Chapter 241: Unable to find the cause of the disease, an unexpected discovery
The patient underwent three MRIs in total, including MRI examinations of the heart, abdomen, and lungs.
But no problem was found.
As for the CT scan and X-ray examination done by the patient, they also focused on the chest and abdominal cavity. Strangely enough, the patient was fine except for mild gastric ulcer and mild fatty liver.
The gastric ulcer has healed after treatment.
This can be seen from the patient's latest examination.
The first hospital the patient went to for treatment was a municipal hospital in another province. After the doctor examined the patient, the diagnosis was gastric ulcer and mild fatty liver.
It is suspected that gastric ulcer caused the vomiting.
But after the gastric ulcer was cured, the patient's condition still did not improve much. The attending doctor of the Municipal People's Hospital was probably so confused that he doubted his life.
It's definitely a headache.
While the two senior doctors were thinking about the cause of the disease, Zhou Can picked up a brain CT film that he thought was suspicious and took a look.
This is also the only brain CT scan taken by the patient.
Everything seems normal, nothing seems wrong.
However, he did not put the film down immediately, but continued to observe it carefully.
This brain CT scan was taken at the provincial people's hospital where the patient lived. After the gastrointestinal tract, even the chest and abdominal cavity, were completely checked and no cause could be found, the attending doctor probably began to change his diagnostic thinking and wanted to see if there was a brain tumor.
The results did not reveal any obvious abnormalities.
Zhou Can also suspected that there was something wrong with the patient's brain.
In addition to causing great harm to organs such as the liver and kidneys, drunkenness also causes serious damage to the brain.
It can cause vasoconstriction and reduced blood flow in the brain, leading to hypoxia of the cerebral cortex, intellectual impairment, lack of concentration, decreased memory and judgment, and even visual impairment.
Anyone who has ever been drunk will find that things seem to be spinning around, or even upside down.
Or there may be double images.
In addition, alcohol will affect the blood supply and nerves of the brain, causing brain atrophy and accelerating the aging and death of brain cells.
According to medical research, alcohol is particularly harmful to the nerves.
This patient often has to drink alcohol at social events, so the damage to his brain must be considerable.
Zhou Can was suspicious in this direction.
Like the attending physician at the Provincial People's Hospital, Zhou Can examined the brain CT scan and first checked whether the patient had a brain tumor.
In this era of high incidence of cancer and hemangioma, the chance of developing a brain tumor in the skull is too high.
But after a careful inspection, Zhou Can was finally slapped in the face.
He didn't even find a small tumor with a diameter of less than 0.5cm.
Even a small hemangioma is good!
None at all.
Zhou Can couldn't help but think of a difficult case he had successfully diagnosed. The patient was a student who had symptoms similar to enteritis due to excessive pressure from the high school entrance examination. The patient was eventually diagnosed with neurotic digestive dysfunction.
Could this patient also be suffering from neurotic digestive disorder?
This possibility cannot be ruled out.
He subconsciously looked at the patient.
From the medical records, we can see that the patient is now 41 years old, which is the most stressful age in a man's life.
Could it be that it was due to stress that eventually led to non-parenchymal vomiting?
This is really possible.
"Excuse me, before he got sick, was your family under a lot of financial pressure?"
Zhou Can asked the woman.
"It's OK! My husband's annual income is not bad, and I also had a stable job at the time. Basically, our annual income combined would not be less than seven figures. As for work pressure, there is definitely some. But my husband is a very optimistic and cheerful person. He often takes me and the children out to travel to relieve stress."
The woman thought about it and answered seriously.
Zhou Can instantly looked up to the couple.
Those who can achieve a stable monthly income of more than 20,000 yuan are basically the elite of this society. No matter what means are used, as long as it is not illegal, as long as this income can be achieved, it is very remarkable.
The couple's combined annual income exceeds seven figures, at least over one million.
With such a high income, you can live a comfortable life in any city.
It is true that you cannot judge a book by its cover, and you cannot measure the depth of the sea.
Looking at the way the couple are dressed, they are both very ordinary.
Who could have imagined that their incomes would once be so high!
What people fear most is getting sick.
It can be imagined that this male patient must have been full of energy and vigor before he fell ill, a rare talent among men.
As a result, after falling ill for just over a year, he was no longer in human form.
Many successful people emphasize that good health is the most important thing. They compare good health to 1 and career success to one or more zeros.
When the 1 representing health does not exist, no matter how many zeros follow it, it is useless.
"We have already done all the necessary tests. There is no point in doing it again. The cause of his illness is too complicated. I have no way of diagnosing it with my decades of experience. Given his current condition, I am afraid we cannot admit him to the hospital for observation. Even if we admit him to the hospital, if we cannot find the cause, our hospital will be helpless."
Director Shang thought for so long but couldn't find where the patient's lesion was.
So I could only tell the family that they should seek help from someone else!
Some people may think it is a very shameful thing that experts cannot find the cause of the disease.
In fact, whether in ancient times or modern times, it is very common to fail to find the lesion. In ancient times, the imperial doctors and famous doctors in society were already amazing!
