Best Of... Operation Ouch!

I'm Dr Chris.

And I'm Dr Xand.

-We're identical twins.

-Twins!

Do you know your body does loads of amazing things

without you even realising it?

Welcome to my poo factory.

And we're going to show you how.

Smell my armpits!

We've got gobsmacking experiments...

Wow!

Mind-bending body tricks... THEY LAUGH

And real medical mysteries.

I've got a stone in my ear.

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

Do you want to high-five?

-Coming up today...

-On Operation Ouch!

Xand, why are you wearing the medical emergency blanket

from the ambulance?

This is Super Xand's space cape.

Xand, put it back where you found it.

We perplex the public in Mindbenders...

SHE SQUEALS

And we're looking back at some of our best bits.

THEY COUGH We find out what comes out

when you cough...

Oh, yuck!

And Matthew's life is transformed by an amazing device.

Absolutely extraordinary to be holding one in my hands.

It's one of our favourite hospital cases.

-Ooh, is it Alice?

-Yes.

-ALICE Alice?

-Yes.

-ALICE Alice Alice?!

-Yes, it's Alice!

-Great!

In Manchester, waiting with her mum and dad

is five-year-old Alice,

and it looks as though she's hurt her hooter.

Ooh! That does look nasty.

She fell over and bashed her nose,

so she's got a nasty little cut just along the side of her nose here.

The witch came to catch me.

The witch? What's all that about?

Alice and her friend, Colette, were at school.

So, where was the witch?

Unless you mean those dinner ladies. Maybe they're cooking up a spell.

No, Xand. Colette was pretending to be a witch and was chasing Alice.

COLETTE CACKLES Run, Alice!

Alice ran through the playground trying to get away,

but the witch was catching up fast.

Oh, no!

Alice ran faster and faster

and just as the witch was about to grab her,

-she tripped.

-Uh-oh!

Alice went flying across the playground,

-landing face first.

-Ouch. THEY GASP

Here's ear, nose and throat doctor, Ricky Pal.

Maybe he can cast a spell to mend that snout.

-What have you done?

-Just fell over and hurt my nose.

Dr Ricky needs to take a closer look.

There are lots of nooks and crannies in your nose

that could be damaged if it takes a bash -

the nostrils, the nasal passages

and the bit down the middle called the septum.

It's made of bone and cartilage.

Alice's cut hasn't reached the cartilage,

but it has sliced right through her nostril.

Luckily, Dr Ricky knows how to fix it.

She needs to have that stitched in theatre,

so we'll put her to sleep under an anaesthetic,

and then we'll just get the edges of the cut lined up

and stitched together nicely.

Wee!

We'll be back later to see how Alice gets on.

Ouch!

Ready to see one of our all-time favourite experiments?

Yes!

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

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

HE COUGHS

Now, today, we're going to be looking at what happens...

-HE COUGHS

-..when you cough.

Now, a cough is a reflex action that your body does

to get rid of something harmful or irritating

which you breathed in by mistake, like icing sugar, for example.

Icing sugar? Why would I breathe in icing sugar?

We're in a lab, not a kitchen.

When I do bake, I always make savoury things

like, you know the cheese twists with...

-Argh!

-HE COUGHS VIOLENTLY

Water!

Now we're going to show you Chris coughing

like you've never seen it before.

Now, this is a video of the inside of my head.

This was taken using

a magnetic resonance imaging machine,

or MRI.

The main difference between a cough and simply breathing out hard

is my favourite body part,

your epiglottis.

It's normal job is to stop food

going into your lungs when you swallow,

but in a cough, it closes off

the lungs and allows pressure to build up in the lungs.

Xand, do the first part of a cough.

Xand's closed his epiglottis, the pressure's rising in his chest,

-so when he opens it...

-HE COUGHS

..the air rushes out at 60mph.

But if a cough's that powerful, where does it go and what's in it?

Well, we're going to show you.

It's time for competitive...

-HE COUGHS

-..coughing.

What is going on?

Well, I've made these cut-outs that look just like you and me.

They don't look anything like me. They're all blue.

I'm the green twin. Everything I wear is green.

It's greenish.

It's...it's not... Does that look the same?! It's turquoise!

-Doesn't look anything alike.

-It's not relevant, Xand.

The point is I've put plates

full of a special scientific gunk called agar jelly

on the faces of our cut-outs.

So, if any bacteria happen to land on any of our plates,

they're going to multiply so much we can actually see them.

OK, Chris, are you ready? Three, two, one, cough.

We're doing two experiments -

one where the plates are 10cm away

and another where they're 50cm away.

-Well. All done.

