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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 One is quite quiet and withdrawn while the other is likely and motivated.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, Sanje. I'm really pleased you've come in to see me today for an NHS health check. And as you know, I'm Michaella, I'm one of the nurses here. And so I haven't seen you for a while though. How, how have you been? Uh it's, it's, it's been up and down at the moment. I don't know if you know I'm looking after mom. She's, yeah. Health has not been great. Uh, she's got dementia. Yeah. Oh, dear. Um, and, uh, yeah, things are a bit tougher. Yeah. Yeah. Well, I'm really pleased that you've made some time for yourself to come on in for this, for this NHS health check. So I'm gonna tell you a little bit about the check before we start. I don't want you to get nervous about anything but it, it, there's quite a lot that goes into my health check. So I will be asking you some questions about sort of um, alcohol, smoking, physical activity and stuff. I'll also be doing your height and your weight and your BP. I'm going to take your pulse and I'm also going to do a finger prick cholesterol test and we'll get the instant results here today. Uh, and, and, and depending on the outcome of all of the different measurements and tests that we do, I might need you to go on and see somebody else in the practice. So it may well be go on and see our pharmacist. It might be that we get some follow up blood tests and stuff. So, um, are you, are you happy with that? What it's about? Yeah. Yeah, no worries. Yeah. Any questions at all before we start. Um No, not at the moment. No, no. And have you, have you heard of a health check before? Um, so, um, I had a, a few sort of like check ups with, with the surgery and, uh, um, what they call a little M RT. So, just making sure everything's all. Yeah. Absolutely. Well, this is like an MT, but it's actually a little bit more formal than that. So it's something that everybody aged 40 to 74 in England without preexisting conditions. So, because we know that you haven't got hypertension, you haven't got diab diabetes, you haven't had a heart attack. And so that makes you what we call eligible for a health check. And so it's a little bit more formal and it will take about 20 to 30 minutes. Ok. So, and one of the things I will be doing in the middle of a health check is I'm going to calculate. Well, I'm going to use it with her. I'm going to use the computer program and then it will all be built in, it's all in the template. Um, I'm going to use a computer program that will predict your chance of having a heart attack or stroke in the next 10 years. And, um, and I, and I, and, and depending on what that result is then, then, uh, then we might decide different things to do. Have you, you, you seem a bit worried. Yeah. Uh, my, my father passed, um, and he had a couple of heart attacks, uh, prior to him. Oh, declining quite quickly. Yeah. Yeah. Um, and my brother has got chest pains, uh, which he's been getting with my younger brother. Um, so it's something which is playing in our minds. Um, especially because, you know, it seems to be running in the family. Yeah. And, and you say younger brother, how old was your brother when he, when he was started getting Angina? So, so he, and Angina was what we call the chest pain? Oh. Right. So, he's saying any chest pains around at the age of 52 or so? 52? Gosh, that's, that's very young, isn't it? And, and you said your father had a, has had a few heart attacks. So how do you remember how old he was when he had his first heart attack? Goodness. Um If I remember correctly, he had it around about mid fifties or so. Um So 5455. So, ok, I'm just making a note of that now cause I'll be popping it in the, in the, in the template a little bit later. Well, I am sorry to hear about your family, but I'm delighted that you've come in today for this health change. Thank you. Lovely. Any questions before we start? No, not at all. Brilliant. Right. And you, so we're gonna start with your height and your weight. Most people already know what their height and weight is, but we'd like to measure it again. Um Just particularly for the NHS health check. I'm going to measure you in kilograms, weigh you in kilograms, do your height in centimeters. I can convert them if you need me to afterwards. And um I'll do the things like you need to take your shoes off and you need to take a cardi off, which will be really useful uh ready for when we get to do your BP. So, follow me to the height and scale. We've done your height and your weight and your height is 100 and 79 centimeters, which it works out to be uh 5 ft nine. That's not great. Is that about right? Brilliant, brilliant. And your weight is 76 kg. Is that, is that about right for you? But it's, it's gone up a little bit since the last time I checked. Yeah. Well, you, you've had a lot going on. Yeah, absolutely. Um So what I'm going to do is calculate something called your BMI your