Gob-smacking Growth Plates Operation Ouch!

He's Dr Chris.

He's Dr Xand.

Yes, he's still got his beard.

And we're still identical twins.

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

LAUGHTER

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

BOTH: Man overboard.

SIREN BLARES

Ouch & 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.

So, we do need to get Xand to hospital.

Meet our new brilliant Ouch Patients.

Hello.

And our lab experiments...

will blow your mind.

That is an amazing view.

Are you ready to join us?

Woo!

Well, it's lucky I was wearing my swimming trunks today.

Coming up today...

..on Operation Ouch!

Xand's having a party.

What a disaster.

Ouch Patient Maisie is back.

That's super exciting.

And there's a baby on board.

Actually, should be head the other way.

But first...

Come on, Chris, it's time to get to the emergency department.

Apparently, there's a new case.

Over in accident and emergency,

five-year-old Dominic is playing with his brothers Daniel and Davien.

You don't look ill, Dominic.

-What's up?

-I've got something stuck in my ear.

You've got something stuck in your ear?

What happened?

Let's look at the concrete evidence.

Dominic was 100%, without a doubt, at school.

Indeed, is that all you have?

Well, that's it, Chris, but I do have some strong leads.

-Go on.

-One lad told me he was fiddling with a wobbly tooth,

when it pinged out straight into Dominic's ear.

-Right.

-Another girl saw ants trampolining in the playground,

and one ant flipped right in.

Unlikely.

And the headteacher spotted a tiger flicking marbles straight at

-Dominic.

-Xander, are you making this up?

Well, yes. But...

No buts. No-one knows what happened.

Not even Dominic.

But whatever it was, it most certainly gave him a reason to go...

-BOTH:

-.."ouch!"

The doctor's going to pick it out.

-Dominic?

-Here he is.

When did you put something in your ear?

Well, there was a tiger...

Don't start that again.

-Shall we have a look?

-I think Daniel's beaten you to it.

And then you can see in.

And Davien too.

-I can see a pencil.

-Wow, I'd never have thought of that.

I think you're right. I think it might be the tip of a pencil.

Worst-case scenario, this could cause damage to his eardrum.

So, we need to get it out, really.

Be right back in a sec, all right?

Be quick, Dr Ashley.

There are three budding doctors here, and they're after your job.

Your temperature is 38.3.

Your eyes are not very good.

You need to put some cream in your eye.

Quick doc, poor mum.

Just in the nick of time.

Shall we try and get it out?

Dr Ashley is going to use a probe to try and hook it out.

Are you ready?

The bit of pencil was actually a bit bigger than I thought it was going to be.

You're being very good.

So, it's difficult for me to get behind it to hook it out.

OK, so what's plan B?

We're going to use some forceps.

Forceps it is.

They're like a big pair of tweezers to try and grab it out.

Couldn't quite grip it.

It's a bit too far in the ear. Almost had it.

Uh-oh, is there anything else left to try?

Find out later if Dr Ashley can finally draw a line under this pesky

pencil ear problem.

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!

So, are you ready?

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

Today is about cells, and I'm using this modelling clay to...

Xand, what are you doing?

Well, I thought I'd take the opportunity to make some new

creatures for my new aquarium since the last one didn't go so well.

Well, that is an understatement.

You flooded the entire lab.

So, we did agree no more aquariums.

Well, I didn't agree.

Your body is made up of trillions of cells and it makes new cells

when old cells divide in half.

This is a process called mitosis,

and this happens to millions of cells around your body every second.

Now, mitosis works like this.

Chris, show me a new cell.

Now, this cell will grow bigger and bigger while it makes a copy of all

its contents including its DNA.

Then, it checks everything is in order, and if it is,

it splits itself in half making two new cells.

And then the cycle begins again, producing four cells, then

eight cells, then 16 cells, then 32, 64, 128,

then 256, then 512...

Xand, I think everyone gets the idea.

CRASH!

This is what real mitosis looks like sped up.

Watch this cell as it splits in two.

This is how lots of your body parts grow.

But how do your bones get bigger?

After all, they're mostly made of a mineral, a bit like rock,

and rocks don't divide.

Xand, to understand this, we need a bone.

One human bone coming up.

Chris, we've got a few in there.

What size are you looking for?

I don't know, something about that long, a humerus maybe.

Come on out, humerus. Come on, come with me.

Come on, that's good. Now, stand there next to Dr Chris.

Right, Dr Chris meet humerus, humerus meet Dr Chris.

Xand, this isn't humerus.

This is Esther. Hi, Esther.

Hi, Chris.

Esther has broken her collarbone.

How did you do that?

