Episode 2 A&E on the Road


Episode 2

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Transcript


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Racing to treat a patient in need of critical care.

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Can I have a crew, please?

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This is the West Midlands Ambulance Service.

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This could have been a fatal accident, 100%.

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A dedicated team of doctors and paramedics...

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-Hi, there. Want an ambulance?

-Don't like it when they cry.

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..they responded to a million 999 calls every year.

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Fighting to save lives.

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Basically went straight up in the air, crashing down.

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Because some emergencies are so severe...

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He's fractured his femur...

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..treatment must begin...

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-Now take a deep breath in, mate.

-..out on the road.

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I am grateful to every paramedic.

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If I could give them a medal, I would.

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Today, paramedics battle to help an injured motorcyclist.

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Right, it looks like your big bone at the top of your leg,

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-the femur, it looks like that's been broken.

-Oh, dear.

-OK?

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A lady collapses while out shopping...

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I says, "Jean, are you all right?"

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She says no. After that, she passed out.

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And Tracey and Dan rush a woman with a severe kidney infection to hospital.

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What's the matter?

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SHE MOANS AND SOBS

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Short, sharp breaths, like we said.

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There is always a burden on the Ambulance Service from call volume.

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We are expected to respond to anything, anywhere at any time.

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I quite enjoy working on my own.

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I find that what I'm doing,

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it's my decisions and I know what I'm doing and I feel I have got my

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confidence and capabilities to be able to do the best for people.

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It's early evening,

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and rapid response paramedic Ste Hill

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is blue-lighting it to the scene of a motorbike crash.

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We are on the way to a road traffic collision on the bypass in Lye.

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We are only a couple of minutes away.

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It's come through as the patient's come off his motorbike

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and he's been seen to be flung in the air.

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So there is a crew on the way.

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Obviously the job is outside.

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Motorbike, there is a risk of any sort of injury.

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Particularly if he's hit anything -

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pavements or a lamp post or something.

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It's a serious smash.

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But thankfully the biker is conscious and responding to the paramedics.

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Talk to me, Les, what happened today?

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I just run off the road, basically.

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Talk to me, Les. Were you knocked out at all?

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-No.

-Where is hurting at the moment?

-The leg.

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I'd finished work for the day.

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And headed back home.

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Round the ring road. Actually to the lights.

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And that's it.

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I can remember maybe about 150 yards of that ride across there

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and I can't remember anything else.

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Les has lost control of his bike and been flung 50 yards into an

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electrical cabinet on the roadside.

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What we're going to do, Les,

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we're going to have a good look at you.

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We will get you off the floor and keep you nice and still.

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And then we'll get you in the back of the ambulance

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-and we'll have a closer look at you, all right?

-Take a deep breath in.

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OK. Right, it looks like the big bone at the top of your leg,

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-the femur, that's been broken.

-Oh, dear.

-OK?

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Is there any pain there, mate?

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-No, mate.

-Any pain up here?

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Right, I'm just going to pop your boot off, mate. All right?

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Les has had a road traffic collision.

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He's come off his motorbike. We guess he's been thrown 50 yards down the road.

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Injuries at the moment - he's got a leg injury, upper leg injury.

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We reckon he has fractured his femur.

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Also suspecting some sort of abdominal injuries.

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We have been treating him with pain relief, some fluids.

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And we're going to mobilise him and he'll be off to hospital -

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all being well, very quickly.

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I suppose in the back of my mind...

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..you've always got that little doubt of the danger.

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Motorcyclists account for 21% of road deaths,

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despite making up just 1% of road traffic.

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Any early indications as to condition, whether it is

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going to be threatening or life-changing?

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Potentially, if he's got internal injuries,

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we'll treat it as life-threatening.

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For now. He's got an obvious fracture to his left leg,

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his upper left leg,

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we are suspecting he has got some sort of abdominal injury,

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because his blood pressure is quite low.

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How are you feeling, Les?

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-Sore.

-Sore? We're going to get you something for the pain.

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Now we've stabilised your blood pressure,

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we're going to get you something for the pain, all right?

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Just have a feel of the pulse in your foot, mate, all right?

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Can you feel this OK?

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Can you feel me touching your foot?

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-I can feel it, yeah.

-OK, mate, good lad.

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The impact has forced Les's shinbone through the sole of his foot.

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Right, what we're going to do now,

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while Laura's holding your head, have you seen these hard collars

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-that wrap around there like that?

-Yeah, I've seen them before.

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All right, we're going to pop one on you.

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What we're going to do with Les - and there's no easy way to do this -

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we're going to have to move him because he's wedged up against here.

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What we're going to do is roll him slightly to his left.

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He's got a nasty fracture to his thigh bone.

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One of the bones in his lower leg

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-has come through the bottom of his foot.

-OK.

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If you just sort of steady as best you can, mate, all right?

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Les, keep your arms crossed as tight as you can, mate.

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Tight as you can, good lad.

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Out of all motorists, motorcyclists tend to sustain the worst injuries.

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The nature of riding a bike with no protection around you,

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no airbags or seat belts, when you come off,

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you're going to hit something hard

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which is going to cause serious injury.

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I wouldn't want any of my family or loved ones to ride a motorbike,

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through what I've seen and the injuries that can be sustained.

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Ready, steady, roll.

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OK, yeah, I think we've got that.

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Just bear with us a minute, mate,

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we'll try and readjust this on the ambulance, all right?

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You're strapped in, you're not going to have much movement in your head.

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Just try and keep it as still as you can.

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We're detached from everything, aren't we?

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On three, mate. One, two, three.

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-That's the tubing, isn't it?

-Yeah.

