Episode 2

Download Subtitles

Transcript

0:00:03 > 0:00:08Wrexham Maelor Hospital is the second-largest hospital in Wales.

0:00:08 > 0:00:09And for the first time ever,

0:00:09 > 0:00:13it has allowed cameras to follow its every move.

0:00:13 > 0:00:15You don't want to die, do you? Not at your age.

0:00:15 > 0:00:18With 34 wards and nearly 700 beds,

0:00:18 > 0:00:23it's a busy hospital and its children's ward is no exception.

0:00:23 > 0:00:25You don't know what's going to come through that door.

0:00:25 > 0:00:28We can see anything from surgical children that come in for

0:00:28 > 0:00:31tonsillectomies to complex children with heart conditions.

0:00:31 > 0:00:33Can I just hold your hand?

0:00:33 > 0:00:36Every year it sees over 5,000 children.

0:00:36 > 0:00:40Children are poorly, but they are very quick to turn round.

0:00:42 > 0:00:44Some are happy to be there.

0:00:44 > 0:00:46Others can't wait to go home.

0:00:49 > 0:00:52But they all have one thing in common.

0:00:52 > 0:00:54You will come home one day, I promise.

0:01:05 > 0:01:08Dr Nick Nelhans has always wanted to be a children's doctor.

0:01:10 > 0:01:14I think as a medical student, I didn't really have much idea what I wanted to do and I went through

0:01:14 > 0:01:17a phase where I was going to be a surgeon

0:01:17 > 0:01:19and then sort of decided it wasn't really for me.

0:01:19 > 0:01:24I think the thing that I really enjoy about kids is that

0:01:24 > 0:01:26because, as a general paediatrician,

0:01:26 > 0:01:28children can come in with any problem,

0:01:28 > 0:01:33from something really benign to something really serious.

0:01:33 > 0:01:36- How's the babies?- They are absolutely grand, thank you.

0:01:36 > 0:01:38- Great.- Yes, not got many, as you can see.

0:01:38 > 0:01:41- And there's one going home? - One going home, yes.

0:01:41 > 0:01:42Back down to South Wales.

0:01:42 > 0:01:47- Brilliant, brilliant. Well, shall we start the ward round, then? - Yes, absolutely. Come on, then.

0:01:47 > 0:01:50He's now one of the most senior doctors in Wrexham Maelor,

0:01:50 > 0:01:53the Clinical Director of Paediatric Services.

0:01:56 > 0:02:00A lot of being a consultant is a lot of administration and that sort of

0:02:00 > 0:02:03thing, so it's actually quite nice to get your hands dirty and see

0:02:03 > 0:02:05people and that's what I went into the job for, I guess.

0:02:05 > 0:02:07Good morning, and how are you and Indy?

0:02:07 > 0:02:08- Yeah, we're good.- Good.

0:02:08 > 0:02:12- Yeah, she's doing well. - She's snuggling in?- Yeah. - Tolerating feeds?

0:02:12 > 0:02:14- Yeah, really well.- Good. - She's breast-feeding on demand.

0:02:14 > 0:02:17- Peeing and pooing?- Yes, definitely. - Breast-feeding on demand?

0:02:17 > 0:02:20- Breast-feeding on demand. - Clever girl. Clever girl.

0:02:20 > 0:02:22Because you've got that variety of possibilities,

0:02:22 > 0:02:24you always have to try and think, you know,

0:02:24 > 0:02:28ahead of the game and the other thing I quite enjoy,

0:02:28 > 0:02:30even if children are quite poorly,

0:02:30 > 0:02:33if you do or you or the team do the right thing,

0:02:33 > 0:02:38they improve very quickly and it sort of appeals to my sort of

0:02:38 > 0:02:39short-term-ism.

0:02:39 > 0:02:40CHILD CRIES

0:02:42 > 0:02:44What? What?

0:02:44 > 0:02:45What's the matter?

0:02:46 > 0:02:50- Hello.- Hello.- Come to see you. How are you doing, Billy?

0:02:50 > 0:02:52- Fine.- Fine. Now...

0:02:52 > 0:02:55I think the other thing about kids is they're actually quite good fun.

0:02:55 > 0:02:58Let's see what they've said about you. And you obviously need to

0:02:58 > 0:03:00listen to this, to make sure we've not said anything wrong.

0:03:00 > 0:03:03So, 29 years old.