My brother pushed me off a mini bike.

-Ouch!

-Is he in trouble?

-Yes.

-Good.

Now, moving on from the collarbone, we can now see...

..the humerus. That's the arm bone.

At the top of the humerus is the growth plate.

It's made of a soft, squishy material,

and there are cells there that produce cartilage.

The cartilage then hardens up and turns into bone that's added

in layers, and that is how your bones grow.

Chris and my bones are not still growing, but Esther's are,

and so are yours. Once you get to be an adult,

your growth plates close up.

Esther, thank you very much for coming into our lab and showing us

your amazing arm X-ray.

All right, humerus, back to the cupboard. Go on, off you go.

CREAKING

Do you know, Chris, I've been thinking, why does it take so long

to grow? I mean, waiting to get taller is just so boring!

Well, that is a great question, Xand. Let's find out.

To show you why your bones take years to grow and make you taller,

Xand and I are going to make some bones.

One femur each to be precise.

-The leg bone.

-We'll both be using

this plaster putty to represent the cartilage

cells in the growth plate.

It's not real bone,

but it will set hard like the cartilage in your body.

I'm going to be making my bone the natural way.

I'm going to be making my bone the much more fun and quick way.

I'm calling it the all-in-one, one-stop shop,

overnight bone making method.

-Catchy.

-I thought so.

OK, Chris, are you ready?

I am ready.

WHISTLE BLOWS

I'm chucking all mine in this plastic tube to make the bone

in one go. I'll be done in no time.

No plastic tubes for me, Xand.

I'm trying to be as true to how our bodies build bones in real life as I

can. So, I'm drying each layer,

making it set firm before adding another.

Well, I must say,

my one-stop, bone shop, overnight method

is really working out well.

I'm getting a bit bored with how long this is taking you.

I'm going to go find something else to do.

I can't believe Xand thinks his bone is finished.

This takes time.

So, this is a bit more like what happens in your body.

Your growth plate lays soft cartilage down on the top of the

bone shaft, and that cartilage then gradually is turned into bone

and becomes hard.

Oh, come on, Chris!

We've got to finish here!

I mean, that's growing about as fast as real humans!

Xand, that is the whole point.

I may not have made much, but this is almost as strong as real bone.

Are you honestly telling me that this femur that you have made

has the required structural stability?

I absolutely am.

Hm... Oh, no!

Oh, no, it's all going wrong!

Xand's bone is all floppy and hasn't set.

If this was a real person,

it would be a very weak femur and they'd be flopping about

on the ground.

What a disaster!

So, we've shown you that the cells in your body multiply by a process

called mitosis.

This, and the special growth plates at the end of your long bones

help you grow.

And we've shown you that growing bones has to take time,

otherwise you'd end up with floppy, soft ones.

Well, I must say, Xand, this is a much more responsible

sea life diorama.

No aquarium, and no risk of flooding.

I'll see you in the morning.

Right.

Swim time, everybody.

Meet Kayden, Maisie, Bolou, and Millie.

We're following them across the series as they let us know what it's

like to be a regular hospital outpatient.

They invite us into their lives, at home, and as they undergo treatment.

We're catching up with 11-year-old, Maisie.

Hello.

She has coeliac disease, which means she can't eat gluten.

I have a hospital appointment with the dietician.

She's the person who tells me if I'm doing my gluten-free diet correctly.

And I'm really hoping that she'll have my blood result.

If it's good, then I should be able to be eat oats.

So, that's super exciting.

Fingers crossed.

Maisie has regular tests to detect the levels of gluten

antibodies in her blood.

She needs her blood count to have gone down for her to be able to eat

those oats.

This was just after you were diagnosed...

-Yeah.

-And you were just under 32.

Today, it was just under 64.

-So, it's going up.

-OK.

-So, it means that there are some gluten

sneaking in somewhere, basically.

If you feel like you've stuck to it 100%, that's great,

but there could be some contamination

that we don't know about.

Uh-oh, some pesky gluten has crept into Maisie's diet.

If you're getting a bit of the runs,

have a sort of think about what have you eaten in the last 24 hours.

-Right.

-Keep a little diary if you need to, keep a little notepad.

-OK.

And it might be over time you start to see more of a pattern.

I found out that my results had gone up at quite a steep hill.

They were just under 64, so I can't eat oats,

which I'm pretty disappointed about.

Maisie's done well keeping an eye on her diet so far,

but there's a little bit more work to do.

See you later, bye!

Remembered Dominic with the pencil in his ear?

I do, Chris. I do.

I remember it very well.

Well, let's find out how he's getting along.

Good. Good, good, good, good, good plan. Good plan. Good plan.