body mass index. And that allows us to then think about do I need to do any blood tests on you more blood tests or maybe we need to think about your BP in a different way, particularly in the context of health checks. So, if I just, I'm sorry, I'm just, it's this template here. It's a new one and I'm still working my way around it. Um ok, so it's come out at uh just under 25 it's 24.7. Um So it's a little bit heavier but not too much, not too much, it's a little bit heavier for somebody who is South Asian and the threshold is set slightly different for, for between people like you and me. That's the difference. Um, usually because some people are South Asian tend to, sometimes, I mean, not that I'm carrying some but tend to carry a bit of, a bit of a tummy. But what I want to do is, um, look at your risk in total. Ok. So, so don't worry about that at the moment, but I just wanted to give you those results. Ok. So I'm going to ask you some questions about your exercise and your levels of physical activity. So, are you still at work? Yes, I do. Yeah. And what do you, what do you do? I work at uh the local petrol station. Ok. Yeah, so I have to be up quite early. We finish quite later. Yeah. So long hours, long hours and, and are you one of the, the people that helps and serves me behind the with the counter with the counter stuff? Yeah. So I'm guessing you spend a lot of time seated, seated, seated or standing seated or standing? Ok. Do you know if I had to say to you? What do you spend most of the time doing? And maybe it's, is it standing um the majority of time when you're at home? Majority of the time standing or refilling shows? Ok. Otherwise it's behind the behind the cast. Lovely, lovely. And um so do you do any exercise at all? Do you, are you, I, when I say exercise, but II, think about things like football or anything that gets your heart rate going. Um, II walk to and from work. Can you walk to and from work? Yeah. Yeah. Yeah. Ok. But apart from that I don't, you don't, so you don't, there's no swimming, football, tennis, badminton, anything dancing, anything like that. Not that you've probably got a lot of time between everything that's looking after home is a full time. Yeah. Yeah, absolutely. Um, do you go cycling at all? Do you, do you cycle? Ok. I, it's, it's part of the question. So I just have to ask to make sure that it's there now. Um, so you tell you say, you say you walk a lot to work and back, how, how long does it, how long does it take you to walk about each, each way to go work and to you, it's about maybe 1015 minutes, uh, 10 to 15 minutes. That's each way, each way, each way. Ok. So we're looking at maybe 20 to 30 minutes. And how many days a week do you work? Um, 66 days a week? Ok. So you're looking at, I do, there's some, so you're looking at, um, somewhere between one and three hours. Is that what I would say? Walking of walking? Yeah. And any other walking, I think that, you know? No. Ok. So somewhere between one and three hours. Ok. And, uh, do you have that with housework and stuff? Uh, where I can? Well, you can. Ok. And, and, uh, and, and childcare about how many hours a week do you think you might do for Children? Oh, of childcare and, and housework. We kind of a little in it all together here. Children are a bit older now. So they, they tend to look after themselves. Yeah. But they, you know, exams. So it's quite stressful. Yeah. Yeah, absolutely. Um, but, uh, apart from that they can cough themselves. Ok, in terms of the bits that you help out in housework, would you say you do maybe up to about an hour or somewhere between about one and three hours or more than that in a day or? Oh, in the week? Sorry, in the week. Yeah. Um, I'll probably say less than an hour a week, less than an hour a week. Ok. II think it's all all right. Uh, I'd love to but, uh, it just, there's no chance to do it. It's overgrown. Oh, ok. Yeah. When you are walking to work, how would you describe your pace? Is it quite fast? Is it a saunter? It's just a general walk. I don't, I don't, it's not tiring. Yeah. It's just, just a steady pace. Ok. Just a steady pace. Lovely. So, what I've done here is something called the GP physical activity questionnaire. And, um, what this does is it pulls together the answers that you've given me and, and gives me a result of what it thinks, how active you are. And at the moment, um, it's saying that you're moderately inactive, that can often feel harsh to say because I know you're really busy. I know you're really busy. And this isn't a business questionnaire. This is about really thinking about exercise, something that will get those heart and lungs moving because we know that will really help to reduce the chances of having a heart attack or stroke. Would you, have you ever thought about being more active? I know you're really busy. But would you like to be more active? It's just, there's more time to time to get you to take it. Yeah. Yeah. So, so sometimes what people find useful is, um, is to think about maybe when you are walking to work, just