0:00:02 > 0:00:05Shetland, the most remote part of the UK.
0:00:06 > 0:00:10Here, you're closer to the Arctic Circle than you are to London.
0:00:10 > 0:00:11And nearer Norway
0:00:11 > 0:00:12than you are to Edinburgh.
0:00:13 > 0:00:15There are more puffins than people.
0:00:15 > 0:00:19ALL CHEER And more seals than supermarkets.
0:00:20 > 0:00:24But this wild landscape is also home to 23,000 islanders.
0:00:25 > 0:00:29They're so far from the mainland that when things go wrong...
0:00:29 > 0:00:31A&E, can I help you?
0:00:32 > 0:00:35..from helicopter rescues and spinal injuries...
0:00:35 > 0:00:38We're all here to make sure that you're OK.
0:00:38 > 0:00:39..to serious medical mysteries...
0:00:39 > 0:00:41Can we get assistance in, please?
0:00:41 > 0:00:43Something's not right.
0:00:43 > 0:00:44..Shetland's island medics
0:00:44 > 0:00:47have to be ready for anything and everything.
0:00:47 > 0:00:50- What happened? - I got in a fight with a seagull.
0:00:50 > 0:00:52- This was sheep shears, was it?- Yes.
0:00:53 > 0:00:55SIREN WAILS
0:00:55 > 0:00:57It means the tight-knit team of medics,
0:00:57 > 0:01:00volunteers and emergency services have a special bond.
0:01:00 > 0:01:01This might tickle, then.
0:01:01 > 0:01:02LAUGHTER
0:01:03 > 0:01:06And they know just how to keep each other going...
0:01:06 > 0:01:07A wee treat for night shift.
0:01:07 > 0:01:11..so they're always ready for any island emergency.
0:01:11 > 0:01:13BOTH LAUGH
0:01:19 > 0:01:24Today, the Gilbert Bain Hospital works hard to win over hearts...
0:01:25 > 0:01:27..and minds.
0:01:28 > 0:01:30Providing care for the young...
0:01:30 > 0:01:32Perfect.
0:01:32 > 0:01:35..and comfort for Shetland's more senior residents.
0:01:35 > 0:01:37Home, sweet home.
0:01:43 > 0:01:45In Shetland's capital, Lerwick,
0:01:45 > 0:01:49the Gilbert Bain Hospital serves some 23,000 hardy islanders.
0:01:50 > 0:01:54As with all hospitals, its lifeblood is the talented,
0:01:54 > 0:01:56dedicated nursing team...
0:01:56 > 0:01:57SHE LAUGHS
0:01:58 > 0:02:00One, two, three...
0:02:02 > 0:02:05..who work tirelessly to provide top-quality care...
0:02:05 > 0:02:08- Ow!- Oh, sorry, petal.
0:02:08 > 0:02:11..day and night, all year round.
0:02:12 > 0:02:14Our nursing staff...
0:02:14 > 0:02:18have a great range of skills.
0:02:20 > 0:02:24Nurses are becoming more and more relied upon
0:02:24 > 0:02:27to provide care in different settings.
0:02:28 > 0:02:33So they will put in cannulas, do ECGs, take your bloods.
0:02:33 > 0:02:36So we are spoilt in a way
0:02:36 > 0:02:39that we've got nursing staff that do all of that.
0:02:42 > 0:02:44It's Saturday morning, but there's no lie-in
0:02:44 > 0:02:48for senior charge nurse Aimee Sutherland.
0:02:48 > 0:02:51Caring for all and sundry from the moment she wakes.
0:02:51 > 0:02:53Me and my partner's got two Jack Russells
0:02:53 > 0:02:56and my daughter's got a Jack Russell and my son's got a German shepherd,
0:02:56 > 0:02:58who's just turned one.
0:02:58 > 0:02:59Down.
0:02:59 > 0:03:01I was born and brought up in Shetland,
0:03:01 > 0:03:02so I've been here all my life.
0:03:02 > 0:03:03Nearly 43 years.
0:03:05 > 0:03:09Beautiful scenery. I personally couldn't live in a city.
0:03:09 > 0:03:11I couldn't live anywhere else.
0:03:14 > 0:03:17Sort of thinking, what kind of day is it going to be?
0:03:17 > 0:03:19Are we going to walk into busy-ness
0:03:19 > 0:03:21or...walk into quiet?
0:03:25 > 0:03:26I'm the senior charge nurse,
0:03:26 > 0:03:29which used to be what was known as the sister.
0:03:29 > 0:03:32So in charge of the department and the staff.
0:03:32 > 0:03:35It was something I never, ever thought I would do, if I'm totally honest.
0:03:35 > 0:03:37Morning. Morning!
0:03:37 > 0:03:39As a senior charge nurse,
0:03:39 > 0:03:40Aimee manages the care teams,
0:03:40 > 0:03:43but also directs a patient's pathway from admission,
0:03:43 > 0:03:48through examination and treatment, to eventual discharge.
0:03:48 > 0:03:50Got a really good team, so everybody's...
0:03:50 > 0:03:53Everybody's really good at doing their own role
0:03:53 > 0:03:55and we have senior staff nurses as well
0:03:55 > 0:03:58that take on a lot of responsibility, as well as myself.
0:03:58 > 0:03:59Even my little Hannah Banana!
0:04:03 > 0:04:06But weekend or not, mornings can be busy.
0:04:07 > 0:04:11And long summer days on Shetland mean younger folks are outdoors
0:04:11 > 0:04:12from first light.
0:04:14 > 0:04:1712-year-old Bruce has been brought in by his mum
0:04:17 > 0:04:19with a pain in his leg.
0:04:19 > 0:04:21Hop in to this middle room here, dear, OK?
0:04:22 > 0:04:24Bruce has been running around outside -
0:04:24 > 0:04:28A LOT - during his school holiday.
0:04:28 > 0:04:29Do you want to pop yourself up on the bed?
0:04:36 > 0:04:39I'm Aimee. I'm just going to ask you a pile of questions first,
0:04:39 > 0:04:41is that all right?
0:04:41 > 0:04:43I'll ask it between you and Mum, OK?
0:04:43 > 0:04:44And when did this happen?
0:04:44 > 0:04:47Yesterday. He was out for a training run with me
0:04:47 > 0:04:50and after about eight miles, he just had horrendous pain...
0:04:50 > 0:04:52- OK.- ..in his left knee, as if something had gone.- Uh-huh.
0:04:52 > 0:04:54- So we got... - Was that in the evening?
0:04:54 > 0:04:57- No, yesterday morning. - Yesterday morning.
0:04:57 > 0:05:00Eight miles is a relatively long run,
0:05:00 > 0:05:03but nurse Aimee's keen to find out if there are other problems.
0:05:03 > 0:05:06Like a small fracture or dislocation.
0:05:06 > 0:05:08So does the pain travel anywhere else?
0:05:08 > 0:05:12No, it's just like down this side.
0:05:12 > 0:05:15Are you able to raise the leg off the bed?
0:05:17 > 0:05:18How does that feel?
0:05:19 > 0:05:24- Well, here it's not as bad...- OK. - ..but it's a bit sore.
0:05:24 > 0:05:25Can you bend the knee?
0:05:27 > 0:05:28Just slowly.
0:05:28 > 0:05:31And is the pain in here when you do that?
0:05:31 > 0:05:32In here, yeah.
0:05:32 > 0:05:35OK. What we'll do first is get you some pain relief, OK?
0:05:35 > 0:05:37- OK.- Before the doctor comes and properly examines it,
0:05:37 > 0:05:40- so it's got a fair bit of pain relief onboard. OK?- OK.
