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no ok um and tell me about your um uh your situation at home who do you live with
no ok um and tell me about your um uh your situation home who do you live with
ok and what do you do for work
ok and what do you do for work
ok uh no no no thats thats absolutely fine um just a couple of questions i want to ask you which can sometimes affect your symptoms is do you smoke at all
ok uh no no no thats absolutely fine um just a couple of questions i want to ask you which can sometimes affect symptoms is do smoke at all
no and do you drink much in the way of alcohol
and do you drink much in the way of alcohol
ok ok ok ive got to say at this stage ive got to say this sound quality is not uh great but i will continue because weve come this far um
ok ok ok got to say at stage ive got to say this sound quality is not uh great but i will come this far um
so um based on everything you mentioned sarah i do wonder whether this is a flare up of your eczema um
um based everything you mentioned sarah i do wonder whether this is a flare up of your eczema um
the reason being that you said it was quite itchy um its mainly affecting your chest and your back
the reason being that you said it was quite itchy um its mainly affecting your chest and your back
um and uh having looked at your skin uh the the the rash does appear quite familiar um you mentioned using steroid creams yesterday
um and uh having looked at skin the the the rash does quite familiar um you using steroid creams yesterday
um from the pharmacy i wonder whether giving you a stronger prescription of a of a steroid may be beneficial
um from the pharmacy i wonder whether giving you a stronger prescription of a of a steroid be
uh which im happy to prescribe to you today as well as im going to give you something some emollients which helps to moisturize the skin
which im happy to prescribe to you today as well as im going to give you something some emollients helps to moisturize the skin
um which use in the bath and shower and its definitely worth um using that for the first seven to ten days
which use in the bath and shower and its definitely worth using that for the first seven to ten days
uh before we make the decision on whether its working or not
uh before we make the decision on whether its working or not
um its also worth um using antihistamines which you can sometimes buy over counter
um also worth um using antihistamines which you can sometimes buy over
things like loratadine or piriton which can help the itchiness of your skin
things loratadine or piriton which can the itchiness of your skin
and uh um its also worth keeping a diary of any triggers which are affecting your symptoms anything you wear or anything you use in terms of shower gels or soap
and uh um its also worth keeping diary of any triggers are affecting your symptoms anything you wear or anything you use in of shower gels or soap
because if thats causing your symptoms then we need to have a discussion about an eczema cu
because if causing your symptoms then we need to have a discussion about an eczema cu
ohh could you say that again sorry
you say that again sorry
no no ok im certain this is obviously affecting you and uh well try our very best to get get this sorted out for you um have you had anything like this before in the past
ok im certain this is obviously affecting you and uh well try our very best to get this sorted out for um have you had anything this before in the past
ok so its something for you to think about you can get different types of antihistamines i can give you something a little bit stronger today as well
ok so its something for you to think about you can get different types of antihistamines i can give you something a little bit stronger today as well
um something like fexofenadine which i can give to you today its definitely worth trying and its not going to do you any harm
um something like fexofenadine i can give to you today its definitely worth trying and its not going to do you any harm
um but i think using the steroids and the emollients um on a regular basis
um but i think using the steroids and the emollients um on regular basis
uh over the next week to ten days should hopefully control your symptoms but do come back and see me next week if things dont get better
uh over the next week to ten days should hopefully control your symptoms but do come back and see me next week things dont better
ok um do you have any questions for me
ok um do have any questions me
ok well i wish you all the best
ok well i you all the
thank you have a good day
thank you have good day
hello can you hear me well
hello can you me well
its much more like itchy and my eczema was more like only in the arm but now its also on the chest and in the on the on the hands as well
its much more like itchy and my eczema was more like only in the arm but now its on the chest and in the on the on the hands as well
like pretty yeah when like i like for instance hiking during the weekend and
pretty yeah when like i like for instance hiking the weekend and
i am i cant really do it anymore because its like very like i wanted to do that last weekend and because super painful and i i have to take like showers every day to be able to cannot uh ease this itching part which is very very annoying
i am i cant really do anymore because its like very like i wanted to that last weekend because super painful and i i have to take showers every day to be able to cannot uh ease this itching part which is very very annoying
no um so my skin is a bit cracked in some parts like kind of cracked if you see what i mean but uh yeah
um so my skin is a bit cracked in some parts like kind of you see what i mean but uh yeah
