0:00:02 > 0:00:06What would a doctor discover if they lived with you 24 hours a day?
0:00:06 > 0:00:08- Hello.- Hello.
0:00:08 > 0:00:10Corel, come and meet the doctor.
0:00:10 > 0:00:13- How much would you be willing to reveal?- Hello...
0:00:13 > 0:00:17I'm scared I may get bullied for how I look, and my weight.
0:00:17 > 0:00:19I feel like I'm drugged.
0:00:19 > 0:00:21But Nicola, you're right - you ARE drugged.
0:00:21 > 0:00:23Would they be shocked by what they find?
0:00:23 > 0:00:26Nobody has explained to her,
0:00:26 > 0:00:31in language that she understands, how to manage her condition.
0:00:31 > 0:00:32It is not acceptable.
0:00:33 > 0:00:37Most GPs only get about ten minutes with each patient.
0:00:37 > 0:00:40Dr Rangan Chatterjee wants to try a different approach.
0:00:41 > 0:00:45All the time in my consultation room, I'm seeing problems that are
0:00:45 > 0:00:47lifestyle problems, and they don't need a pill,
0:00:47 > 0:00:49they need a lifestyle change.
0:00:50 > 0:00:52He's about to spend time with families
0:00:52 > 0:00:55who struggle with their health.
0:00:55 > 0:00:57Everything we've tried has basically failed.
0:00:57 > 0:00:59WOMAN GROANS
0:00:59 > 0:01:03He'll gain insight into every aspect of his patients' lives.
0:01:03 > 0:01:06How do they eat, how do they sleep, how do they move and exercise,
0:01:06 > 0:01:09and how do they, sort of, switch off and relax?
0:01:09 > 0:01:11He'll detect undiagnosed illnesses...
0:01:11 > 0:01:14It probably puts you at a higher risk of early death.
0:01:14 > 0:01:16..deliver some home truths...
0:01:16 > 0:01:18I think this fear is holding you back.
0:01:18 > 0:01:21Please don't turn it into this is, erm...
0:01:21 > 0:01:23this is because I'm mentally fearful.
0:01:24 > 0:01:29..and discover ways we could all live longer, healthier lives.
0:01:29 > 0:01:32It's amazing how many times, when you get those basics right,
0:01:32 > 0:01:35all the other problems get so much better.
0:01:35 > 0:01:38Feeling good, energy up...
0:01:38 > 0:01:40I can even dance!
0:01:40 > 0:01:41- Have a dance, yeah!- Hey, hey!
0:01:48 > 0:01:52Tonight, Rangan is going to help two families with busy working mums,
0:01:52 > 0:01:55both suffering from stress and exhaustion.
0:01:55 > 0:01:57Right, so, not only have I got one, I've got the short one...
0:01:57 > 0:02:01First up is the Singletons in Bolton -
0:02:01 > 0:02:0517-year-old Cameron, 12-year-old Logan,
0:02:05 > 0:02:06and six-year-old Zachary...
0:02:06 > 0:02:07Two against one.
0:02:07 > 0:02:11I've been craving a chocolate biscuit all day.
0:02:11 > 0:02:12I am a biscuit addict.
0:02:12 > 0:02:17..41-year-old dad Ian, a teacher, and mum, 39-year-old Nicola.
0:02:19 > 0:02:21They've called the doctor for Nicola, whose illnesses leave her
0:02:21 > 0:02:23exhausted and often in pain.
0:02:25 > 0:02:28I always say to people, think of your most tired day
0:02:28 > 0:02:29and then times it by ten.
0:02:29 > 0:02:34Day in, day out, for weeks, months, years on end.
0:02:34 > 0:02:36I actually, honestly, cannot remember what
0:02:36 > 0:02:37it's like to feel awake.
0:02:37 > 0:02:39It's a fight every single day, and...
0:02:39 > 0:02:43and, you know, she looks perfectly normal.
0:02:43 > 0:02:46You know, walking past her on the street, you wouldn't have a clue,
0:02:46 > 0:02:49and I think a lot of people just don't see it.
0:02:49 > 0:02:52They don't understand it, and, "Oh, you're just being lazy."
0:02:52 > 0:02:55Cos, well, no, it's not laziness.
0:02:59 > 0:03:02Dr Rangan believes that the best way to find the root cause
0:03:02 > 0:03:04of a person's illness is to investigate
0:03:04 > 0:03:06every part of their lives.
0:03:06 > 0:03:10He's devoting the next few months to helping the Singleton family.
0:03:10 > 0:03:12- Hello.- Hello.- Hi.
0:03:12 > 0:03:14- Hi.- Can I introduce you?
0:03:14 > 0:03:15- Cameron.- I'm Cameron.- Cameron, hi.
0:03:15 > 0:03:17- This is Zachary.- Hi, Zach. Hi. - Logan.
0:03:17 > 0:03:19Logan, hi. I'm Dr Chatterjee. How are you doing?
0:03:19 > 0:03:21So, can you tell me a little bit about
0:03:21 > 0:03:23what's actually going on with your health?
0:03:23 > 0:03:25I have fibromyalgia -
0:03:25 > 0:03:27that's been about a year I've had fibromyalgia.
0:03:27 > 0:03:30- I've had ME for about nearly... - Four.
0:03:30 > 0:03:32Diagnosed officially about four years,
0:03:32 > 0:03:34but I think since I got pregnant with
0:03:34 > 0:03:35my youngest child, who is now six.
0:03:35 > 0:03:39An underactive thyroid... I also have sciatica.
0:03:39 > 0:03:42Nicola has been diagnosed with numerous conditions.
0:03:42 > 0:03:46Fibromyalgia and ME are characterised by extreme tiredness
0:03:46 > 0:03:49and unexplained pain all over the body.
0:03:49 > 0:03:52Sciatica is nerve pain in the back and legs.
0:03:52 > 0:03:54- Everything hurts.- Every day?
0:03:54 > 0:03:58- Every day.- Is that when you move the joints, or is that just
0:03:58 > 0:03:59you just sitting here now?
0:03:59 > 0:04:02I can be lying there in bed at night, and your fingers become
0:04:02 > 0:04:05really heavy and stiff, or you get pins and needles.
0:04:05 > 0:04:09Every time I bend, every time I move, it hurts.
0:04:09 > 0:04:12Is there one thing that you think we could achieve?
0:04:12 > 0:04:14What would that one thing be?
0:04:14 > 0:04:17What I'd like to do is really just to...
0:04:17 > 0:04:21hopefully to gain, sort of, some energy,
0:04:21 > 0:04:23you know, for it not to hurt. Everything hurts.
0:04:27 > 0:04:31It's just staggering. I've got at least eight different diagnoses.
0:04:31 > 0:04:32Erm...
0:04:32 > 0:04:35For me, there's never eight separate things going on
0:04:35 > 0:04:36in someone's body, never.
0:04:36 > 0:04:42I'm trying to see, can I identify the root cause that's...
0:04:42 > 0:04:45that may be, sort of, pulling all of this together?
0:04:45 > 0:04:48There's something going on that we haven't identified yet
0:04:48 > 0:04:49and we need to find out what that is.
0:04:49 > 0:04:51SHE CHUCKLES
0:04:51 > 0:04:54To fully understand Nicola's illness, Rangan wants to speak to
0:04:54 > 0:04:55those closest to her.
0:04:57 > 0:05:00I had a long chat with your mum before and she was telling me a lot
0:05:00 > 0:05:02about the things that affect her health.
0:05:02 > 0:05:03Erm...
0:05:03 > 0:05:04How does that affect you?
0:05:04 > 0:05:07I know I'm helping someone out with, er,
0:05:07 > 0:05:12sort of, like, a disability of back pains, leg pains, nerve pains,
0:05:12 > 0:05:16I think, and it makes me feel good on the inside,
0:05:16 > 0:05:20but I wish we could, like, play.
0:05:20 > 0:05:24Do you remember before your mum got this ill? Can you remember that?
0:05:25 > 0:05:28She actually helped me ride my bike.
0:05:28 > 0:05:31I had stabilisers. We just went up and down the street...
0:05:31 > 0:05:34- Right.- ..and it was a bit bumpy, so she helped me
0:05:34 > 0:05:37just get stable and everything.
0:05:37 > 0:05:40Do you think she'd find it hard now?
0:05:40 > 0:05:45Definitely, with all the legs...leg pain which she has,
0:05:45 > 0:05:48- she would find it hard.- Yeah.
0:05:50 > 0:05:52Do you ever think about your mum's health?
0:05:52 > 0:05:54It can feel very hopeless sometimes, cos we've spent the last
0:05:54 > 0:05:57four or five years trying to do something about it,
0:05:57 > 0:06:00one way or another, and we've not gotten anywhere, really.
0:06:00 > 0:06:02How does it feel for you,
0:06:02 > 0:06:05having me coming out of the blue into your house?
0:06:05 > 0:06:08I don't expect anything, because everything they've tried has
0:06:08 > 0:06:09basically failed.
0:06:09 > 0:06:11They've just had to put her on tablets, and then on more tablets,
0:06:11 > 0:06:13and then on a stronger dose of more tablets,
0:06:13 > 0:06:15and then on a different tablet entirely that
0:06:15 > 0:06:16she probably shouldn't even be on,
0:06:16 > 0:06:19and then she's got all these side-effects, and it's just a mess.
0:06:19 > 0:06:20It's an absolute mess.
0:06:23 > 0:06:27One thing I CAN promise you, right here, right now, is that
0:06:27 > 0:06:32I will do everything I possibly can to try and work out what's going on.
0:06:32 > 0:06:34You've got my word, I'm going to try my best on that, OK?
0:06:36 > 0:06:40I really want to help Nicola, but I feel even more compelled to
0:06:40 > 0:06:43do my best after chatting to her kids.
0:06:43 > 0:06:47This is impacting the whole family - it's not just her.
0:06:47 > 0:06:50It's really become clear to me how...
0:06:50 > 0:06:53much of an impact Nicola's health is having on their entire lives.
0:06:56 > 0:06:57Nicola, would it be all right to have a look at
0:06:57 > 0:07:00- the medications that you're on? - Yeah, of course you can.
0:07:00 > 0:07:03Rangan fears that, to tackle her constant pain,
0:07:03 > 0:07:06Nicola has been overdosing on heavy painkillers.
0:07:06 > 0:07:08There's a lot there, isn't there?
