Colossal Coughs Operation Ouch!

He's Dr Chris.

And he's Dr Xand.

Yes, he's still got his beard.

And we're still identical twins.

Your body is amazing and we're going to show you why.

We're head-to-head in Operation Takeover.

-BOTH:

-Man overboard.

Ouch And About hits the wards.

What kind of ambulance did you get?

I didn't get an ambulance, I got a helicopter.

First Aid is back.

We do need to get Xand to hospital.

Meet our new brilliant Ouch patients...

I'm off to my physio appointment.

..and our lab experiments... DR XAND SCREAMS

..will blow...

..your...

-..mind!

-That is an amazing view.

Are you ready to join us?

I can't see a thing.

-Coming up today on...

-Super Xand!

..Operation Ouch!

We're all a-splutter in the lab.

-There we go.

-We're sniffing out medical mysteries.

That might be the squishiest nose I've ever seen.

And things get tasty.

-Is that all right?

-It would be helpful if you kept it in the bowl.

But first...

INDISTINCTLY: Medical teams are always at the ready.

Xand, the sweet, please.

And the other one. OK, now continue.

Medical teams are already at the ready.

Let's see who the first case in A&E is.

Can I have my sweet back?

No.

Six-year-old Winnie is waiting to see the doctor with her mum

in the children's emergency department.

Look, poor Winnie has a sling.

I've got a sore arm.

Winnie walks with a walking frame,

so I saw her wobble and then topple over.

So that's why I'm a bit worried it might be fractured.

Oh, no, how did it happen?

Winnie was at her favourite after-school activity.

-And what's that?

-Well, she does lots of activities like dance, swimming,

tennis, cheerleading.

Wow! So she was dancing in the swimming pool with a tennis racket

-while cheerleading?

-No, Xand.

Winnie's absolute favourite thing to do is play over at her best mate's

-Sophie's house.

-It looks fun.

Yes, but as they were playing catch in the garden,

Winnie slipped on the wet grass,

trapping her arm underneath her walking frame.

-BOTH:

-Ouch!

Oh, dear. Let's hope Dr Ashley Timings-Thompson can get you sorted.

First, the doc checks the nerves in Winnie's arm by making sure she can

-feel properly.

-We need to play a game, OK?

Ooh, I love a game.

What you need to do is close your eyes really tight.

No peeping!

And then when I touch you on your arm, just say yes.

-Yes.

-Very good.

-Yes.

-Well done.

-Yes.

-Very good.

Winnie wins. Time to check her movement.

Is that sore?

I think you might have broken a bone in your elbow, OK?

So what we need to do is get an X-ray.

I like having X-rays.

Do you?

It's like a computer above you taking a picture inside

and when you look at it, it's very interesting.

Well, you're in luck today.

You're getting two X-rays from different angles.

Good girl, you're all finished.

And then it's straight to the doc for the results.

Looking at your X-ray,

I just wonder if you've got a very small break in this part

of your bone here. So what we're going to do is put your hand

in what we call a collar and cuff just to keep it steady overnight

and then we'll bring you back tomorrow,

-see how you're getting on.

-OK.

Winnie needs to see an orthopaedic surgeon -

a doctor who specialises in bones.

Tomorrow, I'm going to come back to see if I need

any further treatment.

OK, Winnie. We'll be back to find out how you get on.

And now to our lab.

It's time for some big body experiments.

Some of them gory.

This is not for the squeamish.

Some extreme.

It's freezing!

We're ready. Are you?

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

Today we're looking at why we cough and the part of your body that makes

-it happen.

-Xand, what are you doing?

This is a lab, not a laundry.

-I know, but...

-There is a time and a place to do your dirty washing

and this isn't it because today we're going to look at one of the

biggest organs in your body. The organ involved in coughing.

-Yes, it's...

-Your lungs!

That's what all this is for, Chris.

If you laid your lungs out flat,

opened up all the little spaces inside them,

they'd be about 50 square metres.

That's huge.

That's the same as all this material around the lab.

