Cotton Wool Welded To Eardrums (Why Don't We Numb Up Patients?)
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- Опубликовано: 16 окт 2024
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A lot of people are commenting saying this could be a cognitive/mental health issue. If you have any knowledge in this area please leave your thoughts below. Thankyou.
I'm familiar with eating strange substances, but not sticking things in the ears behavior. Perhaps his ears itch & he forgets about the consequences, or he enjoys the procedures? As long as he can afford it, I can't think of ways to intervene other than family restricting cotton swab and ball access.
That's actually what I was thinking
The leg movements certainly suggests something neurological going on.
Could be doing it in his sleep or during a mental health episode. I've seen odd things happen during sleep when I worked as a Medic in the army in in-patient. But I don't know
the leg movment is probably a sign of something like adhd i do that to when i have to sit still and cant move alot
When I was a kid with an ear infection my mom would put half a cotton ball in my ears to hold in the drops at bedtime. I was young and figured they just went away. They all thought I was losing my hearing until a doc at Sick Kids in Toronto reached in with what I now know are crocodile forceps and pulled them out. The feeling was incredible- a release of pressure and un-dampening of sound and vaguely ASMResque - to the point where I can clearly recall it now, at 50 years old. I would not be astonished if the patient did it deliberately the second time.
😦😦😦
Hopefully DR had a good talk with momma!
I don’t think this was a child lol but I can only imagine this feeling good lol
I wonder...what was even her plan?
or did your mother think cotton was a magic compound that dissolved on it own?
if I showed cotton in my kids ears, I wouldnt just be like "well, thats a job well done" and forget about it.
thats hilarious!
and potentially dangerous so...not so hilarious..
@@thedazzlingape2006 it wasn't her intention to keep it there lol. We were done the same as kids. Nothing got stuck. They usually fall out.
I'm a retired Registered Nurse and worked in a MD office.... Did many ear flushes and learned to ask question round a bout at times. If you see this patient again try asking WHO puts cotton in his ears....that way he has no self blame.....usually works to get the answer you need! Great work on your part, by the way!!!
excellent idea and response Judith.
The "no" can be honest... I mean my father once forgot about a cotton piece that apparently got stuck to the eardrum 3 years before. The guy who removed it was surprised at how so much skin got stuck to it trying to migrate past it and was surprised that he didn't feel anything wrong.
True. If he is older, there could be mild cognitive problems. Or embarrassment!
I once forgot about a tampon. Not an uncommon thing for people to do, surprisingly.
Well in my case my ears don't produce much wax and I'm absolutely fascinated with watching and morbidly longing to experience sectioning. His ears appear relatively clean of debris other than the cotton bud. I've considered putting something in there but won't. Maybe he couldn't resist all I know for sure is I WANT WAX!!!🤯😏🤫😁🤭😉❤️
@@angelaisaclicheyeah, that can be deadly though, so I'm glad you remembered and are still here 🤗.
@@ellencox8415 yeah, pretty lucky 😬 thank you, I'm glad you're here too 😊
Hey Connor. Wondering if this patient may have a mental health concern. I've seen patients do bizarre things to try to drown out auditory hallucinations. As a child, my son used to tear up little pieces of paper and fill his ears - never to this extent, but it was a routine behavior. I work with psychiatric patients and I know how creative they can be in responding to their psychosis and delusional experiences.
This was my suspicion as well. Really looked like he was desperately trying to drown out noise.
Interesting analysis, thankyou
Might be worth asking him if he hears voices & if he's in treatment. Medications are available to help the down the voices which can be really loud. Imagine someone or "a lot of someone" shouting at you 24/7 - except you can't see them. Absolutely maddening!! But he needs another way to manage the noise - if this is the problem. Referral to a psychiatrist may help you help him. Eager to see how this progresses. Good luck with this very interesting situation.
@@RobinWilliams-j8lPersonally, I would ask if he's hearing "sounds," rather than "voices," because of the stigma. If he denies putting the cotton in in the first place, I doubt he'd want to admit to hearing voices. Can't auditory hallucinations be other sounds as well anyway?
@@pants6416 Some people think they won't be believed if they admit to "hearing talking in their head." You make a good point. I usually ask if they can hear people talking or sounds - like bells or music - that other people don't seem to hear. Sometimes it's hearing their own name. What a lot of people mention is the volume of the sounds that they're trying to get away from. Also, I saw a suggestion about this behavior possibly being a sensory thing - that also makes sense to me. There are a number of possibilities here. It will be interesting to see if we ever learn what's really going on.