0:07:08 > 0:07:11You take, maybe sometimes up to eight of these...
0:07:11 > 0:07:13- Up to eight sometimes. - ..codeines a day.
0:07:13 > 0:07:17Two tablets of Zapain, naproxen up to four,
0:07:17 > 0:07:18and the Lyrica up to three.
0:07:18 > 0:07:22That's 17 pills,
0:07:22 > 0:07:23on a bad day, you're taking.
0:07:23 > 0:07:25- I feel like I'm drugged.- Yeah.
0:07:25 > 0:07:27I feel like I'm completely and utterly spaced out.
0:07:27 > 0:07:30But Nicola, you're right, you ARE drugged, because you're nearly
0:07:30 > 0:07:32on 20 pills every day.
0:07:32 > 0:07:35You are still feeling bad, but then you think you have to
0:07:35 > 0:07:38take them to help you, and I think there's a vicious cycle.
0:07:38 > 0:07:41Yeah. This is my future.
0:07:41 > 0:07:44And I don't like it one little bit, so...
0:07:44 > 0:07:46hence asking you to come here.
0:07:48 > 0:07:52Rangan has been assessing Nicola for over eight hours...
0:07:52 > 0:07:54No, we're not going in the car. Come on.
0:07:54 > 0:07:57..but it's on her evening walk that he sees first-hand
0:07:57 > 0:08:00her extreme levels of exhaustion.
0:08:00 > 0:08:03So, it's my challenge of the day.
0:08:03 > 0:08:06- For me, this is like climbing Mount Everest.- Yeah.
0:08:08 > 0:08:10Nicola walks for an hour each day,
0:08:10 > 0:08:14until the pain and exhaustion forces her to stop.
0:08:14 > 0:08:16- I feel stiff.- Stiffer...
0:08:16 > 0:08:18- Stiffer, yes.- ..and more sore than when we started the walk?
0:08:18 > 0:08:19- Yes.- Yeah.
0:08:20 > 0:08:23You definitely look as though you've had it taken out of you.
0:08:23 > 0:08:25Yeah. It does,
0:08:25 > 0:08:28it IS tiring. It is really tiring.
0:08:28 > 0:08:31But that sense of achievement is huge for me.
0:08:31 > 0:08:33You know, actually, I've noticed...
0:08:33 > 0:08:35Now, have YOU noticed this?
0:08:35 > 0:08:38That sometimes your eyelids, they're blinking slower now?
0:08:38 > 0:08:39And that tells me your body is very tired.
0:08:39 > 0:08:42Sometimes your eyes want to close by themselves.
0:08:42 > 0:08:44Yeah, yeah. Is that how you feel now, a little bit?
0:08:44 > 0:08:47Yeah. I don't move. I just don't move.
0:08:48 > 0:08:51I'll try and come up with a plan to help you.
0:08:51 > 0:08:54This family, and in particular Nicola, is desperate.
0:08:55 > 0:08:57I think she...
0:09:00 > 0:09:03I think she hides it a lot,
0:09:03 > 0:09:04and I think I'm their last chance.
0:09:09 > 0:09:12In the morning, Rangan begins analysing Nicola.
0:09:14 > 0:09:16Fibromyalgia, chronic fatigue syndrome -
0:09:16 > 0:09:20they're a bit of a medical mystery, and it can be quite hard for us to
0:09:20 > 0:09:22do things that get these patients better.
0:09:22 > 0:09:26She's got all these different diagnoses, but ultimately,
0:09:26 > 0:09:30the two big things that are affecting her quality of life,
0:09:30 > 0:09:34when you strip it all away, is pain and fatigue.
0:09:34 > 0:09:36That walk, when she came up the hill,
0:09:36 > 0:09:39she just suddenly stopped being able to generate energy,
0:09:39 > 0:09:42and there's a lot of research suggesting that in some patients
0:09:42 > 0:09:46with chronic fatigue syndrome and fibromyalgia, actually,
0:09:46 > 0:09:50their mitochondria aren't really working as well as they should be.
0:09:50 > 0:09:53Mitochondria are basically the powerhouse of the cell.
0:09:53 > 0:09:56It's... It's like an energy factory for the body,
0:09:56 > 0:09:59so I'm going to give Nicola some nutritional supplements
0:09:59 > 0:10:03to help get these mitochondria, these energy factories,
0:10:03 > 0:10:04working much better.
0:10:05 > 0:10:09Rangan's next job is to explain his vision to Nicola.
0:10:09 > 0:10:12I'm going to use an analogy of a train to try and demonstrate the way
0:10:12 > 0:10:14I'm thinking about this at the moment, OK?
0:10:14 > 0:10:19So, this train is meant to be you, Nicola, OK?
0:10:19 > 0:10:22And I think that over many years of picking up labels,
0:10:22 > 0:10:24I think you're being held back.
0:10:24 > 0:10:28OK? So, for example,
0:10:28 > 0:10:31your chronic fatigue syndrome, OK?
0:10:31 > 0:10:33That's been attached onto you.
0:10:33 > 0:10:36This is your fibromyalgia...
0:10:36 > 0:10:38that you've been labelled with as well.
0:10:38 > 0:10:41This... So your underactive thyroid..
0:10:41 > 0:10:44This...is the anxiety symptoms that you feel.
0:10:44 > 0:10:47Your gut symptoms that are bothering you...
0:10:47 > 0:10:49I could make this train even longer.
0:10:49 > 0:10:53The point is, you've picked up all these different labels,
0:10:53 > 0:10:57you've got all these diagnoses and these pills to try and treat the
0:10:57 > 0:11:00symptoms of all these problems, OK?
0:11:00 > 0:11:02But actually, I think they're holding you back.
0:11:02 > 0:11:05They're not allowing Nicola to keep going on with her life,
0:11:05 > 0:11:08so what I propose we do
0:11:08 > 0:11:12is we get rid of all these labels, OK?
0:11:12 > 0:11:14We get rid of all these different labels
0:11:14 > 0:11:17that have been attached to you,
0:11:17 > 0:11:21and what I want to do is I want to focus on you as Nicola,
0:11:21 > 0:11:26and say, "What's not working? Let's fix it and see where we get to."
0:11:26 > 0:11:27That sounds great to me.
0:11:28 > 0:11:30It's just so overwhelming -
0:11:30 > 0:11:34the ME, learning to cope with that, which took a long time,
0:11:34 > 0:11:37and then the fibromyalgia,
0:11:37 > 0:11:39and then, on top of that, the sciatica.
0:11:39 > 0:11:41It was just like, "Any more..."
0:11:41 > 0:11:44What is it? What is it that's upsetting you?
0:11:45 > 0:11:46Well, it just sounds hopeful...
0:11:50 > 0:11:53..and we've not had that for a long time.
0:11:53 > 0:11:54HE SNIFFLES
0:11:57 > 0:12:00While Rangan waits for Nicola's blood results,
0:12:00 > 0:12:02he travels to his next patient,
0:12:02 > 0:12:05who is also suffering from severe exhaustion.
0:12:05 > 0:12:08Yeah, tiredness, exhaustion, I see that every single day -
0:12:08 > 0:12:10particularly amongst women -
0:12:10 > 0:12:15and the interesting thing is, there can be so many different causes,
0:12:15 > 0:12:19and actually, I'd say it's something that, as a profession,
0:12:19 > 0:12:21I don't think we're that good at treating.
0:12:21 > 0:12:24I think there's a lot of people out there who are tired,
0:12:24 > 0:12:28who are stressed, who are exhausted, and actually, they don't know
0:12:28 > 0:12:29how to get any help.
0:12:29 > 0:12:33- Hello, nice to meet you. I'm Laverne.- Hi, I'm Dr Chatterjee.
0:12:33 > 0:12:34- Hi.- Hi.
0:12:34 > 0:12:37Corel, come and meet the doctor.
0:12:37 > 0:12:38- Hello.- How are you doing?
0:12:38 > 0:12:40- OK.- Hi, my name's Rangan.
0:12:40 > 0:12:42Really nice to meet you. Are you well?
0:12:42 > 0:12:44Rangan is meeting the Hayes family...
0:12:44 > 0:12:45Hello, Mum, are you all right?
0:12:45 > 0:12:48..granny Doreen, mum Laverne,
0:12:48 > 0:12:52and her two sons, 16-year-old Sampras and five-year-old Corel.
0:12:52 > 0:12:54Come through.
0:12:54 > 0:12:56I am concerned for Laverne.
0:12:56 > 0:12:59- What are you concerned about? - I'm diabetic.
0:12:59 > 0:13:03Before I was diagnosed with diabetes, I remember
0:13:03 > 0:13:07all the symptoms that I had and all the things I was going through,
0:13:07 > 0:13:11and now I can see it's straight on Laverne.
0:13:11 > 0:13:13What sort of problems do you need help with?
0:13:13 > 0:13:15My headaches, you know, my stomach bloating,
0:13:15 > 0:13:18the fact that I'm just, like, always tired...
0:13:18 > 0:13:20How long has this been going on for?
0:13:20 > 0:13:22I would say at least...
0:13:25 > 0:13:26..seven years?
0:13:26 > 0:13:28Seven years.
0:13:28 > 0:13:30A long time.
0:13:32 > 0:13:35Rangan wants to see if markers of type 2 diabetes
0:13:35 > 0:13:37are present in their blood...
0:13:39 > 0:13:41- There, thank you very much. - You're welcome.
0:13:41 > 0:13:44..but he also wants to investigate Laverne's exhaustion
0:13:44 > 0:13:46by following her daily routine.
0:13:46 > 0:13:48I'm running a bit late, as I do.
0:13:48 > 0:13:50First stop, the school run.
0:13:50 > 0:13:52Do you sleep well?
0:13:53 > 0:13:55Sometimes.
0:13:55 > 0:13:58Then it's off to her job at a local car showroom.
0:13:58 > 0:14:00- Morning!- Hello!
0:14:01 > 0:14:03Then Laverne shops for the family...
0:14:03 > 0:14:05But I want the fresh ones here.
0:14:05 > 0:14:07..and goes home to cook dinner.
0:14:07 > 0:14:08And this fatigue,
0:14:08 > 0:14:11- have you ever spoken to your doctor about that before?- Yeah.
0:14:11 > 0:14:13When I go to the doctor, I see lots of different doctors.
0:14:13 > 0:14:16I don't get to see the same one. So you see different ones,
0:14:16 > 0:14:17they tell you this, they tell you that,
0:14:17 > 0:14:21but no-one actually comes up with, you know, a solution to the problem.