That's right. Your lungs have a huge surface area,

but to understand how you can fit it inside your chest,

come and take a look at this.

Here comes a Gross Alert.

This is a real pair of cow's lungs.

Now people often think that lungs are a bit like empty bags

full of air, but in fact, they're solid

so you can see here a cross-section through the lung.

Now these tubes are the large airways that take air down to the

segments and the segments look like they're made of foam and that's

because the segments are full of tiny little air sacs

called alveoli.

In humans, alveoli are far too small to be seen.

But you can see them in these massive cow's lungs.

They pass oxygen from the air into your blood to be used by your body.

With every breath you take, you inhale air, also viruses,

pollen dust and bacteria.

But don't worry, your lungs have an amazing trick to get rid of stuff

that you inhale that you don't want.

-Coughing.

-XAND COUGHS

Exactly. And we're going to show you how it works.

Coughing is a really clever technique that your body uses

to get rid of anything unwanted from inside your lungs,

including the large amounts of mucus

produced when you're ill with a chest infection.

To show you how coughing works,

we're going to inflate this pair of healthy lungs using gas from this

canister. Xand, inflate the lungs.

This is awesome.

We've never done this before.

Even at medical school we never saw lungs inflated outside of a body.

So here, where the lung's gone white,

these alveoli are fully inflated.

Wow! This is one of my favourite experiments ever, I think.

These lungs are a lot like your lungs, but a bit bigger.

They are actually about six times bigger.

All right, Xand, turn off the gas and let's breathe out.

And now the lungs are deflated.

Now to show you the importance of coughing,

we need to infect one of these lungs.

So I'm going to put some mucus into it.

This is like what happens if you have a very serious chest infection.

I'm going to insert some fake mucus into the lung.

Now, look what happens when Xand turns on the gas.

The mucus-infected lung doesn't inflate properly any more

because it's blocked.

And this shows you the importance of coughing for getting mucus

out of your lungs so those airways don't get clogged up.

And to demonstrate coughing, I've got some balloons over here.

I have here, two balloons.

Now, mine is a nice, healthy, mucus-free balloon.

Xand, I'm afraid yours is very badly infected.

As you can see from the large amount of mucus in the airway.

Eurgh!

Now let's inflate the balloons.

Three, two, one.

This doesn't feel fair, Chris.

My mucus-filled balloon is really hard to blow up.

You can see my balloon inflates extremely easily and also...

..deflates extremely easily.

-How is it going, Xand?

-Very badly.

I've got a mouthful of mucus and I can barely get any air

into this lung.

Seems to me, Xand, that you should have a bit of a cough.

Ooh, that'd make me feel much better.

OK, ready? Three, two, one.

There we go.

When you cough, all the muscles around your chest and abdomen

contract suddenly. This creates enough force to eject the mucus

up your trachea and out of your mouth

like the mucus coming out of this balloon.

Now that has nicely cleared the mucus from Xand's airways

and now his lungs are clear again.

So, that's why you cough when you have a chest infection.

We've shown you just how important the alveoli are in your lungs

and how they help you breathe easily.

And we've shown you that when they get clogged up with mucus, you can't

inflate your lungs properly so you have to cough.

Plus, it was a great excuse to cover Xand in gunk.

Well, I must say, Chris, after that cough, I feel a lot better.

I'm off to play footie in the park.

But what about this mucus on the floor?

Who is going to help me tidy this up?

-Xand?

-It was your experiment.

We're both...

-BOTH:

-Ouch And About!

I'm hitting the wards with my Ouch bleeper.

Have you got a question for me?

Wow.

And I'm hitting the streets to answer your medical mysteries.

Xand's in the hospital canteen,

but there's no time for snacking.

Huh?

It's bleeper o'clock.

Ooh!

It's from Ruth who's had an ankle operation.

-Hello, Ruth.

-Hello.

-Have you got a question for me?

-Yeah.

Why do I got a squishy nose?

What's the diagnosis, doc?

Sounds like a case of...

Let's see if you NOSE the answer.

