0:00:02 > 0:00:08- What would a doctor discover if they lived with you...- Hello, Doctor, how are you?- ..24 hours a day?
0:00:08 > 0:00:11How much would you be willing to reveal?
0:00:11 > 0:00:13- Do you think you may be addicted?- No.
0:00:13 > 0:00:16Would they be shocked by what they find?
0:00:16 > 0:00:19- That's frankly pretty dangerous. - That looks horrible.
0:00:19 > 0:00:25Like most busy NHS GPs, Rangan Chatterjee only gets about ten minutes with each patient.
0:00:25 > 0:00:27Excuse me one second. Hello?
0:00:27 > 0:00:31Now, he's taking on the biggest challenge of his career.
0:00:31 > 0:00:34I believe that 99% of a patient's health outcome
0:00:34 > 0:00:37is what happens in that time outside the surgery room.
0:00:37 > 0:00:41He's about to live alongside individual families who struggle with their health.
0:00:41 > 0:00:43- Who needs help with what? - My lower back.
0:00:43 > 0:00:47- I feel out of control of my own body.- I'm worried about cancer.
0:00:47 > 0:00:53For the first time, he'll gain insight into every aspect of his patients' lives.
0:00:53 > 0:00:57This is a unique opportunity. I think I will be able to learn so much.
0:00:57 > 0:01:01- Do they cook fresh foods? Is this how you eat every day?- Pretty much, yeah. - Yeah?
0:01:01 > 0:01:05Is it a noisy street? Are there stressful relationships? SHE SIGHS
0:01:05 > 0:01:10All these things have a huge and significant role in determining their health.
0:01:10 > 0:01:13- Go!- He'll detect undiagnosed diseases.
0:01:13 > 0:01:17- I think you've already got it. - He'll deliver some home truths.
0:01:17 > 0:01:21- Do you get how serious this is? - He doesn't!- Yeah.- I...honestly want to help you.
0:01:21 > 0:01:25And discover ways we could all live longer, healthier lives.
0:01:25 > 0:01:27SHE YELLS I think it really has the potential
0:01:27 > 0:01:30to change the way we all look at health in this country.
0:01:30 > 0:01:35It's imperative that we do something about it - not tomorrow, but now.
0:01:44 > 0:01:45Ah, saved again.
0:01:45 > 0:01:47No. It's actually...
0:01:47 > 0:01:50No, it's there. I told you, that's the post.
0:01:50 > 0:01:52Over there.
0:01:52 > 0:01:55No...I saved it.
0:01:55 > 0:01:59The Ashton family live in Greater Manchester.
0:01:59 > 0:02:02Ray and his wife, Rachel, have two kids -
0:02:02 > 0:02:0413-year-old Chris and five-year-old Lucas.
0:02:04 > 0:02:06Oh, he missed again!
0:02:06 > 0:02:08Oh, no!
0:02:08 > 0:02:1147-year-old Ray has a lot on his plate.
0:02:11 > 0:02:14He's an IT manager for a local NHS trust.
0:02:14 > 0:02:18- Seven, eight.- And he also owns a bodybuilding gym.
0:02:18 > 0:02:22- Perfect, that, mate. Well done. - What do you do?
0:02:22 > 0:02:24What do I do? I look after everybody.
0:02:24 > 0:02:29Yeah. Rachel's very, very caring, very loving.
0:02:29 > 0:02:33- Go on, then, put it round there. - She's probably the rock of the family, if I'm being honest.
0:02:33 > 0:02:36Ray's health has got the family worried.
0:02:36 > 0:02:41Despite looking physically fit, he's suffered from back pain for decades.
0:02:41 > 0:02:44It's got to that point where nothing is helping.
0:02:44 > 0:02:49I can't sit, can't sleep, and I have to sit in a chair upright and try and fall asleep that way.
0:02:49 > 0:02:52I've forgot what it feels like to be pain free.
0:02:52 > 0:02:55In the last few years, Ray's pain has got a lot worse.
0:02:55 > 0:02:57If he doesn't get it looked into now,
0:02:57 > 0:03:01things might go to a point where they can't do anything about it.
0:03:01 > 0:03:04I mean, I'm very, very close to me children,
0:03:04 > 0:03:07but I could do more things with them and I know they'd love it.
0:03:09 > 0:03:11LUCAS LAUGHS
0:03:16 > 0:03:21Dr Rangan Chatterjee has practised medicine for 14 years.
0:03:21 > 0:03:24Now he's taking a break from his NHS surgery in Oldham
0:03:24 > 0:03:28to spend some time focusing on the Ashton family's problems.
0:03:28 > 0:03:32I'm going to get an insight into what parts of their life are linked in together -
0:03:32 > 0:03:36stress, diet, you know, work patterns.
0:03:36 > 0:03:39Whatever they are, they all feed into health.
0:03:46 > 0:03:50- Hi.- Hello, Doctor, how are you?- Yeah, good, how are you?- Wow! Aren't you tall? You'll have to duck.
0:03:50 > 0:03:55- Yeah, absolutely.- Duck in and come and meet the family.- Fantastic. Thank you very much, cheers.
0:03:55 > 0:03:58- This is my youngest, this is Lucas Ashton.- Hello, Doctor. - LAUGHTER
0:03:58 > 0:04:01Can I shake your hand? Hi, Lucas.
0:04:01 > 0:04:04- Who are these people sitting on the sofa?- That's my mum.
0:04:04 > 0:04:05That's your mum?
0:04:05 > 0:04:09The doctor will be immersing himself in the Ashton household
0:04:09 > 0:04:12to investigate every aspect of their lives.
0:04:12 > 0:04:16What I'd like to do, if possible, is just to try and get a bit of an overview,
0:04:16 > 0:04:19in terms of who needs help with what.
0:04:19 > 0:04:23- Me biggest issue that I've had for the longest period of time is me lower back.- OK.
0:04:23 > 0:04:26I've had me back problems for 20 years plus.
0:04:26 > 0:04:28When that flares up, that is bad, it stops me from sleeping.
0:04:28 > 0:04:32- And me neck is certainly an issue from an ache and pain sort of thing. - OK.
0:04:32 > 0:04:36I think it may all originate from me shoulder, because it is me shoulder that constantly throbs,
0:04:36 > 0:04:40- I can sometimes feel it coming right down me arms.- We'll look into all that.
0:04:40 > 0:04:44- Anything else apart from aches and pains?- I've noticed that as the pain's been getting worse,
0:04:44 > 0:04:47I've become more and more irritable.
0:04:47 > 0:04:49I imagine it's not just a few niggles here and there,
0:04:49 > 0:04:52I'm imagining you've got some serious pain issues.
0:04:52 > 0:04:54Ray isn't alone.
0:04:54 > 0:04:58Over 16 million Brits have suffered from back pain.
0:04:58 > 0:05:01Is there anyone else in the family who needs help with anything?
0:05:01 > 0:05:06Lucas has got really, really bad skin and we've been under different consultants, different doctors.
0:05:06 > 0:05:09Hydrocortisone cream, you know, all the lotions and potions.
0:05:09 > 0:05:14Lucas has eczema, a skin condition resulting in a painful, itchy rash.
0:05:14 > 0:05:18- Oh, your arms, as well? - It affects one in five children.
0:05:18 > 0:05:22- So what we're saying is what you've tried so far hasn't worked?- Yeah. - Right.
0:05:22 > 0:05:26I always am very, very sympathetic when kids have got skin problems,
0:05:26 > 0:05:28because I've had experience with my own son, OK,
0:05:28 > 0:05:31so I know... I know what that feels like as a parent,
0:05:31 > 0:05:34- when you see your child itching and you're struggling.- Yeah.
0:05:34 > 0:05:37I get it, it's a horrible feeling. Do you need help, Rachel?
0:05:37 > 0:05:39No, I don't think there's anything that I need help with.
0:05:39 > 0:05:41- So you've got a clean bill of health? - Yeah.
0:05:41 > 0:05:46- I guess it sounds like the focus is mainly going to be on Dad...- Yeah.
0:05:46 > 0:05:48- ..and Lucas.- Yeah.
0:05:48 > 0:05:54Rangan wants to find out how Ray is currently managing his back pain.
0:05:54 > 0:05:56- OK.- I'll be 100% honest with you,
0:05:56 > 0:05:59I used to eat over-the-counter meds for fun, painkillers,
0:05:59 > 0:06:03because I might wake up in the morning when I'm uncomfortable and me ankle's hurting, me back.
0:06:03 > 0:06:07When you say for fun, can you be a bit more specific? I mean, how many?
0:06:07 > 0:06:10I'll get up in the morning and have four of them in the morning.
0:06:10 > 0:06:14Ray starts the day by taking the anti-inflammatory ibuprofen.
0:06:14 > 0:06:17- So 800 milligrams?- Yeah.- And how many times do you do that in the day?
0:06:17 > 0:06:21- Probably twice a day.- Twice a day? - Yeah.- On this?- On that, yeah. - Pretty much every day?- Every day.
0:06:21 > 0:06:26- This is just paracetamol. - Paracetamols with caffeine. OK, how many of these are you taking?
0:06:26 > 0:06:29- Probably three of them in the morning.- Three of these?- Yeah.
0:06:29 > 0:06:33- I mean, the dose on here is one or two tablets every four hours.- Yeah.
0:06:33 > 0:06:36- So you're taking three in one go? - Yeah.
0:06:36 > 0:06:40- It sounds like you're aware that that's over the recommended dose. - Oh, without a doubt.
0:06:40 > 0:06:42And this is not... I'll be 100% honest with you,
0:06:42 > 0:06:46this is not a...a recent thing, that's probably last ten years.
0:06:46 > 0:06:49So I've started off with the recommended dosage
0:06:49 > 0:06:52and I've gone up and up.
0:06:52 > 0:06:54These drugs might be available over the counter,
0:06:54 > 0:06:58but by taking over the recommended dose for so long,
0:06:58 > 0:07:00Ray could be at risk of serious side effects.
0:07:00 > 0:07:04But these aren't the only pills he's using.
