Episode 15 Secret Life of the Hospital Bed


Episode 15

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Transcript


LineFromTo

Hand versus chainsaw. That looks painful.

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Our hospitals are taking care of more patients than ever...

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-You all right?

-No.

-Oh, poppet!

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..with medical teams under constant pressure...

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Can Dr Pitsea comes to resus, please?

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Somebody as poorly as this little one,

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you really need to treat them quickly.

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..to meet our expectations.

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I'm just worried about what it's going to be like afterwards.

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But there's a crucial member of the team we sometimes forget.

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I've never, ever been on a bed like this.

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The hospital bed.

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Another ward.

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Another story. Another bed.

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SHE SCREAMS

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In our lifetime,

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we are likely to need one of them at least three times.

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I've probably spent a quarter of me life on a hospital bed.

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In this series, our cameras have been given unprecedented access

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to beds in four very different hospitals across the country.

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It's life, life and death, and everything that goes in between.

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We'll see the world through the bed's eyes...

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Hello, my love, hiya.

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..as they share the most challenging...

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I don't know what to do. I don't know.

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..most intimate...

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I know.

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..and most rewarding...

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Happy birthday!

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Isn't hospital wonderful?

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..moments of our lives.

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Thank you for being here.

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I wouldn't have been anywhere else.

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The hospital cannot function without beds. Beds are vital.

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This is The Secret Life Of The Hospital Bed.

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Close to the heart of Newcastle city centre

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is the Royal Victoria Infirmary.

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Its state-of-the-art A&E department,

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which opened just six years ago, operates 24/7.

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That patient is just about to go round.

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This gentleman's not well enough to move at the minute.

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Its 29 beds see up to 2,500 patients a week.

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Swing your legs up.

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Right, I've asked them to X-ray that hand,

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so you can pop down off the trolley now.

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A&E bed seven is prepped, ready for its next patient.

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51-year-old Astrid and husband Phil

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have just returned from a holiday in Ibiza.

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She's worried her vision may have been damaged

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following an insect bite.

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We've been on holiday.

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I was sitting on the balcony last night,

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and you feel something on you, sort of like flicked it.

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And felt my face, and there was, like, a little lump at the side.

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And as the day, obviously, went on,

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by the time it was time to go to the airport,

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it was just getting bigger and bigger.

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I couldn't look round the duty-free shop in the airport, I was gutted.

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I was wandering around, I couldn't see.

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Like, I was trying to have a look, because I had the sunglasses on,

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because the light, as well, was hurting my eyes,

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well, hurting that eye.

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I have got pain, but it's actually... I'm going to point at this eye.

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In case I poke myself in it, because I can't see.

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It's actually in the corner, it's sort of like the corner.

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But the rest of it, I can't,

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I can't feel it because all this here is numb.

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And as I'm talking to you now, the pain is now getting worse,

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it's now moving down to the bottom bit.

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So, yes, I am, I am worried, concerned.

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Dr Smith has carried out an initial examination of the swelling.

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She's had an insect bite by the sounds of things, on holiday.

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And then had some localised swelling, like,

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a localised allergic reaction.

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If Astrid's glands are also swollen,

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it could be a sign of widespread infection.

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She's due to be back at work in three days.

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I'm a machine operator.

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So, I actually... I work on packing machines.

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In, like, a factory, a well-known factory. So, yeah, I need my eyes.

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Dr Smith is back.

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So. I've had a chat with our consultant, Reuben,

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he isn't concerned about it, and your eye,

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because obviously, your vision on that eye is better...

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-Yeah, I can...

-..than the other side.

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Very strange, isn't it?

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What we're going to do is treat you for... To prevent any infection.

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So that's what this is for.

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So you need to take two once a day, for five days,

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so there's two, four, six, eight, ten.

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Obviously if things aren't getting better, if it gets worse,

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it's worth seeing your GP as well, they can give you some ointment.

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-All right?

-Yes, brilliant.

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-So, you can go.

-Oh, right, brilliant. Thank you very much.

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Thank you.

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With the doctor confident there's nothing more serious,

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Astrid leaves A&E bed seven.

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They're not concerned, but if it does swell up or go red,

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then, to either go to the GP or come back.

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Continue with my antihistamines, and take my antibiotics.

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And hope for the best.

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Just fingers crossed I don't get the infection.

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In less than two hours,

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A&E bed seven has helped Astrid get diagnosed and treated.

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-It's prepped for its next patient.

-And now it's beautiful.

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Down the corridor, A&E bed 15 is waiting for its next patient.

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Hello. My name's Jackie.

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Second-year law student Siobhan has a potential broken toe.

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Just have a seat over here.

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She's been referred to A&E by her GP

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and has come here with her friend Mary.

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So, have you seen anyone else about this?

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Been to the doctor's today, they sent me straight here.

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What did the doctor think?

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He doesn't know if it's broken, I might need...

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I'll need an X-ray but he thinks it's infected as well.

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Oh, my goodness, it looks pretty sore-looking.

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-Yeah, it is pretty sore.

-Yeah, a little bit of blistering there.

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-Yeah.

-You haven't been buying new shoes or anything recently?

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No, I tried to wear some shoes yesterday

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because I had to leave the house

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-and that's where the blister's come from.

-Oh, I see, right.

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It's rubbed at the top of my shoe because it's so swollen.

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Yeah, looks pretty painful.

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On a Friday evening, Siobhan works as a bartender in Newcastle.

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When you were at work on Friday, did anything happen?

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Not that I remember, but it was just hurting after work

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so I assume I must have stubbed it or something.

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And then I went out,

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and I woke up on Saturday and it was really swollen.

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What happened since then?

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It's just got a lot worse, really, since then, like, it's just

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swelled a bit more and it's spread a little bit down the foot.

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-Is it very painful?

-Yeah.

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Siobhan injured her toe five days ago.

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Nurse Practitioner Lyon thinks the infection may be spreading.