Now, Ruth, how squishy is your nose?

That might be the squishiest nose I've ever seen.

Everyone's nose is a bit squishy, isn't it?

Because your nose is mostly made of cartilage,

and cartilage is rubbery,

but most people's cartilage is quite tough, whereas yours is really,

really flexible, isn't it?

-Yeah.

-You've got a squishy nose for the same reason you've got a

problem with your ankle, haven't you?

What's the main thing you've got?

Larsen syndrome means that some of her tissues,

her connective tissues and her bones don't quite grow the same as other

people's. Have you got some other problems with bones as well?

-Yeah.

-Wow.

So, what Ruth is doing there is dislocating her knee.

Her knee is actually popping out of joint, cos you've got very stretchy

ligaments around your knee and the muscles are a bit looser.

You can just pop your knee out of joint and then pop it back in again.

-And does that hurt at all?

-No.

-DR XAND LAUGHS

Well, thank you very much.

I think you deserve an Operation Ouch! sticker.

-Bye.

-Bye.

Meanwhile, I'm out on the street.

Does anyone have any medical mysteries for me?

Oh, hello. What's your question?

So, first of all, show me the teeth you lost.

Oh, wow, those two bottom ones.

-Yeah.

-Do you know what those two teeth were called?

-Um...

They are called incisors.

You lost your bottom two incisors. And the reason you lost them

is because when you're born, you have your grown-up teeth up here

in your maxilla which is a bone of the skull

and you have your grown-up teeth down here in your mandible

which is your jaw bone, and as the grown-up teeth start to come

through, they push out the baby teeth.

So, it's nothing to worry about.

Losing baby teeth is completely normal and because you asked such

a great question, I'm going to give you an Operation Ouch! sticker.

-There you go.

-Thank you.

Another happy customer.

Back in the hospital, I've had another call.

It's from Shaun who has cancer.

Hello, Shaun. How are you?

I'm good, thanks, Dr Xand.

Now, have you got a question for me?

Yeah. How does cancer form?

What's the diagnosis, doc?

It sounds to me like a case of...

Now, that's a tricky question.

Cancer is when your body's cells keep dividing.

They divide too much.

So, somewhere in your body, one cell had a genetic mutation -

a bit of its DNA went wrong and the gene that stopped it dividing

too many times got switched off or got damaged somehow

and so it started making more and more and more of them.

So, what kind of cancer have you got, Shaun?

-Acute lymphoblastic leukaemia.

-Yeah.

So leukaemia is a kind of cancer of your blood cells and Shaun's

particular kind of cancer is a white blood cell cancer so you effectively

have too many white blood cells.

Now, white blood cells are really useful. They fight infection.

The problem is,

if you're making too many white blood cells it crowds out the other

kinds of cells you need. What kind of treatment are you having, Shaun?

-Chemotherapy.

-So, the reason you're having the chemotherapy

is to kind of reset those genes.

Shaun, have I answered your question?

-Yeah, thanks.

-Here is an Operation Ouch! sticker.

Thanks, doctor.

-Bye.

-Bye.

Job done for today.

Earlier, Winnie came into the emergency department

-with a sore arm.

-Well, let's find out how she's getting on.

-Come on.

-Come on.

-Come on.

-Come on.

-Let's go!

Now!

Winnie had to have her arm put in a sling after an accident.

She'd been playing catch with her friend Sophie,

but she slipped and her arm was trapped underneath

her walking frame.

-BOTH:

-Ouch!

Winnie's X-ray showed she might have a small break on her elbow.

My arm is stinging.

Don't worry, you're back to see an orthopaedic doctor

who specialises in bones.

Here is Dr Janet Cumberland.

Does it hurt when I press on there?

-A bit.

-OK. Can you straighten it out?

That's fantastic.

I think your arm is OK.

Brilliant news.

For her to be this comfortable only the next day,

I'm very happy she hasn't broken anything.

When they looked at the X-ray in A&E,

they could see this little irregularity

on the surface of the bone

and they wondered if that might be a break.