Earlier, Dominic arrived in the emergency department with...

..with something stuck in my ear.

And no-one really knew what was stuck in there.

It could have been a flying, wobbly tooth,

a trampolining ant, or a tiger's marble.

Xand, the doctor said it was lead from a pencil.

BOTH: Ouch!

Dr Ashley tried to use a probe, then some forceps to remove it.

-Almost had it.

-And neither worked.

So, now it's third time lucky, we hope.

Dr Ashley is going to squirt warm water into Dominic's ear using

a syringe to try and flush the pencil out.

Now, I need you to stay very still for me.

And that dislodged it a bit,

so then I was able to go in and hook it out with the probe.

-Have you got it?

-Hurray, we've got it. There we go.

Success! It was a pencil.

The award for perseverance and bright ideas goes to

Dr Ashley Timings-Thompson.

We've managed to get the object out of his ear, so he can go home.

Any lessons learned, Dominic?

I've learned never to get something in my ear.

Good plan. Never get something in your ear ever again.

See you later, guys.

-Bye, everyone wave.

-Bye.

BOTH: Bye!

Still to come - Chris is put through his paces.

Keep going if you can, Chris.

And Ouch Patient Kayden returns.

Today's my last day at primary school.

Did you know that if a baby continues to grow at the rate

they do in the first year of their life,

by the time they reached adulthood they'd be over nine metres tall.

That's twice the height of a double-decker bus.

Wow!

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 Operation Takeover.

Can you guess who today's hero is?

Well, I'll give you a clue.

You'll have met today's hero when you were as old as this little guy,

but you won't remember.

Did you guess it?

Today's hospital hero is head midwife Simon.

In the UK, there are 700,000 babies born every year,

and luckily for us,

there are thousands of midwives who make sure they arrive safely.

Before mums go in to labour, the natural process when a baby is born,

midwives like Simon give special training called antenatal classes.

So, I want you to imagine you've got a really, really big bump.

So, one of the things that happens when you go into labour is you get

these pains that come across your tummy,

and your natural instinct would be to tense up.

So, one of the most important things you can do when you're a woman in

labour is be as relaxed as possible.

Simon has some top tips on relaxation techniques.

Right, I want you to imagine that you're sat on a really sunny beach.

Take a really big breath.

That's it. And out again.

No snoring, Xand.

So, in the next thing I'm going to teach you about is how to get

the baby in the best position.

So, you want it to be head down and its head either to one side

or the other side.

There are exercises to help with this too.

We've seen just how important midwives are for helping women

to deliver their babies.

But will our time as midwives be as smooth as a baby's bottom?

It's time for us to take over as midwives.

Your challenge today is you're going to teach an antenatal class to some

real pregnant women.

We're going to be judged on...

I have been going to antenatal classes

because my wife is about to have a baby.

Xand, how are you feeling?

I'm just wondering if I can use the birthing ball to sort of bounce the

babies out.

We'll both be trying our best with these three very kind mums-to-be.

I hope they know what they've let themselves in for.

Simon will be watching our every move.

First of all, how nice can we be?

Judging from bumps,

you're all fairly advanced in pregnancy and you're the most due,

-aren't you?

-Most advanced, yeah.

-OK.

-He's being really nice.

His eye contact and just his general manner was lovely.

Step aside for Grandmaster Nice.

Can we start off sitting on the balls?

Is that ball approximately OK for you?

-Yes, that's fine. Thank you.

-Lovely.

He's given Becky the biggest ball, which is good cos she's really tall.

Very nice. Really warm and friendly.

OK, time to relax.

Taking a really deep breath in through your nose

and out through your mouth.

And feel your shoulders going relaxed.

That's really good.

Really relaxed.

I really liked the visualising technique that he used.

Closing my eyes.

It was really good.

Top that, Xand.

What I want you to imagine is that you are on a beach,

maybe you can feel the sand, hear the waves crashing.

He's described it really well, the beach and the sea.

Touche, Chris.

Finally, how's our communication?

If the baby is a back labour position...

He's got the baby the wrong way round.

Get it right, Chris.

Should be head the other way.

LAUGHTER

He's the wrong way around, there.

Ha! Snap!

So, one of the really good things you can do,

if you stand up straight,

having a straight back with that nice lumbar lordosis we call it,

the curve of the back.

That was a bit technical.

Lumbar shmumbar, Chris.

Some of the words Chris used were a bit over my head.

It's actually quite terrifying to talk to a group of pregnant women

who are this pregnant.

If you come across a bit nervous, they might not believe what you say.

Put the pillow between your legs and just slightly tilt it over.

