UKMP - Andre konsultasjon om falloplastikk

Dette er en transkripsjon av min første konsultasjon om falloplastikk med Dr. Liedl hos Urologische Klinik München-Planegg i Tyskland. For mer informasjon om klinikken, se Nedre kirurgi: Del 5 - De tyske klinikkene.

Transkripsjonen er på engelsk. Under konsultasjonen ble det vist noen visuelle eksempler i form av bilder og/eller tegning på ark. Dette kommer dessverre ikke frem i transkripsjonen. Unødvendige ord og setninger har blitt fjernet i etterkant.

Her er lenker til alle konsultasjonene jeg har hatt i kronologisk rekkefølge:


Transkripsjon

Dersom du vil ha transkripsjonen i PDF-format kan den lastes ned her.

Sted: Urologische Klinik München-Planegg

Dato: 05.06.2024


00:00:28 Levi
Do you mind if I speak English?

00:00:29 Dr Liedl
Yes, I can.

00:00:30 Dr Liedl
Of course.

00:00:31 Dr Liedl
A moment first.

00:00:51 Dr Liedl
Okay.

00:00:54 Dr Liedl
You are coming from Norway?

00:00:56 Levi
From Norway, yes.

00:00:58 Dr Liedl
Okay.

00:00:59 Dr Liedl
Drammen is in Norway.

00:01:01 Levi
Yes, that's right.

00:01:02 Dr Liedl
Okay.

00:01:08 Dr Liedl
Oki, what's your.

00:01:10 Levi
So I saw you last year in April, because I am seeking phalloplasty.

00:01:16 Levi
And since then I have a lot of new questions.

00:01:19 Dr Liedl
I have a letter at that time.

00:01:22 Dr Liedl
Yes, I know I can open it.

00:01:24 Dr Liedl
Yes, you talked about it.

00:01:27 Dr Liedl
Yes.

00:01:27 Levi
Yes.

00:01:29 Levi
So I have a list of new questions, if you don't mind.

00:01:32 Levi
I will go through them.

00:01:35 Levi
I have realized that it's important to me to try to keep as much sensation as possible.

00:01:45 Levi
And you told me last time that it's possible to keep the clitoris outside.

00:01:50 Levi
But what I'm wondering is, is that possible if you have urethra lengthening?

00:01:56 Levi
And in that case, how does that work?

00:01:59 Levi
Because isn't the clitoris kind of in the way for that?

00:02:04 Dr Liedl
Okay, first, what we are doing normally, the phalloplasty, the best is still the radial forearm, because the shape is fantastic.

00:02:21 Dr Liedl
You can do the urethra simultaneously.

00:02:25 Dr Liedl
And you all nearly always.

00:02:27 Dr Liedl
You have two big nerves.

00:02:31 Dr Liedl
And these two big nerves you can anastomize to other nerves.

00:02:36 Dr Liedl
And we do.

00:02:38 Dr Liedl
We anastomize one nerve on the clitoral nerve end to side.

00:02:45 Dr Liedl
And we anastomose another nerve to a groin nerve.

00:02:51 Levi
Right.

00:02:52 Dr Liedl
And so we are just doing a follow up study about that.

00:03:00 Dr Liedl
And as I saw the results, they are very good.

00:03:04 Levi
Okay.

00:03:07 Dr Liedl
Even if you.

00:03:09 Dr Liedl
If you do the joint, the clitoris.

00:03:12 Dr Liedl
There's also a erogeneous sensation in the fallos.

00:03:17 Levi
Right.

00:03:18 Dr Liedl
It's.

00:03:20 Dr Liedl
It is not yet published, but I can say that data are very, very good.

00:03:25 Levi
Okay.

00:03:26 Dr Liedl
Nobody has done it exactly as we do it now.

00:03:28 Dr Liedl


00:03:31 Dr Liedl
This is a point.

00:03:33 Dr Liedl
What to do with the clitoris.