0:05:41 > 0:05:45I think nursing in Shetland is different in that it's...
0:05:45 > 0:05:50It's a small community and everybody knows everybody in some form.
0:05:50 > 0:05:53You just have to take people as they are and try and help them,
0:05:53 > 0:05:57cos what might be something quite simple to us
0:05:57 > 0:05:59might be a big deal to them.
0:06:00 > 0:06:03Nurse Aimee wants a more detailed examination of Bruce's leg,
0:06:03 > 0:06:06so she fetches Dr Kirsty Sneddon.
0:06:06 > 0:06:08Hello, I'm Kirsty. I'm one of the doctors.
0:06:08 > 0:06:12- What's happened?- He injured it for a run with me yesterday.- OK.
0:06:12 > 0:06:16About eight miles in, he had to suddenly stop
0:06:16 > 0:06:18- with pain at the back of the left knee.- OK.
0:06:18 > 0:06:21So has the pain relaxed a bit with the painkillers?
0:06:21 > 0:06:24- Yeah.- Yeah? OK. - It's made it definitely bearable.
0:06:24 > 0:06:26OK.
0:06:26 > 0:06:29OK. Can you straighten that out?
0:06:29 > 0:06:31Like this one is. Is that sore?
0:06:31 > 0:06:33- Yeah.- OK.
0:06:33 > 0:06:36I'm just going to... Can you manage that?
0:06:36 > 0:06:37- Yeah.- Yeah?
0:06:39 > 0:06:40But it's sore to keep it that way?
0:06:40 > 0:06:42I'm just going to feel gently.
0:06:42 > 0:06:43Try not to kick me.
0:06:43 > 0:06:45- Yeah.- There.- It's that side.
0:06:45 > 0:06:47So it's more tender where we're pushing?
0:06:47 > 0:06:50- Yeah.- Yeah. - Like, that's the worst bit there.
0:06:50 > 0:06:52- Right there?- Yeah.
0:06:52 > 0:06:55How often do you run at eight miles?
0:06:55 > 0:06:57Well, he does train with me quite a bit.
0:06:57 > 0:07:00- I do... I do a bit of running with Mum...- OK.
0:07:00 > 0:07:03..and I play football at least five...
0:07:03 > 0:07:06A good four times a week.
0:07:06 > 0:07:08OK.
0:07:08 > 0:07:10Right, this bit may hurt.
0:07:10 > 0:07:11OK?
0:07:13 > 0:07:15- Yeah.- Is that worse?
0:07:15 > 0:07:18- Yeah.- Yeah. OK.
0:07:18 > 0:07:21- OK. Good news is, the bones are fine.- Yeah.
0:07:21 > 0:07:25OK? The bad news is... I think you've pulled...
0:07:25 > 0:07:30This, here, is where the muscle in your leg comes down
0:07:30 > 0:07:31and joins across the knee.
0:07:31 > 0:07:34It helps the knee bend and move.
0:07:34 > 0:07:36I think what you've done is you've irritated that.
0:07:36 > 0:07:40Hopefully, with a bit of rest,
0:07:40 > 0:07:45some Ibuprofen, paracetamol for the pain, um...
0:07:45 > 0:07:50and your cold compresses, your ice packs, I think it will settle,
0:07:50 > 0:07:51it will start to settle.
0:07:51 > 0:07:54See how it goes in the next couple of days
0:07:54 > 0:07:56and then you can start to build it back up.
0:07:56 > 0:07:58But I wouldn't be running one mile,
0:07:58 > 0:08:01- let alone eight on it straightaway, OK?- Thank you.
0:08:01 > 0:08:04Given that he's so young, I...
0:08:04 > 0:08:07I think the muscle itself is going to be healthy enough.
0:08:07 > 0:08:09It will just take time.
0:08:09 > 0:08:15If it worsens, if it swells up, if it...suddenly becomes very sore,
0:08:15 > 0:08:18if you notice a lump, just come straight back.
0:08:18 > 0:08:21I think in the long run, he'll be fine.
0:08:21 > 0:08:23He just needs to rest it up and let the muscle out.
0:08:23 > 0:08:26I suspect he's probably overused it being the summer holidays and
0:08:26 > 0:08:28playing football five times a week.
0:08:28 > 0:08:31I think doing an eight-mile run has probably overdone it a little bit.
0:08:31 > 0:08:33Um, just let it settle
0:08:33 > 0:08:36and then he can take up his running and his football again.
0:08:38 > 0:08:41On Shetland, kids are more likely to be admitted to hospital from
0:08:41 > 0:08:44overactivity than lack of activity.
0:08:46 > 0:08:50With nearly 1,700 miles of stunning coastline,
0:08:50 > 0:08:53there's fun to be had around these rugged rocks.
0:08:57 > 0:09:00Shetland is a giant outdoor playground, with wild,
0:09:00 > 0:09:03stunning nature on the doorstep offering a childhood like no other.
0:09:07 > 0:09:11It's a place for getting outside and seeking adventure.
0:09:12 > 0:09:15SEAGULL CRIES
0:09:15 > 0:09:19Dr Kushik Lalla arrived on Shetland from South Africa.
0:09:19 > 0:09:23Now he's the senior A&E and surgery doctor at the Gilbert Bain Hospital.
0:09:23 > 0:09:26What I want is for you not to move your neck.
0:09:26 > 0:09:28Cathy is just going to support your head.
0:09:29 > 0:09:32But it's not all serious medical emergencies.
0:09:33 > 0:09:35On this island paradise,
0:09:35 > 0:09:39Dr Lalla has found a home he loves for himself and his family.
0:09:39 > 0:09:43I was absolutely amazed the first time I got to Shetland.
0:09:44 > 0:09:47The community is very close-knit, a fantastic place for kids.
0:09:47 > 0:09:50DISTANT CHEERING
0:09:51 > 0:09:55Right, guys. Now, today will be football.
0:09:55 > 0:09:59I actively help out every weekend,
0:09:59 > 0:10:02but I didn't take up a formal position
0:10:02 > 0:10:06because they expect you to be there every weekend
0:10:06 > 0:10:08and I can't give that guarantee.
0:10:08 > 0:10:10Right, get your boots on.
0:10:10 > 0:10:12- Are you going to play well today? - Mm-hm.- Yeah?
0:10:14 > 0:10:17Today the local kids' teams are having a mini tournament,
0:10:17 > 0:10:22with Dr Lalla's son Josh playing up front for Whitedale FC.
0:10:23 > 0:10:26- Where are we, on the grass pitch? - Yeah.
0:10:26 > 0:10:27And because it's summer in Shetland,
0:10:27 > 0:10:31the eager teams will definitely need to warm up first.
0:10:31 > 0:10:33WHISTLE TRILLS
0:10:33 > 0:10:36First game, we are on pitch four.
0:10:36 > 0:10:40This one. Come on, over here. Whose jacket is this?
0:10:40 > 0:10:44Dr Lalla volunteers as occasional team coach, team medic
0:10:44 > 0:10:47and, of course, passionate touchline dad.
0:10:47 > 0:10:49It's nice being out of the hospital.
0:10:49 > 0:10:51HE CHUCKLES
0:10:51 > 0:10:52That's it, Josh. Go in.
0:10:54 > 0:10:55Oh, unlucky.
0:10:56 > 0:10:58Yeah! Well done, Josh.
0:11:00 > 0:11:02That's OK, up you get.
0:11:02 > 0:11:03Nice, Joe.
0:11:05 > 0:11:06Yep.
0:11:07 > 0:11:09An initial victory for Whitedale FC.
