Episode 2 Doctor in the House

-What would a doctor discover if they lived with you...

-Hello, Doctor, how are you?

-..24 hours a day?

How much would you be willing to reveal?

-Do you think you may be addicted?

-No.

Would they be shocked by what they find?

-That's frankly pretty dangerous.

-That looks horrible.

Like most busy NHS GPs, Rangan Chatterjee only gets about ten minutes with each patient.

Excuse me one second. Hello?

Now, he's taking on the biggest challenge of his career.

I believe that 99% of a patient's health outcome

is what happens in that time outside the surgery room.

He's about to live alongside individual families who struggle with their health.

-Who needs help with what?

-My lower back.

-I feel out of control of my own body.

-I'm worried about cancer.

For the first time, he'll gain insight into every aspect of his patients' lives.

This is a unique opportunity. I think I will be able to learn so much.

-Do they cook fresh foods? Is this how you eat every day?

-Pretty much, yeah.

-Yeah?

Is it a noisy street? Are there stressful relationships? SHE SIGHS

All these things have a huge and significant role in determining their health.

-Go!

-He'll detect undiagnosed diseases.

-I think you've already got it.

-He'll deliver some home truths.

-Do you get how serious this is?

-He doesn't!

-Yeah.

-I...honestly want to help you.

And discover ways we could all live longer, healthier lives.

SHE YELLS I think it really has the potential

to change the way we all look at health in this country.

It's imperative that we do something about it - not tomorrow, but now.

Ah, saved again.

No. It's actually...

No, it's there. I told you, that's the post.

Over there.

No...I saved it.

The Ashton family live in Greater Manchester.

Ray and his wife, Rachel, have two kids -

13-year-old Chris and five-year-old Lucas.

Oh, he missed again!

Oh, no!

47-year-old Ray has a lot on his plate.

He's an IT manager for a local NHS trust.

-Seven, eight.

-And he also owns a bodybuilding gym.

-Perfect, that, mate. Well done.

-What do you do?

What do I do? I look after everybody.

Yeah. Rachel's very, very caring, very loving.

-Go on, then, put it round there.

-She's probably the rock of the family, if I'm being honest.

Ray's health has got the family worried.

Despite looking physically fit, he's suffered from back pain for decades.

It's got to that point where nothing is helping.

I can't sit, can't sleep, and I have to sit in a chair upright and try and fall asleep that way.

I've forgot what it feels like to be pain free.

In the last few years, Ray's pain has got a lot worse.

If he doesn't get it looked into now,

things might go to a point where they can't do anything about it.

I mean, I'm very, very close to me children,

but I could do more things with them and I know they'd love it.

LUCAS LAUGHS

Dr Rangan Chatterjee has practised medicine for 14 years.

Now he's taking a break from his NHS surgery in Oldham

to spend some time focusing on the Ashton family's problems.

I'm going to get an insight into what parts of their life are linked in together -

stress, diet, you know, work patterns.

Whatever they are, they all feed into health.

-Hi.

-Hello, Doctor, how are you?

-Yeah, good, how are you?

-Wow! Aren't you tall? You'll have to duck.

-Yeah, absolutely.

-Duck in and come and meet the family.

-Fantastic. Thank you very much, cheers.

-This is my youngest, this is Lucas Ashton.

-Hello, Doctor.

-LAUGHTER

Can I shake your hand? Hi, Lucas.

-Who are these people sitting on the sofa?

-That's my mum.

That's your mum?

The doctor will be immersing himself in the Ashton household

to investigate every aspect of their lives.

What I'd like to do, if possible, is just to try and get a bit of an overview,

in terms of who needs help with what.

-Me biggest issue that I've had for the longest period of time is me lower back.

-OK.

I've had me back problems for 20 years plus.

When that flares up, that is bad, it stops me from sleeping.

-And me neck is certainly an issue from an ache and pain sort of thing.

-OK.

I think it may all originate from me shoulder, because it is me shoulder that constantly throbs,

-I can sometimes feel it coming right down me arms.

-We'll look into all that.

-Anything else apart from aches and pains?

-I've noticed that as the pain's been getting worse,

I've become more and more irritable.

I imagine it's not just a few niggles here and there,

I'm imagining you've got some serious pain issues.

Ray isn't alone.

Over 16 million Brits have suffered from back pain.

Is there anyone else in the family who needs help with anything?

Lucas has got really, really bad skin and we've been under different consultants, different doctors.

Hydrocortisone cream, you know, all the lotions and potions.

Lucas has eczema, a skin condition resulting in a painful, itchy rash.

-Oh, your arms, as well?

-It affects one in five children.

-So what we're saying is what you've tried so far hasn't worked?

-Yeah.

-Right.

I always am very, very sympathetic when kids have got skin problems,

because I've had experience with my own son, OK,

so I know... I know what that feels like as a parent,

-when you see your child itching and you're struggling.

-Yeah.

I get it, it's a horrible feeling. Do you need help, Rachel?

No, I don't think there's anything that I need help with.

-So you've got a clean bill of health?

-Yeah.

-I guess it sounds like the focus is mainly going to be on Dad...

-Yeah.

-..and Lucas.

-Yeah.

Rangan wants to find out how Ray is currently managing his back pain.

-OK.

-I'll be 100% honest with you,

I used to eat over-the-counter meds for fun, painkillers,

because I might wake up in the morning when I'm uncomfortable and me ankle's hurting, me back.

When you say for fun, can you be a bit more specific? I mean, how many?

I'll get up in the morning and have four of them in the morning.

Ray starts the day by taking the anti-inflammatory ibuprofen.

-So 800 milligrams?

-Yeah.

-And how many times do you do that in the day?

-Probably twice a day.

-Twice a day?

-Yeah.

-On this?

-On that, yeah.

-Pretty much every day?

-Every day.

-This is just paracetamol.

-Paracetamols with caffeine. OK, how many of these are you taking?

-Probably three of them in the morning.

-Three of these?

-Yeah.

-I mean, the dose on here is one or two tablets every four hours.

-Yeah.

-So you're taking three in one go?

-Yeah.

-It sounds like you're aware that that's over the recommended dose.

-Oh, without a doubt.

And this is not... I'll be 100% honest with you,

this is not a...a recent thing, that's probably last ten years.

So I've started off with the recommended dosage

and I've gone up and up.

These drugs might be available over the counter,

but by taking over the recommended dose for so long,

Ray could be at risk of serious side effects.

But these aren't the only pills he's using.

-Talk me through some of the others.

-Yeah.