00:03:39 Dr Liedl
In most cases, we integrate the clitoris into the urethra on the backside of the urethra.

00:03:51 Dr Liedl
And so.

00:03:56 Dr Liedl
And you can feel this erogeneous zone through the scrotum.

00:04:01 Levi
Okay.

00:04:02 Dr Liedl
And you can stimulate it, of course.

00:04:08 Dr Liedl
You also could do separate the clitoris and bring it near the base of the penis of the penoid.

00:04:21 Dr Liedl
But mostly most people do not like it.

00:04:26 Dr Liedl
Normal way is to integrate it on the posterior wall of the urethra.

00:04:32 Levi
Yeah.

00:04:33 Levi
And I think I would prefer that.

00:04:35 Levi
But I'm also really scared of losing sexual sensation.

00:04:40 Dr Liedl
Yes, yes.

00:04:41 Levi
But what you're saying is that I don't really have a lot of reason to worry about that.

00:04:47 Dr Liedl
No, don't.

00:04:50 Dr Liedl
Because it's so.

00:04:54 Dr Liedl
[Draws on paper]

00:04:57 Dr Liedl


00:04:57 Dr Liedl
The clitoris is special. Look.

00:05:03 Dr Liedl
At the clitoris.

00:05:04 Dr Liedl
It is about so.

00:05:07 Dr Liedl
So in big one.

00:05:12 Dr Liedl
And you have here.

00:05:13 Dr Liedl
You have here the.

00:05:15 Dr Liedl
As the urethra comes out.

00:05:17 Dr Liedl
This is the clitoris about. What we are doing is we.

00:05:22 Dr Liedl
This part will be dissected, the skin and this part will be in place.

00:05:31 Dr Liedl
And we can bring the clitoris.

00:05:33 Dr Liedl
The clitoris is...

00:05:34 Levi
It kind of buns upwards or..?

00:05:39 Dr Liedl
And so this will be so that you will have.

00:05:51 Dr Liedl
This part comes here.

00:05:53 Dr Liedl
And so you have a wide urethra.

00:05:56 Dr Liedl
I cannot.

00:05:58 Dr Liedl
But we have a technique developed, which is very good for this part.

00:06:04 Dr Liedl
This is intact.

00:06:06 Dr Liedl
This is fully sensated.

00:06:10 Dr Liedl
This also.

00:06:15 Dr Liedl
[Phone rings]

00:06:29 Dr Liedl


00:06:30 Dr Liedl


00:06:33 Dr Liedl
So this is a very good technique.

00:06:36 Dr Liedl
It took a long time, 30 years to look at this.

00:06:42 Levi
About this drawing, you said this is the clitoris.

00:06:47 Levi
Which part is this that you dissect?

00:06:50 Dr Liedl
It's only on the tip.

00:06:53 Dr Liedl
There is here a small.

00:06:56 Dr Liedl
And this is for the urethra.

00:06:58 Dr Liedl
And this has to be... The clitoris is about.

00:07:02 Dr Liedl
About so.

00:07:08 Dr Liedl
And this is then like.

00:07:10 Dr Liedl
Like this.

00:07:13 Dr Liedl
It makes this.

00:07:15 Dr Liedl
And so.

00:07:17 Dr Liedl
And then here is.

00:07:27 Dr Liedl
This is here.

00:07:28 Dr Liedl
Anastomosis.

00:07:29 Dr Liedl
And this is like this.

00:07:32 Dr Liedl
Difficult to explain.

00:07:33 Levi
Yes, I understand.

00:07:34 Dr Liedl
But you can see that this is integrated in the urethra.

00:07:40 Dr Liedl
We spare a lot of tissue of the.

00:07:44 Dr Liedl
Of the clitoris.

00:07:45 Levi
Okay.

00:07:47 Levi
All right, I can go to the next screen question.

00:07:51 Levi
Yes.

00:07:53 Levi
So, with the staging, is scrotoplasty done at the same time as the phallus or is that at the later stage?