0:11:09 > 0:11:11And it's straight onto game two.
0:11:13 > 0:11:14Take it in!
0:11:14 > 0:11:16It's fantastic for kids, I think.
0:11:16 > 0:11:20It's a safe place, you get them out, you get them active.
0:11:20 > 0:11:22Positions, guys.
0:11:22 > 0:11:24Josh, positions.
0:11:24 > 0:11:26The wins keep coming.
0:11:26 > 0:11:28It's turning into a great day for the team,
0:11:28 > 0:11:31for Josh and for all the proud dads.
0:11:31 > 0:11:33They've won so far every match.
0:11:33 > 0:11:35So, yeah, doing fine.
0:11:35 > 0:11:37ALL CHEER
0:11:38 > 0:11:40Well done. Good playing there.
0:11:40 > 0:11:42Being a doctor is considered to be
0:11:42 > 0:11:44one of the most stressful jobs in Britain.
0:11:44 > 0:11:48So there are perks to living in a small, far-flung community,
0:11:48 > 0:11:50with the great outdoors on your doorstep.
0:11:52 > 0:11:57Kids, it's safe for them to go out and run around.
0:11:57 > 0:12:00You really don't see it nowadays, but, you know,
0:12:00 > 0:12:03you'll find little kids wearing their welly boots,
0:12:03 > 0:12:07playing in little lochs and streams.
0:12:07 > 0:12:08Dr Lalla and his family
0:12:08 > 0:12:11are certainly living the dream on Shetland.
0:12:11 > 0:12:13Getting all the outdoors has to offer them
0:12:13 > 0:12:15on and off the football pitch.
0:12:15 > 0:12:16Get the foot in!
0:12:16 > 0:12:19But while football is the beautiful game,
0:12:19 > 0:12:21it can occasionally end in tears.
0:12:22 > 0:12:2615-year-old Saul has been brought in from school after the ball awkwardly
0:12:26 > 0:12:30struck his knee, causing much pain.
0:12:30 > 0:12:32Dr Etaoin Carroll wants to find out more.
0:12:32 > 0:12:37I was just running and then the ball hit me and my leg just completely...
0:12:37 > 0:12:38I couldn't move it at all.
0:12:38 > 0:12:41And I just kind of fell to the ground.
0:12:42 > 0:12:45And I tried putting weight on it and I just couldn't.
0:12:45 > 0:12:49So some friends helped me hobble to the janitor's at school and get it
0:12:49 > 0:12:53- seen to.- So apart from the knee that you've told me about,
0:12:53 > 0:12:55is there anything else you see a doctor regularly for?
0:12:55 > 0:12:57I've had problems with, like,
0:12:57 > 0:12:59both my knees and, like, my hips and my back.
0:12:59 > 0:13:02What I think we'll do is, I think we'll get an X-ray of the knee
0:13:02 > 0:13:05and then when you've had your X-ray, we'll move you back into somewhere with a bed.
0:13:05 > 0:13:10Because Saul has problems with his knees, as well as his hips and back,
0:13:10 > 0:13:13the medical staff want to see if there's other damage
0:13:13 > 0:13:16or irregularities in his knee joints.
0:13:21 > 0:13:23But taking the X-rays won't be easy.
0:13:23 > 0:13:25Saul's already in a lot of pain.
0:13:31 > 0:13:36So, what we wanted to do is to make you comfortable enough
0:13:36 > 0:13:41that you'll let me straighten your leg a wee bit more than it is now.
0:13:41 > 0:13:43Do you want to give it a shot?
0:13:43 > 0:13:44Yeah.
0:13:46 > 0:13:48Suck hard...and blow it.
0:13:48 > 0:13:52The knee now requires manipulation to straighten the leg and examine
0:13:52 > 0:13:55the meeting point of the thigh and shinbone.
0:13:55 > 0:13:58SAUL INHALES DEEPLY
0:13:58 > 0:14:00Now Dr Lalla can cast his experienced eye
0:14:00 > 0:14:02over the troublesome joint.
0:14:02 > 0:14:05- Yeah, unusual configurations. - Yeah.- Yeah.
0:14:05 > 0:14:08- Just this whole configuration just looks odd.- Yeah.
0:14:09 > 0:14:11And this on the lateral, you know,
0:14:11 > 0:14:14- you can see the growth plate over there.- Yep.
0:14:14 > 0:14:16- That looks...- That's it over there,
0:14:16 > 0:14:19- and that corresponds to this area here.- Yeah.
0:14:19 > 0:14:21- But what is that, then? - I don't know.
0:14:22 > 0:14:26The football injury has caused Saul's current discomfort,
0:14:26 > 0:14:27but there's a potential problem
0:14:27 > 0:14:30with the configuration of his knee joint.
0:14:30 > 0:14:36I think that this is just the way he's actually rotated.
0:14:41 > 0:14:43Your X-rays...
0:14:43 > 0:14:47We'll discuss these at one of our, what's called
0:14:47 > 0:14:49a paediatric meeting.
0:14:49 > 0:14:52So we link in with the guys in Aberdeen,
0:14:52 > 0:14:54the paediatric orthopaedic doctors,
0:14:54 > 0:14:58and they have a look at all these X-rays and tell us, you know,
0:14:58 > 0:15:00"Do that" or "It sounds like this."
0:15:00 > 0:15:04In the meantime, Saul is fitted with a special plaster that will keep his
0:15:04 > 0:15:09knee bent but slowly straighten over time as the pain subsides.
0:15:09 > 0:15:12They'll have note of you as well,
0:15:12 > 0:15:16and if they think they should see you, then we'll arrange that.
0:15:17 > 0:15:19There isn't a specialist paediatrician
0:15:19 > 0:15:23at the Gilbert Bain Hospital, or on the island.
0:15:23 > 0:15:26So, anatomical conundrums like Saul's knee
0:15:26 > 0:15:28can be referred to specific units on the mainland
0:15:28 > 0:15:31for a second opinion, if required.
0:15:31 > 0:15:32If you see people on Shetland,
0:15:32 > 0:15:35the vast majority of them do not want to leave the island
0:15:35 > 0:15:37to receive their care.
0:15:37 > 0:15:41Sometimes patients travel by boat and that's a 14-hour journey.
0:15:41 > 0:15:46If the sea is rough, you can be, you know, throwing up the entire time.
0:15:46 > 0:15:51So it makes sense to try and provide as much care as possible
0:15:51 > 0:15:53on the island.
0:15:55 > 0:15:56The clinic is just in there
0:15:56 > 0:15:59- when you come back in a couple of weeks' time.- Yeah.
0:16:00 > 0:16:04Saul may need an operation to remove excess cartilage from his knee.
0:16:04 > 0:16:08But in the meantime, he can return home to rest.
0:16:08 > 0:16:11Football glory will have to wait.
0:16:18 > 0:16:2359-year-old Theresa suffers from regular debilitating migraines.
0:16:23 > 0:16:26But she was recently struck by a more severe and troubling throb
0:16:26 > 0:16:28in the side of her head.
0:16:29 > 0:16:34Dr Michael Stewart's on the case, but he needs to find out more.
0:16:34 > 0:16:36- What's been happening?- Um...
0:16:36 > 0:16:38- Well, Saturday I had this...- Mm-hm.
0:16:38 > 0:16:41..massive pain in my head and it...
0:16:41 > 0:16:44was sort of like a whooshing sort of feeling in me head.
0:16:44 > 0:16:47- Right, OK. - Me eyeballs sort of rolled back
0:16:47 > 0:16:50and I went really dizzy and lost me balance.
0:16:50 > 0:16:53- Right, OK.- And I've had this headache since.
