Hospital - Episode 5 (Documentary) | Our Stories

you know [Music] just moved yourselves over to the side for a minute this winter one of Britain's busiest NHS trusts opened its doors we have to look after the patients whether they come from book Palace or the park bench to show us what's really happening inside our hospitals we've got lots of patients now competing for an unknown number of events every week more than 20 000 people are treated here the pressure's disco what is it completely gone and the numbers as well as our expectations are rising we just had our worst 10 days on record there's nowhere in the hospital to move anybody more at some point somebody will be telling us whether we're allowed to do any work this is a place with some of the best specialists in the world this team was out job done where lives are transformed this is saving his life it has to work but they are operating at a time when the NHS has never been under more pressure it does feel to me like the elastics a bit nearer to Breaking now than it ever was its very future under scrutiny all right I think we will go out on red because we're under real pressure in the emergency department we're aware of the problems anybody got a solution following the patients from the moment they are admitted anything I've done up to this point means nothing compared to when you can literally give a bit of yourself to save someone else to the moment they leave it's all good news the cancer is gone you don't need any more treatment fantastic thank you bye week we reveal the complex decisions the staff must make about who to care for next that patient is coming to me to be operated on and if I don't do it then there's only one inevitable outcome they're gonna die [Music] ambulance on sets of stroke Simpsons Joey just look for me keep your eyes open nice and wise Jerry look at me can you see me all right 87 year old Jerry has been brought into Charing Cross hospital after suffering a stroke I'm waving a medical emergency that occurs when the blood supply to part of the brain is cut off Jerry open your eyes and look at me family just suddenly I got telephone calls from my son to say Dad wasn't well come home quickly Just One Look and I knew what was happening yeah were you saying on the right Jerry is being looked after by doctors from the hospital's acute stroke unit 70 of their patients are over 65. the longer you wait to try and restore blood flow to the part of a brain that's been affected the more brain cells or neurons will die hi there are you family wife okay he's never had a stroke as far as you're aware no he's never had any brain surgery no no he's never had a brain hemorrhage before we need to rush and the first thing we need to do is to do a brain scan this has all been quite slow let's speed up a bit we want to get treatments into Jerry as quickly as possible Riddell do you want to run ahead until CeCe we're coming well then Jerry you're doing okay [Music] we're gonna do a quick scan of your head which is quite important [Music] sorry guys I have a stroke or we called up they said come up okay what do you want to do it's going to take about five minutes yep all right let's get this done one two three as a stroke patient Jerry has priority for the CT scanner so doctors can quickly decide if he's suitable for an emergency treatment known as thrombolysis his late 80s he's got no neurological history we really need to look at the scan and then we'll make a decision [Music] there are no contraindications so we should just go ahead and give thrombolistic therapy I'm going to go downstairs to make sure family are happy Jerry is a candidate for thrombolysis which is a medical injection that's his aimed to break down the blood clots giving thrombolysis to the wrong patients can cause Hemorrhage or bleeding and that Hemorrhage can be life-threatening and can even cause death um Riddell can you get the thrombolysis ready come come and sit down for a while okay Jerry's just having the last few scans uh there's no bleeding into the head as far as we can tell so it looks like this is a stroke that's been caused by a blood clot and the best course would be to give him this clot busting treatment however it's also important to know it's not a miracle cure at all one of his most serious side effects is bleeding and that bleeding could potentially be life-threatening yes I trust you sure and he's in safe as far as I'm concerned he's in safe hands sure all right I'll be with you soon [Music] would you time two minutes for me and just give a 30 second updates that's one minute okay well done it's just such a shock but it's 87 and we know that it's inevitable that something's going to happen at some point age is a very strong risk factor for stroke so with an aging population you'd expect the incidence of stroke to rise every year that goes by we're feeling incredibly stretched we don't want standards to drop and it feels like standards are slipping okay well done it will be several hours before Jerry's wife Margaret knows how well he's responding to treatment [Music] along with Charing Cross Hammersmith is one of the five hospitals that make up Imperial College Healthcare NHS Trust [Music] a tired Carpenter John requires an operation to replace a valve in his heart if you're on the top floor you might have a nice view or procedure known as a tabby a transcatheter aortic valve importation will be conducted by consultant cardiologist Iqbal Malik the Tavi is a way of deploying a new valve inside the heart without cutting the patient open too much it's an insane thing to even consider isn't it a squashed valve goes into an artery while the patient's awake you crack back to the heart and pop the new