0:07:04 > 0:07:07- Talk me through some of the others. - Yeah.- I can see that there, which is a lot stronger.- Yeah.
0:07:07 > 0:07:11- So this is co-codamol.- Yeah.- And the highest strength that we have.
0:07:11 > 0:07:14- Honestly, how many are you taking? - Two of them every night.
0:07:14 > 0:07:18- Anything stronger than this?- Yeah, them was prescribed, tramadol.
0:07:18 > 0:07:21Again, that was to use in cases when they don't work.
0:07:21 > 0:07:23Cos this is stronger than the co-codamol.
0:07:23 > 0:07:25- And two of them is 100 milligrams. - Yeah.
0:07:25 > 0:07:30- How much are you taking a day?- I tend to only take them probably Saturday and Sunday,
0:07:30 > 0:07:33- maybe Friday, it depends.- So, basically, at the weekend
0:07:33 > 0:07:35- you're taking two of these in the evening.- Yeah.
0:07:35 > 0:07:39- But you're also taking this at the same time?- Sometimes, not all the time.
0:07:39 > 0:07:42- OK.- I tend to either have them or them.
0:07:42 > 0:07:45- Look, I mean, there's a lot here, isn't there?- Yeah.
0:07:45 > 0:07:48There is a bit more somewhere. I've got stronger ones, they're the 100 milligram ones.
0:07:48 > 0:07:52I'll be 100% honest - and this is why I'm reaching out for your help -
0:07:52 > 0:07:57I've got to a stage where I'm taking that dosage that I'm telling you and it's not really working.
0:07:57 > 0:08:01Tramadol and co-codamol contain chemicals that belong to a family
0:08:01 > 0:08:05of seriously strong painkillers known as opiates.
0:08:05 > 0:08:09Abusing them can have life-threatening effects on the brain.
0:08:09 > 0:08:13Some of these are addictive drugs...OK?
0:08:13 > 0:08:17And if you've been prescribed some of these since 2010,
0:08:17 > 0:08:20we're looking at five years -
0:08:20 > 0:08:25- do you think you may be addicted to opiates?- No.
0:08:25 > 0:08:30- OK.- You can say that, yes, I'm dependent on it. I will never believe that.- OK.
0:08:30 > 0:08:32And that's only because of the type of person I am,
0:08:32 > 0:08:36I believe I've got the power to do whatever I want. I can stop taking them tomorrow, which I have done.
0:08:36 > 0:08:41I've got to be up front with you - that is a huge amount of painkiller.
0:08:41 > 0:08:45- Where are you getting them all from? - The majority of them are prescribed.
0:08:45 > 0:08:48They're on a repeat prescription or I can get them from anywhere.
0:08:48 > 0:08:52- From...from anywhere?- I can get 'em off of the internet.- Right. And do you do that?
0:08:52 > 0:08:55I have done, yeah. I've done that in the past, yeah.
0:08:55 > 0:08:58I don't think we should beat around the bush, that's... That can be pretty dangerous.
0:08:58 > 0:09:01- That can have some serious consequences.- Yeah.
0:09:01 > 0:09:05- I've got to be up front with you. - Course you have, I understand that.
0:09:05 > 0:09:09Right at the start of this process, I've got to be blunt and up front with you
0:09:09 > 0:09:13if we're truly going to have a relationship that allows us to move on from this.
0:09:13 > 0:09:18That's been... That's been, frankly, very, very eye opening for me.
0:09:18 > 0:09:24Opiates are really strong painkillers that actually belong to the same family as heroin and morphine.
0:09:24 > 0:09:27I mean, yeah, they can be very effective at managing pain,
0:09:27 > 0:09:30the problem is they're highly addictive.
0:09:30 > 0:09:34Not only that, but he's buying these things online.
0:09:34 > 0:09:37The problem is, when you buy drugs online, you don't know what's in them.
0:09:37 > 0:09:41Even if it is the right drug, you don't know if it's past its sell-by date or not.
0:09:41 > 0:09:44The only safe way to take prescription opiate painkillers
0:09:44 > 0:09:47is to get them prescribed and managed by your doctor.
0:09:50 > 0:09:56Almost two million people in Britain have misused prescription painkillers in the last year.
0:09:56 > 0:10:00Ray's long-term pain is an issue the whole family have to cope with.
0:10:01 > 0:10:06Reading between the lines, it must be affecting him hugely.
0:10:06 > 0:10:10He is in pain, but he's not, like, rolling around in pain all the time,
0:10:10 > 0:10:12it's just... I think he's just used to it.
0:10:12 > 0:10:15- Is that hard for you to cope with? - He has got a temper.
0:10:15 > 0:10:20I suppose because he's tired all the time cos he doesn't sleep through because of the pain.
0:10:20 > 0:10:24- It's not necessarily at me, it's more at our situation.- Yeah.
0:10:24 > 0:10:26It's not really aimed at me.
0:10:26 > 0:10:29Er...and so I don't know.
0:10:29 > 0:10:31Sometimes I worry about him at work,
0:10:31 > 0:10:35I think he's going to come home one day from work and maybe he's going to have punched somebody.
0:10:35 > 0:10:38- Right.- In a meeting and things like that, cos he gets... He wouldn't. - Does he get angry?
0:10:38 > 0:10:41Just because he gets so worked up when he's trying to get a point
0:10:41 > 0:10:43across and people aren't listening to him.
0:10:43 > 0:10:45And I just think a lot of that is
0:10:45 > 0:10:48just down to his stress levels and things like that.
0:10:48 > 0:10:50It's really interesting, hearing your perspective.
0:10:50 > 0:10:55If there was just one thing that would change in the next four weeks, what would that be?
0:10:55 > 0:10:57- His pain.- His pain? - Yeah, help his pain,
0:10:57 > 0:11:02because then I think that'd have a knock-on effect with the sleep and the stress.
0:11:02 > 0:11:07I'm inclined to agree. If his pain went down, it'd be interesting to
0:11:07 > 0:11:09see what else gets better, as well.
0:11:09 > 0:11:13In spite of his debilitating pain, Ray works out every day.
0:11:13 > 0:11:16When did you get into bodybuilding?
0:11:16 > 0:11:20- I actually got into bodybuilding about early 20s.- Early 20s?
0:11:20 > 0:11:25- 21, 22.- When you started going to the gym?- When I started going there properly.- Yeah.
0:11:25 > 0:11:28I was only...I always remember, I was 10st 2lbs,
0:11:28 > 0:11:32but then also the combination of... I knew I had a bit of an issue with me back,
0:11:32 > 0:11:36I kind of thought if I strengthened it up, because I get a bit of advice from friends.
0:11:36 > 0:11:38They'd been to training and said, "What you might have to do
0:11:38 > 0:11:42"is start building your core up and you'll find it'll help your back out."
0:11:42 > 0:11:46- So I thought, "OK, I'll give it a go."- I've not had that much experience of bodybuilders.
0:11:46 > 0:11:50He's very, very big. I'm not sure whether there is maybe some steroid use going on,
0:11:50 > 0:11:54but I want to find out, is his relationship with his gym healthy, or has it gone too far?
0:11:54 > 0:11:57Is it actually quite unhealthy now?
0:12:00 > 0:12:05- Make yourself at home.- Oh, perfect, thank you. Fantastic!
0:12:07 > 0:12:11I'm feeling...pretty drained, actually.
0:12:11 > 0:12:14I think there's a lot to sort out here.
0:12:14 > 0:12:17I think these issues are quite complex.
0:12:17 > 0:12:21I think some of these issues have been going on for years and years.
0:12:21 > 0:12:25And, actually, now I'm slightly worried how much of this I can unravel.
0:12:26 > 0:12:30Rangan wants to observe every aspect of Ray's life,
0:12:30 > 0:12:34so he's staying the night to be with him for his usual 5:30am start.
0:12:41 > 0:12:45- Good morning.- Morning.- Have you had a good sleep?- Yeah, not bad.
0:12:45 > 0:12:47- There's your tea.- Oh, perfect. Thanks very much.- No sugar, no milk.
0:12:47 > 0:12:50- How was your sleep, by the way?- A bit hundred-mile-an-hour in me head,
0:12:50 > 0:12:53so a bit restless here and there and everywhere.
0:12:53 > 0:12:55Nothing major, but everything that's going on...
0:12:55 > 0:13:00In your head, yeah. I'm just going to quickly get myself ready and then I think, are you ready for work?
0:13:00 > 0:13:03Yeah. I'm going to open the gym first and wait till my day manager gets there
0:13:03 > 0:13:07- and then I'll just head up to where I work.- Right, so I'll just jump in the shower
0:13:07 > 0:13:10- and then maybe I can follow you today.- Course, yeah, yeah.
0:13:10 > 0:13:15- To see what...- I'll look forward to it. Thank you very much. Enjoy your tea.- Cheers. Thanks.
0:13:15 > 0:13:19I think, by most people's standards, it's a pretty early start,
0:13:19 > 0:13:23and if he's not sleeping well and he's getting up this early, you know,
0:13:23 > 0:13:26I wonder how much rest and recuperation he's actually getting.
0:13:31 > 0:13:35The first stop in Ray's busy day is his gym.
0:13:35 > 0:13:39A typical morning, you open up, you wouldn't have a workout at that point?
0:13:39 > 0:13:44No, I don't, no. I have me protein drink, go there, open up, wait for me day manager to turn up.
0:13:47 > 0:13:50- Yeah, you're not here to do any training.- So how long have you had this open now?
0:13:50 > 0:13:54- It's been open approximately two years now.- And you've been training for, what, 25 years?
0:13:54 > 0:13:58- 25 years, yeah. I first went in round about 16, 17.- Yeah.
0:13:58 > 0:14:00Walked into a gym, didn't like it.
0:14:00 > 0:14:04It was quite intimidating, I was a very, very slim person, very small,
0:14:04 > 0:14:07- I'm only 5'6" and a bit. - Is that why you started?
0:14:07 > 0:14:09I think that's the reason I first went into a gym.