As someone who works as a DSP/PCA and has a touch of the tism themselves I would agree it could be a mental health issue. Some clients I’ve had will shove anything in their ears to reduce sound especially depending on their level of understanding. For example one takes good care of herself, understands dangers etc so she uses earplugs. This man might not understand it’s a danger. Some clients will -definitely- lie when they know they did something you wouldn’t like them to do haha even if you can clearly see they did the thing. Others would never. Then there are those who like certain feelings (sensory pleasing activities) chewing ice or gum, squeezing their legs, putting pressure on x location. Sometimes their activity of choice isn’t good for them and you have to redirect to something that won’t cause them physical harm but still meets their need for x kind of relief
For this man specifically I’ve got a couple ideas. Either 1) he doesn’t know the material is cotton so he thinks he’s telling you the truth saying he didn’t put cotton in his ears 2) he knows he did it but doesn’t want to admit to it even if you can clearly see 3) he likes the initial pressure of the cotton deep in his ears but eventually it causes discomfort (loss of hearing, pain from agitation) and wants it out again
Thanks for your insightful comment, the third idea is interesting and can see this being the case
This is what I was thinking rather than the psychosis explanation. As sensory stimming sort of person myself I can imagine people addictively doing all sorts of potentially harmful things.
If this is the case, then the whole process of visiting the audiologist to have it removed may also be part of the appeal.
"touch of the tism" made me laugh, you sound awesome
@@dfpguitar After all, Q-tips/cotton buds are potentially harmful yet people still wishy washy them around the ear canal, myself included, despite multiple medical professional's urging me otherwise, thankfully I've never torn cotton off them and gotten myself into this situation.
It’s amazing how small the tools actually are and how delicate the work is. Always a top notch professional presentation !
Thankyou
@DurhamHearingSpecialists I love to watch these ear videos.....it makes it even better when the doctor is so easy on the eyes. 🫡
Hi, Connor. I am a social worker and I suspect that your patient may have some cognitive challenges. If the patient has a short memory issue, he/she may have no memory of pushing in the cotton. I wish you a happy and healthy New Year! I love your videos - I am learning so much. All the best from Pennsylvania! Cheers 🥂.
The question is why his ears are almost completely clean.
Ok, I get saving someone from themselves once, but THREE times? And he never explained himself? You are a more patient person than me! Great work and choice of tools. Looking forward to what you have in store for us. Thank you and Happy New Year!
Thanks Lauren
Exactly what I was thinking!! Although, I suppose if he chooses to continue shoving cotton in his ears, it's a guaranteed customer a few times a year! 😊
Does make me wonder about cognitive function. If there's any impaired cognitive abilities, and then his ear just itches really badly, I can see this continuing.
Maybe the patient just lonely, tried to create a excuse to see someone😆
I hate to say it, but patients who continue to do what they need to stop and refuse to admit they are doing it... usually are the types who are doing it for NSFW reasons. And I just don't want to know his explanation for that.
Maybe the patient pushes the cotton to try to sleep and forgets about it completely.
I'm wondering if maybe his partner might be doing it? Memory loss on both their parts? I've seen people who have dementia starting to do weird things.
If he has an emergency contact, if you do that in the UK, maybe it's time for a chat. A perforated eardrum, raging infection, etc could be prevented.
Thank you Connor, you have the most interesting things.
Thanks, yes a few people have suggested this and I agree it's a good theory
Dementia was my first thought as well. (Used to work at a retirement home and saw it a lot.) Not to mention other conditions that can cause memory loss. Certainly might not be lying on purpose. Embarrassment can be very powerful too, however, so hard to say. I hope someone is looking out for him. Getting old can be hard.
I'll always remember the time my brother, who had been complaining of a sore ear, upon his doctor's visit, had a mouldy Q-Tip head removed from his ear canal.
sorry but i'm gonna need more info for science
@@calumsanderson6741 It was apparently green.
Hi Connor! Happy New Year from Winterville, Georgia, USA. I enjoy your channel, as I am a retired ENT scrub nurse. I began my career in 1970, so you can imagine the changes I've seen in all types of ear surgeries !!! But I love how you educate, and share your cases with us all! May God bless you!
