Episode 2 Operation Ouch!

I'm Doctor Chris.

And I'm Doctor Xand.

-We're identical twins.

-Twins.

Do you know your body does loads of amazing things every day

without you even realising it?

This is what kidneys look like.

We're going to show you how.

Smell my armpits!

We've got gobsmacking experiments...

Wow!

..mind-bending body tricks...

and real medical mysteries.

I got hit with a wooden cricket bat.

So, are you ready to see what you're made of?

-Coming up today...

-On Operation Ouch.

You've got my bag.

What? You've got MY bag.

We show you where blood comes from.

Right there is a blood vessel.

We're going to mess with your mind.

SHE LAUGHS

And amazing surgery changes Ben's life.

So, this is the surface of Ben's brain.

But first...

Every year, half a million people attend

the accident and emergency department

because of sporting injuries.

HE SCREAMS

And here's another one.

In accident and emergency, nine-year-old Tamsin is waiting

to see the doctors.

It's my leg, it's very sore and it's swelled up.

Oh, dear. That doesn't sound good.

When I done PE, that's when my whole leg went purple, green and blue.

Let's find out exactly how this multicoloured mischief happened.

Well, there's two parts to this story, Xand.

OK, what's the first?

Tamsin was at her Thai boxing class

-sparring with her partner Ryad.

-Ooh, wouldn't want to mess with her!

I know, Xand. They both went to do a bandi move -

a flying kick - but their knees clashed!

-Ouch!

-That's not all, Xand. There's more.

-What?

A couple of days later, Tamsin was playing hockey in PE.

-Who's winning?

-Never mind that, Xand.

Because as Tamsin's opponent whacked the ball, his stick accidently

-hit Tamsin's shin.

-On the same leg!

-Ooh!

-Double ouch!

Here to find out more about Tamsin's troubles is Dr Helen Stewart.

If I try and move your ankle...

SHE WHIMPERS

It's obviously quite sore, Chris.

Where did that hurt when I did that?

Just down there? OK.

Well, I'll stop it there because you're obviously in a lot of pain

and I think we need to get some X-rays.

So, it's off to get some snaps to see why her ankle is in agony.

After a few photos, Dr Helen delivers the verdict.

So, I can't see any breaks on the bones,

but because of the pain that you're in,

we're going to treat you the same as we would

if you'd broken something.

-OK.

-Which means...

-pot on the leg.

-No, no, no, no, no!

Pot is another name for a plaster cast and I don't think

it's what Tamsin was hoping for.

-No sports for a little while.

-Oh, my...

-I know. No Thai boxing!

-Oh!

The cast will make her more comfortable,

it'll help the pain and help her to heal.

Tamsin's having a backslab, which supports the back of her leg

and allows for swelling.

It feels so weird.

I think we've got a "pot star" on our hands here, Xand.

# Hospitals are good hospitals are bad

# And they put me in a pot and I'll be good to go. #

Tamsin's got talent. She'll need to come back for a checkup

on that painful pin.

Find out later how she gets on.

Ready to see some amazing experiments?

This is the Operation Ouch Poo Factory.

We're going to show you how your incredible body works.

Just don't try anything you see here at home.

Chris, can I trouble you for a favour?

I need to borrow something of yours for an experiment.

-Is that OK?

-Yeah, that's fine, whatever.

Hang on, trouble me for what?

Some of your blood. You've got eight pints of it.

Absolutely not. I'm using mine at the moment.

Yeah, but this is a once in a lifetime chance to get it on telly.

Oh, this does sound good, actually.

Great.

Now, remember, we can only do this because we're doctors.

Now you might think I'm being brave for this needle, but you've

got to remember that needles don't hurt unless you think they hurt.

And I don't think it hurts.

Nice work, Xand.

I have to say, though, for all the vital jobs it does,

like carrying oxygen around my body, it's not much to look at, is it?

I mean, it's just sort of red and gloopy, right?

Wrong.