00:08:03 Dr Liedl
What we are doing is that we do the phalloplasty.

00:08:08 Dr Liedl
You still have a hysterectomy?

00:08:10 Levi
Yes.

00:08:11 Dr Liedl
So I think I recommend it.

00:08:14 Dr Liedl
Let me look.

00:08:15 Dr Liedl
Let me open it.

00:08:17 Levi
I have had the hysterectomy.

00:08:18 Dr Liedl
Yes, yes, I know the letter and open the letter.

00:08:22 Dr Liedl
What I recommended at the time, long time.

00:08:27 Dr Liedl
So I would as here written, the next step should be the phalloplasty.

00:08:41 Dr Liedl
And we will recontract the urethra.

00:08:45 Dr Liedl
But let the posterior part open and then you can leave hospital without any problems.

00:08:54 Levi
Right.

00:08:55 Dr Liedl
Because there is.

00:08:58 Dr Liedl
We know from all centers there is a risk of fistula, of stricture.

00:09:06 Dr Liedl
There are main points.

00:09:09 Dr Liedl
It's a myertus and it's the anastomosis.

00:09:13 Dr Liedl
And if you go home and if there is a stricture develops, it is no problem.

00:09:23 Levi
Yeah, because I can still pee from...

00:09:26 Dr Liedl
And you can you come three to six months later.

00:09:32 Dr Liedl
Then we do.

00:09:35 Dr Liedl
We reconstruct the urethra.

00:09:36 Dr Liedl
We close the urethra.

00:09:38 Dr Liedl
If there is a stricture, we construct, we make a stricture dissection.

00:09:43 Dr Liedl
In anastomosis we have a very fine technique for mere per stenosis.

00:09:48 Dr Liedl
We do a scrotal reconstruction and sulcus plastic.

00:09:53 Dr Liedl
This is the second part, right?

00:09:55 Levi
Okay.

00:09:56 Dr Liedl
And then normally it is a good.

00:10:04 Dr Liedl
And then the third operation is then the penile implant.

00:10:09 Levi
Yes.

00:10:09 Dr Liedl
So you have three surgeries.

00:10:12 Levi
I have another question about the placement of the clitoris.

00:10:16 Levi
Is that in the scrotum or is it in the penis?

00:10:19 Dr Liedl
In the urethra.

00:10:21 Levi
In the urethra.

00:10:22 Dr Liedl
On the back part of the urethra.

00:10:24 Levi
Okay.

00:10:26 Levi
Okay.

00:10:28 Levi
But how does that, does it, does the urethra go like upwards and then it wouldn't be behind or it's.

00:10:39 Dr Liedl
So you have this, you have, like this, you have the posterior part. [Drawing on paper]

00:10:54 Dr Liedl
Here's the urethra.

00:10:56 Dr Liedl
And this is.

00:11:03 Dr Liedl
And if you make it like so, you have here the urethra.

00:11:07 Dr Liedl
And on the posterior part here you have.

00:11:10 Dr Liedl
You have the urethra.

00:11:13 Dr Liedl
This is a clitoris and this is a urethra.

00:11:17 Levi
Okay.

00:11:18 Dr Liedl
You know, it is embedded here.

00:11:21 Dr Liedl
And like that it is make that.

00:11:24 Dr Liedl
That not.

00:11:25 Dr Liedl
What good is if the clitoris is like this?

00:11:30 Dr Liedl
Because then the flow is disturbed.

00:11:33 Dr Liedl
It has to be flat.

00:11:35 Levi
Right.

00:11:35 Dr Liedl
That is a round lumen.

00:11:41 Dr Liedl
And this is with this technique we have for it, we spare lot of sensation.

00:11:49 Dr Liedl
And also we have a good urethra.

00:11:53 Levi
Okay.

00:11:54 Dr Liedl
This is a technique.

00:11:56 Dr Liedl
It was a process of many years to come to this.

00:12:00 Levi
Okay.

00:12:00 Levi
So what is left of the clitoris after that will be in the base of the phallus, or..?