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Potential nature of quite serious injuries to this gentleman.

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We're guessing a sort of pelvic and abdomen injury as well.

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So if that's the case, it could be life-threatening.

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Crew are on the way to Queen Elizabeth,

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they've just liaised with the major trauma desk in the control room.

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They've passed on an alert so they will be there in about 15 minutes.

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So, three people on the crew, we are not needed, so we will withdraw.

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We will go back and prepare for the next case.

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Five months after the incident, Les is faced with a difficult decision.

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It's been very traumatic.

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My left foot is totally shattered, to the point

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where surgeons have said that the healing time is going to be

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such a long process and that I could still end up losing the foot.

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So I have made the decision of

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actually having it amputated at this point.

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I think I was lucky that day to come away from the scene with my life.

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I haven't met the paramedic that helped me.

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But thank you.

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You do a fantastic job.

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Getting emotional now.

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I can't thank you enough. I really can't.

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Er...

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It's...

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I wouldn't be here without 'em, I don't think.

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So from the bottom of my heart, thank you.

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Sorry.

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I've been in the Ambulance Service about 18 months now.

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I started off in training school, came out on the road,

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fresh, and then picked up Tracey

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after about five months of being on the road.

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I became his surrogate work mum.

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I look after him.

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Yeah, she does look after me.

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I do think she's one of the best paras at Dudley ambulance station.

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By far.

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Just the way she is calm on jobs.

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That's definitely rubbed off on me.

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Dan has picked things up really quickly.

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So I have taught him well.

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She has taught me well, yeah.

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It's early evening and Tracey and Dan are en route

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to a woman in extreme pain.

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33-year-old female who has rang 111 this evening

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because she's got stomach pain.

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She's got a bit of back pain as well.

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She's got a headache...

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..and that's all we know at the minute.

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You all right, darling?

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Right, let's have a talk about what's going on this evening, then.

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What's the matter?

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It started Sunday evening, just severe pain in my left

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side of my stomach.

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Just under my rib. And that just gradually got worse.

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I was still able to function as normal yesterday,

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just every now and then doubling up in pain.

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And then last night I developed a severe headache and back pain.

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I couldn't sleep at all with it all night.

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-OK.

-It's just got worse and worse.

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I had been feeling unwell for a number of days

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but then suddenly that day it became so intense

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and it was hurting to breathe and hurting if I tried to walk.

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And I just knew I needed to get medical attention.

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So what prompted the call, because the pain just got too much...?

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It just got my so bad and my headache and my back

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and I couldn't even move.

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OK.

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Is it all right if I do a few obs on you?

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Are you all right to sit up?

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-It's really painful if I sit up.

-You'd rather lie down there?

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Right, I'll see if I can get to you.

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-Have you done your temperature or anything like that?

-No.

-OK.

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Let's have a look.

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There you go. You've got an infection somewhere.

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Right, show me where this pain is.

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-This area here.

-OK, all right.

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I was developing intense pain in the sort of mid,

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lower back either side of my spine.

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Just underneath where your ribs end.

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It was very, very tense,

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and when I tried to take a breath in,

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it felt like someone was squeezing

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something inside of me really, really tight.

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Which was very, very painful.

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In terms of what's going on, the way you describe the pain,

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you've got a bit of a temperature, you've got a headache, you don't feel like eating.

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It seems like it may possibly be a bit of a kidney infection you've got.

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When people get kidney infections they can be quite painful.

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Sometimes they've had a water infection that's not been treated

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and it's just got worse.

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You know, you need to see a doctor.

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And probably get some antibiotics sorted out for you

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before it gets any worse.

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Are you happy to pop up to A&E?

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OK.

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But before they can move her, Tracey and Dan need to get Melissa's

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pain under control.

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Try some Entonox.

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Hopefully it will take the edge off.

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All right? You've had it before, so just grip it with your teeth.

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Then it might make you a bit dry, it might make you a bit woozy.

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It wasn't helping it at all, was it, really?

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She was in quite a bit of pain.

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I'll go first.

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SHE MOANS

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All right, darling. Sick bag's there.

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As I said, I know it's not the best

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but obviously it's the best we've got for the minute, all right, OK?

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We will go to New Cross.

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Happy, Trace? All right.

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As my colleague said, looking like a kidney infection.

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With the kidneys, you have to be careful.

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We don't know how long she has had it or what is going on underneath.

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She is clearly in a lot of pain.

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She has clearly got quite a high pain threshold.

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Obviously she had the paracetamol so we can't give her anything stronger.

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She needs a few further tests, basically, that we can't do.

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-So we will see what happens there.

-SHE CRIES

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What's the matter?

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What's the matter, darling? What's the matter?

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Mm? What's the matter?

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It just suddenly got worse.

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Short, sharp breaths, like we said.

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Tracey and Dan, the paramedics, were really good.

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Lovely people, very patient,

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very calm, and I think you need that.

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When you're in a lot of pain,

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it can make you a bit panicked or flustered.

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And you need someone who is staying calm, is reassuring,

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and I think it's always good as well when they talk to you and try

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and distract you a little from your pain.

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All right, here we are.

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Yeah.

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OK?

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Right.

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She is feeling cold and trying to snuggle up,

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so I think there is definitely some sort of infection there.

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So hopefully... I don't know whether they will scan her or treat her

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with antibiotics and send her home.

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But, yeah, job done.

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Melissa reached hospital just in time.

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Doctors diagnosed her with kidney stones and a kidney infection.

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She was given antibiotics to treat the infection and passed

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the kidney stones six weeks later.

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A high proportion of the patients we tend are elderly.

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And what they're complaining of

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might be down to a chronic condition.