It is much to look at, but only if you put it in one of these.

This is a centrifuge machine.

This is MY centrifuge machine! I've been looking for that.

Stop interrupting, we're trying to do an experiment.

By spinning Chris's blood around at high speed, the centrifuge machine

will separate the different parts that make up blood,

so we can see them.

And ten minutes later...

BELL RINGS

So, there we go.

Now, this top liquid layer is called the plasma

and it carries nutrients around your body

and also carries waste material that your body wants to get rid of.

And underneath the plasma, you can see this red layer,

and that is made up of red blood cells or, erythrocytes,

and these carry oxygen all around your body.

And also in there are the platelets,

and those are the cells that help you form blood clots.

And right between these two layers, you can see

a little bit of cloudiness.

Those are white blood cells to fight infection.

Well, there we go, Chris. We're all done with that now.

Why are you giving me this?

I only needed to borrow it. I'm a man of my word.

So you've seen what your blood is made up of,

but do you know where your blood comes from?

Well, we're going to show you.

Gross alert coming up!

Amazingly, your blood comes from your bones.

If you thought your bones were just solid hard white things that

kept you standing up, then think again,

because there's more to bones than that.

Now, to demonstrate this, I've got a pig's femur.

That's the big bone that you've got in your thigh,

and we're going to open this one up to see how bones make blood.

The femur is one of the strongest bones in the body,

so we're going to need some very specialist kit to cut it open.

Exactly.

Right, Xand. Or we could use...

a medical femur saw.

It's the only thing the doctors ever, ever use to cut bones.

OK, we'll do it your way.

It's time to saw open some bone.

Chris, the saw.

'Get ready, because this is going to be a bit messy.'

This is the inside of a pig's femur, and right here,

this squishy stuff is red bone marrow.

Now, it's the red bone marrow that makes all your blood cells.

In fact, every single day,

your bone marrow makes 500 billion blood cells.

Busy!

Now, the inside of your bones looks like this.

It's pink with a lot of red marrow.

But as you get older, your marrow starts to turn yellow.

Chris, the yellow bone marrow.

Coming right up.

This is the inside of an adult cow's leg bone.

This yellow bone marrow is a much lighter colour.

It's very soft and squidgy,

and that's because it's mostly fat cells.

And this is what your mum and dad's bone marrow looks like.

And that's because your body needs more blood when it's growing a lot.

But as you get older, and you don't have so much growing to do,

some of the red marrow which makes blood,

turns to yellow marrow, which is basically a fat store.

So, you have more red marrow than a grown-up!

But how does blood get from inside the bones to

flowing around your body?

Well, we're going to show you.

Come and have a good look at this.

Right there, between that bit of bone marrow

and the hard bit of bone, is a blood vessel.

So, that's coming right inside your bones to pick up all that

nice, new blood being made by the marrow every single day.

How cool is that?

So, we've shown you that ,inside, your bones are amazing

blood-making factories, and veins come right inside the bones

to pick up that blood.

And we've seen that blood is made up of different things,

all of which have different jobs in your body.

You know, Chris, I did have a sense that that chainsaw was a bit

over the top.

Did you, Xand?

I could feel it in my bones.

It's not just emergency teams in hospitals that

-are ready to help you.

-I know!

There are medical crews all over the country on standby 24/7.

SIREN BLARES

We're on call with the UK emergency services, showing you

what it's really like on the front line saving lives.

On call with me is paramedic Jan Vann.

SIREN BLARES

This is a state-of-the-art rapid response vehicle.

It can get to the scene of a medical emergency in minutes.

And I'm heading out in it to show you what it's like to be

a life-saving paramedic.

Jan can take 10-15 emergency call outs in a day,

and a new case is just in.

We've had a 999 call to see a 32-year-old man who's got a rash

and swelling in his mouth.

Now, that sounds to me like an allergic reaction.

So, I've got my camera in the front, Eric has got his camera,

and we're going to be getting you as close to the action as possible.