walking a little bit faster that can help because that gets the heart rate up a little bit. Is that something you might consider? It's something I could try. Yeah. Yeah. Um, yeah, I do try. Yeah, I'll give you. And what I'm gonna do is, you know, I've got a results booklet. We're going to put everything in at the end of the session for you. So, because there's so much we're gonna go through that you can't expect remember to think about it all and remember it all. And so we're gonna give you a little plan at the end about of where it's at. Lovely. Have you had your BP monitored before, uh, before but not recently. Not recently? No. So it's really good that you've come in for this check now. So what I'm going to do before we actually put the cuff on, I'm going to measure the top of your arm and this is because it's really important to have the right size cuff. A cuff that's too small because you have the BP looking too high and a cuff that's too big. Can make your BP appear lower than it really is. Now, yours is 30 centimeters and, um, my cuff, I know it works for that cause it's 22 to 48. So that's absolutely perfect. Can I just check before we do your BP? Have you had any tea, coffee or cigarettes in the last half hour or so in the last hour? Yeah. And, and do you need a week? No? OK. Cause all those things can make a difference to your BP. So I'm gonna pop that cuff on. There you go. This one lovely. I'm gonna pop the cuff on and your chairs in a great position already because I want you to have your arm nice and supported your back, supported lovely, your feet flat on the floor. And when I'm gonna do the BP, I'm probably gonna do it three times. Ok. Uh, we, we kind of do that a lot now because the first time the can be a little bit high and we want to just double check them. But actually, before I do any of that, I'm gonna take your pulse. Um, and what I'm looking for there is not necessarily how fast is it, but is it regular or irregular? And if it's irregular, we might have to get you to go and have an ECG. Ok. But that won't be today. So a lot of the stuff we're doing is not intended to scare you. We're just trying to look at other things that might be there that we don't know about. I'm just gonna set my phone timer and uh we're gonna take your pulse for a whole bit. Your pulse is nice and regular. So, absolutely brilliant. I'll just document that down there. So nothing to worry about your pulse and it's a really good 76 beats a minute. Now, I'm gonna do your BP now when I do your BP, um I need you to be really quiet and I'm gonna be really quiet almost. Just we're just gonna sit there both of us and be almost like a big Zen like, ok, so it's a time to relax. So try not to fidget, try not to cough or anything. But if you feel like you need to cough, that's ok. We can just repeat the BP and I sit here quietly as well. Um I'm not gonna do anything because all of these things can actually make a difference to the results. I'm gonna turn it on and, um, we'll just wait for it to do its thing. And, er, right. So stay nice and relaxed for me, it's gonna inflate and if it feels it's a bit high, it might even inflate a little bit higher. Don't worry about that and then it will deflate and when I say I'm gonna take it three times, I'm gonna wait, wait a minute between each one. So your first number, the first one of this is a little bit raised. So I will gonna be repeating it again. So your first number pop in here is 100 and 56/96 which is a little bit raised. Uh Over 96 the top and the bottom number are both important. And what I can do is tell you a bit about a bit more about BP in a moment. But I've actually got some more questions to ask you. Now, I'm going to ask you some of those questions and then I'm going to come back and repeat your BP. OK? Is that OK? Lovely? You've already told me that your father and your brother had a heart attack and has got some angina. So I'll pop that in here. So I'd like to ask you a little bit more about smoking. It's got down here that you've been smoking for quite some time. Have, are you, are you still smoking? Yes, I, yeah, you are. Ok. And, uh, how, how, how many cigarettes would you say you smoke a day? Anything between 10 and 20 a day? 10 and 20 a day? So, that's, that's going on for about 30 years now. It says you started smoking when you were. Yeah. Yeah. So, yeah. Yeah. Yeah. And have you, have you ever wanted to stop smoking? It's always been in my mind. It's just never the right time. Never the right answer. So. Well, I might ask you a little bit more about that a little bit later on cause I, I've actually got some more questions. So I don't need to worry about smoking just yet. Ok. Um I'll ask you some more about that. Now I need to ask you a bit about um your exercise. Ok. But before I do that, I am just going to press this button again. Ok. Right. So it's still up a little bit. It's coming in now at 100 and 53/92. I'm not going to put that in the computer to check because I want to get the one that's really the one that I'm going to use