0:03:03 > 0:03:05- No.- Ten. Is that right?

0:03:05 > 0:03:07- Yes.- Cool.

0:03:11 > 0:03:13Next on Dr Nick's ward round,

0:03:13 > 0:03:15an 11-year-old girl in overnight

0:03:15 > 0:03:17because she's been struggling to breathe.

0:03:19 > 0:03:22Miss Lydia. I'm Dr Nelhans, I'm delighted to see you.

0:03:22 > 0:03:25Can I have a quick listen to you, is that OK?

0:03:26 > 0:03:29I'm going to have a quick listen to your chest and what I want you to do

0:03:29 > 0:03:31is really, really big deep breaths. Go...

0:03:31 > 0:03:33Can you do that?

0:03:33 > 0:03:34Cos I've got old ears, see,

0:03:34 > 0:03:37and if you don't breathe really, really loud,

0:03:37 > 0:03:40I'll think you're not breathing, I'll think you're a zombie.

0:03:42 > 0:03:44Wow.

0:03:44 > 0:03:45Lovely.

0:03:45 > 0:03:48And again...

0:03:48 > 0:03:49And again.

0:03:50 > 0:03:51And last one.

0:03:53 > 0:03:54Lovely. Well done, Lydia.

0:03:54 > 0:03:58Now, let's see how good you are at maths.

0:03:58 > 0:03:59Oh, God!

0:03:59 > 0:04:04I bet you're really good. So, in this, there's 100, yeah?

0:04:04 > 0:04:09If you take this without using that, how much gets into your lungs?

0:04:09 > 0:04:1050%?

0:04:10 > 0:04:1210%.

0:04:13 > 0:04:17However, you've answered my next question, if you use this and this,

0:04:17 > 0:04:18how much gets into your lungs?

0:04:18 > 0:04:22- 50%.- So that's five times as much medicine, so when you're taking your

0:04:22 > 0:04:25puffers, always use this.

0:04:25 > 0:04:28So, you're going to promise me you're always going to use that,

0:04:28 > 0:04:30aren't you? OK, Miss Lydia.

0:04:33 > 0:04:35Hello, Children's Ward ward clerk, can I help you?

0:04:37 > 0:04:40Levi, a 13-year-old Type 1 diabetic,

0:04:40 > 0:04:43hasn't done what he promised the doctors.

0:04:44 > 0:04:46It was this morning he got up sick.

0:04:46 > 0:04:49And he's been sick all day.

0:04:49 > 0:04:53He's had some drink, but he's been vomiting the drink back up.

0:04:54 > 0:04:57Last night Levi was out with his friends

0:04:57 > 0:05:00drinking high-sugar energy drinks.

0:05:00 > 0:05:03Type 1 diabetics are warned against doing this because their

0:05:03 > 0:05:05bodies don't produce insulin,

0:05:05 > 0:05:06which processes the sugar.

0:05:07 > 0:05:12Levi now has ketoacidosis and is in serious danger of slipping

0:05:12 > 0:05:13into a coma.

0:05:17 > 0:05:20- Why are you cross?- Because he doesn't listen to me...

0:05:22 > 0:05:24..when he's meant to.

0:05:24 > 0:05:26And he's not taking his insulin when he should do.

0:05:26 > 0:05:28Consultant Dr Kamal Weerasinghe

0:05:28 > 0:05:30is immediately on the case.

0:05:30 > 0:05:35Not taking insulin means Levi's body is now burning fat to produce energy

0:05:35 > 0:05:39which is releasing acidic ketones into his blood.

0:05:39 > 0:05:42This has serious life-threatening consequences.

0:05:42 > 0:05:43There's no time to waste.

0:06:24 > 0:06:26Are you and Levi friends?

0:06:27 > 0:06:28Not at the moment!

0:06:30 > 0:06:32I don't think... He's not friendly

0:06:32 > 0:06:35with anybody in the hospital now,

0:06:35 > 0:06:36is he? Yeah.

0:06:36 > 0:06:39But then the only thing is that he needs help now.

0:06:41 > 0:06:44He says he hates having it, doesn't like doing it.

0:06:44 > 0:06:46He hates having diabetes.

0:06:47 > 0:06:50Kamal says you're allowed one piece of ice.

0:06:51 > 0:06:53Sorry. I brought you a few.

0:06:54 > 0:06:57It's to freshen your mouth up.

0:06:57 > 0:06:58I'll pop it on there for you.

