Pennod 9 Ward Plant


Pennod 9

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-Ysbyty Gwynedd

-serves the largest area in Wales.

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-Children from everywhere

-come here...

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-..which puts considerable pressure

-on one of the busiest wards.

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-We are full.

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-Not only are we full but Glan Clwyd

-and Wrexham are also full.

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-Some are used to being here.

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-He can explain how he's feeling

-but I have no idea what it's like.

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-We're learning together.

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-Others try their best to escape.

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-But everyone hopes

-for the same outcome.

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-It's all come back clear

-so we can stop the antibiotics.

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-To get better in order to go home.

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-Thank you.

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-Every year, hundreds of children

-come in and out of Dewi Ward.

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-But not every one of them

-lives in Gwynedd.

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-Some children

-with complex conditions...

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-..come to the area on holiday.

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-Usually, their local hospital

-will write to us...

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-..just to let us know that they're

-in the area between certain dates.

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-They tell us about their treatment.

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-We have a folder specifically

-for people on holiday.

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-These patients can call their local

-hospital when they're not well.

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-They use us in the same way and

-we communicate with their hospital.

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-People who are on holiday

-may not be seriously ill.

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-Sometimes they forget

-their pump or something...

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-..and that makes them ill.

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-But also, it's a bit tricky

-to send them home.

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-Usually, we try to keep children in

-hospital for as little as possible.

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-We like to send them home quickly.

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-But it's different

-when you're sending them back...

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-..to a tent on a mountain side!

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-They may not be familiar

-with the route back to hospital.

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-This is Lily from Wigan.

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-Her gran lives on Anglesey...

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-..and her family has a caravan

-near Porthmadog.

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-It's half term

-so the family has come on holiday.

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-Lily has a rare hormonal problem.

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-But staff at Ysbyty Gwynedd

-know all about it already.

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-The mother had been in touch so we'd

-given her what we call open access.

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-We'd received an email...

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-..from the specialist hospital

-she attends in Manchester.

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-That information comes to us and we

-follow the plan they put in place.

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-She doesn't need an IV, does she?

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-She doesn't need an IV, does she?

-

-But is she eating?

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-We can try giving her something.

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-I'll try and get a D number.

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-Lily has what is called

-idiopathic ketotic hypoglycaemia.

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-If she starts to vomit,

-it's difficult to get her to stop.

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-Because of that,

-her blood sugar levels go down...

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-..and the blood ketone levels

-go up.

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-That can be very dangerous.

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-Luckily for us tonight...

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-..Lily had stopped vomiting

-by the time she got here.

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-But she has a very detailed protocol

-regarding what to do.

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-We're supposed to try

-oral solutions first...

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-..but if that doesn't work, it would

-have to be a cannula and IV fluids.

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-The protocol we've received

-from Manchester...

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-..tells us exactly what to do.

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-Luckily, she's doing well.

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-She's had

-some anti-sickness medicine.

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-If she's OK for the next 30 minutes,

-they're going to head home.

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-She hasn't been sick at all

-since she arrived.

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-Thank you very very much.

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-Lily is ready

-to continue her holiday.

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-Bye!

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-Bye!

-

-Thank you.

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-It's all down to

-Ysbyty Gwynedd's expertise.

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-Dewi Ward is used to

-dealing with children...

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-..who have rare conditions.

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-Ysbyty Gwynedd

-serves a huge number of children...

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-..over a vast area.

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-That means that we sometimes

-have children in...

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-..with quite rare conditions.

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-I can think of one our patients,

-for example.

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-He's one of only 50 in the world

-who have his condition.

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-And here he is - Archie.

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-Everyone on Dewi Ward knows him.

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-Archie has ohtahara syndrome.

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-It's a severe type of epilepsy.

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-He was having up to 50-60

-seizures a day.

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-Now it's under 10.

-Fingers crossed it remains that way.

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-They say that people with the

-condition live about two years.

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-But they've given Archie

-a life expectancy...

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-..of between 6 and 16 years.

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-We hope that stays that way for now.

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-It's not a nice feeling

-but it's better than two years.

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-You know.

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-If he only had two years to live, it

-would mean so little time with him.

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-Now that he has longer to live, they

-may be able to do more by then...

