Episode 8 Operation Ouch!

'He's Dr Chris.'

'He's Dr Xand.'

'And, yes, we're identical twins.'

'Do you know your body does heaps of amazing things every single day?'

That is incredible.

'And we're going to show you how.'

Oh, you've cut him in half!

'We've got incredible experiments.'

Whoa.

'And real life medical emergencies.'

-The doctor's going to make it all better.

-Ouch!

'We'll be turning our bodies inside out...'

Oh, yuck.

'..to show you what you're made of.'

HE BREAKS WIND

-You should see a doctor.

-Better go find one.

HE COUGHS

Dr Xand?

HE SIGHS

-Coming up today on...

-..Operation Ouch!

What he said.

'We unleash the hidden energy in your food.'

Whoa!

HE LAUGHS

'We sink our teeth into your medical mysteries.'

There he is, look at that.

'And we're on the front line, saving lives with the UK's paramedics.'

And at the moment the suspected diagnosis is a stroke,

so we need to get there fast.

'But first...'

In the emergency department the team are ready for their first patient.

Let's meet her.

'In Liverpool accident and emergency,

'13-year-old Alice has done something to her leg.'

I have a dislocated knee.

'Well, how do you know?'

Because I can feel my whole knee shift in the wrong direction.

'Weird. Well, how did that happen?

'It was break time at school and Alice was chilling with her mates.

'Oi, Xand, leave the snow controls alone.'

'Sorry. You did say she was chilling.

'Righto, so did she dislocate her knee running as fast as you can see?'

'No.'

-'Did she jump in the air like she really didn't care?'

-'No.'

'Was she swinging in the gym balanced on one limb?'

'No. And the right answer doesn't rhyme either.'

'What was it then?'

'She just turned and her kneecap popped out.'

'Oh. Ouch.'

SCHOOL BELL RINGS

I've dislocated my knee eight or nine times before.

'Eight or nine times? That's no laughing matter.'

SHE LAUGHS

'On the case is Dr Anne Kerr.'

What we need to do today, I need to have a little look at it,

it's going to hurt, obviously, so we'll get the gas and air,

then I'll try and have a look at your knee

and see if we need to straighten it up ourselves.

'Gas and air is a mixture of nitrous oxide and oxygen.

'As you breathe it in, the gas numbs the pain receptors in your brain

'and it can also make you feel a bit funny.'

It's called laughing gas for a reason.

SHE LAUGHS

'The laughing gas has kicked in and the pain is numbed.

'So the doc can get that kneecap back in place.'

So all we have to do really is gently straighten the knee

whilst pushing the kneecap forwards into the middle of her knee.

'Because Alice has dislocated her kneecap so many times,

'she needs to come back to the hospital for a closer examination.'

'Time for another look at the problem leg.

'Doing that today is surgeon Nick Barton-Hanson.'

'He's examining Alice while she's asleep under anaesthetic

'so she won't feel a thing.'

There are two main tests,

the first to see if her kneecap slides over to the side,

which it did a bit more than the other side.

And the other one to see where the ligament's torn.

That seems to be quite wobbly.

'Your body is tied together to keep everything in place.

'Ligaments tie bones to bones, and tendons tie muscles to bones.

'If a ligament is damaged, it can make your body wobbly and unstable.'

'So what's the verdict?'

The reason she's been having so much trouble with that knee

is because of the damage to that ligament.

'And that was caused by an old injury,

'and now her kneecap can move forward and back.

'So how can you help, Doc?'

What I'm going to do for her is to create a new ligament,

that can be done in one operation.

'Wow, amazing!

'We'll see how Alice gets on with that later in the show.

-'And now to our lab...'

-Ouch!

-'..for some amazing body experiments.'

-Uh!

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

Ooh, spaghetti bolognese, my absolute favourite.

-Xand.

-Yes, Chris? This is delicious by the way.

It's not for you, it's for our experiment.

But it's tasty and I'm hungry.

Look, you can have some later, perhaps.

But I want to talk about food now,

because every year you eat about 500kg of food,

and that's enough to fill two bathtubs to the brim.

Why are you keeping food in the bath?

Food goes in the fridge.

If you keep the food in the bathtub, where do I have a bath?

In the fridge?

Look, Xand, no-one's interested in your kitchen/bathroom confusions.

Now you don't just eat food because it tastes good,

your body is actually an amazing energy conversion machine.