-I can see that there, which is a lot stronger.

-Yeah.

-So this is co-codamol.

-Yeah.

-And the highest strength that we have.

-Honestly, how many are you taking?

-Two of them every night.

-Anything stronger than this?

-Yeah, them was prescribed, tramadol.

Again, that was to use in cases when they don't work.

Cos this is stronger than the co-codamol.

-And two of them is 100 milligrams.

-Yeah.

-How much are you taking a day?

-I tend to only take them probably Saturday and Sunday,

-maybe Friday, it depends.

-So, basically, at the weekend

-you're taking two of these in the evening.

-Yeah.

-But you're also taking this at the same time?

-Sometimes, not all the time.

-OK.

-I tend to either have them or them.

-Look, I mean, there's a lot here, isn't there?

-Yeah.

There is a bit more somewhere. I've got stronger ones, they're the 100 milligram ones.

I'll be 100% honest - and this is why I'm reaching out for your help -

I've got to a stage where I'm taking that dosage that I'm telling you and it's not really working.

Tramadol and co-codamol contain chemicals that belong to a family

of seriously strong painkillers known as opiates.

Abusing them can have life-threatening effects on the brain.

Some of these are addictive drugs...OK?

And if you've been prescribed some of these since 2010,

we're looking at five years -

-do you think you may be addicted to opiates?

-No.

-OK.

-You can say that, yes, I'm dependent on it. I will never believe that.

-OK.

And that's only because of the type of person I am,

I believe I've got the power to do whatever I want. I can stop taking them tomorrow, which I have done.

I've got to be up front with you - that is a huge amount of painkiller.

-Where are you getting them all from?

-The majority of them are prescribed.

They're on a repeat prescription or I can get them from anywhere.

-From...from anywhere?

-I can get 'em off of the internet.

-Right. And do you do that?

I have done, yeah. I've done that in the past, yeah.

I don't think we should beat around the bush, that's... That can be pretty dangerous.

-That can have some serious consequences.

-Yeah.

-I've got to be up front with you.

-Course you have, I understand that.

Right at the start of this process, I've got to be blunt and up front with you

if we're truly going to have a relationship that allows us to move on from this.

That's been... That's been, frankly, very, very eye opening for me.

Opiates are really strong painkillers that actually belong to the same family as heroin and morphine.

I mean, yeah, they can be very effective at managing pain,

the problem is they're highly addictive.

Not only that, but he's buying these things online.

The problem is, when you buy drugs online, you don't know what's in them.

Even if it is the right drug, you don't know if it's past its sell-by date or not.

The only safe way to take prescription opiate painkillers

is to get them prescribed and managed by your doctor.

Almost two million people in Britain have misused prescription painkillers in the last year.

Ray's long-term pain is an issue the whole family have to cope with.

Reading between the lines, it must be affecting him hugely.

He is in pain, but he's not, like, rolling around in pain all the time,

it's just... I think he's just used to it.

-Is that hard for you to cope with?

-He has got a temper.

I suppose because he's tired all the time cos he doesn't sleep through because of the pain.

-It's not necessarily at me, it's more at our situation.

-Yeah.

It's not really aimed at me.

Er...and so I don't know.

Sometimes I worry about him at work,

I think he's going to come home one day from work and maybe he's going to have punched somebody.

-Right.

-In a meeting and things like that, cos he gets... He wouldn't.

-Does he get angry?

Just because he gets so worked up when he's trying to get a point

across and people aren't listening to him.

And I just think a lot of that is

just down to his stress levels and things like that.

It's really interesting, hearing your perspective.

If there was just one thing that would change in the next four weeks, what would that be?

-His pain.

-His pain?

-Yeah, help his pain,

because then I think that'd have a knock-on effect with the sleep and the stress.

I'm inclined to agree. If his pain went down, it'd be interesting to

see what else gets better, as well.

In spite of his debilitating pain, Ray works out every day.

When did you get into bodybuilding?

-I actually got into bodybuilding about early 20s.

-Early 20s?

-21, 22.

-When you started going to the gym?

-When I started going there properly.

-Yeah.

I was only...I always remember, I was 10st 2lbs,

but then also the combination of... I knew I had a bit of an issue with me back,

I kind of thought if I strengthened it up, because I get a bit of advice from friends.

They'd been to training and said, "What you might have to do

"is start building your core up and you'll find it'll help your back out."

-So I thought, "OK, I'll give it a go."

-I've not had that much experience of bodybuilders.

He's very, very big. I'm not sure whether there is maybe some steroid use going on,

but I want to find out, is his relationship with his gym healthy, or has it gone too far?

Is it actually quite unhealthy now?

-Make yourself at home.

-Oh, perfect, thank you. Fantastic!

I'm feeling...pretty drained, actually.

I think there's a lot to sort out here.

I think these issues are quite complex.

I think some of these issues have been going on for years and years.

And, actually, now I'm slightly worried how much of this I can unravel.

Rangan wants to observe every aspect of Ray's life,

so he's staying the night to be with him for his usual 5:30am start.

-Good morning.

-Morning.

-Have you had a good sleep?

-Yeah, not bad.

-There's your tea.

-Oh, perfect. Thanks very much.

-No sugar, no milk.

-How was your sleep, by the way?

-A bit hundred-mile-an-hour in me head,

so a bit restless here and there and everywhere.

Nothing major, but everything that's going on...

In your head, yeah. I'm just going to quickly get myself ready and then I think, are you ready for work?

Yeah. I'm going to open the gym first and wait till my day manager gets there

-and then I'll just head up to where I work.

-Right, so I'll just jump in the shower

-and then maybe I can follow you today.

-Course, yeah, yeah.

-To see what...

-I'll look forward to it. Thank you very much. Enjoy your tea.

-Cheers. Thanks.

I think, by most people's standards, it's a pretty early start,

and if he's not sleeping well and he's getting up this early, you know,

I wonder how much rest and recuperation he's actually getting.

The first stop in Ray's busy day is his gym.

A typical morning, you open up, you wouldn't have a workout at that point?

No, I don't, no. I have me protein drink, go there, open up, wait for me day manager to turn up.

-Yeah, you're not here to do any training.

-So how long have you had this open now?

-It's been open approximately two years now.

-And you've been training for, what, 25 years?

-25 years, yeah. I first went in round about 16, 17.

-Yeah.

Walked into a gym, didn't like it.

It was quite intimidating, I was a very, very slim person, very small,

-I'm only 5'6" and a bit.

-Is that why you started?