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-..and he might end up being here

-for a long time.

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-Or longer than we expect.

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-Six or sixteen

-is better than one or two for me.

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-This next little boy is called Owen

-and he's also been through the mill.

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-He was born five weeks early.

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-At six weeks of age,

-he had E. coli meningitis.

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-He had it again at ten weeks.

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-He also had sepsis. Since then,

-his health hasn't been great.

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-Last night, he was just up...

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-..and he was making

-these jerky movements and crying.

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-I'm just worried that it might be

-a sign of something more serious.

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-He's been in Alder Hey

-in intensive care and everything.

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-Yes, he was on life support.

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-He's doing well

-but he gave us a fright last night.

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-I just want to know

-exactly what's going on.

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-Just in case he's having seizures.

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-He seems fine in himself otherwise.

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-But there's quite a bit

-of developmental delay.

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-He doesn't say anything yet.

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-But that's all

-in the process of improving.

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-You're getting support, aren't you?

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-You're getting support, aren't you?

-

-Yes, all the right support.

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-Your health visitor

-has been fantastic.

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-Yes, we just want to know

-what this is.

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-Waiting is hard

-when you're only 18 months old.

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-But Mam...

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-..and Nain...

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-..and Dad are all here.

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-It all helps to pass the time.

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-The doctor is a bit perplexed

-by Owen's condition.

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-He only has the seizures at night.

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-He seems perfectly healthy

-in the day.

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-Oh, your tummy's empty.

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-So now you need some juice.

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-What do you think? Juice?

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-Yeah, your tummy.

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-The next step is an EEG test.

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-It's an electronic examination

-of the head...

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-..to look for signs of epilepsy.

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-We're just hoping he can have this

-EEG so we can see what's going on.

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-It's easier if they can eliminate

-a few things.

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-That's what we want to do.

-If everything is fine, that's great.

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-But they need to be able

-to eliminate things.

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-While the doctor

-arranges everything...

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-..Owen finds an opportunity

-to escape - again!

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-But he won't get very far!

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-The front doors are locked

-and no-one new will come in tonight.

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-The ward is full!

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-We are full.

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-It's not that unusual

-but it's happened quite quickly.

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-It happened very quickly today.

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-It's November and it's 9.50pm.

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-Since mid afternoon, we've had

-one after another come in.

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-At the moment, I think we're OK.

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-There are a couple more

-waiting to be seen.

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-I think most of them

-are likely to be staying in.

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-But we may have one cubicle

-and one bed left.

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-Not only are we full but Glan Clwyd

-and Wrexham are also full.

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-If Wrexham is full

-and you live in Wrexham...

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-..you could go to Chester

-or even Alder Hey or Arrowe Park.

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-There are other hospitals

-quite close by.

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-If you're supposed to go to

-Glan Clwyd and they're full...

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-..you could either go to England

-or come here if we're open.

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-But if we're full, patients to the

-south or west of the hospital...

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-..have no choice

-but to drive further.

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-If someone has come all the way from

-Dolgellau or Blaenau Ffestiniog...

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-..it doesn't feel right to tell them

-to go back on the A55...

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-..and drive for another 100 miles

-to reach Liverpool.

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-So we have to make space for them

-somehow.

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-.

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-Subtitles

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-It's a new morning on Dewi Ward

-and every bed is full.

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-Thankfully,

-there was no crisis overnight.

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-It was alright overnight

-to be honest.

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-Typical.

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-We're preparing

-a couple of things...

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-..before handing over

-to the day staff...

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-..who should be here

-in about ten minutes hopefully.

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-Time for the night shift

-to leave...

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-..and for the doctors to decide

-who's well enough to go home.

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-To make room for some new patients.

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-My name is Owen Williams

-and I live in Felinheli.

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-I'm here today

-because I have a chest infection.

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-Owen is also a haemophiliac.

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-If he has an injury or a bruise,

-his blood won't clot.

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-When he was a little baby

-having his immunisations...

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-..he had to have them

-here on the ward...

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-..rather than

-with the health visitor.

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-We've had a few issues.

-What's happened?

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-You've had a bleed

-into your knee twice.

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-A bleed into your hip twice.

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-And a stint

-when he was struggling to breathe.