00:12:08 Dr Liedl
You have.

00:12:14 Dr Liedl
We have the penis.

00:12:17 Dr Liedl
Then you see the urethra going down.

00:12:23 Dr Liedl
You have here the scrotum and the clitoris is about here.

00:12:32 Levi
Okay.

00:12:34 Levi
All right.

00:12:35 Levi
That answers what I was wondering.

00:12:38 Dr Liedl
Okay.

00:12:39 Levi
Okay, let's see.

00:12:41 Levi
My next question is, I would like to keep the vaginal entrance open.

00:12:47 Levi
But the way I understand it, it's going to be smaller and less accessible.

00:12:54 Dr Liedl
You want the vagina to be left open?

00:12:58 Levi
Left open.

00:12:59 Dr Liedl
Okay.

00:13:00 Dr Liedl
It's possible, yeah.

00:13:03 Levi
The way I understand, it will be a lot smaller.

00:13:08 Levi
I heard someone say that it is possible, if it's too small, to have surgery later to open it up.

00:13:14 Levi
Is this something you're familiar with and do?

00:13:18 Dr Liedl
Yes.

00:13:19 Dr Liedl
So we can, if there is a vagina here, if... The problem is this region. Here's the phallus.

00:13:42 Dr Liedl
Here.

00:13:45 Dr Liedl
Here is a risk of fistula.

00:13:48 Dr Liedl
And to prevent a fistula or to repair a fistula, we need tissue from here around flaps.

00:13:57 Dr Liedl
And then there can be a narrowing here.

00:14:00 Dr Liedl
But this narrowing can be prevented by said plastics or repaired by said plastics later.

00:14:11 Levi
Okay.

00:14:12 Dr Liedl
It is no problem.

00:14:14 Levi
That's good to know.

00:14:15 Dr Liedl
Yes.

00:14:17 Levi
Okay.

00:14:18 Levi
What kind of size can I expect?

00:14:21 Levi
On the phallus.

00:14:25 Dr Liedl
We normally do 15 centimeter.

00:14:28 Levi
Okay.

00:14:30 Dr Liedl
15 to 16 centimeter.

00:14:33 Dr Liedl
We did a follow up study about, I think four years later and we had a mean length of all, all complicated included, about 13.5 cm.

00:14:53 Levi
Okay.

00:14:54 Dr Liedl
There's a small shrinkage.

00:14:56 Levi
Yeah, that makes sense.

00:15:00 Dr Liedl
But the normal length of a penis in normal man is stretched or irrigated is 13.5.

00:15:15 Dr Liedl
We have also the mean of normal men.

00:15:18 Levi
So that sounds like it's.

00:15:19 Levi
I can expect a regular size.

00:15:22 Dr Liedl
Yes.

00:15:23 Dr Liedl
And don't.

00:15:26 Dr Liedl
The problem is even that many want to have a big penis.

00:15:31 Levi
Okay.

00:15:32 Levi
Yeah.

00:15:33 Dr Liedl
And how. What's your height?

00:15:37 Levi
170.

00:15:43 Dr Liedl
Yeah.

00:15:43 Dr Liedl
Okay.

00:15:44 Dr Liedl
You are a medium sized man.

00:15:47 Dr Liedl
Okay.

00:15:48 Dr Liedl
Of course.

00:15:48 Dr Liedl
If you are 2 meters, have a bigger penis than if you are perhaps... 160.

00:15:54 Levi
Yeah.

00:15:55 Levi
Proportional.

00:15:57 Dr Liedl
And I have seen people from other centers, they are smaller than you.

00:16:03 Dr Liedl
They have a penis of 18 centimeter and they are unhappy.

00:16:09 Levi
It sounds impractical.

00:16:11 Dr Liedl
Totally impractical.

00:16:14 Dr Liedl
So in some people it is.

00:16:17 Dr Liedl
If you are smaller, perhaps it is better to have only 12 cm in your 13 end is good.