valve into position patient goes home the next day that's something that would have been ludicrous to consider 10 years ago so you're in 98 and a half straw no if you don't have diabetes no you don't look 98 thank you age is just a number you see at 98 John will be the oldest patient ever operated on by the Tavi team some of the team is nervous that will be seen as lunatics doing a 98 year old you know they can they can do what they like I bet you when it's there granny they'll be asking for a 98 year old to have their Tabby done have you done any other 98 year old that would be a newer thing I think we're not far off it I think we've done 95 but um yeah survived yes let's go through the case so he's 98. we know he's cracking in 200 it hasn't changed the renal team semen don't want to do anything meticulate the average 80. so these are patients who can't have open heart surgery and a number of years ago we couldn't offer patients anything so now we're in a privileged position and of offering Tabby to these elderly patients he's got so much more in him he's still so full of life my grandparents are my favorite people in the entire world they I'm sure it's the same for everyone how many times you've been to hospital before in your life I had some varicose fans out um or when I was about 50 years ago now that was the last time you've been he's incredible at the age of 87 he walked up to CBS um I think he only stopped running races against me and my brother around the age of 90. and he would he would try and win as well this wasn't like he was trying to let us win [Music] but it's not about age it's what we were saying to you before it's not just about age it's about how fit you are otherwise you'll be running out of here [Music] three choices Give It Up even or give it your all [Music] it's now a good time to ask you what you'd like for Christmas [Music] Mr Roland hi Dr Malik nice to see you okay so um can you hear me okay yeah we've been through the risks before you know what we're talking about but I will double check that you do understand just as a short memory test what is the problem that you had with your heart well we'll get out of breath pretty quickly you know yeah couldn't walk really far okay in terms of risk if we did a hundred cases okay then about five of them would have a bad problem yeah and that problem you didn't have a problem stroke bleeding heart attack okay is that is that an acceptable level of risk for you yeah I haven't went to Alternative okay what's your date of birth John March 1918. 1918 my goodness okay and can I just get you to sign on the dotted line John if you're up for having this procedure done it's a miraculous treatment for the older patients that we couldn't treat before that we're now treating every cardiologist would hope to have one really important step that has suddenly changed in their lifetime that they can experience and I think for me at the age of 50 now it's Tavi [Music] demand for heart valve procedure Tavi has tripled at Hammersmith in the last three years what the old valve yellow John is the second of these patients Sonic bows list today the first is a patient in their 80s is that pressure real again who are you calling Rex International it's bleeding too much so he thinks you might want to open okay so this is an unexpected [Music] the first case hasn't gone according to plan because there's been some bleeding internally tabies you can't quite predict what's going on normally they're very straightforward and this is the first for the year where we've had a major complication it's now likely that the patient will need a post-operative intensive care bed but that means one won't be available for 98 year old John if his operation runs into trouble I'm trying to find another bed sometimes if they've got any capacity here we can use one as their intensive care beds as a backup pullback for the next case [Music] hello are you the boss I am today you may have heard we had a bit of a um emergency in the first procedure today we've therefore lost our Su bed but we have a second Tabby we need a fallback Critical Care bed because he's so he's he's 98. otherwise quite well no previous surgeries we're full at the moments [Music] two of the patients were going to go and I think one was a Cardiology so the dealers we have to take one back there'll be a degree of swapping okay we are in some difficulty in there the bleeding's restarted and therefore we can't really think about other cases we have a senior surgeon operating but I think the rest of the day in this particular lab is is not going to be working out I think we're going to have to cancel the table this is just not realistic we're not even ready now and by the time he gets on it'll be four by the time we finish at six if something goes wrong at six we're much less covered too I think it's Safety First operating out of hours on elective cases that are high risk is not clever I think if it all went well I'd be finished by five you know I think that's fine but actually if it didn't go so well then the complication is being managed out of hours with you know less team around I think it's unfortunate so old father time has defeated us so I I don't exactly just your luck but the the thing that's destabilized is a very rare eventuality so sorry about today okay I'm going to get them to give you a cup of tea give you some food because we've kept you starved all day okay okay uh okay so I'm just coming down now it's something I wasn't expecting I was almost certain that it was going to happen today What can you can you do we know that there is a risk to doing the procedure but we were told by the cardiologist without this operation he has a 50 chance of sudden death