Lots of bones can have little bits of irregularity in them.

That's just normal for the patient.

Fabulous. So you can carry on doing dancing and cheerleading.

Yeah.

Yes, Mum, but Winnie still needs to take care.

She's damaged the soft tissue around her elbow which can take up to six

weeks to heal.

I'm feeling very happy.

Any advice for me and Chris when we're playing catch?

Not to go on the grass when it's slippy.

Got it.

-BOTH:

-Bye, Winnie.

Still to come...

We're looking dishy.

There is an unidentified object.

Whoa!

And we work out who done it?

What on earth has happened here?

But first,

did you know that the loudest burp ever recorded was over 100 decibels?

LOUD BURPING

That's louder than a tractor.

Wow! XAND BURPS

-Excuse me.

-Xand!

Amazing people do lots of important jobs inside and outside hospitals

that help to keep you safe. But what will happen when we have a go?

I feel a bit silly.

This is...

Can you guess who today's Hospital Hero is?

Well, I'll give you a clue.

You might see them when your tummy is doing this.

TUMMY RUMBLES

They might wear one of these

and they work with lots and lots of this.

Food!

Chris, this is going to be the best Hospital Takeover Challenge yet!

I mean, who can complain about having to eat all this yummy...?

-Xand! We're not here to eat.

-Aren't we?

We're here to find out about the amazing people that work

-in the hospital canteen.

-Oh, yeah.

We're about to take over the job of today's heroes -

executive chef Simon and restaurant supervisor Donna.

They're on the front line at Alder Hey Hospital restaurant

where they serve around 500 meals a day to patients, their families

and staff.

Pleasure.

This is different to a normal restaurant in that people who

are in a hospital usually have something to worry about

or some problem, that's why they've come.

Sometimes parents are looking to get away from the bed side.

In the restaurant, it's a friendly face for them to speak to.

And what about the serving food?

Do you get any tricky situations there?

Yeah. Some people have allergies.

It could be a life or death situation with the allergy.

-So the stakes are quite high.

-STEAKS are high.

-That was good.

-That was good.

To find out what makes a good canteen worker,

we need to talk to some customers.

So, Ruby, you've been coming to the Alder Hey canteen

-for how many years now?

-Eight.

So you know this canteen pretty well.

Yeah. I think it's nice that they want to know about me and make me

feel a bit better.

Kera, have you got any tips?

You've got to be nice to the people.

What do you think would be the worst thing that we could do?

Maybe set the place on the fire.

Who do you think is more likely to do this, me or Chris?

-You.

-What?

-Because you're more crazy.

Thanks, Ruby and Kera.

We've learned just how important the hospital canteen is for patients

-and their families.

-But will our attempts to be hospital servers

go as well as fish goes with chips

or will we make a real dog's dinner out of it?

Get it? Good, eh? DOGS BARK

Get it?

It's time for us to take over as canteen workers.

Your Takeover Challenge today is you're going to serve the special,

which is a hot salad with chicken and bacon.

Sounds like a piece of cake.

No, it's a hot chicken and bacon salad.

Oh.

There we go.

First, Simon gives us a quick demonstration on the best way

to serve our salads.

Put in six pieces of chicken.

We're going to be judged on...

Don't forget to ask about allergies.

The two allergens that we have in this meal here is, we have mustard

in the dressing and we have gluten in the croutons.

-OK. Cool.

-How is that?

That looks fantastic.

Donna and Simon will be checking our every move.

The key to a good hot salad, Chris, is showmanship.

People want flair, excitement, speed.

I might try and set it on fire.

Xand, the key to a good salad is hygiene.

Get your finger out of your ear.

Disgusting.

Xand's up first.

-How are you doing today?

-Very well, thank you.

-And who are you with?

-This is my son, William.

Hey, William. Are you allergic to anything?

-No.

-Good communication, Xand.

You remembered the allergies.

SHE LAUGHS

How does it look, William? Does it look edible?

That's great, thank you very much.

-You've done a good job.

-Done very well.

That was his first salad. The portion size was slightly out.