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-That's why they have to be very

-careful if he has a chest infection.

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-He could be bleeding inside

-without anyone knowing.

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-I'll take your pulse as well.

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-There are some sports

-I'm not allowed to do...

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-..like karate, boxing and rugby.

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-I have played rugby before

-but not contact.

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-It was touch rugby.

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-When we moved on to contact,

-I had to stop.

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-If he has a bleed into a joint...

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-..because it's encapsulated

-it will continue to bleed...

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-..and it causes stiffness and pain.

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-If it's left untreated, it can lead

-to problems such as rheumatism...

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-..at a very young age.

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-So usually,

-if it's quite a small injury...

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-..we have a medicine he can take.

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-If it's a more serious injury

-or if he needs an operation...

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-..he has to have intravenous.

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-He's under the care

-of Alder Hey Hospital in Liverpool.

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-They've been so supportive

-in teaching us...

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-..how to give him the treatment.

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-They've also gradually taught Owi

-how to treat himself.

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-It's something he'll have to learn

-to live with during his life.

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-If I bruise badly...

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-..I take some medicine.

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-Not every day.

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-There are varying levels

-of severity.

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-Yes, severe and...

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-Which one are you?

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-Mild.

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-He has to be aware

-and be able to treat himself.

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-My cousin has it.

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-Because we don't really know much

-about it, we've talked to him a lot.

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-For example,

-he does a lot of cycling.

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-He explained that when you go to

-the gym and your legs feel stiff...

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-..that's how it feels but it doesn't

-improve - it just gets worse.

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-Owi can explain to me how it feels.

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-But I don't know how it feels.

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-We're learning together, aren't we?

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-I could have worse things.

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-Caio also has to live with a disease

-that he'll have throughout his life.

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-Are you OK? Caio?

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-Yes. I'm just going to check

-your blood sugar.

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-I'm sure you're well used to this.

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-Where shall I do it?

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-Caio has come

-to have his adenoids out.

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-But because he has

-type 1 diabetes...

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-..they must ensure that

-his blood sugar levels are fine...

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-..before giving him anaesthetic.

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-OK. 6.4.

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-I'll go to tell Jan, the nurse.

-She'll carry on.

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-There we are.

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-OK?

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-OK?

-

-Thank you.

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-The reading says 6.4.

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-That's perfect.

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-There's no time to waste.

-Caio is ready for his treatment.

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-He hopes it will help

-everyone to sleep.

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-I hope that I won't snore any more

-and also that I'll hear better.

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-I have difficulty hearing.

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-Sometimes I shout

-and I don't realize.

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-So it should help with that as well.

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-You can come.

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-Yes, Mum comes.

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-Yes, you can be with him

-until he goes to sleep.

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-Owen Williams?

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-Can you come through

-to the X-ray room?

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-Owen has to have an X-ray

-on his chest...

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-..and some blood tests.

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-He's been coming to hospital

-since he was a baby...

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-..and the staff know him well.

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-Eleri isn't one

-to miss an opportunity.

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-Owen has to come back

-for a blood test.

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-Owen is one of

-my haematology patients.

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-Because he has to be

-treated often...

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-..inhibitors can develop

-in his blood.

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-Depending on how many there are...

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-..that can affect

-how clotting factor VIII works.

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-Because Owen is a haemophiliac...

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-..he doesn't have enough factor VIII

-in his body unlike other people.

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-So we have to help him

-if he has a little accident.

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-By giving him factor VIII...

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-..we're introducing something to

-his body which shouldn't be there.

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-Those are the inhibitors.

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-Every three months,

-haemophiliacs have a blood test....

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-..to make sure

-there are no inhibitors.

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-If there is a problem,

-we adjust the treatment accordingly.

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-So far, it's been negative.

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-Let's see. I like that one.

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-I think we'll go for that one.

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-Juicy juicy!

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-Just to be clear, Eleri is talking

-about the vein - not the boy!

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-No, not that.

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-Do you want any cream?

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-Do you want any cream?

-

-No, thank you.

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-Go on.

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-Go on.

-

-But it's cold.

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-Do you want the spray?

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-Do you want the spray?

-

-Yes.

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-Yes, what?

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-Yes, what?

-

-Yes, please.

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-It's freezing!