John will have to come back next week for another attempt at the procedure [Music] I like shows like casualty lvcc house Gray's Anatomy I like stuff like that because I'd like to be a children's nurse and help people like me good the trusts Pediatric Center offers pioneering treatments for patients up to 19 years old [Music] Debbie was diagnosed with sickle cell disease when she was three Sickle Cell It's like a blood disorder it causes pain in the joints and your arms and your knees and your legs but it can affect any part of the body really can I pop this yeah yeah but more severely your brain it can cause strokes and neurological problems and that's what happened to me that's when they considered that I need like a transplant so that I don't get any more damage to my brain the only cure for sickle cell disease is a bone marrow transplant which 18 year old Debbie has been waiting for since 2009. a standard bone marrow transplant requires the donor's tissue type to be a 100 mat doctors have been unable to find Debbie a suitable donor but a new treatment is offering her a lifeline Sally how is Deborah today it's not feeling very well would you mind giving me a chat so I can have a look at it in normal circumstances where you to do a 50 mismatch transplant that will almost certainly lead to the patient dying from the new bone marrow attacking the body of the patient but we now have a method which will enable this new bone marrow which is only 50 months not to be rejected by hypotenai [Music] don't open it this new method allows Debbie's 22 year old brother Sam to be her donor even though his tissue type is only a 50 match with hers I moved to see Debbie Deborah um what way that way or bless her because the illness she hasn't had that 18 year old life at all so if I can give her a chance Fighting Chance to obviously never have to be in that condition again or go through all the crisis he's been going through again because she's got so much to catch up on and so much more to do and I remember when we used to go to the same primary school and me always looking out for a like going into the younger playground to see if she's all right so luckily enough that was a close match heavy have you been worrying about things okay because all that worry is for us okay she's worried okay if you want me to be here 24 7. at the moment this type of transplant for sickle cell disease is only funded for children and young adolescents up to the age of 19. and then you have some more of the mezna which is the kidney protection running afterwards is there a risk of death with this type of bone marrow transplant yes there is a risk of death and the risk does go up with the degree of mismatch of the donor however as current situation stands this is Debbie's last chance to get her bone marrow transplant but I just want to have it so that I can continue with my life [Music] Gary I like how are you feeling now [Music] two and a half hours since stroke patient Jerry was brought into a e that's a view Jerry what year is it now oh oh I don't know don't worry about that that's fine touch my finger see my finger Jerry can you see my finger there touch your nose perfect how old are you so much do you know what day it is today Thursday yeah good lift up your leg okay five seconds one two three they have saved us here they've got Jerry moving again we've got him talking again the change is remarkable in such a short space of time I think you're going to do fine but we need to keep you in hospital for a few days we'll pop in a bit later on okay okay nice to see you thank you all the best thank you very much Jerry will recover at Turing cross Hospital's hyper acute stroke unit or hasu one of eight specialist stroke centers in London the thing that everyone worries about is someone who's had a stroke is they're at risk of having another stroke so he's not out of the woods at all we're going to have to closely monitor him he's got very powerful medication on the board things look promising let's keep our fingers crossed [Music] I'm going to put it over the top because it will be finished before that probably 18 year old Debbie is preparing for her bone marrow transplant by receiving chemotherapy to deplete her immune system chemotherapy just makes you feel completely lifeless you don't want to eat it makes you feel so sick like you've got no energy whatsoever and you just can't do anything [Music] hey Dad how is she oh it's silver sooner like this though I know I'm here how you feeling [Music] oh I didn't realize it was to this extent heavy don't worry I'll see you soon that was uh very difficult to see never seen it like that ever ever and I've never really heard of say she feels not good even if you don't feel good so she feels alright you know I mean she was always very optimistic but obviously chemo's obviously left her rendered her into that sort of State hasn't it so it's very hard very hard to say [Music] Debbie is traveling to Hammersmith hospital where she will receive a high dose of radiation the day on their way right great thanks bye it's the last date of treatment before her transplant hi Deborah my name is Faye I'm one of the radio for doing your treatment today we're going to be uh putting some little measuring devices onto your skin just do a small little dose first and then once we're happy we'll then do the the main part of the treatment are you okay do you want some water I think no just a headache the whole thing is a bit like a trojan horse we're trying to get past the guards see you in a bit Deborah if you don't do it there will be a lot of reaction between the two immune systems one of Debbie's and one of the new bone marrow we've got a country of 270 coals of