0:07:00 > 0:07:04Usually when they get to teenagers,

0:07:04 > 0:07:08their management is a little more tricky when they're diabetic because

0:07:08 > 0:07:11they, you know, they want to go out with their friends and they want to

0:07:11 > 0:07:15eat what their friends are eating and sometimes there's alcohol

0:07:15 > 0:07:18involved and partying until late at night and less sleep,

0:07:18 > 0:07:21so their management is a bit more tricky

0:07:21 > 0:07:24when they get to teenagers, yep.

0:07:25 > 0:07:29Not taking his insulin means Levi's blood sugars are out of control

0:07:29 > 0:07:33and his ketone level is eight times what it should be.

0:07:33 > 0:07:38He needs intravenous fluids to rehydrate the body and insulin

0:07:38 > 0:07:42to break down the sugar. But too much too soon

0:07:42 > 0:07:44could prove disastrous.

0:07:44 > 0:07:47It needs to be done slowly and carefully.

0:07:49 > 0:07:52This is the worst stages of the diabetes, apparently.

0:07:53 > 0:07:56Nobody hits this stage of diabetes, cos it's the worst.

0:08:01 > 0:08:03Our team has been visiting home,

0:08:03 > 0:08:06but even in spite of us visiting,

0:08:06 > 0:08:08nothing had worked very well.

0:08:09 > 0:08:10So basically...

0:08:12 > 0:08:17..for him, we'll attempt to retrain him, if possible.

0:08:18 > 0:08:21Teenagers, with teenagers it's not sometimes...

0:08:22 > 0:08:25Not with everybody, but some teenagers...

0:08:25 > 0:08:29But then this is one of the challenges with teenagers.

0:08:29 > 0:08:32Levi, can I just check your blood sugar and your ketones again?

0:08:39 > 0:08:42So, his ketones have gone up, 5.2.

0:08:44 > 0:08:48And his blood sugar is 18.7.

0:08:48 > 0:08:51His blood sugars are still too high.

0:08:51 > 0:08:54Nurses will keep checking on him every two hours.

0:09:06 > 0:09:11I'm Annabel, Oliver's big sister and he's my little...

0:09:11 > 0:09:13The tiniest brother I have.

0:09:15 > 0:09:20He's been having lots of problems, like sickness and operations,

0:09:20 > 0:09:23like on his heart because he had holes.

0:09:24 > 0:09:28Because of his heart, he couldn't breathe that well and he has to have

0:09:28 > 0:09:30an oxygen tank.

0:09:30 > 0:09:36But the doctors are letting him out without his oxygen tank.

0:09:36 > 0:09:37He just has it at night now, doesn't he?

0:09:37 > 0:09:39Yep, he just has it at night.

0:09:39 > 0:09:42Dr Nick Nelhans called us to the hospital.

0:09:43 > 0:09:46I'm pretty sure it was one of the nurses that rang, but I can't

0:09:46 > 0:09:49honestly remember. But they said I needed to come to the hospital

0:09:49 > 0:09:53as soon as possible and they'd had some test results back.

0:09:53 > 0:09:57So I went as fast as I could to the hospital and then...

0:09:59 > 0:10:01..he just... He told me that he was going to have...

0:10:03 > 0:10:06..issues and he told me what the name of it was,

0:10:06 > 0:10:09he gave me like a massive wad of paper...

0:10:10 > 0:10:12..of what the condition was and stuff.

0:10:13 > 0:10:16And then it was just... I don't really remember what happened from

0:10:16 > 0:10:20then. I remember running out of the hospital with Patrick

0:10:20 > 0:10:23and bursting into tears on some random person.

0:10:24 > 0:10:26It was not nice.

0:10:26 > 0:10:28It was awful.

0:10:28 > 0:10:33Oliver has a condition called 49, XXXXY.

0:10:33 > 0:10:37He has 49 chromosomes rather than the normal 46.

0:10:37 > 0:10:41It affects one in 100,000 and because it affects different

0:10:41 > 0:10:45patients in different ways, the long-term consequences are unknown.

0:10:47 > 0:10:52The only things that we knew was that he'd have developmental delays,

0:10:52 > 0:10:53learning disabilities,

0:10:53 > 0:10:57he'd have speech and language delays and he'd be infertile.

0:10:57 > 0:11:00Those were the things they could tell us would definitely happen,

0:11:00 > 0:11:03but the degree of which depends very much on Oliver.

