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uh im reassured that you dont have anything more serious such as meningitis or indeed | uh im reassured that you dont have anything more serious such as meningitis or indeed |
brain cancer i know that was a big worry of yours initially um | brain cancer i know that was a big worry of yours initially um |
well i hope that puts your you know mind at ease um certainly this is the second migraine youve had in the space of a month um | well i that puts your you know mind at ease um certainly this is second migraine youve had in the space of a month |
so i think moving forwards theres a couple of options i think keeping a headache diary would be quite important uh to see exactly whats triggering these headaches | so i think moving forwards theres a couple of options i think headache diary be quite important uh to see exactly whats triggering these headaches |
and in terms of trying to treat your headaches today some strong painkillers would be advisable so think about paracetamol or even co codamol | and in terms of trying to treat your today some strong painkillers would be advisable so think about paracetamol or even co codamol |
um and some anti inflammatories such as ibuprofen and naproxen hows that sound to you | and some anti inflammatories as ibuprofen and naproxen hows that sound to you |
ok um did the pain come on quite suddenly or was it more of a gradual build up | ok um did the pain come on quite suddenly or was it more of a build up |
um and uh you know if your headaches were to become more persistent then we could maybe think about giving you some medications that will stop your headaches from happening in the first place something prophylactic medicines | um and uh you know your headaches were to become more persistent then we could think about giving you some medications that will stop your headaches from happening in the first place something prophylactic medicines |
then we could have a discussion next time i see you next week perhaps | then we could have a next i see next week perhaps |
ok um now a couple of things i want you to think about is you know if your symptoms arent getting better next two three days or indeed theyre getting worse | ok um now couple of things i want you think about is you know if your symptoms arent getting better two three days or indeed getting worse |
id like you to come back and see me um straight away if possible so if your headaches getting worse not responding to medications | id like you to come back and see me um straight away if possible your headaches getting worse medications |
or your um neck pain is getting worse or you develop any weakness in your arms and legs or your vision then i want you to come back and see me straight away ok | your um neck pain is getting worse or you develop any weakness in your arms and legs or your vision then i want you to come and see me straight away ok |
does that sound all ok | does that sound all ok |
great any questions for me | great any questions me |
ok have a good day | ok have good day |
ok and are you able to describe what kind of headache it was for example was it throbbing or was it more of a sharp pain | and are you able to describe kind of it was for example was it throbbing or was it more of sharp pain |
and is it moving anywhere else at all | and is it moving anywhere else at all |
ohh i just got a terrible headache since mid day | ohh just got a terrible headache since mid day |
no but its worse when i move | no but its worse when |
well like if i lean forward or like move my head or neck yeah headache gets worse | well like if i lean forward or like move my head neck yeah headache gets worse |
im just really worried like ive just been googling and like ive read you know if your headache gets worse if you move it could be a sign of brain cancer | im just really worried like ive just been googling and like read you know if your headache gets worse if you move it be a sign of brain cancer |
ohh yeah yeah and id like you know | ohh yeah yeah and id like you know |
my my friends mum she she recently died of a brain tumor so its really concerning me actually | my my friends mum she she recently died of a brain tumor its really concerning me actually |
eh feels like it some days | eh feels like some days |
yeah well im wearing sunglasses right now its just you know the lights really hurting my eyes | yeah well im wearing sunglasses right now its just you know the lights really hurting my eyes |
um on the left side its just making me feel so ill i just feel like i need to vomit | um on the left side its just making me feel so ill i just feel like i need to vomit |
um no i dont feel feverish | um no i dont feel feverish |
no i havent noticed anything like that | no havent noticed anything like that |
um im not really prone to them no no but i did i did have a similar headache a few weeks ago | um not really prone to them no did i did have a similar headache few weeks ago |
um yeah i had to take painkillers and had to go go to bed and rest and | um i to take painkillers and had to go go to bed and rest and |
couple days off work and i work in the fashion industry and you know theyre wondering whats going on like i have to take sick days | days off and in the fashion industry and you know theyre wondering whats on like i have to take sick |
i need to get back to work today but you know what if it is a brain tumour whats gonna happen with my future and my career | i need to back to work today but you know what if it is a brain tumour whats gonna happen with my future and my career |