00:16:27 Dr Liedl
I will start at 15, then perhaps you will have.

00:16:33 Dr Liedl
It varies.

00:16:34 Dr Liedl
We have some.

00:16:35 Dr Liedl
They have even after four years, 15 cm.

00:16:40 Dr Liedl
No shrinkage at all.

00:16:43 Dr Liedl
But some have shrinkage and if a complication, then it can be shrink or more.

00:16:48 Levi
Of course.

00:16:48 Dr Liedl
But this is our data, our exact data.

00:16:54 Levi
But that sounds actually quite good.

00:16:57 Levi
So it sounds like you would usually start out with 15 and expect shrinkage down to like 13, 14.

00:17:03 Dr Liedl
Yes, yes.

00:17:04 Levi
Okay.

00:17:04 Levi
That sounds very much for what I'm hoping for.

00:17:07 Levi
So that's good.

00:17:11 Levi
Another question is with the erectile devices, I understand that you have to replace them every certain amount of years.

00:17:19 Dr Liedl
No, don't have.

00:17:21 Dr Liedl
The problem is if there is an infection, then we have to remove the implant.

00:17:32 Dr Liedl
And if there's no infection, it can work many years.

00:17:40 Dr Liedl
I have patients, they come after 20 years and say there's a problem because they said, okay, now is no fluid within the system.

00:17:52 Levi
Right?

00:17:54 Dr Liedl
This is.

00:17:55 Dr Liedl
That can be.

00:17:56 Dr Liedl
And we some months ago was.

00:17:59 Dr Liedl
I know I did surgery in 2000 about and everything good.

00:18:08 Dr Liedl
And now there's no fluid.

00:18:10 Dr Liedl
You have to do a change after 20 years.

00:18:14 Levi
That's a long time.

00:18:15 Dr Liedl
And there are some.

00:18:17 Dr Liedl
You are working more than 20 years, but there is a risk of change because of mechanical problems and so on.

00:18:28 Dr Liedl
And if an infection, we have to remove it, wait three to six months and do a redo.

00:18:35 Levi
Okay.

00:18:36 Levi
What are the consequences of changing the implants?

00:18:40 Levi
Will there be a lot of extra scarring or can it damage any tissue?

00:18:44 Dr Liedl
No, no, it's easy.

00:18:46 Levi
So it's routine.

00:18:47 Dr Liedl
We have a routine.

00:18:48 Dr Liedl
We have a big experience about that.

00:18:52 Levi
Okay, that's great.

00:18:54 Levi
I'm almost done with the questions, but I was wondering, the scrotoplasty type that you do, does it have a name, the method that you use?

00:19:04 Dr Liedl
We didn't publish it.

00:19:06 Levi
Okay.

00:19:06 Dr Liedl
But it contains two principles.

00:19:10 Dr Liedl
First is the laba majora in female goes back to 4 cm before the anal canal.

00:19:23 Dr Liedl
The scrotum goes to five to 6.

00:19:29 Dr Liedl
Perineum is very big.

00:19:31 Dr Liedl
In male, five to six centimeter.

00:19:34 Dr Liedl
So we do a vau incision and do it then, like ypsilon and close this. [Draws on paper]

00:19:58 Dr Liedl
Then we bring up.

00:20:00 Dr Liedl
This is the posterior part of the scrotum.

00:20:03 Dr Liedl
This is one important point. [Taps on drawing].

00:20:07 Dr Liedl
Vau ypsilon plastic.

00:20:11 Dr Liedl
It's a classical part of surgeon.

00:20:13 Dr Liedl
And the second most important part that we do in the labia majora, there is a fatty tissue, has a name.

00:20:25 Dr Liedl
It is a bulbous fungiosus fatty tissue.

00:20:30 Dr Liedl
And this is when, with the urethra closure, we bring it.

00:20:38 Dr Liedl
It's a midline.

00:20:41 Dr Liedl
And then we have here the urethra.