Look, I hope your lad does well with his operation.

-I'm sure he will.

-Xand is speeding through it.

He has done it really fast. Really well. It looks good.

And really filling, so I'm happy with it.

Here we go, right. How am I doing tossing the salad?

-Is that all right?

-It would be helpful if you kept it in the bowl.

Oh, dear. I'm sure I'll do better than that.

Go on, then, Chris, it's your turn.

Do you have any allergies?

-No.

-No.

Great communication, Chris.

A bit of tomato. A bit of this lettuce, cucumber.

He's doing fine. He's picking it up,

-but he's doing a little bit too much chatting.

-She's got a point.

We can give six pieces of chicken. One, two, three...

Speed up, we haven't got all day.

Have you got any allergies?

None I know of.

Lots of onion? Got no meetings this afternoon?

Just a few!

Uh-oh, time's up.

-There was a spare one.

-Put the food down, Xand.

We're ready for the verdict.

I think overall you both did very, very well.

Portion size - Xand you wasn't as good on the portion size.

The reason being is when you started to shake your salad, a little bit

landed on the floor. It was like he was doing a dance

-behind the counter.

-I wanted to put on a bit of a show, to be honest.

People don't want shows, Xand, they want salad.

Speed-wise, unfortunately, Chris, you were quite slow.

But one person done too much chatting.

And the winner of the challenge is...

For Simon, it's a draw, but the clear winner for Donna is Dr Xand.

Well done, Xand, on a narrow victory,

but I think what we both learned today is just what an important job

the hospital catering department does.

I think to be honest we should leave it to the professionals.

Thank you very much.

I wonder if there is any salad left?

Xand, I'm home.

Ooh! Ah, Chris, just, er, hang on a minute.

Xand!

DRAMATIC MUSIC

What on earth has happened here?

Ah, well, the thing is...

That's my Doctor of the Year award.

How did it get broken?

-Was this you?

-No.

Unless we were broken into, I cannot see an explanation.

That's the explanation.

I came in myself and someone barged past me

-and kind of pushed me out of the way.

-Xand, that's terrible.

-Did you get hurt?

-No, I've got a little bruise on my arm.

It's nothing really.

This is a case for Investigation Ouch!

We need to take photos of absolutely everything.

That bruise looks awful and how did that cut happen?

Sorry, Chris, I've got to go.

Don't worry, Xand, I've got just the person to help me solve it.

This is forensics expert Professor Peter Vanezis.

He's an expert in medical evidence.

He sifts through clues at crime scenes

to help the police solve cases.

This is called forensics.

Today, he's helping me find out who hurt Xand and who broke

my Doctor of the Year award.

So what should we start by looking for?

Well, obviously look at the glass to see if there are any fingerprints.

It looks like also there's a little bit of blood on the glass

which was shattered.

This is a special aluminium powder

which will make any fingerprints stand out.

Ooh, I found one.

Why do fingers leave a mark behind on surfaces?

Fingerprints actually consist of the secretions from the glands in your

skin. It's that sweaty material which is left behind on the surface

and you can pick it up by dusting.

Everybody's fingerprints are different. Even identical twins.

If I find Dr Xand's fingerprints, does that close the case on him?

-It certainly doesn't, no.

-But he knows he is not allowed to touch my

-award.

-Well, does he do what he's told?

Almost never.

It's time to move on to my evidence board.

Xand said he got it eight hours ago buttering toast,

but there was blood on the award. What does our expert think?

A butter knife is not the kind of knife that you would actually cause

a cut like that. The important thing is it is fresh.

There is no evidence of any drying of the blood at all.

So it's something which has happened very recently.

So that's not an old cut.

Hmmm. It's not looking good for Xand.

Yellowing tells us from all the studies that have been done

that it's around about 18 to 24 hours

when we see the yellow bruising start to come in.

It doesn't come in before then.

Dr Xand said this bruise was sustained as the burglar pushed past

-him.

-That's impossible.

So that's an old bruise.

Hmmm. Xand, you're in trouble.