well you know i noticed some zig zag lines in my vision a few minutes before the headache started | well you know i noticed some zig zag in my vision a few minutes before the headache started |
you know really about this never had headaches like this before like why should i get them now | you know really about this never had headaches like this before like why should i them now |
no my mum my mum has has migraines but ive ive not been diagnosed | no my mum my mum has has migraines but ive ive not been diagnosed |
my mom has an underactive thyroid as well | my mom has an underactive as |
my vision blurred um you know it just | my vision blurred um you know it just |
um i take the pill microgynon | um i take the pill microgynon |
yeah its really stressful actually | yeah its really stressful actually |
having problems at like work you know managers like putting a lot of pressure on me to deliver and uh yeah its not a good time | problems at like work you know managers like putting a of pressure on me to deliver and uh yeah not a good time |
i dont feel down just a little bit stressed | i dont feel down just little bit stressed |
i yeah pains just horrible just making me feel so unwell um | i yeah pains just just making me feel so unwell um |
um i live on my own | um i live on my own |
thank you uh thanks so much i was so worried that i had cancer and ohh now you say migraine yeah i guess my mum has similar symptoms to me and yeah it does make sense | thank you uh thanks so much was so worried i had cancer and ohh now you say migraine yeah i guess my mum has similar symptoms to me and yeah does make sense |
k that sounds good | k that sounds good |
just want you to do something | just want you to do something |
dont know really it just happened | dont know really it just happened |
yeah i guess its yeah i guess its throbbing um on that left side | yeah i guess its yeah i guess its throbbing um on that side |
alex ohh hello hi can you hear me | alex ohh hello hi can you hear me |
ok great um how can i help you this morning sir | ok um how can i you morning sir |
no ok you didnt you didnt notice any abnormal white spots redness at the back of your throat | no ok you didnt you didnt notice any abnormal white spots redness at the back of your throat |
thats ok thats ok and you mentioned a runny nose um again what kind of discharge is coming out is it clear or is it a bit more coloured | thats ok thats ok and you mentioned runny nose um again of coming out is it clear or is it a bit coloured |
ok you feel quite congested do you | ok you feel quite congested do you |
ok fine um you also mentioned a cough as well can you tell me a bit more about that | ok fine um you also mentioned a cough as well can you tell me a bit more that |
ok and is it worse any particular time of the day | ok and is it worse any particular time of the day |
is it is it worse any particular time of the day for example in the evenings night time mornings | is it is worse any particular time of the day for example in the evenings night time mornings |
i can imagine yes uh and this has again been going on for last uh three four days has it | i imagine yes uh and has again been going on for last uh three four days has it |
ok um right ok have you noticed any fevers or temperatures at all | ok um right you noticed any fevers or temperatures at all |
thats very sensible um very good um in terms of your chest otherwise have you any difficulty breathing or any pain in your chest | thats very sensible um very good in terms your chest otherwise have you any difficulty breathing or any pain in your chest |
when you say winded do you feel uh do you feel more short of breath would you say on exertion is that when you ok um and and thats mainly on exercise but when youre resting theres no problem | when you winded do you feel uh do you feel more short of breath would you say on exertion is that when you um and and thats mainly on exercise but when youre resting theres no problem |
ok fine just a couple other questions if you dont mind any pain in in your ears at all | fine just a questions if you dont mind any pain in in your ears at all |
no you dont feel blocked or any discharge coming out of your ears | no you dont feel blocked or any discharge coming out of ears |
ok fine um what im gonna do im just gonna run through a few uh yes no questions if you if you dont mind just a review of your systems any any headaches at all | ok fine um what im gonna do im just gonna run through few uh no questions if you if you dont mind just a review of any at all |
whereabouts are the head headaches | whereabouts are the head headaches |
ok and with those headaches have you had any problems with your with your eyesight your vision | ok and with those headaches have you had any problems with your with your eyesight your vision |
uh any difficulty with seeing bright lights | uh any seeing bright lights |
no ok um and just moving down now in terms of any any feeling nausea or any vomiting | no ok um and just moving down now in terms of any any feeling nausea or any vomiting |
ok tell me about your bowels are your bowels working ok | ok tell me about bowels are your bowels working ok |
hows your appetite sir | hows your appetite sir |
ok um and youre eating and drinking uh youre eating ok otherwise | ok and youre eating and drinking uh eating ok otherwise |
sorry to hear that | sorry to hear that |
ok um have you noticed any any funny rashes at all on your skin | ok um have you noticed any any funny rashes at all on your skin |
no and any general muscle pain or aches joint pain | no and any general muscle pain or aches joint pain |
