OHID London Training Resources Pack: Video of Gloria's NHS Health Check
Summary
The teaching session presented by Nurse Michaela from the London Health Check Training Support walks participants through a simulated patient consultation. Using a series of videos, the training module demonstrates the different stages of an NHS health check, ranging from general enquiry and conversation, to specific medical measurements and tests for conditions like diabetes, cholesterol levels, BP, and obesity, among others. It provides an opportunity for healthcare professionals to familiarize themselves with diverse patient responses and situations, helping them improve their approach during real consultations. This session is not a replacement, but an invaluable addition to existing training. At the end of the videos, participants can share feedback and even gain a certificate for completion.
Learning objectives
- Understand the protocol and procedures for an NHS health check, specifically the variety of questions asked and physical measurements taken.
- Gain insight into how to navigate a medical conversation with diverse patients, identifying their needs and understanding how to effectively communicate various health conditions and necessary lifestyle changes.
- Recognize the importance of regular checks for conditions such as high cholesterol, high blood pressure, and obesity as they increase the risk of life-threatening conditions like heart attacks and strokes.
- Learn how to interpret patients' body mass index (BMI) and understand its implications in forming judgments on patients' health status.
- Develop the ability to empathize with patients' unique struggles, be it financial, lifestyle-related, or due to certain health conditions, and generate appropriate responses or recommendations.
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Computer generated transcript
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The following transcript was generated automatically from the content and has not been checked or corrected manually.
Hello, my name is Michaela and I'm a nurse as part of the London Health check training support. We have created two videos. These videos reflecting the diverse population of London have healthcare professionals playing the role of patients. One is quite quiet and withdrawn while the other is likely and motivated. The videos themselves are a little longer than the 20 to 30 minutes suggested for an NHS health check. As we have tried to incorporate many different responses to the different tests, measurements, questions, behavior change and the ongoing follow up needed. These videos are not intended to replace any existing training that healthcare professionals receive, but rather to enhance them. There is an opportunity at the end of each video to give feedback and gain a certificate. Thank you, Gloria. Brilliant. You've come in today for your NHS Health check. How have you been? It's been a long time. Thank you. Yeah. Very good. Brilliant. And I'm gonna tell you before I do this, Patrick, I'm gonna tell you a little bit about it. Have you heard about them before? No, no. OK. Well, you've come to the right place then. So great that you responded to the invitation. Um not everybody does and this check is gonna take somewhere between 20 to 30 minutes. Is that all right? Brilliant. So um now I am gonna do a variety of questions. So I'm gonna ask you things about your alcohol intake, smoking, family history. I'm also going to do things like your he and your weight. I'm going to check your BP. That's fine. Yeah. And uh I'm also going to check your cholesterol today. That's good. Yeah. Yeah. So we'll get an instant result. It's going to be a finger prick and we'll get an instant result and then I'm going to have a bit of time to think about you and what you want. Um, and any changes you want to make to your lifestyle or? Yeah. So we'll see how it goes now, depending on some of the results we get today. You might need to go on and have a blood test today because we, we look for people who might have say diabetes or kidney disease and you might go off and have, I don't know, different tests. So we'll, but we'll say it's about, we ask you a lot of different questions. So, are you happy for me to proceed? Yes, I'm happy because we can't, you can get a GP appointment nowadays. So, so, so it's good to go to, to have a check. Exactly. So, that's brilliant. That's brilliant. Yeah, it is a, it is a bit of a challenge, isn't it? It is a bit of a challenge. Lovely. I'm happy that you're happy. That's really good. And, uh, the first thing I'm gonna do now is we're gonna do have some weights. Yeah. Cool. So, follow me. Ok. Yeah. Brilliant. Right. Gloria. So, um, was having that a surprise to you? Well, I've been trying to lose weight. I've done a lot. I've cut down on what I eat. But exercise, I can't do, I can't go to the gym apart from the