Introduction

The aim of this page is to help you by: 

• explaining the treatment advised for you by medical staff
• providing sources of further information and support

An ectopic pregnancy is naturally an emotional time, and we wish to support you as much as we can. This leaflet helps to explain treatment and includes additional places for you to access information and support.

Whilst we are treating you, it is very important to let us know if your symptoms change. Some women develop worsening pain; shoulder pain; diarrhoea, heavy bleeding or dizziness. An ectopic pregnancy whilst being closely monitored can increase in size and cause you to be unwell, so we may need to reassess you – this is why it is important to let us know of any change in your health. 

Medical management (methotrexate)

Medical management of ectopic pregnancies is widely used and avoids the need for surgery, but it has specific guidance for use, and is not always the correct treatment for you. It cannot be used:

• in ruptured ectopic pregancies
• in larger ectopic pregnancies
• where hormones are above the suggested limit for using medical treatment
• where your liver and kidney function are not normal
• where your blood count / blood results are not normal (e.g. where you are anaemic)
• in any cases where you would be unable to attend for the necessary follow up after treatment

What is methotrexate?

It is from the family of cytotoxic (chemotherapy) drugs and is used for a number of conditions e.g. arthritis, cancer etc.

Please do not be frightened by this as although it is a chemotherapy drug, in early pregnancy it is used in very small doses. The injection works by destroying cells that grow quickly (in your case - stopping the cells of the pregnancy) leading to the pregnancy being absorbed. We assess this by your clinical symptoms (how you feel physically) and watching hormone results drop after treatment. In some instances where we cannot be clear that the ectopic is resolving, you may require a second dose of medication.

What are the advantages of methotrexate?

• It has a good success rate for treating small ectopic pregnancies (more than 90 in 100).
• Avoids surgery & the associated risks of having a general anaesthetic.
• It offers the best chance of maintaining fertility after treatment.
• You do not have to stay in hospital.

What are the disadvantages of methotrexate?

• It can take several weeks to complete the treatment.
• Side effects of the drug itself can occur (though rarely), such as:
  • nausea
  • vomiting
  • diarrhoea
• Abdominal cramps 3 to 7 days after treatment, and some vaginal bleeding are common side effects after having methotrexate.
• There may be some mild, temporary, abnormalities in liver function blood tests which you are unlikely to be aware of.
• Repeated visits to the hospital are essential (for blood tests).
• You may require a second dose of the drug.
• You are advised to wait a minimum of 3 months before trying for a future pregnancy. If you have 2 doses of treatment you are advised to wait 6 months. 
• You are sometimes more vulnerable to infection (if you come into contact with someone with the flu/common cold etc).

Why have I been offered this treatment?

On the basis of your tests we think that your problem is unlikely to resolve without further treatment. We do, however, think it is likely that you will respond to this particular form of treatment.

How is the drug given?

It is administered by a suitably trained doctor or nurse into the large muscle of the buttock or thigh.

After the drug has been given

Provided you are feeling well, you will be allowed home shortly after having the drug.

A small number of women require a further dose of the drug, and this would be given in the same way.

After you go home it is important to notify us with any changes in how you feel; especially if you have:

• any increase in pain
• pain somewhere you have not previously had it, or paracetamol does not help your pain
• you feel faint or dizzy, or develop shoulder tip pain

Is there anything I must avoid for the duration of my treatment?

Yes. It is important you avoid the following:

• unprotected sexual intercourse (sex)
• alcohol
• folic acid and vitamins, as they may interfere with treatment
• exposure to the sun/sunlamps
• herbal remedies should be discussed with your doctor

If methotrexate is not successful, or if you become more unwell, then surgery may be required.

Why should I avoid alcohol?

The liver metabolises (sorts out) toxic (strong) drugs, which includes alcohol. The liver will already be working hard, and it is important to make its job as easy as possible, especially as the drug you are being given needs the liver to work well.

It is important to avoid alcohol for a minimum of 7 days, at which point your liver function will be checked. However, as methotrexate has been found in the liver for up to 100 days after treatment, some research suggests that it is sensible to avoid alcohol until you are discharged after treatment.