0:16:53 > 0:16:55It's just been a really crushing headache.
0:16:55 > 0:16:57Does it feel like your normal migraine?
0:16:57 > 0:16:59- No, it doesn't.- No?- No.- No.
0:16:59 > 0:17:01And do your migraines normally always feel the same?
0:17:01 > 0:17:04- Yes.- Yes, OK.- Yeah, yeah. - So it's a NEW headache?
0:17:04 > 0:17:08- It is, it's... It's a real severe headache.- Mm-hm.
0:17:09 > 0:17:14Regular migraines are an unpleasant condition, and surprisingly common -
0:17:14 > 0:17:17affecting one in seven people across Britain.
0:17:17 > 0:17:19That's over nine million sufferers.
0:17:20 > 0:17:23But for Theresa, this new and more severe headache,
0:17:23 > 0:17:25along with a loss of balance,
0:17:25 > 0:17:28could be a sign of something worse.
0:17:28 > 0:17:31She's had a sudden onset headache a few days ago
0:17:31 > 0:17:35and she thought it would just get better because she normally has migraines.
0:17:35 > 0:17:39Um, but the GP's worried... A sudden onset headache is worrying,
0:17:39 > 0:17:42but then also she's got some funny signs, like poor balance,
0:17:42 > 0:17:44which are kind of worrying her as well,
0:17:44 > 0:17:46that there might be a bleed in the brain.
0:17:48 > 0:17:53So, Theresa will need a CT scan and a series of cognitive tests.
0:17:53 > 0:17:56A loss of strength, sensation or reflex could indicate
0:17:56 > 0:17:59that her brain has been damaged.
0:17:59 > 0:18:00- Any double vision at all?- No.
0:18:00 > 0:18:03Any new changes in the vision since you've had this headache?
0:18:03 > 0:18:05Slightly blurrier.
0:18:06 > 0:18:08OK, can you put your fingers out wide?
0:18:08 > 0:18:10Squeeze my finger, as hard as you can. Come on.
0:18:10 > 0:18:12- I am!- OK. Can you lift this leg straight up for me?
0:18:12 > 0:18:14And don't let me push it down...
0:18:14 > 0:18:15Don't let me push it down.
0:18:15 > 0:18:17OK. Now this one. Don't let me push it down.
0:18:17 > 0:18:20OK, grand. Can we get your shoes and socks off?
0:18:20 > 0:18:22- THERESA LAUGHS - Is that allowed?!
0:18:22 > 0:18:25If there's been a bleed on Theresa's brain,
0:18:25 > 0:18:28reflex reaction times will be slower.
0:18:28 > 0:18:29Pop your leg out to the side.
0:18:30 > 0:18:32There we go.
0:18:33 > 0:18:35So I'll need to get some blood samples.
0:18:35 > 0:18:39We need to know how your kidneys are doing first before we do the scan.
0:18:39 > 0:18:42- OK.- Um, and then we'll take it from there.
0:18:42 > 0:18:44All right.
0:18:44 > 0:18:48- So, it takes about an hour for the kidney tests to get back.- OK.
0:18:52 > 0:18:53OK, right.
0:18:54 > 0:18:56So we'll get all that sorted.
0:18:56 > 0:18:59Are you happy to wait in the waiting room just whilst we get the results?
0:18:59 > 0:19:00Pop your shoes on before you go!
0:19:01 > 0:19:05- HE LAUGHS - I don't want you to stand on something by accident.- OK.
0:19:05 > 0:19:08Theresa will have a potentially long series of tests
0:19:08 > 0:19:10to determine what's happened inside her head.
0:19:11 > 0:19:15And she'll need to spend an anxious night in hospital under observation
0:19:15 > 0:19:18before a brain scan in the morning.
0:19:21 > 0:19:25Shetland's location in the North Sea means there's a lot of offshore
0:19:25 > 0:19:27employment for local people.
0:19:32 > 0:19:3656-year-old Gary is an able seaman aboard a North Sea supply vessel,
0:19:36 > 0:19:39currently docked in Lerwick.
0:19:39 > 0:19:42Overnight, Gary developed difficulty breathing
0:19:42 > 0:19:44and worrying pains in his chest.
0:19:46 > 0:19:49Nurse Emma Williamson takes on one of the many vital,
0:19:49 > 0:19:51yet unsung medical tasks -
0:19:51 > 0:19:53to prepare the patient for examination.
0:19:54 > 0:19:58Put on that attractive gown. I see you've a rather hairy chest!
0:19:58 > 0:20:01We might have to do a bit of shaving.
0:20:01 > 0:20:04But the first thing that we really need to exclude
0:20:04 > 0:20:06is that it's come from your heart.
0:20:06 > 0:20:09- So this is just a heart tracing that I'm going to do.- Mm-hm.
0:20:09 > 0:20:13So, um, I have to put wee stickers on your chest.
0:20:13 > 0:20:16- Hence the shaving.- Mm-hm.
0:20:16 > 0:20:20A heart trace test, or electrocardiogram,
0:20:20 > 0:20:23measures the rhythms of the heart to check it's operating normally.
0:20:24 > 0:20:26But it must be taken into account
0:20:26 > 0:20:31that Gary is a 60-a-day cigarette smoker.
0:20:31 > 0:20:34Dr Lauren Camet has her concerns.
0:20:34 > 0:20:37I think he spoke to the ship medic about it just briefly.
0:20:37 > 0:20:41The ship medic, quite, I think, responsibly, reported this to the captain,
0:20:41 > 0:20:43who wanted Gary to come and get checked out in A&E.
0:20:43 > 0:20:48- Hi, Lauren.- So, Gary, when did this sensation come on last night?
0:20:48 > 0:20:51- Three o'clock in the morning. - Three o'clock in the morning.
0:20:51 > 0:20:54And were you awake already or did it waken you up from your sleep?
0:20:54 > 0:20:56- I was wakened.- OK.
0:20:56 > 0:20:59- You couldn't sleep for it, would that be fair to say?- Mm-hm.
0:20:59 > 0:21:03Is it normal for you to be up at that time in the morning, or...?
0:21:03 > 0:21:05- No.- No, OK.
0:21:07 > 0:21:09Why were you awake, if you don't mind me asking?
0:21:09 > 0:21:11Were you feeling unwell in any other way?
0:21:11 > 0:21:14No. Any palpitations?
0:21:14 > 0:21:17- What's that? - Feeling your heart beating fast.
0:21:17 > 0:21:21- No, not that I can remember, no. - No. OK, that's fine. That's fine.
0:21:21 > 0:21:23Breathing problems and heart palpitations
0:21:23 > 0:21:25could point to something more serious...
0:21:25 > 0:21:27Nice big breath in now, please.
0:21:27 > 0:21:30..especially for a heavy smoker like Gary.
0:21:30 > 0:21:33Time for a nervous chest X-ray. MACHINE DINGS
0:21:33 > 0:21:35Perfect, that's all done, thank you.
0:21:36 > 0:21:39There's a chance that Gary has unstable angina,
0:21:39 > 0:21:44a very serious condition where the heart has restricted blood flow
0:21:44 > 0:21:45and doesn't get enough oxygen.
0:21:47 > 0:21:49This can lead to a heart attack.
0:21:49 > 0:21:51So Gary can't be discharged yet.
0:21:51 > 0:21:54But that doesn't stop him going AWOL.
0:21:54 > 0:21:57Another job for hard-working nurse Emma.
0:21:59 > 0:22:02Yeah, have you seen him going anywhere? He's got a cannula in, so...
0:22:02 > 0:22:04Unless he's at the toilet.