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You've got a little bit of tracking going up your foot as well,

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see that little red line? We have to really look after that. Right.

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I'm not going to do anything drastic with it, OK?

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-Just looking at the bottom bit...

-OK.

-..to see what's going on.

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-Can you feel me touching that?

-Yeah.

-Can you move it at all?

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-Ah, ahh... Ahhhh!

-That's painful all the way?

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-Yeah, yeah, all the way, just where it's red.

-Just here? Right.

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-I think we'll need to do an X-ray on this.

-Yeah.

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OK, because it may be broken and that may be the reason

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why it's so swollen.

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I can't think of any other reason, I can't see any other puncture wounds

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or anything that's going on with the toe.

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If there is a possibility you've injured it,

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we need to exclude an X-ray. Exclude a fracture, sorry.

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Siobhan and A&E bed 15 are on the move.

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I can't believe I'm being wheeled around for a toe, this is great!

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I feel like royalty.

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I just want to get it sorted so I can walk, cos at the moment, like,

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it's hard going to uni, so I just kind of need it sorted.

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It's a toe, at the end of the day, like, it's not that important.

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It is actually affecting me a lot more than I think

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a toe would normally.

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-Bye.

-Good luck!

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Almost 25% of all bones in the human body are in the feet.

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A toe bone is one of the top five most common bones to break.

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If you could just relax your foot there.

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Delays in treatment can lead to long-term chronic pain

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and arthritis.

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Siobhan's X-rays reveal no breaks.

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I'll just give you a little slip

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to bring back through with you to A&E, OK?

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OK.

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It's back to the consultation room and Nurse Practitioner Lyon.

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Well, you maybe have stubbed it, and the bruising's caused by that.

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The blister's obviously caused by the shoe,

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and what you've ended up with is an infection.

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The tracking, you notice that little red line we were looking at earlier.

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-Yeah?

-It looks a bit better since you've had your foot elevated.

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So you can see how good it is to elevate your foot.

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Nurse Practitioner Lyon prescribes antibiotics for the infection.

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She also recommends Siobhan rests,

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to stop the infection from spreading.

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We're going to ask you to elevate your foot,

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-because you don't want this line spreading up your leg.

-OK.

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Because you can become unwell with that.

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You know, the infection is localised just now,

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but it can travel and make you feel pretty ill.

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So if anything happens, your foot swells any more,

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-tracking comes, you've got to come back and see us.

-Right, OK.

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-I'm going to have to ring work, aren't I?

-What do you do?

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I work behind a bar. There's not much elevation around there.

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Unless I have literally one foot on the bar while I'm pouring a pint.

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I don't think that will be allowed.

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Just bend your knee and put the toe on the paper.

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That would be great.

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I think it's mainly the blister that's the problem, you know.

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-Does it matter about the blister, could you not pop it?

-No.

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-Is it bad to pop blisters?

-To be honest, it's not that tense.

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You know what I mean? So it's full of fluid,

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and the fluid does help the healing as well.

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-So should you never pop blisters?

-It will pop them itself.

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Oh, my God, what's that?

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Siobhan's toe is cleaned and dressed to protect it.

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That'll make it feel more comfortable.

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I'm not happy at all. I've got so much to do.

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-You really do need to rest it.

-I will.

-And elevate it.

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If you don't do that, it's only going to get worse.

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I feel really bad, and really guilty that I'm going to be missing work,

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and uni, for a toe.

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Siobhan is booked in for a checkup in two days' time.

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She can now head home.

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A&E bed 15 gets ready for its next patient.

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Birmingham is home to the Queen Elizabeth Hospital.

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It has one of the largest hand surgery units in the country.

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There may be some numbness around that area afterwards,

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but that will recover with time.

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Every year, 11 consultants perform

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more than 3,000 hand trauma operations.

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We're waiting for those bones to knit together,

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so we're going to put a plate and screws in.

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Around 80% of these happen here on the day surgery ward.

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-Are you in here, Lena?

-Yes, I am.

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-25 and 26 have arrived, you OK if I bring them in?

-Yes.

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The 81 beds here work 12-hour shifts.

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They transport patients for operations

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to repair and reconstruct their hands.

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Day surgery bed 52 is waiting for its first patient of the day.

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-You've got Cathy P on till 3:30, haven't you?

-Yeah.

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So, hopefully, by that time, we can start pooling staff.

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-Have you had your break this morning?

-Yeah.

-Good.

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Susan shattered several bones in her hand when she fell

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while on holiday in Rhodes with her husband, Brian.

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It was a really good holiday, very restful.

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And we were only just discussing, the day of the accident,

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how well the holiday had done us,

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and then, I go and have this nasty fall.

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She received initial treatment in Greece,

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but now needs reconstructive surgery.

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Without it, she risks losing some of the use of her left hand.

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He tells me I'm not a good patient.

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Susan has worked as a midwife for 32 years.

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Brian, do you think medical professionals make good patients?

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No, they don't.

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They don't appreciate the lack of control they suddenly have

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over a situation that they'd normally have control over.

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Brian's not a trained nurse.

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When he's looking after me as well,

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I want things done to a certain standard.

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And he can't always perform to that standard.

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THEY LAUGH

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I've been drying her hair this morning, I've not done it right.

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I've not done it right at all.

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"You're not firm enough, not firm enough."

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And then, "You're being too firm now!"

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I think I'll be OK as a patient today.

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It's later on, when I'm convalescing,

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-that I'll be frustrated.

-Tell me about it.

-I'll be there.

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Making the lunch. Putting the washing out. Washing the pots.

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That sort of thing. But I don't mind, I can do it.

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He had to have a little nap yesterday afternoon because

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he was so worn out from looking after me, so...

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Hiya.

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Nurse Guy settles Susan onto bed 52.

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Next, she's visited by consultant surgeon Mr Tan.

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Hello, hi, Susan.

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-My name is Simon Tan.