0:11:03 > 0:11:06Yeah, he got quite agitated yesterday evening.

0:11:06 > 0:11:09- Any particular reason? - I think he couldn't breathe.

0:11:09 > 0:11:12- Yeah. It was just all...? - He just got a bit panicky.

0:11:12 > 0:11:15Yeah, yeah. Better have a little listen to you, then, young man.

0:11:17 > 0:11:20I met Oliver, I think, on the ward round the day after he was born.

0:11:20 > 0:11:24Hello, good buddy. Arranged for him to have some genetic bloods done

0:11:24 > 0:11:27which showed he had a very rare

0:11:27 > 0:11:31condition that I've never seen in my entire career,

0:11:31 > 0:11:35it's a very unusual syndrome and it's obviously had quite significant

0:11:35 > 0:11:37effects on his life.

0:11:37 > 0:11:39OK. And listening to his chest,

0:11:39 > 0:11:41there's a lot of transmittance sound,

0:11:41 > 0:11:43sort of nasal congestion sort of noises,

0:11:43 > 0:11:47but his actual chest itself sounds absolutely beautiful.

0:11:47 > 0:11:49He just sounds a little bit snuffly.

0:11:49 > 0:11:51Although he initially did quite well,

0:11:51 > 0:11:54at the beginning of December, he got a chest infection,

0:11:54 > 0:11:57which is obviously very common in children this time of year and after

0:11:57 > 0:12:02that he wasn't coping very well and ended up having cardiac surgery.

0:12:05 > 0:12:08We went home for 2½ weeks.

0:12:10 > 0:12:14It was a nice 2½ weeks and then we've been in hospital ever since.

0:12:14 > 0:12:16Despite being six months old,

0:12:16 > 0:12:19Oliver has shown no signs of wanting to feed,

0:12:19 > 0:12:21so the ward have been giving

0:12:21 > 0:12:25him an overnight liquid feed through a tube down his nose.

0:12:27 > 0:12:31Basically, he couldn't come home while he was on a continuous feed

0:12:31 > 0:12:33because he needed constant supervision

0:12:33 > 0:12:35and the longer he was in hospital,

0:12:35 > 0:12:38the more things he was catching and I just wanted him home,

0:12:38 > 0:12:41I just wanted to be a real family again and I wanted to...

0:12:41 > 0:12:46I wanted him to be able to mix with the other children and while he was

0:12:46 > 0:12:49stuck in hospital, it just wasn't going to happen.

0:12:49 > 0:12:53So now Oliver is scheduled to have an operation to put the feeding tube

0:12:53 > 0:12:55directly into his stomach.

0:12:55 > 0:12:59Once that is done, Oliver - and his mum - can go home.

0:13:08 > 0:13:11Next in, 16-year-old Gethin.

0:13:13 > 0:13:18Gethin's come in because he's got unexplained sores that come up

0:13:18 > 0:13:20periodically all over his body.

0:13:24 > 0:13:26It looks awful and it does look like a burn, doesn't it?

0:13:26 > 0:13:30And they come up really quickly so we've no idea why.

0:13:30 > 0:13:33And every time the consultant has seen him,

0:13:33 > 0:13:36they're all drying up so he said, "Right, next time...

0:13:40 > 0:13:43"Next time they come up, bring him in, onto children's ward."

0:13:43 > 0:13:45Because he's got open access,

0:13:45 > 0:13:48because he's deaf-blind, congenitally deaf-blind.

0:13:48 > 0:13:52He does have a bit of residual vision, so he can see a little bit,

0:13:52 > 0:13:53but not enough that they think it's...

0:13:55 > 0:13:57..functional. This is a new thing.

0:13:58 > 0:14:01He's only had it for a few months.

0:14:01 > 0:14:03We actually... School tried it.

0:14:04 > 0:14:08He goes to Seashell Trust in Manchester and they thought, right,

0:14:08 > 0:14:11we'll try a cane and see how he gets on.

0:14:11 > 0:14:14See what he does. Apart from the one time where he swung it around

0:14:14 > 0:14:16like a lightsaber, which was brilliant.

0:14:17 > 0:14:20Other than that, he marched off down the corridor and went, right,

0:14:20 > 0:14:24this is what I've been missing, this is, like, now my independence.

0:14:25 > 0:14:30The sores on Gethin's body need to be swabbed to test for bugs.

