No they can't get a cannula quickly because the thing is I can if I get a cannula I can give you some anti sickness to make you feel better without that I can't because you're vomiting so let me just get a cannula I'll come back and do it quickly and then we'll take it on the is that alright once I borrow this will there be a charge they will okay £20 an hour £20 an hour okay fine so if I'm only here for 20 seconds then what's the chance it goes up you want me here for longer you don't you'll regret it alright this is charles I'm coughing I'm just show you my back sounds good what's up thank you alright thank alright so like I said I'm rob from 1 of the gastroenterology doctors what's been happening tell me about that basically I started getting headaches stomach pains constantly I went to the doctor the doctor brushed me up with stress went to a and e he put me on naproxen amitriptyline in a and e yeah right and stuck me on 900 mg of aspirin nice which is so headaches yeah yeah which is a good treatment for a cluster headache in a young man he had me taking it daily which is not good yeah 1 1 1 basically told me it was an overdose and I knew they'd come up here spent 8 hours up here they've done all the tests mhmm and then said I've a come up here today mhmm fine here you are let let me get some of your fingers to get off of that alright so 9 mg 1 dose yeah not yeah yeah spread out and it's yeah which is a good dose but if you're having a cluster headache it's a good dose to sort you out but if it hasn't worked quite reasonable yeah yeah and do you do yeah yeah I'm not sure I'm not I'm just not I'm sure you're racking up really you've got the hard margins isn't it can I get anything else like loyalty fine so when was this when were you coming to a and so it all started 2 months ago a month ago I've been into a and e I was on it for a month mhmm it didn't really get me anywhere so so 2 months ago you came in you were having tummy pain headache feeling sick mhmm they put me on what did they say was the cause stress right okay right I'm not good with eating that's okay sorry so basically you said it's stress and anxiety if that's okay that would be amazing taking all of our meds and then they go jay actually started getting a lot yeah basically it was to the? Where he mhmm thanks so much basically generally as long as he's cared for bunion white as a seal all the time tummy pains headaches everything just broken out it's got to the. Where I can't do anything and how do you feel in yourself alongside it apart from crap do you have any like do you have fevers no nothing like that like that other symptoms no nothing k I had dark stool mhmm which is why I ended up in my how dark are talking black black yes yeah difficult to flush all that it started to go yeah this morning was a lighter lighter color okay but before when it was jet black yeah did it stick to the toilet bowl yeah didn't flush it away and you had to go in it with a brush or whatever yeah fine okay fair enough alright so you had that after you had all of the aspirin and I rang 111 and just said it's a new symptom you know what do you think yeah they basically said to me wish you an ambulance don't stick your fingers your throat don't do this don't do that it's an overdose alright okay so I was like the ed doctor was the 1 who prescribed it and she goes no no you should we're gonna have to write up reviews for this and and that's what they did in the ed when I said it's them up there they were saying oh you know you've this you've gotta they're writing up reviews and reviewing reports investigating this because they should not have given him mhmm 900 mg a day day constantly any 1 time every day yeah and she said that he got food for that which jay had because he paid for him to take so we didn't get it and then he said we're gonna what's this was it suspended discharge suspended admission admission sorry so he was home all yesterday right really not well until yeah could he's queen and then he popped in to come in at 10:00 this morning to have so we can sort out see what else of course you know we can sort out well of course you do he's spread up a bit now bubbly vibrant he he he's appetite is next level but now he can't even look at food what do you think caused the thing that started it all off t lots what was it I wanted to say stress it's developed to the. Now where it's like I'm not really stressed out but somehow it's still there yeah it's not going I think we all say stress causes things a lot lately it's all about there's something about it it seems to be catching lately everyone's got things related to stress I don't I don't believe it but yeah I finished all my college stuff and somehow it's still the same yeah yeah interesting yeah so I'm trying to stick it down so it doesn't flap around for you yeah you know it's nothing you know it's you can't really do anything yeah just I'm good every time I go to do something I can yeah I'll do some fatty medicine and I have to lie down it's just I can't do anything screwed I wanna feel better because I am feeling so bad at all of course excuse me yeah we're ready yeah I need to know what you're having fine so I guess for me there's a couple of things there's what's going on it sounds like you're bleeding from your tummy yeah with that jet black tarry stool with very acidous blood coming through yeah it could be because of the aspirin it could be because of the naproxen both of them together is probably a bad combination they inflame the stomach yeah and it can cause stomach ulcers and so investigating