Chapter 616: Locking Gray Matter, Family Members’ Trust is the Motivation
Because the risk of surgery is so high, moving a vertebra is like moving the main beam of a house. Both doctors and patients should be extremely cautious. The consequences can be compared to moving the load-bearing wall of a house during modern renovation.
After Zhou Can found out that the boy's neurological function decline mainly started from the medulla oblongata, his mind quickly recalled the relevant anatomical decomposition of the nerves.
Each spinal cord segment gives off a pair of spinal nerves, for a total of 31 pairs.
There are 8 pairs of cervical spinal nerves.
If you want to check, just check the cervical nerves.
There is no need to check the remaining 12 pairs of thoracic nerves, 5 pairs of lumbar nerves, 5 pairs of sacral nerves and 1 pair of coccygeal nerves.
Speaking of the coccyx, there is a particularly interesting phenomenon.
Most people have only one pair of coccygeal nerves, but a few people have two pairs of coccygeal nerves, giving them a total of 32 pairs of spinal nerves.
Just like some people have only 8 molars, while others have 12.
Although the extra four teeth are called wisdom teeth in medicine, their functions are no different from those of molars. With four extra molars, people with this type of teeth will have stronger chewing functions.
It looks like an inconspicuous enhancement of chewing function.
It seems like people with 8 molars can still eat.
In fact, people with 12 molars benefit in many ways. First, their teeth are stronger, so they can grind more food in the same amount of time. And they can grind the food into finer pieces.
This will ease the digestive function of the gastrointestinal tract.
In medicine, both Chinese and Western medicine recommend chewing slowly and swallowing thoroughly, which is to take care of the body's digestive organs.
Especially our stomach.
The stronger the digestive function, the stronger the body will be, in theory. At least it will be easier for a person to get nutrition than a person with 8 molars.
People with an extra pair of spinal nerves are not monsters.
Some scientists believe that this is a feature of incomplete human evolution. Because the extra pair of coccygeal nerves can also be seen as being used to control the tail. However, humans have long lost their tails during the evolution process.
This will make the lower limb movement function more flexible and stronger for people with 32 pairs of spinal nerves.
At least that's how it can be understood in theory.
The little boy couldn't speak, couldn't move his head, and couldn't move his body.
If we want to further find out which part of the spinal nerve has a problem, it is difficult to accurately determine the problem by checking the electroencephalogram or the body's nerve conduction.
According to the anatomical structure of the spinal cord, the spinal cord consists of gray matter, white matter, central canal, anterior and posterior cords, spinal ganglia, spinal nerves, etc.
The gray matter part is the lower center of human body's reflex activities.
Including patellar reflex, urination reflex, defecation reflex, sweating reflex, sexual reflex, etc., all need to be transmitted through the gray matter of the spinal cord.
Many patients with paralysis of the lower body will suffer from urinary and fecal incontinence, which is due to problems in the lower nerve centers.
Zhou Can performed a knee-jerk reflex test on the child to check the lower nerve centers.
The knee jerk reflex in the right leg was weak, but the reflex in the left leg was normal, which meant that there must be something wrong with the gray matter of the spinal cord.
This is actually a very good diagnostic direction.
He went to ask Director Yin for advice, hoping to use this as a breakthrough point to see if Director Yin could provide more diagnostic experience for him to learn from.
Director Yin did provide a lot of valuable clinical diagnostic experience, but it was somewhat contrary to Zhou Can's ideas.
In other words, the two don't go together.
It’s not that Director Yin’s diagnostic opinions are useless, but they don’t point to the idea discovered by Zhou Can.
This is also a common problem among veteran experts.
Precisely because they have so much clinical experience, their thinking is relatively rigid and not as flexible as that of young people.
If I have to describe it, the diagnostic thinking of older experts is more stable, while that of younger doctors is more aggressive. They may be imaginative and may make mistakes, but sometimes they are able to find the correct lesion through their own unique way.
This phenomenon occasionally occurs in large hospitals, and the veteran experts shake their heads and sigh, thinking that the patient cannot be cured.
Finally, he was cured by the young doctor.
Of course, when hospitals promote their work, they will protect the reputation of the senior experts, and the chief physicians will often take the lion's share of the credit, while the young doctors who actually cured the patients will take a smaller share. Or they may just mention it briefly.
Many young doctors feel dissatisfied and think this is unfair.