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For example, they might be having chest pain through to chronic high

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cholesterol and blood pressure.

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So we're dealing with the end result of sort of long-term conditions.

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More than half of people treated by the West Midlands Ambulance Service

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are over the age of 65.

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Ste is in Stourbridge, on his way to help an OAP in trouble.

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We are responding to a lady in her 70s who has collapsed outside

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Costa coffee in an indoor shopping precinct in Stourbridge town centre.

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Pulling up at the address now.

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Hello there, is it Jean?

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Hello there, my name is Ste.

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I'm one of the paramedics. What's happened?

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-I don't know.

-You don't know.

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What I want to do is check you over quickly and then we'll decide what we're going to do.

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Have you got any pain anywhere?

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We shop in Stourbridge every Friday morning.

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And we'd done the shopping, we were just going for coffee.

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And she bought me coffee to the table and I said, "I don't feel very well."

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I says, "Jean, are you all right?"

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She says no,

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and after she said that, she was violently sick

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and then she passed out.

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It appears your pulse is a bit slow in the wrists

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so it might be that your blood pressure is sort of a bit low.

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So I'm going to lie you on the floor, is that OK?

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Right, lie yourself down for me.

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Sit down, sit down.

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OK. Jean, I'm going to lift your legs up.

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We'll see if you start to feel any better like that.

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-OK?

-OK.

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One of the big things with low blood pressure is literally the pressure

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is that low that the blood doesn't get to your vital organs -

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ie your brain, you heart and your lungs.

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Five-two, can I have a crew, please?

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Can you back me up with an amber response?

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I've got a lady passed out with low blood pressure.

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If the blood supply to the brain is reduced,

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the easiest thing you can do is get the blood back there by lifting her legs off the floor.

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And it just causes, through gravity, blood to run back to the brain.

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-Do you feel any easier now?

-Yeah.

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She is starting to feel a little bit better,

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but she looks quite pale and clammy, so we are going to do a routine set of observations.

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We've asked for an ambulance to come

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and then we'll check her over more in depth on the back.

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Do you have any medical problems normally?

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-Yes.

-What do you suffer with normally?

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-My heart.

-Your heart?

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-And diabetes.

-OK.

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Jean has been diabetic for eight years.

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Diabetes is basically when your body can't regulate blood sugar levels.

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First and foremost, it would be high, as an undiagnosed diabetic.

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Quite often people who suffer from diabetes,

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it can cause their sugars to go low and that can cause them to have funny turns.

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Jean, the next test I want to do is take a spot of blood from the tip of your finger. Is that OK?

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-Yeah.

-Do you test your own blood sugars?

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-Yeah.

-You do. Do you know what number it normally is?

-About seven.

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About a seven.

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A normal reading for a blood glucose, a BM, would be between five and eight.

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-A little scratch on your finger, is that all right?

-Yeah.

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OK, just squeeze that on your finger for me. Thank you.

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All right. Your blood sugars are 15. Is that quite high for you?

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-Yeah.

-It is. Her blood sugars are quite high.

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They're 15. She's a diabetic, that's a lot higher than normal.

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Can you give my hands a really good squeeze with both hands, OK?

0:17:190:17:23

Close your eyes for me. I want you to hold your arms up in the air.

0:17:230:17:26

OK, that's lovely, pop them down.

0:17:260:17:28

We've done a quick survey of her neurological function,

0:17:290:17:32

which has proved OK.

0:17:320:17:33

So we're not suspecting a stroke at this time.

0:17:330:17:35

As soon as the ambulance gets here,

0:17:350:17:37

we will do more in-depth ECG and we'll have a look at her heart.

0:17:370:17:40

This isn't the first time Jean has collapsed.

0:17:400:17:43

Last September was the last one she had.

0:17:430:17:46

And it happened in Debenhams at Merry Hill.

0:17:460:17:49

Exactly the same thing, passing out.

0:17:490:17:51

This was the first time that I'd been there when it did happen.

0:17:510:17:56

And it was very frightening to see how ill she was.

0:17:560:18:00

If we sit you up, the chances are

0:18:000:18:01

you're probably going to go dizzy again. All right?

0:18:010:18:04

Would you have any objections to me popping a little needle into your arm? Or your hand?

0:18:040:18:08

We're going to give you some fluid, is that OK?

0:18:080:18:11

Just relax your hand.

0:18:110:18:12

We've given the lady some sodium chloride, basically salty water.

0:18:120:18:18

Fluid replacement, should bring the blood pressure up.

0:18:180:18:21

Hiya, are you all right?

0:18:210:18:24

-Hello.

-Right, this is Jean.

0:18:240:18:26

She is fully aware of what went on.

0:18:260:18:28

No pains. Obviously I haven't done a 12 lead where we are.

0:18:280:18:30

-I've discussed with her that we will do one in the back the ambulance.

-OK.

-All right?

-Yeah.

0:18:300:18:35

Give me your hand, my darling, nice and steady.

0:18:350:18:37

-OK?

-That's it, just have a breather a moment.

0:18:370:18:40

That's it, OK?

0:18:400:18:42

In the ambulance, the paramedics check Jean's blood pressure again.

0:18:420:18:45

Looks all right. Have a sit down.

0:18:460:18:48

29, 70, perfect.

0:18:480:18:49

-That's me.

-Have a sit down, Jean.

0:18:490:18:52

You were lying flat for a good 25 minutes, weren't you?

0:18:520:18:55

-Yeah.

-Yeah. And your blood pressure remained really low,

0:18:550:18:57

that's why we give you some fluid.

0:18:570:18:59

But as it is now, your blood pressure is quite stable.