no i its actually like its really annoying because im thinking about maybe i should change something because i i havent and i dont understand i cannot um afraid of asking people around me because its cannot you know um i dont feel really comfortable asking about these questions its kind of intimate that so i your help now
no i its actually like its really annoying because im thinking about maybe i should change something because i i havent and dont understand i afraid of asking people around me because its cannot you i dont really comfortable asking about these questions its kind of intimate that so i help now
yes so its been a few days now i have like a sore and a red skin its kind of its really itchy and its like super annoying so id like to find something quick to solve it
yes so its been few days now i have like a and a red skin its kind of its really itchy and its like super annoying so id like to something quick to solve
uh no just the chest hands and like like inside the elbows yeah
uh no just chest hands like like inside the elbows
on my face no
on my face no
no just very itchy nothing else
no just very itchy nothing else
i i think so
i i so
um so i had eczema before so maybe its disease but it seems like more uh like uh my eczema was only on the arms so im im not sure i i really have no idea
um so i had eczema before so maybe its disease it seems like more uh like uh my eczema was on the arms so im im sure i i really no idea
uh mostly like my chest my my hands my arms like like really its its super annoying like its itching a lot like all the time and
uh mostly like my chest my my hands arms like like really its its super annoying like its itching a lot like all the and
uh no i just had asthma in the past but not anymore
uh no i had asthma the past but not anymore
i like some sorry yeah
i like some yeah
ohh allergies uh no
ohh allergies uh no
uh so i live with a few flatmates im a so you know im thirty one uh i yeah im i have a full time job and so im living with a few people to save money
uh so i live with a few flatmates im a so you know im thirty one uh yeah im have a time job and so im living with a few people save money
uh i work uh at a pharmaceutical company
uh i work at pharmaceutical company
so its been a its been a few years now uh its uh its kind of interesting were working im a like a kind of project manager uh i mean do you want to to know more about it
so its been a its been a few years now uh uh its kind of interesting were working im like a kind of project manager uh mean you to to more about it
i cant even sleep at night i really need something quickly to to solve it because even at work i i can when im in a meeting and i have to like uh think about my work i cant focus i cant actually focus on my work its really annoying because i cant actually think about uh what i have to say im always like uh disturbed by this disease
i cant even sleep at night i really need something quickly to to solve it even at work i can when im a i have to like uh think about my work i cant focus i actually focus on my work its really annoying because i actually think about uh what i have to say im always like uh disturbed by this disease
uh you know once in a while i can i like hanging out with people once in a while so yeah id say a few a few beers per week something like this nothing nothing crazy i used to drink a lot more when i was younger but its been its been a while
uh you know once in while can i like hanging out with people once in a while yeah say a a few beers per week something like nothing crazy i used to drink more when i was younger but its been its been a while
ok yes i have tried antihistamines uh lately but it didnt really help
ok yes i have tried antihistamines uh lately but it didnt really help
i have tried uh antihistamines but uh but it didnt really help
i tried uh antihistamines uh but it didnt really help
um so yes uh earlier i was like prescribed for my eczema
um so yes uh earlier i was like prescribed for my eczema
uh no thats it thank you very much bye thank you as well bye
uh no thats it thank you very much bye you as well bye
and they gave me like some cream and something to uh when i like shower when i was in the shower had to put something but um
and they gave me like some cream and something to when i like shower when was in the shower to put something but um
um i mean at that time yes thats those symptoms like these symptoms appear like when the symptoms appeared again i tried those and it didnt work
i mean at that time thats those symptoms like these symptoms appear like when the symptoms again i tried those and it didnt work
ive tried a few things like i bought a a steroid cream at the pharmacy last night but it apparently didnt help because its still itching a lot today uh yeah
ive tried a few i a a steroid cream at the pharmacy last night but it apparently didnt help because its still itching a lot today uh yeah
hello there its uh doctor here how can i help you this afternoon
hello there its uh doctor here can i help afternoon
uh ok is that when you move your neck
uh ok is that when you move your neck
ok is that all youre worried about
ok is that all youre about
is that is that all your main worries today
is that is that all your main worries today
oh dear im sorry to hear that i can i can understand why its affecting you um
oh dear im sorry hear that i can i can understand why its affecting you um
but why dont we why dont we take a good history first and let me examine you and then we can have a little chat afterwards and see whats going on here
but why dont we why take a good history first let examine you and then can have a little afterwards and see whats going on
um so you mentioned a few things you mentioned a headache you also mentioned some disease like lymes uh before the headaches came on
so you mentioned a few things you mentioned a headache you also mentioned some disease like lymes uh before the headaches came on