that is part of what we'll do but I also like to find out what's going on to start the whole thing off because I don't believe it was a stress personally what are you studying at college computing fine okay do you like it yeah I love it great fine going on to a cyber security degree cool super great so you've got a place at uni that's all gone well you're starting in yeah because you're are you in some odd you're about to go on some holidays now some work to do with some holidays but there's nothing like extreme it's you know I've got mumps to do it you seem very chilled yeah yeah it just it's a tenser can't seem to get over it now it's just yeah the tummy pains yeah mhmm and the headaches because it just headaches too relaxed relaxed okay any other symptoms alongside the headaches visual changes no I I even well I couldn't go see my doctor when it first happened because they told me I need to have a a petition at that and it's fine my vision's fine everything's fine mhmm and the eyes are there I'm an healthy young man but are you a headachy person do you get headaches a lot not over the now no no it'll be very uncommon for you to get it yeah and it's only the last few months that they've but before that not really no not really fine okay and do you remember when the headache came on about 2 weeks after I applied to go on to a college funded trip to the netherlands mhmm ended up falling through and then from then onwards it kinda just you know alright but that's what they'd done they went oh it's stress it stresses tablets sleep better right but it hasn't helped me no could sleep for 10 hours I could sleep for 2 hours I could do describe the headache to me tension based like front like a tight band around your around my eyes mhmm front of the head fair enough yeah stomach pain just feel like feel like my stomach's cramping almost mhmm mhmm it just goes all tight and you changed your bowels 2 months ago obviously we know what's happened lately roughly 2 months couple days ago that I realized and and I was like oh okay that's you know sorted yeah on 12 okay alright well let's get some blood tests done okey dokey see if there's any sign that you're bleeding significantly whether the clot in the blood's okay yeah whether the salts and all the things like that liver the kidneys all that stuff is okay because all of those things can make you have headaches then the question about what we do in terms of the ulcer or if you have got an ulcer in your tummy if your blood counts are low because you've had this jet black tarry stool I'm likely to recommend keeping you in hospital to do a camera test to look for an ulcer if your blood counts aren't low then we can be relatively reassured and you can come back in the next few days for a camera test with us does that make sense okay yeah the camera test I'm talking about is me and my colleagues do it's an upper camera test so we use a thin flexible camera it's about the size of a syringe to go over the back of your tongue into your oesophagus so 1 the other end exactly yeah yeah not the other end yeah so you'll be made quite sleepy and we give you some throat spray for it you can't feel your throat and you're quite sleepy if you have sedation which I'd recommend oh yeah take every fit I can if I were young I'd have sedation yeah then I'd to say lie you on your left hand side have a look down on our camera if there's an ulcer there we can treat it if it needs treatment while we're there we can put clips or bands or burn it away and fix it and if there's no ulcer there then fantastic but you know it's probably got better by itself in that meantime we can do that for you like I say either in hospital if your blood counts are low or in a few days time if your blood counts are okay worries sound alright yeah great I can come and actually if you're staying in hospital for it come and do the consent form with you but if you're going home we can do that at a later okay then no worries so that's kind of the possibility of the stomach ulcer thing I would stop taking the naproxen and the acetaminophen I guess and you already have would be that's fine and then in terms of the headache let's see what the blood tests show in terms of causes of metabolic causes of a headache I don't think it'll show much but we'll see and then if we don't find anything there then I'll come back and we can have a chat about what we do about it whether we think about scanning your head which can provide some reassurance that there's nothing no I had a ct you a ct of your head yeah fine I'll have a look at it I'll do it again a month ago fine I'm guessing that was fine but I'll have a look at it and make sure wait he never called me up for it so I assume it was okay okay yeah fine I'll make sure it's and yeah so then further reassurance is difficult to provide but sometimes seeing a neurologist can be helpful for that they're the experts in managing people with headache but certainly in terms of stomach ulcer that's my I can do that yeah yeah that's what we're exactly literally yeah take an hour 40 minutes to allow to get the blood test back and then I'll probably tell you what the story is okay that'll some anti sickness for now yeah no worries thank you very much anything I've forgotten any questions no we have time good fine anything of anything else surrounding us exactly and I'll be back with you then thank you very much thank do want me open or close investigations ct head may 2025 no acute intracranial abnormality bloods june 2025 salicylate levels undetectable lipase normal fbc u and e normal lft normal