zero jaws of 40 on the y25 on the excess and we've checked all covered all this and diodes already we're good to go here [Music] it doesn't seem very well at all unless you've been like this just today or it's about a week now I feel for her I can't really count how many times I've royed Deborah in the middle of the night Hospital just very nervous about today so not knowing isn't it quite natural it has been a very very rough and long journey I've been looking after her since her mother left 11 years ago okay I feel for her because it has been a struggle but Stockport de la Fonte said the bone marrow transplant success rate in his hands is very high that's what he said and I believe his word [Music] how are you how are you darling do you have pain in your in your eyes when you look at me Debbie's immune system is now so depleted even a mild virus could kill her would you mind if I quickly touch your tummy will that be okay you can see that though it is fantastic that we are not able to carry a transfer the truth is that the treatment itself is very tough so we have a little bit of cold hands the doses that we use in transplantation are far higher than you would use usually in the treatment of cancer and so the number of side effects is children suffer and these young people suffering substantial okay it's a difficult time okay we'll leave you in peace so we are going to attend the Tavi multidisciplinary team meeting which is a meeting we have every week essentially to discuss all cases that we are considering for the Tavi procedure second time consultant cardiologist Garden Mikhail is preparing for 98 year old John's heart valve procedure [Music] so small disciplinary it's attended by cardiologists surgeons Echo Imaging doctors CT doctors all the Tavi team okay good morning so the first case is Mr John Roland's 98. this case was the case that we were supposed to do last week and it got canceled so we're just rediscussing him because he's booked can I just ask first so 98 98. you need to persuade me that there is no frail to you can we just re-review the Echo and the lb function sometime do you want to take us through the echo yeah in many ways we are and the NHS is a victim of its own success so we have so many LD patients now um and we are getting into discussions about life expectancy when patients are already in their 90s but the PA pressure was up as well with a good ventricle what how do you explain that overlapping function looks preserved with the Tabby MDT is particularly difficult because this is a high risk group of patients cost does come into it so I have a responsibility to manage the resources effectively but actually we try and pick the winners on clinical grounds and we have to decide does he have enough Reserve to come through the procedure because I'm afraid it is the case that you can have an outcome which is a fate worse than death so it is quite challenging 147 is a recent change or he's had increasing shots of breath over the past um six months six months ago apparently he's walking about four miles and now he can only walk about 200 meters he's never smoked he's got good lung function um with severe electric sources and slightly raised pulmonary artery pressures and he's got a very supportive family as well her also on board with Italian is just very keen to have something done he wants to continue living and have a good quality of life and wants to be less symptomatic but he's not low risk at 98 that he's not going to be low risk I'd want a clear statement that even said that as well the last conversation we've had with him he will accept risk just to feel better okay fantastic so he's all set we can't be ageist we are dealing with an aging population and he wants a better quality of life we can't deny a patient that no matter what their age is [Music] you don't need to go quickly we can just take our time enjoy the sense of déjà vu a week after he was first canceled John is back at Hammersmith Hospital You couldn't possibly say anything about quantity of Life how long will make him live but he's a very active 98 and his quality of life has really got worse it's very important that he's up for it his family is up for it and the team is up for it so can you just look up John Roland's blood results if any of the team had dissented then we'd think again yes [Music] you want to sit on the chair grandad are you happy to be having the operation yes I'm not I'm not happy to be having it but what's the alternative because of getting worse all the time recently and it can only walk about I I used to walk miles and now I can only work a couple of hundred yards never I also went I am genuinely terrified but something might happen to him because I can't but honestly I can't bear the thought of life without my Grandad in it [Music] it's just about waiting now isn't it even their price wait [Music] I am very very very nervous because at the end of the day it's just got to be it's just got to work 22 year old Sam is donating his bone marrow in an attempt to cure his 18 year old sister Debbie of sickle cell disease so he's been consented for a mobilization with gcsf injections for for stem cells and to undergo our Harvest under sedation on theater all right Samuel do you know why you're here today Lake bone marrow to my little sister okay not the anesthesia yet but it's just something to relax you a bit okay what are you thinking about Sam I don't know I'm just scared like all these machines and I just want it to go well [Music] if here I've done up to this point means nothing compared to when you can when you can literally give a bit of yourself to save someone else now that's doing something that's responsibility okay ladies are you ready