I think that's the reason I first went into a gym.

Cos if someone looked at you now,

they at no point would think you're tiny and slight.

I do think that. When I look in the mirror I still think I still see that little skinny lad that started.

-Do you?

-Yeah, yeah.

-Do you think that's part of the drive to keep working out and keep getting bigger?

I'll be honest with ya, I've been on a course of steroids before now

and I've gone up to 16 and a half stone, but I still did not believe I was big -

I still thought I was that 10st 2lbs person that walked into a gym.

-So the initial reason to take steroids is to get bigger?

-Yes, it was to get bigger.

The example I always use is I say you will never see yourself grow, but you'll see yourself shrink.

It's estimated that nearly 60,000 bodybuilders use steroids in England and Wales alone.

They can be very dangerous, increasing the risk of heart attacks and high blood pressure.

Ray may not take them any more,

but it's clear that being big is still very important to him.

He told me that when he looks at himself in the mirror, he sees that thin, almost scrawny young lad.

I think most people will look at him and think, "That's a big, strong guy."

But it's interesting, he doesn't see that when he looks in the mirror.

With the gym open for the day,

Ray has to get to the local hospital trust by 8am

to get on with his day job as an IT manager.

-How long have you worked here for?

-12-13 years.

I don't always take annual leave and that is my choice - there's no pressure on me to do that.

Thank you. Cheers.

As well as working an intense 45-hour week...

I'll get you a chair.

..Ray is also on call through the night, two weeks out of four.

-So this is basically where I spend most of my time throughout the working day.

-OK.

Sat here...typing away, looking busy.

-And this is most I've ever seen these working now.

-LAUGHTER

-What is your perception of Ray?

-He's a bit of a wrong 'un, in't he?

-LAUGHTER

But he's all right, yeah. Don't look in his drawer for all his drugs.

LAUGHTER

-Erm...

-I that's not actually a lie, I do have painkillers here.

-Oh, I see. Right, OK.

I do have... Like I say, not a lot of people know about me ailments as such,

but I do have painkillers out, just for when I do have...

Cos again, take a few pills still sat here, have a drink and off I go.

-It's not something...

-So you don't want to, you know...

-You wouldn't go off and have a walk and have a stretch.

-No, no.

-You would just pop a pill and keep going?

-Yeah, definitely.

-So, you're spending a lot of your day sat down?

-Sat down, yeah.

Like over a third of men in the UK,

Ray is inactive at work and regularly sits at his desk for several hours at a time.

-So standing for even four, five minutes, the pain comes on?

-Straight away, yeah.

-Sitting relieves the pain?

-Yeah, definitely.

But then when you get up from sitting, you can feel really, really stiff?

-Yeah, yeah.

-OK. So there's something not quite right there.

He has a full life, there's lots of things going on, he cares about other people, his job,

he doesn't take his annual leave.

I noticed a passing comment, "Yeah, don't look in his drug drawer."

And, as Ray pointed out, he does actually have a drawer of pills,

where if he's having any pain, he'll take a painkiller.

He doesn't want to bother anyone, he wants to just crack on and get the job done.

In view of what I've been finding out over the last day or so,

er, yeah, more alarm signs for me.

At 5pm, Ray's still on the go and back down the gym for his daily workout.

I think once I get through the door, it's that escapism,

it's that forgetting everything that's gone on throughout the day.

So I use it as Ray time, to get away from everything.

In an average week, Ray can rack up 14 hours of weightlifting.

But given his pain issues,

seeing him put his body through so much stress is clearly a shock for Rangan.

I'll do one more set on there, then I've done me three sets of ten.

It's misleading to think that is healthy.

This may surprise people, this may surprise Ray,

but I would say at the moment, he's better off coming home and sitting on the sofa than doing that.

-Do you feel the pain after?

-Not directly after.

I tend to find...just go home, shower,

have some tea and then it's relaxation time.

-And that relaxation time...is that when you feel the pain?

-Yeah.

-Yeah.

-But as I'm training, I can't feel it.

It almost seems as though you shut it out when you're getting on with your stuff,

you're getting on with your job, you're getting on with your training,

and it's only when you sit around and go, "Actually, I'm in a lot pain."

Ray's lifestyle could be contributing to his pain,

driving his dependence on painkillers.

But before he addresses this,

Rangan would like to run some medical tests to check for any underlying problems.

-Actually, shall I get the red one?

-It don't matter.

-I'm not expecting to spill it, but, er, OK.

A blood test will measure a number of things,

from the condition of his muscles to his cholesterol levels.

Okey-doke.

But that's a big muscle, I'm just wondering if it's going to fit round there.

High blood pressure is a major cause of heart disease and strokes

and can be brought on by a number of factors,

including physical and psychological stress.

It's a smidgen high, actually.

Normal blood pressure, really I would want to see about 120 over 80.

Because Ray's been taking so many painkillers for so long,

Rangan's concerned about dangerous side effects.

He's back at home doing some research.

My long-term goal has to be to get Ray off these opiates,

but to do so, I really need him pain free.

What's really worrying me at the moment, though,

is he's taking over the recommended dose of over-the-counter drugs, such as ibuprofen,

but also paracetamol, and that can cause permanent liver damage.

I think the best thing to do would be to take him to see a liver specialist and to get a scan done.

Unintentional paracetamol overdose

is the most common cause of acute liver failure in the UK.

Thank you.

The liver's the one thing that possibly could be a problem.

I'm a bit unsure, you know, he may find something.

And, if I'm being honest, this is the biggest fear.

-Ray Ashton?

-Yeah.

-Come on in.

-Hello.

Ray is having an ultrasound.

This will reveal any damage caused by his overuse of painkillers.

At the moment I'm looking at your liver.

The body is dependent on the liver to manage chemicals circulating in the blood.

Taking too much paracetamol can damage the cells in the liver, leading to failure.

-And breathe away. OK, come and lie flat, and we're done.

-Yeah.

The scan is complete.

Consultant hepatologist Dr Michael Heneghan has Ray's results.

-Hello. Dr Heneghan?

-Hi, nice to meet you. Michael Heneghan.

-Dr Chatterjee. This is Ray.

-Ray, good to meet you.

-Pleased to meet you.

-How are you?

-Thank you very much.

-Nice to see you today.

-It's nice to see you, hopefully.

I have to say that your... Your story frightens me in many respects,

because I've rarely met someone

who actually has as much paracetamol and as much ibuprofen on a sustained basis.

And it seems like you have gotten into a habitual pattern or a habit of taking these drugs.