0:22:06 > 0:22:07Gary?
0:22:09 > 0:22:11Stepping out for a phone call,
0:22:11 > 0:22:14Gary managed to light up another cigarette...
0:22:14 > 0:22:17before nurse Aimee ushers him back in.
0:22:17 > 0:22:20Obviously, I can't force people to stay in hospital,
0:22:20 > 0:22:24but when I think it's definitely for their benefit...
0:22:24 > 0:22:26And if he had a heart attack on a ship,
0:22:26 > 0:22:30which is a 60-minute helicopter ride from the nearest hospital,
0:22:30 > 0:22:34that's a lot more danger to his life than if he has a heart attack,
0:22:34 > 0:22:36you know, within ten minutes.
0:22:37 > 0:22:39With Gary back indoors
0:22:39 > 0:22:42and his condition still potentially very serious,
0:22:42 > 0:22:44Dr Camet is keen to run more tests.
0:22:46 > 0:22:49What we'd like to do is get another ECG,
0:22:49 > 0:22:52but while you're on a treadmill walking, OK?
0:22:52 > 0:22:55So what we do is, we have you on the treadmill and get you kind of going
0:22:55 > 0:22:56faster and faster,
0:22:56 > 0:23:02- but record your heart through that to see what happens, OK?- Yeah.
0:23:02 > 0:23:07If you do have angina or if you have a narrowing in one of the arteries
0:23:07 > 0:23:10in your heart, what we might see is changes on the ECG,
0:23:10 > 0:23:12and that would be really helpful for us.
0:23:12 > 0:23:15- Try and behave yourself.- I know. - SHE LAUGHS
0:23:15 > 0:23:16- See you!- It's OK.
0:23:16 > 0:23:18Now, is that...? Happy for us to do this?
0:23:18 > 0:23:19That's super.
0:23:19 > 0:23:21OK, so if you just rest your right hand on here
0:23:21 > 0:23:24and keep the left arm nice and straight.
0:23:24 > 0:23:27Monitoring Gary's heart at pace will show the medical team
0:23:27 > 0:23:31how this vital organ functions while he's on the move and at work.
0:23:34 > 0:23:36HE COUGHS
0:23:36 > 0:23:39Well done. The reason you stopped is because your blood pressure has gone
0:23:39 > 0:23:41- a wee bit higher than we'd like it to be. OK?- Yeah.
0:23:41 > 0:23:45So what we need to do is rest you down on the bed and let you recover.
0:23:45 > 0:23:50So, Gary will need a little lie down and a bit of a breather,
0:23:50 > 0:23:53as well as medication to bring down his blood pressure
0:23:53 > 0:23:55and unblock his arteries.
0:23:55 > 0:23:59But he's well enough to officially leave the hospital.
0:24:02 > 0:24:05SEAL SNORTS
0:24:05 > 0:24:08Not every medical problem can be solved at the hospital.
0:24:08 > 0:24:12And not every patient can make it to the Gilbert Bain.
0:24:12 > 0:24:17One such case is on the books for occupational therapist Jill Beswick.
0:24:17 > 0:24:20Occupational therapists work, um,
0:24:20 > 0:24:22in both mental health and physical health,
0:24:22 > 0:24:24and we're trained, we're dual trained,
0:24:24 > 0:24:26so we look at the whole person,
0:24:26 > 0:24:29looking at both the physical needs and the mental health needs,
0:24:29 > 0:24:32and we work across all age ranges as well,
0:24:32 > 0:24:35from very newborn babies to the very elderly,
0:24:35 > 0:24:37and certainly within our services,
0:24:37 > 0:24:41we've still been supporting people at home that are 97, 98,
0:24:41 > 0:24:44back home from the care homes to live independently at home.
0:24:45 > 0:24:48So, Jill's work takes her to many a far-flung destination,
0:24:48 > 0:24:51providing support to the very young and old.
0:24:51 > 0:24:54One of the things, for me, when I first arrived in Shetland
0:24:54 > 0:24:57was trying to work out how we were going to get there.
0:24:57 > 0:24:59You've got to look at your ferry timetables...
0:24:59 > 0:25:01This visit was planned for tomorrow,
0:25:01 > 0:25:03but we've looked at the weather forecast,
0:25:03 > 0:25:08we know it's going to be 47mph wind tomorrow with driving rain.
0:25:09 > 0:25:12There's no way we can take an 80-year-old lady out in that.
0:25:12 > 0:25:16And the lady in question... is 80-year-old Stella,
0:25:16 > 0:25:19who had a bit of a fall and broke her hip.
0:25:20 > 0:25:23Stella's itching to get back on her feet and living independently,
0:25:23 > 0:25:27having received treatment at a residential nursing home.
0:25:27 > 0:25:29So we'll just pull up here,
0:25:29 > 0:25:32so that we're nice and close for getting her into the car.
0:25:32 > 0:25:34Oh, good morning, Stella!
0:25:34 > 0:25:35Oh, hold on!
0:25:35 > 0:25:37I'm taking pills!
0:25:37 > 0:25:40I'm getting used to having a slave!
0:25:40 > 0:25:43- I'll get the Zimmer... - That surely isn't true!
0:25:43 > 0:25:46We're going to have to get you home and whip you into shape
0:25:46 > 0:25:47if that's the case, Stella!
0:25:47 > 0:25:49It's breezy out there.
0:25:49 > 0:25:51- Will you be able to carry your bag? - Yes.
0:25:51 > 0:25:52There we go.
0:25:55 > 0:25:58- OK.- Can I take your handbag?
0:25:58 > 0:26:00Lovely, yes.
0:26:00 > 0:26:02It's probably better to go up and over, isn't it?
0:26:04 > 0:26:06Whilst Stella's been enjoying some R&R,
0:26:06 > 0:26:09her house has been receiving some TLC.
0:26:10 > 0:26:13Stella's concerned about her restricted mobility,
0:26:13 > 0:26:17so a team has been in making essential adaptations.
0:26:18 > 0:26:20Now Stella gets to inspect their handiwork.
0:26:20 > 0:26:22- How's that?- Lovely!
0:26:22 > 0:26:24Whay-hay!
0:26:24 > 0:26:26Oh, I can't see, hang on.
0:26:26 > 0:26:28Step in as close as you can.
0:26:29 > 0:26:31It's an emotional moment for Stella,
0:26:31 > 0:26:34who's been away from home now for several weeks
0:26:34 > 0:26:35and is not entirely sure
0:26:35 > 0:26:38how much the interior has changed in her absence.
0:26:38 > 0:26:40OK? In you go.
0:26:40 > 0:26:42- Home, sweet home.- Well done!
0:26:42 > 0:26:44- Perfect.- Whoa! I need a holiday!
0:26:44 > 0:26:46ALL LAUGH
0:26:46 > 0:26:49Now Stella must gauge how she'll cope with living on her own.
0:26:56 > 0:27:00The Gilbert Bain A&E Department is no different to any other hospital -
0:27:00 > 0:27:05open 24 hours a day, seven days a week, 52 weeks of the year.
0:27:05 > 0:27:09Patients can arrive at any time of the night.
0:27:09 > 0:27:11- So, my name's Dr Hare.- How are you?
0:27:11 > 0:27:13What have you been doing to yourself?
0:27:13 > 0:27:15- I was at training tonight...- Uh-huh.
0:27:15 > 0:27:19- ..and, um, it was just from... And someone jumped over...- Yep.
0:27:19 > 0:27:23- ..and as they jumped, something must've fell off them, and went in my eye.- OK.