However, when a member of the royal family fell ill, they would often kneel down in a large group and apologize.
Because they couldn't find where the lesion was.
There is no way to start.
If you can't diagnose the problem, the best thing to do is to admit it.
Forcing someone to take medication is a mistake on top of a mistake.
It's easy to move your head.
The woman became anxious when she heard this.
"Professor Shang, please find a way to save my husband! I have taken him to many large hospitals, and they told me that Tuya Hospital is very good at treating digestive diseases. I have come here with my husband from afar, please find a way. I will even kowtow to you."
The woman's determination to save her husband is touching.
Director Shang was a little hesitant for a moment, as hospitalization was definitely not an option.
The patient is already so ill, but the cause of the illness has not been found. He will most likely die in the hospital if admitted.
Even if the family members do not cause trouble at that time, it will be extremely disadvantageous to the doctor involved.
"Hurry up, hurry up! Our Tuya Hospital is really limited in quality! As long as it can be cured, we will never leave it alone. The Renhe Hospital in the imperial capital is better than our Tuya Hospital in terms of the level of doctors and the level of advanced equipment. You can take your husband to the imperial capital to have a look."
Director Shang tried hard to push the patient out.
The family was recommended the Imperial Capital Renhe Hospital. This move was exactly the same as those small hospitals pushing patients to Tuya Hospital.
"Where else can my husband go in this condition? Even if we go to the capital, we are unfamiliar with the place and I am afraid we will still not be able to find the cause of his illness. Professor Shang, please have mercy on my husband! I beg you!"
The woman was in tears and she even knelt down and kowtowed to Director Shang in order to save her husband.
Zhou Can looked at all this and felt particularly moved.
Husband and wife are birds of the same forest, but when disaster strikes, they fly away separately.
With the husband being so ill, if his wife were a little colder, she would have run away long ago.
It would be great if we could find out the cause of the patient's illness.
Apart from anything else, just based on this woman's attitude of saving her husband, it is worth doing our best to help her.
"I'll prescribe hospital admission for you, and then find an opportunity to invite other experts from the hospital for a hospital-wide consultation. If we still can't find the cause, then we really have nothing we can do. Then, you can go to other hospitals for a checkup. Is that okay?"
Director Shang looks serious, but he has a soft heart.
Seeing the patient's family members kneeling like this, he had no choice but to bite the bullet and admit the patient to the hospital.
In fact, with his rich experience in diagnosis and treatment, he clearly stated that if a disease cannot be diagnosed, hospitalization is unlikely to produce any results.
"Thank you, thank you!"
When the woman heard that the doctor finally agreed to admit her husband to the hospital, she was so happy that she thanked him repeatedly.
Many family members and patients are panicked and frightened when facing terrible diseases. At this time, doctors are their only support.
Even if they don't receive any treatment in the hospital, they will feel more at ease.
In fact, once a hospital admits a patient, it needs to be responsible for the patient's safety.
We will indeed do our best to treat the patients.
"According to the hospitalization procedures, some basic tests need to be repeated, such as blood tests and electrocardiograms. Do you think this is okay?"
"Okay! We understand."
This was not the first time that she and her husband had been hospitalized, so she was quite familiar with the hospital procedures.
Director Shang did not rush to issue an application for examination, but turned to look at the assistant physician Huang Xinggui.
“Are there any beds available in the inpatient department?”
"I'll call and ask. Beds are always in short supply, so I don't think there are any. Because I still have a dozen patients waiting in line, waiting for beds to be vacated for hospitalization."
Huang Xinggui called the inpatient department on the spot.
When I asked, it turned out that there wasn't any.
"Come on, let me tell you!"
Director Shang heard it clearly from the side.
Faced with the earnest looks in the family members' eyes, and considering that they came from other provinces, I really couldn't bear to send them away.
"Hello, I'm Shang Feng! There's a patient here who came all the way from another province. He's been to many hospitals but couldn't find the cause of his illness. I think they're having a hard time. It's really inconvenient for a woman to carry her husband who weighs over 100 kilograms. Can you think of a way to get him a bed?"
It's not easy to arrange a bed.
Even though Director Shang is the head of the department, he still spoke with a thick face.
"Okay, okay, thank you!"
Director Shang hung up the phone.
It seems that he is quite satisfied with the result.
"The inpatient department said that we need to coordinate first. If there are really no beds, we can only add a temporary bed in the corridor. When a bed becomes available tomorrow, we will give you priority."
It's already afternoon and the possibility of beds being available is extremely small.
It is more reliable to add a temporary bed in the corridor.
In line with the principle of humanity, the hospital sometimes has to temporarily add a bed in the corridor in the face of some special situations. After the patient is accommodated, at least there will be medical care to manage the patient.
I can also take medication and receive intravenous drips normally.
"Thank you, thank you so much!" The woman knew how difficult it was to achieve this result, and she thanked Director Shang with tears of gratitude.
If Director Shang hadn't said this, her husband would have had to wait in line for a bed like other patients.
After making all the arrangements, Director Shang then issued an application for examination for the patient.
