Hello there.
I am the Doctor who's seeing you today.
Yes I've not long woken up and yes I'm still wearing my pyjamas; so I have the records
here from our last check-up.
I want to start by making a few visual inspections
now previously your BMI was 27
and looking at the accumulation of adipose tissue in the midsection I'd assume that your
BMI has probably increased from last time
okay let's have a little look
first you need to take off your glasses let me have your bifocals please
okay obviously we are concerned with sight.
Just looking at the bifocals unfortunately the pads are in disgusting condition; just
have a little look at those.
You've obviously not visited your Opticians in a while.
Your glasses have not been serviced; we have an accumulation of crust and they're starting
to go a little bit green due to the skin secretions reacting with the materials there so you really
need to get to the Opticians there.
Absolutely filthy
Okay so we've done visual inspections; I'm just going to get the equipment out we're
going to be using today; very sophisticated equipment.
Have a little look here
okay I have everything I need for checking you out
I've also got my sophisticated stethoscope here.
I've actually upgraded our equipment to this very sophisticated model here; what do you
think of this?
Okay let's have a little listen
okay just breathe normally please
and in through the nose and out through the mouth
and just breathe normally please
again
take a deep breath in, hold it, and out
And deep breath in again.
Hold it and out.
Yeah actually picking up a lot there the heart rate is a little bit high
I'll check your blood pressure in a short while
okay let me take the equipment out of the case now
Okay let me check your temperature now; I want you to open the mouth, lift the tongue
and place it just underneath, and lower the tongue, close the mouth gently and just relax
for a second or two
and looking there I don't actually understand these numbers but we have a sad face that
illustrates to me things aren't so good there.
Temperature not so good.
Okay I want to have a little look inside your mouth now.
I'm actually going to be scrutinizing your teeth today; I have this this scale here for
grading the teeth.
Okay so
if you could open wide for me please
one nine
size 10.
premolar11.
posterior molar 11.
let's jump to other back there.
That's actually an 8
Coming across
then 11.
10 and 11.
Open wide again please
have a nine there, seven
eleven
and an 11.
12 and 11 there.
Okay so just looking in the mouth unfortunately your teeth are in a state of discoloration
there.
Not too happy with that; obviously you need to cut down on the coffee, you need to be
careful what you're drinking
all right so glasses pads not very good
heart rate a little bit high and teeth discoloured
Okay, shall we have a little look inside your ears with the expensive otoscope here?
Have a little look at this new model the surgery has recently acquired.
Okay let's have a little look inside this ear please
Okay so there's a lot of accumulation
of wax especially on the concha, now the ear canal appears blocked, a lot of wax
okay I can't see the tympanic membrane too much wax in that ear, okay and for the other
one
a bit closer now, you can get the external parts.
I don't think you've washed your ears in a few days
okay and quite clearly an accumulation of wax, too much wax, surprised price you can
hear me with what's going on there inside your plug hole
Okay that's rather disgusting so you need to do something about that, to get your ears
syringed
Okay what are we going to do next?
We're going to do some reflexes.
We have the reflex hammer here; part of the exclusive new equipment that the surgery has
acquired.
So I just want the arms to go floppy at the sides there please
Okay reflexes not too bad so you've got one thing going for you there
Okay let's move on to blood pressure now; just roll up your left sleeve.
Okay here is our new device; we're checking your blood pressure; going this on the upper
arm there
give the device a little squeeze and then I'll read off the scale.
Okay breathe normally; do not hold the breath
Okay it's appears that we have problem with the monitor there
Okay let's try again please.
Okay, good, are you ready?
Okay thank you; I'll write those numbers there
Okay let's have a little look inside your eyes now unfortunately the ophthalmoscope
is quite old
and in a little bit state of decay; the light source isn't working
but we can see the external areas with a little bit of
increased magnification so just look straight ahead
look up
look right
look left, look down, I'm actually not going to lift the lid because the eye is looking
rather yukky.
I can see that there's redness, look straight ahead, and there's some sticky discharge on
the lower margin there
have a look at your other eye; just look straight off to the distance
now looking up
left and to the right, looking down
okay so your eyes are red sticky; have you not noticed this?
Right well I'm going to
just make a note of that and I'm going to instill some antibiotic drops, both eye
switch to a new brand here, there we go, we've switched to this brand here, sorry about the
sunlight
okay just looking up to the ceiling
pop a drip in this one and one drop in that one, thank you.
While those are working I'm just going to review your medication in your tray here
amitriptyline, topiramate, atorvastatin, and ramipril
okay I'm going to prescribe
some new medication for you; there we go; I want you to take one of these a day please,
one of these tablets today
put them in your tray
okay and I'll see you again next time