-Lovely to meet you.

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-Nice to meet you.

-Hello.

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-Are you right-handed or left-handed?

-Fortunately, I'm right-handed.

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-And when was your fall?

-Friday night.

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And so, did you... you went to hospital in Rhodes?

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Went to the hospital in Rhodes,

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I've got some paperwork of what they did there.

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They did an X-ray. I did bring the X-ray into A&E on Sunday.

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With the fracture, it's quite comminuted,

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so it's in quite a few pieces, and it extends into the joint,

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and those pieces aren't sitting

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-the way that they're meant to.

-Oh, right.

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So, the idea of today is that we want to restore the bone

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and the architecture and the joint as accurately as we can,

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and the reason that we're doing that is because we know from experience

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that if we leave them displaced and as displaced as yours is,

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there is a significant risk of loss of function,

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-ongoing pain and deterioration in the wrist...

-Right.

-..down the line.

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And there is a risk of a degenerative arthritis developing.

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Now, once we've put all those pieces of bone back into place,

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we've got to make sure that they stay there,

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so we achieve that by putting an implant in,

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-so it's a titanium implant, a metal plate with some screws.

-Right, yeah.

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OK? In terms of what you can expect afterwards,

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-it will be pretty sore, actually.

-Will it?

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Mmm. So we're going to have to arrange a little cocktail

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-of medications for you to go home on.

-Right.

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You'll probably be in a plaster just for the first week, ten days.

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You're not going to be able to do anything manual, maybe,

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-for six weeks?

-Right.

-Eight weeks.

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-OK, great. See you shortly.

-Thank you, see you later.

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-What time is now?

-11 o'clock. I feel like we've been here hours.

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-What time did we get here?

-I assume we got here about 9:20.

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-You all ready?

-Yes. Off we go.

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-See you.

-See you later, bye-bye.

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He's not very romantic, my husband, he never gives me kisses.

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Men generally aren't.

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Susan's procedure in the day surgery clinic will take up to two hours.

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She will also spend up to an hour in the anaesthetic room.

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Day surgery bed 52 will wait nearby for the duration of the procedure.

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-You will feel some cold gel going on top now.

-OK.

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Anaesthetist Dr Cibelli is using a nerve block on Susan's hand.

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It's a targeted local anaesthetic

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which should numb all feeling in the area.

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-Would you mind to do this for me?

-Flex?

-Yes.

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-Is it a bit more difficult than normal?

-Yes.

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It feels heavy, feels heavy.

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OK, good, that's exactly what I want.

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It will allow her to be awake throughout the operation,

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and will speed up her recovery time.

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'Obviously, it's a worrying time.'

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But...I do trust everybody.

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I'm feeling OK.

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My hand's feeling quite comfortable now,

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cos the anaesthetist has put all his stuff in.

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Susan can't go straight into her surgery,

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as the anaesthetic needs time to take effect.

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I'm feeling quite relaxed now, listening to this music,

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and quite chilled.

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The nurse put it on, it's quite nice, whatever she's chosen.

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I can wiggle my toes to it.

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30 minutes later, anaesthetist Dr Cibelli

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checks his block has worked.

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-I'm spraying you here.

-That's cold.

-Cold.

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-Can you feel it here?

-No.

0:17:390:17:42

-Can you feel it here?

-No.

-No.

0:17:420:17:44

-So it's an amazing block, isn't it?

-Can't feel it.

0:17:440:17:47

-I wish you good luck in theatre, then.

-Thank you.

0:17:470:17:49

Starting to feel a bit shaky now,

0:17:490:17:51

probably nerves because I'm going into theatre.

0:17:510:17:54

Right, just keep your other hand inside the trolley for us,

0:17:540:17:57

don't reach out for any of the walls.

0:17:570:17:59

Husband Brian will have to wait alone for several hours

0:17:590:18:03

until Susan returns from theatre.

0:18:030:18:05

At Newcastle's Royal Victoria Infirmary,

0:18:170:18:20

the minor injuries unit is open seven days a week

0:18:200:18:22

between eight in the morning and nine at night.

0:18:220:18:25

Staff have access to up to six beds in this area,

0:18:280:18:31

seeing and treating a wide range of patients

0:18:310:18:34

with urgent but not emergency conditions.

0:18:340:18:36

Bed two has just become free.

0:18:400:18:41

Its next patient is 22-year-old Hannah.

0:18:440:18:47

She's come in with a painful abscess on her abdomen.

0:18:480:18:51

She's worried it may be a sign of a more serious infection.

0:18:510:18:55

It really, really, really hurts. So, I can't...

0:18:550:18:58

I've had ice on it, and I've had loads of stuff to try and it's like...

0:19:000:19:04

alcohol wipes on it and it's just not getting better.

0:19:040:19:07

Hannah is taken to minor injuries bed two.

0:19:080:19:11

Sit yourself up.

0:19:110:19:13

I'm one of the nurse practitioners.

0:19:130:19:15

Swing your legs up, make yourself comfortable.

0:19:150:19:18

Nurse Practitioner Kendall has worked at the RVI for 16 years.

0:19:180:19:23

So tell me what's been happening.

0:19:230:19:26

Er, basically, I've got sort of an infected abscess on my side.

0:19:260:19:32

-On my right side.

-So has anything come out of it?

0:19:320:19:36

Yeah, quite a lot.

0:19:360:19:38

Quite a lot of green and black gunk.

0:19:380:19:42

This is not Hannah's first abscess.

0:19:420:19:44

Yeah.

0:19:440:19:45

She's had several over the last three months.

0:19:450:19:48

That big, and black, and raised, and full of pus.

0:19:480:19:52

'I went into hospital, thinking it was a spider bite,'

0:19:520:19:55

and I had to get a big, like,

0:19:550:19:57

two-pound-sized wound cut open, and squeezed all the gunk out.

0:19:570:20:01

And you can see if my leg's that wide, it's about that big.