0:18:590:19:02

But from what we've seen today, we would advise a trip to the hospital.

0:19:020:19:05

-Waste of time.

-If it is that you don't want to go...

0:19:050:19:09

No, it's not that. I don't mind hospitals.

0:19:090:19:11

No, obviously our advice would be to get it checked out.

0:19:110:19:14

If you don't want to go, that's fine.

0:19:140:19:16

Jean has made quite a good recovery

0:19:160:19:18

with the fluids we have given her. She responded quite well to it.

0:19:180:19:20

Her blood pressure has stabilised now.

0:19:200:19:23

We advised her to go to the hospital because low blood pressure

0:19:230:19:25

has caused her to have a collapse in a public place.

0:19:250:19:28

She has experienced it before and the experience she's had is she

0:19:280:19:31

doesn't want to receive any further treatment at hospital. This time she doesn't want to go.

0:19:310:19:35

Our advice would be to attend and the fact she doesn't want to travel with us,

0:19:350:19:39

we'll get her to sign our electronic paper device to state that she's

0:19:390:19:42

not going with us at this time.

0:19:420:19:44

But after passing out in the coffee shop,

0:19:440:19:47

Jean's condition deteriorated.

0:19:470:19:49

I couldn't get over it.

0:19:490:19:51

When I got home, I knew it was something different.

0:19:510:19:54

My sisters had to come down.

0:19:540:19:56

They took it in turns to look after me.

0:19:560:19:58

Eventually, Jean collapsed again.

0:19:580:20:01

I passed out at home.

0:20:010:20:02

I was unconscious for two hours.

0:20:040:20:06

When I come round, I phoned my son up.

0:20:080:20:12

And, obviously, an ambulance had to come.

0:20:150:20:19

They took me to hospital.

0:20:190:20:21

Where I was for two weeks while they did a load of tests to find out

0:20:210:20:26

what's the matter with me.

0:20:260:20:27

After weeks of uncertainty, Jean was told she had a faulty heart valve.

0:20:300:20:35

He says, well, you're going to have to have your heart done.

0:20:350:20:38

He says, because that is causing you to black out.

0:20:380:20:41

I ended up in Wolverhampton...

0:20:480:20:49

..to have my heart done.

0:20:500:20:52

Which they did.

0:20:540:20:56

Jean had a successful aortic valve operation.

0:20:560:21:00

But the tests discovered another life-threatening condition.

0:21:000:21:03

It turns out I've got cancer.

0:21:040:21:06

Which I don't mind having since you've got to die of something, for Christ's sake.

0:21:070:21:11

He says he's got to take most of my pancreas out,

0:21:110:21:14

some of the stomach, some of the bowel.

0:21:140:21:17

It is about five things he's got to take out.

0:21:170:21:19

And then just stitch it all together and I'll be fine.

0:21:190:21:22

Jean is putting on a brave face.

0:21:240:21:26

But it's been a difficult time for her.

0:21:260:21:28

Luckily, her best friend Joan has been with her throughout.

0:21:300:21:33

-Oh, thanks, darling.

-Nice cup of tea.

-Thank you.

-Nice cup of coffee.

0:21:330:21:36

Look at these photos here.

0:21:380:21:40

46 years ago, they were taken.

0:21:400:21:42

-Never.

-Stuart was two there and he's 48 now.

0:21:420:21:47

And you and I are lovely and slim and beautiful.

0:21:470:21:51

Joan is my family.

0:21:530:21:54

She's always been like my family.

0:21:560:21:58

She has been my best friend for 50 years.

0:21:580:22:02

And we've had an awful lot of laughter.

0:22:020:22:05

And happiness.

0:22:050:22:06

There's one particular night we went out and she was drunk

0:22:060:22:10

and she couldn't stop vomiting.

0:22:100:22:12

And she'd got a few false teeth.

0:22:120:22:14

So she took them out and I washed her false teeth under the tap.

0:22:140:22:18

That's what good friends are.

0:22:180:22:22

That's friendship, that is.

0:22:220:22:23

We've been very concerned about Jean because she's been quite poorly.

0:22:230:22:27

And I just hope that everything will turn out all right for her.

0:22:290:22:33

I think it's going to take a long, long time for her to get better.

0:22:330:22:37

But she's a very brave lady.

0:22:380:22:39

Very brave indeed.

0:22:390:22:42

My friend in there, she keeps saying I'm brave. I says, I'm not brave.

0:22:420:22:45

I'm just getting on with life.

0:22:450:22:46

Jean will soon have to undergo another operation.

0:22:460:22:50

Luckily, Joan will be by her side.

0:22:500:22:53

She always knows, I tell her where I am.

0:22:530:22:57

If you want me, I'm here.

0:22:570:22:59

50 years is a hell of a long time to be friends.

0:22:590:23:04

And we are very fond of each other.

0:23:040:23:07

-Very fond.

-It's important for anybody to have a friend.

0:23:070:23:12

You've got to have somebody you can talk to.

0:23:120:23:15

Or else you'd go barmy. Everybody should have a Joan.

0:23:150:23:17

Last year, nearly 12 million working days were lost due to anxiety,

0:23:240:23:29

depression and stress-related illnesses.

0:23:290:23:32

Try and calm yourself down, just concentrate on your breathing.

0:23:320:23:35

There is no one reason why anxiety and stress

0:23:350:23:37

is more common these days.

0:23:370:23:39

Stressful lives, financial difficulties,

0:23:390:23:42

lifestyle, can all contribute negatively to someone's health.

0:23:420:23:46

Dr Mike Greenway and medical student Jonathan Charles are on their way

0:23:460:23:50

to treat a woman who is struggling to breathe.