Zhou Can was studying the blood test results that the patient had done not long ago. He had already applied for all the tests for the patient, but he had no intention of letting it go.
"Doctor Zhou, why don't you pack up the patient's examination data and let them go for the examination first!"
Director Shang reminded Zhou Can.
"Oh well!"
Zhou Can was so engrossed in his thoughts that he didn't notice these things.
He quickly put the blood test results into a plastic bag and handed it to the patient's wife.
"We are going to be hospitalized anyway. If you are willing to study it, just leave these examination data here. I will come and get them when you are almost off work."
The woman did not look down on Zhou Can just because he was young.
Instead, she was very happy to let him study her husband's examination records.
"Well... wait until you've completed the hospitalization procedures, and then I'll go to the inpatient department to see him. It's getting late, so hurry up and take him for a checkup! If necessary, you can borrow a wheelchair under the stairs at the corner of the outpatient hall for temporary use. I see that it's quite tiring for you to carry him, so it would be much more convenient to push him in a wheelchair."
Zhou Can suggested to her.
I don't know if the family members are superstitious about this, or if they think it's unlucky for a non-paralyzed person to sit in a wheelchair. They would rather carry such a heavy person around to seek medical treatment than buy a wheelchair to deal with it.
"Okay, thank you!"
The woman struggled to carry the patient on her back and almost fell down. Zhou Can hurried over to help her.
“Be careful, be careful!”
After helping to escort the patient and his family out of the door, Zhou Can finally turned around.
However, he was always thinking about the cause of the patient's illness.
To diagnose this extremely difficult case, doctors need to constantly search for the real lesion from clues and separate the true from the false.
This process is extremely difficult and complicated.
…
Around five o'clock, the woman came in pushing her husband in a wheelchair.
All the hospitalization examinations have been completed and the results have been obtained.
Director Shang took the result and looked at it. There was no serious problem and the patient could be admitted to the hospital.
It must be explained here that inpatients must undergo some necessary examinations before they can be admitted to the hospital. This is based on many considerations, mainly divided into two aspects.
One is to prevent patients from having infectious diseases. If a patient has an infectious disease, he or she cannot be admitted to the hospital or will be directly sent to the infectious disease department for treatment.
Another consideration is to screen patients for hidden high-risk diseases.
If the patient dies as soon as he is admitted, the hospital will never be able to clear itself of blame even if it jumps into the Yellow River.
This must be prevented.
Director Shang personally issued a hospitalization certificate to the patient.
Before the patient left, Zhou Can stopped them.
"Wait! Let me ask you, he repeatedly raised his hand to scratch his head with great effort. Is it itchy?"
Zhou Can walked over and looked at the patient's head while asking.
Not washing your hair for a long time may cause scalp itching.
The patient scratched the right side of his head. It was not known whether he was too weak and had no strength to scratch only this area or what.
The first time the patient stayed in the outpatient department, Zhou Can noticed that in less than thirty minutes, the patient scratched his head four times.
Although this was just an inconspicuous action, it made Zhou Can suspicious.
Just now, the patient scratched his head again, and Zhou Can then asked.
"I don't know. Because he was so sick, I couldn't move him and couldn't wash his hair. I could only shave his head and wipe his head with a wet towel. Maybe it would be a little itchy if you don't wash your hair for a long time. But I remember that before my husband got sick, he would often raise his hand to scratch his head. This seems to be a habit of his."
The woman talked about her past, her eyes filled with fond memories.
Zhou Can carefully examined the right side of the patient's head. There was no hair blocking it, so he could see it clearly.
There wasn't much to discover.
At this time, Zhou Can noticed that the patient's scalp had a slight bulge, and then collapsed. A normal person's scalp may also have a pulse beating phenomenon.
Just after the scalp slightly bulged and then quickly collapsed, the patient raised his hand to scratch the itch again.
However, because it was too tiring, I soon gave up.
Zhou Can originally wanted to observe for a while longer, but he was in a hurry to complete the hospitalization procedures and it was almost time to get off work.
He had to give up.
Anyway, once the patient is hospitalized, there will be plenty of opportunities to observe him carefully.
As the shift was about to end, there were basically no new patients. Most of them came back with their test results to see Director Shang for further diagnosis.
Director Shang treats every patient very seriously.
After a careful reading, a certain answer will be given.
Zhou Can stood at the back and studied, and learned a lot.
Soon, it was time to get off work.
No more patients came at this time.
Basically, patients who can get the test results on the same day have already arrived before the end of get off work.
"Doctor Zhou, I've been studying in the outpatient clinic for an afternoon. How have you learned? Are you able to adapt?"
Director Shang kindly asked him how he felt.
"I've gained a lot. I've learned a lot from you about diagnosing gastrointestinal diseases. For the patient who couldn't find the cause of vomiting, do you think his problem might be in his brain?"
Zhou Can had been thinking about the cause of this patient's illness. Now that he was off work, he finally had the opportunity to discuss it with Director Shang.
"Do you suspect neuropathy?"
Director Shang asked.
"It's a bit like that, but it's not. I suspect it's another disease that's easily overlooked."
Zhou Can expressed his own views.