Only a couple of minutes later and we arrive at our destination.

-Hello. Is it Alan?

-Yeah, that's right.

Take a seat. My name's Jan.

What's the problem today?

I had, like, a rash or something, you know, my tongue was swelling...

-Let's have a look.

-..and my throat feels a bit...

-Tight.

Open your mouth wide as you can.

-Say "Aah."

-Aah.

So your tongue feels big in your mouth, does it?

-Yeah, here feels quite tight.

-OK.

I have a bit of shortness of breath, but...

Alan is experiencing something called anaphylactic shock -

an extreme allergic reaction.

Tigger and Sasha look concerned.

So, is there anything that you're aware of that you're allergic to?

-No, not that I know of.

-Nothing that you know of? OK.

Although Alan's being pretty brave, he has a life-threatening condition.

His lips and tongue can swell and that can cause problems

with breathing and swallowing, so it's actually really important

that Jan's here.

What I'll do is I'm going to give you an injection into your arm

-in a second...

-OK.

-..with a drug called adrenaline.

Now, you may have heard of "adrenaline".

It's actually a hormone that your body makes.

What it's doing, in Alan's case, is constricting the blood vessels

in his tongue, in his lips, and it'll actually reduce that swelling.

In cases like this, it can be life-saving.

I'm sending Alan in the hospital today just so that I can make sure

his tongue doesn't swell again.

So the drugs I've given only work for a short time.

How are you feeling, Alan? Do you feel like it's working?

-Yeah, I do feel a little like the swelling's going down.

-Yeah.

An ambulance has arrived to take Alan into hospital.

You be all right walking out, yeah?

Yeah, fine, yeah.

It's potentially a life-threatening problem that he had

and Jan's really fixed him up.

You could see how much the swelling in his lips had gone down,

and that happens all the way down his throat

and into his lungs, so that's really, really good news,

and they'll be able to treat him really well in hospital.

Still to come...

We baffle your brains.

Did you see anything strange happening in the video?

Our mobile clinic is open for business.

Next patient, please.

And it's a life-changing day for Ben.

Shall we get this show on the road?

Back in accident and emergency, Tamsin's waiting for news

about her injured leg.

Let's find out how she's getting on.

In Sheffield, nine-year-old Tamsin's back in hospital.

How are you feeling?

I've still got a pain, but I hope it's nothing bad.

It all happened when Tamsin's knee was injured at

her Thai boxing class.

And then her shin in a hockey match.

Tamsin's first X-ray showed she didn't have any broken bones,

but she was in such pain that her leg was put in a cast

to help ease her discomfort.

Tamsin is back for more X-rays to be doubly sure there's no damage.

That'll do very nicely.

Here to assess how Tamsin's doing is Dr Naidu Maripuri.

He starts by moving the agonising ankle.

SHE WHIMPERS

Clearly, she's still in a lot of pain.

Dr Naidu then takes a look at Tamsin's X-ray results.

I can't see any obvious fractures there.

-Yay!

-Sometimes what happens is that even if you don't see anything in

the X-rays, there will be some soft tissue injury around the ankle.

Right.

Soft tissue injury is the damage of muscles, ligaments and tendons

around the bone.

They usually come from a sprain, strain or whack to the skin

like Tamsin got higher up her leg.

It can swell, bruise and be really painful.

So, best way to deal with this...

-Protect it with the plaster...

-OK.

-..so that it helps healing

and then we'll see her in two weeks' time.

Don't worry, Mum. It'll be OK.

This time it's a full cast.

It's only for a couple of weeks. By then, her ankle should have healed.

Anything else you want to say or sing, Tamsin?

# I've got another pot I've got glitter

# I've got like many, many, many, many colours. #

APPLAUSE

That'll do nicely.

-XAND AND CHRIS:

-Bye!

Now, did you know that you share 98% of your DNA with a gorilla?

So, we have a lot more in common than just appearance!