0:14:30 > 0:14:34But Gethin can't properly see or hear anything that's going on

0:14:34 > 0:14:38which makes a simple procedure difficult.

0:14:38 > 0:14:41- Do you think he'll turn over to you, Mum?- Yes, yes, he will.

0:14:41 > 0:14:45- Can he feel this first, because...? - Yeah, absolutely.

0:14:45 > 0:14:47- So he'll know what's coming. - I won't open it.

0:14:47 > 0:14:48Here you go.

0:14:48 > 0:14:52Just on the back of your neck, just here, just softly.

0:14:52 > 0:14:53Is that all right?

0:14:53 > 0:14:56- To Mum?- To Mum or to me?

0:14:56 > 0:14:58Mum or Roz, which is it going to be?

0:14:58 > 0:15:01- That's fantastic. - Very gently.

0:15:01 > 0:15:02Do your neck first.

0:15:02 > 0:15:05You can keep looking this way. Are you looking?

0:15:05 > 0:15:07It'll just be...

0:15:07 > 0:15:08It's not done yet.

0:15:08 > 0:15:11You're going to touch it, you're going to touch it.

0:15:11 > 0:15:13- Can I just hold your hand? - It'll be super quick.

0:15:14 > 0:15:17- All right, darling. - Well done, well done.

0:15:17 > 0:15:21Tiny one now, just you seem to have turned all the way round.

0:15:23 > 0:15:25Oh, where we going?

0:15:25 > 0:15:27- Run away!- I nearly got it.

0:15:27 > 0:15:29Are you going to come back?

0:15:29 > 0:15:32- Shall I go and try and catch him? - You could do.

0:15:34 > 0:15:38Attempts to swab Gethin's sores have moved from the nurses station

0:15:38 > 0:15:40to the corridor...

0:15:42 > 0:15:43..to the playroom.

0:15:50 > 0:15:52After a long chase, success!

0:15:52 > 0:15:54Fantastic.

0:15:54 > 0:15:59- Yay!- Good boy.- High five. Is that the tube it came out of?

0:15:59 > 0:16:00Good boy.

0:16:01 > 0:16:069pm, and through the rotating front doors go the day shift and the

0:16:06 > 0:16:10visitors to be replaced by staff who will look after the hospital

0:16:10 > 0:16:11until tomorrow morning.

0:16:13 > 0:16:15A night shift does tend to be a little bit quieter because obviously

0:16:15 > 0:16:17the children are asleep.

0:16:17 > 0:16:21Obviously it can be quite high stress if a little baby's poorly

0:16:21 > 0:16:24or you have someone come in to our high dependency unit, obviously,

0:16:24 > 0:16:28you know, all action stations go and sometimes people aren't aware

0:16:28 > 0:16:31of that, but it actually is quite busy behind closed doors.

0:16:33 > 0:16:39So, as soon as patients are discharged and leave the bed space,

0:16:39 > 0:16:42we strip the bed spaces down,

0:16:42 > 0:16:45get them all washed and then obviously this is one of the admission bays

0:16:45 > 0:16:48so it's ready for anybody else that needs to come in.

0:16:49 > 0:16:53And the first patient of the night, little baby Ada, who has jaundice.

0:16:53 > 0:16:56She has a yellow tinge to her skin.

0:16:56 > 0:16:59We've got a little one who might potentially be coming into us,

0:16:59 > 0:17:01needing phototherapy and we're wondering if we could borrow one of

0:17:01 > 0:17:04your phototherapy units and cots, if possible.

0:17:06 > 0:17:07Thank you!

0:17:09 > 0:17:12Jaundice is caused by a build-up of bilirubin,

0:17:12 > 0:17:17a yellow substance we all have in our blood when red cells are broken down.

0:17:17 > 0:17:20Trouble is, Ada's liver isn't getting rid of it as it should,

0:17:20 > 0:17:24so she looks a bit yellow and needs a bit of help.

0:17:27 > 0:17:29BABY CRIES

0:17:29 > 0:17:32We'll pop the baby in the hot cot to keep them nice and warm because

0:17:32 > 0:17:36we're going to strip them down so that they can get the best benefit from the light.

0:17:36 > 0:17:41The lights will help the baby to metabolise the bilirubin in their blood.

0:17:41 > 0:17:43I'll pop you in your cubicle.