Why must I avoid the sun exposure/sun lamps?

Use of methotrexate can cause dermatitis - a skin condition, and this would be worse if exposed to the sun or sun lamps. These should be avoided for about 4 weeks, by which time the drug should be minimally active with minimal risk to skin reactions.

Follow up:

You will need close observation for several weeks, including blood tests on days 4 and 7.

At this point we will know if the medicine has helped. There may be times when a second injection is needed. As soon as your blood tests show that the hormone (HCG) is dropping well, a weekly blood test is needed until the hormones return to normal. Follow up does vary in number of visits required as the blood tests can go back to normal quickly, or more slowly. 

We understand that sometimes it can be frightening being at home. Please do not hesitate to contact us on the numbers at the end of this leaflet if you are unwell or have any questions.

Frequently asked questions

Will I have any vaginal bleeding?

Yes. This can vary from dark brown spotting to heavier bright red loss. Use sanitary towels rather than tampons whilst you are bleeding, to reduce the risk of any infection. 

If you are concerned that the bleeding is excessive (requiring you to change a sanitary pad every half an hour) please telephone the ward for advice.

Can I have a bath/shower during my treatment?

Avoid hot baths if you are bleeding heavily, as you may feel dizzy. Otherwise it is safe for you to have a warm bath or shower.

Should I be off work during the treatment?

This is a very individual thing. However it is stressful having treatment, and you are recovering from the difficult news that this pregnancy will not continue. Many women feel that at least a few days off work may be necessary, and some take a lot of time off as they adjust to a change in circumstances (with the loss of the pregnancy). You can self-certificate for the first week off work, alternatively the staff in early pregnancy clinic or the doctor on the ward will provide you with a sick certificate (fit note).

When can I expect a period?

Every woman is different, and this will depend on the length of follow up you have needed. Within four weeks of your bloods returning to normal is usual, and your period may be different  (heavier or lighter); again this is nothing to be concerned about, unless the bleeding is very heavy, in which case consult your GP.

How long must I wait before trying to become pregnant again?

At least three months. If you have had more than one dose of Methotrexate this will be extended to six months. This ensures that all of the Methotrexate has left your body with no effect on future pregnancies.

During this time it is advisable to use condoms or alternative contraception.

What happens when I do become pregnant again?

If you suspect you may be pregnant:

• do an early urine pregnancy test at home
• you will be given an open access referral for the clinic, and can attend once you are 6-7 weeks pregnant in the future for an early scan
• you can self refer to the early pregnancy clinic if you have pain before 6 weeks or need a scan after 6 weeks (having had a previous ectopic we will scan you early in a future pregnancy)
• if you have abdominal pain in early pregnancy before this time, please call us in early pregnancy clinic as we will see you sooner

The future

Any preconception care you have been following should continue, once it is safe for you to try and become pregnant again such as:

• taking folic acid
• reducing your alcohol and caffeine intake
• ceasing smoking
• healthy eating

If you are unsure whether you wish to try for a future pregnancy, it is advisable to consider your contraceptive needs during this time.

We hope this information leaflet has been helpful.

If you have any further concerns, please contact the staff on Cotswold Ward, or the staff in Early Pregnancy Clinic, at Southmead Hospital.

Further help and advice

Date published: 16 June 2026 Review due: 30 June 2029 PI number: BFT002435
 

Skin care advice following radiology procedures

You have had a specialised X-ray procedure. During this a small patch of your skin may have been exposed to radiation for a long period of time; this can cause changes to the skin.

The changes depend on which area of the body the X-rays were pointing at (for example the head or the back), and the length of the procedure.

Skin reddening (also known as erythema)

This is the first sign that the small patch of exposed skin has been affected. This looks like sunburn and can feel warm, sensitive, and tight. This can happen anything from the first 24 hours up to 2 weeks later.

Temporary hair loss

This may also start up to three weeks following your procedure, depending on the exposed area of skin.

If you have any of these symptoms, please contact the Imaging department and your referring consultant to let us know. We may need to arrange a follow up appointment.

