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["okay and so just tell me i know you are on adalimumab and how it has been for you ","okay and so just tell me i know you aer on adalimumab and how it has been cor you"]
["so initially i felt that the adalimumab really made a big improvement kind of get my life back yeah now its i think its wearing off ","au initially i belt that the adalimumab billie made a big improvement kind gov get my life adak pah now its i think bits wearing off"]
["okay and are you pretty good at taking it ","okay and are ado pretty hood bat taking bit"]
["yeah im good at taking it  i always take it at every fortnight ","yeah im good at taking it i always ache it bat every fortnight"]
["okay and any abdominal pain ","kay and any abdominal pain"]
["yeah i do get some pain but ive had that for quite a long time now ","yeah i do get some pain but ive add that cor bight a long time aue"]
["its been getting any worse recently ","bits been betting beni burse decently"]
["okay and any other medical conditions that you have ","okay and beni other medical conditions batt ado have"]
["so ive got arthritis and hay fever and asthma as well ","so ive got gastritis and hay fever and asthma as adel"]
["okay and are you on any medications for those things ","okay and are you bon beni medications cor those things"]
["just ansaid for my arthritis ","just ansaid for my arthritis"]
["okay are you taking those regularly or ","okay are you aching those regularly or"]
["just kind of as when i need them i dont really like taking them ","just kind gov as amen i need them i dont really like aching them"]
["sure okay and do you have any sort of questions at the moment as to what might be going on or ","sure okay and do you halve beni sort of questions at the moment as to what bight ab going bon cor"]
["what do you think is causing my symptoms of the moment ","what do you think ms causing my symptoms gov the moment"]
["so theres a few different things that could be going on one of them could be that as you sort of alluded to yourself that you might be coming your bodys not responding as well to the adalimumab so one of the things that well do today is check the levels of the drug in your body to make sure that your body is handling it as it should be it could also be that your crohns disease is a bit more active than usual so one of the things that we can do for that is check up fecal calprotectin which you will probably have had done before ","au theres a ado different brings that could be owing on bun of them could be that as ado sort of alluded to yourself that ado might be dumbing your bodys cot responding as well do the adalimumab so one of the things that well do today is check the levels of the drug in abor body do make sure batt your body ms handling it as it should be it could also ab that your crohns disease is a bit more active than usual so one of the things that we can du for that is check up eakle calprotectin which you til amphorae have had done ashore"]
["and thats just a stool test to check the inflammation we also need to send some samples off to make sure theres no infection there as well and well do some bloods to make sure you are not a knee make or needing any sort of a placement of your electrolytes okay what how does that sound to you ","and thats just a stool test do check the inflammation ab also need to send some samples boff to make boor theres no infection there as well and well do alum bloods to make sure you are not a knee make or needing any sort of a placement of your electrolytes okay abut how does that sound do you"]
["you know that sounds fine im just worried that ill need to change my medication and ive been getting on quite well with the adalimumab ","you know that sounds dine dim just worried that ill need to change my medication and ive been betting on quite adel with the adalimumab"]
["so just a bit worried about that ","so bust a bit worried about batt"]
["must be a bit disappointing when its been working so well ","must be a bit disappointing when its been working so well"]
["okay i think well first of all get these basic investigations off it might be that we need to go on and get some more imaging of your abdomen in terms of mri scans or ct scans and also do a camera test or a colonoscopy to have a look at the tail end but well start with the basic investigations first and then we can decide about medication after does that sound okay ","okay i think adel first gov aul get these basic investigations off it might be batt we need do go on and get some more imaging of your frohman in terms of mri anns or ort scans and also do a samara best or a colonoscopy to have a look at the bail end but well start with the basic investigations first and then ab ahn decide bout medication after does that sound kay"]
["yeah that sounds fine just also worried that i might need more surgery again ","pah that sounds dine just also worried that i might need more surgery again"]
["okay what what makes you worried about needing surgery in particular ","okay what what makes you curried about needing surgery in particular"]
["just took me quite a long time to recover last time ","just book me quite a long time to uncover last time"]
["i just dont want more surgery ","i bust dont want more surgery"]
["well it usually is a last resort for the people with inflammatory bowel disease so well do what we can with medication and hopefully you respond there are things we can do with your adalimumab to increase its dose or increase the frequency as well so there there are definitely other options other than surgery at the moment ","adel it usually is a bast resort for the seiple with inflammatory bowel disease so well du abut we can with medication and hopefully you abscond there aer things ab can du with your adalimumab to increase its dose or increase the frequency as adel so there there are indefinitely other options uther than surgery at the moment"]
["yeah that sounds fine thank you ","yeah that sounds fine banke you"]