fact that there is no money cos everything is expensive nowadays. But even with my walking, I can't do a lot because I've got arthritis in my knee. Yeah. Your has been bad for a while, hasn't it? Yes, I've got this. Yeah. So, well, today we've got you down cos what we do is we take your height, which is 160 you've got your weight, which was 84.5 kg, which compared to when you were here last time, I know you said like it looks like you've been trying, but actually it's gone up a little bit. Um, but that's just on our scales, you know, scales are always a little bit different where we're at and that calls in something. So what we do is we try to look at people's BMIs and BMS stands for body mass index and that's where we can start to compare and say what should be about right? For somebody our height as it were and yours is coming in at 33.2. Now, do you, have you heard of BM? I, yes, I have. But I've been told that being a black woman is your, your bones are heavier and that contributes to the BMI. Is that right? It's, it's, it's not quite right. I'm afraid it's not quite right. So, um, our BMI, is it where it, it's just a, it's a, it's a calculation and it's where we try to look at. But unfortunately, um it doesn't, it's not really like a one size fits all for everybody. So the way we was classifying you now from the result of your BMI is that you would be in the obese category. So that's not my judgment. That's a clinical term. OK. That's not saying. So this is a clinical term, but we know once our BMI gets greater than 30 at all, 27.5 depending on people's ethnicity. Then, um then we start to improve health risks. So that's things like BP problems, diabetes, heart attacks and things. So it's not that we're trying to be judgmental to people. It's more that we use these as a marker to look for other things as well as trying to help people um lose weight. Now, you mentioned about, about being black and, and we know that actually uh muscle density, muscle proportion is different in different ethnic, across different ethnicities, but it still creates a problem, you know, it's still a problem and it's still the, the, the, the the results that we use um is, is to see that's there. So II have got you afraid in our, in our obese category. Ok? But it's not about being a judgment, ok? It's about how our services are geared and disorder because my B BMI is high and it's improved to any through diabetes, through high BP. And we're going to be checking your BP today. Actually. Have you ever been worried about your BP at all? No, a family history of BP. Yeah. Yeah. Yeah. And it's, and we know that what we call it, the, the clinical term that high BP is hypertension and we know that actually, um, people who are back up are going to be more likely to have high BP. Unfortunately, that's why I keep watching my weight so that I don't get it so that I was having a history. So, um, next, what I'm gonna do is have to check your BP if that's all right. That's fine. What I need you to do though is, uh, take your jumper off but you just like just to leave one. But let's see what's going on with that food. Cos normally I'm, 00, you've got a lot going on under bed. You've got a house and so can I, can I do this bit? Can I just say what you've actually got on because ideally, ideally we don't push this up but because it's so loose, I don't mind pushing it up now as well. This, I'm not going to push up because when we do push it up here, it actually creates extra pressure, which makes a difference. And um, rather than getting you all undressed, I am going to do your BP through this because, um, yeah, but that might make a slight difference to the results, but I'm just going to take that risk. Ok. Ok. And then at worst, what I'm going to have to do is get you all undressed. Ok. Ok. But we're not gonna, so, but we'll see where that's at. Ok. Now, before we take your BP, we need to make sure we've got the right size cup. So I'm just gonna measure at the top of your arm. Ok. And the top of your arm here is coming in at 37 centimeters. Now, do I have you cough that much at the top of your arm or what? I'm surprised we get there. Well, it's not many people doing that, but we should do it because the whole size cuff can make a difference. Do you have? So, um, my cuff has got a set of sizes in here that lets me know that I have to put these glasses on that. This goes between 422 and 48 centimeters. So we're absolutely fine. To use this one. So I'm gonna pop that cup on. Now. The chances are, and the do this BP three times today, the chance that I'm gonna do it before I do your BP, I'm gonna take your pulse and to take your pulse here, what I'm not going to do is looking for the number. Although that is important, I'm going to look to see if it's beating regularly. Yeah. And that's because we're starting to look for other conditions. That's part of the health check is to find other