00:20:45 Dr Liedl
And we have here like this.

00:20:50 Levi
Okay.

00:20:51 Dr Liedl
The midline is brought up.

00:20:54 Dr Liedl
And then after three months, we do incision here and go through and bring it up.

00:21:04 Dr Liedl
And then you have a situation like this.

00:21:06 Dr Liedl
You have here.

00:21:08 Dr Liedl
And we have here the implant.

00:21:15 Dr Liedl
And you close it here also here.

00:21:19 Dr Liedl
Then you have here, here the suture.

00:21:23 Dr Liedl
And you have here a wonderful scrotum.

00:21:26 Dr Liedl
This is our technique.

00:21:29 Dr Liedl
You have to publish it.

00:21:30 Dr Liedl
I will publish it.

00:21:31 Levi
Okay.

00:21:33 Levi
So I can expect it to be further in the front than the majora?

00:21:39 Dr Liedl
This is very important.

00:21:40 Dr Liedl
Since we do this in several years.

00:21:46 Dr Liedl
There's no problem.

00:21:48 Dr Liedl
In the past we had problems that one testicle goes up, one goes to back.

00:21:55 Dr Liedl
Then it's all.

00:21:56 Dr Liedl
And with this preparation, the testicle has a fixed place where it stays and there is no problem anymore.

00:22:08 Levi
That sounds good.

00:22:09 Dr Liedl
It also 20 years development was a long time to have all this developed.

00:22:16 Levi
That's good for me.

00:22:18 Levi
Okay, last question.

00:22:20 Levi
I was wondering.

00:22:21 Levi
I have started doing electrolysis on my arm.

00:22:23 Dr Liedl
Yes.

00:22:24 Levi
I was wondering how high up should I go and which areas should I...

00:22:27 Dr Liedl
The most important thing is this part.

00:22:30 Levi
That's the urethra part?

00:22:32 Dr Liedl
Yes, this part is important, but you don't have many hairs here.

00:22:37 Dr Liedl
This is not so important here.

00:22:39 Dr Liedl
This part is important here.

00:22:41 Dr Liedl
Perhaps this, you could...

00:22:42 Levi
This area here?

00:22:44 Dr Liedl
Yes, yes.

00:22:46 Levi
I'm thinking, generally, I want to be hairless down there.

00:22:51 Levi
So if I remove, like, how far down should I go?

00:22:58 Levi
If I do all of this.

00:23:05 Dr Liedl
[Measures tape from wrist down the arm]

Into here.

00:23:06 Levi
Okay, so just measure 15 cm down from the wrist.

00:23:10 Dr Liedl
Yes.

00:23:11 Levi
Okay then I think that is all my questions actually.

00:23:18 Levi
So thank you for answering that.

00:23:22 Levi
Do you know approximately how long I can expect to be on the waitlist?

00:23:27 Dr Liedl
You are on the waiting list still or.

00:23:29 Levi
Yes.

00:23:35 Dr Liedl
It be done on September 23.

00:23:41 Dr Liedl
You can phone.

00:23:44 Dr Liedl
You can phone with the patient management orders or email and say that you were here on the 5 November 5th.

00:24:02 Dr Liedl
September.

00:24:05 Levi
I thought I was in April.

00:24:08 Dr Liedl
I fear.

00:24:09 Dr Liedl
Yes, April.

00:24:10 Dr Liedl
Yes, you're right.

00:24:12 Dr Liedl
April and 3 April 3rd.

00:24:20 Dr Liedl
They can look at here my 3 April and write them.

00:24:31 Dr Liedl
When are you scheduled?

00:24:35 Dr Liedl
When I.

00:24:36 Dr Liedl
At what time?

00:24:37 Dr Liedl
I'm scheduled for phalloplasty.

00:24:39 Dr Liedl
Yes, I was here at.

00:24:43 Dr Liedl
No, another point.

00:24:46 Dr Liedl
It's starting from when you have everything here.

00:24:54 Dr Liedl
This was here, but do we have this one?

