[speaker001:] What can I do for you this morning?
[speaker002:] Ah it's the acne it's I ran out two weeks ago, so we've been on holiday I had to get those prescription.
[speaker001:] Oh.
[speaker002:] I made an appointment to se you sort of this week but that's
[speaker001:] Now it was working well.
[speaker002:] Yeah.
[speaker001:] Is it still working well?
[speaker002:] Yeah, it's about the same really.
[speaker001:] Right okay. But you had a bit of flare up A You flared up in last time you had came off it, didn't you? Temporarily.
[speaker002:] That's right, yeah, so I thought I'd best get it
[speaker001:] Yes.
[speaker002:] rather than run out
[speaker001:] Yes, no you don't want to er flare up, right, so
[speaker002:] [cough]
[speaker001:] Are you growing?
[speaker002:] No, I've stopped growing now
[speaker001:] You've stopped growing. Y
[speaker002:] I've had this all week.
[speaker001:] Oh I [LAUGHTER]
[speaker002:] It's alright. Do you play basketball?
[speaker001:] Is there a family history of being very tall?
[speaker002:] No not really my dads about six foot three
[speaker001:] That's quite tall, yes.
[speaker002:] Well he's six foot, six foot one or six foot t
[speaker001:] Well you're you're tal taller than him, I should think, aren't you? Yeah.
[speaker002:] Yeah, oh yeah, yeah.
[speaker001:] Are you well in yourself?
[speaker002:] Yeah, fine yeah.
[speaker001:] But there's no there's no family history of other medical problems at all?
[speaker002:] No not really
[speaker001:] Just there are one or two I mean when we see tall, thin, young people we think of all sorts of interesting medical things, but most of them are completely at all, you see so
[speaker002:] Yeah.
[speaker001:] We always ask.
[speaker002:] No, fine.
[speaker001:] Right, okay.
[speaker002:] I've had a bit of problem with me knee left knee
[speaker001:] Have you?
[speaker002:] Don't know if it's cartilage or not? I just play football on Sundays and I fence as well, Thursday night.
[speaker001:] Fence? Yes I good fencer, long
[speaker002:] Yeah.
[speaker001:] reach.
[speaker002:] That's right, yeah.
[speaker001:] Football, er I thought you might be big for football. Basketball definitely.
[speaker002:] It's there
[speaker001:] Let's have a
[speaker002:] It's just there it after like when I'm resting it aches
[speaker001:] Yeah.
[speaker002:] a bit.
[speaker001:] Right. What about stairs and steps, when you go up and down stairs and
[speaker002:] I noticed a bit more lately, yeah
[speaker001:] Yeah.
[speaker002:] but not so much
[speaker001:] Twisting? If you've got a
[speaker002:] No not really
[speaker001:] No you're okay, twisting, okay just t just turn
[speaker002:] It's just sort of there.
[speaker001:] slightly. Er No no no no your whole body
[speaker002:] Right.
[speaker001:] get y get your knee in, okay. Now I'll just wobble it backward and let it go.... There's full range of movement. And a stable joint.... It doesn't particularly wobble around, does it?
[speaker002:] No.
[speaker001:] Okay.
[speaker002:] It's just that it's aching, I was wondering if the
[speaker001:] Just er Lift up, let it go completely l loose and limp, that's fine. If I move the kneecap around it from side to side.
[speaker002:] No
[speaker001:] If I push the kneecap up?
[speaker002:] No.
[speaker001:] Okay. Down.
[speaker002:] No that's alright.
[speaker001:] You're okay there? Okay. Just let it flop again. Does it er hurt under there?
[speaker002:] No, not really, no.
[speaker001:] And at the sides of the joint there?
[speaker002:] No. It was just the front moving that was
[speaker001:] Okay. I think if you have mainly pain in there it's much more likely to be a little bit of inflammation under the this tendon which goes from the muscle here over the top of the kneecap and attaches in there.
[speaker002:] Right.
[speaker001:] And it's this muscle that makes the whole leg go [vocalized whipping sound] like that. And it's a huge great big muscle but it can get a little bit er inflamed, as it passes over the front edge of the kneecap there. And that's what gives you the pain right at the front. It's not
[speaker002:] Ah
[speaker001:] rela It's not actually the knee joint itself, it's got nothing to do with the cartilages and it's particularly common in people who are growing.