0:17:43 > 0:17:46This is where she'll be living for the next few days and then obviously

0:17:46 > 0:17:50she'll keep having blood tests taken and then if the bilirubin levels

0:17:50 > 0:17:52come down in her blood, then she'll get to go home.

0:17:52 > 0:17:54- OK.- OK.

0:17:54 > 0:17:56Go on. Thank you.

0:18:00 > 0:18:02Let me get her sorted...

0:18:02 > 0:18:06And to protect sensitive newborn eyes from bright lights,

0:18:06 > 0:18:10Ada will be wearing felt sunglasses for the duration of her stay on the

0:18:10 > 0:18:12children's ward.

0:18:12 > 0:18:14There we are.

0:18:14 > 0:18:16A bit of Velcro, that'll do the job.

0:18:16 > 0:18:20I know they're not perfect but they're on, they're protecting her eyes.

0:18:23 > 0:18:28Right, you're going to have to try and settle down now. I know it's not like being snuggled up but...

0:18:28 > 0:18:30Come on, sh, sh, sh.

0:18:31 > 0:18:35At 11.30 at night, Levi, the diabetic teenager,

0:18:35 > 0:18:37who hasn't been taking his insulin,

0:18:37 > 0:18:40is still only being allowed a few crushed ice cubes.

0:18:42 > 0:18:45So, we'll do this then and I'll go get the other nurse to check your

0:18:45 > 0:18:47insulin ready for tonight, OK?

0:18:48 > 0:18:50What about the doctors about the drink?

0:18:50 > 0:18:52Yeah, as soon as I can get them.

0:18:57 > 0:18:59There we are. Better.

0:19:05 > 0:19:07Your blood sugars are 8.7.

0:19:09 > 0:19:12And your ketones are 2.4.

0:19:12 > 0:19:15So your ketones have gone up by 0.3 a little bit.

0:19:15 > 0:19:17They were 2.1 in the last reading, weren't they?

0:19:17 > 0:19:20But your blood sugar has come down from 11 to 8.7.

0:19:20 > 0:19:23His blood results are heading the right way,

0:19:23 > 0:19:25but are still far from normal.

0:19:25 > 0:19:28Nurses will continue to monitor through the night.

0:19:30 > 0:19:33He's getting really agitated cos he can't have a drink.

0:19:33 > 0:19:36OK. Have you offered him some ice?

0:19:36 > 0:19:38Yeah, he's had ice about half an hour ago.

0:19:38 > 0:19:40- He can have a little bit more.- Yeah.

0:19:47 > 0:19:52For Oliver, the little boy with the rare genetic condition, XXXXY,

0:19:52 > 0:19:54it's been a tough night.

0:19:55 > 0:19:59He's supposed to be going to Alder Hey today but he was up all night

0:19:59 > 0:20:03being sick and generally not very happy.

0:20:05 > 0:20:11But they're taking him anyway, so I'm guessing that we'll go and then

0:20:11 > 0:20:15they'll make the decision at Alder Hey as to whether or not it's safe

0:20:15 > 0:20:17to operate. In theory,

0:20:17 > 0:20:21we should be back tomorrow, but Oliver never does

0:20:21 > 0:20:23what Oliver's supposed to do.

0:20:26 > 0:20:28Are you going to be cross with me now?

0:20:28 > 0:20:30Yeah?

0:20:30 > 0:20:31Oh, don't make me feel bad.

0:20:33 > 0:20:36He gets over it quick. It'll be fine.

0:20:36 > 0:20:39Oliver, who was fed overnight through a tube down his nose,

0:20:39 > 0:20:43has yet again pulled out the tube.

0:20:43 > 0:20:46It's the reason he has to spend his nights in hospital.

0:20:47 > 0:20:50Put down the one he had it down anyway because he's more comfortable

0:20:50 > 0:20:51if he's having an operation.

0:20:53 > 0:20:56Right, let's pop this on your face.

0:20:58 > 0:21:00Oh, I know.

0:21:00 > 0:21:03Come here, darling. You're going to tell me off, aren't you?

0:21:06 > 0:21:07Has he got a vest on?

0:21:10 > 0:21:13No, he's on his fourth change of clothes

0:21:13 > 0:21:15since six o'clock this morning.

0:21:15 > 0:21:17So, no, we haven't put a vest on.

0:21:17 > 0:21:19Oh, dear.