And although paracetamol in itself isn't necessarily addictive,

obviously you feel better when you take it.

You've had an ultrasound earlier in the day and your liver

is actually in remarkably good condition at this point.

And I would reiterate that it is at this point.

If this continues at its current level,

it's really just a matter of time

-before things take on a life of their own.

-Yeah.

-OK?

-Yeah, yeah.

-Yeah?

-Yeah.

-Thank you so much, we really appreciate your time.

-Thank you very much.

-Thank you.

-RAY SIGHS How's that?

-A shock.

You know, when you hear it anyway, it's quite blunt, but...

-Does it worry you?

-Without a doubt. I think you was the one that worried me first,

-the other day in the kitchen.

-Yeah.

To hear a GP look at me and go...

You know, your head was nearly in your hands.

-It was like, "Oh, my God!" So that shocks me.

-It was...

-And that was exactly the same thing in there.

-He was shocked, as well.

I mean, it was... You know, it was almost like, "Wow!"

Already, I feel now, I could go home now and not touch a painkiller again in me life.

-That's how I feel.

-I'm seriously delighted to hear that, and let's see if I can help you do that.

Yeah, definitely.

I think that doctor was very, very clear, this is serious.

If he continues to do what he's doing now,

he'll be back in there within a couple of years.

What I find difficult at the moment with Ray is that I'm bonding really well with him,

and by doing that, actually, my authority as a doctor,

it's still there, but I feel it's lessened in some way,

that I can't really deliver him the same information as I would if I was back in the surgery.

And so actually hearing that news from a different doctor,

who he does have no bond with at all, I think that will have tremendous value for him.

It seems that Ray is starting to get the message about the dangers of painkiller abuse.

Rangan is back at home and he's switching his attention

to Ray's five-year-old son Lucas, who suffers from eczema.

I've got a son who I managed to get eczema free

by looking at environmental factors, gut bacteria and the quality of his diet.

I really hope that that kind of approach is actually going to get Lucas' skin much better.

But I need to investigate a little bit further.

The first thing Rangan wants to do is to take a close look at Lucas's skin.

-You see where you've got itchy skin?

-Yeah.

It's like a big magnifying glass, this, so if I put it on, we can see a picture of your skin.

Right, that's the light on. LUCAS LAUGHS

-Is it funny?

-Yeah.

-It's not meant to tickle. Did that tickle you?

-Yeah.

-Do you know what doctors call it?

-No.

-We call it something called eczema.

-Yeah. Call it some eczema.

-Eczema.

-Do you want me to tell you what eczema is?

-Yeah.

Eczema's a skin condition that causes your skin to be dry, itchy and red.

-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.

-Obviously, when you can see in detail, it looks quite raw there, doesn't it?

-Yeah.

The reason your mum tells you not to itch it, you see that top barrier of the skin,

-the top comes off and it gets all red and itchy, doesn't it?

-Yeah.

It affects one in five kids and one in 12 adults.

We're seeing it a lot these days. We don't know the exact cause of it -

we know it's a mixture of genetics, but also your environment.

-It can be different in each person.

-Yeah.

Can I have a look at the creams that he uses, and the emollients that he uses for his eczema?

Rachel relies on a variety of creams to relieve Lucas' symptoms.

This includes a prescribed moisturiser kept in his bedroom.

-His other one is in the fridge, cos they told us to keep it in the fridge.

-Any other emollient he uses?

-No, that's the only one.

-Just this one?

-Yeah.

-This is the cream you use every day?

-Yeah.

-All over the body?

Just on his patches, I use it, to be honest -

-on the back of his legs and his arms and his face, round his ears.

-And do you find it useful?

-I do think it helps, yeah.

-I always encourage patients to use the emollients as much as possible.

-Yeah.

-Even when it's gone.

-Yeah.

Because it just keeps the skin hydrated and moist and healthy.

-And it just means you're less likely to get flares.

-Yeah.

-Not impossible, but it's just less likely.

So I think that's really good.

These sorts of creams treat eczema symptoms,

but Rangan wants to try and tackle the underlying causes of Lucas's problems.

Eczema's a very complex disease.

We don't know everything about it yet.

There are many different causes, and often more than one cause in the same person.

There could be multiple triggers round the Ashtons' home.

First up, washing detergents.

I'm looking for biological versus nonbiological.

We know with some children, and some adults even with eczema,

they're better off with nonbiological powder. Have you ever heard that?

It's never made any difference, so I just generally buy whatever I buy.

-This is Lucas's bed.

-Can I have a look at the sheets to see what they're made out of?

-Yeah.

Material such as wool and synthetic fabrics could be contributing to the problem.

-Typically, we try and recommend 100% cotton sheets.

-Yeah.

Again, I'm not saying that these are contributing,

it's just we know that they can in some people,

so I'm just trying to see what possible triggers are there.

-It's 100% polyester.

-Right.

Some soaps, shampoos and other bathroom products might also be making things worse.

Does he have a bath and do you put anything in the bath?

He generally has a shower now, so he's in and out.

-If he has a bath, I don't put anything in it.

-The bubble baths, they can really dry skin,

-they can irritate it and make it worse. Did you find that with Lucas?

-Yeah.

There's one final area that Rangan thinks might be a big player in Lucas's problems.

-This one.

-This one? His diet.

-Yeah. Yeah.

-Is that your favourite?

-Yeah, Strawberry.

-Strawberry.

-Yeah.

Lucas struggles to eat enough fresh fruit and vegetables...

-Would he ever eat strawberries?

-No.

..and much of his diet is based on products containing wheat and dairy.

About 10% of eczema cases are caused by foods,

and these are two known dietary triggers of eczema.

-So do you prepare his packed lunch every day?

-Yeah, I do.

He has more or less the same things every day. Like, today he's having a sandwich

and he'll have a pack of breadsticks, a yoghurt and some raisins. And so that's it,

that's... That's his lunch.

-Is that your favourite?

-Yeah.

-Is he quite good with cereal?

-He'll eat his cereal any time of the day.

-Is it quite limited, what he has, then, would you say?

-Oh, very limited, yeah.

-Fruit, vegetables, anything like that?

-No.

-Not at all?

-Not at all, no.

-Not even a banana or...?

-No.

There's this big thing going off in my head, saying,

-does he have some kind of sensitivity to wheat and dairy?

-Hmm.

-And the only way we would know is by what I'd call a well-managed exclusion diet.

-Yeah.

So, for a short period of time, exclude some important foods

-whilst doing other things to see if there's an improvement.