There is a tuft of Mr Grumble's hair on one of the shards of glass.

Although the colour is similar,

we have got to take it to the lab and have it tested.

So what's the verdict from our forensics expert?

You certainly have circumstantial evidence.

You can say that the bruise was not acquired in the way that he said

and the cut also.

There are two things on which his account is completely inaccurate.

There is no hiding from the medical evidence.

Forensics experts like Professor Peter use their knowledge

of the human body to solve crimes.

Time to confront the prime suspect.

-Thank you for coming.

-We live here.

There was no burglar, Xand.

There was only you.

You smashed my Doctor of the Year award and this tuft of brown hair

implicates Mr Grumbles as your accomplice.

No, not Mr Grumbles.

I can't let him take any of the blame.

It was all my fault.

I knew it, but why did you lie to me, Xand?

Only because I knew you'd be angry.

I didn't mean to break your award.

It was an accident, I promise.

While you were out, we were practising for our ballroom dancing

competition. I swung Mr Grumbles around, but I lost control,

and then...

I thought you'd be angry, so I lied.

You should have known better, Xand. Lies will always be found out.

I'm sorry, Chris. I'll glue the award back together right away.

There you go, Chris, good as new.

I EAR there's another patient in the emergency department.

Right, very interesting.

I wonder which body part is affected?

Five-year-old Ethan is in the emergency department with his mum.

He looks OK to me.

So what's up, Ethan?

There's a rubber in my ear.

A rubber in your ear?

How did it happen?

Ethan was at school in a writing class.

Very good handwriting.

Yes. He was learning about Australia.

-Awesome.

-Ethan loves the really cool buildings and the kangaroos.

Who doesn't? Chris, I don't see what the problem is.

This all sounds perfectly nice and normal to me.

Well, it was,

but as Ethan was busy working away, a classmate lent over

and put a rubber in his ear.

-BOTH:

-Ouch!

Uh-oh.

Whee!

-Never put anything in your ear...

-Or someone else's ear.

..that's smaller than your elbow.

Dr Robert Eastman is on hand to help.

Have you tried to get it out?

I tried to get it out at school and didn't....

Nothing else in your ears that you know of?

I hope not!

I don't know.

There could be a whole pencil case down there.

-Is it OK if I have a look in your ears?

-You need a torch.

I've got a torch here, look, here you go.

Dr Robert uses an otoscope,

it's a magnifying lens with a bright light so he can see right down into

Ethan's ear canal.

It is difficult to see what's actually in there because there's

a bit of hardened wax so I just want to get a second opinion on that.

Enter Dr Jane Dawson.

She has seen many a waxy ear problem.

We will lie Ethan down and I'll see if I can hook out that wax

and see if there is anything behind that.

Have you caught anything, Dr Jane?

Here comes a Gross Alert.

Whoa! It's a chunk of hard wax.

Don't panic, Ethan.

Ear wax or cerumen comes out of glands in the ear canal.

All healthy ears need it because it moisturises your ear,

it traps dust and dirt and it has chemicals to fight off infections.

Normally wax works its way out and is wiped away when you wash,

but sometimes you can have too much and you need to see a doctor,

just like Ethan.

But what about that pesky rubber?

Once we got that big chunk of wax out,

I've managed to see right the way down to his eardrum and there is no

-rubber.

-It was that lump of wax that made him feel it was still in there.

Have the docs ERASED the problem, Ethan?

Brilliant. I love the hat, Ethan.

-BOTH:

-So long, partner.

Next time on Operation Ouch!

We have lift off.

And we are now at maximum altitude.

We're taking the plunge.

That's not good.

And we get our teeth stuck into things.

That's disgusting.

So we will see you next time for more Operation Ouch!

Chris, what about us?

I've got a bit of hip action going on.

It's just my way. It's how I like to do it.

-On Operation Ouch...

-Super Xand!

Super Xand! Xaaaannnndd!

Is he going to come and say nothing to me now?

-Has he gone? Is that it?

-LAUGHTER