The patient's words were too heavy, and even Lao Ma himself began to doubt the diagnosis of rabies. If the patient clearly remembered that he had never been bitten by a dog or even had his skin broken, how could he have rabies? His husband said he had been bitten by a dog, but his husband was drunk at that time and was confused and could not remember it clearly. The medical history was more reliable.

Of course Lao Ma knew this.

But if the patient is not rabies, why would he be afraid of water? Lao Ma is confused.

Brother Ma, the patient's pneumonia is really not serious. Brother Hua agrees with Lao Ma's point of view. The patient's breathing difficulties should not be caused by pneumonia. Moreover, the patient looks very weak and has no strength all over, and is about to fall asleep while talking. There should be no neurological problems.

Neurological problems are unlikely to cause breathing difficulties. Lao Ma spreads his hands.

Is there a cerebrovascular accident possible? A few cerebrovascular accidents can cause pulmonary edema. This is a nerve reflex, and the patient will also have difficulty breathing and hypoxia... Before Brother Hua finished speaking, he realized that this inference was not valid, because the patient's chest X-ray saw that the pulmonary edema was not serious. A small chest X-ray has provided a lot of iron evidence.

Lao Ma pondered for a while, but didn't answer Brother Hua's words.

The two stood beside the patient's bed, staring at the patient's ECG monitoring, watching the patient's breathing, thinking about whether to put the ventilator on the tracheal intubation and make the patient feel more comfortable. But after all, they didn't know the cause, and both of them were hesitant. Moreover, the patient's current indicators were still bare, and it was not that they had to have a ventilator.

Your husband said that you usually feel a little uncomfortable, but it will be better in a few days. Where is it uncomfortable? Lao Ma suddenly asked the patient.

The patient's eyelids were about to droop. After hearing Lao Ma's question, he raised his head slightly, as if he was trying to raise his head and open his eyes, but he could only raise his head slightly, his eyes were still blurred. He whispered, he just had no strength all over his body, he was very tired and wanted to sleep, and he would be better in two days.

A trace of strangeness flashed across Lao Ma's eyes, and this was caught by Brother Hua. Lao Ma must have thought of something that Brother Hua did not expect, so his eyes lit up.

Do you think the morning is better and the afternoon is worse? Lao Ma asked.

The patient nodded slightly, as if he was reluctant to speak.

When Brother Hua suddenly realized when he heard Lao Ma ask this. Lao Ma, who was standing beside him, was already very excited.

Both of them observed the patient for a long time. The patient's limbs were weak and had no concealment of breathing. It was difficult to even raise his head, open his eyes, and move his limbs. Most people would think that it was the fatigue caused by hypoxia, but at this moment, they thought of a disease that others might not have thought of.

Myasthenia gravis!!

This diagnosis is about to come out.

The patient is very likely to have myasthenia gravis, and it is a myasthenia crisis. He will not be able to raise his head and open his eyes...

These are the first to start

Seeing the patient lying quietly on the rescue bed and the ventilator was breathing, Lao Ma felt extremely safe because the patient's blood oxygen saturation increased to 100%.

Is it because I am afraid that water is not a unique manifestation of rabies? It is not true. If a patient with myasthenia gravis has weak throat muscles and breathing, she will choke and cough when drinking it. And it will be very difficult to drink it. When she sees the water, she will feel fear of drowning and suffocation, so she is very thirsty, but she still dare not drink water.

The neurologist came over and after learning about the condition, he said that it was indeed myasthenia gravis. Patients with myasthenia crisis often had respiratory failure, which is not common in neurology. But no matter what, they can be re-entered for ICU first and then further treatment. After all, the patient has already been on the ventilator.

What is myasthenia gravis? Many people may not have heard of this disease. It is like this. Our muscles are innervated by nerves. Why can nerves control muscles? That is because there are some transmitters in the nerve and muscle junction. These transmitters are secreted by nerve endings and act on the muscles, thereby giving orders to the muscles. When certain reasons (such as immunity) exist, if the transfer process is disordered, the muscles will not listen to the nerves, and muscle weakness will occur. Some patients have eyelid weakness, which is difficult to open their eyes and always squint during the attack. Some patients may have weak chewing, or limb weakness, and some have weak strength throughout the body. Why does myasthenia gravis occur? I don’t know. It is currently believed that it may be related to immunity, etc., can it be prevented? There is no prevention. Only early detection and early treatment.

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At this time, some drugs need to be used for treatment. For example, bromipydimin, this drug can reawaken the handover of neuromuscular junctions and restore muscle strength. There are also hormones and immunoglobulins. We believe that the onset of many patients with myasthenia gravis is related to immune abnormalities, and hormones are the strongest immunosuppressants, so hormone impact treatment is also effective, even efficient.

After receiving ICU, following the advice of the neurologist, he was given treatment with bromipidine, glucocorticoids, immunoglobulin and other drugs. The next day, the patient woke up smoothly and his eyes were wide open.

Seeing such bright big eyes, Brother Hua knew that myasthenia gravis was undoubtedly diagnosed. This big eyes are much more beautiful, and it is a world of difference compared to the patient's weak eyelids last night.

After using the right medicine, the patient's respiratory weakness improved rapidly, and the difficulty of breathing improved significantly. He successfully took off the ventilator and removed the tracheal intubation.

That's right, the patient has myasthenia gravis. It's not rabies, pneumonia, or myocarditis. It's myasthenia gravis crisis. The so-called crisis means that the disease suddenly progresses to the most critical situation, which may be caused by some reasons, such as infection, improper medication, etc.

From then on, patients finally know why they feel uncomfortable all over the body every now and then, that is, myasthenia gravis attacks. However, some people are not serious at the beginning, and may get better after a few days of rest. However, the disease itself is still there and will still occur repeatedly. Moreover, it is milder in the morning, more serious in the afternoon, and more severe in the evening. You must have a good rest. This is called light morning and heavy in the evening.

Behind each symptom, there are countless possibilities, and there is often only one murderer. At least after this time, fear of water is not the same as rabies, and Lao Ma and Brother Hua have learned a lesson. Fear of water is likely to be rabies, but the premise is that there must be a history of rabies bites, otherwise other neurological diseases must be considered.

This was said by Lao Ma.
Chapter completed!