-Not quite, Chris.

I want you to take this agar plate and hold it in front of your face,

and I'm going to cough on it.

And this time, I'm going to cover my mouth with my elbow -

the way you're supposed to -

and hopefully no germs should land on the plate.

OK. Well, just make sure you do it properly.

HE COUGHS

And now we have to wait.

In lab conditions, bacteria takes some time to grow.

Luckily, we came prepared for a long wait.

And finally the test results are in.

So, let's check out the cut outs

that were 50cm away first.

Oh! Yuck!

This has worked really well.

All these bacteria have grown into thick, furry, yucky blooms.

Eurgh.

Well, let's have a look at mine.

Eurgh! They're even worse than Xand's.

Mine are also growing in horrible slimy, furry, green colonies.

And all this from just one cough.

Now for the cut-outs that were only 10cm away.

Oh! This is even worse!

There's loads of furry stuff in here.

Oh, that is disgusting.

Let's have a look at mine.

Eurgh.

There's a huge bacterial splat in the middle of the plate.

I must have coughed up a lot of saliva with that one.

So this is like coughing into someone's face

when they're right next to you, and that's bad news for them

when you realise that the average cough has 20,000 viruses in it.

Which brings me to our last result.

Let's have a look at the plate where I covered my mouth

and coughed at Chris.

Ugh! Two bacteria.

I knew you hadn't covered your mouth properly.

I think you can see, though, that this is a lot better

than the other ones we did.

So, there you have it.

In case you were in any doubt about

whether or not to cover your mouth when you cough,

we've shown that not only could your cough

reach the person next to you,

-but it could travel a lot further than that.

-Yuck.

And as well as seeing how far they travel,

we've shown you just how much bacteria there can be in coughs.

Well, there's a lot more in yours than in mine, Chris.

You should see a doctor.

Maybe I should. Better go find one.

Ouch!

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.

This is a rapid response vehicle,

and it's on standby 24/7

to respond to whatever emergency call's coming in.

Today, I'm going along for the ride.

And guess what? You're coming with me.

Jan can take 10 to 15 emergency call outs in a day.

And a new case is just in.

So, we've had a 999 call to a 53-year-old lady

who's injured her ankle.

So, it could be anything from a simple sprain

to blood loss, severe pain

and maybe some other cause for the fall

that could be life-threatening as well.

We've got to get there quickly to find out what's going on.

The call has taken us right into the centre of town.

-Hello.

-Hello.

-Hello. Is it Linda?

-It is.

-What's happened?

-Tripped over the manhole cover.

-The edge of that raised platform there?

-Yeah.

-Was you knocked unconscious at all?

-No.

-No.

Have you hit your head or the back of your neck or your back at all?

-No.

-What have you injured?

-My knee and my ankle.

-OK.

-It's really sore.

Are you able to bend your knee at all?

I do, but my ankle hurts.

-Your ankle hurts when you bend it? OK.

-Yeah.

Press down on my hand. Push down as hard as you can.

-Where does that hurt when you push down?

-Round my ankle.

-On the outside?

-Yeah.

Linda's ankle is clearly causing her a lot of pain.

So, it may just look like Jan's feeling her ankle,

but in fact she's feeling in very particular places.

There's a set of rules called

the Ottawa ankle rules, and they help you decide

whether they're likely to have broken a bone.

Jan's trying to figure out what's tender.

That'll tell us whether she needs to go to hospital.

I'm going to need ambo back up for this patient.

She's unable to weight bear and needs an X-ray.

Using the Ottawa rules,

Jan has decided that the ankle is probably broken

and Linda does need an ambulance.

She's quite uncomfortable. We're managing to keep her warm,

but she can't walk on that leg, so we need to get her to hospital

and get her an X-ray. She can be treated from there.

It's important to keep it still

so that if she's got any broken bones,

if the edges rub together

it can create a lot pain and some bleeding,

which will make the ankle worse as well.

You're doing it. That's it. Well done, darling.

Are you able to twist round a little bit?

There you go.

It's really good Jan was able to assess her really quickly,

get her an ambulance and get her to hospital where she needs to be.

And once there, the doctors discovered Linda's ankle was broken

and it was soon fixed.

'Still to come, Chris gives me a hand in Mindbenders.'

Oh!

Xand goes Ouch & About with our mobile clinic.

Next patient, please.

'And it's microsurgery time for Matthew.'

The tip of that drill is smaller than a grain of rice.

Remember Alice and her cut nose?

Her cut knows what?

Her cut nose.

Yeah, so what does her cut know?

What? Her cut nose.

Chris, I'm asking you for the third time,

what does her cut know?

