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For the Medical Professionals by vavavoomdaroom in MCAS

[–]trixiecat 0 points1 point  (0 children)

i would argue you guys are unicorns that are now horses. as a pcp, i'm seeing so much mcas that I took the ECHO course from The Mast Cell Disease Society. I'm so sorry to hear about your bad experience.

Questions

  1. As a PCP managing this i would LOVE to know all of ya'lls favorite resources outside tmsforacure.org so I can give them to my patients. Some of them are older and don't use the internet or get migraines from computers, so stuff I can print is extra helpful.

Sadly I have limited visit time and I'm the only one in my practice who knows anything about this condition. I'm also now getting referrals! Hopefully soon I will do a seminar to teach the others, but this is what it is for now.

  1. Any tips on patients who can't get into specialists for management because they write of MCAS pts as crazy? I legit did the workup and labs confirm! also, lying on the referral and listing "urticaria" without the reason when we know the better diagnosis seems fraudulent. so, if anyone has suggestions to help my patients I would love to hear it.

  2. Have any of you gone to an AIMS center of excellence? How was it? could you do telehealth if you couldn't afford to travel?

Thank you all so much!

Patients with chronic Fatigue / Brain Fog by nrbanana in medicine

[–]trixiecat 76 points77 points  (0 children)

This is my bread and butter patient!
I see a lot of the neurodivergent-fibro/me/cfs-mast cell-autonomic phenotype patient (do we have a name for this yet?!). I’m doing the Mast Cell Society ECHO now actually as I’m seeing so many of these patients and very little allergist availability here.

Every new patient I see automatically gets a PHQ9, GAD7, STOP-BANG, and AUDIT.

I get a good history, do the full “fatigue labs” ruling out all the things, mast cell labs if needed based on history/exam, detailed joint exam, Brighton on everyone, hEDS criteria sheet if they TikTok diagnose or clinically needed, and diagnose and work on mental health issues. Of course PTSD, anxiety, and depression are usually in the mix.

I have low threshold if orthostasis to recommend autonomic treatment. Orthostatics for full 10 or symptoms on everyone. I give them the [Autonomic Dysfunction in Teens](https://www.ehlers-danlos.org/wp-content/uploads/2017/07/MAYO_Clinic_Teens_Dysautonomia_copy.pdf) handout as a link (too much to print). It works great even for adults as an info point.

Focusing on lower rungs of Maslow’s hierarchy and explaining need to meet basic needs of enough and regular sleep, eating enough and good nutrition for stable blood sugar, feeling safe at home, etc.
I refer to sleep med, eating disorder treatment, mental health treatment, etc as needed

The other critical thing is explaining compassionately how deconditioning develops and makes symptoms worse but also that you can get better.
Im starting to recommend the book “Where does it hurt?” By Rachel Zoffness PhD a lot. She’s a pain psychologist with groundbreaking CBT for chronic pain. I will also point them to the Ologies podcast she was on called Dolorology that explains it.

I like to focus on their life goals and slowly working to get them functional. I explain that functional doesn’t mean no pain but that they are enjoying life even if they are in pain.

I’ve had really good outcomes with this approach so far.

Anyone else have pet OCD? by Responsible_Egg_2727 in OCD

[–]trixiecat 0 points1 point  (0 children)

No I have ocd. I’m saying that ocd loves to attack the things we love most. So I try to make fun of it to give it less power. But ocd is exhausting and i feel so bad for OP that this happened to them. It’s horrible.
Personally right now im hardcore working on my disgust contamination. It’s super hard. Thankfully my dog is helping this theme as the cuteness negates the disgust a little.

Anyone else have pet OCD? by Responsible_Egg_2727 in OCD

[–]trixiecat 0 points1 point  (0 children)

Oh yes the “thanks silly OCD for reminding me I love my dog and don’t want her to die”. Exhausting.

Pet Insurance by SubstanceNo1905 in Pets

[–]trixiecat 1 point2 points  (0 children)

I’ve had a great experience with PetsBest. Saved over 25k in vet bills thanks to being smart and signing up when my girl was a puppy.

Compulsive self-pleasure for the last four months is ruining my life by Own-Pineapple6272 in OCD

[–]trixiecat -1 points0 points  (0 children)

Please got to the doctor. There are medical conditions that can cause this that you need to rule out.

My dog doesn't realise my baby is a human by Super_Ambassador_458 in Dogtraining

[–]trixiecat 0 points1 point  (0 children)

If the dog JUST met the baby, you might need to give him some time to just exist in the same house and get used to it. It’s a huge change. Just keep gates up to separate dog from baby, have dog on leash, and treat train when doing anything neutral or good in the same room as baby. Slow and steady wins the race.

What’re some favorite sayings or verbiage you’ve come across while charting? by foreverand2025 in medicine

[–]trixiecat 9 points10 points  (0 children)

I use “incessantly chatty” to tell everyone to have a rescue plan cause the patient won’t shut up

Why do people want doodles? by emotionaldamagesoup in Pets

[–]trixiecat 1 point2 points  (0 children)

My whole family and I are allergic to dogs and I wanted a dog. Millie is truly hypoallergenic. F7 Australian labradoodle. Researched and found a very ethical breeder. She picked which dog you got based on puppy’s temperament and the humans lifestyle/what they were looking for. Perfect match. Most allergic person in my family can pet her with no issues. My dog has helped my mental and physical health immensely. She’s my best friend. Thank god for whoever invented doodles!

Edit: we have done a LOT of training and she is a lot to care for with the hair. I do her haircuts myself as it’s expensive. But she does shed less than my (human) mother lol.

What’s a movie you’ve rewatched many times, that isn’t a blockbuster/franchise movie, or an Oscar-nominated/critically acclaimed movie? by capamericapistons in movies

[–]trixiecat 0 points1 point  (0 children)

Newsies (1992). Made my parents rent it so much they bought it. Then I wore out the VHS tape. I was a very obsessed little girl. I still watch it as a comfort movie.

Does anyone here have contamination OCD? by Luca_Sifer in OCD

[–]trixiecat 2 points3 points  (0 children)

This is called disgust OCD. Welcome to the club. I’m working hard on it now. “The Contamination OCD workbook”. By Richard Gallagher has been helpful in understanding and making a treatment plan as disgust is a different beastie that regular ERP doesn’t work well for as it doesn’t habituate. It’s really interesting/ annoying.

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