good.
26:10Everything went very well.
26:12Yeah.
26:12No, please.
26:13Yeah.
26:13We're pleased with that.
26:14So, I suppose, Antoinette will be waking up in the theatre now in the next five minutes or so,
26:18because I promised her we'd bring in the minute we were done.
26:19So, she's only going to be coming around.
26:22Once she wakes up, she'll be able to recovery.
26:25Perfect.
26:26Perfect.
26:26That's plenty of time.
26:28Not at all, John.
26:30All right.
26:30Take care.
26:31See you.
26:31Bye-bye.
26:33Are you not going home?
26:36Oh, I'll be going at six.
26:38Oh, six.
26:38Oh, there's a few.
26:39Have you eaten it?
26:40I have.
26:41Yeah.
26:41Good girl.
26:41Turn around.
26:43Oh, I'm just here.
26:45Sweeties.
26:45Oh, that's very nice.
26:46I know.
26:48I'll have the crackers.
26:57Just 50 minutes ago, Fia was rushed to CUH by ambulance.
27:02She is now being moved to the paediatric emergency department and will continue to be monitored closely.
27:08She is stable, but remains unwell.
27:13She has any siblings at home?
27:16Yeah, she is.
27:17She's about at home.
27:17How old is she?
27:18She's six.
27:20I was at home with Finn.
27:21I do go into a panic like when I see her, when I see her like that, you know, it's
27:28scary.
27:29Darren can keep calm, you know.
27:34As much as you can't do anything to help it in, as a sense, other than be there and support
27:45Bev, Bev support me, be there for Fia.
27:49Yeah.
27:50To myself and Bev, family is everything.
27:54Now, her numbers are all good now.
27:57I will just send her some numbers now there and we'll come back to you, okay?
28:01Okay.
28:04And we'll keep an eye on her numbers there, okay?
28:07Awesome.
28:08Thank you so much.
28:09Perfect, thank you.
28:13Down syndrome, it's not all that she is.
28:18But to me, it's the best part of her because, you know, I wouldn't change a thing about her.
28:23Like, she's, she's amazing.
28:27It is challenging, but it's not the end of the world.
28:32If I could say anything about it now, it's, it's not to be scared about.
28:37Yeah, because, she's a great girl.
29:00We're at the frontline.
29:02When you walk into the emergency department, you really can't expect what's going to be thrown at you, what you're
29:08going to face.
29:09And you don't know whose life you'll impact that day.
29:13I got a call, and it was Christy.
29:16He said, I'm in an ambulance, and he's having a heart attack.
29:19All of a sudden, like, you're sort of, what did he tell me, what did he tell me?
29:23It's a frightening thing, you know.
29:28He's my only brother.
29:29I have nine sisters now, but he's my only brother.
29:33Christy Jacob has been rushed to CUH from University Hospital Waterford.
29:37He's had medication for pain reduction, but is having a heart attack, and needs urgent treatment not available in Waterford
29:44at this time of night.
29:45Hi there.
29:46Hello.
29:48My name is Syma.
29:49I'm one of the doctors here.
29:50And what time did the chest pain start?
29:51It started about eight o'clock.
29:52Eight o'clock.
29:53It's a good thing you came straight to hospital.
29:55Can we get a repeat ECG on him while he's here?
29:57Yeah.
29:57Um, you know that you've had a heart attack?
29:59I've told you that.
30:00Yeah.
30:01Um, what, has his blood pressure been en route?
30:04Hey, Dylan.
30:05How are you?
30:05This is Dylan.
30:06Can I do this for a second here now?
30:07One second.
30:08Because the transfer time from Waterford to Cork University Hospital, because on blue lights, is around an hour.
30:14Sorry again?
30:15They do have to treat it before they transfer the patient over to CUH.
30:19And the treatment which then is given is to try and attempt to dissolve the blood clot.
30:24To limit the damage done to the heart muscle.
30:27Increase these case, unfortunately, the thrombolysis had not worked.
30:31Yes.
30:32So time is key.
30:33Okay.
30:34You've almost certainly got a blocked artery in your heart, okay?
30:37We gave you some medication in the water to try and unblock it.
30:40Yes.
30:40And it hasn't really worked as well as we thought it would.
30:43Okay.
30:44So we're going to need to proceed ahead and you may need a stent.
30:47Registrar Dylan Finnerty has been in constant contact with consultant cardiologist Richard Tanner.
30:53Richard is at home, but is on call for emergencies and has made a decision to activate the CAT lab.
31:04He has 30 minutes to get to CUH along with two specialist nurses and a radiographer.
31:10Where's the project?
31:12Where's the project?
31:12Where's the project?
31:13Where's the health?
31:13Healthy, I'm all tonight.