00:25:10 Dr Liedl
We need a certificate of your psychotherapist.

00:25:17 Levi
Okay.

00:25:18 Levi
I thought I had given you that already.

00:25:20 Levi
Maybe I.

00:25:27 Dr Liedl
Don'T have it.

00:25:29 Dr Liedl
Okay, you can mail it to us.

00:25:31 Levi
I can mail it again.

00:25:33 Levi
Should I mail it by post?

00:25:34 Levi
Maybe instead of email as you want?

00:25:37 Dr Liedl
Post or email as you want?

00:25:41 Levi
Yes, I will get to that.

00:25:43 Levi
Is there something special that needs to be in that situation?

00:25:46 Levi
Because I have one certificate that says I have gender incumbrance diagnosis and I fulfill the criteria for fallopian.

00:26:30 Dr Liedl
Give the letter again.

00:26:32 Dr Liedl
And here.

00:26:39 Dr Liedl
This is important.

00:26:43 Dr Liedl
It can be short, but short communication.

00:26:49 Dr Liedl
First, the diagnosis gender disorder.

00:26:55 Dr Liedl
Second, if there are other psychological disturbances.

00:27:04 Dr Liedl
And there should be what you want with surgery that you are informed about the diagnosis, informed about alternative treatments.

00:27:24 Dr Liedl
You have to be fully informed about everything.

00:27:27 Dr Liedl
This is.

00:27:29 Dr Liedl
And this should be written by the psychiatrist and so on.

00:27:34 Levi
Okay.

00:27:35 Dr Liedl
This is part of the s three guideline.

00:27:38 Levi
Right.

00:27:41 Dr Liedl
And of also this is important.

00:27:44 Dr Liedl
And it can be very short.

00:27:48 Dr Liedl
One page about.

00:27:49 Levi
But it has to have those points.

00:27:50 Dr Liedl
Yes.

00:27:50 Dr Liedl
And perhaps that your insurance.

00:27:55 Levi
Yeah, I am paying for it myself.

00:27:58 Levi
Okay.

00:27:58 Dr Liedl
Then it's no problem.

00:27:59 Levi
Okay, thank you.

00:28:02 Levi
I will get right.

00:28:04 Dr Liedl
Okay.

00:28:04 Dr Liedl
Okay.

00:28:06 Levi
Thank you so much.

00:28:07 Dr Liedl
Another point.

00:28:08 Dr Liedl
What would be important for treatment?

00:28:12 Dr Liedl
We need information if you have any resistances against anti.

00:28:22 Dr Liedl
Antibiotic.

00:28:23 Dr Liedl
Antibiotic?

00:28:23 Levi
Yes.

00:28:24 Dr Liedl
And we could do a swab from the anal canal to look if there's any that can be doing in Norway.

00:28:36 Levi
Yeah, I can ask my regular doctor.

00:28:39 Levi
Okay.

00:28:41 Dr Liedl
And the swab from the nose.

00:28:43 Dr Liedl
There's a staphylococci.

00:28:45 Dr Liedl
And the anal canal there are the gram negative and positive from the.

00:28:55 Dr Liedl
From the bowels.

00:28:56 Levi
Okay.

00:28:57 Dr Liedl
Okay.

00:28:57 Levi
I will write that down.

00:28:59 Dr Liedl
Okay.

00:28:59 Levi
I get my doctor to.

00:29:02 Dr Liedl
You can do it today.

00:29:03 Dr Liedl
But it is expensive.

00:29:04 Levi
Yeah, yeah.

00:29:05 Levi
No, I'll do it.

00:29:05 Dr Liedl
Do it.

00:29:06 Levi
It's free in Norway.

00:29:07 Levi
Okay.

00:29:07 Dr Liedl
Okay.

00:29:09 Dr Liedl
Okay.

00:29:09 Dr Liedl
Goodbye.

00:29:10 Levi
Thank you so much.

00:29:11 Levi
Goodbye.


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