In Manchester, Alice is waiting for surgery on her hooter.

Alice was being chased by her friend, Colette,

-who was pretending to be a witch.

-COLETTE CACKLES

As Alice was running away,

she tripped and went flying across the playground,

landing face first.

Ouch!

The cut it quite deep, so Dr Ricky has decided that

Alice's nose needs to be stitched up.

So, it's time for her operation with surgeon Iain Bruce.

Thanks to a general anaesthetic,

Alice will be fast asleep and won't feel a thing.

And to protect her face,

her head is wrapped up like an Egyptian mummy.

Any bleeding in the wound is stopped by something called cauterising,

where these tweezers use heat to seal off the blood vessels.

Look away if you're squeamish,

because we can see exactly how deep that cut has gone.

And with a few stitches, she's all fixed up.

All I've done is cleaned it up,

so there's no dirt underneath the skin,

and then I've stitched it back,

trying to create the shape of the nose as it was before.

I'm really hopeful that

in a few weeks' to a couple of months' time,

you won't be able to tell anything has happened.

Great news. And a couple of hours later, Alice has woken up.

The doctors fixed my nose.

-But how does it feel, Alice?

-It feels nice.

-Aw, glad to hear it.

-Bye, Alice!

-Bye, bye, bye, bye, bye!

-Watch out for those witches!

Ouch!

Now, did you know your fingernails

take six months to grow

from the root to the tip?

That's four times faster

than your toenails.

Wow!

Ouch!

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

-It's weird.

Scramble your senses...

And baffle your brain...

-BOTH:

-In Mindbenders.

-Good morning.

-What do you mean good morning? You're late.

It's nice to meet you.

-It's nice to meet you.

-I see where this is going.

-Yes, Xand, it's nice to meet you.

-Oh!

I didn't just bring my fake hands to fool Chris.

We're going to be using them for today's mind-bending trick.

And so can you put your hand right there,

as if that was your other hand, basically.

And stick your other hand under the cloth.

Yeah, that's perfect, so it's next to that hand.

Today's trick is going to show how what you see affects how you feel.

We're stroking the person's real hand behind the screen

at the same time as stroking the fake hand

which is in front of them.

Is that plastic hand beginning to feel like your hand? Yeah?

Keep looking at it.

It actually feels like that's my hand.

It doesn't look real, but it feels real.

-Are you feeling like I'm brushing your hand?

-Yeah.

-Really?

-Yeah, that feels like you're brushing my hand.

It's really strange, yeah.

I feel like it's my hand.

Now we've got the illusion going,

it's time to see how they react with a fake spider on the fake hand.

Ugh!

-That worked really nicely.

-CHRIS CHUCKLES

I felt like it was actually my real hand.

-Oh!

-THEY CHUCKLE

Did you feel like the spider was on your hand?

Yeah, I think I did. But it weren't cos my hand was there,

so why would I feel it on there? It's a really weird sensation.

SHE SQUEALS

Did you think you had a spider on your hand? Yeah, yeah, yeah?

Stay focused on that hand.

-Oh...

-CHRIS AND XAND CHUCKLE

So, we managed to trick plenty of people,

but how does it work?

So, there's a bit of your brain called the premotor cortex,

and that brings together your senses of touch, of position and of vision

so that your body can figure out

what's happening in the world around it.

What's so interesting about this experiment

is that your sense of vision is the most important sense,

and so your brain actually temporarily rewires itself

to adopt the plastic hand as your own.

Amazing!

Well, Chris, fooling all those people has tired me out.

Give us a hand.

Xand, I'm not falling for the old fake hand trick again!

Oh!

We're at a theme park to solve your medical mysteries.

Xand is preparing the clinic ready for his first patient.

And Chris is Ouch & About in the park

to answer your burning questions.

Wow, I'm impressed.

At the clinic, Xand is open for business.

Next patient, please.

First in is nine-year-old Poppy with an interesting ailment.

So, Poppy, what have you come to see us for?

I've got some strange red spots on my face and my arms.

What's the diagnosis, doc?

Sounds like a case of...

-Spot on.

-Now, let's have a look at them.

I've got the Ouch-cam here,

and I can see it right there on your face.

Do you think it looks like a spider?

Little bit.

Well, in fact it's called

a spider nevus,

because some people say it looks a bit like a spider.

It's got little blood vessels coming out

so you can kind of see spiders' legs.

The blood vessels that are supplying blood to your skin,

one of them's got a bit big

and it's bringing more blood

than it should to the skin,

and so all the tiny blood vessels in your skin, called capillaries,

have got a bit bigger, and so they're a bit more red.