31:15How's the nutrition?
31:17Do you smoke?
31:19How many?
31:21Are they roughly?
31:22A few people.
31:23At least they seem to be different.
31:24I'd say a five, ten, whatever.
31:26Asthma?
31:27No.
31:32I don't smoke anymore.
31:36You see so much in the emergency department, you see so many illnesses, you see patients
31:43at their sickest.
31:52And it makes you appreciate the little things in life, you know, going back home to your
31:57family, trying to get as much out of life.
32:01You don't really know what's going to happen, you know?
32:03Even though they're treating you, you can still die.
32:07Things can change in an instant.
32:09I only want to know that and go to the doctor.
32:10Yeah, absolutely.
32:12I guess what we can say at the moment is you're having a heart attack, okay?
32:15Yes, I was told that at the moment.
32:16If we do nothing, okay, you just push away the wrists here.
32:19So we'll get to see.
32:20We'll just wait and go down there.
32:22Okay.
32:22Thank you very much.
32:23I really appreciate all this, what you're doing.
32:26Um, doctor?
32:27Yep.
32:28This is very different, right?
32:30Yeah.
32:31Yeah.
32:33Mm-hm.
32:34Okay.
32:35I'm sorry.
32:39I appreciate the name.
32:40Yeah.
32:41Yeah.
32:42There you go.
32:43Not allergic to anything?
32:45No.
32:45No.
32:46So what we'll do is we'll lie you flat on the table.
32:48Yeah.
32:49We'll go through a little larvae at the wrist, okay?
32:51So, preferably we go at the wrist.
32:53Sometimes we have to go at the top of the leg instead.
32:55All right.
32:55We'll tread a very fine wire up the arm, then into the chest.
32:58We inject some contrast dye and take some x-rays of the chest.
33:01And we're looking for a blockage, okay?
33:03So if we see a blockage model, I know we'll leave it.
33:06Okay.
33:08All right.
33:08We'll get you down.
33:09Thank you very much.
33:10Take care of this and get it.
33:12All right.
33:13All right.
33:13All right.
33:13All right.
33:14All right.
33:14All right.
33:20All right.
33:21There was one patient that came down and we were all tipped off before he came down that
33:25he needed to be called JC and not by his real name.
33:28The patient himself thought he was Jesus Christ.
33:33So we had to call him JC because if he was called by his real name, he would have gone
33:37ballistic.
33:38But unfortunately, one of the surgeons came up to meet him and he looked down at him.
33:43He says, good morning JC.
33:45How are you?
33:46My name is Mohammed.
33:47And the patient looked up at him and held his hand.
33:50He said, I've waited all my life to see you.
33:56How's that pain in your chest like this?
33:58I can't, boy.
33:59Still there.
34:00Christy Jacob is having a heart attack.
34:02He was treated in University Hospital, Wardford before being rushed by ambulance to CUH.
34:08First floor will probably be quicker if you want to just go up one and then go down one.
34:12Pretty big, yeah.
34:13Because we're really struggling with that.
34:14Stabilised in the emergency department, he's on his way to the cath lab.
34:22On-call consultant cardiologist Richard Tanner has made it to the hospital within 30 minutes.
34:28When an artery is completely blocked, we know that the extent of damage is dependent on the time that artery
34:34remains closed.
34:36When it remains blocked and blood supply is cut off, it can lead to extensive damage to your heart.
34:42Even if we open up the artery at that time, there's a certain amount of muscle in his heart that
34:47will be dead and irreversible.
34:50And the consequence of that is heart failure.
34:54So, time is critical in the treatment of heart attacks.
35:02You think you're invincible, but you're not.
35:05You think you're invincible, but you're not.
35:05You think you're invincible, but you're not.
35:05And this kind of highlights the fact that you're mortal.
35:12He's a master butcher and he loves you meat.
35:16Fish is for cats.
35:18That's what he said.
35:20We're all guilty of overindulging and all that, but if it affects you that badly, you have to kind of
35:26stop it.
35:28Sing at the drop of a hat and he likes women.
35:32He's never married around, so he's a single man.
35:34He's a man about town.
35:36He can do what he wants.
35:37Kind of a party animal in a way, but he's an older party animal.
35:41You kind of can't blame him until something happens to you.
35:47Can I take the stent, please?
35:51To keep the artery open, we place the stent, which is like the scaffold that keeps that artery open.
35:56So that stays in your body and it will be there for the rest of your life.
36:01No, no, no.
36:02Okay, almost done, almost done.
36:03Ready?
36:04Almost done.
36:06So Christopher, you stent in and the artery opens up, okay?
36:11He's a kind man.
36:13We want him around as long as we can have him.
36:25Five-year-old Fia continues to be monitored in the paediatric emergency department.