So it's constantly turning what you eat into energy,

even when you're asleep, and you use the energy from this food

for all sorts of things, which is why I need this spag bol, Xand.

Now watch.

'You use up to 75% of every meal for things like breathing,

'circulating blood and growing.'

Are you trying to make a pie chart out of spaghetti bolognese?

Why don't you use a pie?

Like, I had a pie for this very job

but it just vanished from the fridge.

I hate it when that happens.

'Then 10% of what you eat is used up

'simply to digest what you've just eaten.'

I think that's a little bit more than 10%,

I'll just adjust it for you.

'The remaining 15% is used up doing things you choose to do.'

Whether it's watching Operation Ouch!,

walking your dog or playing with your mates.

But how does your body turn your food into energy?

Well, we're going to show you.

In order to release chemical energy from food,

your body has to combine it with oxygen from the air,

that's why you breathe.

Now we've got pure oxygen here.

Now we also have one digestive biscuit here

and then the same weight of pasta.

Now they might be the same weight,

but they give your body different types of energy.

'We're going to release the energy

'from both the pasta and the biscuit

'so you can see the different levels of energy you get from each.'

First up, pasta, and I'm going to soak it in this liquid oxygen.

'Inside your body, when oxygen and food are combined,

'a chemical reaction happens naturally,

'but outside the body we need to ignite the chemical reaction

'using fire.

'Now, we're using special equipment to do this experiment in our lab,

'so don't even think about trying this at home.'

That's a terrible way of cooking pasta,

especially after you did such a nice job with that spaghetti.

Xand, it's not a cookery show, this is about energy.

'Pasta releases energy in your body slowly and steadily,

'just like the small, steady flame burning here.

'Will it...?'

'Let's find out.'

Ready?

Whoa!

HE LAUGHS

Now that burns in quite a different way to the pasta.

'So, yes, the massive flame shows that our biscuit

'does immediately release more energy,

'but don't be fooled by our action replay,

'it's for a shorter amount of time.'

'It's why you immediately perk up after eating something sweet

'but then have a slump soon after.'

You've ruined it!

I was really looking forward to that!

This is a complete disaster!

I think it was a great success.

'So while we get energy from all the food we eat,

'some foods like pasta release it slowly.

'While other sweet foods deliver a quick but short-lived energy burst,

'which isn't much use if you want to get through the day.'

And so a digestive biscuit should only be enjoyed as a treat,

isn't that right, Xand?

HE MUMBLES

'Now we're getting Ouch & About with our mobile clinic.'

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

'If you're anxious about an ailment...'

'..or curious about a condition...'

'..then the Ouch-Mobile is the place for you.'

That is incredible.

'Chris is preparing the clinic, ready for his first patient.'

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

'At the clinic, Chris is open for business.'

Next patient, please.

'First in is ten-year-old Soriah,

'with a question about some troublesome teeth.'

Soriah, why have you come to the Ouch-Mobile today?

Because I've got an interesting extra tooth

in between my two front teeth.

'What's the diagnosis, Doc?'

This sounds like a case of...

'Sounds right to me.'

Open wide.

There he is, look at that.

So when you're born, all your grown-up teeth

are already in your jaw.

And when your milk teeth are falling out

it's cos your grown-up teeth are pushing them through,

and I think what's happened is that tooth is an old milk tooth,

and as the two big grown-up teeth have come through,

they've pushed that one back.

Will my extra tooth ever fall out?

In some people they do fall out,

but probably you're going to need it taken out by a dentist.

The good news is most of the time the dentist will put you to sleep,

so you won't feel a thing, you just wake up and the tooth is gone.

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

Why does your tummy flip

when you go up or down on a roller-coaster?

Inside you not everything is firmly fixed down,

so there are some bits of your body that are firmly attached

and don't move much, but your stomach isn't one of them -

it's quite elastic and it can move around.

So what is literally happening is you're going up,

and your stomach's being pulled down. As you go over the hill,

your stomach keeps going up and you start going down again.

So your stomach is almost flipping, it can make you feel a bit sick.

Dr Xand, how do antibiotics know which part of your body to affect?

What's happening is every cell in your body

is exposed to the antibiotics,

but you can imagine the bacteria are quite different cells

to the ones in your body, like, they just work in different ways,

they've got different enzymes, different proteins and so on.

And so the antibiotics are specially designed

to interfere with the bacteria

without interfering with the cells in your body.

It's a very difficult question.

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

Next patient, please.

'And it's eight-year-old Cassius whose toes need some tending.'

