Listening A08

Listening A08
Extract 1: Questions 13-24

You hear a neurologist talking to a new patient called Jason Lee. For Questions 13-24,
complete the notes with a word or short phrase.

You now have 30 seconds to look at the notes.

Patient Jason Lee

Development  noticed an increased incidence of (13)

of condition  went to optician (inflammation in both eyes)
 sometimes had spots that looked like (14)
 later had (15) on leg (some swelling)
 skin left permanently (16)
 a few severe headaches
 thought he might be developing (17)
 most symptoms were intermittent
 believed diet was possible cause of symptoms

Diagnosis  had blood and urine tests

 GP suspected possible Lyme disease
 another GP thought it could be (18)
 (19) confirmed diagnosis

Initial  prescribed (20)

treatment  side effects: (21) and temporary hair loss
 currently trying (22) (no side-effects reported)

Further  will see ophthalmologist for administration of (23)

treatment  (24) prescribed to deal with increasing number
of headaches
 Listening A08
F: Well, Mr Lee, first I need to get an overview of how your condition has developed.
Can you just describe for me the initial symptoms?

M: Well, it’s a long story and it took ages to get to a diagnosis. It’s been very difficult to
cope with.

F: I totally understand your frustration.

M: There were quite a few symptoms but I didn’t connect them all at first. I had three or
four separate lots of mouth ulcers in the space of less than a year, and they were
quite painful and I couldn’t eat properly. I’ve occasionally had them in the past but not
as numerous and frequent as this. Then, in June last year, I suffered from this really
bad inflammation of both eyes. I went along to my optician and he gave me
something for it and said it would settle down.

F: And did it?

M: Actually, yes. That’s been one of the weird things about all my symptoms. They flare
up and then they sort of disappear after a while, and I rarely had all the symptoms
going on at the same time, thank goodness. Once or twice I came out in spots – and
it brought back unhappy memories of acne when I was a teenager. Around the same
time I noticed these slight skin lesions on my leg. The skin was red and felt very
tender. Even after the swelling had gone down, the skin looked odd – you know,
quite discoloured, and it still is. I can show you.

F: Were there any other symptoms?

M: Well, I started getting these awful headaches. One of them really knocked me flat for
a whole day. The only other thing was a definite stiffness in the joints. My mother had
arthritis so I thought I had the same problem too, but again like a lot of the other stuff
I’m telling you it sort of went away without any treatment. At this stage, I was sure it
was my diet that was causing all these problems and thought some food types might
be triggering some of the symptoms.

F: And what did your GP say when you saw him?

M: He ordered various blood and urine tests, and at one point he thought I might have
contracted Lyme disease because I do enjoy my walks in the countryside and a
couple of the symptoms seemed similar. The tests didn’t point to anything. I saw a
 Listening A08
different doctor and he speculated about possible lupus and explained what it was.
He wasn’t totally convinced though. The lack of certainty was upsetting and just
made matters worse.

F: And then you had further tests?

M: Yes, the diagnosis became more definite when they did a pathergy test. I had such a
strong reaction that it seemed to be like the final piece in the jigsaw puzzle.

F: Right, and then you were referred here.

M: Yes, and I’ve had to see various specialists to deal with the different symptoms. I was
given some immunosuppressants straightaway, though they did warn me that there
was the possibility of side-effects. I know it can be like that with almost every drug but
I didn’t expect to suffer the way I did. Basically, I had a lot of abdominal pain. And
would you believe it, some of my hair started to drop out!

F: Right, so that treatment was discontinued?

M: Yes, I was told that biological therapies would probably be more effective – is that
right? I haven’t reacted in the same way to this new treatment, at least not so far.
There have certainly been no strange side-effects. I feel a little better overall.

F: OK. Now, I believe you’re seeing the ophthalmologist this morning.

M: Yes, she’s going to give me some corticosteroid eye drops. And the other urgent
problem right now is getting to grips with the headaches. They’ve been increasing
recently. Your colleagues have put me on beta blockers. I’m hoping they’ll prevent
these headaches developing in the first place.

F: Yes, they should work well. Now we just need to discuss your recurring joint pain and
see what we can do to ease that ……. [fade]

Word count: 678 words

 Listening A08
Key:

13. mouth ulcers

14. acne

15. (skin) lesions

16. discoloured

17. arthritis

18. lupus

19. pathergy test

20. immunosuppressants

21. abdominal pain

22. biological therapies

23. corticosteroid eye drops

24. beta blockers