-Hmm.

-And...

-That would be a major thing, though, cos that's, like, what he lives off.

Look at it this way - we could either not do anything and it can keep being a daily struggle for you,

or, for the next few weeks, whilst I'm with you, we can try some things that, yes, will be difficult -

there's no question - but they may potentially lead to things

getting a lot easier for you quite quickly.

I don't think Lucas is going to be up for the diet changes at all,

because he finds it really hard to try new things and stuff.

So we can't really take anything away without replacing it because otherwise he won't be eating,

and if he doesn't eat, then he doesn't sleep.

So I just think it's going to be really hard and I'd be very...

It's not that I don't think it would work,

I'm just thinking we're going to find it really hard to make the changes.

I'm concerned about Lucas's diet.

90% of what Lucas eats is wheat or dairy.

These are two of the commonest food triggers for eczema

and that's all he's eating.

Now, I can't tell you that they are causing a problem,

but what I can tell you is that it's definitely worth a short period of time

where we try without, just to see what happens.

I'm definitely sensing a bit of reluctance, though, from Rachel,

and I think this is going to be quite hard.

Having identified a few things that might be contributing to Lucas's eczema,

the doctor now can focus on Ray's pain once more.

In the UK, back, neck and muscle issues are so common

that around 31 million days of work are lost each year as a result.

Rangan is hoping that by studying the way Ray moves,

he'll be able to get to the bottom of the back pain that has plagued him for 25 years.

I'm a little bit nervous at the moment because Ray is a very, very complicated case.

I've brought him here to London to see a chap called Gary, who I met through my NHS training.

Hopefully, he'll be able to help.

I can't help but thinking, I've seen other doctors, I've seen other specialists,

they've not been able to help me,

so what's this other expert got that they haven't got?

Gary Ward is a musculoskeletal therapist,

who specialises in addressing pain by teaching people to move differently.

-Ray.

-Gary, I take it.

-Gary. Pleased to meet you.

-You look like you work out a bit.

-I do, yeah.

I've been in and out of bodybuilding-type gyms for 25, 27 years, so...

I've brought Ray down to see you because for many years

he's had quite a lot of musculoskeletal problems, pains.

-I think particularly shoulder and back?

-Yeah.

To touch on how it all started, me lower back was the first thing at a young age, 15, 16.

I used to stand up watching football matches and I started to notice more and more

the longer I was standing up, the more aching me back was.

It wasn't no sudden thing, I was stood there for half an hour, I was like, "Oh, me back's aching!"

So, was there anything as a child or as a kid that...

may have happened to you that may have led to some back pain?

Inevitably, I got... You know, fell out of trees and fell off walls and things like, you know,

-you pick yourself up and off you go, so...

-Have you had any surgeries?

-Ever been under the knife at all for anything?

-Only, I think - again I was a young teenager -

I got jumped by some lads who shattered my jaw

and I got wired up, but only that time, wired up for six weeks.

-But that's only...

-That's pretty important.

-Oh, is it? Oh, sorry, right.

-So shattered jaw.

-They broke me jaw in both places, I had to be wired up.

-When was this?

-When I was about 15, so '83, '84.

-OK.

-I'm just trying to think now how old I'd have been.

-Does that precede the backache even?

Yeah, in terms of noticing it watching the football.

OK, so, yeah, I think that's enough.

So look straight ahead for me.

These are the pressure distributions.

-Does that mean there's nothing going through?

-Yeah, not nothing, 12%.

The pressure scan shows that Ray isn't distributing his weight evenly.

The front of his left foot is taking half the load it should be.

This is affecting his centre of balance, with serious knock-on effects.

-You've got full-time tension in this right lower back area.

-Yeah.

Well, that's... When I'm standing all the time, that's exactly what I feel, yeah.

-Feel like you're falling backwards?

-Yeah.

-Ray, are you OK to take your top off?

The effects are most obvious in the way Ray walks.

So when he's putting his left foot forward,

-he's trying to do everything possible...

-To keep his weight off his left foot

Push your jaw to the right.

There's quite a difference in the spine there.

-I can see that just kinking to the right, so...

-It kinks there, right?

-Yeah.

-Yeah.

And then all kinking back towards his left and then back over towards his right,

and then carries on up into the head, where we can see

that the head is being carried higher on this side than this side.

-Yeah, I saw that from the other side, I saw there's a tilt...

-Yeah, he's got the little right tilt going on.

-..in his jaw, isn't there?

-To the right.

-OK.

The legacy of Ray's broken jaw even determines the strength in his arms.

-Ah.

-Jaw forward, breathing in.

-It's going to go, that one.

-Yeah, I see it.

OK. Jaw left.

-So, is what I'm seeing, when his jaw's to the left...

-It's weaker.

-..he's really weak?

Having identified Ray's issues,

Gary can start giving Ray some techniques to overcome them.

Using wedges to reposition Ray's feet,

Gary teaches Ray exercises that encourage his brain to start using forgotten muscles.

This should help realign his spine.

-What we call a dark zone.

-Right.

-So...

Why do you call it a dark zone?

Cos it's the kind of place that you didn't know that you could go,

so the brain's not used to how to manage it, so it's learning, in my

opinion, it's learning all the time.

-So he's put himself in a position that he never normally gets into.

-No.

Knee into the front.

-There you go.

-How does this feel, Ray, at the moment?

At the moment, it's quite uncomfortable, to be honest.

Not in a painful way, but it's just I feel like I'm using muscles I've not used before.

Mobility...in your spine is key.

No need to hold it, get in and get out.

Ray will have to repeat these specially tailored exercises every day,

but already there are noticeable changes.

-So he's not... He's using his pelvis to get into...

-That's straight now.

Yeah. Stand you up tall.

Just take a straight look at the spine. You can hopefully feel it, as well, Ray.

How do you feel at the moment?

-Amazing. It's...

-Really?

-It's just...

I just feel so... I just feel different in myself.

I do feel a lot lighter underfoot

It's like night and day, watching you walk from before.

I mean, I can't tell you exactly what's different,

but it's like two different people walking.

-To me it seems smoother.

-Exactly.

Ray's pain is coming from his muscles and his skeleton

and the way they interact with each other.

So we need to re-teach Ray's muscles

and re-teach his skeleton what normal is

and then, hopefully, that will lead to better pain management.

I'm going to take this away now and I'll be doing that every day.

Thank you so much. I cannot thank you enough. That was great.

To come down here and spend just a couple of hours with that man and feel how I do now,

I am, for once in me life, lost for words after what's just happened in there.