0:14:21 > 0:14:24Back out for the school pick-up...
0:14:25 > 0:14:27I heard she's just had Spanish class.
0:14:27 > 0:14:29..and then it's time for her gym session.
0:14:31 > 0:14:35Do you pretend that IS someone, when you're hitting it?
0:14:35 > 0:14:38Rangan wants to discover if Laverne's hectic lifestyle
0:14:38 > 0:14:40is affecting her health.
0:14:40 > 0:14:45What I'd like to do is measure how busy your life is
0:14:45 > 0:14:48- and how much stress that's putting on you, OK?- OK.
0:14:48 > 0:14:50And so I've brought a test. It's actually... It's very simple to do.
0:14:50 > 0:14:54- It's basically... It's a... It's a stress test.- OK.
0:14:54 > 0:14:57OK? You would have to spit into a tube four times during the day.
0:14:57 > 0:14:58Oh, right.
0:14:58 > 0:15:01And each time it's going to measure something called cortisol,
0:15:01 > 0:15:03which is basically your stress hormone,
0:15:03 > 0:15:08and what it does, it gives me an idea of how stressed your life is,
0:15:08 > 0:15:11and when I get the results, I might, I hope,
0:15:11 > 0:15:12be able to come up with a plan to address it.
0:15:12 > 0:15:15- Right now?- If you don't mind, yeah.
0:15:15 > 0:15:17- OK.- Is that OK?
0:15:17 > 0:15:19And I just want to check that you're doing it right
0:15:19 > 0:15:21and then check we've got enough that we need, OK?
0:15:21 > 0:15:23- OK.- Yeah?- Yeah.
0:15:23 > 0:15:24OK.
0:15:25 > 0:15:28The spit test isn't the only way Rangan
0:15:28 > 0:15:30is going to gather information.
0:15:30 > 0:15:33I've actually brought the waterproof wrist monitor, that
0:15:33 > 0:15:37I would like you to wear 24 hours a day for the next few days.
0:15:37 > 0:15:39- It's going to measure your activity levels.- OK.
0:15:39 > 0:15:41It's going to measure your exposure to light.
0:15:41 > 0:15:44It's going to measure your sleep quality,
0:15:44 > 0:15:47and I'm hoping that, by getting that data, it's going to give me a much
0:15:47 > 0:15:50better understanding of what's going on with you.
0:15:50 > 0:15:56She's your classic case of a woman who is frankly go, go, go,
0:15:56 > 0:15:59the entire time. She's doing what she needs to for her kids,
0:15:59 > 0:16:03for her mother, whatever her work requires, she's there.
0:16:03 > 0:16:05In many ways, she's Superwoman,
0:16:05 > 0:16:10but actually that's coming at a cost, and the cost is her.
0:16:10 > 0:16:11CHILD SQUEALS
0:16:11 > 0:16:15After dinner, when most people are thinking about bed,
0:16:15 > 0:16:19Laverne heads out to her second job as a nightclub bouncer.
0:16:19 > 0:16:21DANCE MUSIC PLAYS
0:16:21 > 0:16:25Up to five nights a week, Laverne runs the door of a local club.
0:16:25 > 0:16:28She's on her feet for up to 12 hours,
0:16:28 > 0:16:31patrolling the venue and dealing with Northampton's revellers.
0:16:32 > 0:16:34I've always had two jobs.
0:16:34 > 0:16:35Right.
0:16:35 > 0:16:39For financial reasons, and also because of my boys,
0:16:39 > 0:16:44I've always tried to work part-time, so I'm there for them after school.
0:16:44 > 0:16:48- Right.- It's just the way it is, It's just what I have to do.
0:16:48 > 0:16:49Yeah.
0:16:50 > 0:16:55And even after the club has closed, Laverne's work is far from finished.
0:16:59 > 0:17:00How was it tonight?
0:17:00 > 0:17:03Very, very busy - a hard one tonight.
0:17:03 > 0:17:06- Yeah?- A really hard one tonight.
0:17:06 > 0:17:08Thanks for showing me around today,
0:17:08 > 0:17:10and I hope you get a good night's sleep, OK?
0:17:10 > 0:17:11- Thank you.- Take care. Bye.
0:17:11 > 0:17:12Bye.
0:17:12 > 0:17:14It's midnight.
0:17:14 > 0:17:16She must be absolutely exhausted.
0:17:16 > 0:17:20She's been going all day, nonstop.
0:17:20 > 0:17:22She's been working in that club.
0:17:22 > 0:17:25She is just pushing it too hard,
0:17:25 > 0:17:30and I'm not quite sure at the moment how I'm going to get through to her
0:17:30 > 0:17:32that something needs to change.
0:17:41 > 0:17:44Rangan travels back to Bolton, to begin his treatment plan
0:17:44 > 0:17:46with the Singleton family.
0:17:46 > 0:17:48He starts by giving Nicola vitamin boosters.
0:17:50 > 0:17:52So Nicola, there's a few things I've identified in your bloods that
0:17:52 > 0:17:54I think we could do with optimising.
0:17:54 > 0:17:56One of them is your B12 level,
0:17:56 > 0:17:59but also I noticed that your vitamin D level was very low,
0:17:59 > 0:18:03and I'm suspicious that you may need some nutrients
0:18:03 > 0:18:06to help you with generating energy in the body.
0:18:06 > 0:18:09He also gets her to fill out a questionnaire that
0:18:09 > 0:18:11gives her a score for her health.
0:18:12 > 0:18:15But Rangan suspects one reason for Nicola's exhaustion and pain
0:18:15 > 0:18:17could be her diet.
0:18:17 > 0:18:20A lot of foods, in particular processed foods,
0:18:20 > 0:18:22refined foods and sugar,
0:18:22 > 0:18:27what they do is they cause inflammation in your gut, OK?
0:18:27 > 0:18:29That's not a good thing. It's a bit like a fire in your gut.
0:18:29 > 0:18:31That's what they cause, OK?
0:18:31 > 0:18:34This inflammation is associated with many of your symptoms.
0:18:34 > 0:18:37It's very hard for me to distinguish between what IS harming you
0:18:37 > 0:18:39and what has the potential to,
0:18:39 > 0:18:43so the way we tackle it is with what's called an elimination diet.
0:18:43 > 0:18:48So we cut out the common known food triggers -
0:18:48 > 0:18:51I'm talking about wheat, dairy products,
0:18:51 > 0:18:54processed foods, and sugar.
0:18:54 > 0:18:56OK...
0:18:56 > 0:18:59The elimination diet removes common foods like wheat and dairy,
0:18:59 > 0:19:02which could be causing Nicola problems.
0:19:02 > 0:19:06Eliminating foods can identify allergies and intolerances that
0:19:06 > 0:19:09might affect a lot more than Nicola's gut.
0:19:09 > 0:19:12I'm looking at what the food's going to do to your body, as opposed to
0:19:12 > 0:19:14how many calories or how much fat's in it,
0:19:14 > 0:19:18that honestly doesn't interest me when I'm looking at these.
0:19:18 > 0:19:20I'm interested in thinking,
0:19:20 > 0:19:22"Is this the correct fuel for you to be putting in your body
0:19:22 > 0:19:24"at the moment or not?"
0:19:24 > 0:19:28If there's only wholesome, healthy food for you in the house,
0:19:28 > 0:19:31that takes willpower out of the equation.
0:19:31 > 0:19:33So this is going to be tough on you too.
0:19:34 > 0:19:37But getting the boys to part with their favourite food
0:19:37 > 0:19:39is easier said than done.
0:19:39 > 0:19:41- Yeah, that's the biscuit tin. - The biscuit tin.
0:19:41 > 0:19:43Dad's favourite place.
0:19:43 > 0:19:44He's got a biscuit belly.
0:19:44 > 0:19:46- He's got a biscuit belly?- Yeah!
0:19:46 > 0:19:48There are more biscuits.
0:19:49 > 0:19:51I will definitely miss cheese.
0:19:51 > 0:19:53I don't have many crisps, and I don't have many biscuits.
0:19:53 > 0:19:55You do. You have a bag of crisps a day, honey.
0:19:55 > 0:19:58- No, I don't have a bag of crisps a day.- You do.- No, I don't.
0:19:58 > 0:20:00- At least I'm not going to cry over a piece of cheese.- I know...
0:20:00 > 0:20:02- OK, right, well, we'll get on to that.- Shh!
0:20:02 > 0:20:05Stop, stop. Logan, I'm not having a go...
0:20:05 > 0:20:08Hey, guys, would you mind if I added something in here?
0:20:08 > 0:20:11I've come in, and I'm interested in how to move forward, to primarily
0:20:11 > 0:20:13help your mother,
0:20:13 > 0:20:16and I hope the rest of the family as well at the same time,
0:20:16 > 0:20:19but primarily my focus is on your mum.
0:20:19 > 0:20:23We've been stuck with this for the last six years or so,
0:20:23 > 0:20:27so if you've got a solution, let's roll with it.
0:20:27 > 0:20:28Why not?
0:20:28 > 0:20:31The family have agreed to three weeks on the elimination diet.
0:20:33 > 0:20:37Rangan also wants to address Nicola's reliance on painkillers.
0:20:37 > 0:20:41The problem I'm seeing is a problem I see a lot these days, OK?
0:20:41 > 0:20:43You're on multiple different medications to
0:20:43 > 0:20:45help multiple different symptoms.
0:20:45 > 0:20:47The medications aren't helping the underlying cause,
0:20:47 > 0:20:49they're just treating symptoms,
0:20:49 > 0:20:52and the medications themselves are potentially very dangerous.
0:20:54 > 0:20:57One of Nicola's painkillers is an opiate called co-codamol.
0:20:57 > 0:21:00They are very, very, very strong.
0:21:00 > 0:21:01You've already had four.
0:21:01 > 0:21:06It's about half eleven, and you've already taken
0:21:06 > 0:21:09a lot of opiate and a lot of paracetamol, erm...
0:21:09 > 0:21:12And I think it's just a reflection of how long you've been coping with
0:21:12 > 0:21:15this, is that you don't bat an eyelid.
0:21:15 > 0:21:17Now, I would love, over the next few weeks,
0:21:17 > 0:21:20to see if we can reduce how much you need these medications.
0:21:20 > 0:21:22I'm not talking about stopping them all,
0:21:22 > 0:21:25because I think you've got symptoms for what you...
