So the next patient is richard greenwood 307375 observations new score 0 respiratory 18 sats 97% on air blood pressure 138 over a 103 pulse 86 temperature 36.7 investigations d dimer naught 0.9 open brackets high close brackets full blood count normal et attendance earlier today 2 days ago power washing driveway noticed that day red mark on the right calf worsening yesterday and today pain on palpation of calf calf being more swollen in the left calf went to pharmacy to advise dd background past medical history of hypertension no known drug allergies maybe come back to you yeah was just moving on the line yeah so told me to go home at the time I was just wearing shorts with with wellington boots on yep should've been empty on it mhmm like short bellies no long all nice bellies right but yesterday morning it started coming up like this mhmm and then so it's about say year long yesterday and it's gone to this today mhmm and obviously there's a very big varicose vein in here as well mhmm okay and apparently the the the total for instance it's usually just larger than yeah it does look bigger doesn't it mhmm is it tender to touch yeah quite okay yeah it's a little bit warm to touch as well yeah no that's what you're saying yeah fine and do you feel well in your shell yeah yeah you feel like you've some shivers and shakes how soon after you said when did the pains when did the kind of discomfort start it's a good time to write back yeah yeah yeah I mean how how many finish this back yourself I finished in in exeter about I think it was about 02:00 on on friday yeah and then just drove home and was just chilling out in the afternoon that was all I wasn't doing anything special at all because it it was quite warm there and yeah yeah so yesterday morning about 09:10 o'clock yeah yeah yeah it started coming up last any short of breath at all no good sorry and any recent year of work travel nope but my pre study's got a lot in the legs quite active and capable yeah yeah I have huge garden and you know you've gotta keep on top of that mhmm walk the dog every day great 2 3 2 3 km a day walking the dog you know steps have been up yeah been really well up in the last few weeks weight loss or anything like that no good no wonderful fine I'm sure the a and e team explained the what the test they did yeah they said white blood cell was fine yeah all normal counts fine blood counts are normal but the there was a bit raised on the whether they test for dvt for a clot exactly you learn the test is good for ruling out a clot but crap for telling us if there is a clot that makes sense so it's not a very good test to prove you've got a clot but it's a good test to prove you don't have a clot yours is high which makes us think we should do another test it's much better for a clot okay and that would be an ultrasound scan okay yeah we can't do that tonight no we can do that on tuesday december okay yes okay that's alright fine yeah yeah in the meantime because you might have a clot on your leg yeah I'd suggest fitting you up make sure that that clot doesn't shoot up to your lungs yeah cause any mischief yeah you have any medical problems no no you've never had any big bleed nothing like that nothing nothing fine you're taking your regular medicines yeah I'm on losartan okay amlodipine fine blood pressure fenlafaxine super 111 it's for I tend to get rashes lumps and bumps and I don't I don't think I've got any around here at the moment I can show you but it tends to come out of my arm I don't know what it is but it's it it tends to sort of come off in very small blotches now and again and just just to keep nothing like that nothing like that no no no no no no no so it sounds entirely reasonable that we've put you on some blood thinners then it'd be safer to do it's a medicine that you take twice a day we'll fix a pan you have a high dose of it for a week and in that time you might decide whether you don't have a clot yeah and then we can work out what to do with the result of that so come back on tuesday for the scan and I give you an appointment card to see what it was because I'm not even got I didn't think she said it was hard so I don't know I'll remind myself okay alright yeah and we'll get you some blood thinners until then we'll get you back here with the results and scan and we can try fine sound okay yeah no worries great and you get you the box of medicine the letter from us and the appointment card and I can get out of here yeah kind alright good do you have any questions nothing wrong nope wonderful all good thank you great I'm just see how I go I'm there pretty good oh yeah you need tracing your heart yeah okay is that alright yeah good I'm good is it it's an excuse to I was gonna say yes then but no when was it again tuesday tuesday it's 11:30 actually and it's then on 11:30 tuesday I think think the I think comes here for