Chapter 109 Director Yin’s excitement, being entrusted by others, and being loyal

Author: Jiangbian Yuweng

Chapter 109 Director Yin’s excitement, being entrusted by others, and being loyal

The relationship between blood and body is like that between gasoline and car.

When a car leaves gasoline, it loses its source of power. When the body's blood does not circulate, nutrients and oxygen will not be supplied to the body's cells.

Paralysis is often accompanied by problems with the blood supply.

For example, patients with hemiplegia may feel that the paralyzed side is particularly sensitive to cold, has poor blood flow, is numb, etc.

"The blood supply to her lower limbs has not been seriously affected!"

Director Yin said with certainty.

So many famous doctors have seen it. If they can't find such a simple problem, wouldn't those famous doctors be in vain?

"No, no, no, I'm not referring to the blood supply of the lower limbs, but the blood supply of the upper limbs."

Zhou Can's eyes were firm, revealing an excited light of seeking the truth.

"Is there a problem with the blood supply to the upper limbs?"

Director Yin frowned. If he hadn't seen Zhou Can's ability, he might have scolded him, "You have to study for a few more years!" and then turned around and left.

At this moment, he was maintaining great patience and even had a hint of expectation.

This difficult case was one that he failed to solve three years ago. Today, three years later, he still cannot make a clear diagnosis.

The more difficult it is, the more interesting it is to him.

Because at his level, cases of normal difficulty no longer pose any challenge to him.

"Due to muscle atrophy, paralyzed patients will naturally suffer from insufficient blood supply, especially to the terminal limbs. To be honest, I shook hands with the patient and her hand was very cold, indicating that there must be a problem with the blood supply to her upper limbs. At that time, I still

I'm just curious. After listening to your advice just now, I got some inspiration."

"Since there are no major abnormalities in her electrocardiogram, it means that the blood supply to the whole body should be relatively balanced. So I suspect that she has a systemic insufficient blood supply caused by damage to her motor neurons."

Zhou Can boldly conducted a series of inferences and dialectics.

"Well, it is indeed possible. But it doesn't mean anything. It is common for paralyzed patients to have blood supply that is weaker than normal."

Director Yin Hua didn't pay much attention to Zhou Can's discovery.

It can even be said that I am a little disappointed.

The weakening of the blood supply to the whole body is just a common phenomenon that occurs in most paralyzed patients.

In the words of traditional Chinese medicine, it means that there is excess and loss of blood and Qi, and there is a deficiency of Qi and blood.

"I checked the cause of the patient's miscarriage that year. The patient stated that he first carried heavy objects upstairs, then felt unwell, and finally fainted at home. However, the diagnosis after admission showed viral infection? Cranial nerve abnormality?"

Zhou Can clicked on a diagnosis sheet from when she was first admitted to hospital.

This is a very original medical record.

That year, after she fainted, she was sent to the Third City Hospital for treatment by the 120 ambulance in accordance with the principle of nearest rescue.

She developed paralysis of her lower limbs after the miscarriage. The Third City Hospital could not diagnose the cause, so her family sent her to the Provincial People's Hospital, which has a higher level of medical care. Later, the Provincial People's Hospital also could not find the cause, and the patient became severely depressed.

The family transferred him to Tuya Hospital for further diagnosis and treatment.

Many patients will have this experience. They thought it was a minor illness, but after treatment in ordinary hospitals, it was ineffective. In the end, it could only be upgraded level by level.

Three years ago, the reputation of the Provincial People's Hospital was similar to that of Tuya, or even slightly better.

Today, Tuya Hospital has left it behind.

It has become the hospital with the highest medical level and diagnosis and treatment capabilities in the province.

"Do you think the patient may have had symptoms of lower limb paralysis before being admitted to the hospital?" Zhou Can made another extremely bold speculation.

"It should be impossible. Before admission, the treating doctor will definitely do a series of examinations on her. The medical level and diagnosis and treatment capabilities of the three hospitals in the city are not bad, and their medical quality control has always been extremely strict. If the patient was

If there is paralysis of the lower limbs, it will definitely be written on the admission record. But they clearly stated paralysis after abortion in the medical record."

Director Yin is well aware of the strength and medical style of various hospitals in the city.

At this level, you should often be invited to major hospitals to participate in exchanges, guidance or lectures.

After having contact with the doctors in those hospitals, you will naturally have the opportunity to understand that hospital.

"Could it be that when the patient was admitted, the paralysis of his lower limbs was not obvious yet, so he was ignored? The 120 admission record states that the pregnant woman fainted in the toilet at home."