0:20:020:20:05

I was in hospital for three days and then I came out and it's been

0:20:070:20:10

recurring over and over again.

0:20:100:20:12

Abscesses can be caused when bacteria gets under the surface of the skin.

0:20:130:20:17

Hannah's side is scarred due to previous abscesses.

0:20:190:20:22

There's one here and one there.

0:20:240:20:26

And they all just come and go, and whether they fill with pus or not

0:20:260:20:30

is dependent on how quickly I can get some strong antibiotics into me.

0:20:300:20:34

-I went in with it and they gave me some Flucloxacillin.

-Mm-hm.

0:20:340:20:38

The more antibiotics are taken, the less effective they can be.

0:20:390:20:42

Infections can become immune to antibiotics.

0:20:440:20:46

"If you give me Flucloxacillin it's not going to work.

0:20:480:20:51

-"I feel like I've done that and it won't work." So she gave me Co-amoxiclav.

-Right.

0:20:510:20:55

Hannah wants to make sure that she doesn't get any more painful abscesses.

0:20:550:20:59

I think as you build up maybe a tolerance to antibiotics, it's

0:21:010:21:05

just not working any more so I need to have something stronger to

0:21:050:21:09

sort of combat it.

0:21:090:21:11

I'm just really unsure about what it could be and nobody knows.

0:21:110:21:15

Have you ever got to the bottom of this?

0:21:150:21:18

-Have you seen your GP and have they done any bloods to see why?

-No.

-Anything?

0:21:180:21:21

That's what I'm hoping to get from today or just get a referral

0:21:210:21:24

-somewhere because it's just happening all the time.

-Yeah.

0:21:240:21:27

Like one in five people in the UK, Hannah

0:21:270:21:30

has searched online to try and self-diagnose.

0:21:300:21:33

Looking for symptoms on the internet is basically one of

0:21:330:21:36

the things that makes you a bit more paranoid about what you've got.

0:21:360:21:39

There's so many different things that can cause an abscess or

0:21:390:21:43

can cause a little spot to fill with gunk or pus or something

0:21:430:21:47

like that, but once someone's put something in your head,

0:21:470:21:50

you can't shake the feeling of it, and then it makes you a bit more scared.

0:21:500:21:54

But it hasn't got better.

0:21:560:21:57

Hannah is worried about what some of her friends have suggested.

0:21:570:22:01

I spoke to one of the girls that I work with who had seen MRSA

0:22:010:22:07

when she was in Thailand in a hospital.

0:22:070:22:09

And she said it looked very similar to that.

0:22:090:22:12

The worst thing they could tell me was that I had a Staphylococcus aureus infection

0:22:140:22:20

that had no cure or was a bit like I was going to have it for ever.

0:22:200:22:24

Hannah must stay with minor injuries bed two until Nurse Practitioner

0:22:240:22:28

Kendall takes a swab for analysis.

0:22:280:22:30

In Birmingham at the Queen Elizabeth Hospital, Susan

0:22:430:22:46

has left day surgery bed 52 for the operating table.

0:22:460:22:49

She's having a plate and screws inserted to bind together

0:22:530:22:56

bones that have shattered in her hand.

0:22:560:22:58

Her husband of 34 years, Brian, must wait outside theatre.

0:23:000:23:04

She's always treated illness as an imposition, a nuisance,

0:23:070:23:11

and gets very annoyed with being ill.

0:23:110:23:13

I'll be criticised and she'll lose her temper with me a few times,

0:23:130:23:17

but it isn't losing it with me.

0:23:170:23:19

It's losing it with the situation. She won't listen to me.

0:23:190:23:22

Even though I've got five or six weeks of this.

0:23:220:23:25

HE CHUCKLES

0:23:250:23:27

So... Yeah.

0:23:270:23:29

I'll just have to take it day by day.

0:23:290:23:32

Operation over,

0:23:330:23:35

and Susan will soon be reunited with day surgery bed 52.

0:23:350:23:39

I'm relieved it's over, but...

0:23:390:23:42

I was comfortable during the procedure.

0:23:420:23:44

I know I was in good hands.

0:23:440:23:46

Susan's operation has been carried out with a local anaesthetic,

0:23:470:23:51

so she doesn't need to spend long in recovery.

0:23:510:23:54

Thanks a lot. Bye-bye.

0:23:540:23:57

It's a nice, smooth drive.

0:23:570:23:59

-Are you all right?

-Yeah.

-And there we are.

0:24:010:24:04

-Thank you.

-All the best, now.

-Thanks a lot.

-You take care.

0:24:040:24:08

-Are you OK?

-Yeah, fine, yeah.

0:24:090:24:11

I've just had some morphine, but it's not kicked in yet.

0:24:110:24:13

-My arm's throbbing.

-Throbbing?

-Mm.

0:24:130:24:15

What happened? Was it painful?

0:24:150:24:17

-I think the operation was longer than they thought.

-A lot longer.

0:24:170:24:20

More complicated than they thought, yeah.

0:24:200:24:22

Cos he said to me an hour and a half to two.

0:24:220:24:24

You were gone three-and-a-half hours.

0:24:240:24:26

-There was two surgeons.

-Two?

-Two, yeah.

-Oh, my word.

0:24:260:24:29

It was quite complicated.

0:24:290:24:30

'She's worried now that she's going to constantly be in pain

0:24:300:24:33

'for the rest of her life.'

0:24:330:24:35

She's worried, short-term, that the pain's going to be severe

0:24:350:24:38

and that she's going to get sleepless nights.

0:24:380:24:42

She'll be worried about her job,

0:24:420:24:44

that she may not be able to go and do it like she used to be able to.

0:24:440:24:49

That will concern her,

0:24:490:24:51

that life may not be quite the same as it was.

0:24:510:24:54

Nurse Fulford checks Susan's pain levels.

0:24:550:24:59

How are you feeling? Still pain?

