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ok yes i have tried antihistamines uh lately but it didnt really help
ok just i 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 the antihistamines uh but it 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
ok
ok
that sounds good
that sounds good
uh no thats it thank you very much bye thank you as well bye
uh no thats it thank you very much right thank you 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 uh they gave me like some cream and something to uh when i like was shower uh when i was in the shower i had 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
and i mean at that time yes but those symptoms like these symptoms a uh like when the symptoms appeared 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 things like i bought like a steroid cream at the pharmacy last night but it apparently didnt help because its still itching a lot today uh yeah
a steroid cream
uh steroid cream
hello
hello
hello there its uh doctor here how can i help you this afternoon
hello there its uh doctor here how can i help you this afternoon
uh ok is that when you move your neck
ok is that when you move your neck
ok um
ok um
ok is that all youre worried about
ok is that what youre worried about
is that is that all your main worries today
is that is that what your main worry is today
oh dear im sorry to hear that i can i can understand why its affecting you um
oh 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 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
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 the headaches you also mentioned some zig zag lines 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 on the left is that on both eyes or just left left eye
both eyes ok have you any difficulty with seeing bright lights at all
both eyes ok have you had any difficulty with seeing bright lights at all
ohh i see ok um and you mentioned that you felt quite nauseous have you vomited at all
oh i see ok um and you mentioned that you felt quite 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 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 and this earlier today ok um any temperatures or fevers
ok um any other funny skin rashes that you may have noticed
ok um any other funny skin rashes that you may have 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 they last for
did you do anything that made it better
did you do anything that made it better
yeah
yeah
yeah yeah
yeah yeah
yeah yeah
yeah yeah theres lot
yeah sure i mean i can see your concern obviously is a lot theres a lot of worry there
yeah sure and i can see your concerns obviously theres a lot 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 let let let as i said lets take it step by step um and see exactly what the cause of these headaches are first um im just gonna ask you some um very uh yes no questions thats ok maam 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 difficulty 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
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 any 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 all right um and and youre feeling otherwise ok so for example your um
uh your your breathings ok youre not feeling breathless or
uh your your breathing is ok youre not feeling breathless or
no ok um do you have any other medical history i should be aware of
no ok um do you have any other medical history i should be aware of
mm hmm
mhm
no so for example have you had has anyone told you youve had migraines in the past
no so for example if you had if anyone told youve had migraines in the past
no ok do you
no ok do you take
ok
ok
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 so my next question was about family history is there anything in the family so apart from migraines is there anything else anything related to the 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
under fire as well ok um ok any other problems for example the brain or um you mentioned brain cancer any other family history of that
no ok um in terms of medications do you take anything on a regular basis
no ok um in terms of medications do you take anything on a 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 months ok and is that mainly for contraception or is that for something else
ok alright
ok all right
mm ok and
mm ok and uh
thats something you meant to have a little discussion about today as well um
thats something we may 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 or your situation at home you mentioned you work in the fashion industry
and your work is your job quite stressful at the moment
is your work is your job quite stressful at the moment
have you been
have you been
is it getting you down
mm is it getting you down
ok alright and what kind of things do you do to alleviate your stress normally
ok all right 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 exercise
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 and do you smoke at all yes so 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 try and get you well soon um you mentioned its on your lefthand side is that right and it started at midday a few hours ago
ok alright um so normally at this id like to kind of proceed to examination um
ok all right 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 um may have a migraine uh mi 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 the headache on one side throbbing nature the nausea vomiting um sensitive to bright lights
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
yeah yeah
yeah
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 hope that put your you know em at ease um certainly this is the second he migraine youve had in the space of a month um
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 keeping a headache diary will be quite important uh to see exactly whats triggering this headache
and in terms of trying to treat your headaches today some strong painkillers would be advisable so think about paracetamol or even co codamol
but we should also try and treat your headaches today and some strong painkillers would be advisable so you know think about paracetamol or even coco
um and some anti inflammatories such as ibuprofen and naproxen hows that sound to you
um and some antiinflammatories such as ibuprofen and naproxen how does that sound to you
ok um did the pain come on quite suddenly or was it more of a gradual build up
mm ok um did the pain come on quite suddenly or was it more of a gradual buildup
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 if your headaches were to become more persistent then we can maybe think about giving you some medications that will stop your headaches from happening in the first place something you know prophylactic medicines
then we could have a discussion next time i see you next week perhaps
then we can have a discussion next time i see you 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 a couple of things i want you to think about is you know if your symptoms arent getting better in the next 23 days or indeed theyre 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 so if your headache is getting worse and not responding to 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
or your um your 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
does that sound all ok
does that sound all ok
great any questions for me
great any questions for me
ok have a good day
ok have a good day
right
what
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
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 is it moving anywhere else at all
and is it moving anywhere else at all
hello
hello
ohh i just got a terrible headache since mid day
oh i just got this terrible headache since midday
no but its worse when i move
no but its worse when i move
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 or neck yeah the 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 ive read you know if you you get headache gets worse when you move it it could be a sign of brain cancer
cancer
ok yeah
ohh yeah yeah and id like you know
oh yeah yeah and ive like you know
my my friends mum she she recently died of a brain tumor so its really concerning me actually
my my friends mom she she recently died of a of a brain tumor so its really concerning me actually
yeah
yeah
eh feels like it some days
and it feels like its on both