So, Cassius, what brings you to the Ouch-Mobile?

On one of my feet, on all of my toes, on all of my nails,

they're golden-y yellow.

'What's the diagnosis, Doc?'

So this sounds like a rare case of...

'Easy for you to say.'

Goodness me, yeah.

I can see under your nails is also infected.

Fungus that has infected your nails, it's a bit like a mushroom.

And if you ever go to a mushroom farm,

they have to grow in dark, damp conditions,

a bit like the conditions we find in your shoe.

What can I do about it?

There are a couple of things you can do.

You can take medication, you can get anti-fungal treatments

that you paint on the nail.

The second thing you can do

is wear quite loose-fitting shoes that breathe easily,

and, sometimes, on a sunny day like this,

you should just wear flip-flops.

'And don't forget to change your socks every day, too.'

'Job done for today.'

'Still to come, speed is of the essence

'for the West Midlands Ambulance Service.'

This numbness in this side of the face is not normal.

-'We show you how to cope with a medical emergency.'

-Agh!

My finger!

'And over a million kids in the UK have this health problem.'

Blow out as hard and as fast as you can.

'Find out what it is later.'

Remember Alice and her dislocated knee?

Well, let's head back to the accident and emergency department

to see how she's getting on.

'In Liverpool, Alice is back for an operation on her dodgy knee.'

'Oh, yes, I remember, she was just chilling.'

'Oh, no, you don't, we haven't got time, this is just a recap.

'It was break time at school and Alice was sitting on a table

'swinging her leg.'

'Then she turned and her kneecap popped out.

'Ouch!'

'So what is this op going to do?'

Hopefully this'll make my life better.

'And with that, Alice heads off down to theatre for an operation

'to rebuild her knee ligament, using one of her own tendons.'

'Now remember, your body is tied together

'to keep everything in place.

'Ligaments tie bones to bones, and tendons tie muscles to bones.

'But Alice's ligament is damaged,

'making her knee wobbly and unstable.'

'Still smiling, Alice is soon off to sleep

'and ready for knee fixer extraordinaire

'Mr Nick Barton-Hanson.'

'It's lights, camera, action as Nick's using a special camera

'to fix Alice's knee.'

'The first thing he does is pull out two of Alice's tendons.

'These long, stringy things attach muscles to bones.'

That's going to be the new ligament when it's put in.

'Before that, he needs to stretch them.

'This makes them less elastic and a bit stronger.'

'Now he needs to get Alice's knee ready for her new ligament.

'A shaver and vaporiser gets rid of the old damaged ligament

'and scar tissue.

'Next, a hole is drilled in the bone to hold the new ligament.

'Now the new ligament is prepped and ready to go into Alice's knee.'

'That done, the whole thing's tightened up and locked in place

'with a plastic screw.'

That's more like it, doesn't wobble around any more or dislocate.

'Ain't Mr Hanson the man?'

'Alice gets stitched up.'

And we're finished. The operation went very well.

She's got a lot of hard work to do herself now.

I think she'll do very well with it and she should be fine.

'Our patient is soon awake,

'but it will take six weeks of physiotherapy

'to get her knee working again.'

Hopefully I can do sport now and football, and it'll be yay!

'Great result!'

-BOTH:

-'Bye, Alice. Bye, bear.'

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

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

The West Midlands Ambulance Service is on standby all day, every day,

to respond to emergencies.

I'm hitching a ride in this rapid response vehicle

so you get to see up close what it's like to be first on the scene.

'On call with me is paramedic Jan Vann.

'She can do 20 emergency callouts in a day!

'And a new case is just in.'

We've been called to see a 44-year-old lady,

and at the moment the suspected diagnosis is a stroke.

Now that means that she's potentially got

a blocked blood vessel in her brain.

If you act quickly, you can get a much better result

than if you wait, so we need to get there fast.

'Minutes later we arrive at the address.

'Inside, Jyoti is in shock.

'She's lost feeling down one side of her body and has no idea why.'

It suddenly started going all numb.

-On the... On the left side of your face?

-Yes.

-OK.

And then I started going down, down, down,

then my husband pulled me back up.

-You started slumping in the chair, did you?

-Yeah.

I'm going to do a few checks on you.

If it is something serious like a stroke,

which obviously we're all concerned about,

it can be managed and it can be treated, OK?

(So Jyoti has high blood pressure and she's got diabetes,

(and both of those things make having a stroke a little bit more likely.)

-Can you feel me touching it?