0:14:09 > 0:14:11Cos if someone looked at you now,
0:14:11 > 0:14:13they at no point would think you're tiny and slight.
0:14:13 > 0:14:18I do think that. When I look in the mirror I still think I still see that little skinny lad that started.
0:14:18 > 0:14:22- Do you?- Yeah, yeah.- Do you think that's part of the drive to keep working out and keep getting bigger?
0:14:22 > 0:14:25I'll be honest with ya, I've been on a course of steroids before now
0:14:25 > 0:14:28and I've gone up to 16 and a half stone, but I still did not believe I was big -
0:14:28 > 0:14:32I still thought I was that 10st 2lbs person that walked into a gym.
0:14:32 > 0:14:36- So the initial reason to take steroids is to get bigger? - Yes, it was to get bigger.
0:14:36 > 0:14:42The example I always use is I say you will never see yourself grow, but you'll see yourself shrink.
0:14:42 > 0:14:48It's estimated that nearly 60,000 bodybuilders use steroids in England and Wales alone.
0:14:48 > 0:14:53They can be very dangerous, increasing the risk of heart attacks and high blood pressure.
0:14:53 > 0:14:55Ray may not take them any more,
0:14:55 > 0:14:59but it's clear that being big is still very important to him.
0:14:59 > 0:15:06He told me that when he looks at himself in the mirror, he sees that thin, almost scrawny young lad.
0:15:06 > 0:15:11I think most people will look at him and think, "That's a big, strong guy."
0:15:11 > 0:15:14But it's interesting, he doesn't see that when he looks in the mirror.
0:15:17 > 0:15:19With the gym open for the day,
0:15:19 > 0:15:22Ray has to get to the local hospital trust by 8am
0:15:22 > 0:15:25to get on with his day job as an IT manager.
0:15:25 > 0:15:28- How long have you worked here for? - 12-13 years.
0:15:28 > 0:15:32I don't always take annual leave and that is my choice - there's no pressure on me to do that.
0:15:32 > 0:15:34Thank you. Cheers.
0:15:35 > 0:15:38As well as working an intense 45-hour week...
0:15:38 > 0:15:40I'll get you a chair.
0:15:40 > 0:15:44..Ray is also on call through the night, two weeks out of four.
0:15:44 > 0:15:48- So this is basically where I spend most of my time throughout the working day.- OK.
0:15:48 > 0:15:52Sat here...typing away, looking busy.
0:15:52 > 0:15:56- And this is most I've ever seen these working now. - LAUGHTER
0:15:56 > 0:16:01- What is your perception of Ray?- He's a bit of a wrong 'un, in't he? - LAUGHTER
0:16:01 > 0:16:04But he's all right, yeah. Don't look in his drawer for all his drugs.
0:16:04 > 0:16:06LAUGHTER
0:16:06 > 0:16:11- Erm...- I that's not actually a lie, I do have painkillers here. - Oh, I see. Right, OK.
0:16:11 > 0:16:15I do have... Like I say, not a lot of people know about me ailments as such,
0:16:15 > 0:16:19but I do have painkillers out, just for when I do have...
0:16:19 > 0:16:23Cos again, take a few pills still sat here, have a drink and off I go.
0:16:23 > 0:16:25- It's not something... - So you don't want to, you know...
0:16:25 > 0:16:28- You wouldn't go off and have a walk and have a stretch.- No, no.
0:16:28 > 0:16:31- You would just pop a pill and keep going?- Yeah, definitely.
0:16:31 > 0:16:35- So, you're spending a lot of your day sat down?- Sat down, yeah.
0:16:35 > 0:16:37Like over a third of men in the UK,
0:16:37 > 0:16:43Ray is inactive at work and regularly sits at his desk for several hours at a time.
0:16:43 > 0:16:48- So standing for even four, five minutes, the pain comes on? - Straight away, yeah.
0:16:48 > 0:16:51- Sitting relieves the pain? - Yeah, definitely.
0:16:51 > 0:16:55But then when you get up from sitting, you can feel really, really stiff?
0:16:55 > 0:16:58- Yeah, yeah.- OK. So there's something not quite right there.
0:16:58 > 0:17:03He has a full life, there's lots of things going on, he cares about other people, his job,
0:17:03 > 0:17:05he doesn't take his annual leave.
0:17:05 > 0:17:09I noticed a passing comment, "Yeah, don't look in his drug drawer."
0:17:09 > 0:17:13And, as Ray pointed out, he does actually have a drawer of pills,
0:17:13 > 0:17:17where if he's having any pain, he'll take a painkiller.
0:17:17 > 0:17:20He doesn't want to bother anyone, he wants to just crack on and get the job done.
0:17:20 > 0:17:25In view of what I've been finding out over the last day or so,
0:17:25 > 0:17:28er, yeah, more alarm signs for me.
0:17:34 > 0:17:38At 5pm, Ray's still on the go and back down the gym for his daily workout.
0:17:40 > 0:17:43I think once I get through the door, it's that escapism,
0:17:43 > 0:17:46it's that forgetting everything that's gone on throughout the day.
0:17:46 > 0:17:48So I use it as Ray time, to get away from everything.
0:17:48 > 0:17:54In an average week, Ray can rack up 14 hours of weightlifting.
0:17:54 > 0:17:55But given his pain issues,
0:17:55 > 0:18:01seeing him put his body through so much stress is clearly a shock for Rangan.
0:18:01 > 0:18:04I'll do one more set on there, then I've done me three sets of ten.
0:18:04 > 0:18:07It's misleading to think that is healthy.
0:18:07 > 0:18:10This may surprise people, this may surprise Ray,
0:18:10 > 0:18:15but I would say at the moment, he's better off coming home and sitting on the sofa than doing that.
0:18:15 > 0:18:18- Do you feel the pain after? - Not directly after.
0:18:18 > 0:18:20I tend to find...just go home, shower,
0:18:20 > 0:18:23have some tea and then it's relaxation time.
0:18:23 > 0:18:28- And that relaxation time...is that when you feel the pain?- Yeah.
0:18:28 > 0:18:31- Yeah.- But as I'm training, I can't feel it.
0:18:31 > 0:18:34It almost seems as though you shut it out when you're getting on with your stuff,
0:18:34 > 0:18:37you're getting on with your job, you're getting on with your training,
0:18:37 > 0:18:41and it's only when you sit around and go, "Actually, I'm in a lot pain."
0:18:47 > 0:18:50Ray's lifestyle could be contributing to his pain,
0:18:50 > 0:18:53driving his dependence on painkillers.
0:18:53 > 0:18:55But before he addresses this,
0:18:55 > 0:18:59Rangan would like to run some medical tests to check for any underlying problems.
0:18:59 > 0:19:05- Actually, shall I get the red one? - It don't matter.- I'm not expecting to spill it, but, er, OK.
0:19:05 > 0:19:08A blood test will measure a number of things,
0:19:08 > 0:19:11from the condition of his muscles to his cholesterol levels.
0:19:17 > 0:19:19Okey-doke.
0:19:19 > 0:19:23But that's a big muscle, I'm just wondering if it's going to fit round there.
0:19:23 > 0:19:26High blood pressure is a major cause of heart disease and strokes
0:19:26 > 0:19:29and can be brought on by a number of factors,
0:19:29 > 0:19:31including physical and psychological stress.
0:19:31 > 0:19:33It's a smidgen high, actually.
0:19:33 > 0:19:38Normal blood pressure, really I would want to see about 120 over 80.
0:19:43 > 0:19:47Because Ray's been taking so many painkillers for so long,
0:19:47 > 0:19:49Rangan's concerned about dangerous side effects.
0:19:49 > 0:19:53He's back at home doing some research.
0:19:53 > 0:19:56My long-term goal has to be to get Ray off these opiates,
0:19:56 > 0:19:58but to do so, I really need him pain free.
0:19:58 > 0:20:01What's really worrying me at the moment, though,
0:20:01 > 0:20:06is he's taking over the recommended dose of over-the-counter drugs, such as ibuprofen,
0:20:06 > 0:20:10but also paracetamol, and that can cause permanent liver damage.
0:20:10 > 0:20:15I think the best thing to do would be to take him to see a liver specialist and to get a scan done.
0:20:16 > 0:20:19Unintentional paracetamol overdose
0:20:19 > 0:20:22is the most common cause of acute liver failure in the UK.
0:20:28 > 0:20:30Thank you.
0:20:30 > 0:20:34The liver's the one thing that possibly could be a problem.
0:20:34 > 0:20:38I'm a bit unsure, you know, he may find something.
0:20:38 > 0:20:41And, if I'm being honest, this is the biggest fear.
0:20:41 > 0:20:44- Ray Ashton?- Yeah.- Come on in.- Hello.
0:20:44 > 0:20:46Ray is having an ultrasound.
0:20:46 > 0:20:50This will reveal any damage caused by his overuse of painkillers.
0:20:51 > 0:20:54At the moment I'm looking at your liver.
0:20:54 > 0:20:59The body is dependent on the liver to manage chemicals circulating in the blood.
0:20:59 > 0:21:05Taking too much paracetamol can damage the cells in the liver, leading to failure.
0:21:05 > 0:21:09- And breathe away. OK, come and lie flat, and we're done.- Yeah.
0:21:09 > 0:21:11The scan is complete.
0:21:11 > 0:21:15Consultant hepatologist Dr Michael Heneghan has Ray's results.
0:21:16 > 0:21:19- Hello. Dr Heneghan?- Hi, nice to meet you. Michael Heneghan.
0:21:19 > 0:21:24- Dr Chatterjee. This is Ray.- Ray, good to meet you.- Pleased to meet you. - How are you?- Thank you very much.
0:21:24 > 0:21:28- Nice to see you today. - It's nice to see you, hopefully.
0:21:28 > 0:21:33I have to say that your... Your story frightens me in many respects,
0:21:33 > 0:21:36because I've rarely met someone
0:21:36 > 0:21:42who actually has as much paracetamol and as much ibuprofen on a sustained basis.
0:21:42 > 0:21:50And it seems like you have gotten into a habitual pattern or a habit of taking these drugs.