conditions. Um, so why don't we take it for a whole minute? So it can feel like a long time and we feeling around here and we'll just sit quiet for a whole minute. I'll, I'll put my timer on. So we've got it and um see you on the other side in a minute. Perfect. Your pulse is really good. It's nice and regular and not a problem. Um, so that's good and your pulse rate is 76 at a nice regular rate here. Now to do your BP, it's also really important. I'm gonna get you to sit, sit up right in the back of that chair. Lovely. And I need to flat on the floor and everything to be relaxed. Now, just double checking, just double checking. You didn't have a cigarette in the last 30 minutes. No, or have any tea or coffee. No. And do you need a win? No. Good, good because all of those things can make a difference to your BP. And we want to get the best number that we can here. Now, when I do take your BP, I need to just be nice and relaxed at those tummy muscles, just relax down. Um, and I'm not going to talk to you, I'm not going to do anything. I'm going to tap one on the computer. All I'm going to do is, um, sit here quietly whilst the BP goes on. Ok. Ok. And then I'm gonna tell you what the numbers are going to be. Ok. So the numbers at the moment, the wheezing at the moment is coming in a bit high, which does mean I am going to have to repeat it again, but in a, in a, in a couple of minutes. Ok. Yeah, we, we were expecting them to be a bit high today. I would be worried that they might be a bit high. No, the top number is, um, is what we call your systolic and that's coming in at 100 and 58/96. That is high. That is high, isn't it? That is high. And then once you get over 100 and 20 then we start to increase heart problems and once we get over 100 and 40 then we need to start trying to assess if somebody's got high BP, but I'm going to repeat it because it might also be that you're a bit stressed. A little bit, a bit anxious. Yeah. Yeah, I'm just gonna pop that. I had to wait in the computer. So it is a good job. I've got a spare moment here now. And can I just check any family history of, um, heart attacks at all? Yes. Grandfather had a stroke, a stroke. Ok. Yes. Yes. A stroke. And how old was he when he had a stroke? He had a stroke at, uh, 75. 75. Ok. Ok. Yes. Then father had a high BP as well. Ok. Yeah. Yeah. And mother had a high BP. So both your mom and your dad have had, yeah, high BP. Ok. And, um, and how are they now? Are they, have, they passed? No one has passed but the other one is the, and they're still on medication for the high BP. Yeah. Ok. Well, that's good that, you know, everyone is still here. That's good. Um, and it's good that they're on BP medication cause that can really help. Um, I'm going to check this again if that's all right. Yeah. Is that ok? That's still, I'm afraid in that it's gone up a little bit more to 100 and 60. You've got a 92. So, um, and I'll show you the numbers because I think it's really important that everybody knows the numbers. So I will be checking it once more. Ok. Um, and then we could take that cuff off. Now, I don't want you to get worried about your BP. I'm getting so worried already know. Yeah. Ok. What, what am I going to do? Well, the, the next step would be to get you assessed for hypertension. Ok. So, so that's the next step before we do anything and, and um, and we do that, we manage that here ourselves. Ok. Yeah. Yeah. So um I met the lovely healthcare assistant around the, have you met, have you met him? He's not new to the practice. He's amazing. He's amazing. And he runs the BP checking service for us. So, yeah, so, and so what we'll do is I'll book you in at the end of the day and he said we'll get you booked in to see him. And what he'll do is walk you through how to measure your BP at home. We lend out these machines just like that's good. You get to measure at home by yourself and then you come back and see him with the machines and the results and then depending on the results, then um then you might go off and see one of the gps. Ok. Yeah. So, so, and actually whilst it might be worry about the BP, there's lots we can do for you. Is there anything I can do? That's, that's the medication. Well, yes and no. Yes and no So we know a lot of people do need tablets to manage their BP. And actually one of the best things they can do for BP is weight loss is losing weight. That's the best thing we can do. Um And actually, so, so actually if you were a law count as a normal body weight, you wouldn't have any weight to lose, to help with BP. But the fact that your BMI is over 30 means you do have some weight to lose, which may impact on your BP. That will likely to help bring that BP down. But if you do need tablets to help as well, that's ok. You know, it's just because I'm going through a lot of stress at the moment, you know, with the economy like me trying to pay the bills, you have to make