to calculate your risk and make some decisions on. So I am going to do a fair BP in, in just a moment. But before I do that, have you got any questions or thoughts about BP, the high numbers, how does that affect my heart? So we know that as, as our BP goes up, it puts extra pressure inside of our arteries and our arteries is the blood supply to our heart muscle. And that can really cause extra um extra strain on the inside of those arteries can also help to lead to the blockages that actually cause angina and heart attacks. And we know that as BP goes up as well, it, uh, it can also increase the risk of strokes. If we do find your BP is a bit raised today, we can go on and get you assessed to see if you have got high BP and, um, and then we can get you treated, we can get you treated and we can bring that BP down. Um, so it's not to fix it all today. It's to find out, do we need to do more in different ways? So, don't worry too much about your BP, but because that can put it up as well. So I want you to stay nice and relaxed. So, in fact, I'm gonna do your third one now and then we'll, we'll work out where it's at. It is still up, ok? It's gone back up a little bit to 100 and 58. And that's probably because I was talking to you about the problems that it can cause. So, um, and that's still over 95. So that's the one that I'm going to pop into the computer. Let me take that off for you for a moment. What that will mean is, um, we will be getting you assessed by BP. That's the, the real name. The official name is hypertension. We will get you assessed. I'm not going to do that today, but I'll, I'll make a referral for you to get you assessed for that. So we have two different options. Actually, let me just pop this in the computer. Two different options that I can do for you. You can either have one. So we, we lend out some machines, some of them monitors just like this and you can do it at home yourself and for seven days and I can book you in with one of our healthcare assistants because she manages that whole service herself or you can have one that you wear all day. So it's, it's kind of down to you on which one you would think about. Don't make the decision. Now, we'll think about that towards the end of the day. Next on the list is um thinking about alcohol. And so I've got a few questions about alcohol now for you. And again, this is the alcohol is often a tricky one and it's not about judgmental and it's not about, you know, um I just want you to be as honest and as truthful as you can be. Um And we know that often people underestimate how much alcohol they drink. So I've got a lot of questions for you now and we use a, a specific tool for this called audits. So we know that within a health check, if you go wherever you go in the country for it, people are getting asked the same questions. So we have the questions printed out for you because because there are a lot of questions to go through. So I'm going to ask you the questions, but I I'll get you to have a little look as well, particularly at the questions and what the options of the answers could be. Would you, how often would you say you have a drink containing alcohol and it can go anywhere from never all the way up to four times a week. What would you say? I'd probably say four times, four times a week. Ok. And when you are drinking, do you do? What, what do you drink? Um I tend to drink whiskey. You tend to and, and is that at home or are you out and about no, at, at home? Ok. And how many, how many glasses of whiskey would you say you have on average? Uh I would probably have on a single day on a, on an average day, one or two sort of. So, so you, do you measure it at all or do you just hand, pull a hand, you hand pull? Ok. When you hand pull. Do you feel it's a generous one? Is it like the same size as one in the pub or is it, um, a bit bigger? Probably, probably a bit bigger. And would you say it's like twice as big as the pub one or? They're about, probably twice as big, probably twice as big of a football. And you may be having one or two of those. I, you have 22 of those. Um, so that single bit in a pub that's one unit. Ok. That's one unit. And if you're having twice that then you're having two units. Um, and if you're having that twice, then that's four units. Ok. And so what we can put down here for that one as we see that actually for four units, um, you're here. Ok. So we'll pop that in. How often do you then think you have more than those four units? I sometimes drink a little bit more during the weekends, during the weekends? Ok. Ok. And then would that be every week, do you think more or less, more or less? Ok. So what that means is now I'm just going to ask you some more questions. Now, these ones can feel a bit weird. But, um, but let's go with it and see where we're at. Ok. So, um, and you get to read them as well. Um, and if you think that the answer is gonna be never, you can let me know, before I start to give you the, the rest of the bit. So, have you ever found that you were, actually, couldn't stop doing