0:21:25 > 0:21:27and you have actually become reliant,
0:21:27 > 0:21:30so whether it's, you know, reliant on being pain-free...
0:21:30 > 0:21:31That's what scares me.
0:21:31 > 0:21:34It's dealing with the level of discomfort that I'm going to
0:21:34 > 0:21:38be feeling without the pills.
0:21:39 > 0:21:43Rangan wants to reduce Nicola's 17 painkillers a day by at least half,
0:21:43 > 0:21:46a process that should always be done under medical supervision.
0:21:49 > 0:21:52By five o'clock, Nicola is exhausted,
0:21:52 > 0:21:57leaving the boys to tackle their first meal of the elimination diet.
0:21:57 > 0:22:00- What are we...? What are you cooking?- Spaghetti Bolognese.
0:22:00 > 0:22:03Instead of putting spaghetti with it, which has got the wheat in,
0:22:03 > 0:22:07- we're having some rice noodles to replace the...- I love noodles!
0:22:07 > 0:22:09..to replace the spaghetti.
0:22:09 > 0:22:13Some people struggle to digest gluten in wheat pasta,
0:22:13 > 0:22:16and it can lead to inflammation in the gut.
0:22:16 > 0:22:21And Dr Chatterjee is just preparing some sweet potatoes.
0:22:21 > 0:22:23Guys, I have this a lot at home, and my kids do as well -
0:22:23 > 0:22:26they love it, so I'm optimistic at the moment.
0:22:26 > 0:22:27I'm not a normal kid.
0:22:29 > 0:22:30Does it sound good?
0:22:30 > 0:22:32We've not had it yet. Let's find out...
0:22:32 > 0:22:35- It sounds fine.- Sounds good - how it tastes is different.
0:22:36 > 0:22:42Nicola wakes up just in time for the boys to deliver their offering.
0:22:42 > 0:22:43That looks pretty good, yeah.
0:22:43 > 0:22:45It tastes like chicken.
0:22:45 > 0:22:48It's.. It's, like, you know, it's...
0:22:48 > 0:22:50It's fine. It's nice. It's...
0:22:50 > 0:22:53It could have been a lot worse.
0:22:53 > 0:22:54This is really nice, actually.
0:22:54 > 0:22:56We don't normally have rice noodles,
0:22:56 > 0:22:59- but actually they're absolutely fine.- Mmm!
0:22:59 > 0:23:01Shall I just pop it there for you?
0:23:03 > 0:23:05'As doctors, we all want more time with our patients,
0:23:05 > 0:23:08'and I can't complain about that here,'
0:23:08 > 0:23:09but with that comes a huge challenge.
0:23:09 > 0:23:13The challenge is that, as you spend more time, you get closer,
0:23:13 > 0:23:15you start to build up a personal connection,
0:23:15 > 0:23:19that actually can make it quite hard to remain objective.
0:23:19 > 0:23:22I think that's going to get more and more challenging.
0:23:27 > 0:23:30In Northampton, the blood results are back.
0:23:30 > 0:23:34Rangan tested both mother Doreen and daughter Laverne,
0:23:34 > 0:23:36and he's received some worrying results.
0:23:36 > 0:23:39Let's say, for example, we've got optimal health here, OK?
0:23:39 > 0:23:40Blood sugar is excellent,
0:23:40 > 0:23:42the whole body's functioning really, really well.
0:23:42 > 0:23:47And up here we've got type 2 diabetes, OK?
0:23:47 > 0:23:48This is a curve.
0:23:48 > 0:23:50You're round about here.
0:23:50 > 0:23:53OK? Things have been going wrong for a long period of time.
0:23:53 > 0:23:56Your fasting insulin level was far too high.
0:23:58 > 0:23:59Now, yours was very high, OK,
0:23:59 > 0:24:04yours was 25, and we like to see it, really, under six, OK?
0:24:04 > 0:24:09But yours was 13 - you're moving up that curve.
0:24:09 > 0:24:11Was that a bit of a shock?
0:24:11 > 0:24:12Yeah, it is.
0:24:12 > 0:24:14It's actually not a shock to me.
0:24:14 > 0:24:17I was going to the doctor's all the time and taking all the tests,
0:24:17 > 0:24:20but I wasn't diagnosed with diabetes, not until when it got to,
0:24:20 > 0:24:22as you said, that level.
0:24:22 > 0:24:25- Things have gone wrong a long time before then.- Yeah.
0:24:25 > 0:24:27And I actually find it intensely frustrating
0:24:27 > 0:24:30that we wait until people have a diagnosis
0:24:30 > 0:24:32- to say, "Oh, now you're type 2 diabetic."- Yeah.
0:24:32 > 0:24:34Well, hold on a minute - we can pick this up beforehand,
0:24:34 > 0:24:38so let's pick it up beforehand and tell people what they can do
0:24:38 > 0:24:40to NOT become diabetic.
0:24:40 > 0:24:42I'm actually, really, sort of,
0:24:42 > 0:24:44thankful for this sort of information,
0:24:44 > 0:24:47because I definitely want to do something about it.
0:24:47 > 0:24:52I definitely don't want it to get to that stage where it's just too late.
0:24:52 > 0:24:56Rangan has also found something alarming in Doreen's blood results.
0:24:56 > 0:24:59I'm a little bit concerned by your blood results,
0:24:59 > 0:25:01and I'll tell you why.
0:25:01 > 0:25:06There's a few markers that are elevated, that worry me.
0:25:06 > 0:25:07Mm-hm.
0:25:07 > 0:25:09One of them is your homocysteine level.
0:25:09 > 0:25:13Now, homocysteine is basically a compound in the blood
0:25:13 > 0:25:14- that we measure...- Mm-hm.
0:25:14 > 0:25:19..and it's associated with heart attacks and strokes,
0:25:19 > 0:25:23- and it's very highly elevated in yourself.- Mm-hm.
0:25:23 > 0:25:27Your blood sugar control is not brilliant at the moment.
0:25:28 > 0:25:32I really want to see it quite low, and yours is very high.
0:25:32 > 0:25:35Putting it all together, it probably puts you at a higher risk
0:25:35 > 0:25:36of early death.
0:25:40 > 0:25:41OK...
0:25:41 > 0:25:43I'm sorry to give you information like that,
0:25:43 > 0:25:47but I honestly do feel that I wouldn't be doing my job properly
0:25:47 > 0:25:49if I didn't tell you honestly what I thought
0:25:49 > 0:25:51- about the state of your blood tests. - I'm glad.
0:25:51 > 0:25:54I'm glad you're honest, because at least something can be done
0:25:54 > 0:25:57about it, whereas if I just go on the way I've been going on,
0:25:57 > 0:26:01then I probably would have had a heart attack or something suddenly
0:26:01 > 0:26:04because it wasn't picked up on, so I'm actually...
0:26:04 > 0:26:06I'm quite happy.
0:26:08 > 0:26:12One of the most effective ways of dealing with type 2 diabetes is
0:26:12 > 0:26:14through the food we eat.
0:26:14 > 0:26:16Rangan has asked a nutritionist to show them how
0:26:16 > 0:26:18to cook more healthily.
0:26:18 > 0:26:21- Guys, this is my friend Darryl. - Hi, Darryl, nice to meet you.
0:26:21 > 0:26:22- Nice to meet you.- Are you all right?
0:26:22 > 0:26:24You know, Darryl used to be prediabetic.
0:26:24 > 0:26:26Oh, right, OK.
0:26:26 > 0:26:27- Yeah.- So, Darryl has been...
0:26:27 > 0:26:31- I've been exactly where you are now. - Where I'm at, at the moment, yeah.
0:26:31 > 0:26:33- I didn't want to take any medication, OK?- Yeah.
0:26:33 > 0:26:36So I had to change my lifestyle,
0:26:36 > 0:26:40and making these food choices reversed my prediabetes,
0:26:40 > 0:26:44so I'm now in the clear, and I have been for well over a decade,
0:26:44 > 0:26:47- by eating this way, yeah. - Wow! That's great.
0:26:47 > 0:26:50Darryl is keen to point out the common foods that can raise the risk
0:26:50 > 0:26:52of type 2 diabetes.
0:26:52 > 0:26:55White bread, highly refined, highly processed -
0:26:55 > 0:26:57it really spikes your blood sugar.
0:26:57 > 0:27:01What might surprise you is that actually two pieces of that bread
0:27:01 > 0:27:04will actually raise your blood sugar more than a chocolate bar.
0:27:04 > 0:27:07- No way!- Yeah. - Wow, that's very... I'm amazed.
0:27:07 > 0:27:09- Oh, my gosh.- Yeah. We've got some white rice here.
0:27:09 > 0:27:10Yeah, white rice as well.
0:27:10 > 0:27:12A lot of people think white rice is very healthy,
0:27:12 > 0:27:15but, for you guys and the problems you've currently got,
0:27:15 > 0:27:18white rice can also spike your blood sugar quite quickly.
0:27:18 > 0:27:20And that's one thing that I do eat a lot of.
0:27:20 > 0:27:22- Yeah, me too.- I do.
0:27:22 > 0:27:25So, one of the things you can have instead of the white rice
0:27:25 > 0:27:27is cauliflower rice.
0:27:27 > 0:27:30- OK.- OK? So it's much lower in carbohydrate content,
0:27:30 > 0:27:32so it's going to... It's not going to have the same impact
0:27:32 > 0:27:35- on your blood sugar. OK? - That can't taste nice.
0:27:35 > 0:27:37Yeah, well, I mean, to be fair, it's an acquired taste.
0:27:37 > 0:27:39- SHE GROANS - OK?
0:27:39 > 0:27:43They start cooking a family favourite, curried goat...
0:27:43 > 0:27:46Oh, that smells absolutely fantastic.
0:27:46 > 0:27:49..served, of course, on a bed of cauliflower rice.
0:27:49 > 0:27:51And use coconut oil.
0:27:51 > 0:27:53Because it's a fat,
0:27:53 > 0:27:55this is going to have no impact at all on your blood sugar, OK?
0:27:55 > 0:27:58So it's a really healthy oil to use.
0:27:58 > 0:28:00One of the ingredients here that we spoke about earlier
0:28:00 > 0:28:01- was the turmeric.- Mm-hm.
0:28:01 > 0:28:04So turmeric is a really good way to reduce inflammation.