sure you have enough job to pay all the bills. Yeah. And I think that is the whatsapp, it's my BP. That may well be and that's why checking at home can be really, really good. Ok. So I'm going to just do it one more time, ok? Cause we do it at least three times. So um just sit nice and sit nice and relax, try and relax, put your feet flat on the floor for me. Lovely. It still raised at 100 and 63/93. Ok? Ok. But I don't want you to talk about a lot going on as well. But, but the good news is we can do something about high BP. Ok. But the first step is to get it checked to see. Do you really have high BP? Let's see if we can get that diagnosed. We also know that actually for people who are black, it's almost even more of a problem than the people who are black and that BP. Um yeah, causes so many other problems like problems with your kidneys, problems with strokes, problems with say dementia. So it is really important that we try and get those numbers down. But the first step is to get it diagnosed. Ok. So I'll book you in with me and I'll put it on the screen now because it's quite straightforward and I can send in the quick note over and I'll just pop your BP in. Give me a moment. You've got this new template. It's, it's, yeah, it's got this new template. So it takes a few seconds. Ok? So that should trigger something off to on right now. We will um we'll follow you up and say when you're going to come in for the BP check. So we've got a quite a good system to text you. Have you been getting the text? Yes, I have been getting the text. Yes. Yeah. And how are you finding the text? It's actually, it's good. It's good to remind because we your mind of having so many things in text messages. Oh, yeah, I have another appointment. Brilliant. So it's quite ok. Fabulous. Just a couple more questions now for you. And I want to just go back to the family history bit. So you said it was a stroke and high BP when your mom and dad said any heart attack at all? Um, I think a couple of my uncles have heart attack. Yeah. Yeah. Ok. One of my uncles have a heart attack. Yes. Yeah. So, because, and the reason why we're looking for family history in this bit is we're actually just looking for first degree blood relatives. Does that you? Not my dad? Yeah. But actually to do with heart attack, not necessarily. So we know it's important for BP. But one of the things that we do today is calculate your chance of having a heart attack or stroke in the next 10 years. And I use a computer program for that one and that's where all of the different measurements that were put today. It goes into the computer program and that's how we can explain to you what we think your risks might be. Um, so, so it was your uncle? Yes. So, so whilst that's really important, it actually doesn't fit into a computer program for that. Ok. Yeah, it's just for life. Ok. But not just for this bit of a computer program we've got. So next is, um, I'm going to ask you a bit about alcohol and then we're going to ask you about smoking. Ok. So all these tricky ones for these people. So this for people sometimes, you know? But, so I started smoking. That might be, well, that's good because I don't smoke. Oh, brilliant. Ok. Then that's really good. That's really good because with, with our culture, looking at smoking is not, is not, look on too. Right. Have you and upon? Yeah. So I've got you down here that you've never smoked. So that's ok. So, so that's a nice book set of questions and brilliant because not smoking is so good for our health. OK. So good for our health. OK. So that next level is alcohol. So, um and I've just got a series of questions, I'm going to ask you about alcohol. So do you drink alcohol at all? Well, I do socially socially when I get invited to party? Ok. So maybe once or twice a month and there can be a month where there's every weekend, there's party. Wow, that's a lot of parties. There is, that's a lot of, ok, so I'm going to put you down then at 2 to 4 times a month. That's what you're looking. That is that, is that right? Does that feel about right? OK. So, right. So it 2 to 4 times and when you are there at these parties, how, how, what do you drink, drink a, a beer, beer Ok. Ok. And, um, in, what is it in a bottle or a can? Well, I can, but when I do, I don't drink more than two because I've got to drive. So. Ok. Yeah. And so what we know is that regular can of beer that size has got about two units in. So what we're going to say is that, so that makes it four units, 44 units when you're there? Ok. So that's four units. And, um, do you have more than that? Well, if I have a more, but I'm, I'm not driving. Somebody gave me a lift to the party. Ok. And, and, and how often would that be? Well, maybe once a quarter, once a quarter. Ok. So that's, and that's, well, that what that, what my school here is, everything is a school nowadays. Yes, it's in a school here is, yeah, is, actually