[speaker002:] Or tall.
[speaker001:] Or Or have grown. Well no, not particularly tall but certainly growing and it's probably been It's probably just er related to that.
[speaker002:] Right.
[speaker001:] And you don't need to do anything. Keep yourself generally fit,. So we'd better make a note of that. Ache left knee, perhaps nothing to see. Ah and then... and you're not getting any side effects from Erithramita
[speaker002:] No. No side effects, fine as far as I can tell.
[speaker001:] Okay. Now you're now er nineteen aren't you?
[speaker002:] I'm going to a university
[speaker001:] I was going to ask what you're doing.
[speaker002:] in September. Erm
[speaker001:] what three times a day aren't you?
[speaker002:] Yeah.
[speaker001:] Yeah.
[speaker002:] It's Dundee and they've asked me to transfer my medical records up to the local G P up there.
[speaker001:] Actually what we'll do is we'll give you Er you're probably a bit bigger than you were when we were giving you three er on three times a day. We'll give you twice a day but a slightly bigger dose so that's actually five hundred milligrammes twice a day. Give you a hundred and eighty which is three months worth of those. Yes when you go up there you'll have to register but if you I mean I presume the university term's what ten weeks?
[speaker002:] Yes, ten or twelve weeks cos I starting
[speaker001:] Yeah.
[speaker002:] in It starts September the twentieth
[speaker001:] Yeah.
[speaker002:] so it is a bit earlier. But
[speaker001:] So you're going to be there more than you're going to be here,
[speaker002:] Yeah.
[speaker001:] and er you obviously will need to register there. Now there's two important things, first thing is your notes will take a long time to get up there maybe up to three months.
[speaker002:] Right.
[speaker001:] I think some one has to walk from Nottingham to Dundee.
[speaker002:] [LAUGHTER]
[speaker001:] No it's just that they take ages and ages and ages cos Dundee will ask Nottingham, Nottingham will ask us to bring the notes back, then we'll send them to Nottingham, Nottingham will send them to Dundee, Dundee will send them to your G P.
[speaker002:] Right, okay.
[speaker001:] Convoluted isn't it? Convoluted, but that's the way it goes and we can't actually release the notes to anyone but the local people in Nottingham. So we can't send them up to your doctor. There's absolutely nothing to tell your doctor fortunately, so we don't have to do a summary for you or anything like that. But
[speaker002:] Right.
[speaker001:] the important is that he knows what you're on and why you're on it, and you can tell him that.
[speaker002:] But I've got enough You'll write Will
[speaker001:] Erm
[speaker002:] you write a prescription
[speaker001:] one twice a day I I I would keep going with three month prescriptions anyway, so that'll keep you going till the end of November No not quite the end of November, but you can then see him and say look, I've got this this is why I'm on these for.
[speaker002:] Yeah, right.
[speaker001:] And er he can introduce that. You'll probably find when you register you're invited to go along for a new patient medical anyway, and all sorts of things like that.
[speaker002:] Right.
[speaker001:] All fun and game Just one twice a day. Best taken on an empty stomach so half an hour before food. Don't interfere with paracetamol, they don't interfere with aspirin, they don't interfere with alcohol.
[speaker002:] That's alright then.
[speaker001:] Okay. Just to exaggerate those three points, I know, I can remember being a student myself. Er the other thing of course, when you're down here we can carry on treating you with what's called a temporary resident.
[speaker002:] Yes it's like the holidays, vacation
[speaker001:] Yeah no problems seeing you while you're down here as a temporary resident, delighted to do so. Okay?
[speaker002:] Thanks very much.
[speaker001:] Very good, what are you doing up there?
[speaker002:] It's retail and distribution management.
[speaker001:] Aha.
[speaker002:] a degree so,
[speaker001:] Aha.
[speaker002:] but it's a year out as well. So it's four years.
[speaker001:] Four years, Okay.
[speaker002:] Have a nice holiday.
[speaker001:] See you bye now.
[speaker002:] Bye. [tape change]