I just... It's just blown me away.

There's still a long way to go with Ray,

because, actually, there are so many layers of complex issues with him that that's just the start.

There's a huge psychological element about multiple aspects of Ray's life which I need to delve into.

Ray's blood test reveals signs of muscle damage,

so for the next few days he's giving up pumping iron

and instead he's doing Gary's movement exercises.

Everything's improved. I just seem in a better mood at the...at work, at home, here at the gym.

And it's only because... I've still got a few niggling issues with me sleep and me shoulder,

but me backache's gone! That's the only way I can say it.

So I'm just... I'm buzzing.

I haven't seen Ray that excited over his health in a long time, cos usually everything's just negative.

He felt so much better,

it's obviously made a massive difference already.

It's been a week since Rangan took Ray to see Gary...

-Hey, Doc!

-Hi, Ray. How you doing?

-..and he's popping round to check how he's doing.

-Yeah, well, still on cloud nine, mate, still buzzing.

-Are you?

-Still amazing, still every cliche you can imagine, still.

-Really?

-Loving it, mate.

Absolutely feel fantastic.

Generally, the last few days, have you been taking less painkillers or...?

-I... I kid you not, I have had no painkillers, mate, not a single one.

-Not at all?

-Not the over-the-counters, not the strong ones, nothing. Honestly.

-Oh, fantastic!

Whether that's in me head or what, I feel a different man, mate, honestly. You know, honestly.

-Ray, I'm so happy to hear that.

-So am I, honestly.

-I'm delighted to hear that.

-It's been...

-I was just going to ask -

you've come off painkillers, which I'm truly shocked at, but delighted.

-Any side effects from that? Any withdrawals?

-No, nothing at all.

I kid you not, Rangan, honestly, I'm... I'm going to bed elated,

feeling relaxed, feeling great.

I get up in the morning, I'm having this new... I look forward to things.

-It's a bit weird to explain it. So I think I'm in an even better mood at work.

-Yeah.

-You know, at the gym. Like I say, I'm a new man.

-Good.

-Right, I don't want to hold you up.

-Right, thank you very much. Great to see you.

It's common to experience side effects when coming off strong painkillers,

and best to take advice from a doctor first.

I think it's fantastic that Ray is off the opiates,

but, you know, these are highly addictive drugs.

I just hope that Ray can stay off them and that he has the willpower to keep going.

With Ray's back pain and opiate use seemingly under control,

the doctor is putting his focus back on five-year-old Lucas.

He wants to see if it's a sensitivity to wheat or dairy

that's contributing to his eczema.

Today, Rangan is doing something he doesn't normally do for his patients - their shopping.

Lucas is really, really fussy, but I really want to get him off wheat and dairy for a short period of time.

That's 90% of his diet at the moment, and they're two very common triggers.

I think because he's so fussy,

I need to choose foods that he's familiar with, but just try and get alternatives.

If Lucas's eczema is triggered by dairy products,

they can be replaced by ones made from soya, almonds, coconut and rice.

If he's sensitive to wheat, he can have corn-based cereals instead.

You can try them all and see which one you like.

It might get it all drier.

Yeah, it might make your spots go.

-Is it nice?

-Yeah.

-They won't go straightaway.

-LAUGHTER

-I liked it.

-You like it?

-Oh!

-I didn't just make it...

-Want some more?

-No.

-No, OK.

-Do you know what I saw you eating this morning?

-Yeah.

-Yoghurt.

-Whoa!

-Who likes yoghurt?

-Me.

-RACHEL LAUGHS

-I like that.

-Do you like that?

-Do you like it?

Yeah. It's yummy.

-Ah! You're going back for more?

-Yeah.

-Wow! Looks good, that.

-Is that one nice?

-Yeah.

What's great about this, I think we were both worried - you probably more than me -

but I was worried going round the supermarket thinking, "What's he going to like?"

And we can also give you things to help the gut bacteria

-that I told you about, you know the good and bad bacteria?

-Yeah.

Rangan wants Lucas to take probiotic supplements.

He believes these live bacteria and yeast cultures strengthen the immune system.

You can open these up, pop them in anything, whether it's a drink or whether it's his yoghurt.

-(Skin get better?)

-Yeah.

-What do you think?

-I think that it's them two.

-It's all for you.

-Yeah, all for me.

-All for you.

I mean, I think the yoghurt's sort of the easy one. I mean, I don't know what it tastes like,

but it tastes quite similar and looks the same.

Because a lot of things to him...

I'm not quite sure about the milk, and that's not gone down,

-cos usually if I give him a cup of milk, it's down the hatch.

-Yeah.

-We'll see how it goes.

-Yeah. No, I know.

-Got just them ones left.

-Do you want to try one?

-Yeah.

The doctor's also keen to try replacing a few more things that could be triggering Lucas's eczema.

-I've bought some new things for you. Do you want to open them?

-Yeah.

Hypoallergenic bedding instead of synthetic.

-These are 100% cotton sheets.

-Yeah.

-We know that people react less to these

than they might do to polyester or other materials.

-Shall we go and try it?

-And nonbiological washing powders to replace the biological ones.

-Washing liquid, non-bio.

-There's more things.

-There's more things.

-These are for Mummy, really.

-Yeah.

-Unless you do the washing.

-You don't help with the washing, do you?

-I do.

-Do you?

-Do you?

-OK, we'll give it a go.

I'm hoping all these things together, hopefully, we can make a difference.

It's two weeks since Rangan took Ray to the movement specialist.

His new exercise regime seems to have sorted out his back issues,

but he's still suffering from residual shoulder pain.

Rangan's checking up on how he's getting on without taking the addictive opiate painkillers.

Feel quite happy about most things about life in general, it's good.

-Have you felt any mood problems since you've come off the opiates?

-No, not at all.

From coming off the painkillers, I've had no adverse reaction at all.

So, when was the last time you took co-codamol or tramadol?

I've not took tramadol, all I've took is the co-codamol. I've not took a single tramadol at all.

-But you have had to take something again?

-Just for me shoulder.

-And the shoulder's been bad for over a week.

-When did you take the co-codamol?

On the weekend, last weekend, on the Saturday and the Sunday.

So about four days ago, four or five days ago you took some.

That's just for me shoulder, yeah, just two co-codamol.

Ray, I'm getting a little confused,

because...I thought that since we'd seen Gary,

you were saying that you've not taken any opiates at all.

And I think you told me like, you know, "I can go and throw them away now."

-I think if you remember...