Zhou Can persisted in this determination.

"This situation is quite possible."

Director Yin agreed with Zhou Can's point of view this time.

"It's a pity that the Third City Hospital lacks high-level doctors who can support the hospital. It would have been nice to have measured myoelectricity for this patient at that time."

If the pregnant woman had undergone electromyographic testing when she was admitted to the hospital, it would have provided a strong basis for subsequent diagnosis.

Now that it has been more than three years, the inspections that were not done will have a completely different meaning if they are done again.

"Director Yin, please take a look at these examination reports. These are electromyography tests done by Renhe Hospital in Imperial Capital. Yesterday, I specially compared them with several electromyography monitoring reports of normal people. Qiu Jie's nerve conduction velocity is not the same.

Slowly, just from the neck down, the intensity of the myoelectric signal continues to attenuate. Like climbing a slope, the closer to the lower limbs, the weaker the attenuation."

"Then her evoked potential electromyography test and motor unit count showed no obvious abnormalities."

Director Yin has long discovered what Zhou Can said.

"What do you want to say?"

Director Yin didn’t know that he had assisted so many evidences, what exactly was he trying to identify?

Pathological diagnosis is extremely complex, especially in such difficult cases, the difficulty of syndrome differentiation is even more frightening.

Everyone will read the inspection information.

To find a clue among thousands of clues and then sort them out clearly is the level of diagnosis.

"I think the patient's cause is a problem with the source of the motor nerves in the lower limbs. Her lesions are above the neck, and postpartum infection should be just a false cause of the disease."

What Zhou Can is doing now is to clear the air and find the real focus.

"There may be a problem with the spinal nerves, or there may be a problem with the nerve center or brainstem." Zhou Can further added.

[Pathological diagnosis experience value +0.9.]

Looking at the sudden increase in experience points, his heart beat faster and he became more convinced that his diagnosis was correct.

His diagnostic method, which is almost blind guessing, would not be recognized by famous doctors or even senior residents who have undergone standardized training.

However, pathological diagnosis sometimes must dare to break out of the constraints of the framework and cannot stick to the rules.

One of the biggest shortcomings of Western medicine is that it is not flexible enough.

It all talks about checking the data.

Even if there is inspection data, there is still a question mark after the diagnosis result.

Why?

Because I am afraid of being overthrown and being slapped in the face!

Under China's current medical system, what doctors fear most is misdiagnosis and medical malpractice. The question mark after the diagnosis results reflects many practical problems.

In the final analysis, it is also a kind of lack of confidence in Western medicine.

Looking at the old Chinese medicine practitioners in the past, there was rarely any ambiguity. Either I couldn't understand your disease, please ask someone to be smart. Or they could clearly determine the focus of the disease, write down the pathology, and then prescribe a prescription.

"Why is the diagnostic experience value only increased by 0.9?"

This is the first time Zhou Can has encountered this situation.

I have encountered situations where the experience value was increased by 0.2 before. That was because the patient had multiple lesions at the same time and he only diagnosed one.

The experience value obtained this time is very close to 1. The difference of 0.1 is probably because the specific location of the lesion has not been determined yet.

Director Yin fell into deep thought after listening to Zhou Can's diagnosis.

One minute passed, two minutes, three minutes...

This time it was his turn to fall into a 'magic confusion' like Zhou Can.

In fact, many famous doctors have this characteristic.

In order to conquer a certain disease, one may forget to eat and sleep, even when eating, going to the toilet, or even sleeping and dreaming, thinking about diagnosis and treatment.

After nearly six minutes, Director Yin followed Zhou Can's diagnosis and reorganized his thinking.

His eyes were shining with excitement.

That was the excitement and excitement that only came after a major breakthrough in diagnosis.

"Xiao Zhou, what you are talking about is entirely possible. After repeated arguments, I feel that this female patient's paralysis is probably due to changes in the cranial environment, or compression of the cranial nerves. Hemangioma, neuroma, osteoma, basically all can

exclude."

After all, a lot of inspections have been done.

There is a tumor in the brain, it must have been found.

"If the patient is willing, you can ask her to come to the hospital to see me for another diagnosis. My opinion is to give her another head MRI. There is a high chance that the exact lesion can be found."

Director Yin said to Zhou Can.

If the patient doesn't want to believe Director Yin, or has given up hope in Tuya Hospital and refuses to come, then there is nothing we can do.

"Okay, I'll inform her now."

"If she is willing to come, there is no need to register again. I will explain it to the hospital when the time comes."
To be continued...