0:28:04 > 0:28:06Lovely. Mmm!
0:28:06 > 0:28:09Do you feel deprived in any way, eating this?
0:28:09 > 0:28:12- No.- The cauliflower rice is actually a lot nicer
0:28:12 > 0:28:13than I thought it would be.
0:28:13 > 0:28:15- OK.- Yeah.- This has really opened my eyes up to say,
0:28:15 > 0:28:18"I can actually do a lot of things with this."
0:28:18 > 0:28:20- That's great.- Absolutely.- Yeah.
0:28:20 > 0:28:22I think there may be challenges along the way, OK,
0:28:22 > 0:28:24I don't think it's going to be quite that easy.
0:28:24 > 0:28:28Obviously, Darryl has come in and he's cooked for them.
0:28:28 > 0:28:31How that plays out day in, day out, that I need to see.
0:28:31 > 0:28:35I feel so good for the beginning that it makes me want to continue -
0:28:35 > 0:28:37next step, next step, next step.
0:28:37 > 0:28:38Oh, Mum!
0:28:40 > 0:28:41Aw, you big baby!
0:28:41 > 0:28:43But it's... The feeling's good.
0:28:43 > 0:28:45- LAVERNE SIGHS - Aw, come on, come on.
0:28:47 > 0:28:48Come on.
0:28:52 > 0:28:56Doreen and Laverne begin their new diet immediately,
0:28:56 > 0:28:57and at the same time,
0:28:57 > 0:29:00Rangan continues to monitor Laverne's stress and her sleep.
0:29:04 > 0:29:08When the tests are over, Rangan has the results.
0:29:08 > 0:29:10Great, thanks.
0:29:10 > 0:29:12I mean, the good news is you're getting
0:29:12 > 0:29:14a pretty reasonable amount of sleep, OK?
0:29:14 > 0:29:18- It's relatively normal, how many hours you're sleeping for.- Mm-hm.
0:29:18 > 0:29:21The problem is, is that...
0:29:21 > 0:29:25- the quality of your sleep doesn't appear to be very good.- Mm-hm.
0:29:25 > 0:29:27There's no regular, sort of, erm...
0:29:27 > 0:29:29There's no regular go to sleep and wake-up time,
0:29:29 > 0:29:32- so it's moving around day-to-day quite a lot.- Yeah, yeah.
0:29:32 > 0:29:34And when it IS this erratic,
0:29:34 > 0:29:37it's very hard for your body to properly rest and recuperate,
0:29:37 > 0:29:41and you're describing that often you will be in bed for a long period of
0:29:41 > 0:29:44- time, but you're still knackered when you wake up...- Yeah.
0:29:44 > 0:29:47- ..and clearly that's not a good thing.- No, it's not.
0:29:47 > 0:29:49Not sleeping well is associated with an increased risk of
0:29:49 > 0:29:51heart attacks and strokes.
0:29:51 > 0:29:52Really?
0:29:52 > 0:29:56Although, what happened on this day? This was a Friday, and...
0:29:57 > 0:30:02..according to this, you went to sleep at around 1:00am
0:30:02 > 0:30:05and you woke up around 6:00pm the following day, which is...
0:30:05 > 0:30:08what? 12, five...
0:30:08 > 0:30:1017 hours.
0:30:10 > 0:30:12I was exhausted, I really was.
0:30:12 > 0:30:15Yeah. Well, clearly you must have been exhausted because...
0:30:15 > 0:30:18- Yeah, I remember now.- ..unless you are absolutely whacked,
0:30:18 > 0:30:21no-one's going to stay in bed for 17 hours.
0:30:21 > 0:30:24So, again, I think this is just another reflection of
0:30:24 > 0:30:26how tired your body is.
0:30:26 > 0:30:28If you're stressed and tired,
0:30:28 > 0:30:32sleeping for over nine hours may not be beneficial.
0:30:32 > 0:30:35Too much sleep has a similar effect on the body to jet lag,
0:30:35 > 0:30:37often leaving you low and miserable.
0:30:37 > 0:30:39What was your mood like then?
0:30:39 > 0:30:40How did you feel?
0:30:42 > 0:30:45I was just happy with the fact that I could sleep...
0:30:45 > 0:30:46Yeah.
0:30:48 > 0:30:53..and I just took advantage of that, and that's what I did, I slept.
0:30:53 > 0:30:54I didn't even eat.
0:30:54 > 0:30:58I didn't eat until about 7:30, I think it was, that night.
0:30:58 > 0:31:01- Are you OK?- It's...
0:31:01 > 0:31:03I can't... I obviously can't go on like this, can I?
0:31:07 > 0:31:10If I'm being honest, no, you can't.
0:31:10 > 0:31:12So if you go on like this...
0:31:12 > 0:31:16I'm going to just work myself into an early grave, aren't I?
0:31:16 > 0:31:18You... Yeah, I think you are.
0:31:19 > 0:31:22Rangan immediately makes changes to her bedtime routine.
0:31:23 > 0:31:25Can you tell me a bit about what happens?
0:31:25 > 0:31:27You'll come here, either from work
0:31:27 > 0:31:30or from, what, putting the kids to bed?
0:31:30 > 0:31:32The TV will go on. Erm...
0:31:32 > 0:31:35If there's something interesting on there, I'll watch it.
0:31:35 > 0:31:37So the TV always goes on?
0:31:37 > 0:31:39- Yeah.- Yeah, OK. - As soon as I get...
0:31:39 > 0:31:42As soon as I walk in my room, I'll put the TV on.
0:31:42 > 0:31:44I've actually brought something with me.
0:31:44 > 0:31:47- In fact, I'll get it out and show you.- Oh, my gosh!
0:31:47 > 0:31:48What are you worried about?
0:31:48 > 0:31:50You're going to tell me that me putting the TV on
0:31:50 > 0:31:53is not good, it's interfering with my sleep...
0:31:53 > 0:31:58Me having my phone, I should maybe switch it off at night.
0:31:58 > 0:32:00That's what you're going to say, aren't you?
0:32:00 > 0:32:02I'll tell you what I'm going to say.
0:32:02 > 0:32:04- SHE LAUGHS - I'm going to show you what I think
0:32:04 > 0:32:07may be a contributory factor to what's going on with you.
0:32:07 > 0:32:09There's a hormone in our body called melatonin
0:32:09 > 0:32:11- which helps us fall asleep.- OK.
0:32:11 > 0:32:15- We know that certain colours of light...- Mm-hm.
0:32:15 > 0:32:16- ..the main one being blue light... - OK.
0:32:16 > 0:32:20..actually switches off melatonin in your body.
0:32:20 > 0:32:24So, this will help me to measure different colours,
0:32:24 > 0:32:29and I'm particularly looking, is there any blue light in this room,
0:32:29 > 0:32:32that may be switching off your melatonin,
0:32:32 > 0:32:35and actually is contributing to you not sleeping very well?
0:32:37 > 0:32:40Can you see? Are you ever in bed without your phone?
0:32:40 > 0:32:42- Never.- OK.
0:32:42 > 0:32:44- Yeah.- All right, so...
0:32:46 > 0:32:48Loads of blue light.
0:32:48 > 0:32:52Blue light contains short, powerful wavelengths that boost our attention
0:32:52 > 0:32:55and reaction times and wake us up...
0:32:55 > 0:32:59There's a distinct possibility that these are contributing to
0:32:59 > 0:33:00your sleep problems.
0:33:00 > 0:33:02..but there is a solution.
0:33:02 > 0:33:04- OK, they're called amber glasses. - OK.
0:33:04 > 0:33:08- If you have these on, and watch what happens...- Yeah, OK.
0:33:09 > 0:33:11- It's...- Wow.
0:33:11 > 0:33:13There, that's it, and is that something you think
0:33:13 > 0:33:16- you may be able to implement? - Yeah, definitely.
0:33:16 > 0:33:19- Yeah, you just literally clip them on.- Just... Yeah, absolutely.
0:33:19 > 0:33:24Rangan also tweaks the temperature to an optimum of 17 to 19 degrees,
0:33:24 > 0:33:26and gives her ear plugs to promote good sleep.
0:33:30 > 0:33:33Rangan will continue to monitor Laverne's sleep pattern,
0:33:33 > 0:33:35and hopes to see a marked improvement.
0:33:40 > 0:33:44In Bolton, Nicola is struggling with Rangan's treatment plan.
0:33:44 > 0:33:46It's Saturday morning, and I feel rotten.
0:33:47 > 0:33:52She's not been able to eat while she's been not really feeling well.
0:33:52 > 0:33:55Hellish, hellish, hellish, hellish...
0:33:55 > 0:34:00It's definitely going to be an adventure, to live with this one.
0:34:00 > 0:34:06I had no idea just how traumatic it would be from the beginning.
0:34:07 > 0:34:09I mean, how ARE you getting on?
0:34:09 > 0:34:13I'm used to feeling nauseous, but it's just all day.
0:34:13 > 0:34:14It's great for weight loss.
0:34:14 > 0:34:17I lost four kilograms in four days, so that's quite good.
0:34:17 > 0:34:19So, I've found it very hard to cope this week.
0:34:19 > 0:34:21To the point of giving up?
0:34:21 > 0:34:23Yeah, absolutely.
0:34:23 > 0:34:27I've actually got one of your results back, that
0:34:27 > 0:34:28has only just come back,
0:34:28 > 0:34:30and it's actually confirmed one of my suspicions.
0:34:30 > 0:34:33You have got - we abbreviate it SIBO -
0:34:33 > 0:34:36it's called small intestinal bacterial overgrowth,
0:34:36 > 0:34:40and basically it's suggesting to me that you've got
0:34:40 > 0:34:43the overgrowth of bugs in the wrong part of your gut.
0:34:43 > 0:34:48I have seen, with a lot of patients with chronic fatigue,
0:34:48 > 0:34:50that they have this issue.
0:34:50 > 0:34:53Rangan believes Nicola's extreme tiredness and pain
0:34:53 > 0:34:56could be caused by bacteria in the wrong part of her gut,
0:34:56 > 0:35:00causing inflammation not just locally, but throughout her body.
0:35:00 > 0:35:04These are meant to be short-term things to help get you to
0:35:04 > 0:35:06where you need to get.
0:35:06 > 0:35:09Although SIBO is in its early days of research,
0:35:09 > 0:35:11he decides to treat Nicola with antibiotics.