0:24:590:25:01

Um... It's still pain, but, you know, it's...controllable.

0:25:010:25:06

More women are admitted to hospital every year than men.

0:25:060:25:10

-Shall we sit you up a little bit more?

-Yeah.

0:25:110:25:13

Your foot's hanging out the bed.

0:25:130:25:15

You look like you've got a crick in the neck.

0:25:150:25:18

Push all the way back.

0:25:180:25:19

That's it. And do you want a tea or a coffee?

0:25:210:25:23

I wouldn't mind a tea now, please. That would be great. Thank you.

0:25:230:25:26

Susan's husband will need to care for her for the next six weeks.

0:25:260:25:31

Yes, Brian's been very supportive while I've sustained this injury.

0:25:310:25:36

It's been very challenging for him.

0:25:360:25:39

He's been helping me do the little things, like...

0:25:390:25:42

doing my bra up!

0:25:420:25:44

Little things, yeah. Challenging things, yeah.

0:25:440:25:47

Sometimes...

0:25:470:25:48

he needs asking, because sometimes...

0:25:480:25:52

I don't think men always anticipate your needs,

0:25:520:25:54

so I have to ask him,

0:25:540:25:56

but when I ask him, he always does it,

0:25:560:26:00

so I can't complain.

0:26:000:26:01

-Are you all right?

-Mm, aye.

-Good. Is it hurting still?

0:26:050:26:09

-Don't talk about it till I talk about it, because...

-OK.

0:26:090:26:12

..I'm trying to distract myself from it.

0:26:120:26:14

-I don't want to focus on it, if you know what I mean.

-Yeah.

0:26:140:26:17

I'm trying to disassociate myself with it, if you know what I mean.

0:26:170:26:23

It's a good job...

0:26:230:26:24

In the afternoon, you'd have been in overnight, possibly.

0:26:240:26:26

That might have been a good thing,

0:26:260:26:28

with the level of pain I'm going to be in.

0:26:280:26:30

-Yeah. You just don't know, do you?

-No.

0:26:300:26:33

If you see the nurse, just say to her,

0:26:330:26:35

"When do you want to get rid of us?"

0:26:350:26:37

-Yeah, OK.

-I'm just going to scan your wristband, if that's OK.

0:26:370:26:40

Yeah, sure.

0:26:400:26:41

-We've got some magic drugs!

-Then we'll get you up and running.

0:26:410:26:45

I'm not usually a drug person, but I'll make an exception today.

0:26:450:26:48

-Yeah, I would.

-They're a nice bright yellow as well.

0:26:480:26:50

-Oh, are they?

-Oh, lovely.

0:26:500:26:52

-They turn your insides green.

-OK.

-Two yellow ones.

-Lovely.

0:26:520:26:55

Thank you very much.

0:27:030:27:04

You happy swallowing that?

0:27:080:27:10

-So, that's the slow-release morphine I've just had, yeah?

-Yeah.

-OK.

0:27:100:27:14

-And with the Oramorph that you get from pharmacy later...

-Mm-hm.

0:27:140:27:17

-..that should help keep your pain at bay.

-Yeah.

0:27:170:27:20

When do you want to get rid of us?

0:27:200:27:22

-In the next 10, 15.

-10, 15 minutes?

0:27:220:27:24

Seven hours after Susan settled onto day surgery bed 52,

0:27:260:27:29

it's time to leave.

0:27:290:27:31

Keep the dressing clean and dry, so if you're going to have a shower,

0:27:320:27:35

put a carrier bag on it, keep it waterproof.

0:27:350:27:38

Keep the sling on now.

0:27:380:27:39

When you go to bed, take it from around your neck,

0:27:390:27:41

but keep the sling actually on

0:27:410:27:43

and keep it elevated, if you've got some pillows.

0:27:430:27:46

Yeah, that's what I've been doing, is doing it with pillows at night.

0:27:460:27:49

-Not using his back.

-No.

0:27:490:27:51

He doesn't like it when I'm on my back, because I snore.

0:27:510:27:54

He likes me on my side.

0:27:540:27:55

-I can't sleep on my side, so it's challenging.

-Yeah.

0:27:550:27:58

Just going to have to live with it.

0:27:580:28:00

-You'll have to put up with the snoring, won't you?

-I will, I know.

0:28:000:28:02

Decided.

0:28:020:28:04

-OK.

-Thanks, Jenny. I appreciate that.

-Thank you.

-Thanks very much.

0:28:040:28:07

-Do you want your coat?

-Yeah.

0:28:150:28:18

-No, I'll just hold it.

-Are you sure?

-Yeah.

0:28:180:28:20

-All right, thank you.

-Thank you. Take care.

0:28:200:28:23

-Bye-bye now.

-Bye-bye.

0:28:230:28:24

-All right, then?

-Yes, thank you.

0:28:240:28:26

-You take care. Look after her, all right?

-I will. I'll try my best.

0:28:260:28:29

Day surgery bed 52 is cleaned down, ready for its next patient tomorrow.

0:28:330:28:37

The Great North Children's Hospital in Newcastle

0:28:490:28:52

is one of the largest paediatric units in the UK.

0:28:520:28:55

It has its very own A&E, which is open all hours, seven days a week.

0:28:590:29:03

I haven't got any medical beds.

0:29:040:29:06

I need to find a bed on long stay for that patient.

0:29:060:29:09

There are nine beds on the unit,

0:29:090:29:11

which care for young patients who need immediate medical attention.

0:29:110:29:16

We struggle, quite regularly, with the amount of beds we've got.

0:29:170:29:20

It can be quite tricky to judge who needs a bed,

0:29:200:29:24

who can come out of rooms.

0:29:240:29:25

Paediatric bed 27 is ready to receive its next patient.

0:29:280:29:32

It's half past three in the afternoon.

0:29:350:29:36

13-year-old Harvey is brought to bed 27 by Nurse Mills.