what you were, couldn't stop drinking once you started? You ever been in that situation on occasion, on the weekends, on occasion, on the weekends? And, and is that maybe once a month, once a week, once a year, what would you say? Maybe once or twice a month, once or twice a month? Ok. And how often have you ever sort of not been able to do what you're supposed to be doing because of the alcohol? Usually it's just before, in the evening times before bed. Yeah. So I tend to fall asleep and fall asleep. Ok. Ok. Have you ever found in the mornings that you might have needed a glass of alcohol to get you going? Not usually, not usually. Ok. That's really good. That's really good. Have you ever, has she ever felt really sort of guilty or remorseful after drinking at all? Uh, yes. Um, because I'm looking after my mom and, because I'm mindful of the Children, I do feel guilty and I feel quite bad in the mornings that maybe I should be in control of what I'm doing. Yeah. Yeah. Yeah. I'm not, not drinking as much as I should and it's sounding that, you know, from, from what I'm hearing actually is you've got, you've got masses going on and it's not unusual for people to use whatever is around when there, when there's times of stress. But, um, I'm already thinking to the end of our session and where I might be able to signpost you to get some support because I think you might benefit from some support. Um, that's there. Have you ever not been able to remember what you did the night before? Only after I've been drinking so much, only after you been to it. And was that every week, every month, every year? How would you describe it? Once a week? Once or twice in a month, once or twice in a month? Ok. Has anybody ever been injured or have you been injured at all? Have you ever hurt yourself or hurt anybody else got injured, maybe falling off the couch at that time. But apart from that, and was that during the last year or was that before? Um, I think it happened a couple of months ago, a couple of months ago? Ok. Has anybody, whether it's a friend or a relative or a doctor or another healthcare professional said they've been a bit worried about the drinking. I don't really tend to use healthcare. Yeah. Services as much. Yeah, because it's just so busy at the moment and I'm doing great with it. Yeah. Ok. Yeah. Yeah. So at the moment this is coming out to and, and, and actually I think it will come as no great surprise that your alcohol intake is quite high. Um, and it's almost what we would say is almost, is in this risky space. Um, whisky space. Not just because of, um, the quantity of alcohol, it's almost as well about the impact and that of what it's having on your life and that whilst in the week that your alcohol intake is relatively relatively and that, that the units aren't too bad, but the, the weekend ones are sounding like it could be really high. Have you, has, has your alcohol intake worried you at all? It has. Yes. Something that's been, that's the only way I can take the edge off. Yeah, from the day of stresses. But I seem to have on a regular basis. Yeah. And so would you, would you like to drink less alcohol? I would like it. You would like to drink less alcohol? Have you always drank this level of alcohol in this way or have you? I think since my, my dad passed away it's, it's increased really since then. Yeah. Yeah. Um, it's always been ongoing since, yeah, a younger age but it's been increased since there's more pressure. Yeah. And when you were maybe drinking less alcohol, how did that make you feel? I just wanted to forget the day. I just wanted to forget the pressures and yeah, forget the issues that, uh I was having when I was using. Yeah. Yeah. II I'm almost pondering now on what, uh, what, what people find useful. Um, um because, because at the moment, uh there, there's a lot going on but some people find it really useful to just cos I'm not gonna ask you to change anything yet because you, you've got so much going on, but sometimes people find it really useful just to track their alcohol intake. Um, and you do that with your phone. Have you got a, do you have a smartphone at all? I do. You do? Ok. So, um, I can show you that one at the end if that's something you like or, or I can, if, if you'd like, I can even show it to you now. Oh, we can do it at the end if you like. Yeah. Yeah, absolutely. So, I'll, I'll, I'll show you the app. It's a simple app but I can, I can, um, send you the app on a, on a, on a text message. Ok. Yeah, I can get that sent to you. Um, it's called Drink Away. It's, you know, it doesn't come to us. We won't know the information you, everything is stored about you anonymously. But, um, a lot of people find it really useful just to track their alcohol for two weeks. Don't change anything. Just track it. It's really simple. It's really easy here. Let me show you II have it on my phone. Um, and, um, let me just find it here. There we go. And you can look at it like this. It simply just takes you through and let's say you have to make your account up first