0:21:50 > 0:21:55And although paracetamol in itself isn't necessarily addictive,
0:21:55 > 0:21:59obviously you feel better when you take it.
0:21:59 > 0:22:02You've had an ultrasound earlier in the day and your liver
0:22:02 > 0:22:07is actually in remarkably good condition at this point.
0:22:07 > 0:22:11And I would reiterate that it is at this point.
0:22:11 > 0:22:14If this continues at its current level,
0:22:14 > 0:22:16it's really just a matter of time
0:22:16 > 0:22:20- before things take on a life of their own.- Yeah.
0:22:20 > 0:22:23- OK?- Yeah, yeah.- Yeah?- Yeah.
0:22:23 > 0:22:28- Thank you so much, we really appreciate your time. - Thank you very much.- Thank you.
0:22:28 > 0:22:32- RAY SIGHS How's that?- A shock.
0:22:32 > 0:22:36You know, when you hear it anyway, it's quite blunt, but...
0:22:36 > 0:22:41- Does it worry you?- Without a doubt. I think you was the one that worried me first,
0:22:41 > 0:22:43- the other day in the kitchen.- Yeah.
0:22:43 > 0:22:46To hear a GP look at me and go...
0:22:46 > 0:22:48You know, your head was nearly in your hands.
0:22:48 > 0:22:51- It was like, "Oh, my God!" So that shocks me.- It was...
0:22:51 > 0:22:54- And that was exactly the same thing in there.- He was shocked, as well.
0:22:54 > 0:22:58I mean, it was... You know, it was almost like, "Wow!"
0:22:58 > 0:23:01Already, I feel now, I could go home now and not touch a painkiller again in me life.
0:23:01 > 0:23:07- That's how I feel.- I'm seriously delighted to hear that, and let's see if I can help you do that.
0:23:07 > 0:23:09Yeah, definitely.
0:23:09 > 0:23:13I think that doctor was very, very clear, this is serious.
0:23:13 > 0:23:16If he continues to do what he's doing now,
0:23:16 > 0:23:18he'll be back in there within a couple of years.
0:23:20 > 0:23:25What I find difficult at the moment with Ray is that I'm bonding really well with him,
0:23:25 > 0:23:29and by doing that, actually, my authority as a doctor,
0:23:29 > 0:23:33it's still there, but I feel it's lessened in some way,
0:23:33 > 0:23:38that I can't really deliver him the same information as I would if I was back in the surgery.
0:23:38 > 0:23:42And so actually hearing that news from a different doctor,
0:23:42 > 0:23:47who he does have no bond with at all, I think that will have tremendous value for him.
0:23:49 > 0:23:54It seems that Ray is starting to get the message about the dangers of painkiller abuse.
0:23:57 > 0:24:01Rangan is back at home and he's switching his attention
0:24:01 > 0:24:05to Ray's five-year-old son Lucas, who suffers from eczema.
0:24:05 > 0:24:08I've got a son who I managed to get eczema free
0:24:08 > 0:24:12by looking at environmental factors, gut bacteria and the quality of his diet.
0:24:12 > 0:24:17I really hope that that kind of approach is actually going to get Lucas' skin much better.
0:24:17 > 0:24:19But I need to investigate a little bit further.
0:24:27 > 0:24:31The first thing Rangan wants to do is to take a close look at Lucas's skin.
0:24:31 > 0:24:33- You see where you've got itchy skin? - Yeah.
0:24:33 > 0:24:39It's like a big magnifying glass, this, so if I put it on, we can see a picture of your skin.
0:24:39 > 0:24:42Right, that's the light on. LUCAS LAUGHS
0:24:42 > 0:24:46- Is it funny?- Yeah.- It's not meant to tickle. Did that tickle you?
0:24:46 > 0:24:49- Yeah.- Do you know what doctors call it?- No.- We call it something called eczema.
0:24:49 > 0:24:53- Yeah. Call it some eczema.- Eczema.
0:24:53 > 0:24:55- Do you want me to tell you what eczema is?- Yeah.
0:24:55 > 0:25:00Eczema's a skin condition that causes your skin to be dry, itchy and red.
0:25:00 > 0:25:06- That's your skin, isn't it?- Yeah.- So, I don't know if you can see how dry the edges are of that spot?- Yeah.
0:25:06 > 0:25:10- Obviously, when you can see in detail, it looks quite raw there, doesn't it?- Yeah.
0:25:10 > 0:25:14The reason your mum tells you not to itch it, you see that top barrier of the skin,
0:25:14 > 0:25:18- the top comes off and it gets all red and itchy, doesn't it?- Yeah.
0:25:18 > 0:25:21It affects one in five kids and one in 12 adults.
0:25:21 > 0:25:24We're seeing it a lot these days. We don't know the exact cause of it -
0:25:24 > 0:25:28we know it's a mixture of genetics, but also your environment.
0:25:28 > 0:25:31- It can be different in each person. - Yeah.
0:25:31 > 0:25:35Can I have a look at the creams that he uses, and the emollients that he uses for his eczema?
0:25:35 > 0:25:40Rachel relies on a variety of creams to relieve Lucas' symptoms.
0:25:40 > 0:25:43This includes a prescribed moisturiser kept in his bedroom.
0:25:43 > 0:25:48- His other one is in the fridge, cos they told us to keep it in the fridge.- Any other emollient he uses?
0:25:48 > 0:25:52- No, that's the only one.- Just this one?- Yeah.- This is the cream you use every day?- Yeah.- All over the body?
0:25:52 > 0:25:54Just on his patches, I use it, to be honest -
0:25:54 > 0:25:58- on the back of his legs and his arms and his face, round his ears.- And do you find it useful?
0:25:58 > 0:26:03- I do think it helps, yeah.- I always encourage patients to use the emollients as much as possible.
0:26:03 > 0:26:05- Yeah.- Even when it's gone.- Yeah.
0:26:05 > 0:26:09Because it just keeps the skin hydrated and moist and healthy.
0:26:09 > 0:26:14- And it just means you're less likely to get flares.- Yeah.- Not impossible, but it's just less likely.
0:26:14 > 0:26:16So I think that's really good.
0:26:16 > 0:26:19These sorts of creams treat eczema symptoms,
0:26:19 > 0:26:23but Rangan wants to try and tackle the underlying causes of Lucas's problems.
0:26:23 > 0:26:25Eczema's a very complex disease.
0:26:25 > 0:26:27We don't know everything about it yet.
0:26:27 > 0:26:31There are many different causes, and often more than one cause in the same person.
0:26:32 > 0:26:35There could be multiple triggers round the Ashtons' home.
0:26:35 > 0:26:38First up, washing detergents.
0:26:38 > 0:26:42I'm looking for biological versus nonbiological.
0:26:42 > 0:26:45We know with some children, and some adults even with eczema,
0:26:45 > 0:26:48they're better off with nonbiological powder. Have you ever heard that?
0:26:48 > 0:26:52It's never made any difference, so I just generally buy whatever I buy.
0:26:52 > 0:26:56- This is Lucas's bed.- Can I have a look at the sheets to see what they're made out of?- Yeah.
0:26:56 > 0:27:01Material such as wool and synthetic fabrics could be contributing to the problem.
0:27:01 > 0:27:04- Typically, we try and recommend 100% cotton sheets.- Yeah.
0:27:04 > 0:27:07Again, I'm not saying that these are contributing,
0:27:07 > 0:27:09it's just we know that they can in some people,
0:27:09 > 0:27:11so I'm just trying to see what possible triggers are there.
0:27:11 > 0:27:14- It's 100% polyester.- Right.
0:27:14 > 0:27:19Some soaps, shampoos and other bathroom products might also be making things worse.
0:27:19 > 0:27:21Does he have a bath and do you put anything in the bath?
0:27:21 > 0:27:24He generally has a shower now, so he's in and out.
0:27:24 > 0:27:28- If he has a bath, I don't put anything in it.- The bubble baths, they can really dry skin,
0:27:28 > 0:27:32- they can irritate it and make it worse. Did you find that with Lucas?- Yeah.
0:27:32 > 0:27:37There's one final area that Rangan thinks might be a big player in Lucas's problems.
0:27:37 > 0:27:40- This one.- This one? His diet.
0:27:40 > 0:27:42- Yeah. Yeah.- Is that your favourite?
0:27:42 > 0:27:45- Yeah, Strawberry.- Strawberry.- Yeah.
0:27:45 > 0:27:48Lucas struggles to eat enough fresh fruit and vegetables...
0:27:48 > 0:27:50- Would he ever eat strawberries?- No.
0:27:50 > 0:27:55..and much of his diet is based on products containing wheat and dairy.
0:27:55 > 0:27:58About 10% of eczema cases are caused by foods,
0:27:58 > 0:28:01and these are two known dietary triggers of eczema.
0:28:01 > 0:28:04- So do you prepare his packed lunch every day?- Yeah, I do.
0:28:04 > 0:28:08He has more or less the same things every day. Like, today he's having a sandwich
0:28:08 > 0:28:13and he'll have a pack of breadsticks, a yoghurt and some raisins. And so that's it,
0:28:13 > 0:28:15that's... That's his lunch.
0:28:18 > 0:28:23- Is that your favourite?- Yeah.- Is he quite good with cereal?- He'll eat his cereal any time of the day.
0:28:23 > 0:28:27- Is it quite limited, what he has, then, would you say? - Oh, very limited, yeah.
0:28:27 > 0:28:31- Fruit, vegetables, anything like that?- No.- Not at all?- Not at all, no.
0:28:31 > 0:28:33- Not even a banana or...?- No.
0:28:33 > 0:28:36There's this big thing going off in my head, saying,
0:28:36 > 0:28:39- does he have some kind of sensitivity to wheat and dairy?- Hmm.
0:28:39 > 0:28:45- And the only way we would know is by what I'd call a well-managed exclusion diet.- Yeah.
0:28:45 > 0:28:50So, for a short period of time, exclude some important foods
0:28:50 > 0:28:54- whilst doing other things to see if there's an improvement.- Hmm.