Thankyou for watching Nancy, happy new year!
Happy New Year, Connor! I worked with a physician who did not numb a patient undergoing debridement for two reasonsons. One if a patient jerked a bit or there was bleeding it told the doctor two things. First the paind indicated nerve regeneration and second, the bleeding showed the tissue was coming in nicrly. He had a soft and gentle touch and his patients were so lucky to have him. I do hope your holidays were wonderul and 2024 will have great things in store for you.
Thanks Therese, happy new year. That doctor sounds like a smart chap.
Debridement of what? I had my leg wound debrided and I was under a general anaesthetic and the pain on waking was so bad morphine and fentanyl was inadequate and ketamine was given. It would've been torture without pain relief.
couple of possibilities i can think of off the cuff:
1.) he keeps forgetting he isn't supposed to use cotton wool and is too embarrassed to admit to it.
2.) some mild Munchausen syndrome?
3.) he's got a general practitioner who's shoving wool in his ears as part of an ear treatment.
4.) some new age practitioner doing wierd stuff to his ears? idk maybe they shove wool in your ears when they do candling.
5.) refuses to stop using cotton wool because even through you keep telling him not to, but too non-confrontational to tell you directly? also you keep removing it just fine, so he probably doesn't see it as that big a problem?
I think 1 and 5 are good answers
If so I wonder if redirection be a answer maybe suggest a plastic reusable ear cleaner and teach usage maybe a family member can get rid of all the cotton wool and replace it with that. But if they di have memory issues could be an issue I work with patients with dementia and redirection something you have to do over and over sometimes unable@@DurhamHearingSpecialists
He might have a problem in the Eustachian tubes and think it's his ear canal. My Mom's collapsed@
Don’t ask “did you put anything in your ear,” doctor, ask if he uses Qtips!!!
I don’t know if you have never enjoyed using them ‘against prescribed,’ but it feels AMAZING!!
Obviously most of us don’t have this problem, BUT some obviously do.
It's so odd that the patient would put cotton wool in his ear, (and possibly doesn't remember?) IDK. Made for a great video though. Thanks for sharing and I can't wait to see what you have in store for us in the upcoming month. Happy New Year and hope you have a great 2024.
Thankyou, happy new year
it's really really hard to stop the habit of using cotton buds to clean your ear. you just keep feeling itchy.
Exactly
I just cross my fingers and hope swabbing around the outside isn't _as bad_ as cotton swab use can be. Like, I know its wrong, but I could be doing it _way_ more wrong.
A few drops of olive oil help wax and dead skin migrate out of the ear, it stops the itching too.
The problem is, cotton buds absorb too much of the oils in your ear, which makes the skin too dry - and dry skin is itchy skin. I agree with the olive oil suggestion. Even if you can't stop using cotton buds, using a little bit of olive oil afterwards will help stop the skin getting so dry and itchy.
@@heatherexcell3078 I've stopped using cotton buds... now i use that small metal scooper
You have me hooked watching these video's i have learnt more from you than i did in all my nursing career and I'm now 68 years old and I'm fascinated with these procedures i wish during my training and time in ENT i had someone like you explaining things i would have been far more interesting instead i found my time in this department so boring but you have brought it to life thanks absolutely superb viewing 😊
There's lots of good, valid suggestions here. I wonder if he might just enjoy the process, the sensation of having the blockage removed.
I can't stop watching these I have watched almost 15 they are oddly satisfying
This could be related to a condition known as Dermatillomania, also known as excoriation disorder (per the DSM-5) or skin-picking disorder, is a psychological condition that manifests as repetitive, compulsive skin picking. It is one of a category of disorders known as body-focused repetitive behaviors (BFRBs) that are currently classified in the DSM-5 under Obsessive-Compulsive and Related Disorders.
Yay Connor! Happy New Year to you! Got excited when I saw your notification. Have missed your uploads. You are definitely the 'rolls royce' of ear health in my opinion! ❤ I love the recess videos! This one is unusual but captivating 😂 Another brilliant ear lesson 😊
Thanks Stella, happy new year!
Is it a possibility that the patient had a condition that they didn’t share with you. Maybe something to do with lapse of memory seems like if he continues to do this he’s going to be back maybe with more damage ?? if you ever find the reason out why he was doing it please share it this was a great video
It's a good theory, will keep my eye on them
Either that or my theory that they have some kind of kink and don’t want to say it.