36:30She will be admitted when a bed becomes available.
36:36Okay.
36:37Thanks a lot.
36:42Maybe because of the vomiting, the white cells in the blood is a little bit high, but
36:48her CRP like a kind of infection is normal.
36:52Nothing to worry, like because of the vomiting, her white cells are high.
36:55Okay.
36:57So, anyway, they will follow up her in the ward there, like, you know.
37:00Yeah, they'll take more bloods there and so on.
37:03Yeah, yeah.
37:10So, her primary concern to the hospital for Fia is now dehydration, vomiting and sugar,
37:16hypoglycemia, not because of any cardiac issue or trisomy 21 or Down syndrome.
37:21She is in the hospital.
37:23Only thing, the dehydration.
37:24So, we are treating her dehydration now.
37:41Today, Brian Murphy is scheduled for complex surgery to try and ensure he can continue
37:46to walk into the future.
37:50For the last couple of years, he had an awful lot of problem walking because he had so much
37:55trouble with his knees, couldn't really walk very far.
37:57And if he was walking then, she was at a snail's pace and I'm like, will we ever get home?
38:05I've seen a lot of football at the basketball club now.
38:09This might have nothing to do with it, but I had trouble with me knees.
38:17Eventually, I had to get him done.
38:19The pain was chronic.
38:21It still is.
38:22This is a bigger operation.
38:24Why, you know, but...
38:25Brian would be in pain every time he tries to walk.
38:28He's quite a stoic character.
38:29He's a man who doesn't complain and I know that if he's complaining of something, he's genuine.
38:34The older you are and the frailer you are having a surgery, then the less likely you have
38:38of a better outcome.
38:40Morning, Brian.
38:41How are you?
38:41How are you?
38:42Good.
38:42Good.
38:44So, we're going to do your surgery this morning.
38:47All right.
38:47It's now causing him significant pain and the only solution that I have to be able to reconstruct
38:52this for him is to give him a total femur replacement.
38:55I've no hearing aid.
38:56You thought I had to replace just the knee, but I have to replace the whole femur.
39:00Yeah, yeah.
39:00So, once you have to replace the entire femur, you're essentially replacing the entire knee
39:05and the entire hip in one go and then replacing the entire femur at the same time.
39:09But I don't think you have a choice because I think that this thing is completely loose
39:12and you've got so much pain, you can't walk on it.
39:15So, we just have to go ahead and do this.
39:17You can say, look, I don't want to do it, but I don't think you're going to be able to
39:21walk
39:21and your pain won't go away.
39:22The challenge of trying to look after somebody with a problem that's more complex is challenging
39:27you to try and improve as a surgeon.
39:30If you do only simple things all the time, you never get better.
39:33So, you have to try and step up and do more complex things.
39:37This is a big surgery.
39:38There will be a reasonable amount of blood loss in this.
39:41Just worry how long it will take you to know.
39:44You shouldn't be worried about that.
39:46Oh, I know that.
39:47I don't know how long it's going to take.
39:49It will just take as long as I need to get it done safely for you.
39:53You put your trust in them, then for those five, six, seven year olds, whatever he does.
40:00You'll have to.
40:01It is a substantial surgery.
40:03It's going to take a bit out of you.
40:05You may need a bit of blood or something like that afterwards.
40:08People like Brian, they can lose a lot of blood.
40:10The other worries you have with people like Brian are the risk of clots.
40:16And there is the very rare patient who gets a severe clot in the lung and that can kill them.
40:24I'm so happy.
40:26How are you?
40:30Have you eaten?
40:32Can I just have something?
40:34I'm just not missing if I go to school.