0:28:54 > 0:28:57- And...- That would be a major thing, though, cos that's, like, what he lives off.
0:28:57 > 0:29:02Look at it this way - we could either not do anything and it can keep being a daily struggle for you,
0:29:02 > 0:29:07or, for the next few weeks, whilst I'm with you, we can try some things that, yes, will be difficult -
0:29:07 > 0:29:10there's no question - but they may potentially lead to things
0:29:10 > 0:29:13getting a lot easier for you quite quickly.
0:29:15 > 0:29:18I don't think Lucas is going to be up for the diet changes at all,
0:29:18 > 0:29:21because he finds it really hard to try new things and stuff.
0:29:21 > 0:29:25So we can't really take anything away without replacing it because otherwise he won't be eating,
0:29:25 > 0:29:27and if he doesn't eat, then he doesn't sleep.
0:29:27 > 0:29:31So I just think it's going to be really hard and I'd be very...
0:29:31 > 0:29:33It's not that I don't think it would work,
0:29:33 > 0:29:37I'm just thinking we're going to find it really hard to make the changes.
0:29:37 > 0:29:39I'm concerned about Lucas's diet.
0:29:39 > 0:29:4390% of what Lucas eats is wheat or dairy.
0:29:43 > 0:29:47These are two of the commonest food triggers for eczema
0:29:47 > 0:29:49and that's all he's eating.
0:29:49 > 0:29:52Now, I can't tell you that they are causing a problem,
0:29:52 > 0:29:56but what I can tell you is that it's definitely worth a short period of time
0:29:56 > 0:29:59where we try without, just to see what happens.
0:29:59 > 0:30:03I'm definitely sensing a bit of reluctance, though, from Rachel,
0:30:03 > 0:30:06and I think this is going to be quite hard.
0:30:06 > 0:30:10Having identified a few things that might be contributing to Lucas's eczema,
0:30:10 > 0:30:14the doctor now can focus on Ray's pain once more.
0:30:14 > 0:30:18In the UK, back, neck and muscle issues are so common
0:30:18 > 0:30:23that around 31 million days of work are lost each year as a result.
0:30:25 > 0:30:29Rangan is hoping that by studying the way Ray moves,
0:30:29 > 0:30:34he'll be able to get to the bottom of the back pain that has plagued him for 25 years.
0:30:34 > 0:30:40I'm a little bit nervous at the moment because Ray is a very, very complicated case.
0:30:40 > 0:30:46I've brought him here to London to see a chap called Gary, who I met through my NHS training.
0:30:46 > 0:30:48Hopefully, he'll be able to help.
0:30:48 > 0:30:52I can't help but thinking, I've seen other doctors, I've seen other specialists,
0:30:52 > 0:30:54they've not been able to help me,
0:30:54 > 0:30:57so what's this other expert got that they haven't got?
0:30:57 > 0:31:00Gary Ward is a musculoskeletal therapist,
0:31:00 > 0:31:04who specialises in addressing pain by teaching people to move differently.
0:31:04 > 0:31:07- Ray.- Gary, I take it.- Gary. Pleased to meet you.
0:31:07 > 0:31:10- You look like you work out a bit. - I do, yeah.
0:31:10 > 0:31:14I've been in and out of bodybuilding-type gyms for 25, 27 years, so...
0:31:14 > 0:31:17I've brought Ray down to see you because for many years
0:31:17 > 0:31:20he's had quite a lot of musculoskeletal problems, pains.
0:31:20 > 0:31:23- I think particularly shoulder and back?- Yeah.
0:31:23 > 0:31:27To touch on how it all started, me lower back was the first thing at a young age, 15, 16.
0:31:27 > 0:31:31I used to stand up watching football matches and I started to notice more and more
0:31:31 > 0:31:34the longer I was standing up, the more aching me back was.
0:31:34 > 0:31:38It wasn't no sudden thing, I was stood there for half an hour, I was like, "Oh, me back's aching!"
0:31:38 > 0:31:42So, was there anything as a child or as a kid that...
0:31:42 > 0:31:44may have happened to you that may have led to some back pain?
0:31:44 > 0:31:50Inevitably, I got... You know, fell out of trees and fell off walls and things like, you know,
0:31:50 > 0:31:53- you pick yourself up and off you go, so...- Have you had any surgeries?
0:31:53 > 0:31:58- Ever been under the knife at all for anything?- Only, I think - again I was a young teenager -
0:31:58 > 0:32:00I got jumped by some lads who shattered my jaw
0:32:00 > 0:32:03and I got wired up, but only that time, wired up for six weeks.
0:32:03 > 0:32:07- But that's only... - That's pretty important. - Oh, is it? Oh, sorry, right.
0:32:07 > 0:32:11- So shattered jaw. - They broke me jaw in both places, I had to be wired up.
0:32:11 > 0:32:16- When was this?- When I was about 15, so '83, '84.- OK.
0:32:16 > 0:32:20- I'm just trying to think now how old I'd have been. - Does that precede the backache even?
0:32:20 > 0:32:23Yeah, in terms of noticing it watching the football.
0:32:23 > 0:32:26OK, so, yeah, I think that's enough.
0:32:26 > 0:32:28So look straight ahead for me.
0:32:30 > 0:32:33These are the pressure distributions.
0:32:33 > 0:32:37- Does that mean there's nothing going through?- Yeah, not nothing, 12%.
0:32:37 > 0:32:42The pressure scan shows that Ray isn't distributing his weight evenly.
0:32:42 > 0:32:46The front of his left foot is taking half the load it should be.
0:32:46 > 0:32:51This is affecting his centre of balance, with serious knock-on effects.
0:32:51 > 0:32:54- You've got full-time tension in this right lower back area.- Yeah.
0:32:54 > 0:32:58Well, that's... When I'm standing all the time, that's exactly what I feel, yeah.
0:32:58 > 0:33:02- Feel like you're falling backwards? - Yeah.- Ray, are you OK to take your top off?
0:33:04 > 0:33:07The effects are most obvious in the way Ray walks.
0:33:07 > 0:33:10So when he's putting his left foot forward,
0:33:10 > 0:33:13- he's trying to do everything possible...- To keep his weight off his left foot
0:33:13 > 0:33:15Push your jaw to the right.
0:33:15 > 0:33:17There's quite a difference in the spine there.
0:33:17 > 0:33:21- I can see that just kinking to the right, so...- It kinks there, right? - Yeah.- Yeah.
0:33:21 > 0:33:24And then all kinking back towards his left and then back over towards his right,
0:33:24 > 0:33:27and then carries on up into the head, where we can see
0:33:27 > 0:33:30that the head is being carried higher on this side than this side.
0:33:30 > 0:33:34- Yeah, I saw that from the other side, I saw there's a tilt...- Yeah, he's got the little right tilt going on.
0:33:34 > 0:33:36- ..in his jaw, isn't there? - To the right.- OK.
0:33:36 > 0:33:41The legacy of Ray's broken jaw even determines the strength in his arms.
0:33:41 > 0:33:45- Ah.- Jaw forward, breathing in.
0:33:45 > 0:33:48- It's going to go, that one. - Yeah, I see it.
0:33:48 > 0:33:50OK. Jaw left.
0:33:50 > 0:33:55- So, is what I'm seeing, when his jaw's to the left... - It's weaker.- ..he's really weak?
0:33:57 > 0:34:00Having identified Ray's issues,
0:34:00 > 0:34:04Gary can start giving Ray some techniques to overcome them.
0:34:06 > 0:34:09Using wedges to reposition Ray's feet,
0:34:09 > 0:34:14Gary teaches Ray exercises that encourage his brain to start using forgotten muscles.
0:34:16 > 0:34:19This should help realign his spine.
0:34:19 > 0:34:22- What we call a dark zone. - Right.- So...
0:34:22 > 0:34:24Why do you call it a dark zone?
0:34:24 > 0:34:27Cos it's the kind of place that you didn't know that you could go,
0:34:27 > 0:34:30so the brain's not used to how to manage it, so it's learning, in my
0:34:30 > 0:34:32opinion, it's learning all the time.
0:34:32 > 0:34:36- So he's put himself in a position that he never normally gets into.- No.
0:34:36 > 0:34:38Knee into the front.
0:34:38 > 0:34:41- There you go.- How does this feel, Ray, at the moment?
0:34:41 > 0:34:43At the moment, it's quite uncomfortable, to be honest.
0:34:43 > 0:34:47Not in a painful way, but it's just I feel like I'm using muscles I've not used before.
0:34:47 > 0:34:51Mobility...in your spine is key.
0:34:51 > 0:34:54No need to hold it, get in and get out.
0:34:54 > 0:34:58Ray will have to repeat these specially tailored exercises every day,
0:34:58 > 0:35:01but already there are noticeable changes.
0:35:01 > 0:35:04- So he's not... He's using his pelvis to get into...- That's straight now.
0:35:04 > 0:35:07Yeah. Stand you up tall.
0:35:07 > 0:35:11Just take a straight look at the spine. You can hopefully feel it, as well, Ray.
0:35:13 > 0:35:15How do you feel at the moment?
0:35:15 > 0:35:18- Amazing. It's...- Really? - It's just...
0:35:18 > 0:35:21I just feel so... I just feel different in myself.
0:35:24 > 0:35:27I do feel a lot lighter underfoot
0:35:27 > 0:35:30It's like night and day, watching you walk from before.
0:35:30 > 0:35:32I mean, I can't tell you exactly what's different,
0:35:32 > 0:35:34but it's like two different people walking.
0:35:34 > 0:35:37- To me it seems smoother.- Exactly.
0:35:37 > 0:35:40Ray's pain is coming from his muscles and his skeleton
0:35:40 > 0:35:43and the way they interact with each other.
0:35:43 > 0:35:45So we need to re-teach Ray's muscles
0:35:45 > 0:35:48and re-teach his skeleton what normal is
0:35:48 > 0:35:51and then, hopefully, that will lead to better pain management.
0:35:51 > 0:35:54I'm going to take this away now and I'll be doing that every day.