0:29:380:29:42

He's in so much pain, he can't stand up.

0:29:420:29:44

Shimmy your bum right up here.

0:29:440:29:47

-Do you want me to lift your other leg?

-Do you want me to?

0:29:480:29:50

There you go.

0:29:530:29:54

Harvey's mum Joanne drove him to hospital

0:29:540:29:56

after he injured himself playing badminton.

0:29:560:30:00

-Have you done this to get out of school?

-No.

0:30:000:30:03

-You had a 2:15 finish as well.

-Oh, did you?

0:30:030:30:06

-Have you had any pain relief at all, Harvey?

-Um, no.

0:30:060:30:09

-Would you like some?

-Please.

0:30:090:30:11

Harvey is hypermobile or double-jointed.

0:30:110:30:15

It's a hereditary condition that means his joints can move

0:30:150:30:17

beyond the normal range expected.

0:30:170:30:19

Me, my mum, my sister are all double-jointed.

0:30:190:30:24

My mum's knee locked when she was little

0:30:240:30:27

and she had to have an operation

0:30:270:30:29

and my sister's knee locked not long ago.

0:30:290:30:31

Mine used to lock bent, couldn't straighten it.

0:30:310:30:34

I used to sit funny, like a W, like I tell you not to. Mm-hm.

0:30:340:30:39

And my leg locked behind me at a friend's house

0:30:390:30:42

and had to be pulled out and clicked back into place.

0:30:420:30:45

Nurse practitioners in this department work alongside doctors

0:30:460:30:49

assessing patients.

0:30:490:30:51

Nurse Practitioner Ainsley is looking after Harvey.

0:30:520:30:56

-Hello! Have we got Harvey?

-Yeah.

-Hello, hello, hello.

0:30:560:31:00

Do you want to tell me what's been happening today?

0:31:000:31:02

-I was playing badminton at school.

-OK.

0:31:020:31:05

And jumped up to hit it and then, like, landed funny on my leg.

0:31:050:31:09

Did you go over and end up on the ground, or...?

0:31:090:31:12

-I landed and my foot went like that.

-OK, so you kind of twisted a bit.

0:31:120:31:17

-And did it feel like your knee locked?

-It did, like, afterwards.

0:31:170:31:22

OK. Has this ever happened to you before?

0:31:220:31:25

Like, not as bad as this.

0:31:250:31:27

-He's got hypermobile joints.

-Right, OK.

0:31:270:31:29

So he's quite often with his shoulders doing this,

0:31:290:31:32

or like... like that, to click them out.

0:31:320:31:35

-I haven't seen it do this before.

-OK.

0:31:360:31:38

But I've had it where it's like it's going to go and he's kicked it out.

0:31:380:31:42

OK, fine. Let's have a wee look at your knees and things first.

0:31:420:31:45

Hypermobility can cause clicking, severe pain,

0:31:470:31:51

and recurrent injuries in joints.

0:31:510:31:53

It affects one in five people in the UK.

0:31:530:31:57

-You've not been able to bend it at all?

-No.

0:31:570:31:59

-How have you been getting around since it happened?

-Wheelchair.

0:31:590:32:02

Wheelchair from school to car and car to here.

0:32:020:32:06

How's it feel underneath?

0:32:060:32:07

-Really sore.

-Really sore. On the outside there OK?

0:32:070:32:11

-Are you sure?

-Yeah, I...

-Just underneath, OK.

0:32:110:32:15

-Here.

-Where I'm touching there, OK.

0:32:160:32:19

-And across your knee.

-Mm-hm.

-Sorry, sweetheart.

0:32:190:32:23

-Can you lift it straight up?

-It hurts.

-Can you do that, yeah?

0:32:230:32:26

-Can you keep it there at all?

-No.

-No?

0:32:260:32:29

Sorry, sweetheart, I'm guessing this is really sore.

0:32:310:32:34

Is that sore as well?

0:32:340:32:36

It's difficult, it does look and feel just that little bit swollen

0:32:370:32:41

around this bottom end here.

0:32:410:32:43

-We'll get some X-rays taken, OK?

-Right.

0:32:430:32:46

Then we'll have a look at your pictures when you come back

0:32:460:32:49

and then we'll go from there.

0:32:490:32:50

We'll get a porter to take him round on the trolley, OK?

0:32:500:32:53

-That's brilliant.

-Won't be too long.

-Thank you.

0:32:530:32:56

I'd prefer for this bed than the one at home

0:32:560:32:59

because I've got to climb up ladders.

0:32:590:33:01

I don't know how I'm going to climb. Probably lie on the sofa bed.

0:33:010:33:04

-You can have the dog's bed tonight.

-I can't fit in it anyway.

0:33:040:33:07

All right?

0:33:090:33:11

Hospital porter Neve arrives to take Harvey to X-ray

0:33:110:33:14

on paediatric bed 27.

0:33:140:33:16

Stick them on, there we go.

0:33:160:33:18

'It's really important to ensure that we rule out fractures,'

0:33:180:33:23

dislocations, and sometimes infections in joints.

0:33:230:33:26

The importance of that is quite detrimental to the child

0:33:260:33:29

if we don't follow up these injuries and ensure that the right

0:33:290:33:32

specialities are getting involved from the onset.

0:33:320:33:35

Biggest worry would be crutches and not be able to go back to school.

0:33:360:33:40

Bed 27 will stay with Harvey until he finds out

0:33:400:33:44

just how serious his injury is.

0:33:440:33:46

In the minor injuries unit of the Royal Victoria Infirmary,

0:33:550:34:00

bed two is occupied by 22-year-old Hannah.

0:34:000:34:02

She's come in with a painful abscess on her side.

0:34:030:34:06

-So has anything come out of it?

-Yeah, quite a lot.

0:34:060:34:09

Quite a lot of green and black gunk.

0:34:090:34:13

She's worried it might be a sign of a more serious infection.

0:34:130:34:17

Let me have a little look at your tummy, then.