the harvesting of bone marrow from Sam's hips is being conducted by an expert team at Hammersmith Hospital's Center for hematology Ready Steady move when we do the bone marrow harvest the areas that we need a date are posterior iliac crest which are just the bones that you will feel on the bottom of your butt that is the exact place where we have to sort of put the needle through and extract the model [Music] the whole process will last less than two hours [Music] [Music] so we're taking five meals per syringe [Music] at the end of the day it's just the gift of Hope you know it's just the gift of life [Music] it's quite similar to to blood so you wouldn't be able to sort of distinguish before Sam's bone marrow can be transplanted into Debbie it must be tested in the hematology lab one of the big requirements of the whole process is that the pro the product is esterile and free of contamination so before we do any processing with the Harvest we take some blood cultures just to make sure that the product that we got from some was harvested in a sterile way and then that there's no microbial contamination hi Deborah are you all set 15 years after being diagnosed with sickle cell disease Debbie is receiving the new bone marrow that could cure her so this is yourselves yeah you can it's all your brother's boner cool it's just like a blood transfusion Debbie's half-match transplant has the risk of rejection so the body rejects literally the the new tissue so you're going to have 15 drafts and 15 seconds okay however ninety percent of the children have um not only Survivor transplant but also been cured of the of the underlying disease um it will be about three and a half hours but unfortunately some complications can never be completely prevented it will be a few weeks before doctors know if the bone marrow transplant is a success but this one will end the all crisis [Music] it's a rather large box it says what's inside Angela it's going to be John's new heart valve John's new heart valve has been shipped to Hammersmith from the United States comes with lots of um unfortunate kit to try and help us make it small enough to fit inside the body that's the actual valve itself and when you check we've got the right size 26 valve and it's the correct size we've got there the valve itself is the most expensive part these Tabby valves cost anywhere between 12 and 18 000 pounds and then there's a Time taken for the procedure and so I think if you wrapped up all of that you probably wouldn't get much change from 30k I would think but it's cost effective because if he came in heart failure he's likely to stay two weeks on the first admission probably 10 days in the second admission if you make it to a third admission there's probably another two weeks you can see that very quickly we've got to be on 30 days at a thousand pounds a day and we're then going to be in credit so uh we're not spending 30 000 pounds on a patient because we fancy it we're spending thirty thousand pounds not only to help him and his symptoms but I would have a very strong argument that that is actually going to save the NHS money in the long run okay it's all the operator go to the other operator okay fantastic so there's a large team around them good a good very good team thank goodness okay yeah a lot of brains exactly they're a brains some of them working as well say uh so Okay so we've got your name sorted out the procedure it's a transformal Tavi uh right leg is the main axis uh 26 millimeter S3 valve we've just checked that all okay so John the you're part of the team so we need to keep you nice and still okay [Music] Joan will be awake throughout the procedure okay ready okay that's that pipe here so John we're just making a crack for our big pipes to go in hopefully it's not too uncomfortable I have a pair of forceps basically what we're doing is we're going through the right femoral artery which will lead us up into the heart yeah once the big pipe is in we're pretty much coming to do the valve and so that's the time we take the valve it's prepped over on the other table so that's what the valve looks like and that's a three cusps we've washed the valve in to something the size of the big spiral um and then as soon as we're ready to go they'll hand it over to us we can put it in the clip so a bit of pushing now John better pushing so it's quite a tough push because the valve is to be like a goat in a boa constrictor it's expanding as we go all right John yeah all right you're doing very well right okay so everyone quiet so ready to floor record pacing balloon up balloon up slowly slowly slowly slowly balloon down facing off okay and a pressure back okay let him recover okay so there's the new valve here it's in very good position which is good and we're going to put some color on that oh look at that amazing flow going forwards with that turbulence no leak coming backwards that we can see okay well done we've done this uh we're nearly 300 times so it's like a Formula One Pit Stop isn't it hello talk to me Carl oh it's all done they're all finished it's all gone very well all right [Music] to look to the right yeah just a bit slow [Music] John all right you still with us John John hello there there we go hi John before the case is not over I'm scrubbing back in most of the time nothing happens our screen crate is very low probably about one one and a half percent but absolutely for every patient including me if I was a patient if if I'm dead I don't really care if I'm alive with a big stroke I'm pretty annoyed about the whole situation um so yeah stroke is not our biggest concern but as truth is not good John just repeat your name for me can you do that tell me your name John squeeze