latelenovela Chapter 351
Chapter 351
"No blood in the stool..."
"Is there constipation?"
"No, it's normal..."
"Show me nails..." (see if there will be iron deficiency anemia)
The patient holds out his hand.
Lin Feng looked at the patient's fingernails, very healthy, no problem.
Temporarily rule out "anemia".
Next, start to check for "muscle weakness"...
Just when Lin Feng wanted to ask for a consultation...
At this time, the patient spoke again:
"Doctor Lin, in addition to my bad appetite and lack of strength, I often have paralysis of my lower limbs, that is, I feel numb..."
Lin Feng was taken aback!
In this case, if it is a serious disease, it may be a problem with the cranial nerve, or it may be that the lumbar spine compresses the nerve and causes numbness of the lower limbs...
Lin Feng asked, "Is there often?" "
Patient: "Nor is it ... It's once or twice a day, two or three times a day, three or four minutes each time..."
Lin Feng frowned...
This situation, to be examined to be clear, may be a problem with its own nerves.
"I'll give you 3 orders, look at "lumbar MRI", "brain CT", "electromyography"..."
First of all
There is numbness and weakness of the lower limbs, saying that the first consideration of nervous system problems, head CT is a must be done, first rule out whether there is cerebral hemorrhage, cerebral infarction, brain tumor and so on.
At the same time, the lower limbs are numb, and there is a possibility of lumbar spine compression, so a lumbar MRI examination should also be done.
The electromyogram corresponds to "muscle weakness".
Lin Feng explained these three to the patient.
"Doctor Lin, you open."
Now the patient is still very afraid of his current illness, at this time he no longer cares about money, and does not dare to save this money.
......
After 2 hours,
All three tests yielded results.
MRI of the lumbar spine: a little lumbar disc herniation. This is far from compressing the nerves, which is not enough to cause limb pain and numbness.
Cranial CT: No problem.
Electromyography: there is damage to the nerves of the lower extremities, and the nerve conduction rate is slowed.
Lin Feng looked at this result,
Breathed a sigh of relief.
Sure enough, muscle weakness!!
However, muscle weakness is only a manifestation.
What is the cause?
Acute myelitis?
Periodic paralysis?
Myasthenia gravis?
Lin Feng thought about it, but he didn't feel like it.
Especially in myasthenia gravis, muscle strength will improve as long as rest and sleep, but the patient said that after a week of rest, it was not good, indicating that it was not.
At this time,
Lin Feng suddenly thought of another disease:
"Guillain-Barré syndrome"!
This disease manifests muscle weakness, numbness, is peripheral nerve inflammation, may be related to autoimmunity, patients may also have fatigue, poor performance, because it is nerve inflammation, so there will be numbness, weakness and other manifestations, some severe cases will even appear paralysis, respiratory failure.
"You may currently have Guillain-Barré syndrome..."
Lin Feng explained what "Guillain Barré syndrome" is...
After the patient listened: "Dr. Lin, I believe you, you say, what should I do next?" "
Lin Feng: "If it is "Guillain Barré syndrome", the cerebrospinal fluid will manifest, so it is best to do a "lumbar puncture"..."
"Huh?"
Puncture?
The patient does not understand medical things, but when he hears this 'puncture', it is very fierce.
"Dr. Lin, can you explain it to me? puncture..."
"Oh... In fact, it is a needle that penetrates through the lumbar spine and extracts the spinal fluid inside..."
“........................"
The patient's face changed at this moment.
It hurts to hear!
Don't talk about him, his wife's face turned white.
"Doctor Lin, is there any other way?"
"No, to diagnose Guillain Barré syndrome, this test must be done... If the diagnosis is not clear, in case of paralysis in the future, it will be more tricky. "
Lin Feng threatened.
The kind that is deliberately said to be the worst.
"Paralyzed?"
At this moment, the patient and his wife were frightened and screamed in surprise!
"So, ah, I still have to do this check... By the way, there is local anesthesia, it will not be very painful. "
"This..."
After a few minutes of struggle, the patient finally agreed to a lumbar puncture.
Puncture is more uncomfortable than patching up the paralysis.
......
Soon, Lin Feng performed a lumbar puncture on the patient.
puncture
It is a long needle of more than 20 centimeters, inserted from the back of the waist, all the way into the lumbar spine.
The clear fluid-like spinal fluid is then withdrawn.
Lin Feng's technique is naturally very skillful.
Very smoothly, the spinal fluid was withdrawn for the first time.
Then it was sent to the laboratory department for inspection.
Three hours later, at 1 p.m., the test results came out."
Guillain-Barré syndrome is not supported!
Now,
Lin Feng wondered.
The patient's clinical manifestations, and electromyography, brain CT and a series of other examinations, are quite in line with "Guillain Barré syndrome"?
But
This test result cannot deny 100% of the disease of Guillain Barré syndrome.
"Let's get into the hospital..."
Lin Feng made a decision.
Admit the patient, observe the treatment, find the cause... Or do a new lumbar puncture.
......
Flash
Four hours passed,
The patient was admitted to the hospital for observation...
Lin Feng continued to receive patients in the consultation room, and received more than 30 patients...
By 17:00...
Lin Feng was ready to leave work, go to the ward, and hand over the patient with other doctors.
One by one, the patients were handed over, and soon everyone came to the patients with muscle weakness.
"Hmm???"
Lin Feng's nose twitched violently...
"Alcohol?"
He smelled alcohol, thick ...
Lin Feng glanced at the patient's hospital bed, and then saw a bottle of wine on the bedside table, the kind of two pot head...
Lin Feng frowned: "You drink?" "
The patient was embarrassed: "Ahem... This one...... Yes..."
The bed nurse was angry all of a sudden: "Didn't you emphasize not to drink?" How did you drink? Are you all like this, and you still drink? "
She didn't even notice it, a little weak-hearted, a little annoyed.
The patient scratched his head and was embarrassed: "All of a sudden alcohol addict ... I'm from the northeast, just this mouthful..."
And at this time,
Lin Feng's heart moved,
A possibility came to mind!
Is it the illness caused by drinking?
Happy in my heart!
"Do you like to drink?" Lin Feng asked urgently.
"Yes, I'm from the northeast, and I've been drinking since I was a child..." the patient laughed.
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ps: Three more ends...
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