yeah ok alright um and uh just having a look at the rest of your history are you otherwise fit and well or do you have any other medical problems i should be aware of | yeah ok um and uh just having a look the rest of your history are you otherwise and well or do you have any other medical problems i should be aware of |
so you are otherwise fit and well uh any any allergies at all to any medications i should be aware of | so are otherwise fit and well uh any allergies at all to any medications i be of |
any family history at all so anything relevant in the family that i should be aware of anything like diabetes high blood pressure | any family history at anything relevant in the family that i should be aware of anything like diabetes high blood pressure |
you say grandma sorry my apologies grandma ok uh do you know what type of diabetes it is is it type one type two | you say grandma sorry my apologies grandma ok uh do you know what type of diabetes it is is it type one type two |
mm ok im sorry to hear that seems like theres a lot going on there um so lets start with your your sore throat first um tell me a bit more about that if you can | mm ok im sorry to hear that seems like theres a lot going on there um so lets start with your your sore throat first um tell me a bit more that if you can |
um anything else which you think is significant | um anything else which you think is |
excellent ok ok um just moving on to what we social history just to get to know you a bit more as a person tell me who do you live with at home | ok ok um just moving on to what we social history just to get to know you a bit more as a person tell me who do live with at home |
ok and you said youre working at the moment | ok and you said youre working at moment |
what do you do for work | what do you do for work |
ok and hows your work going at the moment uh over the last has it has it been affecting your work | ok hows your work going at the moment uh over the last has it been affecting your |
mm ok is that stress is that affecting your um your mood at all any in any way | mm ok that stress is your um your mood at all any in any way |
well if theres anything you want to talk to me about you can always come see me about your mood um stress anxiety happy to help | well if theres anything you want to talk me about you can always come see about your mood um stress anxiety happy to help |
ok ok and just very briefly just in terms of smoking uh do you smoke at all | ok ok and just very briefly just in of smoking do you smoke all |
ok so not not regular um and what about alcohol | ok not not regular um what about alcohol |
um ok um so um | um um so um |
just having listened to your story um uh really just to summarize you know since the last four days youve been feeling generally quite unwell sore throat runny nose bit of a dry cough bit of muscle pain weakness | just having to your um really to you know since the last days youve feeling generally quite unwell sore throat runny nose bit a dry cough bit of muscle weakness |
um had initial fever but now settled um i dont think theres a lot to worry about i think you probably have you know a bit of a viral what we say viral illness maybe a viral upper respiratory tract infection or maybe early signs of a flu | had initial fever but settled um i dont think theres a lot worry about i think you probably have you a bit of a viral what say viral illness maybe a viral upper respiratory tract infection or maybe early signs of a flu |
um these normally last about seven to days and just gets better really um over time but things you can do to really help yourself um is get plenty of rest id probably advise you taking a day or two off work if you can um | um these normally last about seven to days and gets better really um over time things you can to really help um is get plenty of rest id probably advise you taking a day or two off work if you can um |
making yourself pushing fluids and make yourself well hydrated continue with the regular paracetamol ibuprofen um and and you should see how things go really um if next week youre still not better id like you to come back and see me | making yourself pushing and make yourself hydrated continue the regular paracetamol ibuprofen um and and you should see how things go really um if next youre still not better id like you to come and |
um is that clear does that does that make does that make | um is that clear does that does that make does that make |
ok ok and did you have any uh difficulty or pain on swallowing | ok ok and did you have uh difficulty pain on swallowing |
and things to look out for if youre really not getting better if you if you have a high fever or your breathing is becoming a bit more labored or chest pain id like you to come back and see me much sooner give me a call um and we can help you out ok | and things to look for if youre really not getting better if you if you have a high fever or your breathing is becoming a bit more labored or chest pain id like you to come back see me much sooner give me a call and we can help you out ok |
great have a great day good luck with your work thank you bye bye bye bye | great a great day good luck with your work thank you bye bye bye bye |
you did you manage to have a look at the back of your throat in the mirror | you did you manage to have a at the back your throat in the mirror |
no um i i didnt think about uh | no um i i didnt think about uh |
yeah yeah its uh its clearing up | yeah yeah its its clearing up |
sort of um sort of getting my nose stuffed all the time its very had to uh to get it free | sort of um of getting my nose all the time its very to uh to get it free |