0:35:54 > 0:35:57Thank you so much. I cannot thank you enough. That was great.
0:35:57 > 0:36:02To come down here and spend just a couple of hours with that man and feel how I do now,
0:36:02 > 0:36:06I am, for once in me life, lost for words after what's just happened in there.
0:36:06 > 0:36:09I just... It's just blown me away.
0:36:09 > 0:36:11There's still a long way to go with Ray,
0:36:11 > 0:36:17because, actually, there are so many layers of complex issues with him that that's just the start.
0:36:17 > 0:36:23There's a huge psychological element about multiple aspects of Ray's life which I need to delve into.
0:36:29 > 0:36:31Ray's blood test reveals signs of muscle damage,
0:36:31 > 0:36:34so for the next few days he's giving up pumping iron
0:36:34 > 0:36:39and instead he's doing Gary's movement exercises.
0:36:39 > 0:36:44Everything's improved. I just seem in a better mood at the...at work, at home, here at the gym.
0:36:44 > 0:36:50And it's only because... I've still got a few niggling issues with me sleep and me shoulder,
0:36:50 > 0:36:55but me backache's gone! That's the only way I can say it.
0:36:55 > 0:36:57So I'm just... I'm buzzing.
0:37:00 > 0:37:05I haven't seen Ray that excited over his health in a long time, cos usually everything's just negative.
0:37:05 > 0:37:07He felt so much better,
0:37:07 > 0:37:10it's obviously made a massive difference already.
0:37:14 > 0:37:17It's been a week since Rangan took Ray to see Gary...
0:37:17 > 0:37:22- Hey, Doc!- Hi, Ray. How you doing? - ..and he's popping round to check how he's doing.
0:37:22 > 0:37:24- Yeah, well, still on cloud nine, mate, still buzzing.- Are you?
0:37:24 > 0:37:29- Still amazing, still every cliche you can imagine, still. - Really?- Loving it, mate.
0:37:29 > 0:37:31Absolutely feel fantastic.
0:37:31 > 0:37:35Generally, the last few days, have you been taking less painkillers or...?
0:37:35 > 0:37:40- I... I kid you not, I have had no painkillers, mate, not a single one. - Not at all?
0:37:40 > 0:37:45- Not the over-the-counters, not the strong ones, nothing. Honestly. - Oh, fantastic!
0:37:45 > 0:37:51Whether that's in me head or what, I feel a different man, mate, honestly. You know, honestly.
0:37:51 > 0:37:55- Ray, I'm so happy to hear that. - So am I, honestly. - I'm delighted to hear that.
0:37:55 > 0:37:56- It's been... - I was just going to ask -
0:37:56 > 0:38:00you've come off painkillers, which I'm truly shocked at, but delighted.
0:38:00 > 0:38:03- Any side effects from that? Any withdrawals?- No, nothing at all.
0:38:03 > 0:38:06I kid you not, Rangan, honestly, I'm... I'm going to bed elated,
0:38:06 > 0:38:08feeling relaxed, feeling great.
0:38:08 > 0:38:12I get up in the morning, I'm having this new... I look forward to things.
0:38:12 > 0:38:16- It's a bit weird to explain it. So I think I'm in an even better mood at work.- Yeah.
0:38:16 > 0:38:21- You know, at the gym. Like I say, I'm a new man.- Good.
0:38:21 > 0:38:25- Right, I don't want to hold you up. - Right, thank you very much. Great to see you.
0:38:25 > 0:38:28It's common to experience side effects when coming off strong painkillers,
0:38:28 > 0:38:32and best to take advice from a doctor first.
0:38:32 > 0:38:35I think it's fantastic that Ray is off the opiates,
0:38:35 > 0:38:38but, you know, these are highly addictive drugs.
0:38:38 > 0:38:42I just hope that Ray can stay off them and that he has the willpower to keep going.
0:38:45 > 0:38:49With Ray's back pain and opiate use seemingly under control,
0:38:49 > 0:38:53the doctor is putting his focus back on five-year-old Lucas.
0:38:53 > 0:38:57He wants to see if it's a sensitivity to wheat or dairy
0:38:57 > 0:39:00that's contributing to his eczema.
0:39:00 > 0:39:05Today, Rangan is doing something he doesn't normally do for his patients - their shopping.
0:39:07 > 0:39:12Lucas is really, really fussy, but I really want to get him off wheat and dairy for a short period of time.
0:39:12 > 0:39:17That's 90% of his diet at the moment, and they're two very common triggers.
0:39:17 > 0:39:19I think because he's so fussy,
0:39:19 > 0:39:24I need to choose foods that he's familiar with, but just try and get alternatives.
0:39:24 > 0:39:27If Lucas's eczema is triggered by dairy products,
0:39:27 > 0:39:31they can be replaced by ones made from soya, almonds, coconut and rice.
0:39:34 > 0:39:38If he's sensitive to wheat, he can have corn-based cereals instead.
0:39:41 > 0:39:44You can try them all and see which one you like.
0:39:44 > 0:39:47It might get it all drier.
0:39:47 > 0:39:49Yeah, it might make your spots go.
0:39:55 > 0:39:59- Is it nice?- Yeah. - They won't go straightaway. - LAUGHTER
0:39:59 > 0:40:01- I liked it.- You like it?- Oh!
0:40:02 > 0:40:04- I didn't just make it... - Want some more?- No.- No, OK.
0:40:06 > 0:40:09- Do you know what I saw you eating this morning?- Yeah.- Yoghurt.
0:40:09 > 0:40:13- Whoa!- Who likes yoghurt?- Me.
0:40:17 > 0:40:20- RACHEL LAUGHS - I like that.- Do you like that? - Do you like it?
0:40:20 > 0:40:22Yeah. It's yummy.
0:40:22 > 0:40:26- Ah! You're going back for more?- Yeah.
0:40:26 > 0:40:30- Wow! Looks good, that. - Is that one nice?- Yeah.
0:40:30 > 0:40:34What's great about this, I think we were both worried - you probably more than me -
0:40:34 > 0:40:37but I was worried going round the supermarket thinking, "What's he going to like?"
0:40:37 > 0:40:40And we can also give you things to help the gut bacteria
0:40:40 > 0:40:43- that I told you about, you know the good and bad bacteria?- Yeah.
0:40:43 > 0:40:46Rangan wants Lucas to take probiotic supplements.
0:40:46 > 0:40:50He believes these live bacteria and yeast cultures strengthen the immune system.
0:40:50 > 0:40:54You can open these up, pop them in anything, whether it's a drink or whether it's his yoghurt.
0:40:54 > 0:40:59- (Skin get better?)- Yeah.- What do you think?- I think that it's them two.
0:40:59 > 0:41:03- It's all for you.- Yeah, all for me. - All for you.
0:41:03 > 0:41:06I mean, I think the yoghurt's sort of the easy one. I mean, I don't know what it tastes like,
0:41:06 > 0:41:09but it tastes quite similar and looks the same.
0:41:09 > 0:41:10Because a lot of things to him...
0:41:10 > 0:41:13I'm not quite sure about the milk, and that's not gone down,
0:41:13 > 0:41:17- cos usually if I give him a cup of milk, it's down the hatch.- Yeah.
0:41:17 > 0:41:21- We'll see how it goes.- Yeah. No, I know.- Got just them ones left.
0:41:21 > 0:41:24- Do you want to try one?- Yeah.
0:41:26 > 0:41:31The doctor's also keen to try replacing a few more things that could be triggering Lucas's eczema.
0:41:31 > 0:41:34- I've bought some new things for you. Do you want to open them?- Yeah.
0:41:34 > 0:41:39Hypoallergenic bedding instead of synthetic.
0:41:39 > 0:41:42- These are 100% cotton sheets. - Yeah.- We know that people react less to these
0:41:42 > 0:41:45than they might do to polyester or other materials.
0:41:45 > 0:41:51- Shall we go and try it?- And nonbiological washing powders to replace the biological ones.
0:41:51 > 0:41:55- Washing liquid, non-bio.- There's more things.- There's more things.
0:41:55 > 0:41:58- These are for Mummy, really.- Yeah. - Unless you do the washing.
0:41:58 > 0:42:02- You don't help with the washing, do you?- I do.- Do you?- Do you? - OK, we'll give it a go.
0:42:02 > 0:42:05I'm hoping all these things together, hopefully, we can make a difference.
0:42:13 > 0:42:17It's two weeks since Rangan took Ray to the movement specialist.
0:42:17 > 0:42:22His new exercise regime seems to have sorted out his back issues,
0:42:22 > 0:42:25but he's still suffering from residual shoulder pain.
0:42:25 > 0:42:30Rangan's checking up on how he's getting on without taking the addictive opiate painkillers.
0:42:30 > 0:42:33Feel quite happy about most things about life in general, it's good.
0:42:33 > 0:42:37- Have you felt any mood problems since you've come off the opiates? - No, not at all.
0:42:37 > 0:42:40From coming off the painkillers, I've had no adverse reaction at all.
0:42:40 > 0:42:43So, when was the last time you took co-codamol or tramadol?
0:42:43 > 0:42:49I've not took tramadol, all I've took is the co-codamol. I've not took a single tramadol at all.
0:42:49 > 0:42:51- But you have had to take something again?- Just for me shoulder.
0:42:51 > 0:42:55- And the shoulder's been bad for over a week.- When did you take the co-codamol?
0:42:55 > 0:42:58On the weekend, last weekend, on the Saturday and the Sunday.
0:42:58 > 0:43:00So about four days ago, four or five days ago you took some.
0:43:00 > 0:43:03That's just for me shoulder, yeah, just two co-codamol.
0:43:03 > 0:43:06Ray, I'm getting a little confused,
0:43:06 > 0:43:10because...I thought that since we'd seen Gary,
0:43:10 > 0:43:13you were saying that you've not taken any opiates at all.
0:43:13 > 0:43:16And I think you told me like, you know, "I can go and throw them away now."
0:43:16 > 0:43:20- I think if you remember...- But we didn't go and throw them away and I wish I had done that now.