0:34:170:34:19

Come and lie yourself up.

0:34:190:34:21

-Yeah, yeah.

-Are you sure?

-Just lie back. If you don't mind.

0:34:210:34:25

An abscess is a small collection of pus under the skin surface

0:34:250:34:30

that then grows.

0:34:300:34:32

Sometimes it can just be on the surface,

0:34:320:34:34

sometimes it can be deeper under the skin.

0:34:340:34:35

Oh, yeah, I see what you mean. Just pull that down...

0:34:350:34:37

'Sometimes we don't do anything for them.

0:34:370:34:40

'They have to be, for us to do anything,

0:34:400:34:42

'they have to be a certain size, diameter, firmness.'

0:34:420:34:46

-That's firm, isn't it?

-Yeah. Ahhhh!

0:34:460:34:49

-Sorry.

-It's OK.

0:34:490:34:51

-Ahhh, it's like the worst pain ever.

-I know, I know, I know.

0:34:510:34:55

-Just let me have a quick feel. Everywhere else OK?

-Pretty much.

0:34:550:34:59

I think you're a candidate, because it's firm.

0:34:590:35:02

-HANNAH GROANS

-OK?

0:35:020:35:04

We'll maybe refer you on to the surgeons. OK?

0:35:040:35:07

Hannah is concerned it might be the superbug MRSA.

0:35:070:35:11

-Once someone's told you about it...

-I know.

0:35:130:35:15

-..I couldn't get it out my head.

-I know.

0:35:150:35:17

I was like, "Oh, God, I hope it's not that."

0:35:170:35:21

-But it might be!

-Oh, absolutely, you're right to think that, yeah.

0:35:210:35:25

I was like, "I don't want to go into hospital,

0:35:250:35:27

-"cos I don't want to... I don't want to, like, infect everyone."

-Yeah.

0:35:270:35:30

-I don't want to be patient zero!

-Yeah!

0:35:300:35:32

I think she was concerned that it could be MRSA positive,

0:35:320:35:35

because she'd been talking to some friends.

0:35:350:35:38

I don't know without swabbing it and sending it off.

0:35:380:35:41

Nurse Practitioner Kendall takes a swab of the abscess

0:35:410:35:44

to send for tests.

0:35:440:35:46

-..I bet you can.

-I'm not...

-Just give it a little squeeze.

0:35:460:35:49

-Ngh!

-Well done, well done.

0:35:500:35:53

It's gross, that, isn't it?

0:35:530:35:54

-Like, it's the least...

-It's fine.

0:35:540:35:56

We're all right with things like that.

0:35:560:35:59

Hannah will see a surgeon in the day clinic tomorrow.

0:36:010:36:04

So, you can just leave that dressing on -

0:36:050:36:07

you don't need to worry about it.

0:36:070:36:08

Don't get it wet, it's not waterproof.

0:36:080:36:10

Carry on with the antibiotics, carry on with your painkillers.

0:36:100:36:13

-OK.

-Yeah? But hopefully it's going to be fine,

0:36:130:36:16

it might just be that it needs an incision and drainage,

0:36:160:36:19

-and that's what they'll do if they need to tomorrow.

-Yeah.

0:36:190:36:21

-Thank you, bye.

-Take care, bye-bye.

0:36:210:36:24

Basically, I've got to have minor abscess surgery tomorrow

0:36:260:36:30

at half past seven in the morning,

0:36:300:36:33

which basically just means they're going to cut me open and drain me.

0:36:330:36:37

That's the best sort of possible outcome, really.

0:36:380:36:41

Hannah's boyfriend Joe has come to collect her.

0:36:420:36:45

Have I been worried about it? Yeah.

0:36:460:36:48

You have been really worried.

0:36:480:36:50

Yeah, it's been rubbish. You've had a...

0:36:500:36:52

-You've had a bad time of it, haven't you?

-Mm.

0:36:530:36:55

It's... It's just cos we live on our own now,

0:36:550:36:58

we're, like, fully fledged adults,

0:36:580:37:01

and my mam lives really far away, so Joe is like my guardian now!

0:37:010:37:05

Joe looks after me.

0:37:050:37:06

Don't you? She said, "Don't touch it any more," so...

0:37:060:37:09

-Can I not squeeze it any more?

-No!

0:37:090:37:10

-That's the best bit.

-It really, really hurts.

0:37:100:37:13

Like, loads.

0:37:130:37:14

I can't even sleep on it,

0:37:140:37:16

but tomorrow I'm going to have a big...

0:37:160:37:18

The doctor's going to cut it open and squeeze it out.

0:37:180:37:21

Doctors will also examine the results of blood tests

0:37:230:37:26

to make sure Hannah doesn't have a problem with her immune system.

0:37:260:37:29

Minor injuries bed two will be cleaned thoroughly

0:37:320:37:35

before meeting its next patient.

0:37:350:37:37

It's 4:15 at Newcastle's Great North Children's Hospital.

0:37:440:37:48

Paediatric bed 27 and porter Neve

0:37:500:37:52

are taking 13-year-old Harvey for an X-ray.

0:37:520:37:55

What you done?

0:37:550:37:56

I've locked my knee playing badminton.

0:37:560:38:00

-Have you?

-Yeah.

0:38:000:38:01

It's just something stupid.

0:38:030:38:04

You need to pick a more exciting sport, Harvey.

0:38:040:38:07

I thought you would say something like rugby or something.

0:38:070:38:10

I would rather play any of them than badminton.

0:38:100:38:13

During Harvey's PE lesson at school, he dislocated his knee.

0:38:140:38:18

He's hypermobile, or double-jointed,

0:38:190:38:22

but now can't bend his leg.

0:38:220:38:24

-Thanks.

-Thanks.

0:38:270:38:28

Do I need my socks off?

0:38:290:38:31

Yeah.

0:38:310:38:32

What about that one?