I have absolutely no idea what it could be but I have seen weirder things in my time on the internet.
"I'm not entirely certain what his thought process was..."
That's an awfully polite way to put it.
honesty about cotton bud usage is to ear cleaning as honesty about floss usage is to dentistry 😂
This reminds me of my 80yo father (with advanced dementia) who once took the tiny button battery out of his hearing aid and shoved it right down into his ear, like this cotton wool, as far down as it would go.😱
It was only detected because I was attending to him for around 5+ hours each day in the nursing home and, knowing he tended to have wax build up in his ears, would regularly check them with my small LED torch. Imagine my amazement when I spied this shiny battery way down in his ear canal well beyond my reach!😱🤦♀️
Five doctors, two EDs in two separate hospitals over 12 hours, with the help of two assistants, we managed to hold him down while a sixth doctor finally fished it out!😱 Had that last ditch effort not worked, Dad would have had to have a general anaesthetic in order to extract it.
What a drama for all concerned!
I’m wondering what would have happened had I not discovered it because nursing home staff would never have found it (as they don’t have any reason to peer deep inside residents ears)?!🤷♀️😱
When you hook up some fibers with your hook, you should turn it several times. It will form a strong robust thread attached to the cotton ball.
"Lidocaine, cocaine..."
Howling 😂
How many of your patients also have sinus troubles? For some of us sinus problems and ear problems go hand in hand . Love your content.
LOTS, I'd say every fifth/sixth patient has sinus trouble
Definitely with everyone talking about dementia, I don't know how old the patient is, but my Nana started to do strange things and did not remember them. Noises would increasingly bother her.
Happy New Year, I really love this channel, Connor and the videos. Thank you to the patients who have agreed to share with us their ear struggles.
Thankyou, happy new year
@@DurhamHearingSpecialists 😘
Seen it several times so far, it’s very difficult to remove. I have used crocodile forceps and soaking the cotton with an oil to improve suction to it.
Excellent video Connor ❤
I think you could title this the never ending story 🎉
I hope you had a great Christmas and New year..
Looking forward to the next visit.
Cheers from Tassie
Thanks Dianne, happy new year
The little custom tool was nice ,in my kitchen I buy them all 😂nice work👏👏
In my POV, there's many types of mental disorders this could point to, my first thought being OCD because of the compulsions that could cause consistent usage of cotton despite the consequences. But him denying the usage of them could be a number of reasons. There are so many mental illnesses that can cause gaps in memories even specifically targeting certain actions consistently. DID/other disassociative disorders, or even just memory lapse from old age. However to me it's more likely that he's just lying about it or has a cognitive disorder (uf that's the correct term) rather than a mental one. Happy new year btw, and thanks for everything you do with these videos! I know nothing of ears but I love watching and learning about the body!
Glad to hv you back☺️ love watching your interesting and instructive videos❤️
Sincere question, I'd love a Q&A styled video - How does one go into this line of work? This is so strangely satisfying to me lol
Sure I'd like to do a Q&A vid
I'd like to participate in the Q&A video 🎉 please announce well in advance 😁
Your videos are always worth waiting for!
Thankyou
I've never seen Jai's energy change like that. I wonder how that went after the video ended. 😂
You're so polite "Not sure what their thought prosses was" is a very interesting reaction to a patient doing exactly what the doctor told them not to do. Lol
🎉 Hope you’re doing very well indeed, Conor from Nova Scotia, Canada.
Looking so forward to some more weird and wonderful ears soon!
Thankyou Cate
In the times ive had to see the ent, i told them to just go for it. The relief after is worth it
As an intelligent medical person, it seems that you have come to your own conclusion but those comments may not be a good thing for your channel. Maybe, just maybe, there's an ailment that's generally associated with older folks that is causing this repeated issue with this patient. If not, there is always the possibility of Munchausen syndrome, especially considering the denials from the patient. Whatever is going on, good for you for handling it in the kind manner that you have been. Great job. Happy New Year my friend.
I agree with you 💯 percent. All those theories can be very harmful to others.