I'm getting the mums-to-be to try various positions to help get

the baby in the right one for it to be born.

Up to you, Chris, but I'm showing them how it should be done.

Pillow between your legs is to try and have the pelvis a bit more open,

and that allows for the baby's head to shift down a bit.

Trying more positions on ourselves rather than just talking about it

would have been maybe a bit more helpful.

Thank you very, very much indeed. Good luck.

Class dismissed. It's time for the verdict.

Simon, how did we do?

So, from a relaxation perspective,

the women felt relaxed in both of the classes.

-So, you did a good job.

-So, we're dead heat for relaxation, really.

Niceness, your mum would be really proud of you both.

-You're both really, really nice.

-Aw!

-Yeah.

So, it's down to the final category - communication.

Xand, you we're really quite nervous.

-OK.

-And Chris was quite happy to get the women to move around and do stuff.

-Oh.

-You tended to talk more about it.

Simon, who is the overall winner of today's challenge?

-Dr Chris.

-Oh!

-Yes!

You know what, this is the one challenge that I'm happy to lose

because it's quite important that you know what you're doing

when your wife has a baby soon.

If there's one thing we've learned today,

it's that midwifery is definitely best left to the professionals.

Time to hand our jackets back.

-Thank you very much indeed.

-Thank you.

Hi, everyone. Well, since we filmed Operation Ouch, I have had a baby!

Look at this. This is Lyra.

Ouch viewers, meet an Ouch baby.

All that Lyra does at the moment

is eat, and sleep, and scream,

and poo in huge quantities.

Don't you? So, she's a bit like her Uncle Xand, really.

Oi, cheeky!

Hi, I'm Kayden.

Last time we followed ten-year-old Kayden,

who has cystic fibrosis, to his hospital check-up.

Because of Kayden's condition, he has to have a special diet.

I have to have high fat food like cake and chocolate.

Kayden's high-fat diet is important because mucus clogs his pancreas

which produces the enzymes to help him digest his food.

My mum helps me monitor my food,

but I'm going up to my secondary school soon,

which means I'll have to monitor it a bit more,

which I'm not looking forward to.

Today's my last day at primary school,

and it's my leaving assembly.

I got a medal and a certificate for getting better at everything.

Well done, Kayden!

I'm just about to get my lunch.

As well as having a high-fat diet,

Kayden has to take tablets containing enzymes

which help him break down his food.

Miss Brown normally gives me my medication.

I have three tablets with my dinner...

..and I have two tablets with my pudding.

If he doesn't have his enzymes with his food,

he won't digest his food properly

and you get a really poor little bellyache, don't you, Kayden?

And sometimes, I have to do it all by myself.

I'm kind of excited, cos that means I won't have Miss Brown going,

"Take your tablet."

Thanks for following my story.

See you next time, bye!

Ouch!

XAND SIGHS

Er, Xand, where have you been?

I've been on a mountain climbing expedition.

I wanted to look at the effects of low oxygen levels on the human body.

This is something that could really help patients.

Well, that's true, but why did you have to go up a mountain?

Because, Chris, at the top of mountains,

there isn't very much oxygen.

Did you know there is also a place in London

where you can study exactly the same thing?

It's a lab, and I'm going there right now.

Time for Investigation Ouch!

I'm visiting the Extreme Everest Team

at University College London,

to find out why they're researching how some people

are better than others at surviving with low oxygen levels.

Here to tell us what they do is Dr Denny Levett.

We are a group of doctors who actually work in intensive care

looking after very sick patients.

Patients in intensive care have very serious illnesses,

and often have low levels of oxygen in their blood.

What we find with our patients, sadly, is that some people

perform much better when their oxygen levels are low than others,

and we need to understand that process better.

Having low oxygen levels is called hypoxia.

Your body needs a constant supply of oxygen, and if the levels drop,

your tissues and organs stop functioning.

So, if these doctors can learn how healthy bodies

survive on low oxygen levels,

it could unlock some treatments to help ill patients with hypoxia.

Now, because it's so hard to do science on severely ill patients,

the team here use themselves in experiments,

as well as some select volunteers.

This facility has special equipment which allows the team to recreate

low oxygen levels normally found at high altitude, up mountains.

And today, I'm going to be taking part in an experiment

to see how my body copes with low oxygen levels.

For the first part of the test,

I'm in a room of normal levels of oxygen.

I'm fitted with monitors so Dr Denny can see how my body copes

when exercising.

OK, Chris, off you go.

I'm going to cycle as hard as I can for six minutes.

Remember, this first test is at normal levels of oxygen.

So, how's he doing, Dr Denny?

The 99 is the oxygen levels in his blood.