0:38:320:38:34

Well, no, because they like to compare, don't they?

0:38:340:38:36

They'll want to look at if your feet are different,

0:38:360:38:38

and if your...very hairy ankles are different!

0:38:380:38:42

Hi, Harvey, how are you? My name's Tom.

0:38:430:38:46

Hypermobility is something that runs in his family.

0:38:460:38:50

His mum Joanne and sister also have the condition.

0:38:500:38:53

So, which leg is it we're looking at?

0:38:530:38:55

-Er, this one.

-OK.

0:38:550:38:56

X-rays will reveal if anything's broken.

0:38:580:39:00

Nice and still.

0:39:040:39:05

-You're going to go back round to see the doctor now...

-OK.

0:39:100:39:12

..and they'll look at the images and decide what to do next.

0:39:120:39:14

-All right?

-Yeah.

-Probably just cut it off from about there.

0:39:140:39:17

-Hopefully not!

-SHE LAUGHS

0:39:170:39:19

Nurse Practitioner Ainsley has brought in A&E consultant

0:39:220:39:25

Mr Jarman for advice.

0:39:250:39:27

So, we've got Harvey in room six at the moment,

0:39:270:39:31

who jumped up and landed quite awkwardly on his left knee.

0:39:310:39:35

What we saw is a lovely X-ray of a normal knee,

0:39:350:39:40

so we know there's no bone injury,

0:39:400:39:42

there seems to be no evidence of bones being in the wrong place,

0:39:420:39:46

such as the dislocation of a kneecap.

0:39:460:39:49

Although patients often refer to their knee as locked

0:39:490:39:52

for a variety of reasons,

0:39:520:39:54

a true medical locked knee is often a situation

0:39:540:39:57

where patients are unable to fully straighten their knee.

0:39:570:40:00

-Let's go and try it.

-Let's try it.

0:40:000:40:02

If not, we can always amputate.

0:40:020:40:04

-Hello!

-Hello.

0:40:060:40:08

Is this young Harvey?

0:40:080:40:09

-It is, yeah.

-How are you?

0:40:090:40:10

-Good.

-Fantastic.

0:40:100:40:12

-I'm Dr Bob, and you must be...?

-Mum.

0:40:120:40:14

Mum, fantastic. So, you're wanting an amputation, is that right?

0:40:140:40:19

Not yet, not yet. Not for a good few years.

0:40:190:40:21

So, which is your dodgy knee?

0:40:210:40:22

-This one.

-Oh, they're both dodgy.

0:40:220:40:24

Is that the dodgy one?

0:40:240:40:26

-That's the one that's been causing trouble today.

-Yeah.

0:40:260:40:28

Yeah. OK, we've just had a look at the X-rays. The X-rays look good.

0:40:280:40:32

There's no breaks to the bone,

0:40:320:40:33

there's nothing looks like it's out of place.

0:40:330:40:36

How bad is the pain, out of ten?

0:40:360:40:38

About seven.

0:40:380:40:39

Harvey hasn't broken any bones,

0:40:410:40:43

but Mr Jarman is concerned about the lack of mobility.

0:40:430:40:47

Hold on to this bit and let go of this bit.

0:40:470:40:50

Harvey is given gas and air to ease the pain.

0:40:510:40:54

What we're going to do is have a wee look

0:40:580:41:00

and see if it's just stiffened up,

0:41:000:41:01

and whether or not it's something

0:41:010:41:03

that we can get going with a bit of gentle movement.

0:41:030:41:05

Right.

0:41:050:41:07

Wow, well done - that's brilliant.

0:41:070:41:09

OK, much better.

0:41:090:41:11

Wahey, fantastic!

0:41:120:41:14

So, got nothing falling off so far.

0:41:140:41:16

-You're doing really well.

-You're doing really well.

0:41:160:41:19

Fab. We've got some movement, which is fantastic.

0:41:190:41:22

You might actually find it just sort of...

0:41:220:41:24

you know, as soon as he gets some movement back in it,

0:41:240:41:27

-it disappears.

-Mm-hm.

0:41:270:41:28

He'll be frightened to move it, so that doesn't help,

0:41:280:41:31

-if you're a bit worried, as well.

-OK.

0:41:310:41:33

So, Harvey, our 13-year-old,

0:41:340:41:36

he was able to get some free movement of that knee,

0:41:360:41:39

which was really good.

0:41:390:41:40

His X-ray was just showing soft-tissue injury,

0:41:400:41:43

nothing obvious broken or dislocated at the time.

0:41:430:41:46

He's going to get some follow-up in a week's time

0:41:460:41:49

with one of our A&E consultants to ensure that, you know,

0:41:490:41:52

he's still got no further problems with that knee.

0:41:520:41:54

After just two hours with paediatric bed 27,

0:41:540:41:58

Harvey is able to leave A&E with mum Joanne.

0:41:580:42:01

Are you OK?

0:42:010:42:03

Bed 27 awaits its next patient.

0:42:030:42:06

Our hospital beds have given us intimate access

0:42:100:42:13

to the work of the NHS.

0:42:130:42:15

Susan's still off work and having regular physio.

0:42:160:42:20

She looks set to make a full recovery.

0:42:200:42:22

Harvey was back in hospital three days later with the same problem.

0:42:240:42:28

He's been referred to a physiotherapist

0:42:280:42:30

to strengthen his knee.

0:42:300:42:32

Hannah's surgery went well.

0:42:340:42:36

The hospital diagnosed a staphylococcal infection.

0:42:360:42:40

Her boyfriend Joe caught it, too,

0:42:400:42:42

but, following treatment, they're hoping they're over the worst.

0:42:420:42:45

And, after two weeks, Astrid's eye returned to normal.

0:42:470:42:51

She's looking forward to travelling abroad again soon.

0:42:520:42:55

The beds are now back on their wards,

0:42:570:42:59

ready and waiting for their next round of patients.

0:42:590:43:02

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