0:21:19 > 0:21:22Today's operation in Liverpool will put the tube directly into his

0:21:22 > 0:21:26stomach. He won't be able to pull it out which means for the first time

0:21:26 > 0:21:30ever, Oliver can be safely fed overnight at home.

0:21:34 > 0:21:37- I'm sorry.- He's only making that noise to make you feel bad.

0:21:37 > 0:21:40- I know he is.- It's fake.

0:21:40 > 0:21:42It's pretend.

0:21:42 > 0:21:44Have you recovered a little bit now?

0:21:44 > 0:21:47Oh, I'm sorry.

0:21:47 > 0:21:49I'm sorry, sweetie.

0:21:49 > 0:21:50Oh, sweetheart.

0:21:55 > 0:21:58Hi, it's just Steph calling from Wrexham Maelor.

0:21:58 > 0:22:01We are supposed to be having a patient transferred over to yourself

0:22:01 > 0:22:05today for insertion of a peg, it's for Oliver Ashton.

0:22:05 > 0:22:09I was just wanting to make sure that you definitely had a bed for him before I send him.

0:22:11 > 0:22:13Yeah, fine, thank you.

0:22:13 > 0:22:14Thanks, bye-bye.

0:22:14 > 0:22:18- Do you want me to come back in 20 minutes then?- If you don't mind.- See how you're getting on.

0:22:18 > 0:22:21- Is that OK?- Yeah, that's fine. - All right, thank you.- Bye.

0:22:24 > 0:22:27Exasperated with her son's behaviour,

0:22:27 > 0:22:31Levi's mother has enlisted the help of his big brother Luke,

0:22:31 > 0:22:33who's come in to lay down the law.

0:22:36 > 0:22:37Do you want to sit there?

0:22:39 > 0:22:42So, what happened, then? Why are you in hospital?

0:22:42 > 0:22:44- I didn't take my needles.- Why? - It's not funny though, is it, Levi?

0:22:44 > 0:22:47Why aren't you taking them?

0:22:47 > 0:22:50I am taking them, just not taking them at the right time.

0:22:50 > 0:22:52What's more important than taking your needle?

0:22:52 > 0:22:54That can save your life.

0:22:54 > 0:22:55- Come on.- Nothing.

0:22:55 > 0:23:00So, would you rather go out and play and die or take a needle and be alive a long time?

0:23:00 > 0:23:03- Take a needle, obviously.- There you go. Otherwise next time you come in

0:23:03 > 0:23:06here, you won't be coming out. You'll be going out in a box.

0:23:07 > 0:23:09You will. You're lucky now, you just about missed it.

0:23:11 > 0:23:14You know what I mean? A bit longer, you'd have been dead.

0:23:14 > 0:23:16It's not going to take long, is it?

0:23:16 > 0:23:19It takes two minutes to put a needle in your arm.

0:23:19 > 0:23:23It would take about four hours if it was me, like, cos I'm scared of them.

0:23:23 > 0:23:27Do you know what I mean? You're not bothered, so it takes two minutes to come in, just go bump, and then

0:23:27 > 0:23:30you're back out to play then you can do what you want for the rest of the day, can't you?

0:23:30 > 0:23:32That's all you have to do, got to start listening.

0:23:32 > 0:23:35You don't want to die, do you? Not at your age.

0:23:35 > 0:23:37I'm scared of dying now and I'm 24.

0:23:38 > 0:23:41You'll end up dead, you will.

0:23:41 > 0:23:43Maybe the scare is what you need.

0:23:43 > 0:23:46I said that since day one, since you haven't been taking them properly,

0:23:46 > 0:23:48the scare will give you it, you know.

0:23:58 > 0:24:01I've just spoken to Alder Hey, you're going to hate me.

0:24:01 > 0:24:03- There's no bed, is there? - There's no bed.

0:24:03 > 0:24:05But they're going to ring me

0:24:05 > 0:24:10when there is a bed available and then I'll ring transport and get him

0:24:10 > 0:24:11sorted. I'm sorry.

0:24:11 > 0:24:15It's not as simple as that, because when they've got a bed, there won't be any transport.

0:24:15 > 0:24:17No, I asked the transport lady and said, look,

0:24:17 > 0:24:20cos we've already had it booked, if a bed's free today,

0:24:20 > 0:24:23how quickly can we get transport?

0:24:23 > 0:24:25And because you've already had it booked today,

0:24:25 > 0:24:28hopefully they'll be able to speed it up.