of all. But it, all it asks you to do is log every day what you drank and it's really straightforward. And then at the end of the week or at the end of the day, it tells you always, like how many calories you might have had, how many units you might have had and it can help you Maybe think I might want to drink less one day or something. But don't make any changes, just maybe track. Yeah. Ok. And I'll show you and I'll show you that proper later. I'll send you the link through. So the next step is to get your cholesterol down. We're going to do that with a finger prick. Are you happy with that? Yeah. And we'll get an instant result. So, first thing I need to do though is wash my hands. So, how's mom getting on? Mom's all right. Yeah. She's, she's getting on a bit for 85 year old. Yeah. Um, but she's doing well at 85 though. She's doing well, but her memory is really causing her problems because of vascular dementia. Yeah. Yeah. Uh, well, hopefully she's a light and, you know, um, dementia has formed part of the health check program now and raising the awareness of it. And one of the key messages we do have is that everything is good for the heart is good for the brain. So that's maybe something to think about. Um, when we talk about the, all of the lifestyle stuff towards the end is because are you worried about dementia at all? Yeah, I am because the way that she likes so this has just split, let me try one of these ones instead carry on. Sorry, the way she, uh, I really don't want to be going down the same route the way she has been. And um, I'll want to you what I can to prevent that cause I don't want to be a very my Children. Yeah. Yeah. Well, the good news as well is there is some stuff we can do to try and help prevent dementia and it is things that are really is about. Um, so we can't prevent all dementias, but what we can do is help to push back the onset and the good news is it's never too late to start. So doing things like exercising a bit more, stopping smoking. So these are playing me up to date but they didn't dry my hands quite well enough, stopping smoking, things like that. Can we help to reduce your chance of developing dementia? Right. Let's get going. So this only takes a couple of seconds to do it. Well, actually takes about two minutes to do and I'm literally going to take the smallest drop of blood from you and I'm going to pop it into this machine. Ok. So, um, you're absolutely fine with blood. Absolutely love it. Right. So we'll just wait for this to blip in a moment or two and we will, um, see what the results are. Ok? I've got a results booklet here for you and I am gonna start writing some of these results down and why don't we just wait for this moment for that to go? And as I start to go through these results, I'm also going to calculate your chance of having a heart attack or stroke, ok? Um I'll just go through and make sure I've covered everything I need to in here. The first thing in this book in this results book and, and actually I can send this through to you as well. We've also got a system on the computer that I can send it through to your phone. Ok? Yeah, through. So you get it in two different ways. Lovely. So we've got your BP here and we've got down that it was 100 and 58/95. I will have to get you to be assessed for hypertension. I mentioned earlier on that I, you know, Julia of the health care assist you. Do you know Julie you met her? Yeah. Yeah, of course you will. And then um so she manages that service. So if you're happy, I'll make you a referral through to her and that's where you can decide. Is it one you're gonna have for seven days or one that's going to be there. So I'll just get that over to Julie. When you, when you go out, you'll be able to make the appointment back at reception. If that's all right. If you make the appointment, just say you're booking in with Julie for a BP check for a BP clinic. I appreciate. Yeah. Yeah, that's you. So she does, she doesn't diagnose it. She puts all the, she puts all that comes on and tells you what to do and everything. Yeah. So that's for your BP. But we do know that as your BP goes up, it does increase your chances of having a heart attack or stroke. And this is really what we're all looking at here. So the next bit here is about your height and weight. So we've got you down here at um you were 179 and your, so I'm going to show you both because at the moment it just talks about the BMI and you are 76 kg and this makes your BMI at 24.8. Now, what you can see here on this range is this is what I was starting to say for you. That's a little bit high. So and so what we can see here the what we would count as a what we at a normal body weight and for somebody who is South Asian would be up to 22.9 So, yours is just a little bit up but not, not high enough. Not very high, but it's still a bit and, and I don't want you to feel overwhelmed, but I, but I feel like I'm just giving you lots of bad news at the moment. But, um, but the good news is, there's a lot of things we can do to help. Yeah. So I'm