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right, That's interesting And are there any times when you Tommy symptoms bother you More seem particularly bad?
0id
Well, it's I'm having a bit of a bad patch at the moment. It's particularly uncomfortable. I have to say I do notice it when my husband's away. He, he travels with his job and he can be away a couple of times A month And that's not very often not good, then I have to say,
3gc
so you notice it's the worst when your husband's not around.
3gc
Maybe I'm thinking about it a bit more. I don't know when he's not there.
3gc
Right. Now, you've been seeing Dr. Brown about this for the last few years. What is it that he's said that he thinks might be wrong here?
1irq
Well, he he thinks it's all in my head. He's he says it's stress.
0id
Right Okay. Um, what do you think?
11orq
Well, I mean, it can't all be in my head. I hit too much physical pain for it to be in my head. I mean, it's real. It's it's a real pain.
10od
And if you had any thoughts yourself about what you think might be causing it
11orq
Well, I mean, I did think that perhaps it was an infection that hadn't cleared up in the early stages. But I think I mean, sometimes I think it's IBS friend of mines got that and it sounds similar. And then other times, I think, I wonder if it's an ulcer on a really bad day, I start to think it might be cancer
10od
right
7ack
My mother in law my mother in law died of cancer last year and she had a growth the doctor didn't investigate that by the time they found it, it was the size of a football and it was it was too late to operate them. So you know, when I go to bed at night now and I just feel and make sure there's nothing different going on And yeah, I worry about that.
3gc
So you're, you're kind of prodding having a feel at night just to see if you can feel anything.
3gc
Yeah. So just want to make sure there's nothing changing down there You know
3gc
Right. Okay. Okay. So just to make sure that I've got the story straight you've, you've seen Dr. Brown for couple of years, you've tried a variety of medications, some prescribed some from the herbal shop, and none of them really made a great deal of difference. You've had some investigations, but you perhaps feel you've not had enough investigations. And times you worried that this could be something quite serious like a cancer. Is that if I got the story, right,
3gc
yes
7ack
Barbara, what was it that you were hoping that I'd do for you today?
1irq
Well, I thought, you know, you're a new doctor here and you've just finished your medical training. I wondered whether you know, with new eyes and new way of looking at at the problem. You probably know about different tests and new tests that my doctor doesn't know about, you know, new developments, that perhaps you could send me for some different tests.
0id
Right. Right. So you're hoping that I'd send you four more tests?
1irq
Right. Okay. Well, I think Barbara having having heard his story and heard about the symptoms, I'm not sure that actually sending you for more tests at this point would be the most useful thing that we could do for you. And the reason for that is because you've you've had some of the main investigations in the last couple of years, and they've not shown anything. And you symptoms haven't really changed that much. So it's very unlikely that if we were to send you for more tests now that they'd show anything different than what we already know. So it'd be I think it would be a waste of time for you to go for more tests.
10od
So it's like, do you think it's all in my head that you're going to be like Dr. Brown, you think I'm imagining all of this?
4crq
What sort of approach?
4crq
Well, I guess, thinking a little bit about those other areas of your life. I'm thinking about the fact that over the last four years, your life's really changed. It seems to have been Really shrunk down. And it sounds as though you're not doing lots of the things that you used to do that you used to get pleasure out of, is that right?
6cd
Well, I just can't do them. Yeah, I can't do them anymore.
0id
And I guess I wonder it sounds as though you've you've dropped doing those things, because you felt you couldn't do them. But I wonder if in a funny way, what's happened is the fact that you're not doing those pleasurable things now, has kind of fed into you feeling unhappy with the way that that your life is at the moment. And I guess I wonder whether that can then make your symptoms worse for you?
1irq
Oh, I don't know.
9on
I guess what I'd be wondering is whether one of the approaches we need to be using now is thinking about what you do with your life and what you do with your day. And maybe trying to bring back some of those pleasurable things. Even if it's just meeting up with your female friends once a week. And whether actually doing those sorts of things might generally improve your quality of life. I'm also thinking about the tablets that you're taking. And the fact that you, you seem to be taking quite a lot of them and wondering whether it's worth of sitting and looking at them and maybe trying to rationalize them a little bit and really decide which are helping you, which are doing nothing, and which may actually be making some of these symptoms Worse, I guess. What would you think about trying that slightly different approach for, say, two or three months just to see whether or not it makes any difference?
1irq
What two, three months is a long time if there is something going on, I mean, that's what happened to my mother in law, you know, they they left her and didn't spot it and
0id
well, I guess, if we if we did decide to work together like this, this new approach, I'd be seeing you regularly, we can keep an eye on your symptoms and if they change then we can investigate as appropriate proof They stay the same, then, you know, we could be pretty clear that there's nothing new happening that that we're missing. How would that sound?
1irq
So, what are you saying then that I should come back and see you
0id
I think that would be a good idea. I think we've only just begun talk about it. And I think perhaps you need to have a bit of time to think about it, and then perhaps come back, perhaps if you booked him for a double slot next week. And that would give us a good chunk of time to think about this new approach. And perhaps if you could also bring your your tablets in or make a list of them. We can look at what you're taking and perhaps go from there. How would that sound Barbara?