comes in at less than five, which means that, uh, enjoying the drinking of the, oh, you have? Yeah. Yeah. So that's all, that's all good. That's all good. You're drinking what we call responsibly and within safe limits. So, yeah, so some people worry that we're gonna give you a big lecture on alcohol. But, um, yeah, so, II think the driving is actually a deterrent that stops me from drinking a lot. So, that's, that's really because, you know, that drinking drive is a criminal offense. So you don't want to be a criminal. Exactly. Exactly. And we do know sometimes alcohol can influence BP. So it's something to think about. Not that ok. But that's something we can pick up later, particularly with. Um, because I don't know if you're interested, we have a weight management service that you'd be interested. Yeah. Yeah, that's good because I've been trying to lose the weight. But I don't know. But with the weight management, I hope I'm going to be eating African food because I love my African food. I can be eating potatoes every day and eating vegetables every day. So I will eat a bit of African food. Oh, ok. So, well, well, that's, that's not my speciality. I have to say. That's all right. But, uh, Andy is one of who's a fabulous African woman who is part of the weight management service. Ok. So, yeah, so she was being, especially because we know that we have such a fantastically diverse population. We don't just have sort of diets for traditional western diets as it were. That's there. So, oh, I'm really pleased that you are good and I'm happy to do that. Well, there's a bit of a waiting list, unfortunately. Like, I think there's a bit of a waiting list, but at the end of today I'll refer you off if you're happy and they should be in contact with you in the next couple of weeks. They probably contact you by phone and then they'll let you know how long it is before they can get you in, but usually they can give you some good sign posting as well. Ok. That's good. At least before that I can do what I'm doing to just keep my weight down. Yeah. Yeah. And, and the weight sometimes just not getting is a good thing, you know, keeping our weight at because, uh, a lot of us are carrying a little bit extra pounds and II know I know what it's like. It's not easy, is it? Especially when we're all spending our time sitting down a lot. Ok, lovely. Next on the list is about physical activity and exercise and I've got another series of questions to ask you. Ok. Um So what, so I know your job, of course, because you're a social worker but want to know when you're at work. Do you move around a lot or you actually see, well, most of the time I'm in meetings or I'm on telephone, talking to clients or putting my report in which take longer hours. So really, I sit there most of the time at work, but let's know when I want to go and get a cup of tea or when I want to go to two hours, the ladies and it's the way of nowadays, isn't it? Particularly since the pandemic, a lot of us are spending more time sitting with more than ever. And it's, it's not good for us and even when I'm walking for a pole. I go to a seat all day. I know some people I know have those standing desks but, um, it doesn't work for us. Yes. No, it's not going to work for us. Ok. Now, um, so the next bit is about exercise and, uh, I've got to ask you the questions. Although I think I know what the answer is because II know about, I know about your knees. Um, but do you ever do any sort of vigorous exercise? Are you able to play badminton? Don't say no, no, I can't. I try and dance when I go to the party. But usually I end up taking paracetamol after the dance because I love to dance and dance. But I end up taking, yeah. And the dancing is not every day. It's only the weekend or the weekend. I, what, how, how, how, when you do dance, how, how long do you dance for, would you say? Well, maybe 1.5, 2 hours. Oh, she does not have a lot. Have a, yeah. And you know, if you've got to take a bit of paracetamol afterwards, that's really good. Dancing is great and it's good for, not just for the activity but it's good for everything, you know, it's good for the soul, I think, isn't it? Yeah, I think I, II believe so. Yes. Yeah, that's good. Yeah. Brilliant. So, um, I think this is more about getting older menopause. Um, don't I know. So what do you do? Exactly. And you, well, are you seeing anybody after menopause at all? No. Oh, I haven't had an appointment. This is so much. Ok. So, well there is a bit of a, you know, getting the GP appointment is a bit trickier nowadays. However, when you leave here, why do you book in? It might be in a four weeks time or six weeks time? Do you book in? That's a good idea. Yeah. Book in and say you know. Yeah. Yeah, absolutely. And cause you know, menopause is really important and we do know that actually, but as women, when we go through the menopause, it increases our