Ooh, random!

SIREN BLARES

Now we're going to mess with your mind...

You're him?

..scramble your senses...

I got confused.

..and baffle your brain...

..in Mindbenders!

So, today's mind-bending trick is all about concentration,

isn't it, Xand?

Xand?

-What are you doing?

-I'm concentrating.

Well, that's not how the trick works.

Hey, you're not fooling me.

These children at this school think they're here to play

a simple game, but we've got a trick up our sleeve.

So what we're going to show you is a video of a ball game and all you

have to do is count the number of passes that the team in white make.

Really good. Let's roll the video.

Time to get counting.

So, how many passes do you think the team in white made?

OK, Joshua?

-21.

-21. Giles?

-21.

21.

22.

The correct answer is 21, but did you spot anything weird?

Did you see anything at all, other than the passing?

-Just saw the passing.

-Just saw the passing?

What we didn't tell you, was before the match,

Xand dressed up as a gorilla

and made an amazing ape appearance during the game.

Let's see if anyone spots it this time.

No, no-one seems to have noticed.

In fact, it took three attempts, and then finally...

Erm, I saw...

a gorilla.

A gorilla? Who thinks Cecilia's crazy?

There was no gorilla, was there?

So, just watch it again, don't worry about the passes now,

just see if you can see a gorilla.

-There is...

-Wait a minute.

-There is the gorilla at the back, dancing.

Oh, that gorilla?

-Oh, that gorilla?

-XAND LAUGHS

And we fooled the other groups too.

Oh, there is that gorilla.

-Oh, that gorilla?

-So, why didn't they spot it?

It's because you're looking at them passing the ball,

but you don't notice that the gorilla's walking past.

Cecilia is right.

You're so busy concentrating on the passes that you don't notice

the gorilla in the room.

This is called...

The failure to notice something important

because your attention is engaged elsewhere.

So, always keep your eye out for the unexpected.

Well, Xand, I mean you really got stuck into your part as a gorilla.

Well, you know, Chris, whenever I'm asked to take on a part,

I try and really get into it.

-At one point, I was going to interview a gorilla...

-Xand...

-..and ask them about their motivation.

-Xand...

You've left your gorilla feet on.

Today, we're at a theme park to solve your medical mysteries.

Chris is preparing the Ouch-mobile for his first patient

and Xand is out in the park to answer your burning questions.

That's amazing.

At the clinic, Chris is open for business.

First patient, please.

First in is nine-year-old Alfie, with his multicoloured mop.

So, Alfie, what brings you to the Ouch-mobile today?

So, I have a birthmark in the back of my head which is light brown,

when all the rest of my hair is dark brown.

What's the diagnosis, Doc?

Right, this sounds like a classic case of...

Huh! Easy for you to say.

-Shall we have a closer look?

-Yeah.

Can you open the eyelid for me?

-So, there you are.

-Yeah.

Now, can you turn around and show me this blondish patch?

And that just looks like you've got a little spray can

of light brown paint and squirted it on the back of your head.

-OK.

-So, the cells that make those hairs aren't making hair pigment,

-and it's a thing called poliosis.

-OK.

-So that bit of hair may keep getting lighter as you get older.

-OK.

Well, Alfie, thank you for bringing in your light brown

patch of hair on the back of your head.

-Well, thank you, Dr Chris.

-It's a real pleasure.

Away from the clinic, Xand is Ouch And About in the park.

Why, just before we're about to vomit,

does our mouth start to fill with sweat?

So what's actually happening is that your mouth is kind of getting

ready for you to be sick and trying to protect itself by putting

a lot of saliva into your mouth at once.

It's just your mouth trying to protect you,

cos there's a bit of acid in your stomach, it doesn't taste very nice,

and so you kind of get a watering mouth just before it happens.

Back at the Ouch-mobile, there's a new case in the waiting room.

Next patient, please.

And it's nine-year-old Niella, whose eye needs examining.