0:35:13 > 0:35:18I'm a little bit concerned as to whether she's got the willpower
0:35:18 > 0:35:20to get through the next few days.
0:35:20 > 0:35:24At the moment, it wouldn't surprise me if she calls it a day.
0:35:27 > 0:35:29But Nicola finds it harder and harder.
0:35:31 > 0:35:34There's a good girl. Good girl.
0:35:34 > 0:35:36Come on, then...
0:35:38 > 0:35:41She sent me a text this week, very politely, sort of, saying,
0:35:41 > 0:35:44"Look, I need some space." You know, "Don't come round."
0:35:44 > 0:35:45Erm...
0:35:45 > 0:35:47And it was quite hard actually to get that,
0:35:47 > 0:35:50because I want to help her,
0:35:50 > 0:35:55but she has agreed to let me come and see her today, and so...
0:35:55 > 0:35:57Yeah, I'm a little bit nervous about what I'm going to find.
0:35:59 > 0:36:02- Hello.- Hello. How are you? - I'm good. How are you?
0:36:02 > 0:36:04We're all right. We're managing.
0:36:04 > 0:36:06- Are you?- Ish.- OK.
0:36:06 > 0:36:07- How are you doing, all right?- Hello.
0:36:07 > 0:36:09- Hiya.- You all right?
0:36:11 > 0:36:12How are things?
0:36:14 > 0:36:16- They've been better.- Yeah.- OK.
0:36:16 > 0:36:18- They've been better. - SHE WHISPERS INDISTINCTLY
0:36:18 > 0:36:22- Yeah. They've been better, haven't they?- Yes.
0:36:22 > 0:36:25- Well, shall we sit down, and you can tell me what's been going on?- OK.
0:36:25 > 0:36:27- Yeah? What do you think?- Yes.
0:36:27 > 0:36:29I thought I'd hit the ceiling,
0:36:29 > 0:36:32or every day shouldn't be this tough,
0:36:32 > 0:36:36and mentally I'm on the floor,
0:36:36 > 0:36:38and that's the toughest.
0:36:38 > 0:36:43I think we really are in the middle of that horrible, horribly difficult
0:36:43 > 0:36:45process where we're saying,
0:36:45 > 0:36:49"OK, the only way we're going to get these walls bigger and stronger
0:36:49 > 0:36:50"is by dismantling them."
0:36:50 > 0:36:54I think that this fear, whilst it's totally understandable,
0:36:54 > 0:36:57I think this fear is holding you back from getting better.
0:36:57 > 0:36:59No, it's not. Absolutely not.
0:36:59 > 0:37:01This isn't... No, this isn't... Don't...
0:37:01 > 0:37:04It sounds like you're turning it into a mental thing.
0:37:04 > 0:37:08I'm mentally pissed off because I'm physically unwell.
0:37:08 > 0:37:12I've been focusing on getting through each and every day,
0:37:12 > 0:37:15and still being able to be, like...
0:37:15 > 0:37:19for the boys, so please don't turn it into, this is...
0:37:19 > 0:37:22this is because I'm mentally fearful,
0:37:22 > 0:37:24because, yeah, I am to a point,
0:37:24 > 0:37:28but it's not THAT that is stopping me from becoming well.
0:37:28 > 0:37:32It's the physical feeling of being unwell.
0:37:32 > 0:37:37I don't want it to be said that actually it's that fear
0:37:37 > 0:37:42that is keeping me unwell, because that just makes me so, so cross.
0:37:43 > 0:37:45- OK.- Yeah.
0:37:45 > 0:37:47Can I just have a minute, please? Just...
0:37:57 > 0:37:59I need to explain, I think, what I meant by that.
0:37:59 > 0:38:03I didn't mean to, erm...
0:38:03 > 0:38:05I certainly didn't mean to upset her,
0:38:05 > 0:38:10and I'm not for one second saying this is in her head.
0:38:10 > 0:38:11- I don't think that.- I...
0:38:11 > 0:38:13I don't think she thinks you do, as such.
0:38:13 > 0:38:15Obviously she reacted like that,
0:38:15 > 0:38:19- but I think a lot of people do... - Yeah.
0:38:19 > 0:38:22Because it's not...
0:38:22 > 0:38:23You know, she's not got a broken leg,
0:38:23 > 0:38:27she's not got a cast on her leg, she's not got a set of
0:38:27 > 0:38:30whatever they're called, crutches,
0:38:30 > 0:38:35so it doesn't look like she's ill.
0:38:37 > 0:38:39I'm frustrated that we've not hit that turning point yet,
0:38:39 > 0:38:42the turning point where not only I believe she's getting better,
0:38:42 > 0:38:44but SHE believes it as well, cos she doesn't.
0:38:44 > 0:38:50She really doesn't at the moment. And I need to come up with a plan.
0:38:50 > 0:38:54I need to find something else to do with her, that's going to get her
0:38:54 > 0:38:56over that threshold, so that she starts to feel it
0:38:56 > 0:38:58and she starts to believe it.
0:39:03 > 0:39:07I'm confused now. I don't even know what to buy!
0:39:07 > 0:39:09Meanwhile, Laverne Hayes is also losing faith
0:39:09 > 0:39:11in Rangan's treatment plan.
0:39:13 > 0:39:15Cos I would have got fruit juice before,
0:39:15 > 0:39:17but I know fruit juice is not good.
0:39:17 > 0:39:21I am not sitting down to a glass of water with my dinner. I'm not.
0:39:21 > 0:39:22I'm not... I'm just looking.
0:39:22 > 0:39:25The doctor will never forgive us for the fizzy drink - never ever.
0:39:25 > 0:39:29They're following the type 2 diabetes diet plan,
0:39:29 > 0:39:32but cutting out sugar and carbohydrates is far from easy.
0:39:32 > 0:39:34Why are you picking up this?
0:39:34 > 0:39:36- I...- But it's carbohydrate.
0:39:36 > 0:39:39No, it's not! It's iron.
0:39:39 > 0:39:40See what I mean?!
0:39:40 > 0:39:42- You've become, like, a professional...- No!
0:39:42 > 0:39:44- ..on what's right and what's wrong. - No, no, no.
0:39:44 > 0:39:46No, since I've spoken to the doctor,
0:39:46 > 0:39:49- and I've done a bit of research... - Yeah.
0:39:49 > 0:39:51There are other easy swaps that can reduce the chances
0:39:51 > 0:39:53of type 2 diabetes -
0:39:53 > 0:39:55eat porridge, not breakfast cereals,
0:39:55 > 0:39:58snack on nuts rather than crisps,
0:39:58 > 0:40:00and switch meat for fish a couple of times a week.
0:40:00 > 0:40:03We do need some form of carbohydrate,
0:40:03 > 0:40:05and sweet potato's got less carbohydrate
0:40:05 > 0:40:07than the ordinary potato.
0:40:07 > 0:40:09I don't like sweet potato.
0:40:09 > 0:40:11Tough on you, then.
0:40:11 > 0:40:13Oh, I'm not... I don't want to do this!
0:40:16 > 0:40:17SHE GROANS
0:40:17 > 0:40:20I'm telling you, I am just, like...
0:40:20 > 0:40:23I... I've had enough! I'm really...
0:40:23 > 0:40:26I'm about to have a meltdown, because I just can't deal with this.
0:40:26 > 0:40:29I really, really just cannot deal with this.
0:40:29 > 0:40:33I can't deal with this. I can't do it. And if I...
0:40:33 > 0:40:37And if I keep doing what I'm doing, I'm going to get diabetes,
0:40:37 > 0:40:38and I'll probably lose a leg or an arm.
0:40:44 > 0:40:47They may have managed to buy ingredients for mealtimes,
0:40:47 > 0:40:51but Laverne is struggling to find snacks she can eat on the run.
0:40:51 > 0:40:54- 'Hello.'- Hi, Rangan, it's Laverne.
0:40:54 > 0:40:57'Oh, hello, Laverne. How have you been getting on?'
0:40:57 > 0:40:58I'm struggling!
0:40:58 > 0:41:00'Oh, what's going on?'
0:41:00 > 0:41:01It's not...
0:41:01 > 0:41:04It's not really the food part - it's the snacking part.
0:41:04 > 0:41:09It's, like, during the day, when I start getting hungry.
0:41:09 > 0:41:11'OK, so what are you normally having?'
0:41:11 > 0:41:13Er... A sausage roll.
0:41:13 > 0:41:16- 'Do you like carrots and hummus, for example?'- No.
0:41:16 > 0:41:18'You don't? OK. Do you like olives?'
0:41:18 > 0:41:20Oh, no!
0:41:20 > 0:41:21'You don't? OK, OK!'
0:41:21 > 0:41:23- Oh, gosh!- 'Do you like eggs?'
0:41:23 > 0:41:25I'm a nightmare, ain't I?
0:41:25 > 0:41:27- 'You're not...'- Yes, you are a nightmare, Laverne.
0:41:27 > 0:41:29We have got to make the time, we have got to make those changes,
0:41:29 > 0:41:31and all we can do is support each other.
0:41:31 > 0:41:33- But it's not that easy. - It's not easy.
0:41:33 > 0:41:35- I'm struggling.- 'Laverne, you're right, it's not easy.
0:41:35 > 0:41:39'It's not easy. And the main reason it's not easy is because
0:41:39 > 0:41:41'what I'm asking you to do is very different from
0:41:41 > 0:41:42- 'what you're doing now.'- Yeah.
0:41:42 > 0:41:44'It's just a new habit to get used to.
0:41:44 > 0:41:46'Like, all the habits you're doing,
0:41:46 > 0:41:49'are things you have got used to over many years.'
0:41:49 > 0:41:52I'm going to do this. I'm definitely... I'm going to do this,
0:41:52 > 0:41:55I'm going to do it. I just... I don't want to be a diabetic.
0:41:56 > 0:41:59Now you need to make sure you've got enough ingredients to
0:41:59 > 0:42:01disguise this cauliflower rice.
0:42:01 > 0:42:02Yes?
0:42:02 > 0:42:04Well...
0:42:06 > 0:42:09Thank you for the different thing.
0:42:09 > 0:42:12It's very nice. Amen.
0:42:12 > 0:42:13Amen. Good boy.
0:42:13 > 0:42:16I think it's given me a reason now to experiment with it,
0:42:16 > 0:42:18- and I WILL experiment with it. - You will, you will.
0:42:18 > 0:42:19- I know you will. - I will experiment with it.