0:23:500:23:52

When we get there we will have to see what is going on.

0:23:520:23:56

It sounds as though she is unwell.

0:23:560:23:58

I'm not sure how old she is but she has a breathing problem.

0:23:580:24:01

It could be anything from anxiety to pneumonia or to asthma.

0:24:010:24:06

A flare-up of COPD or anything,

0:24:060:24:09

so we will have to see when we get there.

0:24:090:24:11

The patient has collapsed at work and is being treated by first aiders.

0:24:220:24:27

Hello. My name is Mike,

0:24:270:24:28

I'm one of the doctors with the Ambulance Service.

0:24:280:24:31

-Have you had these sort of things before?

-No.

-No?

0:24:310:24:34

OK. Did you suddenly feel all panicky,

0:24:340:24:37

tight-chested and tingling in your hands and all those sort of things?

0:24:370:24:40

-Yeah. I've gone dizzy. Every time I stand-up I feel I'm just going to drop.

-Right, OK.

0:24:400:24:45

You say you've not had it before?

0:24:450:24:48

Can I just borrow your hand, is that all right?

0:24:480:24:50

You're ever so cold and shut down, aren't you, there?

0:24:500:24:52

When we first saw Hannah, she was sat on the floor looking distressed.

0:24:520:24:58

She was breathing very fast and not really able to make eye contact

0:24:580:25:04

and speak to us properly.

0:25:040:25:05

This led us quickly to think this might be what is called a panic attack.

0:25:050:25:09

What I need you to do is to try to just settle your breathing for me.

0:25:090:25:13

That's going to be the important part.

0:25:130:25:15

OK? Just slow your breathing right down,

0:25:150:25:19

concentrate on taking slow and small breaths.

0:25:190:25:23

I felt sick, I felt dizzy,

0:25:230:25:25

I felt like my chest went so tight, I couldn't breathe.

0:25:250:25:29

And I think it was making me panic more

0:25:290:25:31

because I didn't know what was happening.

0:25:310:25:35

One of the problems is when you breathe fast it makes the

0:25:350:25:38

symptoms worse.

0:25:380:25:39

I was having some stresses at home and at work.

0:25:390:25:43

I think that might have possibly triggered my panic attack.

0:25:430:25:48

You all right? Just slowly take your breaths, that's it.

0:25:480:25:51

We'll just do a few observations, just check your blood pressure

0:25:510:25:55

and just see what's going on.

0:25:550:25:56

Cool, so you've got your monitory stuff?

0:25:560:25:59

The treatment for a panic attack

0:25:590:26:01

is to allow her to take control of her breathing.

0:26:010:26:03

So, when you take a breath in,

0:26:030:26:05

lift your shoulders right up, near your ears.

0:26:050:26:07

So take a breath in,

0:26:070:26:08

lift your shoulders right up near your ears.

0:26:080:26:11

Squash your ears with your shoulders.

0:26:110:26:13

And then breathe out and let your shoulders go down. Right down.

0:26:150:26:18

At the moment, we're allowing one person to do the talking

0:26:180:26:23

and helping her to calm down.

0:26:230:26:25

One, two, three.

0:26:250:26:27

It was scary, I couldn't breathe.

0:26:270:26:29

And I wanted to know why I couldn't breathe.

0:26:290:26:32

I sort of felt I was trapped in a hole.

0:26:320:26:35

In a weird way.

0:26:350:26:37

How is that tingling in your hands doing?

0:26:370:26:40

Yeah? Yeah.

0:26:400:26:42

Is it any better or any worse?

0:26:420:26:44

I don't know.

0:26:440:26:45

We needed to get her onto the back of the ambulance,

0:26:460:26:49

away from the eyes of her work colleagues.

0:26:490:26:52

So that she could feel in a safe environment and not feel judged,

0:26:520:26:56

able to calm down in her own time.

0:26:560:26:58

And just stand there for a minute... OK?

0:26:580:27:02

You feel like your legs are all jelly...?

0:27:020:27:04

Once Hannah was on the back of the ambulance,

0:27:040:27:06

she was really able to calm down fully.

0:27:060:27:09

Looking better already.

0:27:090:27:10

Are you feeling your fingers coming back a little bit more now?

0:27:100:27:14

They can stay numb for a while, but, yeah, you look less tense.

0:27:140:27:18

Have you felt yourself unfolding a little bit?

0:27:180:27:22

-Yeah, a little bit.

-Yeah, that's good.

0:27:220:27:25

It didn't take that long, about ten to 15 minutes.

0:27:250:27:29

But that was all she needed to really sort of get control.

0:27:290:27:33

How's that feeling now?

0:27:330:27:34

Are you feeling quite tired?

0:27:340:27:37

-I feel like my head's just not attached to my body.

-Dreamy.

0:27:390:27:42

-My head feels like... Yeah.

-It will come back slowly.

0:27:420:27:45

-So, now am I OK?

-It is a panic attack.

0:27:470:27:49

It's probably worse than you ever thought they could be.

0:27:490:27:52

Yeah, I've never had one.

0:27:520:27:54

In about half an hour, you'll be back to normal.

0:27:540:27:57

When I was in the ambulance and I was coming round and I started talking more

0:27:570:28:01

and I started looking a little bit better than I was,

0:28:010:28:05

they said that I have suffered a panic attack.

0:28:050:28:09

So is my heart beating OK?

0:28:090:28:11

Well, it's beating fine. Your blood pressure is better than mine is.

0:28:110:28:14

Your oxygen saturation is, not surprisingly, 100%.

0:28:140:28:19

100%.

0:28:190:28:22

Can't get any better than that.

0:28:220:28:24

For someone your age, fit and healthy, that's fine.