0:27:23 > 0:27:24It's almost midnight
0:27:24 > 0:27:27and Dr Helen Hare has a patient with an eye problem.
0:27:27 > 0:27:30Whilst 17-year-old Warren was playing football,
0:27:30 > 0:27:33he got whacked in the eye and is in some discomfort.
0:27:33 > 0:27:35What we'll do is, we'll get you through
0:27:35 > 0:27:38and we've got a special light that we use to examine the eyes
0:27:38 > 0:27:41and see if there's anything we can wash out or lift out.
0:27:41 > 0:27:46Dr Hare will use a slider camera to inspect the eye and socket.
0:27:46 > 0:27:48Um, and I need to put some... I'll have a look first,
0:27:48 > 0:27:50and then I need to put some fluorescent in your eyes.
0:27:56 > 0:27:57Chin forward.
0:27:57 > 0:28:00Dr Hare needs to have a closer inspection of Warren's eye,
0:28:00 > 0:28:02and she has a special way of doing it.
0:28:02 > 0:28:06So what I've got here is a wee orange dye.
0:28:06 > 0:28:09So I will pop some of this into your eye.
0:28:09 > 0:28:11- It's going to make your eye look a bit weird and orange.- Yeah.
0:28:11 > 0:28:13And hopefully, when I then shine the blue light on it,
0:28:13 > 0:28:15we'll see something we can deal with.
0:28:15 > 0:28:21The nearest ophthalmic department is 226 miles away on mainland Scotland.
0:28:21 > 0:28:25And although Dr Hare is not an eye specialist, in Shetland,
0:28:25 > 0:28:29having general expertise is a specialism in itself.
0:28:29 > 0:28:31What I need you to do is just look up for me...
0:28:33 > 0:28:36OK. And then just hold it in your eye for a wee minute and then blink.
0:28:36 > 0:28:40The medical team at the Gilbert Bain all have a vast knowledge of general care.
0:28:42 > 0:28:44Where does it feel like it is, sorry?
0:28:44 > 0:28:47Right at the top, like past my eyelid, right there.
0:28:47 > 0:28:48OK.
0:28:51 > 0:28:52OK.
0:28:52 > 0:28:54Right, I think we'll need to stop this for a minute.
0:28:54 > 0:28:56Sorry, Warren, I'm not especially good at this,
0:28:56 > 0:28:59as you may be able to tell, and I'm not having a lot of luck.
0:28:59 > 0:29:01I'm going to see if I can find a colleague
0:29:01 > 0:29:03to give me a bit of assistance, all right?
0:29:03 > 0:29:04- No worries.- Sorry about that.
0:29:04 > 0:29:08Sometimes, though, there are times where you just need to call upon
0:29:08 > 0:29:09a more experienced colleague.
0:29:11 > 0:29:14The problem is, this is a piece of equipment that I haven't used since
0:29:14 > 0:29:18medical school, and I've made a bit of a cack-handed job of it.
0:29:18 > 0:29:22Fortunately, one of the nurses is actually quite experienced in using this kit,
0:29:22 > 0:29:24so she's going to step in for me.
0:29:24 > 0:29:28Fortunately, the multi-skilled nurse, Thelma Irving, is on hand
0:29:28 > 0:29:30to take up the baton.
0:29:30 > 0:29:31- You all right?- Mm-hm.
0:29:33 > 0:29:37- I didn't actually see any... You can just relax if you want.- Yeah.
0:29:37 > 0:29:39I didn't really see anything.
0:29:39 > 0:29:41Um, I didn't really see any optic at the stem
0:29:41 > 0:29:44- that would indicate that you've scratched your eye.- Mm-hm.
0:29:44 > 0:29:47But when modern technology reveals nothing,
0:29:47 > 0:29:50nurse Thelma decides to take a look the old-fashioned way.
0:29:52 > 0:29:54Oh...
0:29:55 > 0:29:58What I'm going to do is, I'm just going to take a wee cotton bud...
0:29:58 > 0:30:02- Mm-hm.- ..and I'm going to just turn your eyelid back.
0:30:02 > 0:30:06It's a kind of uncomfortable feeling but it shouldn't be too painful.
0:30:06 > 0:30:08- That's all right.- And just look underneath your eyelid, OK?
0:30:08 > 0:30:12It's the second most complex organ after the brain
0:30:12 > 0:30:15and composed of more than two million working parts.
0:30:15 > 0:30:19A potential injury to the eye demands close attention.
0:30:20 > 0:30:21You just relax.
0:30:21 > 0:30:24I'm just going to turn your eyelid back.
0:30:26 > 0:30:28And wipe anything that's there.
0:30:28 > 0:30:31And it's not one of the easiest parts of the body to inspect.
0:30:31 > 0:30:34I'm squeamish as well. Like, my eyes are like the worst things I could...
0:30:34 > 0:30:36Oh, I know. But nothing else...
0:30:36 > 0:30:39Both hi-tech and low-tech examinations
0:30:39 > 0:30:41reveal no perceptible damage.
0:30:42 > 0:30:46So what to do with poor Warren and his stricken eye?
0:30:46 > 0:30:49- There's no uptake at the stem that I can see.- Yep.
0:30:49 > 0:30:50Have a look at the slip mark.
0:30:50 > 0:30:53Unless it's really, really high up and I can't see it.
0:30:53 > 0:30:56- So I've suggested that he maybe goes to the optician tomorrow. - Optician? Yeah, absolutely.
0:30:56 > 0:31:00- Do you want me to give him some chloramphenicol ointment in the meantime?- Might as well.
0:31:00 > 0:31:04- And patch cos of the local? - Yeah. Mm-hm, mm-hm.- Yeah, good.
0:31:04 > 0:31:06- Will that be fine?- Perfect.- OK. - Thank you, Thelma.
0:31:06 > 0:31:08No problem.
0:31:08 > 0:31:09- OK.- Cheers.- Bye just now.
0:31:09 > 0:31:11So after a long night's wait,
0:31:11 > 0:31:14it's a trip to the local opticians for Warren.
0:31:14 > 0:31:16And he just needs to wash and rest the eye.
0:31:22 > 0:31:2559-year-old Theresa came into the Gilbert Bain Hospital
0:31:25 > 0:31:30following a severe migraine episode and a worrying loss of balance.
0:31:32 > 0:31:35She already suffers from regular debilitating migraines,
0:31:35 > 0:31:39so medics were eager to arrange a CT head scan to make sure Theresa's
0:31:39 > 0:31:41not had a bleed on the brain.
0:31:44 > 0:31:47Dr Stewart has been overseeing this troubling case.
0:31:47 > 0:31:50PHONE RINGS
0:31:52 > 0:31:56So, her scan of her head was negative, it didn't show anything.
0:31:56 > 0:31:59Um, but it's not ruled it out completely.
0:31:59 > 0:32:01We need to do a bit of a more detailed scan tomorrow.
0:32:01 > 0:32:04So I'm just going to try and admit her overnight,
0:32:04 > 0:32:06although she's not too keen on that,
0:32:06 > 0:32:08and we'll see how that goes.
0:32:08 > 0:32:11We'll get this more detailed scan here
0:32:11 > 0:32:14and then if that's still negative,
0:32:14 > 0:32:17she might need an even more detailed scan in Aberdeen.
0:32:17 > 0:32:20And she might need a lumbar puncture, which is just a needle in the back,
0:32:20 > 0:32:22to look for some blood there as well,
0:32:22 > 0:32:24but we'll see, we'll see.
0:32:24 > 0:32:27A few different avenues to go down depending on what we find.