Yes! Useful and entertaining! Absolutely love your explanations, Conner! ♥️🌟♥️🌟♥️🌟
Perplexing case. But well done and thank you. Looking forward to the upcoming cases
Thankyou Jan
Good job he went to someone who knows what they are doing, and not to one of the two day wonders that are springing up on the high streets!
"No, no no, I dont know what you're talking about"
- every person when asked by a health professional if you've used cotton buds in your ears
Fabulous work. Really entertaining . Mysterious why that patient put the cotton wool so far down into his ear. Nice shout out to your fellow audiologists.
Great video! Looking forward to more interesting cases
Thankyou
I was literally crying for 5 minutes laughing 2:08 - 2:20 😂😂😂 gold! Pure gold!
Hi, what a very unusual and interesting case! I wonder if this gentlemen has some form of dementia, or perhaps he pushes the cotton wool in to block out noise and is then too embarrassed to confess he’s done this. It’s quite disturbing behaviour tbh. Well done getting it all out though!!
Thankyou
Happy New Year, Conor, & I hope Christmas was good to you. All the very best for 2024.🕊
Yeay for the hook! Very interesting and well done, Conor. Happy New Year!
😊🥳🍾
Does he know what you mean by "don't put cotton wool in your ear"? I'm not being snarky, but he may be calling it something else. ALSO: could it be a mental condition? People do things compulsively....like pull out their hair/eyelashes for an example... thus could this be a compulsive action? Something that is more or less not under his control?
i agree, i have ocd and this kinda sounds like a compulsion. some compulsions seem silly but imo its a possibility. im in no way a medical professional
It's a good thought and certainly possible
That's a possibility, I have OCD and sometimes pull my hair without noticing. My partner has to tell me or I wear a beanie in stressful times to stop me from doing it unconsciously.
Agree. I’ve never heard the term cotton wool before this video. It’s could be as simple as the man not knowing what the doctor was talking about.
Happy New Year, Connor! Ready for another year with Durham! ❤❤❤
Thank you Brandi, happy new year
I watch these videos just to see the state of Connor's hair.
"I'm not entirely sure what his thought process was.."
As a person who shoves q tips into my ears, it is usually because it itches. I will have an itch so far down that I can't get it with my pinky finger so I gotta use a q tip to lightly get around it. I will twist it in my ears a little bit and actually almost lost the cotton from the q tip in my ears. I'm just suprised he got it all the way down there cuz it HURTS if that q tips gets in the wrong place even just slightly.
Some people get an immense cathartic sensation from things being removed from their ear canal. Perhaps this person has gotten into the habit of deliberately putting cotton in his ears and then removing it himself with a pair of tweezers… but occasionally he accidentally ends up poking it too deep and has to visit a professional to get it out?
Possibly
Happy New Year from Seattle in the States, Conor! Thanks for your channel - it’s got me booking appointments for me and my son with the audiologist, just to be safe. 😅 Appreciate the education, cheers! 🎉🙏
I would think memory loss is an issue here, early sign of some mental decline.. Thanks for sharing Connor, happy new year 👏👂💜✌️🇮🇪
Try watching Dr. Liang Zhao videos. You can compare the Chinese and British ways of treating the ears and cleaning the ear canal of earwax. Thank you so much for sharing your vlogs. You are so gentle and careful not to do damage to the patient's ear drum. Take care.
I guess the patient is in love with you and likes you taking care of him and his ears 😉
Sometimes the only positive moments in a person’s life can be the gentle manner of a doctor and referral to a specialist. The icing on the cake is the feeling of that foreign body being pulled from within their ear canal. We ALL live somewhere on the spectrum. This patient might be closer to one end of that spectrum than most. I would not be surprised if they returned or went to a new specialist if they thought you were becoming negative in their mind.
seems like he wants attention maybe??? that’s all i can think as to why he keeps doing this
Connor, the Captain of double entendres! 😂❤
I felt the relief........................i can now sleep well tonight. Thank you.
I know… 😮 But this Guy has the Cleanest iner Ear I’ve Ever Seen!😅
This is guy was Cleaning it 24/7 to have it That Spotless!
I do recall my Dad having to go to an ENT twice in a matter of a couple of days, because my Mum had purchased cheap Q-Tips and since my Dad loved to vigorously shove them in his ears, the cotton part detached from the plastic handle and got lodged deep inside. After the second instance we got rid of said Q-Tips ^^
Happened to me also. But I used needle tweezers to get it mine out and saved a trip to the ER.