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-There we are. Done.

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-There you go, darling.

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-It's a good colour.

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-OK. All done.

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-Well done.

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-There we go, Mr.

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-Thank you.

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-Thank you.

-

-You're most welcome. I did nothing!

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-Thank you.

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-William Rhys Roberts is coming in

-for a blood test result.

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-He's only three weeks old.

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-He was rushed in two days ago

-because of vomiting and a skin rash.

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-Since then,

-he's been on antibiotics...

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-..to protect him from sepsis

-and meningitis.

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-I have some good news.

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-We did the blood cultures

-and we tested the urine as well...

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-..and we took a little sample

-from his back.

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-They've all come back clear.

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-So we can stop the antibiotics.

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-I'll ask the nurses to come

-to take out the cannula.

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-We'll have a look at him.

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-We'll make sure

-everything else is OK...

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-..then hopefully

-it'll be home sweet home.

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-OK? So I'll just let the nurses come

-to take out the cannula.

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-Then we'll sort everything out.

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-Thank you.

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-Caio, who has type 1 diabetes,

-is back from theatre.

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-But he won't be left in peace

-to come round.

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-They have to test

-his blood sugar levels again.

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-Sorry.

-Just as you were going to eat.

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-Sorry. I won't be two minutes.

0:19:180:19:20

-Can I just rest this there?

0:19:220:19:24

-I put those there

-when you were asleep.

0:19:270:19:30

-In case you bleed.

0:19:300:19:32

-We're checking Caio's blood

-every 30 minutes.

0:19:370:19:41

-He wasn't able to eat properly

-before going to theatre.

0:19:410:19:45

-So we just need to check

-that his blood sugar levels are OK.

0:19:460:19:50

-There we are. It's 8.7. OK?

0:19:510:19:53

-There you are.

-You can have your food now.

0:19:540:19:58

-I've had a chat with the consultant.

0:20:060:20:09

-He's happy with the plan.

0:20:090:20:12

-I'll have a quick look at him

-while he's feeding.

0:20:130:20:16

-Have you had an appointment?

0:20:180:20:19

-Have you had an appointment?

-

-Not yet.

0:20:190:20:21

-The plan is to go home.

-No more antibiotics, OK?

0:20:260:20:29

-Keep an eye on him

-and on his feeding.

0:20:310:20:35

-How much does he normally have?

0:20:360:20:37

-He was having 5oz every 3-4 hours.

0:20:380:20:42

-And what's he having now?

0:20:420:20:45

-About 2-3oz at the most.

0:20:450:20:48

-Fine.

0:20:480:20:49

-That's enough for him

-according to the calculations.

0:20:500:20:53

-He should be having 2.5oz.

0:20:530:20:56

-Gradually, as he gets better,

-you can build it back up.

0:20:570:21:01

-Make sure he has plenty

-of wet nappies.

0:21:020:21:04

-That will obviously be a sign

-of how much hydration he's getting.

0:21:050:21:09

-If you're concerned at all, give us

-a shout over the next 24 hours.

0:21:110:21:16

-Oh, hello. We've woken you up!

0:21:160:21:19

-He looks beautiful and great

-at the moment.

0:21:200:21:24

-OK?

0:21:240:21:25

-The number for the ward is there.

0:21:250:21:27

-So if there are any problems,

-give us a shout.

0:21:280:21:30

-Right, take him home, OK?

0:21:310:21:33

-Thank you.

0:21:330:21:34

-That's great.

-We'll take him home now.

0:21:380:21:41

-We just need to

-keep an eye on him for 24 hours.

0:21:420:21:44

-Hopefully

-we won't have to bring him back.

0:21:450:21:48

-Another day comes to an end.

0:21:510:21:53

-It wasn't as crazy as yesterday

-but tomorrow is another day.

0:21:540:21:59

-Archie had reacted to the MMR jab.

0:22:080:22:10

-The spots disappeared

-within a few days.

0:22:100:22:13

-Owen's virus has cleared and he's

-not on any medication at the moment.

0:22:140:22:19

-Caio is waiting for an operation

-to close the hole in his ear.

0:22:200:22:25

-Owen's EEG scan came back clear.

-He doesn't have epilepsy.

0:22:250:22:30

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