So, you said you had some other red spots.

Can you show me those?

Oh, OK. So you've got two

on your arm right there.

I've got two, almost in exactly

the same place.

Those are actually

a different kind of red spot

called a Campbell de Morgan spot.

They're also completely normal.

Almost everyone has got some of those.

How can I get rid of them?

The one on your face, sometimes when you just get older, they go away.

If it doesn't go away, there are two things you can do.

One is, you can get a doctor to stick a needle in it,

that'll make it bleed a little and then go away,

and it doesn't hurt very much.

The other way of getting rid of them is with a laser.

But for you, it's completely normal, they're completely common,

and I'll tell you one famous person who's got one - Dr Chris.

Poppy, thank you very much for coming to the Ouch-mobile today.

Thank you, Dr Xand.

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

Archer, what's your question?

How do you get a wobbly tooth?

Do you know that below all your baby teeth,

you've got grown-up teeth already in your jaw

and they're growing through?

And as they grow through, they push the baby teeth out

and that's why it gets wobbly.

-A really good question. Thank you, Archer.

-Thanks, Dr Chris.

Back at the Ouch-mobile are siblings

eight-year-old Charlotte and 11-year-old James.

Charlotte, James, why have you come to the Ouch-mobile?

When I stand up I have a gap in between my knees

-and I can't put them together.

-But I can.

-What's the diagnosis, doc?

-Whoa!

Sounds to me like it's a case of...

Easy for you to say.

Let's find out more about this!

Now, Charlotte, can you open the lid on the Ouch-cam?

Now stand up and show me your knees.

Oh, wow.

Your feet are close together...

Mm-hm.

..but as we move up,

your knees are wide apart.

Now, that is completely different

to your brother

whose knees are touching.

How does this happen?

The answer really is that we don't know.

I can tell you what's happened,

is that your bones have grown slightly differently.

So, we call that

a verus change in your knees.

You've got normal knees

that are a bit further apart than other people's knees,

and other people have got knees that knock together more.

The way that your bones grow

is controlled in quite a complicated way,

and so you can just get a variation

where for some people it grows slightly differently.

Your brother's grown with knees close together

and you've grown differently.

You're still growing and your leg bones are still growing,

so possibly, as Charlotte gets older,

the gap between your knees will shrink.

-Does that make sense?

-Yeah.

Charlotte, James, thank you very much for bringing your amazing knees

-to the Ouch-mobile. BOTH:

-Thank you, Dr Xand.

Job done for today. Clinic closed.

Ouch!

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 here's one of our favourites.

CAR HORNS BLARE Now, the world is a noisy place,

but what happens if I switch it all off?

Now, if you're deaf, you have several ways of understanding

what other people are saying. There's lip-reading...

..and there's sign language,

which relies on hand gestures.

And for loads of deaf people, these things work really well.

But doctors are making amazing medical advances

in improving people's hearing.

'This is Matthew. He's 12. He's deaf

and uses BSL, British Sign Language, to communicate.

'I'm not very good at it, so Matthew has brought along his interpreter.'

How long have you been deaf for?

-Since 2001.

-So your whole life?

-Yeah, yeah. I was born deaf.

'Matthew's here to get a cochlear implant,

'a tiny little device that replaces a bit of the ear,

'which in some deaf people doesn't work.'

Sound travels in waves through your ear to the cochlear.

Inside the cochlear, tiny hairs pick up

the vibrations from these sound waves

and convert them into signals that are sent to the brain.

Matthew is deaf because the hairs in his cochlear can't do this.

But the implant sorts this

by sending sound signals through wires instead.

So, I've never seen this operation before, so I'm very excited.

Good luck.

Leading the team today

is head surgeon James Ramsden.

Now, this surgery is not for the squeamish.

Now, this is a cochlear implant,

which is what Matthew's having fitted.

This bit is a microphone.

It hooks over his ears

and it's what hears what's going on in the world around it,

and it attaches with a magnet through the skin to this bit.

This bit sits under the skin,

and it's these little wires that go into his cochlear

and send the electric impulses into his brain.

That's what allows him to hear.

It's absolutely extraordinary to be holding one in my hands.

What James is doing now

is lifting the skin off the back of Matthew's skull

to make a little pocket where the device can sit.

The surgeon uses a microscope which allows him to work

in very small spaces and use a tiny drill.

So, on the big screen you can see it really well,

but in fact, in real life, the tip of that drill is about this big.

It's smaller than a grain of rice.

Having drilled through to the inner ear,

we can now see the opening that leads into the cochlear itself.

Next is the tricky bit.