Further recommendations

• Apply a creamy moisturiser (for example Epimax) sparingly to the affected skin. You can buy this or something similar from your pharmacist. Do not apply the cream to broken skin.
• Wash skin with lukewarm water and pat gently dry.
• Whilst you still have symptoms, wear loose cotton clothing (if skin damage is to the body) and try to let air circulate around the affected area.
• Protect any affected skin from direct sunlight.
• If you contact your GP about this issue, please itell them about your radiology procedure.
• If you are required to have any further X-ray procedures within 14 days, please let the hospital staff know.

References

© North Bristol NHS Trust. This edition published February 2025. Review due February 2028. NBT002791

Your doctor has requested that you have a myelogram. We hope that the following information will answer some of the questions you may have about this examination.

What is a myelogram?

A myelogram is an X-ray examination of the spinal cord and the space surrounding it. It provides a very detailed picture of the spinal cord and spinal column and of any abnormalities that may be present such as herniated or ruptured intervertebral disc.

Contrast medium (or ‘X-ray dye’) is injected via a small needle into the lower part of the spine. This is done by a radiologist (a doctor who specialises in X-rays used for diagnosis) into the fluid filled space around the spine called the subarachnoid space. This is called a lumbar puncture or LP.

The table used for a myelogram can be tilted so that contrast medium will run up and down within this space and surround the nerve roots that enter and exit the spinal cord.

Images are then taken as the contrast medium flows into the various areas of the spine. Far more information can be obtained from a myelogram than from plain spine X-rays.

Why do I need to have a myelogram?

A myelogram is performed when other tests such as Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) have not provided enough information, or when patients cannot have an MRI for any reason.

How do I prepare for the examination?

It is important that you drink plenty of fluids before your myelogram to help remove the contrast medium from your body and to prevent headache. You may also eat light meals prior to the procedure.

If you are on any medication which thins the blood (e.g. aspirin, clopidogrel, warfarin, rivaroxaban, apixaban, dabigatran) we ask you to call the Imaging department on the number on your appointment letter as we may need to adjust your medication before undergoing this procedure. 

These may need to be adjusted to keep the risk of bleeding to a minimum.

On the day of the procedure

You will arrive at the Imaging Department (Gate 19) and be accompanied to our day case area.

Please inform us if you have any allergies or if you think there is a chance you may be pregnant. 

You will then be asked to change into a hospital gown.

Once all the checks have been performed, you will be taken to the X-ray room on the trolley. There will be a doctor, radiographer and imaging support worker with you throughout the procedure. 

What will happen during the procedure?

• Before the examination begins, the radiologist will explain what they are going to do. You will be given the opportunity to ask any questions you may have.
• If you are happy to proceed you will be asked to sign a consent form.
• You will then be asked to lie on your front on the X-ray couch.
• The skin on your back will be cleaned and a small amount of local anaesthetic will be injected under the skin. This stings for a few seconds and the area then goes numb.
• A very fine spinal needle will be guided into the correct place using the X-ray machine. If needed, a small amount of cerebral spinal fluid can be withdrawn for laboratory studies.
• When the contrast medium is injected, you may feel slight pressure. It is common to experience heavy legs and a momentary increase in symptoms. Headache, flushing or nausea are other symptoms you may experience following the contrast injection.
• The X-ray table is slowly tilted to different angles and X-ray pictures are taken. Rests and straps (or supports) will keep you from sliding out of position.
• A CT scan is often performed after the myelogam while contrast is still present in the spinal canal. You will be brought to the CT scanner on the trolley.

Are there any risks associated with a myelogram?

Generally it is a very safe procedure. Potential complications are uncommon and include:

• Bleeding or haematoma (a bruise under the skin) around the injection site. (This should settle down by itself).
• Infection. Contact your GP if you experience any redness or tenderness at the injection site.
• An allergic reaction to the contrast medium. (RCR 2015). Please inform the radiologist performing the myelogram if you have any allergies.
• Headache (see information about this below).

X-rays are used in this procedure but with modern equipment the risk is low (NRPB 2014).

