Our four GPs hit the streets of Leeds for an urban open surgery to offer their skills and expertise to anyone they meet.
Dr Jonty and Dr Ayan have joined forces in Leeds city market where they meet 19 year old market trader Dale who is concerned about his weight - he's 6ft 2in and only weighs 10 and a half stone.
Dr Jonty calculates that his Body Mass Index is 60 which puts him in the just underweight category. Dale does a very active job, involving long shifts and little time to eat properly. He explains that his bowels are fine and he doesn't suffer any abdominal symptoms.
The doctors reassure him that like many teenagers he is at a stage in his life when he will burn a lot of calories quickly and that as he gets older his metabolism will slow down and he'll start to put on weight quite naturally.
Dr Barbara is at a local scrap yard talking to Charlie who has been getting pains in his chest. Dr Barbara checks his heartbeat which is nice and steady and his pulse is slow and regular. Charlie describes the discomfort as a sharp, lancing type of nerve pain which comes suddenly and then goes away after a few seconds. Dr Barbara suspects the pain may be muscular - and Charlie is relieved to hear this.
In the city centre Dr Ayan meets a painter and decorator who has been getting constant pains in his legs for about a month. Dr Ayan invites Kenny to lie down and asks him to raise his leg. It instantly hurts. Dr Ayan diagnoses an element of sciatica.
He explains that the sciatic nerve splits off in the middle of the spinal chord and goes down the back of each leg. Kenny's pain is probably due to something pushing on the sciatic nerve. It may be a slipped disc, but whatever it is, Kenny would really benefit from seeing a physiotherapist and this is something his GP can arrange for him.
Back at the market Dr Jonty sees waitress Natalie who is concerned with a mouth problem. She has had blisters in her mouth for the past few weeks and recently started coughing up a large amount of blood. Natalie, a smoker, is worried as about a year ago a friend of hers went into hospital with mouth cancer and had similar symptoms.
Dr Jonty reassures her that blood from mouth cancer would tend to come from the gums or the tongue and not be coughed up in the way Natalie describes. However her temperature is high which would indicate a fever and Dr Jonty proposes she have a chest x-ray just to make sure there's no infection in the lungs.
At the shopping centre Dr George meets security guard Neville complaining of a sharp, burning pain in his elbow. Dr George examines the swollen elbow and suspects it is bursitis, a slight inflammation of the fluid filled sac, the bursar, on the elbow area. However because it is so hot Dr George is concerned it may be an acute form of gout. To be certain he'll need to take a blood sample from Neville. In the meantime he will give him medication to ease the acute pain.
Back at the scrap yard Dr Barbara meets Lenny who has been suffering from anxiety attacks for years. He is particularly concerned because these have been increasing in frequency lately.
Dr Barbara points out that the anxiety attacks may be symptoms of depression and Lenny may need to address the underlying causes of his depression. For a minority of people it runs in families and is a physical, clinical thing that they have no control over. For many others, however, it is learned behaviour and therefore can be adjusted.
Dr Barbara suggests Lenny imagine a green field where it is absolutely beautiful and then imagine his worries as a dark woody path at the corner of his sunny field. As Lenny visualises his worries he walks down the woody path and all the time keeps telling himself that he must get off that path and back out into the sunshine. Dr Barbara reassures him that such visualisation will help lift his mood.
She also recommends he take up a group activity as this will involve interacting with other people and so help build up his self confidence. He needs to break the cycle of negativity in which he is trapped. If he feels so low that he really can't put one foot in front of the other then medication may be the answer. Lenny is grateful for the advice.
If you suffer from depression, it's important to try and talk to someone about your problems. Make sure you get enough rest and relaxation and try to improve your lifestyle. Eating a balanced healthy diet, cutting down on stimulants such as alcohol and smoking, and getting regular exercise can really help. If you're still concerned, see your GP.
In the Corn Exchange Dr Jonty meets David who has problems urinating. Dr Jonty suspects his prostate is causing the problem but he'll need to visit his GP to find out more. A urine test will check for diabetes or for any infection. A rectal examination will show whether the prostate is enlarged. Occasionally a prostate can be getting bigger due to cancer but on the assumption that David has a benign enlarged prostate, there are medications that his GP can prescribe.
Dr Jonty again meets Natalie with the results of her chest x-ray. They show her lungs are completely clear and Dr Jonty suspects she has been coughing up blood due to a viral infection.
At the heart of Leeds' Victorian quarter, Dr Ayan meets Elspeth who has been struggling with digestive problems for nearly a year. Dr Ayan feels her tummy area and diagnoses dyspepsia, a condition involving too much acid in the stomach. Untreated it can lead to cancers in the gullet in later life. Dr Ayan recommends she cut down on fizzy drinks, eat regularly, and avoid stressful situations.
If you suffer from indigestion Dr Ayan also advises you avoid late night eating, cut down on alcohol and try to stop smoking. If you are overweight, lose weight and try over the counter antacids. If symptoms persist, see your GP.
Dr Barbara meets craftwork enthusiast Eva who is concerned she may be getting arthritis in her thumb. Dr Barbara thinks this is possible and suggests she wear a wrist support when she is working. If that fails to have the desired effect a cortisone injection into that part of the joint may be the solution.
Dr Ayan meets Neville with the results of his blood test. It shows he does not have gout, and the pain in his elbow is probably due to bursitis. Neville's work involves a lot of leaning forward on his elbows and this is something he should avoid. The medication Dr George gave him originally relieved the acute symptoms - and Neville is delighted to know it isn't gout.
At Leeds City Varieties the amateur production of Oliver! includes cast member Ian, who has been struggling for two years with a shoulder injury, caused by a fall. Dr George recommends physiotherapy and also suggests some simple stretch exercises Ian can do himself which will increase mobility in the shoulder area.
At Leeds Bus Station Dr Ayan meets security manager Dean who has a long standing problem with his feet. When Dean shows Dr Ayan his foot the thickened nails and characteristic smell leave Dr Ayan in no doubt - Dean has a fungal infection. A course of anti fungal tablets should completely clear the infection.
Fungal nail infections are common and the symptoms to look out for are: a thickening of the nail; the nail changing colour, becoming yellow green or black; the nail coming away from the skin; the nail becoming soft and crumbly. If left untreated, the infection can destroy the nail, so see your GP for treatment.
- The Fitness Jumpsite
- Offers a range of exercise information, plus tools for evaluating body mass, weight and calorie burn.
- General information only, looking at causes, symptoms, reasons for concern, and treatment.
- A comprehensive resource for those having back problems, with a searchable database of practitioners.
- NHS Online - Bursitis
- A short guide to the condition, looking at causes, symptoms, treatment options and possible complications.
- Clinical depression
- Concise information and advice about depression, its causes, symptoms and possible treatments.
- Depression Alliance
- UK charity offering help to people with depression, including information about symptoms and treatments.
- Arthritis Research Campaign
- Offers a comprehensive glossary of rheumatic diseases, plus treatment options and up-to-date scientific research.
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from Dr Barbara
- Take up a hobby, learn a new skill or try taking part in a sporting or group activity.
- Use the stairs not the lift at work.
- Eat fish at least twice a week.
- Walk 20 minutes a day. Try to avoid using the car.
- Reduce fat(approx 70g fat per day in average diet).