0:24:28 > 0:24:29But we're lunchtime already,

0:24:29 > 0:24:32they're not going to be able to do the operation today, are they?

0:24:32 > 0:24:34No. No, they're not.

0:24:44 > 0:24:47We just want to go home and be a family and now,

0:24:47 > 0:24:49I don't know how long we're going to have to wait.

0:24:51 > 0:24:53I know. It's rubbish.

0:24:54 > 0:24:56- Oh, I'm sorry.- It's not your fault.

0:24:57 > 0:25:00All right, as soon as something happens.

0:25:00 > 0:25:03- OK, no worries. - If you need to off-load and...

0:25:03 > 0:25:05I need coffee, is what I need.

0:25:05 > 0:25:07I can do coffee. Sugar and milk?

0:25:07 > 0:25:09- Just milk, please.- Milk, OK.

0:25:09 > 0:25:12Sorry, Mr. Oh, he's sleeping.

0:25:12 > 0:25:15Not leaving us yet, pal.

0:25:15 > 0:25:17Right, coffee, milk. Sort that out for you.

0:25:18 > 0:25:20Thank you.

0:25:21 > 0:25:23Are you going to be sick again? You look like you are.

0:25:27 > 0:25:31It's all right, dude, you've got a reprieve.

0:25:33 > 0:25:36Yeah, because he gets so sick with the anaesthetics, it's just like,

0:25:36 > 0:25:40you psych yourself up for it and it's like, and I was OK,

0:25:40 > 0:25:42I was stressed but I was OK

0:25:42 > 0:25:45and I've had a week where I've not slept very well.

0:25:45 > 0:25:48You know, I've had a couple of hours a night and that's it.

0:25:48 > 0:25:52And then this was like, we were going home,

0:25:52 > 0:25:57this was our next step towards home and now it's gone again.

0:26:00 > 0:26:03I don't know why I keep doing this, because every time they're like,

0:26:03 > 0:26:06"Oh, there's a chance you could be going home," I get all excited

0:26:06 > 0:26:09and I push for that and that's what I focus on

0:26:09 > 0:26:12and then it gets taken away and...

0:26:15 > 0:26:16We're back to stuck.

0:26:21 > 0:26:22Sweetheart.

0:26:22 > 0:26:25You will come home one day, I promise.

0:26:25 > 0:26:28You will. You'll be home one day, I promise.

0:26:28 > 0:26:30Yeah? Get tortured by your brother and sister.

0:26:31 > 0:26:33They're really looking forward to it.

0:26:39 > 0:26:42Having been forced to face his own mortality,

0:26:42 > 0:26:45Levi is finally playing ball.

0:26:46 > 0:26:47Have you got your pen?

0:26:47 > 0:26:50- Where's the pen?- There's your pen.

0:26:50 > 0:26:51Before the ward send him home,

0:26:51 > 0:26:55they need to know he's learnt his lesson and is capable of taking

0:26:55 > 0:26:57responsibility for his own diabetes.

0:27:01 > 0:27:03That's good, 0.1 for ketones.

0:27:04 > 0:27:06What was it before?

0:27:06 > 0:27:09He doesn't like it, like any teenager, you know?

0:27:09 > 0:27:13He doesn't want to do it, so we figured out a way how we can fit

0:27:13 > 0:27:17that into his life so he can still go to school,

0:27:17 > 0:27:19hang out with his friends and...

0:27:19 > 0:27:22Without feeling he's left out.

0:27:22 > 0:27:23Without feeling different.

0:27:23 > 0:27:27Eight, nine, ten.

0:27:27 > 0:27:31So, fingers crossed it'll go to plan and he's going to come back in

0:27:31 > 0:27:32another six to eight weeks' time,

0:27:32 > 0:27:35get seen in clinic and see how we're getting on.

0:27:35 > 0:27:38So he can go home today,

0:27:38 > 0:27:40if he keeps to it and his ketones stay down.

0:27:42 > 0:27:44OK. Well done.

0:27:44 > 0:27:46You've done really well then by yourself.

0:27:46 > 0:27:49- How did it feel?- Fine, cos I've been doing it for years.

0:27:49 > 0:27:52- Oh, so you're OK now?- Yeah, he's been doing it since he had it.

0:27:52 > 0:27:55Great, well done. I'm going to lock this away now, OK.

0:27:55 > 0:27:56Thanks.