0:32:27 > 0:32:30- So, what's happening? - I've spoken to the boss
0:32:30 > 0:32:32and he agrees that it's probably best to keep you overnight,
0:32:32 > 0:32:34just cos we are worried about this.
0:32:34 > 0:32:37Albeit a small risk.
0:32:37 > 0:32:41Um, we... We just want to err on the side of caution.
0:32:41 > 0:32:43So it's really up to you.
0:32:43 > 0:32:45- I'll stay.- Are you sure?
0:32:45 > 0:32:47- Yeah.- OK. - Otherwise I'll get an earache.
0:32:47 > 0:32:48DR STEWART LAUGHS
0:32:48 > 0:32:51That's often the reason that people end up staying!
0:32:51 > 0:32:55Um... So, yeah, we'll hopefully get the other scan early tomorrow
0:32:55 > 0:32:57and then take it from there.
0:32:57 > 0:32:59- OK.- OK?- All right.
0:32:59 > 0:33:01I'll get everything sorted.
0:33:01 > 0:33:04- Grand. And if you need any more painkillers, just let us know.- Yeah.
0:33:04 > 0:33:09- And we'll try and not make you wait so long next time.- OK.
0:33:10 > 0:33:11OK?
0:33:12 > 0:33:15Dr Stewart wants another CT scan
0:33:15 > 0:33:18and input from the specialist units on the mainland
0:33:18 > 0:33:20before giving the all clear.
0:33:20 > 0:33:25In the meantime, sadly, it's more anxious waiting time for Theresa.
0:33:27 > 0:33:30SEAGULL CRIES
0:33:33 > 0:33:36Margaret has arrived in the A&E Department
0:33:36 > 0:33:39with some worrying chest pains.
0:33:39 > 0:33:40Nurse Amanda Brown is on the case
0:33:40 > 0:33:43to check the background of Margaret's condition.
0:33:43 > 0:33:47A friendly chat also helps put a worried patient at ease.
0:33:47 > 0:33:50You've been on holiday. When was that?
0:33:50 > 0:33:54Uh... We came back two weeks ago, two weeks ago tomorrow.
0:33:54 > 0:33:56There was me...
0:33:56 > 0:33:59I didn't even have alcohol as an excuse to be daft,
0:33:59 > 0:34:01but the next day I felt really ill.
0:34:01 > 0:34:04Do you feel like it's coming from your stomach,
0:34:04 > 0:34:06or is it in the centre of your chest?
0:34:06 > 0:34:08It was in the chest, but it was very uncomfortable.
0:34:08 > 0:34:13OK, I'll do some observations like they did in the ambulance,
0:34:13 > 0:34:15and then I'll do an ECG
0:34:15 > 0:34:19- just to check that there's nothing going on with your heart.- Yeah.
0:34:19 > 0:34:21But you've been here before,
0:34:21 > 0:34:23so you ken what I'm going to be doing?
0:34:23 > 0:34:26Nurse Amanda helps with the diagnosis.
0:34:26 > 0:34:29Blood pressure can identify possible cardiac issues
0:34:29 > 0:34:32and the ECG examines the heart's performance.
0:34:33 > 0:34:37Dr Cameron Innes is also on hand to assist.
0:34:37 > 0:34:41For a couple of... Just a peerie minute, we'll keep still and...
0:34:41 > 0:34:42I won't speak.
0:34:42 > 0:34:44- You stop asking questions. - Aye. Don't worry.
0:34:44 > 0:34:46SHE CHUCKLES
0:34:46 > 0:34:49The ECG records electrical activity in the heart,
0:34:49 > 0:34:52which the doctor or nurse can cross-reference
0:34:52 > 0:34:54and compare with patterns of proven heart conditions.
0:34:56 > 0:35:00To make it accurate, it requires the patient to remain fairly still.
0:35:02 > 0:35:05OK, you're free to speak now.
0:35:05 > 0:35:07Do you mind if I have a wee listen to your chest?
0:35:07 > 0:35:10- No, not at all.- Have you got any chest pain at the moment?
0:35:10 > 0:35:13- No, just a slight burn there, it's nothing...- A burn.
0:35:13 > 0:35:16Do you get breathless at all when you're lying flat?
0:35:16 > 0:35:19- A little bit.- Do you ever wake up gasping for breath
0:35:19 > 0:35:20- in the middle of the night?- No.- No.
0:35:20 > 0:35:25So when I'm listening to the back, it's easiest to hear all the lung fields.
0:35:25 > 0:35:27So, essentially, you get them to breathe in and out.
0:35:27 > 0:35:30If they've got any infection, it kind of sounds a bit like a crisp packet.
0:35:30 > 0:35:31You can hear it bubbling away.
0:35:31 > 0:35:34- Are you quite comfortable sitting like that?- Yeah.- OK.
0:35:34 > 0:35:37Hers is perfectly clear, which...I was expecting.
0:35:37 > 0:35:40And then when you come round to the front, you listen to the heart,
0:35:40 > 0:35:42so listening for murmurs...
0:35:42 > 0:35:45This is just a kind of turbulent blood flow within the heart
0:35:45 > 0:35:47and it might mean, like, leaky valves.
0:35:47 > 0:35:51You know, the volume and stuff of the heartbeat and also making sure that
0:35:51 > 0:35:54it's all regular and everything's hunky-dory.
0:35:56 > 0:35:58Do you notice your ankles swelling up at all?
0:35:58 > 0:35:59- They're no bad, no.- No?
0:35:59 > 0:36:03- That foot's a bit swollen because I have a bad ankle there, but... - Yeah.
0:36:03 > 0:36:06You ask a lot of patients about their ankles swelling up
0:36:06 > 0:36:07because it can be a sign of...
0:36:07 > 0:36:09Or IS a sign of heart failure.
0:36:10 > 0:36:13All the fluid that kind of stagnates in the leg
0:36:13 > 0:36:16because the heart's not pumping all the blood around,
0:36:16 > 0:36:19it just seeps out into the tissues and swells up
0:36:19 > 0:36:22and it can seep out into the lungs as well.
0:36:22 > 0:36:23Oh, was that a wee bit sore there?
0:36:23 > 0:36:25- It was.- Oop!
0:36:25 > 0:36:29With Margaret's vitals checked and the ECG results reviewed,
0:36:29 > 0:36:30Dr Innes has a plan of action.
0:36:30 > 0:36:32Good. OK.
0:36:32 > 0:36:34So what we're going to do is...
0:36:34 > 0:36:38So all your numbers and things, with the monitoring, look good.
0:36:38 > 0:36:40- Mm-hm. - Uh, what we're going to do is,
0:36:40 > 0:36:45the tracing of your heart that we just did a minute ago,
0:36:45 > 0:36:47there's something that I just want to double check,
0:36:47 > 0:36:49so we'll have to get a blood sample.
0:36:49 > 0:36:50If everything is fine,
0:36:50 > 0:36:54I'm quite confident that you'll be able to get away.
0:37:02 > 0:37:04As good as the service is at the Gilbert Bain Hospital
0:37:04 > 0:37:08and as wonderful as the medical team are, most patients are very,
0:37:08 > 0:37:10very happy to finally go home.
0:37:13 > 0:37:17Like the rest of Britain, Shetland does have an ageing population,
0:37:17 > 0:37:20with around 25% already aged over 60.
0:37:28 > 0:37:32And whilst the island is the perfect, gorgeous setting for retirement,
0:37:32 > 0:37:34or growing old disgracefully,
0:37:34 > 0:37:36it does present extra challenges
0:37:36 > 0:37:39for the talented teams providing health care.
0:37:46 > 0:37:5080-year-old Stella has been away from her home for several weeks.
