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ok | ok |
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ok | ok |
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 |