So, Niella, what brings you to the Ouch-mobile today?

Well, I've got a spot on my eyeball.

What's the diagnosis, Doc?

Well, this sounds like a classic case of...

Spot-on!

So, we can see the spot on your eyeball.

Why don't you open our eyelid?

And there you are.

Now, I want you to get in really close.

And there we can see it, just there.

It's very faint, isn't it?

It's called...

I want to know why it's there.

It's a bit like having a freckle in your eye,

and it's just where the cells are making a bit more pigment,

a bit more of the colour that goes in your skin.

Well, will it stay there for ever?

Yeah, you will probably have that for the rest of your life.

But, that's OK, isn't it?

-I mean, I think it looks quite cool.

-Yeah.

Thank you, Niella, for bringing in your scleral melanocytosis

-for me to see.

-Thank you, Dr Chris.

Job done for today.

Your body is amazing, but sometimes it needs fixing.

All over the UK, there are special teams of professionals

trained to tackle medical mysteries.

And some of their work is life-changing.

Today, I am meeting ten-year-old Ben, who has epilepsy.

Your brain is incredible.

It tells your body what to do by sending electrical messages

through your nerves to your muscles.

Whether you're walking, blinking or picking your nose,

it's these messages from the brain that control movement.

But sometimes, too many uncontrolled messages come from the brain

to the body, creating a storm of electrical activity

and when this happens, it's called an epileptic seizure.

Epilepsy is a condition that affects 60,000 children in the UK,

so you might have it, or you might have a friend who does.

Ben has been having seizures for nearly five months.

Morning.

As well as medicine, in a small number of cases, doctors can use

surgery to treat epilepsy

and that's why Ben has come to Bristol Children's Hospital.

So you have these seizures. How often do you have them?

Two times a day, sometimes.

And what happens when you have a seizure, do you know?

I don't know.

Not sure? And why don't you know?

Cos you're not conscious when you have them, are you?

-You don't remember them at all?

-No.

-So, today's a really big day for you.

-Yeah.

-Why is it a big day?

Cos I'm... Operation.

-You're going to have an operation today?

-Yeah.

Ben's incredible surgery involves removing a small part of the brain

which doctors believe is causing his seizures.

Ben has had MRI scans and electrodes fitted to his head

to pinpoint the exact area to remove.

Dr Mike Carter is carrying out today's operation.

We learned that there are electrical activities coming from

one particular part of the brain and that area of the brain is

the area that contains the abnormality we can see on the scan.

So he's going to have an operation to remove this abnormality,

and hopefully cure his seizures.

It's time for Ben's operation.

He's had a general anaesthetic to put him to sleep,

so he won't feel a thing.

So this black bit here, in this bit of Ben's brain, this is where those

seizures are starting and this is what Mike's going to take out today.

Firstly, Ben gets a snazzy haircut

in the place where the incision will be made.

Then, Dr Mike cuts through Ben's skin and muscle,

to expose the skull.

Look away now if you're squeamish.

So this is the bone.

I'm going to mark out where we're going to make some openings into it.

What Mike's doing is opening a hatch -

he calls it, actually, a trap door - in the side of Ben's skull,

and underneath, we're going to get to the brain.

There you go, there's a bit of bone that's come out. OK?

So we'll keep that, put it back in later.

Another gross alert coming up.

This is the surface of Ben's brain and about two centimetres under here

is that abnormality of the blood vessels

that Mike is going to remove.

To make sure Dr Mike gets to exactly the right part,

he uses an amazing piece of technology called neuronavigation,

which guides him to precisely where the lesion is.

Dr Mike begins to cut into Ben's brain.

We're beginning to see a difference in the colour

of the tissue down here.

I think that's the abnormality - that's certainly where

the image guidance is telling us we need to be.

So the red, angry-looking blob is the abnormality

where we think the epilepsy's coming from.

But, erm, there you go.

-Do you want to have a look at it?

-Wow.