0:37:50 > 0:37:53Whilst her damaged hip was being repaired,
0:37:53 > 0:37:57adaptations were made to her home to enable independent living.
0:37:58 > 0:38:00It's an emotional return for Stella,
0:38:00 > 0:38:03but occupational therapist Jill is on hand to help.
0:38:03 > 0:38:07So keep your hand on it, you need to keep it pushing in that direction.
0:38:07 > 0:38:09STAIRLIFT BLEEPS
0:38:09 > 0:38:11- Are you feeling OK?- Mm-hm.
0:38:11 > 0:38:15And it's not just an exciting, brand-new stairlift.
0:38:15 > 0:38:17The whole house has become more suited
0:38:17 > 0:38:19to Stella's restricted mobility.
0:38:19 > 0:38:22Hands down to the bed before you sit down.
0:38:22 > 0:38:24That's it. Lovely. Yeah. Yeah.
0:38:24 > 0:38:26- Whay-hay! - Just saves this moving on you.
0:38:26 > 0:38:28- OK?- Yeah.- So I'll just move that out of the way,
0:38:28 > 0:38:31- so I'm here while you get yourself... - I've got to lie down, have I?
0:38:31 > 0:38:32Yeah, when you're ready. Yeah. In your own time.
0:38:34 > 0:38:36Oh, yeah.
0:38:37 > 0:38:39- OK.- Right, take a minute.
0:38:39 > 0:38:42And then have a go at getting into bed properly.
0:38:42 > 0:38:45Get nice and comfy, like you were settling in for the night.
0:38:45 > 0:38:49Do you think you would like to get into the middle a bit more or roll over?
0:38:49 > 0:38:51- Roll over!- Mm-hm. - STELLA LAUGHS
0:38:51 > 0:38:55Trying out your new bed is always fun,
0:38:55 > 0:38:57but supported living could be difficult
0:38:57 > 0:38:58for a party girl like Stella.
0:38:59 > 0:39:03Do you think if you had support coming in,
0:39:03 > 0:39:07would you like to come upstairs and be able to use your bedroom?
0:39:07 > 0:39:08Mmm...
0:39:08 > 0:39:10Yeah, but, I mean, somebody will come
0:39:10 > 0:39:13about one o'clock in the morning to make sure I'm going to bed.
0:39:13 > 0:39:15Yeah, and that's what we don't have, yeah.
0:39:15 > 0:39:19The last visit, really, tends to be nine, half nine.
0:39:19 > 0:39:20I'm not going to bed then!
0:39:20 > 0:39:23- I know, you're quite a late lady, aren't you?- Yeah.
0:39:23 > 0:39:24Perfect.
0:39:24 > 0:39:27Home visits might be tricky for this night owl.
0:39:27 > 0:39:31But overall, Stella seems pleased with her newly-adapted home.
0:39:31 > 0:39:33It didn't kill me, or...
0:39:33 > 0:39:36Getting on and off that bed was the easiest thing ever.
0:39:36 > 0:39:38- It was easy.- Wasn't it? - Yeah, brilliant.
0:39:38 > 0:39:42Yeah. So much easier than the beds in the care home.
0:39:42 > 0:39:44I think it shows, really,
0:39:44 > 0:39:47that we need to do the home visit to anticipate any difficulties.
0:39:47 > 0:39:49I thought I'd prepared for most things.
0:39:49 > 0:39:52The stairlift was trickier than I was expecting.
0:39:52 > 0:39:53- Slow and steady.- Whay-hay!
0:39:53 > 0:39:57Stella will finally return home for good in a few weeks' time.
0:39:59 > 0:40:02This will be the most activity you've done in a long, long time.
0:40:02 > 0:40:03- Yeah.- Yeah.
0:40:03 > 0:40:06Until then, it's back to the care home
0:40:06 > 0:40:09for a spot of lunch and a bit of a lie down.
0:40:12 > 0:40:13Lovely.
0:40:14 > 0:40:15OK.
0:40:17 > 0:40:18Bye-bye!
0:40:18 > 0:40:20SEAL SNORTS
0:40:22 > 0:40:25Margaret arrived in the A&E Department
0:40:25 > 0:40:27with worrying chest pains.
0:40:27 > 0:40:30She received a physical examination from Dr Innes
0:40:30 > 0:40:32and another from the ECG machine.
0:40:35 > 0:40:38Next, nurse Amanda provides another vital medical procedure -
0:40:38 > 0:40:40taking blood for analysis.
0:40:43 > 0:40:46- Just one more. Are you OK? - I'm grand.
0:40:46 > 0:40:48Doesn't faze you, then?
0:40:48 > 0:40:50Not one little bit.
0:40:50 > 0:40:53So you said you're allergic to stuff, are you?
0:40:53 > 0:40:55Or is it just sensitivities?
0:40:55 > 0:40:57- They're severe sensitivities... - Uh-huh.
0:40:57 > 0:41:00..but I am allergic to...penicillin.
0:41:00 > 0:41:03Do you get anaphylaxis, like you actually swell up?
0:41:03 > 0:41:05I can, yeah, come out in...
0:41:05 > 0:41:07So were you having a cup of tea?
0:41:07 > 0:41:09- Please. Just black tea.- Black tea?
0:41:09 > 0:41:12- Nae milk, nae sugar?- No, thanks.
0:41:12 > 0:41:14OK.
0:41:14 > 0:41:17I shall go and sort that out, I'll label up these.
0:41:17 > 0:41:20I'll give you the bell just in case you're needing me.
0:41:20 > 0:41:24- OK.- Then you can give it a buzz and I'll not be far away.
0:41:24 > 0:41:27The dedicated nurses offer full-spectrum care,
0:41:27 > 0:41:30from medical procedures to a comforting chat,
0:41:30 > 0:41:32to a cracking hot cup of tea.
0:41:33 > 0:41:38So Margaret is settled to receive blood test results from Dr Innes.
0:41:38 > 0:41:40OK, Margaret, so all your bloods are back.
0:41:40 > 0:41:44- Good.- And everything is completely normal.
0:41:44 > 0:41:48The blood test we did to check starvation of oxygen to the heart...
0:41:48 > 0:41:50- Uh-huh.- That's completely zero.
0:41:50 > 0:41:52- Good.- So that's good.
0:41:52 > 0:41:54- OK?- Lovely. - So happy to let you away.
0:41:54 > 0:41:58- Thank you.- With the advice that you go see your GP.
0:41:59 > 0:42:01Great news for Margaret.
0:42:01 > 0:42:04And she can now return home worry-free.
0:42:04 > 0:42:06Have you got any way of getting home?
0:42:06 > 0:42:09I'll phone some of my folks or family might be around...
0:42:09 > 0:42:11- OK.- ..I think, and, um,
0:42:11 > 0:42:14hopefully they'll be willing to see the old lady up the road.
0:42:14 > 0:42:16- I'm sure they will. All right? - SHE LAUGHS
0:42:16 > 0:42:20- Well, it's been lovely to meet you. - Yeah, you too. - Thank you.- You're welcome.
0:42:26 > 0:42:30Saul is awaiting his knee surgery to have excess cartilage removed.
0:42:30 > 0:42:34But the medics are confident he'll have no future hip or knee issues.
0:42:36 > 0:42:38Theresa had a further CT scan
0:42:38 > 0:42:41and, after consultation with specialists from the mainland,
0:42:41 > 0:42:44was finally given the all clear to return home.
0:42:45 > 0:42:46After several weeks,
0:42:46 > 0:42:49Stella was able to permanently return home
0:42:49 > 0:42:52and is finding her new adapted house most satisfactory.