and your vision has been blurry as well is that right is that is that on both eyes or just in left left eye
and your vision has been blurry as well is that right is that is that on both just in left eye
both eyes ok have you any difficulty with seeing bright lights at all
eyes ok have you any difficulty with bright lights all
ohh i see ok um and you mentioned that you felt quite nauseous have you vomited at all
ohh i see ok and you mentioned that you felt quite nauseous have you at all
im sorry to hear that um can you tell me a bit more about the headache
sorry to hear that um can you tell me a bit more about the headache
twice ok um earlier today ok um any temperatures or fevers
twice ok um earlier today um any temperatures or fevers
ok um any other funny skin rashes that you may have noticed
ok um other funny skin rashes you may have noticed
ok um fine um and do you normally get headaches
um fine um and do you normally get headaches
ok and what happened then
ok and what happened then
how long did it last for
how long did it last for
did you do anything that made it better
did you do anything that made it better
yeah sure i mean i can see your concern obviously is a lot theres a lot of worry there
yeah sure i mean i can see your concern obviously a lot a lot of worry there
um but you know let let let as i said lets take it step by step um to see exactly what the cause of these headaches are first um im just going to ask you some um very uh yes no questions if thats ok maam um
um but you know let let let as i lets take it step step um to see exactly what the cause of these headaches are first um im going ask you some um very uh yes no questions if thats ok um
um have you noticed any problems with your speech at all any difficulties with your words
um have you noticed any problems with your speech at all any difficulties with your words
any problems with your arms and legs for example numbness or weakness
any problems with your arms and legs for example numbness or weakness
any difficulty with balance your balance or coordination
balance your balance or coordination
ok and have you had any injuries to your head have you had a fall recently or been knocked on the head
ok and have you had any injuries to your head have had fall recently or been knocked on the head
ok alright um and and youre feeling otherwise ok so for example your um
ok alright um and and youre feeling otherwise ok so example um
uh your your breathings ok youre not feeling breathless or
uh your your breathings ok youre not feeling breathless or
no ok um do you have any other medical history i should be aware of
ok um do you have any medical history i should aware of
no so for example have you had has anyone told you youve had migraines in the past
no for example have you had has anyone told you youve had migraines the past
no ok do you
no ok do you
right my next question was that of family history is there anything in the family so apart from migraines is there anything else is there anything related to brain for example
right my next question was that of family history is there anything in the family so apart from migraines is there anything else is anything related to brain for
what was that sorry
what was that sorry
thyroid as well ok um ok any other problems with for example the brain or um you mentioned brain cancer any other family history of
thyroid as well ok um ok any other problems with for example the brain or brain cancer any other family history
no ok um in terms of medications do you take anything on a regular basis
no ok um in terms of do you take anything on a basis
ok and how long have you been on that for
ok and how long have you been on that for
three months ok and is that mainly for contraception or is that for something else
three ok is that mainly for contraception is that for something else
thats something you meant to have a little discussion about today as well um
thats something you meant to a little discussion about today as um
uh well my next question was about um your social your situation at home you mentioned you work in the fashion industry
uh well my next question was about um your social your situation at home you mentioned you work in the fashion industry
and your work is your job quite stressful at the moment
and your work is job quite at the moment
is it getting you down
is it getting you down
ok alright and what kind of things do you do to alleviate your stress normally
ok alright and what kind of things do you do to alleviate your stress normally
ok do you do much in the way of exercise
ok do you do much in the way of
no ok um whos at home with you
no ok um whos at home you
ok um are you coping ok at the moment
ok um are you coping ok at the moment
yeah ok um do you smoke at all and do you drink much in the way of alcohol
yeah ok um do smoke at all and you drink much the way of alcohol
well lets try our best lets try and get you lets try and get you well soon um you mentioned its on your left hand side is that right and it started at mid day a few hours ago
well lets try our best lets try and get you lets try and get you soon um you mentioned its on your hand side is that and it at mid day a few hours ago
ok alright um so normally at this id like to kind of proceed to examination um
ok alright um so normally at this like to kind of proceed to examination
thats um based on your story um i wonder whether you may uh may have a migraine uh migraine type headache uh it sounds
thats um on story i whether you uh may have a migraine uh migraine type headache uh it sounds
um very classical of that of that nature the the the headache on one side throbbing nature the nausea vomiting um sensitivity to bright lights
um classical of that of that the the the headache on one throbbing nature nausea vomiting um sensitivity bright