my fingers squeeze my fingers John move your toes okay can you feel that all right John there's been no improvement at all since the Tavi finished so um unfortunately it looks you know that he's had a neurological event we've done all the tests to try and minimize the risk and you know we didn't really think that his risk of stroke was going to be any higher than any other patient hi it's Dr Malik here in the cath lab I need to be put through to 999 London ambulance to get a critical care transfer time is of essence if there's going to be any recovery a complication needs to be dealt with quickly they've had a stroke we need to transfer with critical care transfer to the hazu at Charing Cross over s so they know where you've gone right all right yeah we have a critical transfer from Hammersmith hospital to Gering cross casu we have a 90 8 year old male who had a stroke during a procedure oh hi it's uh Dr Malik here from the Hammersmith Hospital unfortunately there has been a complication during the procedure and are you in a position to talk about that okay so are you still with us the problem is we think there's a stroke so our only hope is that he's in that one-third that recover completely and not the one third that do very very badly and we can't tell really at this very early stage which which group is actually going to be in all right okay sorry the news is not better no no problem no problem okay all the best now bye now bye all right John we're at the different hospital now John has been brought to the trusts hyper acute stroke unit at Charing Cross hospital I just came with him leave this right down for me please John your right arm I know you're trying your right arm try your best that one can you lift it up I'm just gonna extend your red your red leg to prevent any bleeding from your sorry so I'm just trying to check how good is your power you probably had a stroke we think right side uh right side of weakness yeah there's the archery yeah um so just here this is the middle cerebral artery which supplies basically most of the left side of the brain and you can see here there's a bright uh spot here which indicates uh thrombus of clot inside the blood vessel and that would explain his right side of symptoms it's actually a very important part of the brain so losing that part of brain would give him a significant uh neurological deficit what is that part of the brain do well it's certainly his um more complex neurological functions his power sensation to the right side of his of of his body I think this would certainly be a candidate for thrombectomy so let's get things moving just two hours after his heart procedure 98 year old John must now undergo an operation on his break we're planning to do a thrombectomy which is where we go up through the blood vessels in the groin up past the heart through the neck into the blood vessels of the brain and the plan is to try and grab that clot fish it out and hopefully restore the flow of blood to that part of John's brain I've heard people describe thrombectomy as a kind of miracle cure to stroke yeah it is occasions where the stroke is severe at the moment it's only Monday to Friday nine to five absolutely yes so what happens outside of those hours well these patients are going to do as they have been doing up to now badly unfortunately okay John doing really well so we've got a step deployed where the clott is to try and grab it and we've also got a big suction catheter try and suck it at the same time the older the patient more Twisty the vessels certainly in someone who's 98 it's very difficult to get all the equipment up there Johnny doing really really it's a very fine structure it's like a cylindrical mesh so that's going into so that's going into his brain into the blood vessel where the blockage is and by pulling it back you're hoping that it's going to catch the plot [Music] nice and still you're doing well sir so we're quite deep now into the vessels close to the limits of how far we can go ready still John the clock has migrated from the major trunk of the artery much deeper into one of the branches the blockage starts about there however the clock probably goes beyond that so it may not come back we'll see what it looks like it's like some hard stuff there this may well be clocked in the heart we have um calcium within it it's much harder to pull out fingers crossed oh doing very well sir I've got a tiny bit of something okay John you've got the plot out hopefully you'll feel better in a few minutes okay we have uh some clot stuck at the end of that stent if you see here at the end of the tubing I think if you can zoom into this there's a black bit that's just come off the very dark bit it's obviously blocked a major blood vessel that's applying the left side of his brain so now you can see that that area of brain before that wasn't filling is now filling the main thing you can take that out yeah I mean it works when it works it works very well and awesome does it usually does all the best I'll see you upstairs hopefully John makes a good recovery from this all right there's a it's another stroke really yes so okay that's true let's do it one in one out can I ask you let's not ask you just use my fingers as hard as you can that's it it's six days since Jerry had his stroke [Music] okay keep going down we're gonna head straight for the doors yeah just to the doors and then have a touch and then we're going to turn around and go back okay all right what is it like seeing Jerry walk like that after what's happened to him [Music] Jerry is recovering well the last news last Thursday so he came in but further tests reveal a narrowing of one of the blood vessels that supplies his brain