Victor morgan 322915 hello hello hello hello how'd you know ah you're ever so good aren't you I'm rob yap I'm 1 of the gastroenterologists pleasure to meet you what would you like to be called vic vic it's nice to meet you vic hear from your gp that you're having some troublesome upper abdominal pain is that right I don't know where to start really me about that I've had irritable bowel syndrome for a long long time and it's getting progressively worse they've put me on all sorts of medication my mind is the fact that some of this medication makes me worse I could be wrong but that's my feeling okay which medication makes you worse it's difficult to say they put me on metrazole I've got hiatus hernia I've got prostate cancer and then I've got this problem here with my stomach I don't know what that is so I've been on metrazole for quite some time and then hydrocortia got worse no apparent reason so anyway at the end stage I put me on different medication I can't remember what it was now but anyway I stopped taking everything so the best thing is let's pull everything out so I don't take anything unless I really have to and what symptoms do you get what sorry what symptoms do you get at the moment symptoms I because I'm not working anymore because my mobility is not too good mhmm I do a lot of sitting around but every time I stand up I want to weep okay when I go for a weep my gut fills up with with gas mhmm I can't wait till I release the gas and that can take 10 minutes mhmm so flatulence yeah all you do is because I sit down for 2 weeks because I'll be there all day and you're trying to release your urine and nothing's happening and this pressure builds up builds up builds up and then eventually and then you can you can urinate and then some more gas and then some drug or some more urine urine even now I haven't had anything to eat since what 06:00 mhmm had a drink about an hour and a half ago maybe but I feel like I want to win mhmm but if I go from a win I won't be able to okay now at nighttime my wife wife was a a carer for a while so she knows a few things they will take a bottle to bed with you so that you don't have to keep filling up in the the night what happens is that I normally lay on my left hand side I feel the need to wait right hand side take a bottle sit there for 10 minutes before anything happens again there's gas pressure building up and I can urinate a little bit sometimes it's almost nothing so I went through all that full of and what kind of pooing do you do how often do you pee poo yeah at the moment it's quite squishy it's really close to diarrhea not always it's changed colors well it's got quite a lighter color how many times a day do you sorry how many times a day do you go I'll say because because my habit is when I go for a wee I sit down if there's anything in my stomach I can call it at all mhmm and I think I did that probably twice this morning and I sit there and I'm thinking it's uncomfortable so I'm thinking if I could even have to lift it it pops and your gp has referred you for an upper gi endoscopy to investigate upper gi symptoms do you have any upper gi symptoms at all what's that your gp has referred you to have a look down at the camera at the top end look down the mouth oesophagus in the first part down to the first part of the skin and intestine how far down does that go about a metre so we'll get into right into here well there's 6 metres of bowel inside you my so discomfort is so you have abdominal pain as well yeah it's not a pain it's just a noise I need to wee but if I go for a wee I probably won't so whatever's happening is happening just here and it's gas I could get rid the valve mhmm but I don't know what the cure is for that and do you have heart factors or reflux I did because I've got a hiatus hernia mhmm yeah that's why they put me on whatever it is omeprazole was it omeprazole omeprazole and then they changed that to something omeprazole omeprazole yeah yeah I found it to a while mhmm and that made it well I think it might get worse and you're are you nauseated do you feel nauseated sick sick no no going back when I was on the medication it was 2 or 3 times when I went and sat down in the loo I thought oh I feel slightly sick okay but if we go back even further but this is probably not better were you on the antacid isn't it so I'm going back for probably a year when I get out of bed I always feel a little bit disorientated mhmm I've tried to get to the bathroom which is not very far away yeah I said I was really sick and I was sick mhmm and unfortunately I managed to my corner bath is right at the side of the toilet I managed to sit down on the bath and then I passed out and that's happened twice but that's yeah okay and whereabouts did you have any pain discomfort the discomfort I should say right now the discomfort I feel now is that I want to wee you want to wee mhmm and if I sit down and try to wee this pressure will build up it won't allow me I sit there for 10 minutes and there's a trigger and there's some gas and that's a tsunami and what do you are you having any treatment for prostate cancer what's the plan with that no no were you offered any treatment no fair enough all they offered me was a hallway and ablation and radiation therapy and we discussed the possible side effects it's you wouldn't want to go ahead with the treatment very good I'm glad say that problem brain's gone a little bit say again brain's gone a little bit no it's fine they said there might be a problem with erectile function which is obviously very important to all of us men with the treatment well sickly with me I had a guy working online a group of us a week in his 60s and I told him I've got prostate cancer says oh I had it what I had it I thought what happened I said you're drinking out mhmm what of course you've got no sex life after that but mhmm no I didn't know you could do that yep it's quite a lot though no there is it's a big folder oh you do is it so you have p yeah I'm told you yeah your psa is like 7.8 and you had chronic urinary retention back in april and you talked about having a long term catheter or a transurethral section of the prostate and they were just gonna keep an eye on things so in the pelvis it's very small the male pelvis is very small about this big and in there you've a lot of stuff the prostate bladder and the rectum and if you've got prostate taking up a lot of room it's going to be enlarged and it will impact on urinary as well as defecatory in terms of function of your bowels and it may well be that the pressure that you describe is urinary retention it seems as though you have urinary retention from this and they talked about doing a catheter and things like that your gp has referred you for us to use a camera to look at your oesophagus stomach and the first part of your small intestine because of persistent nausea and reflux symptoms but you tell me that you haven't got those symptoms reflux got bad for a while and then I think what happened