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2025.01.22 13:43 Wutz_Taterz_Precious How would you handle a patient with delusions leading to indirect self-harm
How would FamilyMedicine handle this case?
The last patient of the day is being roomed, a 45 yo male with hypertension and a longstanding (10+ year-long) history of delusions about government surveillance, possible undiagnosed schizophrenia but I've never been able to convince him to take psych meds or go to psychiatry. The nurse comes to let me know his BP is 230/130. This is confirmed by multiple machines and a manual cuff. Patient totally asymptomatic but has not taken his BP meds in about two weeks.
He tells me he won't be able to go straight to the pharmacy to start medication because he has "other things to do" that are unsurprisingly related to avoiding government surveillance. He says it will be "a few days" before he can make it to the pharmacy. As far as capacity is concerned, he is able to state quite clearly the harms of elevated BP, including death and stroke and is able to state that he knows meds will bring down his BP and reduce these risks. Nonetheless, his other "tasks" are too important, which is why he can't get the medication for a few days. I consider sending him to the ED given how high BP is, but he of course refuses.
This patient has had these delusions for years; it really doesn't appear to be a case of encephalopathy, and he even had an extensive neuro workup for neuropathy about 5 years ago that included EEG and MRI. He has never expressed any intent to harm others and is not suicidal, but clearly this guy is at risk for stroking out. I briefly pondered an IVC, but this is a jacked dude who would probably require multiple officers to sedate/subdue him and drag him to the hospital (and this is in a rural clinic so would potentially take ages for appropriate resources to arrive). And by that same token, I'm not really sure an IVC would be appropriate, since he seems to have capacity to refuse care. I was able to twist his arm to follow up in a few days for BP check, but will probably be more of the same.
1.) How would you approach the IVC or not IVC question in this case?
2.) Any suggestions about how to convince delusional patients to consider trying medications or seeing a psychiatrist without forcing them to?
submitted by Wutz_Taterz_Precious to FamilyMedicine [link] [comments]
2025.01.22 13:43 Eraticwanderer Fears of raids loom as CPS returns to classes and Trump authorizes ICE to target schools, churches
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2025.01.22 13:43 Dapper_Order7182 Amazon Prime members can get these 23 Steam Deck-compatible games for free right now
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2025.01.22 13:43 vilomstren Eden Brothers Promo Code for January 2025
Visit this page for Eden Brothers Promo Code for January 2025. The website offers a wide selection of coupons, promo codes, and discount deals that are updated regularly, just visit the website to find the perfect one for you.
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2025.01.22 13:43 rhinobisio2 of snowmen
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2025.01.22 13:43 Independent-Rate-194 Staying Patient
Hi All,
I don’t really know how Reddit works or if anyone will even see this, but I wanted to share something amazing that happened to me in case it helps anyone out there who might be feeling the same way I have been.
So, I was born and raised in the West and for a long time I struggled with balancing my deen. Alhamdulillah, over the past few years things have gotten better. I really started building my relationship with Allah after high school i’m a bit older now far from perfect, but I’m in a much better place. As a female, I’ve never been in a relationship, never dated, and don’t have male friends. I won’t lie though I’ve spoken to men on social media before.
Here’s where it gets frustrating. I’ve been told I’m attractive, have a great personality, and that I’m the “full package,” but for some reason, no one ever sticks around. I’ll like someone, and then poof they’re gone. It’s hard not to let it get to me. I know my self-worth shouldn’t depend on this, but it’s tough not to feel down when it keeps happening. Recently, I started feeling so disheartened that my prayers started slipping. I was only doing the fard, not praying on time, and struggling to stay consistent. Then it got even worse I started talking to a guy who I really liked. He seemed amazing but like clockwork, he ghosted me out of nowhere vanished like I’m some bad horror film. I won’t lie it broke me a little. I got upset—not at Allah, of course, but at my situation
I kept telling myself, Allah is the best of planners, and He’s protecting me, but deep down, I was impatient, hopeless, and just plain fed up. I’ve made so many duas for a righteous, pious husband, but apparently, I keep falling for guys who treat me like a free trial subscription—great at first, then they suck.Tonight, after Maghrib, I decided to stop sulking and read the Qur’an for some comfort. I started with Surah Yusuf because it helps when you’re feeling down. After finishing, I closed the Qur’an and just spoke to Allah. I asked Allah to give me a sign that He sees me, that He hears me, and that my patience isn’t for nothing.
SubhanAllah, when I opened the Qur’an again, I landed on Surah Ash-Shura (42:33):"If He willed, He could still the wind, and they would remain motionless on its surface. Indeed in that are signs for everyone patient and grateful."
I can’t explain how much peace this gave me. This verse reminded me of Allah’s absolute control over everything. Just as He can calm the winds or stop them entirely, He can change any situation, no matter how hopeless it feels. It was like Allah was saying, “I see you. Be patient. I’ve got this.” It also reminded me of the importance of patience and gratitude. Patience to trust His timing, even when it’s hard, and gratitude to appreciate the blessings I already have. Life’s trials are temporary, and Allah’s wisdom is always at work, even when we can’t see it.
