Patient Itches a Hole into Her Head | Chicago Med | MD TV

Keegan and I have been neighbors for a few months since I returned. I'm only here because Vicky convinced me. At this point, I've given up on the doctors. Whoops, no, no, no more scratching. I can't help it, it's been three. years, three years, it never stops and it started with a submerged infection, oh the antibiotics to treat it, the side effect of lenizolid was alcohol, that old one, the worst everywhere, and I mean everywhere, but the reaction It disappeared when he stopped taking the pills, except here and it's killing. I shouldn't scratch myself right now. The itching never stops in the shower when you sleep.

I've never used toothbrushes, uh, pencils, even steel wool. Once, nothing stops the itch easily. I know it's hard, just try not to scratch yourself, okay? I'll clean it up and apply some steroid cream should help calm it down. That won't do anything. I have tried creams and antihistamines. Acupuncture. I have seen dozens of doctors, dermatologists, allergists, nothing helps. I just can't stop, ah, don't do it. No, no, that hurts, oh, what I feel is the itch, it's all day, every day, please, just find it and cut it out, okay, let's do a full set of lab tests and go from there, Keegan , I'm Dr.

Charles, how are you? Of course, the psychiatrist's view is that this is not due to feelings and is not OCD. I do not have delusional parasitosis or conversion disorder. The itching didn't start after my dad died or my boyfriend left me. Look, I'm not crazy, my

head

just

itches

and I want it to stop, okay, we'll try to make that happen. Doctors usually send me a referral, so I'll go. Well, you came to us for help, so we'll help you just for now. Do you think you could keep your hand away from the wound? I can't help it.

Okay, so Dr. Joy told me that you've tried over the counter medications with a lot of home remedies. How about bupivacaine? What's that? A five million local anesthetic should be enough. I would do it. I would like to apply a little to the area, if it provides relief I would suggest the problem could be in the skin nerve endings and that would help suggest a treatment plan in the future, then stop talking and carry on, you will feel a pinch, do it, okay, it feels different, different, what better, I mean, it tingles a little but

itches

less hmm, that's a good start, yes, I'll check on you in a moment, so the anesthesia should provide relief for about three or four hours, the itching does not go away.

You know, set her up with some topical patches to take home, sounds good, damn, call Dr. Charles, he can stop, don't scratch, his backup is worse than before, you have to stop scratching, then you have to tie me up five milligrams of diazepam. I can't live like this anymore. I'd rather be dead. What happened? Oh God, he scratched his skull. That is new. I usually have to open them myself to get to the brain. So what do you think is good for whatever? The reason why the cutaneous nerves in that part of her scalp went crazy making her always feel itchy so she keeps scratching is that a solution, yes, surgery right on the nerve she no longer feels itchy or scratched anymore , yes, and possible serious and irreversible side effects. paralysis blurred vision worst case scenario she ends up in a wheelchair I'm not going to open her in an alley daniel the risk you're describing is overshadowed by the reward yes we hope what do you suggest?

Counseling sessions twice a week, of course we have to do it. put a cone around his neck to keep him from scratching sam all those years of scratching those nerves are destroyed there's nothing left to go crazy dr charles if that were the case keegan shouldn't feel anything much less itch if those doors were active the Anesthesia would have provided relief for hours, otherwise you only used five million, it wasn't enough. I agree, the anesthesia didn't work for long, but it worked, which shows that nerves are involved. Great, we have a majority, not that I care. fact, sam, all i'm saying, i don't think surgery will do any good, thanks for your input, but last time i checked he was the neurosurgeon, he put it on the schedule, surgery isn't supposed to be the last option, Dr. charles, her.

He scratched his skull, what is all this? It's an experiment so well, you don't think Keegan can experience the itch of her without cutaneous nerves and I think I can prove it. Sit down, okay? So can you take your left arm and put it on? on the other side of the partition here, thank you, that's like a magic trick, yeah, okay, so I'll start brushing your real hand and the fake hand simultaneously, but I just want you to look at the fake hand, okay, you say what you say. So amputees sometimes still feel like they're missing a limb, right, yeah, a phantom limb, the nerves transmit confusing signals or amputees still feel like they're missing a limb because the brain just assumes it's still there because if that were In that case, nerves would be irrelevant, right?

We're suggesting that Keegan has a phantom itch that his brain is telling Sarah even though it's not, yeah. Just like amputees sense a limb that used to be there. Keegan still notices an itch he had three years ago due to a reaction to a medication when the brain is basically playing tricks on his interesting theory. Where are you going with all this that is not your hand? But the more you look at her while you feel me brush against your real hand, the more your brain might start to mix them up, I guess I can. Buy that, yes, the connection between what we see and what we feel is very powerful, but Dr.

Charles, I still know what my arm is, huh, for a second, did you feel the hammer? Yes, I did it right and we both know there aren't any. any nerve endings in this amazing thing the tricks the brain can play on us keegan keegan wait I've changed my mind I don't think you should have surgery yet oh here we go what crazy ideas did dr convince you. It won't be a nervous problem, it could be a perception problem. In fact, I'm not sure your age is real. It's not real. Are you too serious? Look at me, I have to be tied to the bed so as not to make a bigger

hole

in my body.

head

if the surgery works I have to do it, but what if it doesn't work?

What if you wake up and nothing changes? It has to work because I can't live like this anymore. I want my life back. Surgery will give you everything. okay, come on, okay keegan, wait, wait, the brain can change in response to experience, it's called neuroplasticity. Three years ago a reaction to a medication created a chronic itch that you can't seem to satisfy because it rewired your brain, no surgery will fix that, trust me daniel. Please, please, Keegan, let me try something before you go under the knife. Three years have passed. What can you do for me?

No other doctor has tried a trick. What I do? I don't know how long I can go without scratching. Okay, I want to. You should look at your reflection and scratch the non-itchy side of your head in the mirror. The image will be inverted. It will look like you are actually scratching the itchy side of your head. Oh, I see that, but what's it like to scratch this side? my head is going to make the edge disappear on the other side Keegan, trust me, we know you've been feeling this, but I just want you to consider the possibility that maybe just maybe this itch isn't real and there's no amount of scratching will satisfy it just fine, so what the hell am I doing giving your brain new visual information to override the experience you had three years ago so it can start rewiring?

Okay, look, you're losing me by feeling yourself scratching one side of your head while watching yourself scratch the other. Your brain will be tricked into realizing something isn't right now, hopefully that experience will force you to perceive a new reality, a reality in which the itch does not exist, then you say, but nothing is changing and I. Feel stupid, the exercise is designed to confuse your brain, so don't worry about it, just keep scratching like this harder, softer, just like you're doing, be

patient

, well, give it a try. Keegan will be outside. I'm doing very well. long time let's let her keep scratching she's been dealing with this for three years I mean I was lethal I don't know how long it could take if necessary the fan image theory makes sense but it's still just the theory certainly No I want to give you no false hope.

Dr. Charles. Something is definitely happening. The itch, it's less you.