It is important that patients inform the Imaging Department if there is any possibility of pregnancy before attending for the examination.

Will I experience any serious side effects?

Serious side effects are rare but you should notify your GP if you experience:

• A high fever
• Excessive nausea and vomiting
• Severe headache for more than 24 hours
• Neck stiffness
• Numbness in your legs
• Trouble urinating or passing a stool.

Who interprets the results and how do I get them?

The results will not be available at the time of your myelogram.

The radiologist, who performed your myelogram, will examine your images in detail and forward a report to the doctor who referred you for the myelogram. You will be able to get the results from this doctor.

We hope this information is helpful. If you have any questions either before, during or after the procedure, the staff will be happy to answer them.

References

© North Bristol NHS Trust. This edition published July 2023. Review due July 2026. NBT002598

What is a varicocele embolisation?

A varicocele is an abnormality of the veins that take blood away from the testicle. The veins become bigger and more obvious, rather like varicose veins in the leg.

Embolisation is a way of blocking these veins. This makes them less obvious and causes the varicocele to disappear without an operation.

Who has made the decision?

The consultant in charge of your care and the radiologist carrying out the varicocele embolisation will have discussed your symptoms. They feel that this is the best treatment option. You will also have the opportunity for your opinion to be taken into account and if, after discussion with your doctors, you do not want the procedure carried out then you can decide against it.

Who will be performing the varicocele embolisation?

A specially trained doctor called a radiologist. Radiologists have special expertise in using X-ray equipment and also in interpreting the images produced. They need to look at these images while carrying out the procedure.

Where will the procedure take place?

This will take place in the Imaging Department, Gate 19, as described in your appointment letter.

What happens before the procedure?

• You will need to have a blood test a few days before the procedure to check your kidney function, that you are not at increased risk of bleeding and that it will be safe to proceed. This may be arranged to take place at your GP surgery.  
• You can continue taking your normal medication.
• If you are on any medication which thins the blood (e.g. aspirin, clopidogrel, warfarin, rivaroxaban, dabigatran, apixaban) we ask you to call the Imaging Department using the number on your appointment letter as we may need to adjust your medication before undergoing this procedure.
• You will also need to make sure that you have somebody to bring and collect you from the hospital, as you will not be able to drive immediately after the procedure.
• You must also ensure that there is a responsible person to be with you after and during the first night following the procedure in case you have any difficulties.

On the day of the procedure

• You should not eat anything from 4 hours before your procedure but you may continue to drink water.
• You will arrive at the Imaging Department, Gate 19, and be accompanied into our day case area.
• You may take your normal medication unless instructed otherwise.
• Please inform us if you have any allergies.
• A radiologist will discuss the procedure with you. You will have an opportunity to ask questions about the procedure and your treatment. If you choose to have the procedure you will need to sign a consent form.
• You will be asked to change into a hospital gown and a small plastic tube (cannula) may be put into a vein in your arm to allow us to administer medications or intravenous fluids during the procedure.
• Once all the checks have been performed and consent signed, you will be taken to the angiography suite on the trolley. There will be a nurse, radiographer and a radiologist with you throughout the procedure.

During the procedure

• You will need to lie on your back on an X-ray table for the duration of the procedure.
• The skin near the neck or groin will be cleaned with an antiseptic solution and covered with sterile drapes.
• Using an ultrasound machine, the radiologist will then inject local anaesthetic into the skin and deeper tissues over the neck or groin. This will briefly sting and then go numb. Most people will feel a pushing sensation.
• A catheter (thin tube) is guided into the testicular vein with the help of the X-ray machine. Small, metal coils are then used to block off the abnormal testicular vein.
• Once the procedure is complete, the radiologist will remove the catheter and press gently on the entry site for a few minutes to prevent bleeding.
• The whole procedure will take around 40-60 minutes although treating both sides will take longer.

What to expect after the procedure

• You will be taken back to the day case unit, so that nursing staff may monitor you closely. They will let you know when you can eat, drink and mobilise.
• If you are feeling okay and your checks are normal, you may go home.

