radicalducati Chapter 663
Chapter 663
「663」
soon
The patient Miss Liu was injected with an antagonist for ankylosing spondylitis.
And then one injection a day,
In just 4 days, the results are remarkable.
Miss Liu, who couldn't even get out of bed, could already get out of bed and walk, and her steps seemed cheerful.
What does this say?
It illustrates Lin Feng's diagnosis and is accurate!
Now,
Miss Liu and her parents were extremely grateful to Lin Feng.
On this day,
I specially got a pennant and a fruit basket and sent it to the emergency department.
Many medical staff in the emergency department rushed to take pictures.
Why?
Because it's not too big to watch the excitement!
This pennant,
It has a very special meaning!
As long as it exists for one day, it is a slap in the face to Dr. Wang Lin!
Hang in the emergency department duty room, then Dr. Wang Lin will sit there after that, I'm afraid he can't sit down!
really
When the pennant is hung in the duty room,
Dr. Wang Lin's face was directly black!
Boom~~~~
Dropped a book directly and left quickly.
Dr. Wang Lin felt that behind him, there were many doctors and nurses looking at him sarcastically.
"This Lin Feng..."
Wang Lin gritted his teeth.
He originally thought that when he returned to China with his mentor, he would definitely welcome the support of countless people, and then go smoothly in his work.
Who thinks,
As soon as he returned, he was dismounted by Lin Feng and the medical staff.
This breath is too hard to swallow!
......
......
The undercurrent within the department is turbulent, just embellishment,
The emergency department is too busy,
Lin Feng soon entered a new round of patient diagnosis and treatment.
On this day,
morning
A middle-aged man,
Mr. Zhou,
40 years old,
Symptoms: Right lower abdomen, abdominal pain for 3 days.
Right lower quadrant, abdominal pain,
As an experienced doctor (book friend), what is the first reaction?
Naturally, it is - appendicitis!
However, there is one thing that surprised Lin Feng a little:
The patient, Mr. Zhou, was carried by his friend.
Because in Lin Feng's experience, I have never seen a patient who can't walk with appendicitis and wants others to carry it.
So
Appendicitis???? Be skeptical.
"Lying on the bed, I'll check it for you..."
Do a physical examination.
The focus is on the membranous belly.
Lin Feng pressed Mr. Zhou's stomach a few times,
OK: There is tenderness at the Mai's point in the right lower quadrant, as well as rebound tenderness.
Then ask Mr. Zhou about his symptoms,
Appendicitis is basically supported.
Lin Feng still felt that the pain was too bad, and appendicitis was still doubtful.
"You first hurt, where did it hurt? (Typical features of appendicitis and metastatic right lower quadrant pain)"
Typical appendicitis, at the beginning, is not pain in the right lower abdomen, but pain around the navel, and then gradually manifests as right lower abdominal pain, which is called "metastatic right lower quadrant pain".
Why is this happening?
Because the appendix nerve is introduced by sympathetic nerve fibers through the abdominal plexus and visceral small nerves, appendicitis is mild at first, and the pain passes through the nerve fibers to the brain, and the brain mistakenly thinks that there is a problem around the navel.
Later, the inflammation of the appendix worsened, and the brain really found that the problem came from the appendix in the right lower abdomen, and the pain was fixed in the right lower abdomen.
"It was the appendix in the beginning."
The patient, Mr. Zhou, gave a different answer.
Of course
Appendicitis cannot be ruled out because of this answer. Because many diseases are atypical.
Lin Feng still felt a little problematic,
Repeat the history.
Soon, something caught Lin Feng's attention.
"Wait... You are saying that 4 days ago I had no strength in both lower limbs, and then 3 days ago I had symptoms of right lower abdominal pain..."
"Yes."
The patient, Mr. Zhou, apparently had weakness in both lower limbs, and expressed his accustomed to it and did not take it seriously.
"Wait, I'll give you another check-up, lie in bed..."
Lin Feng this time,
It is a strength test.
Soon, Lin Feng found that the patient's muscle strength in both lower limbs was only level 3 (normal people are grade 5), muscle tone increased, hyperpain in the plane below the umbilicus (more likely to feel pain, equivalent to pain amplification, more sensitive), and lack of temperature (insensitive).
So far!
Lin Feng can roughly judge, not - appendicitis!
It's a neurological problem.
Then, the right lower abdomen, and both lower limbs, where are the nerves mainly walking?
Spinal cord!!
So, inference: the thoracic spinal cord (at least the right lower abdomen upwards) is wrong!
"Let's do an MRI..."
"Dr. Lin, what is MRi?"
"MRI..."
Mr. Zhou looked confused.
"How much does it cost?"
"More than 800, it seems..."
“.................."
Mr. Zhou, all of a sudden.
"Dr. Lin, can you tell me that this examination is something to check or something?"
Lin Feng smiled and explained patiently:
"I just gave you a lower physical examination, right abdominal pain, it seems that it should be a problem with appendicitis, but after checking your muscle strength, it is clear that your lower limb muscle strength is not right, indicating that there may be a problem with the nerves, combined with right abdominal pain, I suspect that there is a problem with the spine... Of course, you can do not do MRI, first draw blood routine, B ultrasound, confirm whether there is appendicitis ... If there is no appendicitis, then there should be a problem with the thoracic spinal cord, go to MARI ... Just choose for yourself..."
Mr. Zhou listened and finally said:
"Let's do a blood draw first..."
"No problem, I'll bill you..."
Student Xiaoru quickly printed the "Blood Routine" and "Abdominal Ultrasound" checklist.
The patient, Mr. Zhou, took the checklist and went for the examination under the burden of a friend.
......
An hour later,
Really!!
It was exactly the same as Lin Feng thought.
Blood routine: no changes in white blood cells. (Appendicitis has inflammation, which then causes changes in white blood cells)
· Ultrasound, no enlargement of the appendix,
..