0:28:240:28:26

Hannah has done really well in being able to calm down.

0:28:260:28:30

She was coaxed through it by

0:28:300:28:32

our ambulance colleagues who did a great job.

0:28:320:28:36

She was able to avoid going to hospital.

0:28:360:28:40

Two weeks on and Hannah is back on her feet.

0:28:400:28:43

Since the first panic attack that I've had, I've not had a second one.

0:28:430:28:47

But, considering the first one was quite bad and scary,

0:28:500:28:56

it does make me more aware of - they can come on at sort of any time.

0:28:560:29:02

Hannah is a lot better now, she doesn't seem stressed.

0:29:020:29:05

She is calmer and she looks a lot more healthier now.

0:29:050:29:08

I think she's let everything all build up

0:29:080:29:11

and it just all got too much for her.

0:29:110:29:14

Right, where are we going?

0:29:140:29:16

The panic attacks were horrible.

0:29:160:29:18

I hope that I don't ever have one again.

0:29:180:29:22

But if I do, I sort of know

0:29:220:29:26

when it is coming and how to control it myself.

0:29:260:29:30

I think the doctors and the paramedics did a fantastic job that day.

0:29:300:29:35

They looked after my little girl, made sure she was better.

0:29:350:29:38

I am very grateful of what they did on that day.

0:29:390:29:45

It felt like they saved my life.

0:29:450:29:47

Right, so you're walking OK, but you're still feeling wobbly?

0:29:540:29:57

-Oh, very.

-Let's come back here.

0:29:570:29:59

I get called out to a lot of elderly people on their own.

0:29:590:30:02

Ranging from just a general safe and well check

0:30:020:30:05

right to the other end of the spectrum.

0:30:050:30:09

Can I have a look at your wrist?

0:30:090:30:12

Let's have a look.

0:30:120:30:13

We get called to a lot of falls with elderly, as well,

0:30:130:30:17

and again you just have to treat them with tender loving care.

0:30:170:30:20

It is early evening, and paramedic Kathryn Davies is en route

0:30:240:30:27

to a pensioner who has fallen in his garden.

0:30:270:30:31

Right, we've got an elderly gentleman

0:30:310:30:34

who has fallen on the floor.

0:30:340:30:36

Don't know if it's a mechanical fall or if he's had some sort of faint,

0:30:360:30:41

we don't know yet. He is unable to get off the floor.

0:30:410:30:45

It is reported that he's got some sort of back injury.

0:30:450:30:48

She's only few miles away,

0:30:500:30:52

but the traffic is causing problems for Kath

0:30:520:30:54

and an ambulance on a different job.

0:30:540:30:56

See, it's difficult at traffic lights when they're on red.

0:30:570:31:00

Because you don't want to push cars over

0:31:000:31:03

into the path of an oncoming car, but now they are green,

0:31:030:31:06

the cars still remain where they are

0:31:060:31:08

instead of just going to let us through.

0:31:080:31:11

They stop and you have to weave through them.

0:31:110:31:13

But people do panic when they hear blue lights and sirens behind them.

0:31:130:31:17

At the man's house, Kath is met by his daughter.

0:31:280:31:32

Where are we? Oh, we're here!

0:31:320:31:34

Hello, my darling.

0:31:370:31:38

What are you doing down there?

0:31:380:31:40

-You tell me.

-Malcolm was actually on the floor.

0:31:400:31:44

He had had a fall, no initial injuries.

0:31:440:31:47

But, again, he just could not get his self up off the floor.

0:31:470:31:51

Can you move this leg at all?

0:31:560:31:59

-Yes.

-Yeah? Can you bend it at all?

0:31:590:32:01

Good. Is that hurting?

0:32:040:32:06

No, it's just there, that's all it was.

0:32:060:32:08

-And you've got no pain at the bottom of your back?

-No.

0:32:080:32:11

I normally go at night, about half past five, to water the garden.

0:32:110:32:15

And I sat on the seat on the patio.

0:32:150:32:19

I've got this condition where I just fall asleep.

0:32:190:32:22

Fell off the seat.

0:32:220:32:24

I took a seat with me under the table

0:32:240:32:26

and knocked the table on top of me,

0:32:260:32:28

and all the plants. I couldn't get rid of it all, I couldn't turn over.

0:32:280:32:32

I panicked then because I thought, well...

0:32:320:32:34

And then I remembered I've got the house phone in my pocket.

0:32:340:32:36

He's been on the floor possibly three quarters of an hour.

0:32:360:32:40

Because these young ladies weren't in the house at the time.

0:32:400:32:43

They've come and found him.

0:32:430:32:44

Unable to lift Malcolm on her own, Kath radios for assistance.

0:32:440:32:48

I'm going to ask for an amber response because the patient is outside in the garden.

0:32:490:32:53

And he is quite cold, so amber response.

0:32:530:32:56

And we are going to need a crew with a manga ELK, please.

0:32:560:33:00

When we have elderly people on the floor, we have to look at ways

0:33:000:33:04

of getting them upright safely.

0:33:040:33:07

All the ambulances now carry a piece of equipment called a manga ELK.

0:33:070:33:11

It's a big lifting cushion and it's the only way now to safely lift

0:33:120:33:18

somebody up off the floor.

0:33:180:33:20

Have you done all these flowers?

0:33:200:33:21

-Yes.

-How fabulous is that?

0:33:210:33:23

It's beautiful. Did you used to be a butcher?

0:33:230:33:26

-Yes.

-You look like a butcher.

0:33:260:33:29

-You know why?

-Why?

-I've just seen your bike.

0:33:290:33:32

-Oh, I see.