So this is the lesion that Mike thinks has been causing

Ben's epilepsy and he's really hoping that, now that

he's taken that out, the seizures will stop.

And a few weeks later, Ben is recovering well.

So, since the operation, how are you feeling now?

-I'm fine.

-Are you?

-Yeah.

My head doesn't hurt.

What about the seizures?

I don't have any since the operation.

Really? Are your thoughts different?

Yeah, cos I couldn't really say things properly,

I couldn't think what the words were supposed to be.

But now I can.

So, as you can see, Ben's surgery has been a really big success.

Not everyone needs surgery - some people can be managed

with medication - but when it is appropriate,

in the right circumstances, it can be absolutely life-changing.

I think that's what we're seeing here.

Right, I'm going to get stuck in. Where's that ball?

Here we go.

In A&E, our next patient has had an unusual accident.

Luckily, she's in the right place.

Phew!

In Sheffield Children's Hospital,

12-year-old Isabelle has arrived with her dad.

Ooh, she looks a bit mucky. What's gone on there, then?

I've hurt my hand.

I don't know, I'm not sure if it's going to be broken or not.

So, how did she manage this muddy mishap?

It was a beautiful spring day

and Isabelle was out with her horse, Harvey.

Oh, that explains the muddy boots, then.

Hey, Chris, where's her riding hat?

She wasn't wearing one, Xand.

-Oh. That's not a good idea.

-I know, but off she went.

There wasn't a cloud in the sky.

Flowers were blooming, lambs were frolicking, birds were tweeting.

-I can't see what the problem is here, Chris.

-Just wait, Xand.

-Because, all of a sudden, Harvey bolted.

-As fast as Usain Bolt?

Well, kind of. Isabelle tried to stop Harvey, but she couldn't.

She was dragged along and Harvey trampled over her hand.

Lucky she didn't bump her head, Chris. Ouch!

He's quite feisty, yeah.

Neigh kidding!

It's time for Dr John Griffiths to check out Isabelle's hoof.

I mean hand. What do you reckon, Doc?

I'm just going to prod and poke and I want you to tell me

if there's any soreness, all right?

OK. It starts to hurt about there. Yeah.

Dr John checks for any nerve damage.

Does it feel the same on both sides?

-It tickles more on that side.

-It tickles more on that side?

There is a chance that she does have a facture,

but we're going to do an X-ray and find out.

This is the stuff night-MARES are made from.

Oh, Xand, enough of the horse jokes!

It's off to the X-ray department to find out what the damage is.

I'm going to start with your hand and then I'll do your wrist.

OK.

There are 27 bones in your hand.

Eight of these are in your wrist.

Any of these bones could have been broken by Harvey's hoof.

But it is the left side of Isabelle's hand

that Dr John is most concerned about.

So, if we look at the bones, there's no real breaks in the bone,

all the lines are nice and smooth,

so I think you've probably dodged the bullet.

Or a bolting horse, more like!

Great news, Isabelle, everything looks A-OK.

A simple splint to support Isabelle's wrist for a few days

and she'll be on the mend.

-Thank you.

-All right, take care, see you later.

Isabelle's got one last message for her MANE man.

Harvey, I'm not impressed.

-I'm not surprised!

-HORSE NEIGHS

You are a lovely little pony and I won't hate you for ever.

Ah, let's saddle up and get out of here.

-BOTH:

-Bye!

Next time on Operation Ouch -

we demonstrate the power of the diaphragm.

Xand, Xand, Xand!

My diaphragm and I are doing something extraordinary

and beautiful.

We mess with your mind.

Oh!

And you'll get to meet our dad.

So we'll see you next time for more Operation Ouch!

XAND SNORES

The femur is one of strongest bones in the body,

-so we're going to need some very...

-HE LAUGHS

The femur is one of the strongest bones in the body...

-And we've seen how blood...

-THEY LAUGH

-Come on!

-What was it?

-It's you standing there sniggering!