0:42:19 > 0:42:21Actually I'm enjoying it. I'm enjoying it.
0:42:28 > 0:42:31In the morning, Rangan returns to tackle the other big problem in
0:42:31 > 0:42:33Laverne's life - her fatigue.
0:42:34 > 0:42:37He's received the results from her stress test.
0:42:38 > 0:42:41Is it good or bad? Just tell me, please.
0:42:41 > 0:42:44OK. Well, it's probably best if I show you.
0:42:44 > 0:42:47- Cortisol is one of your stress hormones, OK?- OK.
0:42:47 > 0:42:50- And it should be highest in the morning...- Yeah.
0:42:50 > 0:42:52..and throughout the day it gradually goes lower.
0:42:52 > 0:42:53So it wakes you up in the morning, OK?
0:42:53 > 0:42:56And then as you go through the day it gets lower and lower,
0:42:56 > 0:42:58- till just before you go to bed... - Right.
0:42:58 > 0:43:00..it's at its lowest, and that's one of the things
0:43:00 > 0:43:02- that helps you fall asleep.- OK.- OK?
0:43:02 > 0:43:05- Now, if I show you on yours...- Yeah.
0:43:05 > 0:43:09..the green is the normal range, OK, so...so far, so good.
0:43:09 > 0:43:10- Right?- OK.- But can you see,
0:43:10 > 0:43:14- in the evening, when cortisol should be at its lowest...- Yeah.
0:43:14 > 0:43:17..yours is actually a lot higher than it should be,
0:43:17 > 0:43:20- and this...- So that means I'm stressed before I go to bed?
0:43:20 > 0:43:21Is that what basically it means?
0:43:21 > 0:43:23Well, it can mean lots of different things.
0:43:23 > 0:43:25Your body hasn't got much reserve left at the moment.
0:43:25 > 0:43:29You're tired all the time, your body clock's out,
0:43:29 > 0:43:31your evening cortisol is up, you know,
0:43:31 > 0:43:33all kinds of things are not...are not...
0:43:33 > 0:43:35are not really where they should be with your body,
0:43:35 > 0:43:39and I think that all that sort of cardio work that you're doing
0:43:39 > 0:43:41is too much for you at the moment,
0:43:41 > 0:43:44and so I've brought you here to have a yoga session.
0:43:44 > 0:43:46OK. Yoga? OK.
0:43:46 > 0:43:49- Have you...? - I've never done yoga before!
0:43:50 > 0:43:52- Does it appeal to you? - I'm willing to give it a go.
0:43:53 > 0:43:55We're going to do a sun salutation,
0:43:55 > 0:43:58which is like a really chilled-out burpee, OK?
0:43:58 > 0:44:00- OK.- Big circle,
0:44:00 > 0:44:03and then a big circle coming into a forward bend,
0:44:03 > 0:44:05and you can completely...
0:44:05 > 0:44:07Yoga is an ancient form of exercise,
0:44:07 > 0:44:10originating in India around 5,000 years ago.
0:44:10 > 0:44:12Down to the floor.
0:44:12 > 0:44:15That's perfect. That's really good.
0:44:15 > 0:44:18It focuses on strength, flexibility, and breathing,
0:44:18 > 0:44:21through a series of controlled movements or postures.
0:44:21 > 0:44:23Coming up...
0:44:23 > 0:44:27This is difficult. Got to really concentrate!
0:44:27 > 0:44:29- It's good though, isn't it? - Mmm!- Yeah.
0:44:29 > 0:44:31Yoga is generally low-impact and safe.
0:44:35 > 0:44:39Clinical trials show that it has a positive effect on reducing fatigue.
0:44:39 > 0:44:41Yes!
0:44:41 > 0:44:44- Oh, my God!- Oh, that's fantastic!
0:44:44 > 0:44:47Did you catch that? Did you catch that?!
0:44:47 > 0:44:49- How do YOU feel, Laverne?- Amazing.
0:44:49 > 0:44:52Yeah, that was really good.
0:44:52 > 0:44:56I do think something like this has been missing from...
0:44:56 > 0:44:59from my, sort of, routine,
0:44:59 > 0:45:04and even once a week, I think, would make such a difference.
0:45:04 > 0:45:06I honestly think that was the very first time
0:45:06 > 0:45:08that I saw you switch off.
0:45:08 > 0:45:09Cos I really enjoyed that.
0:45:09 > 0:45:12- I didn't think I would, to be honest!- Ah...
0:45:12 > 0:45:13You're a star!
0:45:13 > 0:45:16- You're a star!- Oh, I'm so happy! Really, really chuffed.
0:45:19 > 0:45:22Rangan believes a fresh approach might also help Nicola
0:45:22 > 0:45:24with HER pain and exhaustion.
0:45:24 > 0:45:28He's persuaded her to join him trying out something very different.
0:45:28 > 0:45:31It's a class that is a mindfulness class,
0:45:31 > 0:45:34that does a bit of work on breathing and meditation,
0:45:34 > 0:45:35but it's a...
0:45:35 > 0:45:39it's a Breathworks class that's specifically designed for people
0:45:39 > 0:45:43who have got chronic health conditions.
0:45:43 > 0:45:44OK.
0:45:44 > 0:45:49Now, the reason I want to bring you to this class is because I want you
0:45:49 > 0:45:53to learn some, sort of, mindfulness and some relaxation
0:45:53 > 0:45:56- and some breathing-type exercises that you might be able to do.- Yeah.
0:45:56 > 0:45:57- Yeah?- Yes.
0:45:57 > 0:45:59- Are you up for exploring it? - Yes, definitely.
0:45:59 > 0:46:01Yeah? OK. Come on, let's go.
0:46:06 > 0:46:11I was where you are, ten years ago.
0:46:11 > 0:46:15Ten years ago, it was overwhelming and the future looked bleak.
0:46:15 > 0:46:17Through a process called mindfulness,
0:46:17 > 0:46:21former NHS nurse Karen managed to control her own pain.
0:46:21 > 0:46:24I slipped a disc when I was about 19,
0:46:24 > 0:46:27and I eventually just would have these periods of time
0:46:27 > 0:46:30where my back would collapse. I'd have terrible pain,
0:46:30 > 0:46:32I'd be taking tonnes of painkillers, nothing was working.
0:46:34 > 0:46:37Mindfulness is a therapeutic treatment
0:46:37 > 0:46:38being used in some NHS trusts.
0:46:39 > 0:46:42There's encouraging evidence that it may help control the pain
0:46:42 > 0:46:46of patients with fibromyalgia and ME.
0:46:46 > 0:46:49You might notice as you're breathing in that your belly swells
0:46:49 > 0:46:53a little bit, and as you breathe out, it subsides.
0:46:53 > 0:46:57It works through a form of mental training and relaxation.
0:46:57 > 0:47:00So far, Nicola has been coping by trying to
0:47:00 > 0:47:02ignore her pain and illness.
0:47:02 > 0:47:04It hasn't helped her get better.
0:47:04 > 0:47:08- I don't... I do my damnedest not to think, or feel...- Yeah, yeah.
0:47:08 > 0:47:10So it's...
0:47:10 > 0:47:12- So, do you have children?- Yeah.
0:47:12 > 0:47:15OK. So, if one of your children came up to you and said,
0:47:15 > 0:47:18"I don't feel very well," would you say,
0:47:18 > 0:47:20"Yeah, don't think about that. Don't think about it.
0:47:20 > 0:47:21"Let's just watch the telly"?
0:47:21 > 0:47:25If you could be as kind to yourself as you are to your children,
0:47:25 > 0:47:28then there'd be a difference in the way that you behave.
0:47:29 > 0:47:31- How was it? - It was really good.
0:47:31 > 0:47:34- Anything...?- A lot of what she said made a huge amount of sense.
0:47:34 > 0:47:36I just need to get my head around that everything I thought
0:47:36 > 0:47:39I was doing right, I'm actually doing wrong.
0:47:40 > 0:47:42Do you feel like that?
0:47:42 > 0:47:44Yeah.
0:47:44 > 0:47:45Which makes me cross.
0:47:46 > 0:47:49Why does it make you cross?
0:47:49 > 0:47:51Because I thought I was doing it right,
0:47:51 > 0:47:53but actually I was doing it all wrong.
0:47:53 > 0:47:55What were you doing wrong?
0:47:57 > 0:47:59What were you doing wrong?
0:48:02 > 0:48:05SHE SOBS AND SNIFFLES
0:48:05 > 0:48:08All the ways I thought I was coping.
0:48:08 > 0:48:11At the minute I'm feeling a pretty massive failure.
0:48:11 > 0:48:12Aw...
0:48:14 > 0:48:18But it's just working on that, isn't it, and changing it?
0:48:18 > 0:48:22But can I just add there, in, sort of,
0:48:22 > 0:48:25relation to what we've just heard,
0:48:25 > 0:48:28and I know it's hard to suddenly just shift the way you think,
0:48:28 > 0:48:30but you'd never tell your friend, would you,
0:48:30 > 0:48:32"Oh, you're such a failure for the way you've done things"?
0:48:32 > 0:48:35No, you wouldn't do that to your friend, but...
0:48:36 > 0:48:39- I don't know. - But you're doing it to yourself.
0:48:39 > 0:48:41Yeah.
0:48:42 > 0:48:44Yeah, I'm super excited after that.
0:48:44 > 0:48:46Er...
0:48:46 > 0:48:48I think that was a real breakthrough.
0:48:48 > 0:48:50I think she needed to let out all that emotion.
0:48:50 > 0:48:53She's been trying to... She's been trying to keep a lid on it.
0:48:53 > 0:48:55The walls that she's built up around her are actually
0:48:55 > 0:48:58holding her back now. And we've got to break those down,
0:48:58 > 0:49:02and I think we just started that process in there right now.
0:49:02 > 0:49:04DOG BARKS
0:49:05 > 0:49:07Hi. Is it on? Is it on?
0:49:07 > 0:49:12I can see the glimmers of the changes.
0:49:12 > 0:49:15She's not been quite as tired as normal...
0:49:15 > 0:49:20As the weeks go by, Nicola continues to improve.
0:49:20 > 0:49:22Oh! Halloween, sorry.
0:49:22 > 0:49:23I wouldn't say she's better,
0:49:23 > 0:49:26but I'd say there's been a notable improvement.
0:49:26 > 0:49:32She practises mindfulness, is reducing her painkillers,
0:49:32 > 0:49:33and continues with her diet.