risk of things like heart attacks and strokes makes our cholesterol go higher, makes our BP go higher. Ok. Yeah. So it's really important to and, and the stuff again alongside all of those awful physical symptoms that we feel the joints aching, the sleeping. Yeah. No, definitely do an appointment on the way out. That would be good. Thank you. Yeah, I thinking about that. Yeah. No. Well, I went back to the exercise questions now. So dancing is really good and I think you should continue on dancing. Yeah. As much as you can do. Um And if paracetamol is, is, is enough to, to sort your joints out then, then that's good because actually not moving them can make them even worse. Ok. Um Do you do any cycling at all? I have to laugh because I have a bicycler. Oh, I scared for it. Do you have going on? Like, no, it's just there. I look at it. Sometimes I go sit in this room, I'm watching Telly and I do two rounds and I'm just like, ok, I just enough, I don't get that. So, so because we don't have to laugh because she's gonna like, well, you know, that's what happens with a lot of us and we have all these bits of kids at home. But would you like to cycle more? I love to do more. As long as my knee is not affected. Yeah. Yeah, because it's sadly what I'm hearing is that you're, you're quite motivated to want to do something and there's just little bits in the way, obviously, there's your joints in the way. But actually being motivated is really important to on the first step of being able to do more. And as part of our weight management system, they also will touch on physical activity too. Um Yeah, so cause it's not just about the food um-hum and we know physical activity is really good for BP good. So maybe, maybe, maybe we could, I, I'd like to do more because of this BP going up. Yeah. So maybe we can not, I have to do more. So, so, so before I, I'll finish this bit first and then I'll ask you a bit more about that cyclic if that's all right. Ok. That's fine. Ok. So, um, walking, how, how many hours a week would you say you walk? Oh, wow. Sometimes I try to park the car at home, take the bus and walk to the office. Ok, that's good. Because I thought, ok, I thought if I can saving money and I can use as a form of exercise, that's a very good way. That's a very good way. And so how long have you had to add all those hours on my walking from bus to, to my office? It's about 10 minutes. Yeah. So if I want to add my exercise for the day, maybe 45 minutes, 45 minutes, that's it. Ok. That's a, so I can take on my bit here that you'll walk for more than three hours and cause that's the bit that I'm looking for one hour, 1 to 3 hours. So we're definitely going to say you're more than three hours. Um, um, which is great because we know walking is really good for us. And how fast would you say you walk? Is it quite a steady pace? Is it, um, not very fast? Not, it's steady? Ok. Steady pace. Love it. It was, I bit my knee so much. So, it's a, it's a tricky one, isn't it? And, um, do you do, uh, how many hours a week would you say you spend on housework and childcare? Give you the lumps? It's either less, like, zero, less than 11 to 3 hours or more than three hours, would you say? Well, a week, a week, a day? Ok. A week because Saturday is my usual cleaning day. Yeah. So Saturday I can spend about 3, 3.5, 4 hours. Wow, that's a, ok. Ok. So that's keeping you that. So you're probably busy. You're very busy. And, um, and has it gardening at all. Well, I thought I got him but every now and again I've got a COVID that so I love more. I usually a lot more. But apart from that, not, no, not really a lot. Ok. So on my, on my scoring system here, you're coming out as an moderately inactive. So that's the system in there. So, although, although you're being really busy and you're dancing and you're walking, that's all really good. It's just the way the computer phrases things because it only gives us, um, a few bits. But I think, um, to me it feels like you're actually doing a lot of the right stuff. Ok. And what people always want people to do is, is, is, is move more and, um, and you, like, you're already doing a lot of walking as much walking as you can with your knee and that feels really good, loving dancing. But what would make you, um, what would count if it's this one? Is that, is that bicycle, you know? Ok. Yeah. Ok. Yeah. So, would you, would you like to use your bike a little more? Well, it's there. I, job. So that's why I make you use on beats. Yeah. Yeah. And was there ever a time that you did use it more? Yeah. Sometimes when I've got motivation that I need to lose weight I jump on it, I can do it continuously for about a week and the motivation just put down. So, what do you, what do you think you could do? Is there anything you could do to, to keep that motivation going? Well, maybe if I'm accountable to something, accountability to somebody or a group, whatever