Going down so got a few fine fair enough how many is a few 4 5 7 goodness gracious alright must be busy man yes surprised you got time to get another tip I had to do it wales went to oh really so just leaving all the bedroom around so we basically get rid of some of them mhmm mhmm so okay fine and what do do for a living okay so I'm on my table and you're stacking shelves and stuff and you work at night shifts as well no not now okay over the last couple of weeks would you say you've been feeling more unwell or less time generally unwell just generally unwell with feeling a bit under the weather yes sniffly nose yes mhmm just through the eyes yep it has been bad to be fair to hay fever the last couple weeks I've been getting it as well so do you normally suffer with hay fever over the last couple of years alright okay so until then almost fine until then I'm mhmm and then and then any eaten anything dodgy over the last week or so I've some chicken sweetened tuna mustard burger never had problems with it yeah sounds alright doesn't it yeah it sounds like it would be too dangerous or anything and then you and then over the last 2 days you've had loose stools yes how many times a day every couple of hours every couple of hours really fine so 12 times a day kind of thing yeah any blood no no always check out okay but very loose completely watery or with the no it kicks in in sometimes it's really watery sometimes yeah okay and any vomiting yes how much like just over the last 2 days or just today or normally I get up 02:00 in the morning I normally typically really even vomiting those 2 days as well yeah okay that's the true I think the cups were about go I thought mhmm okay so you feel like the room is spinning around you yeah so you felt like you're on shit yeah okay fair enough and then you were sick and what came up the flu to start with but it was just fine sorry fine and that was happening over the last 2 days and then got particularly severe today where you were vomiting a lot shaking in pain having a terrible time on the way back from the tip and that's what brought you into yeah sure so I was going from shivers mhmm and do you think you were having a fever at that time have you had any fevers no not recently okay yeah generally under yeah just generally under okay alright can I have a quick look at you do you mind you allergic to anything no do you drink or smoke I drink a bit fair enough how much do you drink a couple of units a week a week no 2 is that 10 just checking feel a bit warm and sweaty yeah feel a bit dehydrated press your tongue thank you very much good for your time quite tender aren't you yeah okay and then over the last months how have you been treating just general pain and what's up with your back I'm on the bottom I'm on the yeah in your neck yeah it it it was getting squeezed geekers sounds awful how long is that years ago 3 years ago fine so you had a upper spinal surgery 3 years ago and then you had lower spinal surgery when 3 years before that mhmm and that's the degenerative change in your spine yeah alright can I have a look at your back and feel down your spine is that alright yeah important thing big breath nice you you're severe you're little tenderness down the wall or is that otherwise tender always tender okay that's fine rest back waterworks okay yes passing much water today that's good fine you've had a good amount of fluid here you've had 4 l getting it yeah so hopefully that will be washing that dehydration marker out of your blood a bit has anyone told you the results of the test you've had since you've been in fine your ct scan doesn't show anything worrying or sinister in your tummy okay it shows inflammation of the fat around your intestines right which can happen for whatever reason often gastroenteritis or infection are in the small intestine intestine can cause those kind of findings sometimes we need to give you steroids if it gets particularly severe but if you've not had severe pain oh I thought your pain was much worse but actually not too bad it's tender it's tender exactly because you've been vomiting a lot you shouldn't need to rush in to do anything about it we'll give you lots of fluids and painkillers take you to our gastroenterology ward and manage it there okay is that alright yeah any questions or anything I forgot no that's fine sure you'll probably be in hospital until you're feeling better and so your markers of infection and inflammation further down okay I will with the findings on your ct scan I'll probably start with some antibiotics just to treat the gastroenteritis because we're early and we know that antibiotics can decrease the duration of things so I'll start with some antibiotics okay is that alright great I'll ask for them to get a little stool sample from you just to see if we can grow anything that's causing it okay alright yeah let's do it wait ruth if his presenting complaint was diarrhea and vomiting okay then he'll come to us okay