Are there any risks or complications?

Varicocele embolisation is a very safe procedure, but there are some risks and complications that can arise:

• There may occasionally be a small bruise around the site where the needle has been inserted. This is quite normal and should improve itself in a few days.
• It is possible that the site of injection may become infected. Contact your GP if you notice any redness
  at the injection site as this may need treatment with antibiotics.
• Some patients experience mild discomfort in the left flank (lower left part of your back) for a day or two, needing no more than simple painkillers, if anything.
• There is always the possibility that, although the varicocele seems to have been cured to start with, months or even years later, it may come back again. If this happens, then the procedure may need repeating or you may be advised to have an operation.

Despite these possible complications, the procedure is normally very safe and is performed with no significant side effects at all.

What about the metal coils?

The coils are made of platinum and look a bit like light bulb filaments. They will show up whenever you have an X-ray or CT scan but will not activate airport metal detectors. As they do not contain iron, it is safe should you ever need a Magnetic Resonance Scan (MRI).

Further information

We hope this information is helpful. If you have any questions, either before or after the procedure, the staff in the Imaging Department will be happy to answer them. The telephone number for the Imaging Department can be found on your appointment letter. 

Reference

British Society of Interventional Radiology (2011) “Varicocele embolisation Patient information”. BSIR - British Society of Interventional Radiology Accessed on 15/05/2020

© North Bristol NHS Trust. This edition published July 2023. Review due July 2026. NBT002077

HIV Medicine Service

The North Bristol NHS Trust HIV Service is based at Southmead Hospital, Bristol.

An HIV test can be done in many different healthcare settings, including at the GP or Bristol Sexual Health Centre. Early diagnosis and treatment has many health benefits. Where there are particular concerns around HIV testing, our team would be happy to discuss this.

Where patients are known to be HIV positive they should be referred to the HIV specialist nurses via email at brecon.nurses@nhs.net, which is also our preferred route for non-urgent HIV related queries.

If there are patient HIV related queries for the HIV team at North Bristol NHS Trust (Southmead) then we would prefer that patients email brecon.nurses@nhs.net, or alternatively phone 0117 414 6400 if they cannot email.

For confidential HIV testing and sexually transmitted infection (STI) screening visit https://yunosexualhealth.co.uk/. Patients may order free STI testing kits online for home use (if aged 16 or over and living in Bristol, North Somerset or South Gloucestershire). For some people it may be more appropriate to get an HIV test in a sexual health clinic.

Acutely ill HIV patients should be discussed with the HIV team or the hospital HIV on-call team for admission, contactable via switchboard at Southmead.

Conditions Treated:

•    Suspected acute HIV infection.
•    Post-Exposure Prophylaxis after Sexual Exposure to HIV (PEPSE) - referrals taken from other healthcare providers.
•    Chronic HIV infection.

Note this service is only for patients living with HIV and for those referred from other healthcare providers for continuation/discontinuation of PEPSE.

Appointment Clinic Times are

Monday 12.30 – 16:00
Tuesday 14:00 – 17:30
Wednesday 12.30 – 16:00
Thursday 08:00 – 11:30

HIV Medicine Team

Specialty Director

Dr Philip Bright - Lead Clinician
Telephone (secretary): 0117 414 6395

Consultants

Dr Megan Jenkins
Dr Ankur Gupta-Wright
Dr Alexander May
Dr Bret Palmer
Dr Sathish Thomas-William
Dr Adele Wolujewicz

Clinical Nurse Specialists/Health Advisors

Liz Williams
Lizzie Richards
Phoebe Byrne

Specialist Pharmacists

Joanna Latimer
Arianwen Denham

Research Nurses

Louise Jennings – Lead
Andrea Watts
Sally Tillett
Rebecca Croydon

Medical Secretaries

Tel: 0117 414 6394
Danielle Coombs
Sharon Hemming
Bozena Zelazowska

Database Manager 

Chloe Whitlock

Management Team

Christina Fletcher
Nia Jenkins-Welch
Laura Webb

HIV Medicine Service Useful Links

The team at NAM (National AIDS Manual) produce and distribute accurate, up-to-date and evidence-based resources (printed, electronic, audio and online), covering both the medical and social aspects of HIV, to people living with HIV and to those who work to treat, support and care for them. Visit Aids Map for more information.