-But we didn't go and throw them away and I wish I had done that now.

We've got to get something right here and we've mentioned it a couple of times -

-sorry if I'm coming across irate cos I don't mean to be.

-No, no.

What we said we was going to do is get to the root cause.

If we haven't got to the root cause the pain's still going to be there.

I have two options then, Rangan, I suffer with the pain or I take painkillers -

-what would you recommend?

-I'd prefer you to have called me and said,

"Look, I'm in a lot of pain, what shall I do now?"

Because I would have said to you, "Don't take co-codamol"

People who use opiate drugs tend to go back to them after about two weeks.

-Yeah, yeah.

-You have done that.

What I would have probably said is,

"Let's try a non-addictive painkiller," something like ibuprofen.

-Been there, mate.

-I know you have.

The reason I think you've got a dependency problem, OK,

is because when you need something, you go straight back to that.

-There is some dependency issues.

-I know, you've mentioned that four or five times

and you keep on mentioning it, dependency. I am not dependent on taking opiate painkillers,

I am dependent on being pain free.

-I honestly want to help you, OK?

-Right.

-I don't want to agitate you.

-I know for a fact, which I've proved,

-I can give up whenever.

-You haven't proved it, Ray.

-Why have I not proved it?

-Because you're back on them.

-Because that's what gets rid of me pain.

-Fine, but to say you've proved to me you can go without them,

-I would disagree with that statement, OK?

-We'll agree to disagree, then.

-Yeah, fair enough.

Had I known about the shoulder, I could have done something about it.

So now I know that it's bad enough for you to have to take painkillers again, I'm on it, OK?

-Yeah, yeah.

-Yeah?

-Great, yeah, yeah. I appreciate that.

-Come on, let's get out of here.

-Cheers, mate.

With two weeks left with the family,

Rangan's determined to do everything he can to also help Ray's son Lucas.

-Can I have the new one?

-You want the new milk, yeah?

-Yeah.

-Let's get you down, then.

To tackle one possible cause of his eczema...

he's been trying out soya milk and yoghurts in place of dairy.

-Little sips.

-Little sips.

-Hiya.

-Hi.

-How are you?

-Yeah, good.

-Nice to see you.

-You, too.

Rangan wants to encourage Lucas to be even more adventurous with his diet.

I've got lots of nice different colours here.

I thought you might like colours.

-You can try them if you want.

-Want to try something?

-Yeah, I'll try the oranges.

-Go on, then.

-Around a third of very young children in the UK are fussy eaters.

-Is it nice?

-Yeah. Yeah.

At the moment, Lucas eats almost no fruit and veg.

Mmm! Yummy.

These contain vitamins and minerals...

Makes you see better in the dark.

..essential for a child's development.

Ooh!

-And egg!

-Is it like an egg? RACHEL LAUGHS

Mmm! Yummy.

Obviously, all credit to the guy, he's trying them all. I'm really impressed he's trying them.

-Is it nice?

-Yeah.

-Do you know what it is?

-Erm...

-That's a cherry.

-Is it nice?

-Yeah.

-I think, for the time being, that's probably enough to try.

-Yeah.

From what you're saying, that's quite a lot for him to try in one go anyway.

Yeah, that was a big achievement for Lucas, yeah, to even entertain it.

Finally, there could be a hidden eczema trigger in Lucas's toys.

-You know your bear?

-Yeah.

-You like Bear, don't you?

-Yeah.

Sometimes, like, bear might have some dust in him and that dust might be making your skin worse.

-Stop! I don't like that.

-Yeah? No, no, but what we do,

if we put Bear in the freezer for a little while it gets rid of all that dust.

Yeah, and get all rid of this.

We'll get rid of the dust and that might, hopefully, within a few days,

-start to help you with your skin.

-Yeah.

Right, you do it.

-Put him in nicely.

-Yeah.

Do you want to say night-night?

-Night-night.

-Have you said night-night to him?

-Yeah.

Right. LUCAS LAUGHS

-See ya later!

-See ya later!

-Bye!

-Bye!

-We'll come and check on him later, all right?

-Yeah.

-Wow!

This is going to get all that stuff off him.

-Going to get all that dust off him, isn't it?

-Yeah.

To sort Ray's shoulder out,

Rangan's arranged for him to see a local injury specialist.

Now, you're a really, really big guy there, and that muscle isn't doing its job.

-Think of it almost as if the tendon is out of its socket.

-Yeah.

I'll just do a nice little gentle technique here.

That's where I could feel it, and I can't feel that at the moment.

-Yeah.

-Rangan's also helping Ray stick to the movement exercises

he was given to sort out his back pain.

-Brilliant! Just focus on that. Just get that locked in.

-Yeah.

That's it!

-Well done, Lucas. Are you helping your daddy?

-Yeah.

One more. Yeah, good.

Up to this point, Rangan's focus has been on physical therapy with Ray,

but he's concerned that the desire to workout so much

might actually be a symptom of something else.

There's actually one more thing I really need to talk to him about.

It's going to be difficult, it's very, very personal,

but, ultimately, I think this is at the heart of all of Ray's problems.

I really hope he doesn't take this the wrong way.

One thing I've noticed is, you know, when I was in the gym with you,

-you said to me, you know, "Doc, it may surprise you I'm body shy."

-Yeah.

I don't think there's any specific reason why I'm body shy,

it's just I've always been... too thin to take me top off.

I think people looking at you would think, "How can he see a skinny guy?"

It appears to me that you have a slightly distorted self-image of yourself,

and I think it would almost be remiss of me to not bring this up.

As a doctor, noticing this, I think it needs to be addressed.

Would you be potentially interested in talking to someone about this?

In... In respect of what?

There's a great specialist in Manchester who specialises in body dysmorphia, OK?

And I wonder whether you'd be open to having a conversation with him.

Rangan, after the help you've give me, I'm open to anything that you suggest, I'll be honest with ya.

Rangan thinks Ray might have body dysmorphia, when a person has a distorted view of how they look.

In the UK, one in ten men who go to the gym

suffer from a specific form of the condition, known as muscle dysmorphia.

Like Ray, they see themselves as smaller than they are, pushing themselves to work out more,

getting bigger and bigger.

-Hi there. Pleased to meet you, Dr Chatterjee.

-Yeah. This is Ray.

-Hi there, Ray.

-Please to meet ya.

All right, come on in.

Psychotherapist David Knight specialises in body-image issues.

David, so I've been spending a few weeks with Ray and his family and I've noticed a few things

in terms of the way Ray views himself, in terms of his body.