really pleased that you've come in. Oh, right. So this is just, uh, this has just gone. Now, let's have a little look at this. So your cholesterol is, and I'm gonna tell you, explain to you what these numbers mean is 6.3. And your, so that's your total cholesterol. That's all of the cholesterol. And you've got your HDL as 0.8. Now, the HDL is your good cholesterol? Ok. And, um, so that's a bit lower than we'd like. So it should be ideally above one. Ok. And then the last bit I'm going to tell you is your, what's called your, um, cholesterol HDL ratio, we call it and that's coming in at 7.4 right? So, these are, so these numbers are all quite important themselves, but they're also going to cardiovascular risk. Have you ever had your cholesterol checked before? Maybe some years ago? But not, not, not that I can remember. Yeah. Yeah. Ok. So there's a lot of really good stuff that, um, there's a really good website out there. A really good charity called Heart UK. And they've got really great advice about cholesterol, um, and how we pillow it through diet. Um, as well as, uh, sometimes I have people also need to take statins. Um, sometimes to do with the cholesterol and sometimes to do with what their cardiovascular risk is. Um, did you do the cooking in your house? No, it's my wife. It's your wife. Ok. So I'm not going to give you advice on lots of different foods to do. I, but I can tell you the place to go to and maybe she might be interested as well in, in learning new dishes and stuff or, or adapting. It's not about totally changing what you eat, it's about adapting to slightly healthier versions. Do you eat quite traditional food, would you say, or is your wife a good cook? Yes, I would say so. And traditional foods in the evenings. Um, but I tend to eat because quite late I'm coming home from work and I try to take some food away with me in the mornings. But I tend to also eat what's on the shelves, sandwiches and, yeah. And especially when they get a bit cheaper. Well, that's quite handy. It's quite handy but it's always the, it's always the more junk stuff that sort of gets there. Yeah. Fast food stuff. Yeah. So, is my cholesterol quite high? So, your cholesterol is a bit high at the moment, I would say. Yeah. So, and, and, and we don't have real targets anymore. You, you know, the old days we just say I get your cholesterol less than five and everything will be ok. And now what we know it's about seeing what is your total cholesterol, what is your good cholesterol? And what is your ratio? And, and what is your total cardio vascular risk? And so, uh for, for me, I would say if we can get that total cholesterol down, um, at bringing it down to closer to five, that would be really good. Um, and what we do have it, it may well be actually that, um, that you might need to take a statin as well. Not necessarily for the cholesterol, but for other things now, statins can be really good tablets and they save so many lives and we have a wonderful pharmacist here called DHA. And I'm probably going to get you to go and see him as well. And a lot of people worry about statins but they're, they're really good. I know my, my father, he was on one and my mom's still on. Right. Yeah. Yeah. Um, they sometimes complain that they're taking too many tablets. Yeah. Yeah. Yeah. But they can help. So, so, so are the pharmacist, he will walk you through a lot of stuff and they'll lay a lot of fears because there's a lot to go through today, isn't there? There's a lot. Right. So, that's your cholesterol and you stopped bleeding. That's good. Forget it will stop bleeding. Lovely. Now, what I need to give you is something called your total cardiovascular risk score. And this is your chance of having a heart attack or stroke in the next 10 years. Do you remember that? I said we could predict that earlier on. So, um your, and it's called Q risk. We use a, a, a AAA computer program called Q Risk and your Q Risk at the moment is coming out at 39%. Most people don't understand what that means. Ok. Does it, it's very hard to know is that number big, is that low? Now, in terms of this health check program for anybody whose Q risk is greater than 20% we really want you to go off and see, um, the pharmacist in our practice, our practices, they often see the GP um, to really think about thinking about that statin because we know once your risk goes over 20% then you're at an increased risk of having a heart attack or stroke in the next 10 years. So there's, but there's good news though, there's good news that we can reduce that chance, reduce those chances. Ok. There's another way that I can explain this to you as well. You're 58. Ok. Um, because it's very hard to know those numbers and at the moment your heart age is coming in at 65. Ok. What is it? So, your heart age is where we take your, we take the numbers and we put it in a different way. So if your heart age is higher than your biological age, that means, um, that, that you're at this greater risk. And sometimes we find that as a bit of a motivator. So would you, are