1irq
Okay, well, to make an appointment for next week, come back and see you again and talk about it a bit more.
0id
Yes, I think so. I think that would be a good, a good start.
10od
And I'll make a list of the tablets that I'm taking here and bring all the bottles down.
3gc
Okay. All right. Okay. All right. So see you again next week
2gt
I'll make an appointment next week.
2gt
All right. Thank you Barbara.
2gt
Okay, okay.
2gt
bye bye
2gt
I think that was you'd come in after, after the relationship ended. Is that right?
5yq
Yeah.
7ack
Okay. Okay. Can I just check of the bandage to open up a second down there?
5yq
Yes
7ack
Okay, okay. How have you been Jane since we last saw ?
5yq
crap, I mean I just can't I just can't believe that he's gone.
9on
Right. And this is Your boyfriend, Mark, is that right?
5yq
Yeah.
7ack
Okay. Okay. How long have you two been together?
1irq
I mean, it's only a couple of weeks. But, you know, think seems to be going really, really well. I don't understand. I can't believe he is just gone.
0id
Right. What was it that happened Jane to bring, bring that relationship to an end?
1irq
Well, like I said, because it was going so well, you know, I asked I asked him to move in, right. And he said that he didn't want to. And we ended up arguing and getting into big fights And then he said he was going and you know, I begged him not to, but you know, he still went anyway.
0id
So was it after he had gone that you cut?
5yq
Yeah.
7ack
Right. Can you tell me a bit more about what happened when you cut?
1irq
Well he's gone, I just felt so I just couldn't bear the pain anymore.
0id
Right
7ack
And my voices which is incessant, And I just you know just want to get rid of all the pain all the voices and so you know just, you know just cut myself.
0id
And did that help with the pain and the voices?
1irq
Yeah, yeah, just yeah, I mean you took the pain away and tonight was just something about seeing blood really its fine. I just made it feel better.
0id
So, with the cutting is this something that you've, you've done before
4crq
I am doing this since I Was teenager.
6cd
Right. Okay. And it sounds like there are times when you do it when it it helps.
4crq
Right
7ack
and takes the pain off.
6cd
Right. And are there any downsides to the cutting?
5yq
Right. Okay. Okay. And you mentioned Jain voices, And I know you've spoken to doctors about them before.
4crq
but can I just ask you a few more questions about and please, if that's okay. Okay, can you tell me? How long is it that you've been hearing the voices?
1irq
That since I was a teenager as well.
0id
And do you know other is, how many voices are there or who they are?
1irq
I don't know who they are. It's mainly my stepdad.
0id
Right.
7ack
He just tells me how dirty I am and right. How horrible I am.I don't know sometimes it's my mom as well.
0id
What kind of things Does your mom say?
1irq
I think maybe she says about things in my life.
0id
Right. Okay. And how often is it that you get these voices
1irq
out there all the time Yeah, generally the sort of sitting there butAnd then you sometimes the louder than others and it's like the other night, the mice will have been in the room.
0id
Right. Did you think they were in the room?
1irq
No, I mean, I know that they're not there But it's like they're just so loud in my head.
0id
So can I just clarify that other voices seem as though they're inside your head? Or was it like my voice coming through your ears?
1irq
No. So inside inside your head, yeah
0id
okay. Okay. Okay. And am I right in thinking that they they trouble you more at times when you get stressed out?
5yq
Yeah, right.
7ack
Okay. Okay. Can I ask you a few more general questions about how you are in your mood? How, how would you say that you, you feel generally kind of in yourself.
1irq
Most of the time, it's not just like being me.
0id
Sounds as it can be very difficult sometimes. It sounds like you've used cutting in the past to help are there any of the things that you do to help when you feel really bad.
3gc
Drinking, smoke few spliffs now and then so much now, in the past I don't know, I just had a funny thing about food, you know it's all i binge and then just throw it back up again.
3gc
Okay, and that was in the past, but but not recently.
4crq
I haven't done it recently.
6cd
And can I ask Jane, it sounds like when you cook the other night, you were doing it, sort of to kind of get rid of the pain. Can I just clarify where you're doing it to try and kill yourself.
5yq
No.
9on
Okay. Have there ever been times in the past when you have tried to kill yourself?
11orq
late teens, then around when it was 19 I don't know. It just got to a point where I didn't want to be anymore. So I took some tablets
0id
So that was in your late teens and at the time you took the tablets because you wanted to be dead. Is that right?
4crq
Yeah
7ack
Okay. Okay, but you've not wanted to be dead since that time in your late teens?
5yq
No.
9on
Okay. Can I ask a few more general questions about your home situation? Who is it Is it is there anyone at home with you?
1irq
Well my daughter used to live with me, okay But right now she is gone to live with her dad now
0id
Right? So she's gone to live with her dad that quite recently
1irq
a year ago
0id