Ways and choose so yeah right that's good to know thank you hi is this roswell is it I'm talking to today have you gone well I've gone well I'm rob we we spoke on the phone yeah I'm 1 of the gastroenterologists oh it's me hey yeah nice to meet you finally yeah are you feeling you alright yeah I've been no better yeah good I'm glad a bit anxious I'm sorry to hear that it'll be very oh yeah quick and easy I guess I'll maybe find a time and I'll just call the clinic straight away to do the paperwork oh no you've got are you well done yeah I'll do good from that I'm I'm just trying make okay it's very going down to the wrong place so said you did it there it's yeah they built it on a farm somewhere and then dropped it in oh it was it's pretty cool isn't it yeah but yeah so we spoke on the phone didn't we because you had low iron levels in your blood yeah without any anemia at that time and then you were having some tummy pain at that time as well tell me about kidney and kidney so flank and back pain yeah mhmm okay I've got a problem with l 4 and l 5 anyway yeah with that spinal stenosis that you got yeah and you're having injections for it and things like that I have been yeah mhmm and have they been helpful they did they don't they don't want to throw me do they no of course not no and what's the plan with that I don't know yeah I really don't know what it is and tell me about your life more generally you've obviously walked with this stick you live in a in a flat in a house yeah with stairs yes I've stairs you've got stairs yeah yeah fine and do you live by yourself with anyone no with my family with your family fine and what are you able to do you do everything yourself for yourself no a lot of stuff they do for me okay it's difficult for me to do but yeah fine I do try and do things mhmm yeah fine what's your mobility like with the with the stick I can't walk far at all mhmm because of my back yeah and my neck because I'm just finding a little decompression mhmm and that's really painful I'm waiting on ct scan for that yeah of course yeah okay don't like surgery too they don't like it no they told me this is a terrible hospital not good enough for it oh shit think it's alright that's why I said I said I live here it's a good hospital yeah think it's alright having worked at both I think it looks pretty good but yeah in terms of so in terms of what should we do about the the pain you're having you're having pain when you're passing stools is that more nothing more great yeah I should stop what's what's made the difference there the sachets I've been taking the sachets and it's fine good perfect I'm really glad yeah that's great given you had some low iron levels in your stool test the blood was slightly higher yeah it worried me because the gps had the word cancer I mean that's what we're all looking to exclude all the time I don't I doubt very much you have that but I think it's worth making sure you don't yeah the best test to make sure you don't is at a colonoscopy yeah where we use a long camera like today you have to have a look around the whole of the: in order to have that you need to have bowel prep which is 4 to 5 days of a change in your diet eating bland what I've eaten now yeah I I just have blood in my lung I'm sorry and and then the other thing is the prep is 2 l of liquid that you have to drink and then you'd be back and forth to the toilet in quick succession sort of 6 7 8 times yeah with loads of water coming out in order to facilitate the test oh well because it is that's what I was gonna say I mean do you think you would tolerate that or not no fair enough I understand that so then the alternative I guess is a ct scan where you drink some dye the 2 days before and I think you'd tolerate that a lot better yeah it's not as good as the colonoscopy to rule out small things yeah but big worrying things we do yet alright does that kinda make sense yeah makes sense yeah if we do the ct scan the ct scan isn't very good at the last part of the bowel of the rectum as we call it the very last part is not good at that yeah so given you've had bleeding it's sensible to examine that area to make sure you haven't got anything worrying there I can do that today if you want I don't wanna do that obviously you'll be laying on your side already when you have the test so after we do the top end test I can ask you to pull your trousers down and I can just use your fingers to examine your bum is that all right yeah thank you repair have psoriasis say it again have psoriasis holding on my back oh so yeah I've got it away I'm not worried about that but today we were gonna have a look down the top end with an upper gi endoscopy yeah alright the pr examination on there the benefits of diagnosis of the cause of your iron deficiency I'll just tell you about 2 serious risks of the test which is they're causing bleeding so sometimes we deliberately or accidentally make something bleed with our camera if that happens we can usually fix it with the camera but it can take time to do that yeah yeah there's a risk as well of calling of causing perforation which is when we make a hole or a tear in the wrong place yeah if that happens you might even stay in hospital or even have an operation to fix that the good news about those 2 risks is they're incredibly uncommon they happen in less than 1 in 9000 blood loss test hospitals that's right anyway there's 2 problems with the test as well I should tell you about so it's a very good test and the best test we have to look at the upper gi tract but no test is perfect and there's always a chance of not getting to where we want to get to which we call failure either because of your ability to tolerate the test my technique equipment food stomach etcetera and then because it's human beings looking at a screen a chance of missing something on the way which we call misnation yeah alright any questions or anything no I'm happy we'll start those 20 third today we're gonna have some local how are you getting home today my daughter's driving my daughter's driving okay but then you wanna drive later maybe maybe not I don't care yeah fine fair enough and if you didn't manage it without the sedation would you like to try with the suctioning and with the understanding that you wouldn't be able to drive yeah that's what I have to do yeah hopefully I'll be alright there yeah it'll be very gentle your signature is just there where I can make that x I usually come in with your notes I've got it lovely thank you are you ready to go and get it sorted then yes alright what it's been a minute well you say you're not breaking your teeth but you're pretty rapid aren't you I can't remember can be if you wanna be yeah have fun so we're just gonna meet just come on in and take a seat hello good morning hello donna I'm