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Things that make me go hmmm


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I may have shared this but I had an old boy come in telling me he needed his SI joints fused for his low back pain because he watched a youtube video and that what they said. OK.... not totally crazy idea so I ordered the appropriate tests and kicked that can down the road.

Before leaving he says about 10 years ago he got a bug caught in his ear and it took a couple of days to get out. Now his ear itches sometimes and can I give him something for parasites? Think the bug laid eggs in there or something.

Get your Ivermectin at the feed store like everyone else.

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38 minutes ago, sas5814 said:

I may have shared this but I had an old boy come in telling me he needed his SI joints fused for his low back pain because he watched a youtube video and that what they said. OK.... not totally crazy idea so I ordered the appropriate tests and kicked that can down the road.

Before leaving he says about 10 years ago he got a bug caught in his ear and it took a couple of days to get out. Now his ear itches sometimes and can I give him something for parasites? Think the bug laid eggs in there or something.

Get your Ivermectin at the feed store like everyone else.

Try a Fabere'-Patrick maneuver on him in office and see his response, especially if symptomatic at the time.  May save quite a bit of $$$.

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2 minutes ago, GetMeOuttaThisMess said:

Try a Fabere'-Patrick maneuver on him in office and see his response, especially if symptomatic at the time.  May save quite a bit of $$$.

yea I bent him around in as many maneuvers as I could but his pain is such that it made anything real meaningful hard to assess. He was convinced so I could have removed his pelvis and showed him the SI joints and he wouldn't have believed me. One of those times on one of those days I just didn't have the energy for the fight.

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On 12/13/2021 at 9:31 PM, ANESMCR said:

Lady was convinced she had worms in her poo. I’ve been shown pics of feces many times (of course mostly by women), but this woman had an entire iPhone photo album, approx. 30-40 photos. She had enough to create Bristol mosaic masterpiece.

Still thinks she has worms. Saw her again. She has some ID doc that’s been appeasing her delusions and treating empirically with albendazole, ivermectin despite numerous negative stool tests. I was nice enough to provide her Nitazoxanide previously (a rather harmless antiprotozoal/abx).
 

She showed me more poo shots this time. AND video of her crap slowly sinking. She says, “see the movement?!”. She now calls these nonexistent life forms “critters” and “hard shelled nematodes”. I refused treatment and stool testing as I whole heartedly believe she has delusions of parasitosis. But I’m no psych expert. She does have MS and although neurocognitive degeneration is rare, she may have that. Definitely rectal dyssynergy. I’m just sick of looking at her poop.

Edited by ANESMCR
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On 3/26/2022 at 7:02 AM, ANESMCR said:

Still thinks she has worms. Saw her again. She has some ID doc that’s been appeasing her delusions and treating empirically with albendazole, ivermectin despite numerous negative stool tests. I was nice enough to provide her Nitazoxanide previously (a rather harmless antiprotozoal/abx).
 

She showed me more poo shots this time. AND video of her crap slowly sinking. She says, “see the movement?!”. She now calls these nonexistent life forms “critters” and “hard shelled nematodes”. I refused treatment and stool testing as I whole heartedly believe she has delusions of parasitosis. But I’m no psych expert. She does have MS and although neurocognitive degeneration is rare, she may have that. Definitely rectal dyssynergy. I’m just sick of looking at her poop.

Well, antipsychotics supposedly have antiparasitic properties. Win-Win. Login to UTD. 

https://www.uptodate.com/contents/treatment-of-delusional-infestation

 

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