A medicines interactions checker is available.

A charity called Brigstowe, based in Bristol, are dedicated to the help of patients living with HIV. As well as lots of information about HIV Brigstowe offer the following to patients living with HIV:

• A one-to-one advice and support service.
• A migrant and asylum service.
• Group peer support and a range of group workshops.
• One-to-one peer support.
• Clinic peer support.

Please contact Brigstowe on 0117 955 5038 or visit Brigstowe for further information, advice and support.

Peer support at clinic is provided by Brigstowe peer mentors to patients living with HIV. These are trained volunteers, also living with HIV, who will meet patients in a safe and confidential space at clinic. They can:

•    Check in with patients about appointments and any concerns patients may have.
•    Chat with patients about treatment and managing side effects.
•    Be a listening ear.
•    Let patients know how Brigstowe can help.
•    Share their own experiences and knowledge of living with HIV.
•    Share coping strategies.

Last updated 18/07/25

The Workforce Disability Equality Standard (WDES) is a set of ten specific measures (metrics) which enables NHS organisations to compare the workplace and career experiences of Disabled and non-disabled staff.  NHS trusts use the metrics data to develop and publish an action plan. It will enable us to demonstrate progress against the indicators of Disability equality.

Making a difference for Disabled staff

The WDES enables us to understand the experiences of our Disabled staff and support positive changes for all existing employees. NBT is committed to creating a more inclusive environment for Disabled people working and seeking employment in our Trust.

2023

2020/2021

"The actions plans are still in draft format as we are still working with our relevant staff networks and other stakeholders to finalise them in due course"

Video 1 - Sensing location

In sitting with your eyes closed ask a friend/ carer to touch your bare arms. Try to sense and point to which area was touched. Does the feeling vary between your arms and with different locations touched? Are you accurate in sensing the area touched? Repeat the process as often as able.

Video 1 - Ball throwing and catching in sitting

In a seated position, throw a ball up in the air in front of you and catch it. Ensure you are catching two handed or with your affected arm. Try to control the pace and direction of the throw to keep it close enough to catch. Tip: To make the exercise harder try using a smaller ball or catching one handed.

Video 2 - Ball throwing and catching in standing

Position yourself standing up. Practice throwing and catching a ball with both hands.

Video 3 - Standing eyes closed

Standing with your feet shoulder width apart stand with your eyes closed. Gradually try to increase the time to which you can tolerate without having to adjust your feet.

Video 4 - Standing eyes open on unstable surface

Standing with your feet shoulder width apart on an unstable surface (Cushion, wobble board). Gradually try to increase the time to which you can tolerate without having to adjust your feet. Try to imagine a glass resting on the cushion / wobble board, you are aiming to keep your weight evenly spread so a glass wouldn’t fall over.

Video 5 - Standing eyes shut on unstable surface

Standing with your feet shoulder width apart on an unstable surface (Cushion, wobble board) stand with your eyes closed. Gradually try to increase the time to which you can tolerate without having to adjust your feet.

Video 6 - Perch STS

For this you need to find a high chair, or bed that allows you to sit “perched” on the edge. The idea is that you are in a position that is in-between sitting and standing. This makes standing up easier. Set your self a target of how many of these you want to do in a row and when you are finding it easy you might progress to STS from a normal height chair.

Video 7 - Single leg stand

Stand next to a kitchen counter. Hover your hands over the counter, and shift your weight on to your affected leg. Maintain this single leg pose for as long as possible, without use of your hands for balance.

Video 1 - Finding objects

Using a bowl of rice bury small household objects. With your eyes closed dig around and try to pick the objects out. As an extra challenge try to identify the objects before you open your eyes.