But if you consider the issue from the perspective of the hospital's interests, it is acceptable.
The veteran experts are the hospital’s hallmarks and must not be brought down.
Moreover, any industry has a fine tradition of respecting seniors. Even in foreign countries, where profit is king, people still respect their teachers and predecessors.
In some developed , doctors and nurses are paid according to their age.
No matter how hard young doctors work, their income is not as good as that of older doctors with longer service.
The situation in China is slightly better.
Many large hospitals with advanced management have a principle of "more work, more pay". However, it is impossible to pursue absolute fairness.
The senior experts have earned their qualifications through hard work, so it is only natural that they get more when performance is distributed.
It's like a sales manager who can get a portion of the sales commission of his salespeople even if he doesn't work. This is the industry rule.
Zhou Can thought to himself, this child has a problem with the gray matter of his spinal cord. If the specific location of the injury is determined, will the location of the damaged spinal cord be determined at once?
The little boy is unable to move below his neck, and his nerve sensory function becomes weaker as he goes down, which means that the problem is definitely not just in the gray matter.
It’s like in a war, if you capture the enemy’s scout, you can basically determine that the enemy is nearby.
The patient had undergone X-rays at the Imperial Capital Renhe Hospital, and no obvious spinal cord damage was found.
In clinical practice, X-ray examination of spinal cord injury is a commonly used method.
It can not only detect whether there are fractures or abnormalities in bones, but it is also very effective in diagnosing spinal cord injuries.
It can even accurately detect the specific extent of spinal cord injury.
Since the X-ray did not reveal any obvious abnormalities in the spinal cord, the two hospitals did not apply for an MRI examination for the patient.
The little boy's condition was serious and the doctor who treated him was at least at the director level.
With doctors of this level, few people have to worry about food and clothing anymore.
Their medical ethics are often also very high.
MRI examinations are expensive and are not routine clinical examinations. Chief physicians will try not to prescribe this examination if they can.
After Zhou Can had a plan for further examination in mind, he turned to look at the child's mother.
The two looked at each other, and they could see expectation, deep sorrow, and even a hint of fear and confusion in the child's mother's eyes.
What if the child cannot be cured, how will she explain to the child's father?
What about the second half of my child’s life?
The rest of her life will also be ruined.
Having to take care of a child's eating, drinking, defecating and urinating for a lifetime and bearing the expensive long-term treatment costs will become a heavy burden.
She saw the young doctor constantly visiting her son's ward and even inviting other experts to consult in order to cure his illness.
Although she was a little skeptical about Zhou Can's medical skills because he was too young, it did not affect her trust in Zhou Can.
"If you need to know anything, feel free to ask. If there are any treatment options, please feel free to ask."
She spoke first.
It can be seen that this woman has rich social experience and is very intelligent.
From his eyes, she could guess that Zhou Can wanted to ask her a question.
"Are you usually the one taking care of the kids?"
"Yes, I have been keeping the child with me since he was born. When I am at work during the day, I let the child's grandmother and grandfather take care of him."
"Did the child have any abnormalities before the fall? For example, did he have difficulty grasping things after birth, did he often choke when drinking milk, etc."
Zhou Can's question is likely to cause disgust among family members.
No one wants to admit that their child was born with problems.
"Uh... there seems to be no problem with his grasping. On the third day after he was born, I felt that his hands were very strong in grasping things. But if I were to say anything abnormal, my son always seems to like to slightly raise his head. I wonder if this is normal?"
As she spoke, she slightly raised her fair, slender neck, imitating the way her son used to raise his head.
"Is it normal for him to lower his head?"
"It seems normal. It's normal to see him lowering his head to look for something."
"Has your child ever been infected with any serious illness since birth, including during your pregnancy? Colds are not included."
Zhou Can asked again.
Colds are mostly caused by viral infections, and sometimes they are caused by some serious viruses, which are extremely harmful and can even easily take a person's life.
However, in clinical practice, when checking medical history, colds are generally rarely taken seriously by doctors.
Unless you have multiple colds in a short period of time.
Also, doctors and ordinary people have different understandings of colds.
Most people think that a cold is just an illness, a minor illness that can be cured on its own. But in the eyes of doctors, a cold is a symptom of a disease, and there are thousands of types of it.
"I haven't been infected with any serious illness. When I was pregnant, I was weaker than before, so . After the birth of my child, I have been healthy and I only need one or two days to recover from the occasional cold."
