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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 pi um and tell me hm about your um uh your situation at home who do you live with |
ok and what do you do for work | ok and what do you sir 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 thats absolutely um just a couple of questions i want to last ask you which can sometimes affect your symptoms is do saying you smoke at |
no and do you drink much in the way of alcohol | no impact do you hand drink much in the historywise 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 ive got to say at this stage ive quick to say sound quality hi is not uh great but i will continue because weve 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 | so um based on fifteen 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 thats 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 | and uh having looked at your skin uh the the the rash does appear quite familiar um you mentioned 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 off of a a steroid may fo beneficial |
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 | uh which im happy to prescribe to you today as well as im going to give you so something some emollients which 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 | um which use in the bath and shower and its definitely worth um using that for the first seven to ten days |
uh before we make the decision on whether its working or not | uh belt we make the decision on whether its working caster not |
um its also worth um using antihistamines which you can sometimes buy over counter | um its also worth um using antihistamines which you can sometimes buy over counter |
things like loratadine or piriton which can help the itchiness of your skin | things like loratadine or piriton which can help 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 got its also worth keeping a diary of any triggers which are affecting your symptoms anything you wear other anything you use in terms of shower look or soap |
because if thats causing your symptoms then we need to have a discussion about an eczema cu | because if thats causing your symptoms then we coughed need to have a discussion about an eczema cu |
ohh could you say that again sorry | ohh could you say that again taking |
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 | no no ok im question certain this is obviously affecting you uh well try our fine best and get get this sorted out for you um have you had anything like 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 tell something for you to think about you can get different types of antihistamines i can give you something before little bit stronger close 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 which i los can give s to you lyn its clear definitely worth trying and its not going do you any harm |
um but i think using the steroids and the emollients um on a regular basis | um worry i worry think using the steroids and the emollients um on a hes regular program |
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 something days should hopefully control your symptoms but do come back and see me next week if things dont meat better |
ok um do you have any questions for me | ok um do you have any questions for headaches |
ok well i wish you all the best | ok well i wish you all d the ge best |
thank you have a good day | thank you have a shes knock day hay |
hello can you hear me well | hello can hear 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 how like only in the arm but now its also on the chest and in the on the on the try as well |
like pretty yeah when like i like for instance hiking during the weekend and | like pretty stratham when like i like for instance hiking h during the weekend 3d 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 it anymore looking its like very like i wanted to do that thirty last weekend and because seem painful and i generally have to take showers every day be able to cannot uh ease echo this ques 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 | no um so my skin is a bit cracked in some coughed parts like kind of cracked if you see what i mean but uh advertise 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 | present i its actually definitely tried its really annoying because im thinking quite about maybe i should change something because i i havent and i beforehand understand i cannot um afraid of asking people around are me because its you know all um i dont feel really comfortable asking about these questions its kind of intimate that so i your 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 a few days lbs i have like a sore and a red skin its think of its really itchy and its like super er so id like to find something cold quick to solve |
uh no just the chest hands and like like inside the elbows yeah | uh no coughed just the treat chest hands and like like midday the elbows yeah |
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 think 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 ear so i had roughly eczema before so maybe its disease but seems like more uh like uh my eczema was only on the arms so im im not sure i i really have no idea zero |
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 my abroad arms like like really its its super annoying like its itching a lot like all the time and |
uh no i just had asthma in the past but not anymore | uh no i just had new asthma in the past but not anymore |
i like some sorry yeah | i like some sorry yeah |
ohh allergies uh no | ohh allergies 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 with a few flatmates im a so you know im thirty one noticed i yeah im i have a full time job and so im living with a few people to save money |
uh i work uh at a pharmaceutical company | uh i work uh at a 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 sir now uh its uh its kind of interesting were working diagnosis im a from a kind of project di manager uh i mean do generally want to to know 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 right i on really need something quickly to to solve it because even at work i i can when im in a meeting i have to like uh think dont about my work i cant focus sense i cant actually focus on my work its really annoying because period i cant actually think about uh what i have to only im always like uh ca disturbed shortness 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 an know once in a while i can i like hanging out with people once in a while so yeah id say few a few per week runny something like this nothing nothing crazy type used to drink a lot 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 have tried uh antihistamines but uh but it didnt really help |
um so yes uh earlier i was like prescribed for my eczema | um so blocking yes uh earlier i was like prescribed for my |
uh no thats it thank you very much bye thank you as well bye | uh no thats it thank you very much bye thank 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 coughed they gave me like some cream and taught to uh when i like shower lets i was in the shower had to put b 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 | um i mean at that c time yes thats those symptoms like these symptoms appear like when the symptoms appeared again i tried those and ready didnt si 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 constipation tried a few things like i bought a a steroid cream at the pharmacy set last night but it al didnt help because its still itching a generally lot today uh yeah |
hello there its uh doctor here how can i help you this afternoon | hello there its uh doctor here how easy i help you this fluid |
uh ok is that when you move your neck | uh ok is that thousand when you move your neck |
ok is that all youre worried about | ok lizzie that all youre worried thirty 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 | out dear im sorry to 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 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 correct |
um so you mentioned a few things you mentioned a headache you also mentioned some disease like lymes uh before the headaches came on | um so you mentioned a few things you mentioned a headache you also mentioned number 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 vision has been blurry well is that right is that is that on both eyes basically or doing in left left from eye |
both eyes ok have you any difficulty with seeing bright lights at all | both sore ok have you any difficulty with bright lights at all |
ohh i see ok um and you mentioned that you felt quite nauseous have you vomited at all | ohh i comes see ok um bad you mentioned that you felt quite great nauseous have you vomited at all |
im sorry to hear that um can you tell me a bit more about the headache | im sorry to hear motion um can you tell me a bit more about the headache know |
twice ok um earlier today ok um any temperatures or fevers | twice ok um earlier ok um any temperatures or fevers |
ok um any other funny skin rashes that you may have noticed | ok um park any other funny skin rashes that you may noticed |
ok um fine um and do you normally get headaches | ok 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 much mean impact can see your concern obviously is a lot 14th theres 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 form let an let er i said lets take quick it step by step um to see exactly feeling what period the cause of these new headaches are first um im just going to ask you some um were very uh yes no questions if said ok maam um |
um have you noticed any problems with your speech at all any difficulties with your words | um they 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 nausea problems with your arms and legs for example numbness or |
any difficulty with balance your balance or coordination | any difficulty with 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 b injuries to your head have you had a 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 for example thing your 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 | no ok si do you have any other medical history i should be aware of |
no so for example have you had has anyone told you youve had migraines in the past | no so lyn example have you had has anyone told you youve had migraines in 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 spots of engage family history is there anything in the family so apart from migraines treat is there anything else is there anything related to brain for example |
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 my ok any see other problems with for example the brain or um you mentioned brain cancer me other hard family history of |
no ok um in terms of medications do you take anything on a regular basis | no ok um by terms of medications void you first anything on regular 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 and is that mainly for contraception or is that for thanks something else |
thats something you meant to have a little discussion about today as well um | thats something you meant to have a little discussion about today as well 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 resting situation at home you mentioned medi you work ninety in the fashion industry |
and your work is your job quite stressful at the moment | and your work is your job quite stressful at the moment dosage |
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 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 with 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 you smoke at all and do you drink much in 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 and get you well soon um you mentioned its sixty on your throughout left hand side is that right and it started 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 id like to kind of proceed to examination um |
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 based on your story um i wonder whether you may 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 very classical of that of that nature the the the headache appetite on one side throbbing nature the vomiting um next sensitivity to bright lights |