😄 If only there was a video of your reaction the second time he came in. 🎉 Happy New Year from India.
Good to see you back!!😊
Thankyou Lisa
Have a great 2024! Glad to see you again.
Thanks Elizabeth, happy new year!
5:06 LMAO that has to be the best line so far!!!!
Happy New Year from San Diego, Connor!! Looking forward to another year of wonderful videos.
Thankyou Maggie, happy new year
Alto is great. Love his presentation style
I think he's jamming it right down there to stop the pain. When I have had earaches in the past, this worked for me. The pressure relieved the pain.
I once used a cheap quality q-tip and the cotton came off it into my ear. I used a tweezer to remove it
Hi Connor! Just wanted to say your videos are great and I always learn a lot. It is very cool to me that you happen look very much like my little brother as well! Happy New Year!
Thanks Jennifer, happy new year to you and your brother
Thanks Conor 🧡 Great video, as always!
Happy New Year Connor!! I hope you and your family had a wonderful Christmas xx
Thanks Louise, happy new year
I would love to have heard your conversation with this gentleman after removing the 3rd ball of cotton! 🤣🤣🤣💙💙 You have such a steady hand ✋
Thanks Jenny
all you need is to grow the beard, stash, work at a floral store, American accent and be crazy in love & that’ll be close enough! 😂 IYKYK Happy new year kinfolk 💗
Interesting responses regarding the patient and his answers. My rationale is always that I'm seeing a doctor or specialist to fix a problem and to fix the problem as quickly and efficiently, I must be truthful and provide all pertinent information to assist in fixing the issue. Most people I've seen have been non-judgemental, at least to my face, and there's usually doctor-patient confidentiality. There's nothing wrong with being truthful. But as some have pointed out, the bizarre element may be that this patient was, in fact, truthful. We as viewers will probably never know. As long as he's healthy and happy, that's all that matters.
The cleanest ear ever!!
Great to see a post from you. Thank you
Lovely to see you!!! Happy New year. Great video
Thankyou Ellen, happy new year
Hearing specialists must be awesome at the kid game operations!😂
The hook is so tiny! It looks adorable with the regular camera 🤣
Thank you for this video. Fascinating work!
Happy New Year!
Thanks, happy new year
Happy New Year Connor, good to see you back and on great form. It does make me laugh that people think they can fool you into believing they have not used cotton buds 😂😂
Thanks Emma, happy new year
Thank you for such a fascinating case to start 2024!
Thanks Barbara
"the drum looks unhappy" 😂 loved it
Welded?. I have had little balls of welding sparks funnel into my ear. MEOW that is welding!
Hi doctor! Could you please talk about how to take care of ears when using earplugs every night? I’ve been using earplugs to sleep for maybe 7 years now. No abnormal symptoms other than itching once in a while but I’m still worried. Thanks for all your great videos! ❤
Wow that he did it again!
Small blund hook is a great tool . Maybe next time when you have to remove cotton wool again ,when you manage to hook it ,twist it round like your spinning wool . It gives a stronger tread to pull it out in one go instead of bit by bit
Very risky sticking Q-tips deep in the ear and I’m telling you this from experience. I had to end of a Q-tip break off deep in my ear. I thought it came out but it didn’t about a month later I was in a shower it
Im wondering if he is enjoying the attention?
On the bright side, the ear canal otherwise looks spectacular
Ok, so this is interesting. When I was a correctional deputy, one of the inmates decided to mold some earplugs out of a bar of hand soap instead of purchasing a pair of real earplugs off of commissary. One of the plugs ended up getting stuck against his ear drum.
The in house doctor who was able to remove it after a bit of a struggle figured the guy slept on his side and the trapped body heat must have softened the soap enough that it got pushed inward.
The guy tried to use a sharpened pencil to dig it out but that just shoved it in more to the point that he was getting a really bad earache. He refused to put in a medical slip because he didn’t want to spend the $3 it would have cost him to see the doctor.
I finally convinced him to see medical when his messed up equilibrium was causing him to be unstable on his feet. Once the doc got it all out, he asked the guy why he didn’t buy the earplugs that were only $1. The guy said he figured he could use the soap because it was free and save the $1 for candy.
🤯😱🤦🤦🤦🙅🤷
"are you using cocaine?" "almost never!"