Normal is anywhere from 95 to 100.

You're so normal, Chris! Well done!

OK, Chris, you can stop there now.

You've done the full six minutes. Well done.

So, we can see that the oxygen levels in your blood

are still normal.

So, even though...

..I'm totally out of breath and exhausted,

-I haven't been unable to get oxygen.

-Exactly.

Next, I'm going to do the same thing in a special chamber

that's had 50% of the oxygen removed -

the same as being 5,000 metres in altitude.

That's like being over halfway up Mount Everest!

What would happen if I stayed in this room overnight?

Well, the oxygen levels are such that actually,

if you stayed here for a long period of time, you would feel very unwell.

Best get this experiment started, then.

So, OK, Chris.

You can start when you're ready.

I'm doing the same six minute work-out

as I did outside the chamber.

But after only a couple of minutes,

I'm feeling the effects of the lack of oxygen in the room.

So, we can hear Chris breathing heavily already.

HE BREATHES HEAVILY

We can see his oxygen levels have started to drop.

That's way below normal.

And you can see Chris is finding this quite hard work now.

Keep going if you can, Chris.

I'm really struggling.

It's much, much harder work with less oxygen.

Chris's oxygen levels, as you can see, are getting lower,

and he's finding it hard.

And I'm going to stop you there, Chris.

HE PANTS HEAVILY

That was unbelievably horrible.

Like many sick patients in intensive care,

my body struggled to cope with low oxygen levels.

We need to study people who adapt quickly

and people who don't adapt so well

so we can see the difference between them is.

Although it's in the early stages of research,

by studying results like mine

with other people who coped better with low oxygen levels,

scientists like Denny hope to create new treatments that will help

the sickest patients in hospital,

those who are suffering with a lack of oxygen.

Ouch!

Chris, I cannot wait any longer.

I am bursting to know what's happening in A&E, aren't you?

-Yes, well, let's head back there, then.

-Right, come on, let's go!

Waiting with her mum in Sheffield Children's emergency department

is five-year-old Megan with a nasty knock on her noggin.

Gross alert coming up!

I'm waiting to see the doctor.

Well, let's find out what happened.

It was a beautiful sunny day,

and Megan was outside a pub garden walking along a wall...

Like a black cat ready to pounce. Meow!

Um, I guess so.

Or a tight rope walker at the circus.

-Erm...

-Wibbly wobbly!

Now you're getting carried away, Xand.

Megan was walking along a low wall.

-OK...

-When she got to the end of the wall, she walked down some steps,

but as she turned round to go back up, she tripped and fell head first,

banging her head.

BOTH: Ouch!

And it was bleeding.

Here to check out that banged bonce is Dr Robert Eastman.

When anyone's had a head injury,

it's important to assess the nerves coming out of the brain

to make sure that they've not been affected.

So, Dr Robert first checks the nerves that control

Megan's eye movement.

And then all the way down...

Had a look in her ears, had a look in her nose.

That's to make sure that if someone falls over

that they've not injured anything inside the nose.

Megan passes Dr Robert's tests with flying colours.

Now it's time to inspect the wound.

If I feel on your head here, does that feel OK? Yeah?

Just look up for me.

Uh, what's going on here?

Keep your eye on Megan's wandering fingers.

Uh, busted!

So, I was just pressing with my hands to make sure

the skin would go back together so we can Steri-Strip the wounds,

and that will close it up nicely.

Megan heads off to get those Steri-Strips stuck on,

but there's something worrying her.

It's only going to be cold water.

It's not cold water that's troubling Megan, Mum.

I don't want my socks on.

You don't want your socks on?

Is that going to affect your head? SHE LAUGHS

Everyone knows wearing socks affects your head, Mum.

So, all right, I'm going to start with the bit where it's not cut.

We'll get all this blood off.

With those Steri-Strips stuck on,

the skin on Megan's head will start to heal straightaway.

She'll be back to normal in no time.

And her socks are back on.

So, Megan, what have you learned today?

I've learned to be more careful.

Hopefully.

-Fingers crossed.

-Bye!

-Bye!

-Bye!

Next time on Operation Ouch! Chris goes wild in the jungle...

..Xand's got a watermelon on his head...

It's refreshing and delicious.

..and we get snippy...

As they say, it'll always grow back.

SIREN BLARES

We'll see you next time for more...

Operation Ouch!

Chris? Chris?!

Chris!

Chris, wait for me! Wait for me, Chris!

Xand, where have you been?

I've been up a mount...

BEEP

It's quite hard to do it. It's quite hard to do it.

Have you ever seen a mountain? They're massive!

Sorry.