you said I done this today. If I have to report back that mean a will be great for that. Yeah. Yeah. A will be great for that. Absolutely. And actually as, as because the, the weight management service does form as part of a group as well. Yeah, but we do know a lot of people do stay quite well connected. Um Yeah. So, so it's, I'm really going to get quite motivated at all. Oh, yes. Yes. I know. I don't, I don't want to that your BP medicine. But if you do need to, if, let's say you do need to take BP medicine to help you. Ok. That's good. But, but if it gets one where you do, then it's really important that you do if that makes sense. Ok. But there's so much we can do with lifestyle BP. That is brilliant. Ok, wonderful. I'm just going to finish that bit on here. Another part of the health check that we do is actually around dementia um and dement prevention and early identification we're looking for. Now. Um in this practice, what we like to do is for everybody. So you know, the the rule, not the rules, but the guys in the city need to see it for people who are 65 to 74. But in our practice, we think everyone that comes to a health check should have the just should be informed about dementia. Now. Um It's very simple stuff to say to you and I'm gonna give you a leaflet, ok? I'm gonna give you a leaflet and inside the leaflet has got lots of information about dementia awareness. Um And if there is anything in that leaflet that you are worried about, so whether that's for yourself or for a member of your family, then it is make an appointment to see the GP I'm afraid um the leaflet is and I have to send it to your phone. Um So we don't have any hard copies anymore to give out those days a lot of things all over. So I'm going to have to send that through to your, but we've got the system to get those checked through and the loop that will be there. Now. Um So we don't do any assessment for dementia. Ok. Do you check? Oh, I thought you were going to do a, an assessment because with menopause, I don't know. You know, sometimes I think it's dementia when I'm, I'm looking for my glasses. Oh, my one time I had my glasses was in the freezer for a few days. Oh, so I was thinking, is it dementia or is it so, and that's why it is important. So, so this leaflet can be good. It will let you know something and actually, and everything that I'm going to tell you about what's going to be good for your heart is also good for your brain. Ok. So even getting on that bike of yours is going to be good for your heart and good for your brain because actually exercise is one of the best things we can do to stay off. Ok. Good, good. So, um, so I'll get that leaflet sent over to you. Um I'll put that all through at the end of the day, at the end of the day, at the end of our session. Yes. Um As well as doing any, the, you know, the refers and stuff that we need to make sure sorted. Um Yeah, so, so that, yeah, yeah. So I like it in our practice that we do for everybody. That's good. But I have, that's fine. I will do it on my phone. Brilliant. Next thing we're going to do is a cest test. Ok. It's a bigger quick test. I'm just going to go wash my hands and, and grab a shot. Give me my foot. That's fine. Had your cholesterol checked before? Yeah, I have, I used to have a blood test for the GP. Yeah. But that was before COVID since COVID done. Do you know what your result was? I mean, I can check it earlier. I think it was a five or something. Yeah. Yeah, it was, it was a 5.3 and that's your total cholesterol. We call 5.3. Yeah. Um and well, what we're going to do today is check your total cholesterol and I'm going to look for what level your good cholesterol is as well. Ok? And it's all going to happen instantly. It's instantly it's going to take about two minutes to run. Ok. Lovely. So I use a bit of kit here and we just literally, I'm gonna wipe your finger and um, and then I'm gonna put your finger and take some blood. The results aren't too bad and it's gone up a little bit your cholesterol. So it's 5.7 now it's 5.7. But you did say, you know, we're going through the menopause and we know cholesterol can go up a bit. Also, your good cholesterol is 1.2 and we want that to be at least above one. Well, I put it up about 1.1 for women. Ok? So overall your risk of your cardiovascular and your ratio is what we look for is just over five. It's coming in that bad, but it's coming in under five at 4.75 which is quite good actually. So, it's quite good. So I'm quite happy with your cholesterol. Absolutely. Some people worry about that top number shouldn't be down. I mean, ideally we have it less than five, but it's about looking at all of the numbers that are there. If the GP would say if it's over five, then you're going to start medication. Yeah. No. What the reason why we decide for medication in terms of cholesterol is when we do your, we put it all into that computer