-Yeah, I thought so.

0:33:320:33:36

-Hello.

-Hi, folks.

-Hello, are you all right?

0:33:380:33:42

Right, before we do anything, just look at this wonderful view.

0:33:420:33:46

-It's very nice.

-It is, it is.

0:33:460:33:47

We're going to try to get this cushion underneath your bottom.

0:33:500:33:52

-OK.

-OK? And then once it's underneath your bottom,

0:33:520:33:55

we're going to roll you onto your back so you are onto it.

0:33:550:33:59

-Yes.

-Then we are going to try and sit you up.

-OK.

-OK?

-Thank you.

0:33:590:34:02

Right. If you can just try and roll, nice and steady,

0:34:020:34:05

and we'll move the cushions with you.

0:34:050:34:07

-Keep going. You're safe, you're safe.

-Right, OK?

0:34:100:34:17

Nice and steady.

0:34:170:34:18

You're better sitting up.

0:34:190:34:22

OK?

0:34:220:34:23

How do you feel?

0:34:230:34:26

Right. What we'll do, we'll just try and stand you up.

0:34:280:34:32

If you can't get up, the seat is right behind you again.

0:34:320:34:34

All right? Do you want to try?

0:34:340:34:36

-Yes. OK.

-Shall we go after three?

0:34:360:34:38

-Yes.

-One, two, three.

0:34:380:34:41

Push, push.

0:34:410:34:43

Fabulous.

0:34:430:34:45

Right. OK?

0:34:450:34:47

We've got you, you're not going anywhere.

0:34:470:34:49

That's it.

0:34:490:34:51

Because of his age, we are going to take him up the A&E.

0:34:540:34:59

Mainly just for the daughter's sake as well,

0:34:590:35:02

because she's really concerned about him, says how pale he looks.

0:35:020:35:05

I mean, she knows her dad better than anybody.

0:35:050:35:08

He's just sitting there now, he is settling down.

0:35:080:35:11

But I'm happier with him going into hospital as well.

0:35:110:35:14

Yeah!

0:35:160:35:17

Be even better if you had had your pendant on you, wouldn't it?

0:35:170:35:20

-Yes.

-Eh?

0:35:200:35:22

-Consider yourself told off.

-Yes.

0:35:220:35:24

A lot of elderly people have an alarm in the house

0:35:240:35:28

and they also have either a bracelet

0:35:280:35:30

to wear with a big red button to press,

0:35:300:35:33

or one that's round the neck.

0:35:330:35:35

The amount of times we go to elderly people on the floor who have got

0:35:350:35:39

these alarms and they are hanging up on a picture,

0:35:390:35:42

or they are on the bedside table...

0:35:420:35:44

As far as you can, just lean back into the chair.

0:35:440:35:48

Put your arms on your lap...

0:35:480:35:50

Luckily he had brought his mobile phone out with him.

0:35:500:35:53

I had a phone call when I was driving home saying he had fallen.

0:35:530:35:56

So I came here and he was, he was out and he was shaking.

0:35:560:35:59

Very cold. And he said his hip was hurting.

0:35:590:36:02

Couldn't get him up, so we phoned the ambulance.

0:36:020:36:05

Right. OK?

0:36:050:36:07

-Thank you, Kathryn.

-You're welcome.

0:36:070:36:08

He knows he's supposed to wear his fob, but he doesn't like wearing it.

0:36:080:36:11

But if he hadn't got his phone, he would have been out here all by himself all night.

0:36:110:36:14

Malcolm was later given the all-clear in hospital,

0:36:180:36:21

and now wears his pendant all of the time.

0:36:210:36:24

Yes, I make sure I wear it now,

0:36:250:36:27

because I suppose they're life-savers, aren't they?

0:36:270:36:30

I mean, the week before my daughter was in Portugal,

0:36:300:36:33

so what would I have done?

0:36:330:36:35

They are life-savers without a doubt.

0:36:350:36:40

I love gardening, so I try to do as much as I can.

0:36:400:36:45

People used to say I was odd because I used to garden in the dark.

0:36:450:36:49

It worries my daughter what I do.

0:36:530:36:55

But she knows it's what I enjoy.

0:36:550:36:58

My son is the same, he worries about me.

0:36:580:37:01

I'm a bit stubborn.

0:37:010:37:02

I do it my way, they call me Frank Sinatra.

0:37:020:37:05

We cover a lot more distances than we used to.

0:37:150:37:18

And obviously people's expectations

0:37:180:37:20

have got greater. So it doesn't matter if it's a weekend,

0:37:200:37:23

it doesn't matter if it's the week, it is just as busy.

0:37:230:37:27

Paramedic Simone Armfield has been called to attend to a man who has

0:37:300:37:34

collapsed at home.

0:37:340:37:36

All right, we're off to Norton in Stourbridge.

0:37:360:37:40

And it is to a 64-year-old.

0:37:400:37:42

He is unconscious but we have been told he's newly diagnosed diabetic.

0:37:420:37:48

So obviously it might be a hypoglycaemic incident

0:37:480:37:51

where his blood sugars are low.

0:37:510:37:54

Hello. Where are we?

0:38:030:38:05

-Where is he?

-I'll show you.

0:38:050:38:07

Aw. Hello.

0:38:070:38:09

Was this young man's name?

0:38:090:38:11

Adrian.

0:38:110:38:13

I started to feel, well, just shaky and I kept falling over.

0:38:130:38:18

Oh, right.

0:38:180:38:19

Earlier in the day, I'd felt as if I've got quite a bad headache.

0:38:190:38:24

I felt quite lethargic.

0:38:240:38:25

Are you newly diagnosed diabetic?