-I feel that side.

-Can you not feel this side?

-Not much, no.

(So what Jan's doing now is assessing how well

(Jyoti's nerves in the brain are working,

(and that will tell us whether or not there's a problem in her brain

(and how quickly she needs to get to hospital.)

This numbness in this side of the face is not normal,

so I would like to get you checked over at the hospital,

just to make sure that it's not, like, the start

of anything like a stroke.

(So one of the most difficult parts of Jan's job

(is not just making medical decisions,

(but also dealing with people,

(trying to persuade people who are frightened of hospitals

(that maybe it's a good idea to go in,

(and explain to people what's wrong, and that's what she's doing.)

I'll arrange for the ambulance to come,

but I'm going to stay with you the whole time, OK?

5157, just amber backup, please.

RADIO CHATTER

'By the time the ambulance crew arrive...'

Hiya.

'..Jyoti's mood has lifted, thanks largely to the expert care

'she's received from Jan. She even manages a little joke.'

Why do you think you're feeling better?

Dealing with two handsome men like you.

-Is that what it is?

-Yeah.

Don't make their heads any bigger than they are.

-Are we going to the optician's?

-THEY LAUGH

Oh, very good.

So Jyoti's now in the ambulance and she's about to go to hospital,

where she'll get the treatment that she needs.

She's laughing and joking, she's much more relaxed,

it's a really good result for the emergency services.

She said "bye"!

'So you'd better look after those thumbs of yours.'

The car, not only is it my pride and joy,

but it's a perfect way of getting out and about

and experiencing the thrill of the open road.

But remember, long car journeys can be difficult,

so it's best to be prepared.

Are you ready, Xand?

Certainly am. I've got some excellent reading material.

Got a little something to eat in case I get hungry.

And I've got some water.

Fair enough, Xand, but the car can also be a place of danger!

You could choke on those sweets.

Never.

Well, you could read your comic book and make yourself sick.

No, I don't think so.

Well, you can drink too much water and need a pee.

Um, OK.

All right. Let's get your seatbelt on and close the door.

Actually, I do need a wee.

Argh!

My finger.

Uh-oh. Looks like an injury alert.

Aliah, what would you do?

B. I would my fingers up in the air.

'In fact, Aliah is absolutely right,

'the correct answer is B.

'Check this out.'

-So what are you going to now with your broken thumb?

-Oh, uh.

Right, get it up next to that one and put it there.

Put it there, or if you wanted to reduce the swelling,

you could put it anywhere above your heart, put your hand up in the air.

-You might get tired.

-Still hurts!

When you break bones they bleed,

you get swelling under the skin, and that's partly what hurts.

If you put the hand up,

less blood can get to it,

and all you have to do is put your hand above your heart.

Because your heart's where all the blood comes from.

So even if you just put it up there, that'll help.

'So who wants to have a go?

'Now remember, we're showing you what to do in an emergency,

'but it's always best to find an adult.'

SCREAMING

You've just broken my finger?

So what are you going to do now?

Put your hand above your heart.

Ow! Ow!

-So what have you done there?

-I've put my hand here,

so that the blood goes...drains down.

What we could do is we could use her own hood.

Jasmine, do you want to see if you can put your hand

in the hoodie in a way that you can then just chill out?

-How does that work? Does that feel better?

-Yes.

'So if you think you might have broken your finger,

'elevate it to stop it throbbing, support it and tell an adult.'

Right, now, Xand, are you sure you don't need a wee?

No, I've got it all sorted.

'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 sometimes their work is life-changing.'

'Whatever you're doing, wherever you are, you never stop breathing.

'Whether you're playing football...

'..out for a relaxing country walk...

'or having a nice little nap.'

In fact, you breathe 20,000 times a day

and you don't even have to think about it.

Your body does it automatically.

But from time to time,

people can have problems with their breathing,

and this can be due to a condition called asthma.

'Asthma is a very common lung condition.

'You might even have it yourself.

'Every time you breathe, air travels down your windpipe

'and into your bronchi -

'the tubes that carry the air in and out of your lungs.'

'But if someone has asthma, their bronchi can swell and become narrow,

'which causes wheezing and can lead to an asthma attack.'

Over a million kids in the UK have asthma,

you probably know someone with it yourself,

and today I'm going to the asthma clinic

at the Evelina London Children's Hospital to find out more.

And this is how I get to the clinic. Argh!

'In for a regular checkup is ten-year-old James.'