0:43:20 > 0:43:23We've got to get something right here and we've mentioned it a couple of times -
0:43:23 > 0:43:26- sorry if I'm coming across irate cos I don't mean to be.- No, no.
0:43:26 > 0:43:29What we said we was going to do is get to the root cause.
0:43:29 > 0:43:32If we haven't got to the root cause the pain's still going to be there.
0:43:32 > 0:43:35I have two options then, Rangan, I suffer with the pain or I take painkillers -
0:43:35 > 0:43:38- what would you recommend?- I'd prefer you to have called me and said,
0:43:38 > 0:43:40"Look, I'm in a lot of pain, what shall I do now?"
0:43:40 > 0:43:45Because I would have said to you, "Don't take co-codamol"
0:43:45 > 0:43:49People who use opiate drugs tend to go back to them after about two weeks.
0:43:49 > 0:43:51- Yeah, yeah.- You have done that.
0:43:51 > 0:43:53What I would have probably said is,
0:43:53 > 0:43:56"Let's try a non-addictive painkiller," something like ibuprofen.
0:43:56 > 0:43:57- Been there, mate.- I know you have.
0:43:57 > 0:44:00The reason I think you've got a dependency problem, OK,
0:44:00 > 0:44:05is because when you need something, you go straight back to that.
0:44:05 > 0:44:08- There is some dependency issues. - I know, you've mentioned that four or five times
0:44:08 > 0:44:13and you keep on mentioning it, dependency. I am not dependent on taking opiate painkillers,
0:44:13 > 0:44:16I am dependent on being pain free.
0:44:16 > 0:44:19- I honestly want to help you, OK? - Right.
0:44:19 > 0:44:22- I don't want to agitate you.- I know for a fact, which I've proved,
0:44:22 > 0:44:24- I can give up whenever. - You haven't proved it, Ray.
0:44:24 > 0:44:27- Why have I not proved it? - Because you're back on them.
0:44:27 > 0:44:31- Because that's what gets rid of me pain.- Fine, but to say you've proved to me you can go without them,
0:44:31 > 0:44:36- I would disagree with that statement, OK?- We'll agree to disagree, then. - Yeah, fair enough.
0:44:36 > 0:44:40Had I known about the shoulder, I could have done something about it.
0:44:40 > 0:44:46So now I know that it's bad enough for you to have to take painkillers again, I'm on it, OK?
0:44:46 > 0:44:49- Yeah, yeah.- Yeah?- Great, yeah, yeah. I appreciate that.
0:44:49 > 0:44:52- Come on, let's get out of here. - Cheers, mate.
0:44:55 > 0:44:58With two weeks left with the family,
0:44:58 > 0:45:02Rangan's determined to do everything he can to also help Ray's son Lucas.
0:45:02 > 0:45:06- Can I have the new one? - You want the new milk, yeah? - Yeah.- Let's get you down, then.
0:45:06 > 0:45:09To tackle one possible cause of his eczema...
0:45:09 > 0:45:15he's been trying out soya milk and yoghurts in place of dairy.
0:45:15 > 0:45:16- Little sips.- Little sips.
0:45:18 > 0:45:21- Hiya.- Hi.- How are you?- Yeah, good. - Nice to see you.- You, too.
0:45:21 > 0:45:26Rangan wants to encourage Lucas to be even more adventurous with his diet.
0:45:26 > 0:45:28I've got lots of nice different colours here.
0:45:28 > 0:45:30I thought you might like colours.
0:45:30 > 0:45:35- You can try them if you want. - Want to try something? - Yeah, I'll try the oranges.
0:45:35 > 0:45:39- Go on, then.- Around a third of very young children in the UK are fussy eaters.
0:45:39 > 0:45:41- Is it nice?- Yeah. Yeah.
0:45:41 > 0:45:45At the moment, Lucas eats almost no fruit and veg.
0:45:46 > 0:45:48Mmm! Yummy.
0:45:48 > 0:45:50These contain vitamins and minerals...
0:45:50 > 0:45:52Makes you see better in the dark.
0:45:52 > 0:45:55..essential for a child's development.
0:45:55 > 0:45:56Ooh!
0:45:56 > 0:45:59- And egg!- Is it like an egg? RACHEL LAUGHS
0:46:00 > 0:46:03Mmm! Yummy.
0:46:03 > 0:46:07Obviously, all credit to the guy, he's trying them all. I'm really impressed he's trying them.
0:46:07 > 0:46:09- Is it nice?- Yeah.
0:46:09 > 0:46:11- Do you know what it is?- Erm...
0:46:11 > 0:46:14- That's a cherry.- Is it nice?- Yeah.
0:46:14 > 0:46:17- I think, for the time being, that's probably enough to try.- Yeah.
0:46:17 > 0:46:20From what you're saying, that's quite a lot for him to try in one go anyway.
0:46:20 > 0:46:24Yeah, that was a big achievement for Lucas, yeah, to even entertain it.
0:46:25 > 0:46:30Finally, there could be a hidden eczema trigger in Lucas's toys.
0:46:30 > 0:46:34- You know your bear?- Yeah. - You like Bear, don't you?- Yeah.
0:46:34 > 0:46:39Sometimes, like, bear might have some dust in him and that dust might be making your skin worse.
0:46:39 > 0:46:45- Stop! I don't like that. - Yeah? No, no, but what we do,
0:46:45 > 0:46:49if we put Bear in the freezer for a little while it gets rid of all that dust.
0:46:49 > 0:46:51Yeah, and get all rid of this.
0:46:51 > 0:46:55We'll get rid of the dust and that might, hopefully, within a few days,
0:46:55 > 0:46:57- start to help you with your skin. - Yeah.
0:46:57 > 0:46:59Right, you do it.
0:46:59 > 0:47:01- Put him in nicely.- Yeah.
0:47:01 > 0:47:02Do you want to say night-night?
0:47:02 > 0:47:05- Night-night.- Have you said night-night to him?- Yeah.
0:47:05 > 0:47:08Right. LUCAS LAUGHS
0:47:08 > 0:47:11- See ya later!- See ya later! - Bye!- Bye!
0:47:11 > 0:47:15- We'll come and check on him later, all right?- Yeah.- Wow!
0:47:15 > 0:47:17This is going to get all that stuff off him.
0:47:17 > 0:47:20- Going to get all that dust off him, isn't it?- Yeah.
0:47:23 > 0:47:25To sort Ray's shoulder out,
0:47:25 > 0:47:28Rangan's arranged for him to see a local injury specialist.
0:47:28 > 0:47:33Now, you're a really, really big guy there, and that muscle isn't doing its job.
0:47:33 > 0:47:35- Think of it almost as if the tendon is out of its socket.- Yeah.
0:47:35 > 0:47:39I'll just do a nice little gentle technique here.
0:47:39 > 0:47:43That's where I could feel it, and I can't feel that at the moment.
0:47:46 > 0:47:50- Yeah.- Rangan's also helping Ray stick to the movement exercises
0:47:50 > 0:47:53he was given to sort out his back pain.
0:47:53 > 0:47:57- Brilliant! Just focus on that. Just get that locked in.- Yeah.
0:47:57 > 0:47:59That's it!
0:47:59 > 0:48:03- Well done, Lucas. Are you helping your daddy?- Yeah.
0:48:03 > 0:48:06One more. Yeah, good.
0:48:06 > 0:48:11Up to this point, Rangan's focus has been on physical therapy with Ray,
0:48:11 > 0:48:14but he's concerned that the desire to workout so much
0:48:14 > 0:48:17might actually be a symptom of something else.
0:48:17 > 0:48:22There's actually one more thing I really need to talk to him about.
0:48:22 > 0:48:24It's going to be difficult, it's very, very personal,
0:48:24 > 0:48:29but, ultimately, I think this is at the heart of all of Ray's problems.
0:48:29 > 0:48:31I really hope he doesn't take this the wrong way.
0:48:31 > 0:48:35One thing I've noticed is, you know, when I was in the gym with you,
0:48:35 > 0:48:38- you said to me, you know, "Doc, it may surprise you I'm body shy."- Yeah.
0:48:38 > 0:48:41I don't think there's any specific reason why I'm body shy,
0:48:41 > 0:48:46it's just I've always been... too thin to take me top off.
0:48:46 > 0:48:50I think people looking at you would think, "How can he see a skinny guy?"
0:48:50 > 0:48:54It appears to me that you have a slightly distorted self-image of yourself,
0:48:54 > 0:48:57and I think it would almost be remiss of me to not bring this up.
0:48:57 > 0:49:01As a doctor, noticing this, I think it needs to be addressed.
0:49:01 > 0:49:05Would you be potentially interested in talking to someone about this?
0:49:05 > 0:49:08In... In respect of what?
0:49:08 > 0:49:14There's a great specialist in Manchester who specialises in body dysmorphia, OK?
0:49:14 > 0:49:17And I wonder whether you'd be open to having a conversation with him.
0:49:17 > 0:49:22Rangan, after the help you've give me, I'm open to anything that you suggest, I'll be honest with ya.
0:49:24 > 0:49:30Rangan thinks Ray might have body dysmorphia, when a person has a distorted view of how they look.
0:49:30 > 0:49:33In the UK, one in ten men who go to the gym
0:49:33 > 0:49:38suffer from a specific form of the condition, known as muscle dysmorphia.
0:49:38 > 0:49:44Like Ray, they see themselves as smaller than they are, pushing themselves to work out more,
0:49:44 > 0:49:46getting bigger and bigger.
0:49:46 > 0:49:51- Hi there. Pleased to meet you, Dr Chatterjee.- Yeah. This is Ray. - Hi there, Ray.- Please to meet ya.
0:49:51 > 0:49:52All right, come on in.
0:49:52 > 0:49:57Psychotherapist David Knight specialises in body-image issues.
0:49:57 > 0:50:02David, so I've been spending a few weeks with Ray and his family and I've noticed a few things
0:50:02 > 0:50:06in terms of the way Ray views himself, in terms of his body.
0:50:06 > 0:50:11What we need to do, then, is go through a sort of an assessment to see what problems are there.
