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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 |