0:38:250:38:28

You're an old professional, so you've been a diabetic for a while?

0:38:300:38:34

Let me just take your blood. Have you took your blood sugars yourself?

0:38:340:38:37

-No.

-No. So, in yourself, have you felt strange?

0:38:370:38:41

-Have you had any headaches?

-I have today.

-You have today.

0:38:410:38:44

-All day today?

-Yes.

0:38:440:38:45

The sensation was very strange on that day.

0:38:450:38:48

I'd never felt like it before.

0:38:480:38:51

When I have had a dip in my blood sugars,

0:38:510:38:53

I always know when that's happening

0:38:530:38:56

because my legs tend to start to get a little bit like jelly.

0:38:560:39:01

But on this occasion, it didn't feel like that.

0:39:010:39:03

So have you been sick at all?

0:39:030:39:05

No, no. I just feel tired.

0:39:050:39:08

And do you suffer with anything else other than your diabetes?

0:39:080:39:11

I don't know why but you took two antidepressants, haven't you?

0:39:110:39:14

What are these depression tablets that you're taking, then?

0:39:140:39:17

Are they something you've been taking for a long time?

0:39:170:39:21

-Yeah.

-OK. And you haven't taken more than you should today?

-No.

0:39:210:39:25

That day it was quite complex with Adrian,

0:39:250:39:28

because I know he did suffer from depression.

0:39:280:39:31

It was quite worrying for him and quite scary for him and his family.

0:39:310:39:35

because it seemed a neurological...

0:39:350:39:37

There was something neurological going on.

0:39:370:39:39

Have you ever been in hospital for anything at all?

0:39:390:39:42

How long ago was this?

0:39:440:39:46

So it's all been quite close?

0:39:490:39:51

And then it never happened again until today?

0:39:580:40:01

-Yeah.

-What are we going to do with you, then?

0:40:010:40:03

When you're a paramedic and you've got something acute,

0:40:030:40:06

it's quite easy to deal with because you know what you're going to do.

0:40:060:40:10

But when it's quite vague, it's like being a detective.

0:40:100:40:13

Unsure of what might be causing Adrian's symptoms,

0:40:140:40:17

Simone takes an ECG of his heart.

0:40:170:40:19

Well, that says you are normal.

0:40:210:40:23

-It's a waste of time.

-It isn't, not when you're not feeling right.

0:40:260:40:30

-DOORBELL RINGS

-That'll probably be the crew.

0:40:300:40:32

It's all right, there's an ambulance that came as well.

0:40:320:40:35

Why?

0:40:350:40:36

Hello!

0:40:360:40:38

-It's a reunion.

-Hello, sir.

0:40:380:40:41

Right, then. This is Adrian.

0:40:410:40:43

He's not with it, are you? It's the only thing that we can say.

0:40:430:40:47

He knows that he's a bit unsteady on his feet.

0:40:470:40:50

We were suspecting that maybe Adrian might have had a mini stroke, a TIA.

0:40:500:40:55

He might have a bit of dysphasia, where you confuse speech,

0:40:550:40:59

or he might have a weakness to a limb, or some slurred speech.

0:40:590:41:04

But it actually corrects itself within 24 hours.

0:41:040:41:07

And that was what we were querying.

0:41:070:41:10

When you woke up, you were feeling fine then?

0:41:100:41:12

-Yeah.

-Other than you felt a bit stressed, that's why you took your tablets.

0:41:120:41:15

When you took the sertraline, what time did you take it?

0:41:150:41:18

-About half past nine.

-And when did you start feeling bad?

0:41:180:41:23

Well, I didn't feel bad, I just felt a bit stumbly and sleepy.

0:41:230:41:28

And when was that?

0:41:280:41:31

So he started to feel unwell before he took the sertraline.

0:41:310:41:35

So he can't say it's the sertraline that's done it.

0:41:350:41:38

With the antidepressants ruled out as a possible cause,

0:41:400:41:43

and the team suspecting a mini stroke, Adrian must go to hospital.

0:41:430:41:48

We're going to pop you to the... I won't,

0:41:480:41:51

these lovely people will take you.

0:41:510:41:52

A trip up the hospital, get you checked out.

0:41:520:41:55

-Do some blood tests, like.

-Bit of peace of mind.

0:41:550:41:58

Adrian had to go in that day,

0:41:580:41:59

because even though his observations were fine,

0:41:590:42:02

there was obviously something abnormal

0:42:020:42:05

that needed more scans, more tests.

0:42:050:42:07

There's no sort of signs of a stroke at the moment.

0:42:080:42:13

He'll just be going at normal speed to A&E,

0:42:130:42:15

and obviously they can check him.

0:42:150:42:16

Whether he's going to have further tests afterwards,

0:42:160:42:19

whether he'll have some repeat scans, CT scans,

0:42:190:42:22

and obviously just some blood tests to make sure there's nothing else going on.

0:42:220:42:25

Three months later, Adrian is back home,

0:42:250:42:29

feeling optimistic about the future.

0:42:290:42:31

I've had various tests.

0:42:310:42:33

They've assured me that there's nothing serious that's shown up

0:42:330:42:37

on the tests as I've had up to now.

0:42:370:42:39

To get that news was very good.

0:42:390:42:42

When you don't understand what's gone on, you do imagine

0:42:420:42:46

all sorts of things that could or couldn't be there.

0:42:460:42:50

And to be told that there isn't anything serious,

0:42:500:42:54

but two or three more tests to see the specialist in four months,

0:42:540:42:59

is a relief. We are back to normal now.

0:42:590:43:03

Well, I'm feeling back to normal, but Diane might say differently.

0:43:030:43:07

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