She thought about it and answered seriously.
"Does the child's father, grandparents have any history of serious illness?"
"The child's grandfather has heart disease, and the grandmother has diabetes and high blood pressure, but I haven't heard of any other diseases. The child's father only comes home to visit once or twice a year due to work reasons. His condition is highly confidential at work, so I don't know much about it. But I haven't heard him say he has any serious illness."
Her words made Zhou Can deeply feel her difficulty and greatness.
Being able to only be with your husband once or twice a year is probably something that most women cannot accept.
"Okay, I don't have anything else to know for now. I'm going to apply for a somatosensory evoked potential test for my child , mainly to find out exactly where the problem is in the spinal cord. What is certain at the moment is that there should be something wrong with the child's spinal cord. There are abnormalities in the lower central nervous system tests, and it is very likely that there is a problem with the gray matter of the spinal cord. However, problems with the gray matter alone generally do not cause high paraplegia, and the cause needs to be further investigated. To be on the safe side, I'm also going to draw cerebrospinal fluid for laboratory testing to see if there is any bacterial or viral infection or other abnormalities."
When Zhou Can prescribes these unconventional examinations, he usually explains them clearly to the family members.
It is also the doctor’s duty.
Doctors generally don’t explain too much about routine examinations, because a doctor has to see dozens of patients a day and doesn’t have the time and energy to repeatedly explain why these routine examinations are done.
"No problem, I trust you very much, and I can also feel that you are working overtime to diagnose in order to save my child. I am really grateful to you." As she said this, she bowed deeply to Zhou Can.
"Don't be polite, don't be polite. This is what I should do. As long as your family is willing to cooperate and trust us, we will do our best to treat the child. No one can guarantee the final result. I can only say that we will do our best."
Zhou Can said to her.
The somatosensory evoked potential test is something most people have never heard of. This test is very effective in diagnosing spinal cord nerve damage, and its accuracy is very high. This test can also detect the specific location of spinal cord nerve damage.
At present, the main diagnostic direction is to first find out which pair of spinal and cervical nerves has a problem.
Or maybe the problem is only on one side.
As for drawing cerebrospinal fluid for laboratory testing, he was inspired when Director Yin Hua gave him some guidance.
Sometimes, the answers doctors get when they ask family members about their medical history are not necessarily accurate.
Some family members may deliberately conceal some medical history, such as a history of prostitution.
Some family members have poor memory and forget some medical history.
Therefore, for safety reasons, it is necessary to draw cerebrospinal fluid for testing.
The first two hospitals did not do this because the child was a high-level paraplegic due to a fall from a height. The doctors did not even think about this.
…
That night, when Zhou Can lay on the bed hugging Su Qianqian, he was still thinking about the little boy's illness.
He is one of those good doctors who works day and night to treat patients.
The National Day is approaching soon, which makes Zhou Can want to hurry up to find out the cause of the little boy's illness and cure it.
Because his wedding with Su Qianqian is being prepared in full swing.
This is a big thing in life.
Su Qianqian knew that Zhou Can was very busy at work, so she took the initiative to take on almost all the preparatory work.
She even joked with Zhou Can that it was as if she was marrying herself off.
What is more interesting is Su Qianqian’s uncle and aunt’s family.
That night, Zhou Can injured two people before he successfully took Su Qianqian away . Logically speaking, he had a complete falling out with her uncle and aunt, and they would never have anything to do with each other again.
But Zhou Can greatly underestimated the despicable nature of human beings.
My aunt actually called Su Qianqian, crying and asking her to forgive me. She also said that she knew she was wrong, scolded me for being a bad person, and had wronged her in the past.
Fortunately, Zhou Can was right next to him at that time.
He knew that Su Qianqian was a very kind person and easily softened.
He immediately asked for the phone and said to the crying old lady on the other end of the line, "If regret is useful, what do we need the police for? If you dare to call and harass me again, I will make sure your son spends the rest of his life in jail."
Even though Zhou Can kicked his aunt's son, the boy attacked first and he was just acting in self-defense.
Zhou Can has a professional legal team to support him. He is rich and powerful. He directly sued the other party for wanting to imprison Su Qianqian and rob him of the 300,000 yuan in cash. Robbery is a serious crime. As long as the evidence is solid, it would be strange if he didn't spend the rest of his life in prison.