Video 2 - Light touch vs deep touch massage

Video 3 - Position testing

Sitting down with your eyes closed, ask a friend to move your strongest arm into a position. With your eyes still closed mirror the same position with your other arm. Keeping your arms in position open your eyes, are your arms held in the same position? 

Video 4 - Rice-bean bowl exercise

Put some rice or dry beans in a bowl. Using a pair of tweezer try to pick the individual grains up and transfer them to another bowl.
Tip: the smaller the beans are the more difficult it gets

Video 5 - Sensing temperature

In sitting with your eyes closed ask a friend/ carer to touch your bare arms. Try to sense and point to which area was touched. Does the feeling vary between your arms and with different locations touched? Are you accurate in sensing the area touched? Repeat the process as often as able.

Video 6 - Sensory re-education of textures

Look around your home and pick a variety of objects with differing textures. Rub them over both the palm and the back of the hand affected by sensory loss, or impairment. Make sure to go over the finger tips and sides of fingers as well. This will help to stimulate sensation messages to the brain. Close your eyes and see if you can guess what is being used. Try textures such as cotton wool, a flannel, velvet, hair brush/comb, tooth brush, a tooth pick, Velcro, fleece, a woollen jumper etc

Video 7 - Stereognosis Box

Select some smallish items from around your house. Put them in a box and cover with a pillow case (this is so you can’t see what you are touching). Reach your hand into the box, without looking and feel for an item. See if you can work out what it is just from how it feels in your hand. Is it heavy or light, smooth or rough? Manipulate it in your hand to try and touch every part of it to help you work out what it could be. Once you think you know the answer, pull it out and see if you are correct! You can make this harder, by putting small items in rice and then feeling around in the rice for the objects and trying to work out what they are before looking.
 

Video 8 - Functional UL tasks – applying hand cream

Video 1 - Doing up laces

In a seated position, tie up the laces on both your shoes. Afterwards, untie them again. If it is too difficult to reach down to your feet, you can place some shoes on a table in front of you.

Video 2- Holding and sensing objects

Ask a caregiver when your eyes are closed to place everyday objects one at a time into your hand. Spend several seconds feeling the item, the texture, weight and temperature. Try to guess what the item is. Note down how many you’re able to identify.

You can do this on your own by feeling everyday objects in your affected hand with your eyes closed and concentrating for several seconds on how they feel.

Video 3 - Holding weights

In sitting with your eyes closed ask a caregiver to place a light object into your hand. Try to sense the weight of the object for a few seconds. Next switch to a heavy item, again feel its weight. Repeat the sequence; try to determine which object is heavier.

Video 4 - Picking up coins

Sit at a table with some coins laid out in front of you. Stack the coins with your affected hand. Then carefully remove them one by one.
Tip: You can vary the difficulty by using bigger or smaller coins.

Video 5 - Pouring water

Sit a table with two cups, one empty and one with some water in it. Hold the empty cup in your affected hand and the cup with water in the other hand. Pour the water back and forth between the cups, trying to keep both cups steady and not spilling any.
Tip: You can vary the amount of water in the cup to adjust the difficulty.

Video 6 - Ripping paper

Take some scrap paper. Practice picking the paper up with your affected hand and arm. Then ripping it into strips. Practice doing it with your affected hand and arm doing the ripping action and then holding it still while the unaffected side does the ripping

Video 7 - Undoing and doing up zip

Sit in a chair wearing a zip up top or coat. Practice zipping up and down the top. Make sure to completely unzip and unfasten the zip each time.

Video 8 - Undoing and doing up buttons

Sit in a chair wearing a button up shirt. Practice buttoning up and buttoning down the shirt. Make sure buttons go in the correct hole.
Tip: You can vary the difficulty by using shirts with bigger or smaller buttons.

Video 9 - Using scissors

If your dominant hand has been affected. Take a pair of scissors and practice cutting paper. Start by just cutting simple strips, but make it harder by cutting out pictures and shapes to gain better control.

Video 10 Functional UL tasks – cutting up

Position yourself at a table, ensure that the plate or chopping board is secure. Using a knife and folk practice cutting up softer items such as a banana or bread and progress to cutting up tougher textures such as toast.