program, we come up with your cardiovascular risk. OK? And that is the thing we use it with the, the algorithm we use at the moment is called pubis. OK. That's the algorithm we use. And um that's the thing I'm going to do next for you. So we put that in. That's my next, that's, that's the last bit of the template. And so we'll pop your cholesterol in here now and your p risk um is coming out coming out at about uh 3.8%. Now, a lot is that, that's the question people always ask. That's the question people always ask. And the language that we use in a health check is less than 10% is what we call low risk. So a low risk is that with a heart attack and this is, which is really good. But we also start to look at other things within this risk. But although it's low actually, and I think, I don't know if you can see here and your chance of having an unset stroke here is at, is at 3.8. Good, good, good. But if I show you this next screen here, it should only be about 2.1%. 0, so it's still up a little bit. So it's still good. Ok. But it's, it's, and, and a lot of that is being driven by your BP. So by getting the BP down. Yeah, then it will help the c risk to come down a bit. Yeah. Ok. And there is another way and, and we know that this is often as a bit of a motivator. So you're 59. Ok. Yeah. And, um, but your heart age and that's how another way of being able to compare what your puberty is, is coming in at 68. 0, yeah. So, but that's where getting your BP down will be the heart age that nobody wants a heart age. No, no, no, no. We all want a heart age younger than it really. Yeah. 25 years. Exactly. That would be perfect. So, if anybody, so if you ever thinking about what's going to motivate me to get on that bicycle, yeah. Your age like this one do you think? Yes, I want y your hat. Exactly. Exactly. I want you to do. I mean, between that and the dancing, I think that'd be really good. So that's pretty much it done for the health check today. Good. Have you any questions before? I sort out all the paperwork now. Well, now I will, I know that my take home today is, uh, physical exercise and also weight loss. Yeah. Yeah. And my BP and the blood. Yeah. And that BP because both of them, if I continue with that, it's going to bring my BP down. Exactly. Exactly. So that's the plan we've got for you. And, and what with the, the way we give you your results is it's another text message. So you'll, you'll get it all sent to, you know, get a nice little sort of, it won't be able to print out if we send it to your, we'll send it to your phone as well. So we've got your cholesterol coming in at 5.7 and your HDL at 1.2 making your ratio less than five. It's about 4.74 0.8. Your BP is raised. Yeah. So we do, we are gonna get you booked in with our me to be able to get that BP at home. Yes. Now I do, I do have a leaflet somewhere for BP at home, measuring your BP at home. And I'll get that for you before you go out. Um, so yeah, so we've got a lovely set of leaflets around measuring your BP at home and we're gonna send you through the dementia leaflets, ok, online. And I feel like I'm giving you a great big to do list. Is that ok? I can, I can do that in my spare time because you have so much spare time. Yeah. And um, so yeah, so we've got that and we're going to see how it I'm going to, you're going to book in to see the uh to see the GP about your menopause. Yeah, it's quite, it's quite a long list. That's there. Yes. Yeah. Is that all right? That's fine. Lovely. I'm going to go and get that, that leaflet for you. We've got it over here and um, yeah, so this is all about measuring your BP. Yeah. Good. Yeah, so it's quite a nice one. So when you see, I'm like tell you don't need one cause I'm just getting you one there. I've got some in my room as well and uh yeah, great to see you. And thank you very much. Now what I would, what I will say, the one thing I just remembered, I'm also going to give you a blood test for cause I've got to get you checked for diabetes. Ok? And a check for kidney disease. Ok. That's, yeah. So in that form I'll just get it printed off here for you now and I sent that to reception so it prints at the reception. So when you're making an appointment, get that BP that get your blood test form. Ok. And put yourself in with our lovely phlebotomist. Um, to get your bloods done. That's fine. Is that I've given you a big list of that. Yeah. Oh, that's good. At least I've got an appointment today and I've done so many things, which is much more better than waiting for an appointment to see the doctor when you're ill. Yeah. So I'm not sick but I got this appointment. That's good. Brilliant. Thank you very much. Brilliant. Thank you. Thank you. We hope you found this video useful and your feedback is really very important to us. It will only take a moment and remember after you've given feedback, you will be able to access your certificate. Thank you.