0:49:35 > 0:49:37- Oh, coconut milk.- Coconut milk.
0:49:37 > 0:49:39Oh, fab, I can have a Pina Colada!
0:49:39 > 0:49:44At least I feel more human again, and that is a massive impact.
0:49:47 > 0:49:51While Nicola is improving daily, over in Northampton,
0:49:51 > 0:49:54Laverne is practising one of Rangan's solutions
0:49:54 > 0:49:56to her stressful, busy life.
0:49:56 > 0:49:58Excellent stuff.
0:49:58 > 0:49:59- Hello!- Hello!
0:50:00 > 0:50:03Introducing yoga into Laverne's exercise regime
0:50:03 > 0:50:06was a key part of Rangan's therapy.
0:50:07 > 0:50:09This is great to see.
0:50:09 > 0:50:11How long has it been going on for now?
0:50:11 > 0:50:12About four weeks now.
0:50:12 > 0:50:14I just find that
0:50:14 > 0:50:17at the end of the day it helps me to calm down and...
0:50:17 > 0:50:20you know, it's amazing. That's what I think the problem was,
0:50:20 > 0:50:24I wasn't winding down, and it just relaxes my mind.
0:50:24 > 0:50:27- I love it.- Aah. - It's just really good.
0:50:27 > 0:50:29Have YOU noticed anything, Doreen?
0:50:29 > 0:50:30When I call her in the evenings,
0:50:30 > 0:50:32she's not as stressed as she used to be,
0:50:32 > 0:50:34so that must be because she's doing the yoga,
0:50:34 > 0:50:37but I didn't actually know what she was actually doing.
0:50:37 > 0:50:38I didn't realise that, Mum.
0:50:38 > 0:50:41But there's lots of other little things that I'm doing as well.
0:50:41 > 0:50:44But I think that everything combined is just helping.
0:50:44 > 0:50:47My sleep has been a lot better,
0:50:47 > 0:50:50so I think that's why I'm not as stressed as well.
0:50:50 > 0:50:52I tell you, you're feeling better NOW -
0:50:52 > 0:50:54- give it another two or three months...- Yeah.
0:50:54 > 0:50:57..you will feel like a different person.
0:50:57 > 0:50:59I could not have gone on the way I was.
0:50:59 > 0:51:03Six weeks ago, Doreen was failing to manage her type 2 diabetes.
0:51:03 > 0:51:05Right, let's crack on.
0:51:05 > 0:51:08I'm looking forward to having some of this food, actually.
0:51:08 > 0:51:11Rangan's type 2 diabetes diet is bearing fruit.
0:51:13 > 0:51:17You coming along sort of gave me the motivation and the will to do it.
0:51:17 > 0:51:19You cared. You're not just five minutes with me,
0:51:19 > 0:51:20"Yeah, you've got diabetes,
0:51:20 > 0:51:22"you need to take this, this and this, OK,
0:51:22 > 0:51:25"come back and see me in three months' time" -
0:51:25 > 0:51:27I felt as if you came to me and you were personal to me,
0:51:27 > 0:51:29and I needed to respect that,
0:51:29 > 0:51:34that's how I felt. And that's why I thought, "Well, let's give it a go."
0:51:34 > 0:51:37Doreen's blood sugar level is now a healthy four or five.
0:51:37 > 0:51:43- What was it before?- 15, 17, 19, 21.
0:51:43 > 0:51:45- Brilliant. Very, very good.- Yeah.
0:51:45 > 0:51:49Doreen's also lost four kilos, and has far more energy.
0:51:49 > 0:51:51When was the last time you felt this good?
0:51:51 > 0:51:53Nine, ten years.
0:51:53 > 0:51:56You've not felt this good for nine, ten years?
0:51:56 > 0:51:57Thank you for the dinner on the table.
0:51:57 > 0:51:59We hope you enjoy it.
0:51:59 > 0:52:02We hope you continue to provide food here and in Jamaica,
0:52:02 > 0:52:05and to those who don't have food. Amen.
0:52:05 > 0:52:06ALL: Amen.
0:52:08 > 0:52:10It's remarkable, this.
0:52:10 > 0:52:13Just... The turnaround has been phenomenal.
0:52:13 > 0:52:16I'm feeling good, energy up...
0:52:16 > 0:52:18I can even dance!
0:52:18 > 0:52:22I don't believe, as a doctor, in just giving people pills,
0:52:22 > 0:52:25for things that are fundamentally driven by lifestyle.
0:52:25 > 0:52:27That's what I've done with these guys.
0:52:27 > 0:52:29I've not given them a fancy prescription,
0:52:29 > 0:52:33I've just explained to them how to change their food, their sleep,
0:52:33 > 0:52:38how they move, and how they de-stress.
0:52:38 > 0:52:41It's quite simple, really. And look at the results!
0:52:43 > 0:52:47Cheers to good health, good diet, and continue with a good diet.
0:52:47 > 0:52:49- Yeah, absolutely. - That's it.- Cheers to that.
0:52:49 > 0:52:52Couldn't have said it better myself.
0:52:55 > 0:52:57Six weeks ago,
0:52:57 > 0:53:00Nicola Singleton was experiencing constant pain and chronic fatigue.
0:53:00 > 0:53:02Hello! Come in.
0:53:02 > 0:53:04Rangan overhauled her diet,
0:53:04 > 0:53:07reduced her dependency on painkillers, and introduced her
0:53:07 > 0:53:09to new relaxation techniques.
0:53:09 > 0:53:14Pretty soon after we started, I gave you a medical symptom questionnaire.
0:53:14 > 0:53:16It was a series of questions that gives me a score about
0:53:16 > 0:53:19where you were, and I've brought it with me today,
0:53:19 > 0:53:25to see if you could redo it and we could see actually, objectively,
0:53:25 > 0:53:26has there been a change?
0:53:27 > 0:53:31The MSQ questionnaire asks the patient to rate the severity
0:53:31 > 0:53:33of a number of symptoms.
0:53:34 > 0:53:37At the start of the treatment, Nicola scored 90,
0:53:37 > 0:53:40putting her in the highest-risk group.
0:53:40 > 0:53:42Optimal health is a score of ten.
0:53:46 > 0:53:47Thanks for doing that. I know it's
0:53:47 > 0:53:50- quite a lot of questions, isn't it? - Yeah.
0:53:50 > 0:53:54The new score on the same questionnaire, instead of being 90,
0:53:54 > 0:53:56in six weeks, it's down to 53.
0:53:56 > 0:53:58That is huge.
0:53:58 > 0:54:01It's a huge, huge improvement.
0:54:01 > 0:54:02Yes.
0:54:02 > 0:54:07To put it in perspective, if you'd gone from 90 down to 70,
0:54:07 > 0:54:10I would have been really impressed.
0:54:10 > 0:54:13So to get 37 points better, you know...
0:54:13 > 0:54:15- You OK?- Yeah.
0:54:16 > 0:54:19That is just... That is huge, actually.
0:54:19 > 0:54:22Rangan's next assessment is to join Nicola on her daily walk,
0:54:22 > 0:54:25to see if there's been any improvement.
0:54:25 > 0:54:27It'll be fun. I'm glad you could come,
0:54:27 > 0:54:29Cos it's very antisocial for you, isn't it?
0:54:31 > 0:54:34I'll tell you, last time we were at this point in the hill...
0:54:35 > 0:54:37..I think you'd stopped talking to me.
0:54:37 > 0:54:40Probably!
0:54:40 > 0:54:42We don't have to do that whole walk again, if you don't want to.
0:54:42 > 0:54:44- I don't want to tire you. - I'd like to do it.
0:54:44 > 0:54:46- You want to do it?- Yeah.- OK.
0:54:46 > 0:54:49- You feel you'll be all right?- Yeah. I'm pain-free.
0:54:52 > 0:54:54It is so much easier. So much easier.
0:54:54 > 0:54:56Not having the physical aches.
0:54:56 > 0:54:58- Yeah.- So much easier.- Oh, brilliant.
0:55:02 > 0:55:04'Big, big change from last time.'
0:55:05 > 0:55:08Nicola didn't need to be pushed up the hill.
0:55:08 > 0:55:11She was chatting to me, she was talking, she had energy.
0:55:11 > 0:55:16She almost skipped into the house, said she could do it again.
0:55:16 > 0:55:18I can't believe the change so far, and I'm
0:55:18 > 0:55:20really, really pleased to see it.
0:55:23 > 0:55:26The next day is Nicola's 40th birthday,
0:55:26 > 0:55:29and there's a reason for the whole family to celebrate.
0:55:31 > 0:55:33Ooh!
0:55:35 > 0:55:39Rangan wants to know if THEY'VE seen any change in Nicola.
0:55:39 > 0:55:40This morning I...
0:55:41 > 0:55:44..I did something cheeky, I can't remember what,
0:55:44 > 0:55:47and she chased me up the stairs and everything, so she can do that now.
0:55:47 > 0:55:50Are you... You're saying that
0:55:50 > 0:55:51you feel there is some improvement.
0:55:51 > 0:55:55I've definitely picked up... She's more like Mum, basically.
0:56:00 > 0:56:01Hi-de-hi!
0:56:01 > 0:56:03- ALL:- Ho-de-ho!
0:56:03 > 0:56:07For the last seven years, physically,
0:56:07 > 0:56:10it has got harder and harder and harder each day.
0:56:10 > 0:56:13It has been really, really tough to actually even move
0:56:13 > 0:56:15without feeling discomfort.
0:56:15 > 0:56:17So to meet Dr Chatterjee,
0:56:17 > 0:56:22who has spent time listening to all my problems,
0:56:22 > 0:56:24and actually now I can move without wincing,
0:56:24 > 0:56:26and that is huge.
0:56:26 > 0:56:28CHEERING
0:56:30 > 0:56:33Nicola is free from the pain of fibromyalgia,
0:56:33 > 0:56:36and the brain fog that has blighted her for years.
0:56:39 > 0:56:41And thanks to Rangan's diet plan,
0:56:41 > 0:56:45both Nicola and Ian have lost two stone each.
0:56:45 > 0:56:47It's just been a privilege for me,
0:56:47 > 0:56:50been an absolute privilege to be part of it,
0:56:50 > 0:56:52and you'd just never get a chance
0:56:52 > 0:56:54to be on that sort of deep journey with them.
0:56:55 > 0:56:58And it feels great. Feels really, really good.