0:50:11 > 0:50:17I wouldn't say it's an issue, I just think it's something that I don't feel comfortable with,
0:50:17 > 0:50:19and that's getting my top off in public.
0:50:19 > 0:50:21First, he's delving into Ray's past
0:50:21 > 0:50:25to see if any events have contributed to the way he sees himself.
0:50:25 > 0:50:30So if we go back, say as a kid, how were you then?
0:50:30 > 0:50:33As I were growing up, because a lot of my friends were a lot bigger than me,
0:50:33 > 0:50:37it was me that was the gobby one, it was me that kept getting us into trouble, getting into fights.
0:50:37 > 0:50:40- I didn't have a very good relationship with me mum. - In what way?
0:50:40 > 0:50:44Just wasn't that closeness, I think, for whatever the reason is.
0:50:44 > 0:50:50Never met me dad, never knew no information about him, me real dad, so to speak.
0:50:50 > 0:50:53- Do you have any memories of that? - No.
0:50:53 > 0:50:57And I think, "Well, he's never come and tried to find me, so sod him."
0:50:57 > 0:51:03Are there any other sort of incidents that may have had an influence, that you can think of?
0:51:03 > 0:51:08I always say, as a joke as it sounds, I've probably had five serious relationships in me life.
0:51:08 > 0:51:13And out of five of 'em, four of 'em have left me for somebody else,
0:51:13 > 0:51:17totally out of the blue, so to speak, whereas Rachel's stuck by me.
0:51:17 > 0:51:22- So I think that's probably... wouldn't do a lot for me confidence.- No.
0:51:22 > 0:51:26You have lots of things going on here and it... You know,
0:51:26 > 0:51:28there's definitely some body-image issues there,
0:51:28 > 0:51:31- but it's a bit wider ranging than that, isn't it?- Yeah, definitely.
0:51:31 > 0:51:37To help Ray with his issues, David is using a technique called cognitive behaviour therapy.
0:51:37 > 0:51:41- That seems to come up quite a lot for you, doesn't it?- Yeah. - That sort of self-criticism.
0:51:41 > 0:51:47By talking Ray through his thought patterns, he's helping him identify why he behaves the way he does...
0:51:47 > 0:51:49Cos that generates anxiety.
0:51:49 > 0:51:52..and perceive himself in a better way.
0:51:53 > 0:51:56Say if someone makes a positive comment about how you look,
0:51:56 > 0:52:00what your brain tends to do is to take that but then think, "Well, yeah, but..."
0:52:00 > 0:52:05- So that's about your appearance all the time. Does that fit? - Yeah, definitely.
0:52:05 > 0:52:08One of the things we need to do is to get this back in balance,
0:52:08 > 0:52:11or actually probably get it in balance for the first time.
0:52:11 > 0:52:12Ray will need a few more sessions with David
0:52:12 > 0:52:15to really tackle his muscle dysmorphia.
0:52:15 > 0:52:18I can now see the clear path that's happened.
0:52:18 > 0:52:20Something happened in Ray's childhood,
0:52:20 > 0:52:21the relationship with his parents,
0:52:21 > 0:52:25that has led to him building up protective mechanisms.
0:52:25 > 0:52:27He doesn't like the way he views himself,
0:52:27 > 0:52:30but then you have bodybuilding, take steroids to get bigger,
0:52:30 > 0:52:33but whilst you're doing that, you give yourself pain.
0:52:33 > 0:52:34How do you cope with that?
0:52:34 > 0:52:35You take more painkillers.
0:52:35 > 0:52:37You get the problems associated with painkillers.
0:52:37 > 0:52:40It looks like it may be the root cause of a few issues,
0:52:40 > 0:52:43so I need to address that to allow me to move forward.
0:52:43 > 0:52:45Although it was quite deep,
0:52:45 > 0:52:47I'm actually feeling quite excited at the moment
0:52:47 > 0:52:50that we may have got to the root of all of his problems.
0:52:59 > 0:53:02Almost two months after he first met the Ashton family,
0:53:02 > 0:53:05Rangan has returned to Manchester for one final visit.
0:53:07 > 0:53:10He wants to see what impact having a doctor around has had.
0:53:13 > 0:53:19When the Doctor first met Lucas, he would barely eat anything other than cereal and yoghurt.
0:53:19 > 0:53:22- Grapes.- Yoghurt and apples. Do you like them all?- Yeah.
0:53:22 > 0:53:26So great to see at least two different fruits on his plate.
0:53:26 > 0:53:28And that new dairy-free yoghurt that he seems to like.
0:53:28 > 0:53:30Really, really nice. I mean, how's that been for you?
0:53:30 > 0:53:34It was a slow process to start with, with the apple, it was literally nibbles,
0:53:34 > 0:53:37but now he'll have it on his lunch and he just eats whatever's put there,
0:53:37 > 0:53:41so that's a big change. Are you playing football with your grapes?
0:53:41 > 0:53:43And how's he generally been?
0:53:43 > 0:53:45His attitude to the food, I think, is the biggest thing.
0:53:45 > 0:53:49Rather than it always being, "Do I have to have me tea?" He's asking, "When's tea?"
0:53:49 > 0:53:51It's a big change for him
0:53:51 > 0:53:53to sit there munching on an apple like that.
0:53:53 > 0:53:57That's all I've really been trying to do since he started eating.
0:53:57 > 0:53:59- I'm actually intrigued as to how his skin is doing.- Yeah.
0:53:59 > 0:54:03- His skin's pretty good at the moment, isn't it, Lucas? - Can I have a look at your skin?
0:54:03 > 0:54:05Can you show your arms?
0:54:05 > 0:54:09When I first met you a few weeks ago, there were loads of red dots there.
0:54:09 > 0:54:13- Where are they?- In my arm. - They're in your arm?
0:54:13 > 0:54:17- They're not there, are they? That's a lot better, isn't it?- Yeah.
0:54:17 > 0:54:19Wow! Fantastic!
0:54:19 > 0:54:24- My spots are going down.- Ah. Does that make you happy?- Yeah.
0:54:24 > 0:54:28The downside to him having a better appetite, now he's got more energy.
0:54:28 > 0:54:31- Never stops running about and jumping all over. - That's great, though, isn't it?
0:54:31 > 0:54:34- That's what a five-year-old should be doing.- Exactly, yeah.
0:54:34 > 0:54:36It's great to hear that. Really, really great.
0:54:38 > 0:54:43A recent urine test has also shown that Ray is finally opiate free.
0:54:43 > 0:54:46So Ray, tell me, I'm desperate to know, how's the pain?
0:54:46 > 0:54:50Gone. All of it. Me back, me shoulder, everything.
0:54:50 > 0:54:54I feel like a different person, I feel about 20 years younger.
0:54:54 > 0:54:56So when was the last time you had to take painkillers?
0:54:56 > 0:54:59Oh, I've not took any opiate painkillers now for over three weeks
0:54:59 > 0:55:02- and it's probably... This is t'fourth weekend coming up.- Fantastic!
0:55:02 > 0:55:06I still believe that not taking these opiates has improved me sleep.
0:55:06 > 0:55:08- Yeah.- You know, it's improved me mood.
0:55:08 > 0:55:12- You know, I find meself... I'm a lot more happier.- I can see it, Ray.
0:55:12 > 0:55:16I can see that the Ray I met a few weeks ago and the Ray I'm seeing in front of me now,
0:55:16 > 0:55:18it's like two different people.
0:55:20 > 0:55:26Just eight weeks ago, all Ray wanted to do was have a kickabout with his kids...pain free.
0:55:26 > 0:55:29- Dad, you're rubbish.- I'm rubbish?
0:55:29 > 0:55:32Honestly, I'm not overstating this, this is life-changing for me.
0:55:32 > 0:55:36To finally be pain free after all these years, absolutely amazing.
0:55:36 > 0:55:40- It's unreal.- To see the changes today, it's been amazing, absolutely amazing.
0:55:40 > 0:55:44- Thank you very much.- Thank you. Thank you for letting me in and allowing me to help you.
0:55:44 > 0:55:48- I have an old saying, I don't really say it that often, but there's me hand, there's me heart.- Take care.
0:55:48 > 0:55:51Making those kind of changes with Ray and with Lucas,
0:55:51 > 0:55:56it's pretty close to being my biggest achievement as a doctor, ever.
0:55:56 > 0:56:00Make sure you keep those spots away, OK? I don't want to see them come back ever, all right?
0:56:00 > 0:56:03He's probably saved me marriage in a way, because that's where I was going,
0:56:03 > 0:56:07I was getting...addicted to these painkillers, I was being more and more moody.
0:56:07 > 0:56:12And so, not only am I pain free, not only is Lucas now being a normal five-year-old little boy,
0:56:12 > 0:56:15but me and Rachel are talking more, me and Rachel are closer together,
0:56:15 > 0:56:17and that's all because of Dr Rangan.
0:56:17 > 0:56:21Thank you very much. You know I owe you everything. Love you to bits, mate. Thank you very much.
0:56:21 > 0:56:23My pleasure. Take care, all right?
0:56:23 > 0:56:25- Yeah, you take care and take it easy.- Say bye-bye.
0:56:25 > 0:56:28- See you, Lucas. See you guys.- See ya. - See you.- Say bye.
0:56:57 > 0:56:59Next time...
0:56:59 > 0:57:01Rangan is in Shrewsbury...
0:57:01 > 0:57:03- Hello.- Hello, nice to meet you.
0:57:03 > 0:57:05..to deal with a family of junk-food addicts.
0:57:05 > 0:57:09- What is it you require my help for? - Where do we begin? - LAUGHTER
0:57:09 > 0:57:12- Bleep!- But with all four family members in trouble,
0:57:12 > 0:57:16- has he bitten off more than he can chew?- I'm a little bit nervous, actually, about bringing this up.
0:57:16 > 0:57:20- You're coming out of the friendship zone, son.- And after diagnosing a hidden killer,
0:57:20 > 0:57:23he's faced with delivering some difficult news.
0:57:23 > 0:57:25I think you've already got it.