putting him at risk of another stroke so we're having a multi-disciplinary team meeting with the vascular surgeons and also the stroke team and we're having to make a decision what we think the best treatments is for Jerry is there any indication for carotid endarterectomy I think we have to look at the benefits certain people can benefit from an operations clear out the narrowing to prevent further Strokes personally don't think he should have his carotid though my viewpoint I don't think he is clear Castle told us to win actually offering surgery or not I'd quite like to see the patient I mean I'll make a judgment yeah so I'll go and see him this afternoon weighing up the risks because the purpose of doing the operation is to reduce his stroke risk he could possibly die having the operation doctors will let Jerry decide whether he wants surgery or not [Music] hello sir I'm Professor dick Davis and we've just had our meeting to discuss whether you should have an operation to reduce the risk of having a stroke or whether we should just carry on with various medicines I personally think your risks of going on to have an operation are such that it's a very difficult balance my advice would be that we you would be better off having the appropriate medicines and see how you get on now do you have any immediate thoughts about what I've said okay we will tell them that that's what is your preference so all in all I can in a way say Cheerio because there's nothing in a way for me to do and I will um get Dr House to come back and see you and go from there nice to see you okay I think there are quite a lot of people who have decided particularly as they get older that they do not want to have a surgical intervention it's a known surgical intervention that comes with a given risk and therefore feel that they would like nature to take its take its course you've got to sort of weigh up the pros and cons and I think there are a lot of risks regardless in what way you look at it but I think having an operation the risk is much bigger I tend to agree with Jerry for once [Laughter] you've been sleeping hmm okay [Music] since her bone marrow transplant Debbie's blood samples have been sent to the lab every day to see if her brother's cells have taken hold a process known as engraftment hi Connie from Grand Union Ward we've got some urgent Bloods to be collected please so far the results have yet to show conclusive evidence it's working I'm just logging on so that I can look at the results of her blood test today the definition of engraftment is the neutral count of more than 0.5 on three consecutive days [Music] if today is also over 0.5 then she's winning hello Debbie do you know what's been happening with your blood counts do you know what they are today I give you the news it's 1.8 today okay which means it's the third day in a row that it's been more than 0.5 which means you have engrafted so your newborn model is working yes that's right so congratulations yeah so you and your your team team Debbie are doing really well that's good it's good it's like a bit a little bit of magic isn't it yeah on the patience point of view being able to establish normal block of action it's a key moment the transplant have worked and it has been killed it's got a smile excited of course the first step is that you can go out for a little walk okay how is the best bed overall in the UK care of sickle cell in childhood is absolutely excellent and it's world class I came here alive and you're going back alive as God for you yeah she's very fond of me and I'm fond of her I don't think we can leave a day apart I like it it's a bit cold [Music] I was worried and I was considering that perhaps I had um been a little bit too positive in terms of the way that I presented things to him that maybe it would have been better if he hadn't had the tabby no how are you [Music] how are you how has your day been it's been all right he's actually doing remarkably well I have to say [Music] he has had some initial problems with his speech and a little bit with his memory and actually all of those things seem to be more or less resolved now he seems to be baptized as usual self he is interested in the world again we were having conversations about who his favorite Prime Minister was and who he thought was the worst prime minister he's ever witnessed in his lifetime you're doing really well you're welcome when I was training 65 was the cutoff for older age that's a young man these days yes it's getting busier and the patients are getting older because they're surviving longer which is a success story for UK and the NHS we've got all these amazing pioneering techniques such as Tavi but as the population ages how sustainable is all of this was in the current structure of the NHS [Music] thank you foreign because I get to give her another Fighting Chance which is beyond something I could ever dream of doing it means like a new beginning for me and my family so I'm very excited for the teacher [Music] I think we did make the right decision and his heart apparently is is working beautifully so I think he has every chance now that he's had the Tabby of getting to 100 and if he does my goodness the party will have at that point can't wait [Music] thank you

Channel: Our Stories

Views: 106,936

Keywords: Our Stories, Documentary, Observational Documentary, Real Stories, Full Episode, Full Length Episodes, Full Documentary, Fly On The Wall, Yearbook, Real Life, Documentaries, Real Lives, Behind The Scenes, hospital, hospital documentary, bbc hospital, bbc, bbc hospital documentary, medical, medical documentary, nhs, nhs documentary

Id: MgJYRHgq2G4

Length: 57min 13sec (3433 seconds)

Published: Tue May 16 2023