What we need to do, then, is go through a sort of an assessment to see what problems are there.

I wouldn't say it's an issue, I just think it's something that I don't feel comfortable with,

and that's getting my top off in public.

First, he's delving into Ray's past

to see if any events have contributed to the way he sees himself.

So if we go back, say as a kid, how were you then?

As I were growing up, because a lot of my friends were a lot bigger than me,

it was me that was the gobby one, it was me that kept getting us into trouble, getting into fights.

-I didn't have a very good relationship with me mum.

-In what way?

Just wasn't that closeness, I think, for whatever the reason is.

Never met me dad, never knew no information about him, me real dad, so to speak.

-Do you have any memories of that?

-No.

And I think, "Well, he's never come and tried to find me, so sod him."

Are there any other sort of incidents that may have had an influence, that you can think of?

I always say, as a joke as it sounds, I've probably had five serious relationships in me life.

And out of five of 'em, four of 'em have left me for somebody else,

totally out of the blue, so to speak, whereas Rachel's stuck by me.

-So I think that's probably... wouldn't do a lot for me confidence.

-No.

You have lots of things going on here and it... You know,

there's definitely some body-image issues there,

-but it's a bit wider ranging than that, isn't it?

-Yeah, definitely.

To help Ray with his issues, David is using a technique called cognitive behaviour therapy.

-That seems to come up quite a lot for you, doesn't it?

-Yeah.

-That sort of self-criticism.

By talking Ray through his thought patterns, he's helping him identify why he behaves the way he does...

Cos that generates anxiety.

..and perceive himself in a better way.

Say if someone makes a positive comment about how you look,

what your brain tends to do is to take that but then think, "Well, yeah, but..."

-So that's about your appearance all the time. Does that fit?

-Yeah, definitely.

One of the things we need to do is to get this back in balance,

or actually probably get it in balance for the first time.

Ray will need a few more sessions with David

to really tackle his muscle dysmorphia.

I can now see the clear path that's happened.

Something happened in Ray's childhood,

the relationship with his parents,

that has led to him building up protective mechanisms.

He doesn't like the way he views himself,

but then you have bodybuilding, take steroids to get bigger,

but whilst you're doing that, you give yourself pain.

How do you cope with that?

You take more painkillers.

You get the problems associated with painkillers.

It looks like it may be the root cause of a few issues,

so I need to address that to allow me to move forward.

Although it was quite deep,

I'm actually feeling quite excited at the moment

that we may have got to the root of all of his problems.

Almost two months after he first met the Ashton family,

Rangan has returned to Manchester for one final visit.

He wants to see what impact having a doctor around has had.

When the Doctor first met Lucas, he would barely eat anything other than cereal and yoghurt.

-Grapes.

-Yoghurt and apples. Do you like them all?

-Yeah.

So great to see at least two different fruits on his plate.

And that new dairy-free yoghurt that he seems to like.

Really, really nice. I mean, how's that been for you?

It was a slow process to start with, with the apple, it was literally nibbles,

but now he'll have it on his lunch and he just eats whatever's put there,

so that's a big change. Are you playing football with your grapes?

And how's he generally been?

His attitude to the food, I think, is the biggest thing.

Rather than it always being, "Do I have to have me tea?" He's asking, "When's tea?"

It's a big change for him

to sit there munching on an apple like that.

That's all I've really been trying to do since he started eating.

-I'm actually intrigued as to how his skin is doing.

-Yeah.

-His skin's pretty good at the moment, isn't it, Lucas?

-Can I have a look at your skin?

Can you show your arms?

When I first met you a few weeks ago, there were loads of red dots there.

-Where are they?

-In my arm.

-They're in your arm?

-They're not there, are they? That's a lot better, isn't it?

-Yeah.

Wow! Fantastic!

-My spots are going down.

-Ah. Does that make you happy?

-Yeah.

The downside to him having a better appetite, now he's got more energy.

-Never stops running about and jumping all over.

-That's great, though, isn't it?

-That's what a five-year-old should be doing.

-Exactly, yeah.

It's great to hear that. Really, really great.

A recent urine test has also shown that Ray is finally opiate free.

So Ray, tell me, I'm desperate to know, how's the pain?

Gone. All of it. Me back, me shoulder, everything.

I feel like a different person, I feel about 20 years younger.

So when was the last time you had to take painkillers?

Oh, I've not took any opiate painkillers now for over three weeks

-and it's probably... This is t'fourth weekend coming up.

-Fantastic!

I still believe that not taking these opiates has improved me sleep.

-Yeah.

-You know, it's improved me mood.

-You know, I find meself... I'm a lot more happier.

-I can see it, Ray.

I can see that the Ray I met a few weeks ago and the Ray I'm seeing in front of me now,

it's like two different people.

Just eight weeks ago, all Ray wanted to do was have a kickabout with his kids...pain free.

-Dad, you're rubbish.

-I'm rubbish?

Honestly, I'm not overstating this, this is life-changing for me.

To finally be pain free after all these years, absolutely amazing.

-It's unreal.

-To see the changes today, it's been amazing, absolutely amazing.

-Thank you very much.

-Thank you. Thank you for letting me in and allowing me to help you.

-I have an old saying, I don't really say it that often, but there's me hand, there's me heart.

-Take care.

Making those kind of changes with Ray and with Lucas,

it's pretty close to being my biggest achievement as a doctor, ever.

Make sure you keep those spots away, OK? I don't want to see them come back ever, all right?

He's probably saved me marriage in a way, because that's where I was going,

I was getting...addicted to these painkillers, I was being more and more moody.

And so, not only am I pain free, not only is Lucas now being a normal five-year-old little boy,

but me and Rachel are talking more, me and Rachel are closer together,

and that's all because of Dr Rangan.

Thank you very much. You know I owe you everything. Love you to bits, mate. Thank you very much.

My pleasure. Take care, all right?

-Yeah, you take care and take it easy.

-Say bye-bye.

-See you, Lucas. See you guys.

-See ya.

-See you.

-Say bye.

Next time...

Rangan is in Shrewsbury...

-Hello.

-Hello, nice to meet you.

..to deal with a family of junk-food addicts.

-What is it you require my help for?

-Where do we begin?

-LAUGHTER

-Bleep!

-But with all four family members in trouble,

-has he bitten off more than he can chew?

-I'm a little bit nervous, actually, about bringing this up.

-You're coming out of the friendship zone, son.

-And after diagnosing a hidden killer,

he's faced with delivering some difficult news.

I think you've already got it.