got a couple of dogs I've got a lot of friends who's got a problem and somebody once said to me you want to be taking apple cider vinegar for something apple cider vinegar and I think that and 1 or 2 other things that I talked about I think that it very acidic isn't it outside of you know more than I do but yeah it kicked this off but it got worse and then when I stopped everything at all it's it mhmm fell down right now it's not too bad yeah it's not as it's not as asleep now as it was probably 6 months ago still but it's not really bothering me that much the biggest problem I have is to say when I sit down on the loo probably 6 7 8 9 times a day and that's because of the chronic urinary retention that you've got yeah see I feel now that I walk to wean but I feel that all the time so unfortunately I'm not the right person to help me with recurrent urinary retention I've been asked to put a camera down the top end to look for the reflux symptoms that you've been having and it probably related to the apple cider vinegar your gp says you have persistent nausea for 2 months despite your anti acid medicine ongoing reflux symptoms if you want us to have a look down we can but I know what it would be in aid of if they're not symptoms that you say you've got they're symptoms I have but they've not gone away nothing like it was and I've been blaming the medication I mean I know you're busy I've gone through a series of when I was 60 I was invited for a colonoscopy and I thought I'd think I might have for a colonoscopy twice and they explained to me they would just take the polyps off because they'd become cancerous on my third visit it was a completely different medication whatever you call it that cleans your stomach out and even then had the colonoscopy I was still getting diarrhoea I never had that with the first 2 but the third 1 was different and the next thing I know I've got irritable bowel syndrome so which I've never had in my head could be wrong if I'd not had the colonoscopy would I not have irritable bowel syndrome it's certainly possible but what you describe doesn't sound like irritable bowel syndrome because your bowel is normal the flatulence that you describe sounds a lot like it is related to the chronic urinary retention you are the first person that has talked to me you go to the dentist got 20 minutes to talk to you and do a procedure that takes 10 minutes wonder whether that's the right thing to or not it's up to you I'm more than happy to do it takes about 10 minutes we use a long flexible camera have a look into the stomach there are risks associated with it like all things but it's relatively safe test and it'll tell us about whether your reflux symptoms are related to anything sinister or worrying which is what you've been referred to to exclude but the symptoms of abdominal fullness flatulence are related to your urinary retention and that will be best seen best talked about to the urologist and I can ask them to see me again if you'd like I think you're right I've always thought what's the camera for you know because they don't give you they these medications and they say they want you to do certain things but they don't say all that I mean you told me more in 7 minutes and they told me 10 I'm sorry yeah I guess that's the beauty of being in the hospital and having a bit more joy so I'm sorry but what would you like to do today I I could either write a letter to the urologist and ask them to see you in clinic about the symptoms you described see whether you want to explore the potential for a long term catheter or an operation to call the prostate out to let your urine flow better option 2 is we could do that and I could have a look down at my camera because of reflux symptoms and upper abdominal stuff that you have at the moment nothing no pointless sir fair enough yeah I don't think obviously we're here to exclude upper gi cancer and that's what you've been referred on your gp's worried about upper gi cancer which is why you've been referred because of the persistent nausea for 2 months but if you tell me you haven't got that then that's fine it takes a roof of you to tell me you can take the prostate out didn't know that not that I want they doing no it's true you can but sounds like that wouldn't be the kind of thing you wanted there's also excellent hormonal treatments but they unfortunately can cause sexual dysfunction and they can be curative for prostate cancer yeah so would you like to hand it down or not no no they're going to. You I guess not if you've not got those symptoms that your gp says you have then it's not worth it fine then shall I write an letter to the urologist and ask them to see you again then would you not please of course it the last time they were involved was back in april is this the 1 in churchill or in peyton yes was a peyton hospital exactly from your perspective main problem is that ulence and a sudden desire for defecation which you find difficult to control you associate that with bladder and prostate but I doubt there is a real connection there will see chronic retention and a low tension variety continue as you are fair enough the girl in there was a hell bent on giving me a catheter I said I don't want a catheter mhmm I've got 2 mice that's got it and they stink yeah I understand obviously lots of urine stuck in your bladder is not not very good for you in terms of recurrent infections and yeah I understand not very nice is it it's all not very nice I couldn't feel any color from my head no unusual findings on rectal examination fine so let me write to them and see whether there's anything that they think might be relevant and see whether they want to see you again does that sound alright yeah that should be nice cool I'll get that sorted for you come here and come back again alright it was nice to meet you okay undo then see you later okay alright bye bye see you sounds good see you later okay well I thought he doesn't want it though oh well no that's not really we we thought we lost you in there for a minute we were like is he coming back I was lost in there I was glad to get out of there I really was some rescuing I needed rescuing I can't believe you guys did rescuing sorry we were 1 1 1 we're here you're helping you're rescuing me we need rescuing yeah we'll cancel that shortly we'll cancel it yeah thank you I've got to find out what's happening with regards to the rest of the list thanks peter going up there to it darling alright thank you yeah like this we've been working with kids doing it he's got flatulence flatulence and he's got urinary retention what is your symptoms yeah when and he said about the wind and things like that I was thinking oh well yeah and he was like I was like how how far did you get down I was like about a meter he's like down to here then I was like no down to like here yeah yeah so I'm gonna be here you're going anywhere be aware well your problems are yeah yeah I'll go and speak to theresa if I know what's going on in there thanks