So, to anyone else feeling down or struggling with their imaan: turn to Allah. Read the Qur’an, make dua, and pour your heart out to Him. Allah’s got your back, and He’s closer than your jugular vein. And remember, just because you’re the “full package” doesn’t mean the right delivery address won’t take some time. Trust His timing—it’s always worth it besties x
submitted by Independent-Rate-194 to MuslimLounge [link] [comments]
2025.01.22 13:43 itztuculu How can I realpse again
I have a bad habit where I start eating like a pig after I become thin then gain all this weight & its hard to go back to reducing to eating it burns my stomach I used to abuse vyvanse for adhd & a lot of caffeine surgar free but I don’t have access to vyvanse rn last time I ended up weighting 115 now I wait like pound more what can I do so it doesn’t feel like am starving & get back on track am F 18
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2025.01.22 13:43 pawurb Screencast - My Ruby on Rails Development Workflow
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2025.01.22 13:43 DroneStrikesForJesus My favorite take from the Lions subreddit over the weekend
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2025.01.22 13:43 CauliflowerSmart9636 SWE/DE with CFA, how do/did you navigate your career
Hi, I am a SWE/DE doing CFA, passed the Nov level 1 2024 and currently doing level 2, I'm doing it because I'm very interested in finance and my employer encourages me to do so. Therefore I don't regret doing it at all.
I just want to know for those who have passed level 2 or gotten the charter, how helpful has this been for you career wise, and how do you navigate it. What are the possible opportunities for such skill set
submitted by CauliflowerSmart9636 to FinancialCareers [link] [comments]
2025.01.22 13:43 LimeLampShade What is a "Store Manager Counter?"
I'm trying to learn to play as Chris and I enjoy doing so, however I'm confused on how to even summon the Store Manager and what a Store Manager Counter is according to the wiki and how to get them?
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2025.01.22 13:43 AdWonderful2523 I forgot that these masterpieces even existed
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2025.01.22 13:43 CanadianW January 22: Eugène Ysaÿe - Poème Élégiaque, Op. 12
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2025.01.22 13:43 Maya473849 New features.
Hello, I've been using the Brainiac Mode to chat with bots and it disappeared when my free c.ai+ ended. Does anyone know when new features are generally being added for everyone?
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2025.01.22 13:43 macaroniandcheeser I buy beads
Hi, I buy out bead collections and estates. Please message me!
submitted by macaroniandcheeser to Beading [link] [comments]
2025.01.22 13:43 Cynammmon Ooga-booga!
I Have a question.
I've got CB1 for my PS1 on Christmas(best gift ever) Keep on playing it for fun. Also have the NS3 for Switch.
But Now I have a problem. I'm at the "Rolling Stones" - I'll complet the level and at the end I dont have the boxes counter and it goes straight to map. Then I can play "Hog Wild", but If I die at Hog Wild it bring me back to "Rolling Stones " and I need to redoo the RS frst and then do the HW...
I also just started a new game, from zero , first level,got all the boxes but there was no box counter and straight to the map.
Is my game broken or I need to Reedoo everything again?
Thanks for advices ✨️
(Apologise for any grammar mistakes, eng is not my first language)
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2025.01.22 13:43 justin_quinnn Late-Night Truth Social Rant: Trump Slams Bishop for Preaching Love and Mercy - MeidasTouch News
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2025.01.22 13:43 alanger32 Monitor upgrade after 13 years of using just a 60Hz BENQ GL2450 for CS2 player
Hi,
I’m looking to upgrade my monitor after 13 years of using my old Benq GL2450 (60 Hz TN). I want something future-proof with a better overall experience. I mostly play CS2, APEX, LOL, and occasionally RDR2, so I’m looking for a higher refresh rate and 2K resolution. I also spend a lot of time reading and coding.
Currently, I’m using an RX 6800 16 GB. It might not always be enough to run some games at 60fps in 2K, but I’m more likely to upgrade my GPU in the future than my monitor.
I’ve been considering two budget options so far:
2025.01.22 13:43 Educational-Taro8888 LF 1:1 trades
Thank you! submitted by Educational-Taro8888 to MonopolyGoTrading [link] [comments] |
2025.01.22 13:43 epicguy2238 LF Petal Portrait (Set 6)
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2025.01.22 13:43 cnydox Camp zoo aura 🦈 🦏
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2025.01.22 13:43 AffectionateMud6267 Prism song kinda interesting
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2025.01.22 13:43 kylegreenhat Looking for Dialga with ROT. Want to do a lucky trade. Offering mirror
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2025.01.22 13:43 Relative_Effect Why Are We Normalizing the Death of People?
Every day there's some crazy shit happening - cars smashing into each other, houses turning into BBQs, bombs going off. Remember that earthquake last year? Who gives a fuck about the death toll when it's not high enough to make headlines, right? Each number in those stats was a real person, you know. They had lives, families, and dreams. But now? Death's just a number we scroll past on our phones like it's nothing. 46,600 Palestinians dead, a shitload of them women and kids, and we're just like "Meh". We're not heartless, we're just desensitized as fuck. These numbers come at us so damn often, we forget each one was a life, a story, someone's world. We gotta stop this. Stop treating death like it's just another clickbait title.
Every dead person is a goddamn tragedy, not just some number to forget tomorrow. How did we become so numb that human life is just background noise?
a break from the news might fix this I guess?
is this happening to everyone or just delulu me?
submitted by Relative_Effect to Morocco [link] [comments]