[speaker001:] Hello.
[speaker002:] Hello.
[speaker001:] Do have a seat, right what shall we do with you today?
[speaker002:] I seem to have done something silly with my shoulder, it's awfully stiff and [LAUGHTER] []
[speaker001:] Which one?
[speaker002:] This one.
[speaker001:] Right, but you can't think what?
[speaker002:] Well we were at a venture park on er Sunday and I reckon I probably did something on one of the rides without realizing it.
[speaker001:] No.
[speaker002:] Cos it came on sort of about middle of the day.
[speaker001:] Right, you haven't been from anything, or pulling anything too hard or?
[speaker002:] N other than carry my daughter,
[speaker001:] Mm.
[speaker002:] since she's a bit of lump nowadays.
[speaker003:] [LAUGHTER]
[speaker001:] Now, you don't need to take anything off. Can you lift it up, right up?
[speaker002:] Yeah.
[speaker001:] Pretty good, can you get it behind your, get your hand behind your neck? Turn it ro er okay. Can y
[speaker002:] Can't feel it [LAUGHTER]
[speaker001:] can you turn it round and get it behind your back? Can you put your hand behind your back like that? Turn it round. Good okay. Can you, can you actually do that? Can you swing it right round so you can do that?
[speaker002:] Y yeah I can.
[speaker001:] [LAUGHTER] You're not allowed to use that one [].
[speaker002:] [LAUGHTER]
[speaker001:] Okay, good. Okay. So you've got a good range of movement, okay.
[speaker002:] Yes, yeah.
[speaker001:] What happens if you lift something or pull something?
[speaker002:] I get a sharp stabbing pain. If I'm br even
[speaker001:] Yeah.
[speaker002:] when I'm breathing,
[speaker001:] Yeah,
[speaker002:] I can feel it in my, in my
[speaker001:] Yeah, okay just relax. What I'm going to do is to examine now I'm going to go up the collar bone first... over the shoulder pad, [whispering] T-shirt with a shoulder pad [].
[speaker002:] [LAUGHTER] I know, they went out with the ark, didn't they?
[speaker001:] You okay over there?
[speaker002:] Yeah.
[speaker001:] Over the top? Good that's fine. Are you okay with the front of the joint, in there?
[speaker002:] Yeah.
[speaker001:] Yeah.
[speaker002:] It's only in articulate areas,
[speaker001:] I in the side of the joint there? Is that okay?
[speaker002:] It feels a bit tender, but
[speaker001:] Yeah.
[speaker002:] it's okay, yeah.
[speaker001:] Well yeah. Over the top?
[speaker002:] Yeah that's fine.
[speaker001:] Under there?
[speaker002:] Yeah.
[speaker001:] Now if I come round, just sit forward slightly for me, that's right. If I come round the shoulder blade muscles, round there.... Anything?
[speaker002:] No.
[speaker001:] If I was to sort of pinch the muscle at the back here?
[speaker002:] If you can find it, that's [LAUGHTER]
[speaker001:] huge muscle. Is that tender at all?
[speaker002:] No.
[speaker001:] Okay, can you point to where you get most discomfort?
[speaker002:] Right, in
[speaker001:] Oh.
[speaker002:] the centre there.
[speaker001:] Right in there? Oh okay.
[speaker002:] Mm.
[speaker001:] Is that tender to press in there? Oh yes.
[speaker002:] Yes.
[speaker001:] Is that hurting there?
[speaker002:] Yes.
[speaker001:] . That's fine. I'm. Now this isn't your s shoulder directly, but it is the muscles that hold and support and turn the shoulder blade, and of course whenever you do anything with your shoulder the shoulder blade moves with it. So it will tend to pull and it almost definitely is either reaching or pulling or holding something or holding on for your life,
[speaker002:] So I've just strained something?
[speaker001:] venture park. Yeah. It's
[speaker002:] Yeah.
[speaker001:] a muscle pull. But the trouble is with muscle pulls, they heal fairly slowly. They tend to get worse over a fe over a few days, before they start to get better as well. But it will improve, and the important thing is, pain relief if necessary, because you must keep your shoulder moving. If you keep your shoulder still, because it doesn't hurt so much, it'll tend to seize up like a rusty
[speaker002:] Mm.
[speaker001:] gate.
[speaker002:] Practise first thing in the morning.
[speaker001:] So ke that's right, so keep it moving, and the shoulder needs to be, to be able to go all the way up, all the way round, back you know, it's a very mobile joint.
[speaker002:] Yeah.
[speaker001:] But nothing serious though.
[speaker002:] Good. [LAUGHTER]
[speaker001:] So I can write... [whispering] it's a lower full range of movement [], mobilize. That's the important phrase, and if you find it's easier to keep it mobile if you've taken some paracetamol or aspirin, then by all means do that.
[speaker002:] Right. Would it be possible to find out what Priscilla's results were because she's had a urine test and she's extremely sore and they've asked for another urine test, and I'm
[speaker001:] That's right.
[speaker002:] a little bit concerned.
[speaker001:] Wh we hav we haven't grown any bugs, but we have found red blood cells and er white blood cells there which are the sort of blood cells you get in wee if there's been informatio inflammation or infection round. So it points towards an infection but it doesn't prove it. Waterworks infections in kids are actually very very important to identify because they all need investigating.
[speaker002:] Right. Is there anything else that I can do [beep] for her cos she says she is in quite a lot of discomfort at the moment.
[speaker001:] Stacks and stacks to drink. The more dilute the urine, the less it'll irritate, sting and burn. And it'll tend to flush things through. But we must have another sample, and we we
[speaker002:] Yeah.
[speaker001:] don't want the first wee of the mor We don't want the first one in the morning.
[speaker002:] Ah.
[speaker001:] Any, any other one. So let her empty her bladder after it's been sitting there overnight, and then a nice fresh sample. As long as it gets here before
[speaker002:] Ah right.
[speaker001:] half ten. The first one in the morning often has all sorts of rubbish in. It tends to be rather concentrated and isn't really the one we want.
[speaker002:] That's probably why we had trouble last time.
[speaker001:] Well maybe, yes. Okay have you got a fresh bottle?
[speaker002:] I have yes,
[speaker001:] Okay. That's that.
[speaker002:] Right, okay, thank you very much.
[speaker001:] Not at all, we'll see what happens with her, but the sooner we get that the sooner we can take things on if we need to. [intercom over following] Lovely Okay?
[speaker002:] Thank you very much for your help.
[speaker001:] Not at all. If you have further problems, pop back.
[speaker002:] Right, thanks.
[speaker001:] See you.
[speaker002:] Bye.
[speaker001:] Hello Dorothy.
[speaker003:] The s it isn't Dorothy, it's me.
[speaker001:] Oh sorry Joan, I'm sorry.
[speaker003:] [LAUGHTER]
[speaker001:] I do apologize, I really do apologize for that.
[speaker003:] It's
[speaker001:] Oh ta. [telephone conversation for over a minute]