The wires from the implant need to go through the tiny opening

and straight into the cochlear.

Luckily, James has a very steady hand.

The operation's basically over.

They're just sewing up the cuts behind Matthew's ears,

but we won't be turning on those cochlear implants yet.

Matthew has to wait a couple of weeks for everything to heal.

Matthew's back with Mum and Dad and interpreter Mark

to have the cochlear implants turned on, and he can't wait.

We're going to do a little bit of testing.

When you hear a beep,

we just want you to put one of the fish here into the pot.

Will Matthew's implant enable him to hear?

Will he get any fish in the pot?

-Wow.

-Good. Well done.

He caught that! And it's put a big grin on his face.

He's hearing lots of beeps, and then Matthew hears something

he's never heard before.

Matthew.

Matthew.

-INTERPRETS:

-Was that you, Dad?

-INTERPRETS:

-It was really nice.

I shut my eyes and my father said my name.

I knew something was being said, so when I opened my eyes,

I checked, "Did you say my name - Matthew?" He just said, "Yes."

Well done, Matthew.

So, Matthew is going to be hearing more sounds than ever before

and all because of this - his cochlear implant.

Some sounds he's going to be hearing for the very first time.

It's absolutely incredible.

Ouch!

It's time to meet our next patient.

It's another one of our favourites!

Here he is.

In Manchester, seven-year-old Tyler has come in with his great gran.

What have you done, Tyler?

I've burnt my hand.

-You've burnt your hand? Oh, dear.

-It's a bit painful.

The burn has been wrapped in clingfilm by a nurse to protect it,

but how did it happen, Tyler?

I was trying to make myself a brew.

Oh! A cup of tea? Two sugars, please.

I really, really like brews.

I love dunking biscuits into it,

and my favourite biscuit is a custard cream.

Nice one, Tyler. Sounds yummy.

In fact, Xand, it's that custard cream craving,

that got him into this mess in the first place.

-Tyler is a big tea drinker.

-Ooh! Me too.

He loves nothing more than putting his feet up with a brew

and dunking his custard creams in it.

Ooh! Me too.

Because Tyler's only seven,

he asked his big brother, James, to fix him a cuppa,

but James said no.

Brotherly love, eh?

So Tyler set about making his own cup of tea.

But the kettle was full and heavy.

As Tyler poured, the kettle slipped

and the boiling water went all over his hand.

Ouch!

Here's Dr Chuks Nwulia to take a look at that painful palm.

-Hello, Tyler. How are you?

-I'm all right.

So, what's been happening to you today?

-I've burnt myself.

-OK.

-Can you feel any pains or tingling on your hands, like pins?

-Yeah.

-And where are you feeling it?

-In my thumb.

Can you feel me touching? You can't feel anything?

Your skin is made up of layers

of skin cells, fat,

tissue and blood vessels.

When you burn or scald yourself,

the deeper these layers get damaged,

the worse the burn will be.

More minor burns only affect the top layer

and that's what's happened to Tyler's hand.

But it still hurts!

Tyler's lucky. He had a minor burn.

He just needs some painkillers, anti-inflammatories.

He's going to be fine.

That's great news.

Now it's over to nurse Samira

to give the burn a good clean with sterile water...

before dressing it.

-Right, so you need to keep this clean and dry, OK?

-Yep.

That's it.

Now you've got your digits dressed,

I've got another burning question for you, Tyler.

What was the worst bit about today?

I've not had a brew.

Oh, never mind. Let's hope your brother's got the kettle on,

and that he's stocked up on custard creams.

-BOTH:

-Bye!

Ouch!

-On this series of "Operation Ouch!", we've been on fire...

-Wow!

Showing you how your amazing body works.

What we've got here is a real, live baby.

There is a blood vessel.

We've been on the road with the UK's paramedics.

The ambulance has just arrived.

That was a bit hair-raising.

We've baffled your brains in Mindbenders.

-SHE SQUEALS

-I don't get it.

We've met you and your injuries.

I've pushed a Tic Tac up my nose.

What about the seizures?

I don't have any since the operation.

-How are you feeling now?

-OK.

We've been Ouch & About with our mobile clinic.

-Oh, wow!

-It's called Kawasaki disease.

And we've had fascinating investigations.

-HE CHUCKLES

-This is the surface of Ben's brain.

To show you just how incredible your body really is.

Yes! A triumph!

So take care of yourself and that brilliant body of yours.

-Bye.

-Ouch!

-What are you wearing?

-My cape.

That's not your cape.

It's a medical emergency blanket.

No, it's Super Xand's space cape.

Put it back in the ambulance where you found it.