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:
- Første konsultasjon med UKMP
- Første konsultasjon med Dr. Lubos Kliniken
- Andre konsultasjon med Dr. Lubos Kliniken
- Andre konsultasjon med UKMP
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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