40:36Antoinette is recovering from her mastectomy and breast reconstruction surgery, an elective
40:41procedure prompted by discovering she has a variation of the BRCA gene I am
40:49lucky yes I have the gene but I'm ahead of that now so I feel I'm incredibly
40:54lucky and to get this far I get to see my kids grow up I get to see them
41:01graduate from National School to go to secondary school getting on with life
41:10the gene obviously could go into the future the girls will be checked as soon
41:17as they're 18 and they'll have consistent ISO testing and they're going
41:21forward so that at least they'll always be monitored into the corners like you
41:28I won the lotto of life I win because I beat us so that's really important yeah
41:37and I kept my word to myself that I was never going to lose to this
41:48surgeon James Harty is preparing for major surgery patient brain Murphy requires a
41:54knee hip and femur replacement to try and keep him walking into the future it's a
42:01substantial surgery you have to prepare to have a patient who's on the table for
42:05quite some time can the lights be put up please can you put some power on those
42:09lights because they're too weak in Brian's case I will start at the top remove the
42:16femoral component put the hip cup in and then go back down and put the knee bit in
42:20and then join the two from top to bottom by putting the femur in the question then
42:25is can I get the hippo first just pretty do that actually let's just see can I get the
42:28hip Brian I suppose is the love of my life because well he's the only boyfriend of such
42:33really I'd say that I ever had he's kind of been the one and only if I can dislocate the
42:37hip first it might be easier we met through his sister okay and I've got a bit friendly with
42:43him but like Brian was always very very shy back in those days and like if I'd come in the
42:48door he
42:48was gone try and dislocate that hip try and dislocate the hip I don't know it was like kind of
42:53a game
42:53of chasing I just decided I'm going to get you eventually I managed to break him down and I did
43:00I don't know it was a kind of a mutual decision just that we'd get married I like I certainly
43:05don't
43:05ever remember him going down on one knee that's for sure
43:10I consider that this is a salvage type of surgery and I don't expect him to have the same function
43:15and outcome as somebody who might have a hip replacement or somebody who might have a knee
43:20replacement okay there's his proximal femur coming out okay it is a totally different procedure the
43:27muscles don't attach to the bone and you need your muscle to be attached to your bone to be able
43:32to walk and move normally and this implant will not allow the muscle to attach to the bone
43:38hit it again
43:42there she comes okay lift back now
43:47now that's it and she goes up my expectation for Brian would be that he would walk
43:51he'd walk pain-free I think he'll always use sticks or crutches he wouldn't be able to go a
43:56long distance but he would be able to go around and do his daily activities
44:01in she goes now give me the screwdriver please for that so i can turn to the right direction
44:05yeah it's got a spin it's got a spin 180 degrees for me there that's it
44:12okay there it is hold it there Sarah she's locked
44:16yeah locked in let's get this closed up and we start closing the skin first
44:33okay
44:34okay you happy lads okay thanks a million
44:37lads have just closed the rest of it
44:44you can't be dispassionate about the patients you have to feel that you're giving each patient 100%
44:50when you're operating on them and so when you've finished operating on them you have the next patient
44:56and you have to be just as passionate about the second one as you were for the first one
45:02okay
45:09when did you come i was in handies last week
45:12no better girl
45:14you liking cork so far again okay you weren't
45:16yeah i was here before and i left for 10 years and now i'm back oh good woman you brought
45:20the weather
45:21with you i'm gonna get a few of that rhesus cleared out it's a bit messy i need to stick
45:25back
45:26now full rhesus gives me a bit of nerves in the morning like cardiologist richard tanner
45:32performed an emergency procedure on christy jacob during the night now he's back to check on his
45:37patient hey christopher how are you doing all on account of you uh do you have any chest pain this
45:44morning no any shortness of breath none okay and i didn't even have shortness of breath before i
45:49went to hospital it's just a pain in my arm and my chest yeah now quick listen to your heart
45:54there
45:54of course there was damage done to my heart and the aorta like it's like they call it the widow
46:00maker
46:01that's the one that was blocked but they reckon it was 100 blocked which is scary like i said what
46:08would have happened had i went to bed they said you would never woke up uh so
46:15smoking i smoked my last cigarette before i came in that will never ever happen again never happen
46:20again this is really important because yeah we'll be back here again well that i don't need okay i might
46:26can get back there next time that's the problem hindsight is a great thing if i knew then what i
46:31know now i would have changed it all those years ago but just having a good time all the time
46:37i kept
46:38doing it until i had heart failure you're doing very well overall okay yeah i'm happy and i'm i'm
46:47grateful for ye and the water staff as well for yeah acting fast and getting me down good job looking
46:54after you yeah yeah typically after you know what you've had yeah you're kind of three to four days in
46:59hospital okay okay yeah all going well okay that's brilliant it's no problem okay family calling okay
47:07appreciate everything you've done for me you're very welcome okay the reason i do cardiology is that
47:12you know we had a man came in a heart attack which could potentially be fatal or have severe consequences
47:19for the rest of his life and now he's you know sitting out of bed had his breakfast pain free
47:25um ready to
47:27continue his life again all right i'm not worried i'm not worried about good to me i know i just
47:35do buy
47:36the book you know you'd have your arguments and small disagreements and nothing major but a thing like
47:43this kind of brings things into perspective thanks danny talk to you then christy is lucky he got caught
47:56in time hope he makes his own looking future
48:05the relief when she comes home is is it's brilliant like you know coming home from work
48:13and just you know run out just really warms my heart like i just want to see more of that
48:27i think like there is life before cancer and there's life after cancer like there definitely
48:31is there is definitely the whole things like i live my life carefree i love mark he's lovely he's an
48:37amazing doctor i no i don't want to see mark anymore just for him to tell me everything's going to
48:42because he could do boo instead of a grind
48:44so
48:45so
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