Just got to weigh you and see how tall you are.

'A year ago his asthma was so bad he was hospitalised

'and ended up in intensive care,

'but now the condition is being managed at the asthma clinic.'

-You show me how you do it at home, OK?

-OK.

'Nurse Carol wants to make sure James is using his inhaler properly.

'It delivers medicine straight to the lungs, where it's needed.'

Wonderful.

'And James has two inhalers -

'a purple one, which reduces swelling in the airways

'to prevent an asthma attack,

'and a blue one, which calms any swelling and allows air through,

'even if an attack is already happening.'

'Ready for James is Dr Jane Heraghty.

'She wants to find out if his medication is doing its job.'

And does your asthma stop you doing

-anything that all your friends can do?

-No.

-You can run around

-and you're as fast as they are at running around?

-Yep.

Good. That's what we're aiming for.

'To get a proper look at how James's lungs are working,

'Dr Jane uses this special machine

'called a spirometer.'

So what does this machine do?

It's measuring how big a breath he's taking in

and how quickly he can blow that air out

and it shows us if his airways are narrowed.

There we go, let's see if this little boy

can blow these petals off the flower for me.

So big breath in and blow out as hard and as fast as you can.

Go, go, go, go.

Excellent. Look, nice big rainbow, well done.

And how do James's results look?

They're excellent and it shows his lungs are good

and he's taking his inhalers, which is what we want.

'It's a great result for James and there's even better news to come.'

Your lung function tests are good.

You're not getting any asthma symptoms,

so I think we can reduce down your inhalers a little bit.

So we'll get you to take one puff in the morning

and one puff in the evening, so halving your medicines,

but still taking them regularly.

So is that good news?

Yeah. That's good news.

-So I'll see you soon.

-Thank you. Bye-bye.

'Some people grow out of asthma, while others have it forever,

'but with treatments now available, it doesn't have to impact your life.'

Asthma is actually the most common long-term health problem

that people in the UK have, but as we've seen today,

it can actually be really well managed

with regular checkups and the right medication.

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

Luckily he's in the right place to get sorted.

-BOTH:

-Phew!

'Let's see who's in Liverpool's

'accident and emergency waiting room.'

My name is Ben. This is Ruby.

This is Scarlett.

'Nice to meet you, what's up?'

When I was climbing upstairs

with my socks off.

'Yes?'

It's the only way I could get up quicker.

'Right.'

At one point there was a slide,

and I broke my arm.

That will do.

'It certainly will. Let's piece that together, shall we?

'Ben was having a good time playing in the fun park

'with his two sisters.

'He was running and climbing all over the place.'

'Looks fun.'

'But his socks were making him slip so he took them off.'

'Oh, could be smelly!'

'No, Xand, that's your feet.

'Anyway, sockless Ben climbed even higher

'and on the way up he slipped and slammed his arm.'

'Ouch!'

'After a quick trip to X-ray, the next stop is minor injuries.

'Where nurse practitioner

'Sarah Jackson is waiting.'

Can I have a little look at your hand, then?

-Be careful.

-I will be very careful.

'Nurse Sarah carefully checks that Ben's arm is working properly.'

Can you wriggle your fingers for me?

And have you had a picture?

-Yeah. Two.

-Two pictures.

-Shall we go and have a little look and see what you've done?

-Yeah.

'Then she checks his X-rays.'

Looking at the X-ray I saw two small buckle fractures.

'That's those bulges there.'

What we're going to do is we're going to pop him in a splint,

he needs to keep the splint on for three weeks, OK?

-What's a splint?

-It's like a magic plaster.

'Magic!'

This goes on your hand, OK?

'Now Ben gets his splint on, this supports his arm

'and keeps it straight while his bones heal.'

And will I have to go to school like this?

Yeah, you'll have to go to school like that.

'With that answered, he's off.

'Have you learned anything today, Ben?'

I'm going to be more careful with my arm.

'Glad to hear it.'

Be quiet, girls.

'Well sorted, Ben.'

BOTH: 'Bye, girls. Bye, Ben!'

Bye-bye.

'Next time on Operation Ouch!...'

Meet my veins.

'..we get under Xand's skin all in the name of science.'

On me head, son.

'We show you what to do if this happens...'

'And Xand gets an unusual workout.'

I'm going to catch you.

So that's it till next time from...

..Operation Ouch!

They should only be enjoyed as a treat, isn't that right, Xand?

MUMBLES WITH MOUTH FULL

LAUGHTER