Dr. I am a 35 year old white male. 190lbs and 5 5 tall. My Chelesterol is borderline between high and average. my blood pressure is excellent. heart rate excellent. Currently taking a underarm testosterone replacement (Axiron) and hydrocodone (350mg x 4 daily) for pain maintainance until foot surgery in March. I use chewing tabacco daily (about 1/2-3/4 tin). Stress level is high and live with PTSD. My reason for contacting you: 2 weeks ago I visited a spa that was not very clean. They have a dry sauna and showers on-site which I used. The linens didn t seem fresh, but in low lighting it was hard to tell, but as a clean freak I am worried about how I am feeling since visiting this place. A few days after visiting spa, I began itching in the anal gential area. I thought it might have been crabs or lice from the intensity of the itch. My wife and I checked and no bugs or feces were found. My wife thinks it might be a yeast infection probably from bacteria plus a generally poor diet. She has had yeast infections before and I have gotten them from her before. 2 weeks later I am still itching, have a very slight burn while urinating. The itching seems to be widespread now but mainly in crotch, inner thigh, anal areas and buttocks. I have also had days of constipation as well as dirreaha, upset stomach, small bouts of vomiting, swings between high aNd low appetite. And recently developed sharp pains between belly button and ribs as well as occasional pain in the right inguinal region and groin. A other items to note are shortness of breath and 1 instance of tightness in chest when anxious. I am not sure they are all related. The itching is driving me crazy and after self-diagnosing from research online, I am feeling quite anxious. I have had thoughts that it could be the hydrocodone, but I have been on this dose for 4 months now and I have never had itching as a reaction. I even tried to endure my current pain and gave up the hydrocodone for a few days, but the itching didn t subside. I have had foliculitis in the past and this doesn t have the same look or bumpiness that that had. I have non-fragrant liquid soap now and have applied non-fragrant bacterial cream and monostat cream in jock, anal, and buttocks regions. Again, I am overall clean and aware of my general skin sensitivity. There are no real signs of rash, blotchiness, or dry patches. Some small pimples here and there but no tremendous groupings. I am noticing some skin redness and skin damage due to scratching. Overall, I am wondering if the itching plus the digestion issues could be related? Could I have an intestinal parasite or even pinworm? I mention pinworm because it intensifies at night and I thought I noticed a small rice-like brown/white (odd) looking thing on toilet paper after bowel movement...reminded me of a small maggot. I was to disgusted to touch it or probe it. However the itch almost feels like something crawling in small areas then move to another area shortly after scratching that area. My research on these critters has made me suspicious, especially since I had what seemed like a day of food poisoning a few days prior to going to the spa. Any thoughts or direction would be helpful in plan for my Dr visit Thursday, my next free day off. Thank you, J