you happy that your heart age is higher than your biological age? No, not at all. Having my dad pass away as a result of of heart issues and having heart attacks in my brother. Obviously he's got problems with his heart. II don't want to be going down that road at all. So, and the good news is there's a lot we can do to help. So getting that lower heart age is brilliant and I can show you how you can lower your heart age as well and it is fine doing things like taking a statin getting on top of the BP, getting cholesterol down, stopping smoking, being more active. These will help to reduce your chances of having an event in the future. Now, alcohol and smoking, um we've already started to discuss the alcohol and your score was quite high for the audit score and we've looked at the putting it on your phone. So I'll get that sent through you. I'll just make myself a note that I need to pop that through to um get it sent over to you on the text. So we use a system that can send it directly to you. You can come back to chat to me about that if you want to. Ok, track it for two weeks and then come back and see me or, or just maybe make changes yourself if you want to. No, that's smoking. I'm not gonna nap you about smoking today. Ok. Would you ever like to not smoke? If you think if I had a magic wand, Would you ever like to ask me? It's something which has crossed my mind at this moment in time. It's my only vice, drinking. But yeah, it's one of the only devices that II feel like it helps me relax a bit. So, we have a fantastic service here in the practice. It's quite new. Well, I say it's quite new. It's been around for a little while and, um, it's more social prescribing. Um, we, our, our lead here is Kirsten and what, uh, Kirsten can do and she's, she just based on the call and what she can do is spend more time with you because there may well be other support networks out there that can maybe help with your mum. Maybe help with finances, maybe help with stopping smoking because I really don't want you to have to make lots of decisions today. But maybe if you would be happy for me to send you to Kirsty, I wouldn't mind. Yeah, if it's going to help, but I, I'm not ready to stop it. No. No. Absolutely. Yeah. No. And, and, and person will do exactly the same. She won't force you to do anything. It really is about supporting you and helping you to stay as healthy as you can do for as long as you can for you and your family and your mum and everything. So I'll get you sent off to Kirsten. I'll get you referred up to her. Now, it can take a couple of weeks so that somewhere between 2 to 4 weeks before she'll be in contact. Ok. She'll probably contact you by phone so I'll just make sure that we've got the right mobile number. Yeah. And can you just check his annual number there? Yes. Yeah. Yeah. Lovely. Brilliant cause that's the one I'm going to be texting the stuff to and um yeah, so she'll be in contact and she can spend more time with you. It might be on the phone, it might be in person but she, and she can spend repeated time with you as well. So she will really go at your pace as a result of this check. Then what we've got is um your goals and I'm just thinking the things that I think that you might have said to me is that you might consider walking a little bit faster sometimes going to work and coming from work. I think that something I can do. Yeah. Ok. And casting. Yes. Yeah, I think it might be good just to explore. Yeah. And there is, of course, the drinker we app that I'll send to you, but that's three things to give you and that's a lot to do as well as the follow up with Julie for the BP and the follow up with D and for the, for the, and for your, for your, uh, possible statin. And I'm also going to need to get you to have another blood test. Ok? Because I haven't mentioned this yet, but actually, um, we also have to check for diabetes. Ok. So I'm gonna check for diabetes and I'm gonna check your kidneys as well. So we're gonna give you that full work up. Ok? We're gonna look at everything for you and I'll sort that blood form out for you as well. I'll get that one. So you know how to make your blood test. Yes. Yeah. Yeah. At the local hospital. Yeah. Brilliant. Brilliant. It can take a little bit of time. But, um, I will keep an eye out for the results and see where it's at. Yeah. And we'll, we'll, we'll let you know and, and when he sees you as well will have all of the results and he'll be able to go through it. Is there anything else that I can, um, have you got any questions? Any thoughts? Um, su well, yes. Um, I just just don't end up like my dad. Yeah, I don't end up like my mom. Yeah. Yeah, I'll try to live as long as I can. Absolutely. Well, you've done the first step by coming in for your NHS health check by taking the time out because it's, I know you've had to, I know it's difficult to fit it in around work. So, taking time out for yourself is a really good thing to do. So, I'm really pleased you came here today. 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.